Author Question: A client with severe schizophrenia is seen monthly by a community mental health nurse for ... (Read 28 times)

natalie2426

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A client with severe schizophrenia is seen monthly by a community mental health nurse for administration of fluphenazine decanoate (Prolixin Decanoate). During one monthly visit, the client refuses the medication.
 
  Which nursing intervention is ethically appropriate?
  A) Telling the client it is his right not to take the medication
  B) Informing the client that if he does not take his medication he will have to be hospitalized
  C) Arranging with a relative to add medication to the client's morning orange juice
  D) Calling for help to hold the client down while the medication is administered

Question 2

The majority of the treatment team maintains that a patient diagnosed with antisocial personality disorder needs external limits and careful observation, however two nurses state, The patient is really a pleasant person.
 
  We shouldn't be so judgmental.. The most likely reason for the difference in staff opinions is that the patient has been using which coping mechanisms? a. Idealization and devaluation
  b. Projection and rationalization
  c. Splitting and projective identification
  d. Reaction formation and identification



shoemake

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Answer to Question 1

A

Answer to Question 2

C
Splitting is the inability to integrate good and bad aspects of an object, resulting in treating the object as all good or all bad. Projective identification is the practice of projecting certain aspects of the self onto another, who then responds to the negative or positive projections in a manner consistent with the projections. When a patient idealizes the nurse, the nurse has a tendency to lose objectivity and move toward overinvolvement, overprotection, and indulgence. In this instance, two staff members are protective and indulgent, whereas others are more realistic.



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