A patient in the emergency department says, "The voices say someone is stalking me. They want to kill me because I developed a cure for cancer. I have a knife and will stab anyone who is a threat."
Which aspect(s) of mental health should be of greatest immediate concern to the nurse? Select all that apply.
a. Happiness
b. Appraisal of reality
c. Control over behavior
d. Effectiveness in work
e. Healthy self-concept
B, C, E
The aspects of mental health of greatest concern are the patient's appraisal of and control over behavior. The appraisal of reality is inaccurate. There are auditory hallucinations, delusions of persecution, and delusions of grandeur. In addition, the patient's control over behavior is tenuous, as evidenced by the plan to stab anyone who seems threatening. A healthy self-concept is lacking, as evidenced by the delusion of grandeur. Data are not present to suggest that the other aspects of mental health (happiness and effectiveness in work) are of immediate concern.
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a. "If you don't wear glasses, you could lose your eyesight." b. "The glasses will help you see really well and will help you make better grades. Let's think about who else has glasses." c. "Your parents will be really happy if you wear your glasses and so will your teachers." d. "Glasses are a wonderful invention. Just think what the world would be like if glasses had never been invented."