A client is informed by the nurse that they must take their medication, and the client kicks the nurse and runs to their room. Which action by the nurse demonstrates that the nurse falsely imprisons the client?

The nurse informs the client that the behavior will not be tolerated and will be addressed by the psychiatrist.

The nurse throws the medication in the trash and documents the client refuses the medication.

The nurse pushes the client, and the client falls to the floor and sustains a nosebleed.

The nurse goes to the client's room and applies restraints, then forces the medication in the client's mouth.

Answer and Explanation

The Correct Answer is D

Falsely imprisoning a client involves restricting their freedom and movement against their will without proper legal authority or justification. Option D demonstrates false imprisonment because the nurse applies restraints to restrict the client's movement and then forces the medication into the client's mouth, essentially depriving the client of their right to refuse treatment.

Options A, B, and C are not examples of false imprisonment:

A. The nurse informing the client that the behavior will not be tolerated and will be addressed by the psychiatrist is a response to the client's inappropriate behavior. It does not involve restricting the client's freedom or movement.

B. The nurse throwing the medication in the trash and documenting the client's refusal is an appropriate response to the client's refusal of medication. It respects the client's right to refuse treatment.

C. The nurse pushing the client and causing them to fall to the floor, resulting in a nosebleed, is an example of physical assault and battery, not false imprisonment. It is an inappropriate and harmful action by the nurse.

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Correct Answer is A

Explanation

The potential issue that the nursing staff and hospital may have to defend against in this scenario is A. "malpractice."

Explanation: Malpractice refers to a legal claim that can be made against healthcare professionals, including nurses and hospitals, when they fail to provide the standard of care expected in their profession, resulting in harm or injury to a patient. In this case, the lack of documentation that the client was assessed every hour as prescribed can be seen as a failure to meet the standard of care for a client with depression, especially one at risk for self-harm or suicide. If the client attempted suicide in the bathroom and sustained an injury, it could be argued that the lack of proper assessment and monitoring contributed to the client's harm, and this failure to provide appropriate care might be considered malpractice.

The other options, "battery," "false imprisonment," and "assault," do not directly relate to the situation described in the scenario:

B- Battery refers to the intentional harmful or offensive contact with a person without their consent. There is no indication that this occurred in the scenario.

C- False imprisonment refers to the unlawful restraint or restriction of a person's freedom of movement without proper justification. There is no indication of false imprisonment in the scenario.

D- Assault refers to the intentional act of threatening or causing fear of harm to another person. While the client did sustain an injury, there is no indication that it was due to an intentional act of assault in this scenario.

In summary, the potential issue of malpractice arises from the failure to properly assess and monitor a client at risk for self-harm, resulting in harm to the client. The nursing staff and hospital may have to defend against this claim if it is determined that they did not meet the standard of care expected in such a situation.

A. Anticipatory grief B. Disenfranchised grief C. Complicated grief D. Absence of grief

Correct Answer is A

Explanation

Anticipatory grief refers to the emotional response and mourning that occurs before an actual loss or death. In this case, the client is grieving the loss of the pregnancy due to the decision to have an elective abortion. The grief arises from the anticipation of not being able to have the child at this time, even though they may want to have children in the future.

B- Disenfranchised grief: Disenfranchised grief refers to a type of grief that is not openly acknowledged or socially validated. It occurs when a person experiences a loss that is not commonly recognized or is not socially accepted. In this case, the client's grief is not disenfranchised because the loss of an unintended pregnancy through elective abortion is openly acknowledged and socially accepted.

C- Complicated grief: Complicated grief, also known as prolonged grief or unresolved grief, occurs when a person experiences intense, prolonged, or incapacitating grief that doesn't seem to improve over time. It can be a result of traumatic loss or when the person has difficulty accepting the reality of the loss. The client's grief over the elective abortion does not necessarily indicate complicated grief since it is a normal response to the loss of the pregnancy.

D- Absence of grief: Absence of grief would mean that the client is not experiencing any emotional response or sorrow after the elective abortion, which is unlikely in this situation. The client is crying and expressing emotions, indicating the presence of grief.

In summary, the most appropriate choice for the client's experience is "Anticipatory grief" since the client is grieving the loss of the pregnancy before it actually occurred due to the timing of the pregnancy not aligning with their plans.

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A client is informed by the nurse that they must take their medication, and the client kicks the nurse and runs to their room. Which action by the nurse demonstrates that the nurse falsely imprisons the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with depression is found to have attempted suicide in the bathroom and sustained injury. There is no documentation that the client was assessed every hour as prescribed. Which issue will the nursing staff and hospital potentially have to defend against?

Correct Answer is A

Explanation

A client has just had an elective abortion to end an unintended pregnancy. Afterward, the client cries because although they wanted to have children in future years, this pregnancy was not well timed. Which type of grief is this client most likely to experience?

Correct Answer is A

Explanation

The nurse is caring for several clients on the behavioral health unit. Which client will be assessed as demonstrating aggression?

The nurse is meeting with a client who is experiencing complicated grieving from the death of their child to suicide. In order to establish a therapeutic nurse-client relationship, what will the nurse do prior to the meeting?

A client is informed by the nurse that they must take their medication, and the client kicks the nurse and runs to their room. Which action by the nurse demonstrates that the nurse falsely imprisons the client?

A client is manipulative with staff and disruptive in the milieu. Although the client is not demonstrating behaviors that are a threat to self or others, they are refusing all medications. Which action by the nurse is most appropriate?

The nurse is working with an adolescent client that is argumentative with staff and peers on the behavioral health unit. Which therapeutic response will be most beneficial for the client to decrease acting out behavior?

The nurse is completing a family assessment for a victim of intimate partner violence. Which characteristic of the abuser will the nurse identify when completing the assessment?

A nurse observes another nurse acting flirtatiously and bringing small gifts, such as candy, to a client in the behavioral health unit. Which action is a priority by the observing nurse?