A nurse observes an acutely psychotic client scratching at his ...

[sam.t96]

A nurse observes an acutely psychotic client scratching at his arms with his fingernails until his arms bleed. When asked what is happening, the client states he is trying to let the evil spirits out of his body.
 
  He is easily redirected by the nurse, but resumes scratching when the nurse leaves his side. The nurse orders 1:1 supervision of the client to keep him from harming himself. Which principle of bioethics was applied in this situation? 1. Justice
  2. Fidelity
  3. Beneficence
  4. Veracity

Question 2

An involuntary client being treated for an acute exacerbation of paranoid schizophrenia refuses the morning dose of medication. The nurse is frustrated and wonders if the client will ever develop insight.
 
  What aspects of psychobiology could help reframe the client's behavior for the nurse? 1. The client is not responsible for the behavior.
  2. Adhering to the client's medication regimen is a priority to the nursing care.
  3. The frontal and parietal lobe involvement in schizophrenia can cause an unawareness of the illness or the need to take medications.
  4. The client's brain chemistry is altered and medications will help.

[tanna.moeller]

Answer to Question 1

3
Rationale: The nurse's actions are taken to protect the client from harming himself. The client requires 1:1 supervision because his mental status is contributing to self-harm. Fidelity is loyalty and commitment to clients. Veracity is the intention to tell the truth. Justice is the principle of treating others fairly and equally.

Answer to Question 2

3
Rationale: Acknowledging the psychobiology aspects of the client's illness will explain why it is not possible for the client to maintain insight during the exacerbation of the illness. Knowing that the client's illness will respond to medications does not address the nurse's frustration. It is important to know why the client is not responsible for his behavior.