Uttarakhand CHO - 2021
Mental Health Nursing
Medium
A patient who refuses to eat, saying that the food is poisoned, is an example of what?
Appeared in: Uttarakhand CHO - 2021
Explanation
- A delusion is a fixed, false belief that is firmly held despite evidence to the contrary and is not part of the person's cultural background.
- The patient's belief that the food is poisoned is a specific type of delusion known as a persecutory delusion, where the individual believes they are being targeted or harmed.
- This is a disturbance in thought content, which is the defining characteristic of a delusion.
Why Other Options Were Wrong
- Option B: A hallucination is a false sensory perception. The patient is expressing a false belief (thought), not reporting a false taste, sight, or smell of poison (perception).
- Option C: A suicidal idea involves thoughts of self-harm. The patient's reason for not eating is fear of being harmed by others (poison), not a desire to harm themselves.
- Option D: Negativism is a motiveless resistance to all suggestions. This patient has a clear (though delusional) motive for refusing to eat: the belief that the food is poisoned.
Related Visual
Clinical Relevance
- Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Differentiation of common psychiatric symptoms, specifically thought disorders versus perceptual disturbances in acute care settings.
- A nurse's primary responsibility is to ensure patient safety, which includes nutrition. For a patient with persecutory delusions, this involves therapeutic communication and strategies like offering sealed foods to bypass the specific fear.
- Arguing with or trying to 'reason' a patient out of a delusion is counterproductive. It damages the therapeutic relationship and can entrench the false belief.
- What if? If the patient was also experiencing command auditory hallucinations telling them not to eat, the immediate risk for harm would be higher, and the nursing priority would shift to assessing the nature of the commands and ensuring constant observation.
How to Approach the Question
- First, identify the core phenomenon described in the question stem. The patient is stating a belief: "the food is poisoned."
- Next, analyze this phenomenon. Is it a thought, a sensory experience, an emotion, or a behavior?
- The statement represents a thought or belief that is contrary to reality.
- Evaluate the given options. 'Delusion' is defined as a fixed, false belief.
- Compare the patient's symptom to the definitions. The patient's false belief directly matches the definition of a delusion.
- Rule out other options by confirming they do not fit. A hallucination is sensory, a suicidal idea is about self-harm, and negativism is motiveless resistance.
Concept Tested & Keywords
- Concept Tested: Differentiation of common psychiatric symptoms, specifically thought disorders versus perceptual disturbances.
- Stem keywords: refuses to eat, food is poisoned
- Lead-in keywords: is an example of
- Clinical cues: Patient's verbalization of a belief ('food is poisoned') is the key diagnostic clue.
Question ID
QHPJXoF-8r9VybjXOWF3GL
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) pp. 3249-3251, 13421-13423
Practise the full Uttarakhand CHO - 2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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