A nurse is caring for a client who has a mental illness. Which of the following actions by the nurse demonstrates the ethical concept of autonomy?
EXPLAINING UNIT RULES AND POLICIES REGARDING UNACCEPTABLE BEHAVIORS
SUPPORTING THE CLIENT’S WISH TO REFUSE PRESCRIBED MEDICATIONS
MAKING SURE THE CLIENT UNDERSTANDS EXPECTATIONS FOR CLIENT PARTICIPATION
ENCOURAGING CLIENT FEEDBACK ABOUT SATISFACTION WITH THE FACILITY EXPERIENCE
The Correct Answer is B
Choice A reason:
Explaining unit rules and policies regarding unacceptable behaviors is important for maintaining order and safety within the facility. However, this action is more about setting boundaries and expectations rather than supporting the client’s autonomy. Autonomy involves respecting the client’s right to make their own decisions, which is not directly addressed by merely explaining rules.
Choice B reason:
Supporting the client’s wish to refuse prescribed medications demonstrates respect for the client’s autonomy. Autonomy is the ethical principle that recognizes the right of individuals to make informed decisions about their own care. By supporting the client’s decision to refuse medication, the nurse acknowledges and respects the client’s right to make choices about their treatment, even if those choices differ from medical advice.
Choice C reason:
Making sure the client understands expectations for client participation is essential for clear communication and effective treatment planning. However, this action is more about ensuring compliance and understanding rather than promoting autonomy. While it is important for clients to understand what is expected of them, this does not necessarily empower them to make their own decisions.
Choice D reason:
Encouraging client feedback about satisfaction with the facility experience is a valuable practice for improving care and ensuring that clients feel heard. However, this action focuses on gathering feedback rather than directly supporting the client’s autonomy. While it contributes to a client-centered approach, it does not specifically address the client’s right to make independent decisions about their care.
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Correct Answer is ["A","E"]
Explanation
Choice A reason:
Anhedonia, or the inability to experience pleasure, is a negative symptom of schizophrenia. Negative symptoms reflect a decrease or loss of normal functions and are often more challenging to treat than positive symptoms.
Choice B reason:
Hallucinations are positive symptoms of schizophrenia. Positive symptoms involve the presence of abnormal behaviors or experiences, such as hearing voices or seeing things that are not there.
Choice C reason:
Poor judgment is not classified as a negative symptom of schizophrenia. It can be a feature of cognitive impairment associated with the disorder but is not specifically a negative symptom.
Choice D reason:
Delusions are positive symptoms of schizophrenia. They involve false beliefs that are not based in reality, such as believing one has special powers or is being persecuted.
Choice E reason:
Blunt affect, or reduced emotional expression, is a negative symptom of schizophrenia. It involves a lack of emotional responsiveness and is indicative of the diminished capacity to express emotions.
Correct Answer is A
Explanation
Choice A reason:
Asking “What are the voices telling you to do?” is an appropriate response because it allows the nurse to assess the content of the hallucinations and determine if the client is at risk of harming themselves or others. This approach shows empathy and concern while gathering important information for the client’s safety.
Choice B reason:
Telling the client “You need to understand that there are no voices” dismisses the client’s experience and can increase their distress. It is important to acknowledge the client’s feelings and perceptions, even if they are not based in reality.
Choice C reason:
Asking “Why do you think you are hearing the voices?” may not be helpful in the moment of distress. The client may not be able to provide a rational explanation for their hallucinations, and this question could increase their confusion and anxiety.
Choice D reason:
Telling the client “You need to tell the voices to leave you alone” may not be effective, as the client may not have the ability to control their hallucinations. It is more important to assess the content of the hallucinations and provide support.