A nurse is assessing a client who is experiencing stress. The nurse recognizes which of the following is not a predisposing factor for stress?

The correct answer is choice D: "I haven't gotten my period yet, and all my friends have theirs."

Choice D rationale:

This comment should be the nurse's priority to address because it raises concerns about the adolescent's sexual development and reproductive health. A delay in the onset of menstruation might indicate underlying medical issues, and addressing this topic can provide reassurance and information about normal variations in puberty. It also demonstrates the nurse's commitment to addressing the adolescent's physical well-being.

Choice A rationale:

While concerns about physical appearance are valid, in the context of an annual health-screening visit, addressing potential medical issues takes precedence. While the nurse can provide guidance on skincare and self-esteem, these topics can be discussed after addressing the primary health concern.

Choice B rationale:

Social interactions are important for adolescents, but the comment about not being liked by peers does not present an immediate health concern. This issue may be better addressed in a broader discussion about the adolescent's emotions and social well-being.

Choice C rationale:

Feeling treated like a baby by parents is a common sentiment during adolescence. While it is valuable to acknowledge and discuss these feelings, they are not the priority in this context, where the nurse should focus on physical health and development.

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.