Author Question: An outpatient diagnosed with schizophrenia attends programming at a community mental health center. ... (Read 33 times)

JMatthes · **on:** Jul 19, 2018

An outpatient diagnosed with schizophrenia attends programming at a community mental health center. The patient says, I threw away the pills because they keep me from hearing God. Which response by the nurse would most likely to benefit this patient?

a. You need your medicine. Your schizophrenia will get worse without it.
b. Do you want to be hospitalized again? You must take your medication.
c. I would like you to come to the medication education group every Thursday.
d. I noticed that when you take the medicine, you have been able to hold a job you wanted.

Question 2

An adult diagnosed with a serious mental illness says, I do not need help with money management. I have excellent ideas about investments. This patient usually does not have money to buy groceries by the middle of the month.

The nurse assesses the patient as demonstrating:

a. rationalization.
b. identification.
c. anosognosia.
d. projection.

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

Answer to Question 1

ANS: D
The patient appears not to understand that he has an illness. He has stopped his medication because it interferes with a symptom that he finds desirable (auditory hallucinationsthe voice of God). Connecting medication adherence to one of the patient's goals (the job) can serve to motivate the patient to take the medication and override concerns about losing the hallucinations. Exhorting a patient to take medication because it is needed to control his illness is unlikely to be successful; he does not believe he has an illness. Medication psychoeducation would be appropriate if the cause of nonadherence was a knowledge deficit.

Answer to Question 2

ANS: C
The patient scenario describes anosognosia, the inability to recognize one's deficits due to one's illness. The patient is not projecting an undesirable thought or emotion from himself onto others. He is not justifying his behavior via rationalization and is not identifying with another.