Author Question: A client with severe and persistent schizophrenia is seen at the adult outpatient clinic. He is ... (Read 16 times)

DelorasTo · **on:** Jul 19, 2018

A client with severe and persistent schizophrenia is seen at the adult outpatient clinic. He is
delusional and experiencing auditory hallucinations. He tells the nurse I am here to save the world.

I threw away the pills because they interfere with hearing God's voice.. The nurse identifies the
client's reason for medication nonadherence as
a. poor therapeutic alliance with clinicians.
b. inadequate discharge planning.
c. dislike of side effects.
d. poor insight.

Question 2

Which situation indicates use of a negative coping strategy by a client?

a. A client states That heart attack was no fun, but at least it woke me up to my
need for a better diet and more exercise..
b. A client tells the nurse I am going to do whatever my doctor advises; after all, he
knows more about things than I do..
c. The client muses I definitely have cancer. Now I need to look at the effects of
treatment and decide whether I will be able to work daily..
d. A client states I would not be in this position if the company had a better safety
program. I blame them for not explaining the hazards of that machine..

debra928 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

D
The client's noncompliance is most closely related to lack of insight into his illness. The client
believes he is an exalted personage who hears God's voice, rather than an individual with a serious
mental disorder who needs medication to control his symptoms. Data do not suggest any of the other
factors often related to medication nonadherence.

Answer to Question 2

D
Blaming someone else is not usually considered a highly adaptive coping strategy. Options A
(redefinition), B (conforming), and C (confronting) are seen as more effective.