A nurse is assessing a client who has illness anxiety disorder. Which of the following findings should the nurse expect?

Choice A rationale:

Circumstantiality refers to a communication pattern where the individual provides excessive, unnecessary details before reaching the point. In this scenario, the patient's response is not characterized by providing excessive details but rather by the use of words that sound alike but have no meaningful connection.

Choice B rationale:

Clang association is a communication pattern where the individual's speech is characterized by rhyming or the repetition of words that sound similar but lack logical connection. The patient's response, "This is a new day in May and I can't wait to play," demonstrates this pattern, as the words "May" and "play" rhyme but don't form a coherent sentence.

Choice C rationale:

Tangentiality refers to a communication pattern where the individual goes off-topic and never returns to the original subject. The patient's response, while seemingly off-topic, is not a clear example of tangentiality, as the words used are related in a rhyming manner rather than being entirely unrelated.

Choice D rationale:

Neologism refers to the creation of new words or phrases that are not part of any recognized language. The patient's response does not involve the creation of entirely new words; instead, it involves the use of existing words that rhyme but lack a coherent connection.

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.