A nurse is caring for a client who is hospitalized for a mental disorder. The nurse is legally obligated to breach the client’s confidentiality if the client makes which statement?

Choice A reason:
Dependence on parents to participate in the client’s care indicates that the client is not progressing towards independence. Effective in-home mental health care aims to empower clients to manage their own health and reduce reliance on others. Therefore, this response does not demonstrate effective care.
Choice B reason:
A need for continued intensive monitoring in the home suggests that the client’s condition remains unstable and requires constant supervision. Effective care should lead to improved stability and a reduction in the need for intensive monitoring.
Choice C reason:
A decrease in admission frequency to inpatient psychiatric hospitals indicates that the client’s condition is stabilizing and that they are managing their mental health more effectively at home. This outcome demonstrates that the in-home mental health care is effective in reducing the need for hospitalization.
Choice D reason:
A need for crisis intervention services on an ongoing basis suggests that the client continues to experience frequent crises. Effective in-home mental health care should help the client develop coping strategies and support systems to manage their condition, reducing the need for frequent crisis interventions.

Choice A reason:
A predictable social environment is important for providing stability and security, which can contribute to a client’s overall well-being. However, according to Maslow’s hierarchy of needs, physiological needs such as food and water must be met before higher-level needs like social stability can be addressed. Therefore, while important, a predictable social environment is not the immediate priority.
Choice B reason:
Adequate food is a fundamental physiological need according to Maslow’s hierarchy of needs. Physiological needs are the most basic and must be satisfied before an individual can focus on higher-level needs such as safety, love, and self-esteem. Ensuring that the client has adequate food is essential for their survival and overall health, making it the top priority in the plan of care.
Choice C reason:
A positive self-image is associated with self-esteem needs, which are higher up in Maslow’s hierarchy. While fostering a positive self-image is important for a client’s mental health and well-being, it cannot be effectively addressed until basic physiological needs are met. Therefore, it is not the immediate priority in the plan of care.
Choice D reason:
Acceptance from family relates to the need for love and belonging, which is also higher up in Maslow’s hierarchy. While family acceptance is crucial for emotional support and social well-being, it is not as immediate a priority as ensuring that the client’s basic physiological needs, such as adequate food, are met first.