A nurse is caring for a client following an involuntary admission to'an acute mental health facility. The client states, "I'm afraid they will give me drugs that put me to sleep." Which of the following statements should the nurse make?
"You will need to rest so that you can recover from the episode that brought you here."
"I will make sure that we respect your right to refuse medications.
"It's not your choice to be here, so you have to accept the treatment we plan for you."
"Why do you think your provider will prescribe you medications that will make you sleep?"
The Correct Answer is B
A. "You will need to rest so that you can recover from the episode that brought you here.": This response dismisses the client's fear and does not address their concern about being given medications that induce sleep. It also does not acknowledge the client's right to refuse medications or address their autonomy.
B. "I will make sure that we respect your right to refuse medications.": This response validates the client's concern and reassures them that their autonomy and right to refuse medications will be respected. It promotes trust and therapeutic communication between the nurse and the client.
C. "It's not your choice to be here, so you have to accept the treatment we plan for you.": This response undermines the client's autonomy and rights, which can erode trust and impede therapeutic rapport. Involuntary admission does not negate the client's right to participate in treatment decisions or refuse medications.
D. "Why do you think your provider will prescribe you medications that will make you sleep?": This response challenges the client's perception and may come across as confrontational. It does not address the client's fear or provide reassurance about their rights regarding medication administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. A client who has a right peripherally inserted central catheter (PICC):
When a client has a right-sided PICC, it's essential to measure blood pressure in the left arm. This is because the PICC line can interfere with accurate blood pressure readings on the right side due to the placement of the cuff and potential obstruction of blood flow. Measuring blood pressure in the left arm provides a more accurate assessment of systemic blood pressure.
B. A client who had a right hemisphere stroke:
While clients with a right hemisphere stroke may have various neurological deficits, there is no specific indication to measure blood pressure in the left arm based solely on this condition.
C. A client who had blood drawn from the right antecubital area 1 hr ago:
Blood drawn from the antecubital area typically does not affect blood pressure measurements in the same arm. Therefore, there is no need to measure blood pressure in the opposite arm in this situation.
D. A client who had dialysis and is using an arteriovenous shunt in the left lower forearm:
While clients with arteriovenous shunts may have altered blood flow dynamics, the use of a shunt in the left lower forearm does not necessarily require blood pressure measurements to be taken in the opposite arm. Blood pressure measurement should be performed on the side without the shunt unless contraindicated for other reasons.
Correct Answer is B
Explanation
A. Performing a simple dressing change on a client's foot - This action is appropriate and within the scope of practice for assistive personnel.
B. Washing hands with alcohol-based hand rub after bathing a client who has Clostridium difficile - Handwashing with alcohol-based hand rub is not effective against Clostridium difficile spores. Proper hand hygiene for C. difficile requires washing with soap and water. The charge nurse should intervene to correct this action and ensure proper infection control procedures are followed.
C. Providing postmortem care for a client who has recently died - Providing postmortem care is within the scope of practice for assistive personnel and is appropriate.
D. Emptying an indwelling urinary catheter bag for a client while wearing clean gloves - This action is appropriate and within the scope of practice for assistive personnel.
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