A client was involuntarily admitted to a behavioral health facility after trying to harm himself. Which statement by the client would indicate further education is needed regarding his rights?
“You can’t tell my boss that I attempted suicide.”
“I can understand why you restrained me when I threatened you.”
“I can leave anytime I tell you I am not going to hurt myself.”
“I may be here, but I still have the right to vote.”
The Correct Answer is C
This statement indicates a lack of understanding about the legal basis for involuntary admission and the criteria for discharge. Involuntary admission is authorized when a person is a danger to themselves or others or is gravely disabled, and the decision to discharge must be based on an evaluation by a qualified professional that the person no longer meets those criteria. Therefore, the client cannot simply leave by telling staff they will not harm themselves. The other options are not indicative of a lack of understanding of the client’s rights.
Option A may indicate a concern about privacy, but the confidentiality of mental health information is protected by law, so the client's boss cannot be informed without their consent.
Option B shows an understanding of the reason for the use of restraints.
Option D demonstrates awareness of the right to vote, which is not affected by mental health status.
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Correct Answer is D
Explanation
This response is open-ended and non-judgmental, allowing the client to reflect on their behavior and share their thoughts and feelings. It also avoids blaming the client or making assumptions about their intentions, which could escalate the situation and damage the therapeutic relationship.
Option A, “I feel angry when I hear that tone of voice,” focuses on the nurse's own feelings and could be perceived as confrontational or defensive.
Option B, “You make me so angry when you talk to me that way,” places blame on the client and may trigger a defensive response.
Option C, “Are you trying to make me angry?” is also confrontational and may be interpreted as accusing the client of intentionally provoking the nurse.
Correct Answer is A
Explanation
Disassociation is a defense mechanism that involves mentally separating oneself from a stressful or traumatic situation in order to maintain a sense of calm and focus. In this scenario, the nurse is able to block out the sirens and alarms, which may be causing stress and anxiety, and maintain a calm and focused demeanor while speaking with the client's family. This is an adaptive use of disassociation because it allows the nurse to provide effective care and support to the family despite the chaotic environment.
Denial is a defense mechanism that involves denying or minimizing the existence of a stressful or traumatic situation. Rationalization involves justifying or excusing one's behavior or actions. Altruism involves selflessly helping others as a way of dealing with one's own problems. In this scenario, none of these defense mechanisms are being used by the nurse.
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