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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Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Intrusive and judgmental: Asking "Why did you wear clean clothes and comb your hair today?" directly challenges the client's behavior and implies that she needs to justify her actions. This can make the client feel defensive and less likely to open up.
Focuses on the past: The directs attention to the client's previous lack of self-care, which can reinforce negative feelings and discourage progress.
Assumes motivation: It presumes that the client made a conscious decision to change her appearance based on a specific reason, which may not be accurate and can invalidate her experience.
Choice B rationale:
Presumptuous and premature: Concluding that "Your mood must be lifting because you have on clean clothes and have combed your hair" makes assumptions about the client's internal state without proper assessment.
Oversimplifies depression: It suggests that improvements in self-care directly equate to mood improvement, which disregards the complexity of depression and its varied manifestations.
Can create pressure: The statement can inadvertently pressure the client to feel or act a certain way to meet the nurse's expectations, hindering genuine progress.
Choice D rationale:
Paternalistic and condescending: Expressing "Oh, I'm so pleased that you finally put on clean clothes" implies that the nurse has been waiting for or expecting this change, placing the nurse in a position of authority and potentially undermining the client's autonomy.
Focuses on the nurse's feelings: The statement centers on the nurse's approval rather than acknowledging the client's efforts and perspective.
Can reinforce dependency: It can foster a dynamic where the client seeks external validation for her actions, rather than developing internal motivation for self-care.
Choice C rationale:
Observational and non-judgmental: The statement "I see that you have on clean clothes and have combed your hair" simply acknowledges the client's actions without imposing any interpretation or judgment.
Invites conversation: It provides an opportunity for the client to elaborate on her choices if she feels comfortable, promoting autonomy and self-expression.
Validates effort: It subtly recognizes the client's efforts without explicitly praising or criticizing, fostering a sense of self- efficacy and encouraging continued self-care.
Demonstrates active listening: It shows that the nurse has been paying attention to the client's progress, which can strengthen the therapeutic relationship and build trust.
Correct Answer is ["B","C"]
Explanation
Choice A rationale: Anorexia nervosa is an eating disorder characterized by relentless drive for thinness with a fear of gaining body weight associated with self-induced behaviors towards thinness. Symptoms include extreme weight loss, thin appearance, intense fear of gaining weight, bingeing and purging, abnormal blood counts, fatigue, insomnia, dizziness or fainting, bluish discoloration of the fingers, hair that thins, breaks or falls out, soft, downy hair covering the body, amenorrhea (absence of menstruation), constipation, dry or yellowish skin, intolerance of cold, irregular heart rhythms, low blood pressure, dehydration, osteoporosis, swelling of arms or legs. However, the client’s symptoms do not align with those of anorexia nervosa.
Choice B rationale: Bulimia nervosa is an eating disorder characterized by binge eating, followed by methods to avoid weight gain. Symptoms include binge eating, forceful vomiting, long-term fear of gaining weight, preoccupation with weight and body, a strong negative self-image, overuse of laxatives or diuretics, use of supplements or herbs for weight loss, excessive exercises, stained teeth (from stomach acid), calluses on the back of the hands, withdrawal from normal social activities. The client’s symptoms of using laxatives frequently and running for 1 hr after eating a very large meal, which happens at least 9 times a week, align with those of bulimia nervosa.
Choice C rationale: Histrionic personality disorder (HPD) is a mental health condition characterized by unstable emotions, a distorted self-image and a desire to be noticed. Symptoms include persistent attention seeking, dramatic behavior, rapidly shifting and shallow emotions, sexually provocative behavior, undetailed style of speech, and a tendency to consider relationships more intimate than they actually are. The client’s symptoms of feelings of anxiety and depression, starting smoking marijuana as that is what their “new friends do all the time”, and being recently arrested for stealing make-up from a local department store and acknowledging that this “is the first time I was caught” align with those of HPD.
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