A client receives a court order for commitment. Which concept exemplifies a “least restrictive environment”?
Admission of client to a locked inpatient psychiatric unit
Placement of client in a secured padded room in response to threats of self-harm
Involuntary commitment to an outpatient community mental health center
Medication administration for sedation so the client cannot get out of bed
The Correct Answer is C
Choice A reason:
Admission to a locked inpatient psychiatric unit is a more restrictive environment. While necessary for some clients, it limits their freedom and autonomy. The least restrictive environment principle seeks to avoid such settings unless absolutely necessary.
Choice B reason:
Placement in a secured padded room is highly restrictive and typically used only in extreme cases where the client poses an immediate danger to themselves or others. This setting is far from the least restrictive environment.
Choice C reason:
Involuntary commitment to an outpatient community mental health center represents a less restrictive environment. It allows the client to receive necessary treatment and support while remaining in the community, maintaining a higher level of independence and normalcy.
Choice D reason:
Medication administration for sedation to the point where the client cannot get out of bed is a highly restrictive intervention. It significantly limits the client’s autonomy and is not aligned with the principle of providing care in the least restrictive environment.
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Related Questions
Correct Answer is D
Explanation
Choice A reason:
Crisis care is an important component of the mental health care continuum, providing immediate support during acute episodes. However, it is not the primary goal of the continuum of care. The goal is to provide ongoing, comprehensive support that promotes stability and recovery.
Choice B reason:
Case management is a crucial aspect of mental health care, ensuring that clients receive coordinated and continuous services. While it plays a significant role in the continuum of care, it is not the overarching primary goal.
Choice C reason:
Coordination of care is essential for effective mental health treatment, involving the integration of various services and providers. However, it is a means to an end rather than the primary goal itself.
Choice D reason:
Care in the least restrictive environment is the primary goal of the mental health care continuum. This principle emphasizes providing care in settings that allow the greatest level of independence and normalcy for the client while ensuring their safety and well-being. It aims to avoid unnecessary institutionalization and promote community-based care.
Correct Answer is B
Explanation
Choice A reason:
Libel involves making false and damaging statements about someone in written form. It is not relevant to the situation described, where the issue is the use of physical restraints on a voluntarily admitted client.
Choice B reason:
False imprisonment refers to the unlawful restraint of an individual against their will. In this case, applying physical restraints to a voluntarily admitted client who is demanding discharge could be considered false imprisonment if the restraints are not justified by the client’s behavior posing an immediate threat to themselves or others.
Choice C reason:
Medical beneficence refers to the ethical principle of acting in the best interest of the patient. While this principle guides nursing actions, it does not directly address the legal ramifications of using physical restraints.
Choice D reason:
Autonomy is the ethical principle that respects the patient’s right to make their own decisions. Restraining a voluntarily admitted client who wishes to leave the hospital can violate their autonomy. However, the legal issue at hand is more specifically related to false imprisonment.
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