A nurse in an outpatient setting is caring for a client.
The client presents with feelings of anxiety and depression.
They recently started smoking marijuana as that is what their "new friends do all the time". They admit to using laxatives frequently and running for 1 hr after eating a very large meal, which happens at least 9 times a week.
They were recently arrested for stealing make-up from a local department store and acknowledge that this "is the first time I was caught". Complete the diagram by specifying what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

Choice A rationale:

This response is dismissive and judgmental. It implies that the client's partner was wrong to share the news, and it does not acknowledge the client's feelings. This could make the client feel even more isolated and unsupported.

It's important to remember that the client is likely experiencing a range of emotions, including shock, sadness, anger, and anxiety. The nurse's role is to provide support and validation, not to judge the client's feelings or the actions of their partner.

Choice B rationale:

This response demonstrates empathy and understanding. It acknowledges the client's feelings and invites them to share more about their experience. This can help the client to feel heard and supported.

By verbalizing the client's feelings, the nurse is helping them to process the news and begin to cope with the situation. This can be a valuable first step in helping the client to develop a plan for moving forward.

Choice C rationale:

This response is dismissive and unhelpful. It does not acknowledge the client's feelings, and it offers no support or guidance. This could make the client feel even more hopeless and helpless.

While it may be true that there is not much the client can do about the situation immediately, the nurse can still offer support and help the client to explore their options.

Choice D rationale:

This response is premature and potentially unrealistic. The client may not be ready to contact their boss yet, and there is no guarantee that their job will be available to them. This could set the client up for disappointment and further distress.

It's important to allow the client to process the news and consider their options before taking any action. The nurse can help the client to identify potential resources and supports, and to develop a plan that is right for them.

Choice A rationale:

While it's true that the nurse has released the client's information without their explicit consent, this action is justified under the duty to warn and protect.

This duty supersedes the general obligation to maintain confidentiality when there's a serious and imminent threat to identifiable individuals or the public.

In this case, the client's verbal threat to bomb a local church constitutes a credible and foreseeable risk of harm, necessitating the breach of confidentiality to protect potential victims.

Choice B rationale:

Although the nurse's actions may help to avoid malpractice charges by demonstrating responsible care and adherence to ethical obligations, this is not the primary reason for notifying the minister.

The primary goal is to avert harm and fulfill the duty to warn, not to shield oneself from legal liability.

Choice C rationale:

This is the correct answer. The nurse has acted in accordance with the duty to warn and protect, which is a legal and ethical obligation in healthcare.

This duty mandates that healthcare professionals take reasonable steps to warn potential victims and protect the public when a patient communicates a serious threat of harm.

Choice D rationale:

While confidentiality is a cornerstone of healthcare ethics, it's not absolute.

The duty to warn and protect allows for limited breaches of confidentiality when necessary to prevent serious harm, as in this case.

The nurse's actions align with ethical principles and legal requirements, even though they involve disclosing confidential information.