A.24years old man is admitted to Psychiatric unit. During his admission process he tells the nurse “voices are telling me that the end is near and that I should prepare myself for heaven “.When preparing a care plan for this patient .What will be the highest priority nursing diagnosis for this patient?.

A.Impaired safety concerns.

B.In ability to focus on self.

C.Ineffective listening to the nurse. D.Potential for violence to himself related to hallucinating commands.

Correct answer is D.

Rationale: He is hearing voices that are directing him unrealistically.


Published by edochie99

A Registered Nurse with over twenty years of hospital experience, an author with Masters Degree in Nursing,also Bachelor Degree in Nursing,graduated in 1996 from USC,University of Southern California.MSN in 2009 University of Phoenix.

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