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 C
Explanation
Choice A reason:
This statement may come across as dismissive of the potential benefits of medication, which can be an important part of treatment for some individuals. It's essential to consider and respect each client's unique treatment needs, including medication.
Choice B reason:
Pointing out physical manifestations of stress in a confrontational way may make the client feel self-conscious or defensive. It's important to address such observations with sensitivity and in the context of exploring feelings.
Choice C reason:
Inviting the client to discuss their concerns about returning to work opens up a dialogue about their fears and challenges. It's a supportive approach that encourages expression and exploration of feelings.
Choice D reason:
While resolving conflicts is important, this directive statement may feel overwhelming to a client who is already dealing with a new cancer diagnosis. It's better to offer support and guidance in navigating interpersonal issues.
Correct Answer is D
Explanation
Choice A Reason:
Providing sympathy can be comforting, but it may not always be conducive to establishing a therapeutic relationship. Sympathy involves feeling pity for someone else's misfortune, which can sometimes create a power imbalance or imply that the nurse sees the client as unable to cope. In contrast, empathy, which is understanding and sharing the feelings of another, is more aligned with therapeutic communication principles.
Choice B Reason:
Focusing on the words of the clients is important, but it is only one aspect of communication. Therapeutic relationships are built on understanding the full context of communication, including non-verbal cues and emotional undertones. Active listening involves not just hearing words, but also interpreting the message being conveyed and responding appropriately.
Choice C Reason:
Controlling the pace of establishing nurse-client relationships might be necessary in certain situations, but it should not be the primary action. Each client is unique, and the development of a therapeutic relationship will vary depending on individual needs and circumstances. The nurse should be flexible and patient, allowing the relationship to develop naturally.
Choice D Reason:
Demonstrating genuineness when communicating is fundamental to building trust and rapport, which are essential components of a therapeutic relationship. Genuineness involves being open, honest, and sincere. When nurses are genuine, clients are more likely to feel respected and understood, leading to a stronger therapeutic alliance.
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