A nurse in an acute mental health unit is admitting a client diagnosed with bipolar disorder. The nurse recognizes which of the following findings supports the admitting diagnosis of acute mania?

Choice A rationale:

Instructing the client to tell the voices to leave them alone oversimplifies the situation. It disregards the distress and lack of control that individuals with schizophrenia often experience when hearing voices. This response may also imply that the client has complete control over the voices, which is not accurate.

Choice B rationale:

Denying the existence of the voices contradicts the client's experience and could lead to further distrust between the client and nurse. Acknowledging the client's feelings and experiences is essential for building rapport and understanding in a therapeutic relationship.

Choice C rationale:

This response is appropriate because it acknowledges the client's experience and seeks to understand the content and nature of the voices. It demonstrates empathy and encourages open communication, which is crucial in providing effective care for individuals with schizophrenia.

Choice D rationale:

Asking the client why they think they are hearing the voices might be interpreted as confrontational or judgmental. It could make the client defensive and hinder open communication. Instead, focusing on the content of the voices allows the nurse to gain insight into the client's experiences without placing blame.

Choice A rationale:

The ethical concept of autonomy centers on respecting an individual's right to make decisions about their own care, even if those decisions go against medical advice. By supporting the client's wish to refuse prescribed medications, the nurse is upholding the principle of autonomy. In mental health care, it is crucial to acknowledge and respect the client's right to make choices about their treatment, even if those choices might not align with the healthcare provider's recommendations. This action promotes patient empowerment and informed decision-making.

Choice B rationale:

While client feedback about satisfaction with the facility experience is important for quality improvement, it is not directly related to the ethical concept of autonomy. Autonomy pertains to the client's right to make decisions about their treatment and care, particularly when it comes to medical interventions and choices about their own body.

Choice C rationale:

Ensuring that the client understands expectations for client participation is more aligned with the principle of informed consent and effective communication rather than autonomy. While communication is important for respecting the client's autonomy, this choice does not directly demonstrate the core concept of allowing the client to make decisions about their treatment even if they differ from medical advice.

Choice D rationale:

Explaining unit rules and policies regarding unacceptable behaviors is related to maintaining a safe and structured environment within the psychiatric unit, but it does not directly reflect the ethical concept of autonomy. Autonomy pertains to decisions specifically related to the client's medical treatment and care, not just the rules of the unit.