A patient diagnosed with schizophrenia tells the community mental health nurse, "I threw away my pills because they interfere with God's voice." The nurse identifies the etiology of the patient's ineffective management of the medication regime as:
a. inadequate discharge planning.
b. poor therapeutic alliance with clinicians.
c. dislike of antipsychotic medication side effects.
d. impaired reasoning secondary to the schizophrenia.
ANS: D
The patient's ineffective management of the medication regime is most closely related to impaired reasoning. The patient believes in being an exalted personage who hears God's voice, rather than an individual with a serious mental disorder who needs medication to control symptoms. Data do not suggest any of the other factors often related to medication nonadherence.
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