Question

A client hospitalized on a mental health unit with schizophrenia tells the nurse, "The voices in my head say that I'm worthless and that I don't deserve to be alive." What is the nurse's priority concern for this client?

A. Ineffective coping skills
B. Perceptual disturbances
C. Chronic low self-esteem
D. Risk for self-directed violence

Answer 1

The nurse's priority concern for a schizophrenia client who hears voices saying they are worthless and don't deserve to live would be (D) risk for self-directed violence. Immediate safety measures should be taken to protect the client.

Step-by-step explanation:

The client's statement that voices in their head are telling them they are worthless and don't deserve to be alive is highly concerning, especially within the context of schizophrenia. In this scenario, the nurse's priority concern would be D. Risk for self-directed violence. While the client is experiencing perceptual disturbances and may have ineffective coping skills and chronic low self-esteem, the immediate risk of harm to self as a result of the voices' suggestions takes precedence.

In schizophrenia, hallucinations like hearing voices can lead to dangerous situations if the content of the hallucinations is threatening or negative. Prompt action is required to ensure the client's safety and provide necessary interventions which may include close observation, reassessment of medication, and potentially initiating safety precautions or seeking additional assistance to prevent self-harm.

Answer 2

The nurse's priority concern for a client with schizophrenia who hears voices saying they are worthless and don't deserve to live is the risk for self-directed violence. This concern is more immediate than the other options because it poses a direct threat to the client's safety (option D).

Step-by-step explanation:

The student's question asks about the nurse's priority concern for a client with schizophrenia who is experiencing distressing hallucinations. In this scenario, the correct answer is D. Risk for self-directed violence. While the other options may be relevant to the client's condition, the immediate and most critical concern when a patient expresses thoughts of worthlessness and not deserving to live, coupled with voices reinforcing these thoughts, is the potential risk for harm to themselves. The client may be experiencing auditory hallucinations, which is a symptom of schizophrenia that can lead to self-directed violence if not addressed promptly and appropriately by healthcare providers.

Schizophrenia is a complex cognital health disorder that can significantly impair an individual's perception, thought processes, and emotional responsiveness. In managing a patient with schizophrenia, nurses and other healthcare providers must constantly assess for safety risks and protective measures, particularly when the patient reports distressing or harmful thoughts exacerbated by hallucinations or delusions. Antipsychotic medications are typically used to treat schizophrenia; these medications work by blocking dopamine receptors, which can help in reducing the severity of hallucinations and delusions among other symptoms.

Hence, the answer is option D.