A 22-year-old voluntary client has been manipulative of staff and disruptive in the milieu. Although the client is not a danger to themselves or others, the client has created challenges for other clients on the unit and is clearly not making progress. The nurse offers prescribed medication, but the client consistently refuses. The staff realizes that legally this client can:

Be coerced to accept treatment

Have the client’s family petition for a 302 as they recently witnessed the client’s behavior

Continue to refuse treatment

Be committed by their doctor involuntarily to receive needed treatment

Answer and Explanation

The Correct Answer is C

Choice A reason: Coercing treatment violates the voluntary client’s autonomy. Legally, voluntary patients can refuse medication unless they pose imminent danger, requiring involuntary commitment. Manipulation or disruption does not meet legal criteria for forced treatment, as mental health laws prioritize patient rights absent clear harm risks.

Choice B reason: A 302 (involuntary commitment) requires evidence of imminent danger to self or others, not just disruptive behavior. Family petitions cannot override this legal threshold without clinical justification, and manipulation alone does not qualify, making this option incorrect for enforcing treatment in a voluntary client.

Choice C reason: As a voluntary client, the individual retains the right to refuse treatment unless deemed a danger to self or others. Mental health laws protect autonomy, and manipulation or lack of progress does not justify forced medication, making refusal a legal right in this scenario.

Choice D reason: Involuntary commitment by a doctor requires evidence of imminent danger or inability to care for oneself, not just disruptive behavior or nonadherence. Without such criteria, the client’s voluntary status protects their right to refuse, making involuntary commitment legally inappropriate in this situation.

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Correct Answer is B

Explanation

Choice A reason: Insight into mental health problems varies individually and is not a defining feature of voluntary versus involuntary commitment. Both types of patients may lack insight, especially in severe mental illness, making this statement inaccurate as a legal or procedural distinction between commitment types.

Choice B reason: Involuntary commitment, under laws like a 302, restricts a client’s ability to initiate discharge due to assessed danger to self or others. Voluntary clients can request discharge, though medical advice may apply. This legal distinction defines the difference, making it the correct answer.

Choice C reason: Involuntary clients cannot universally refuse treatment, as court-ordered interventions may apply in cases of imminent danger. Both voluntary and involuntary clients have rights to refuse non-emergent treatment, but this is not the primary legal distinction between commitment types, making this option incorrect.

Choice D reason: Aggression is not a defining characteristic of voluntary commitment. Both voluntary and involuntary clients may exhibit aggression, depending on their mental health condition. The distinction lies in legal control over discharge, not behavior, making this statement inaccurate for defining commitment types.

Correct Answer is ["50"]

Explanation

The correct answer is 50 drops per minute
Explanation:
Step 1 is identify the total volume to be infused
50 mL

Step 2 is identify the time in minutes
1 hour = 60 minutes

Step 3 is identify the drop factor for a microdrip set
Microdrip = 60 drops per mL

Step 4 is multiply the volume by the drop factor
50 × 60 = 3000 drops

Step 5 is divide total drops by time in minutes
(3000 ÷ 60) = 50

Result = 50 drops per minute

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse recognizes that the difference between a voluntary and an involuntary commitment is what?

Correct Answer is B

Explanation

The order is to infuse 50ml of piggyback antibiotic over 1 hour. The set calibration has a microdrip drop factor. What the flow rate in drops per minute?

Correct Answer is ["50"]

Explanation

The nurse is caring for an acutely ill client. Which assessment finding should prompt the nurse to inform the healthcare provider that the client may be exhibiting signs of acute kidney injury (AKI)?

A client with end-stage kidney disease is scheduled to begin hemodialysis. The nurse is working with the client to adapt the client’s diet to maximize the therapeutic effect and minimize the risks of complications. The client’s diet should include which of the following modifications?

A nurse is planning the discharge of a client with a mental health disorder. Which factor does the nurse identify as the best chance for the client to remain in the community without readmission?

The client has used defensive communicating with the nurse today. Which can be a positive outcome from the use of defense mechanisms?

A novice nurse is beginning work on a behavioral health unit and states to the preceptor, “What if I encounter a client who is sexually aggressive?” Which is the appropriate response by the preceptor?

The client feels that the client’s rights have been violated. Placing a client in restraints before using other methods of intervention violates which of the client’s rights?

A nurse and client are engaged in a discussion. The client says, “I feel really close to you. You are my only true friend.” Which response by the nurse would be most therapeutic?