A nurse is caring for a client diagnosed with a mental illness. Which of the following actions by the nurse demonstrates the ethical concept of autonomy?
Supporting the client's wish to refuse prescribed medications.
Making sure the client understands expectations for client participation.
Explaining unit rules and policies regarding unacceptable behaviors.
Encouraging client feedback about satisfaction with the facility experience.
Calmly speaking the client's name out of the car window may seem like a non-threatening action, but it involves direct engagement with the client while he is holding a weapon. This could put the nurse at risk if the client reacts unpredictably or feels threatened.
The Correct Answer is A
Choice A Reason:
Supporting the client's wish to refuse prescribed medications is a direct demonstration of respecting the client's autonomy. Autonomy in nursing is the right to self-determination, where patients are provided with adequate information to make their own decisions based on their beliefs and values. By supporting the client's decision, the nurse acknowledges the client's capacity to make informed choices about their own health care, even if the choice is different from what the medical team suggests.
Choice B Reason:
Ensuring that the client understands expectations for participation is more about informed consent and education rather than autonomy. While it is related to autonomy, it does not directly demonstrate the ethical concept since it does not involve a decision made by the client.
Choice C Reason:
Explaining unit rules and policies about unacceptable behaviors is part of the education process and setting boundaries within the healthcare environment. This action is necessary for all clients but does not specifically address the client's autonomy in making personal health decisions.
Choice D Reason:
Encouraging client feedback about satisfaction with the facility experience is a way to involve clients in the evaluation process of the facility's services. While this can be seen as respecting the client's opinions, it is not a direct action of supporting the client's autonomous decisions regarding their treatment plan
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Related Questions
Correct Answer is A
Explanation
Choice A Reason:
This statement is an example of assertive communication because it acknowledges the client's feelings while also standing firm on the nurse's actions. Assertive communication is characterized by being direct, clear, concise, honest, confident, and respectful¹. It involves expressing thoughts and feelings in a considerate way that respects others, aiming to foster and maintain healthy relationships, rectify conflicts, and prevent resentment due to unexpressed needs.
Choice B Reason:
Telling a client to calm down can be perceived as dismissive and may not be considered assertive communication. It does not acknowledge the client's feelings and can come across as commanding or condescending, which may escalate the situation rather than resolve it.
Choice C Reason:
While this statement does convey the consequences of the client's actions, it lacks the empathy component that is crucial in assertive communication. It is important to balance directness with understanding when addressing sensitive issues.
Choice D Reason:
Asking why the client chose to behave negatively could be seen as confrontational and may put the client on the defensive. Assertive communication aims to avoid power games and foster clear outcomes, which is best achieved through statements that do not provoke or blame.
Correct Answer is B
Explanation
Choice A Reason:
Taking steps to prevent the client from verbalizing delusional thoughts is not therapeutic. It can lead to the client feeling misunderstood and unsupported. Nurses should provide a safe environment where clients feel comfortable expressing their thoughts and feelings.
Choice B Reason:
Allowing the client to select food from vending machines can be a temporary measure to address the immediate concern of the client’s fear of being poisoned. It provides a sense of control over their situation and may help to reduce anxiety related to eating.
Choice C Reason:
Simply explaining that others eat the same food and feel safe may not be effective for a client experiencing delusions. Delusions are fixed beliefs that are not easily changed by logical explanations or evidence to the contrary.
Choice D Reason:
Encouraging the client to discuss why someone would poison the food might validate the delusion and could reinforce the false belief. It’s important to acknowledge the client’s feelings without supporting the delusional content.
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