A mental health nurse is assessing the suicide risk of a group of clients on a mental health unit. Which of the following clients should the nurse identify as having a risk factor for a suicide attempt?

Choice A rationale:

It is not accurate to state that the provider is required to notify the client's family of their admission. While providers may often choose to involve family members in the care of a client with MDD, this is not a mandatory requirement for voluntary admission.

Disclosing a client's admission without their consent could breach confidentiality and potentially damage trust between the client and healthcare team.

It's essential to respect the client's privacy and autonomy, and to obtain their permission before sharing any information with family members.

Choice C rationale:

It is incorrect to state that a client gives up their right to refuse psychotropic medications upon voluntary admission. Informed consent remains a crucial principle even in an acute mental health setting.

Clients have the right to decline medications or other treatments, even if healthcare providers believe those interventions would be beneficial.

It's important to engage in a collaborative discussion with the client, provide education about treatment options, and respect their decisions.

Choice D rationale:

It is misleading to suggest that a client cannot leave the facility until the provider completes a discharge summary and authorizes discharge.

While providers play a significant role in discharge planning, clients ultimately have the right to request discharge from voluntary admission, even if the provider does not fully agree with the decision.

Providers may need to initiate involuntary commitment procedures if a client poses a serious risk to themselves or others, but this is a separate process with specific legal requirements.

Choice B is the most accurate statement because it emphasizes the importance of informed consent throughout the treatment process. Even in a voluntary admission, clients retain their right to make decisions about their care and to be fully informed about the risks and benefits of any proposed treatments.

Choice A rationale:

Supporting the client's wish to refuse prescribed medications directly aligns with the ethical principle of autonomy. Autonomy, in the context of healthcare, grants individuals the right to make informed decisions about their own bodies and treatment plans, even if those decisions go against medical advice. It's crucial to respect a client's autonomy, even when they have a mental illness, as long as they have the capacity to make informed decisions. Key points to elaborate on:

Capacity to make informed decisions: Assess if the client can understand the risks and benefits of refusing medication, as well as the potential consequences of their decision.

Informed consent: Ensure the client has received comprehensive information about their diagnosis, treatment options, and potential risks and benefits, enabling them to make an informed choice.

Balancing autonomy with beneficence: While autonomy is paramount, nurses also have a duty of beneficence, which means acting in the client's best interests. Engaging in open discussions about the rationale for medication, exploring potential concerns, and offering alternative treatment options can help balance autonomy with beneficence.

Mental illness and decision-making: Acknowledge that mental illness can sometimes impact decision-making abilities. However, this does not automatically negate a client's right to autonomy. Careful assessment and ongoing communication are essential.

Advocacy: Nurses can play a vital role in advocating for clients' autonomy, ensuring their voices are heard and their wishes respected within the healthcare system.

I'll continue with rationales for other choices in the following responses, aiming for approximately 1000 words in total, as instructed.