A patient with acute psychosis says, “The voices are ordering me to cut my wrists.” Which question should the nurse ask first?
Correct answer: B. “What are the voices telling you to do, and will you act on it?”
- A. “Why do you believe the voices are real?”
- B. “What are the voices telling you to do, and will you act on it?”
- C. “Have you always had unusual religious beliefs?”
- D. “Can you ignore the voices until they stop?”
Explanation
Command hallucinations require immediate assessment of the command's content, the patient's intent, and access to means. Arguing about the voices or advising the patient to ignore them does not establish the level of suicide risk.
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About Psychiatric Emergencies
Psychiatric emergencies include suicidal behavior, homicide risk, severe agitation, panic, acute psychosis, delirium, overdose, and withdrawal states. Students examine rapid risk assessment, crisis intervention, de-escalation, environmental safety, emergency medication, observation levels, and the immediate priorities that differ from routine psychiatric nursing care.
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