A nurse is speaking with a newly licensed nurse who reports that they fear a client might be dangerous to others due to the client's diagnosis of schizophrenia. Which of the following types of stigma should the nurse identify as being associated with this fear?
Self
Institutional
Cultural
Public
The Correct Answer is D
Rationale:
A. Self-stigma refers to the internalized negative beliefs a person may have about their own mental illness, not external fears about others.
B. Institutional stigma involves policies or practices within organizations that discriminate against those with mental illness, not individual fears.
C. Cultural stigma refers to societal attitudes and beliefs about mental illness within a specific culture, not individual fears about safety.
D. Public stigma involves widespread negative beliefs and stereotypes about mental illness, which can contribute to fears that individuals with schizophrenia are dangerous to others.
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Correct Answer is B
Explanation
Rationale:
A. Offering reassurance without addressing the client's immediate concerns may minimize the severity of the situation and delay necessary interventions.
B. Asking the client about the lethality of their plan is crucial for assessing the level of risk and determining the urgency of the intervention required. This information is essential for planning appropriate care and ensuring the client's safety.
C. Allowing the client to be alone is not appropriate when they have expressed suicidal intent, as this could increase the risk of self-harm.
D. Encouraging the client to focus on the positive aspects of life may be part of long-term therapy, but in the acute phase, the priority is to assess and address the immediate risk of suicide.
Correct Answer is B
Explanation
Rationale:
A. While inappropriate clothing might indicate a need for assessment of the client’s awareness or physical comfort, it is not as immediate a concern as the client's behavior.
B. The comment to the nurse is concerning as it may indicate disorganized thinking or potential for inappropriate behavior, which requires immediate attention for safety and therapeutic intervention.
C. A heart rate of 102/min is slightly elevated but not the most urgent issue compared to the client's behavior.
D. Elevated blood pressure should be monitored, but the priority is the client’s inappropriate behavior, which may affect safety.