A mental health nurse is providing teaching for a client who has major depressive disorder (MDD) and is seeking voluntary admission to an acute mental health facility.
Which of the following statements should the nurse include?
"Your provider is required to notify your family of your admission."
"You will still need to give informed consent for treatments after admission."
"You will give up your right to refuse prescribed psychotropic medications upon admission."
"You cannot leave the facility until your provider completes a discharge summary and authorizes your discharge.".
The Correct Answer is B
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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Avoids addressing the client's behavior: This response does not directly address the client's disrespectful tone of voice. It simply gives the client the schedule and expects them to comply. This could reinforce the client's belief that they can act out without consequences.
Misses an opportunity to set boundaries: Setting boundaries is essential when working with clients with BPD. This response does not establish a clear boundary regarding acceptable communication.
Does not promote therapeutic communication: This response does not encourage the client to share their feelings or explore the reasons behind their outburst. It shuts down communication rather than opening it up.
Choice B rationale:
Directly addresses the inappropriate behavior: This response assertively communicates to the client that their tone of voice is unacceptable. It sets a clear boundary regarding respectful communication.
Models appropriate communication: The nurse models respectful communication by using a calm and assertive tone of voice. This can help the client learn to communicate more effectively.
Promotes self-awareness: This response may prompt the client to reflect on their behavior and the impact it has on others. It can help them develop better self-awareness and emotional regulation skills.
Choice C rationale:
Focuses on the nurse's feelings: This response shifts the focus away from the client's behavior and onto the nurse's feelings. It can make the client feel defensive and less likely to engage in productive communication.
May escalate the situation: Asking "why" s can sometimes put clients on the defensive and lead to further conflict. It's generally more helpful to focus on the present behavior and its impact.
Choice D rationale:
Condescending and challenging: This response comes across as condescending and challenging. It's likely to make the client feel defensive and resentful.
Not therapeutic: This response does not promote a sense of trust or rapport between the nurse and the client. It's unlikely to lead to productive communication or behavior change.
Correct Answer is B
Explanation
While the client's statement might seem like other defense mechanisms, here's why Denial is the most fitting choice: Denial:
Involves refusing to acknowledge a painful or threatening reality.
The client attributes their cough, a potential symptom of lung cancer, to a common cold, dismissing the possibility of their condition worsening.
This allows them to avoid the emotional distress associated with facing their illness. Other options and their rationales:
Reaction formation (Choice A): This involves expressing the opposite of what one truly feels or desires. The client doesn't show any outward signs of expressing emotions opposite to their actual feelings about their health.
Suppression (Choice C): This involves consciously pushing unpleasant thoughts or feelings out of awareness. While the client might downplay the cough, they haven't completely pushed the thought of their illness away.
Regression (Choice D): This involves reverting to an earlier stage of development in response to stress. There's no indication of the client displaying behaviors characteristic of an earlier developmental stage.
Addressing other potential mechanisms:
Displacement: Redirecting emotions towards a less threatening target is not evident in the scenario.
Rationalization: Justifying behavior in a way that avoids facing the true reasons is not seen in the client's explanation. Projection: Attributing one's own feelings or desires to others is not present in the client's statement.
Remember:
Denial is a common coping mechanism for dealing with difficult realities like illness.
It's crucial for the nurse to assess the extent of the client's denial and offer support without judgment.
The goal is to help the client acknowledge their illness while providing emotional support and resources for managing their condition.
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