Which statement describes the basis for including the patient in the problem-solving process of determining appropriate care that is unique for psychiatric nursing?
Involving a patient diagnosed with a psychiatric disorder in the planning of care will help give the patient back a sense of responsibility that often is lacking.
Patients diagnosed with psychiatric illnesses are more compliant if they play a part in the planning of their own care.
It is a nursing responsibility to include the psychiatric patient in the planning of care.
Patients diagnosed with psychiatric problems are often incapable of expressing effective problem-solving skills because of their cognitive impairment.
The Correct Answer is A
Choice A rationale
In psychiatric nursing, engaging the patient in care planning recognizes their fundamental autonomy and promotes self-efficacy. Mental illnesses can erode a patient's perceived control and responsibility. Collaborative planning re-establishes a therapeutic alliance, fostering empowerment, improving motivation for treatment adherence, and aligning interventions with the patient's individual values and goals for recovery, thus facilitating a return to functional responsibility.
Choice B rationale
While patient involvement may positively influence compliance, framing it solely as a means to increase adherence is reductionistic and overlooks the core ethical principle of patient autonomy. The primary basis for inclusion is the patient's right to participate in decisions affecting their health, promoting therapeutic partnership, and ensuring the care plan is holistically congruent with their lived experience and expressed needs.
Choice C rationale
It is indeed a nursing responsibility to include the patient, as mandated by ethical codes and professional standards emphasizing patient-centered care and collaboration. However, the basis or rationale for this inclusion is deeper than just the mandate; it lies in the therapeutic benefits of restoring agency and responsibility for the patient, which is unique to psychiatric care contexts.
Choice D rationale
This statement is an inaccurate generalization and perpetuates a stigma against individuals with psychiatric disorders. While some patients may experience temporary or specific cognitive impairments, many maintain significant capacity for problem-solving. Excluding them based on a presumption of incapacity undermines their dignity and right to self-determination in treatment planning.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Covert data refers to hidden or non-observable information, often related to internal thoughts, feelings, or unconscious processes. While the MSE may infer aspects of covert data (e.g., through speech patterns), the data collected is primarily based on direct observation and the patient's immediate behavioral and cognitive presentation, making it objective.
Choice B rationale
Subjective data is information provided by the client, such as their feelings, perceptions, or history. While the MSE relies on client reports (e.g., mood, thought content), the final collected data is the examiner's objective description of the client's appearance, motor behavior, speech, and responses observed during the examination.
Choice C rationale
Physical data typically refers to physiological measurements (e.g., blood pressure, heart rate, lab results) or somatic findings. Although general appearance is noted in the MSE, its primary focus is on mental and behavioral status, making "physical" too broad or potentially misleading for the core data collected.
Choice D rationale
The Mental Status Examination (MSE) is a systematic, structured observation and assessment designed to collect objective data about a client's current mental state. This includes observable behaviors like appearance, motor activity, speech, and the examiner's objective description of the client's affect, thought process, and cognitive function.
Correct Answer is C
Explanation
Choice A rationale
Conducting a comprehensive mental health assessment, which involves gathering a holistic history and current mental status examination, is within the scope of practice for both a registered nurse and an advanced practice registered nurse (APRN). An APRN typically conducts a more in-depth, diagnostic assessment.
Choice B rationale
Establishing a therapeutic relationship, built on trust, respect, and professional boundaries, is a fundamental and essential skill and intervention for all professional psychiatric nurses, including registered nurses and APRNs, forming the foundation for all subsequent care.
Choice C rationale
Prescribing psychotropic medication is a key component of the advanced practice role for psychiatric mental health nurse practitioners (PMH-APRNs) in most jurisdictions, contingent upon state regulations. This function requires specialized education in pharmacology and the authority to diagnose, which is beyond the scope of a general registered nurse.
Choice D rationale
Individualizing a nursing care plan based on patient assessment, evidence-based guidelines, and patient goals is a core professional function of a registered nurse and a critical element of providing competent and patient-centered nursing care across all levels of practice.
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