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:

“That is very interesting. We are not sure why people start to isolate themselves.” This response is vague and does not provide the client with useful information. It may leave the client feeling uncertain and unsupported.

Choice B reason:

“Before symptoms of schizophrenia begin, people often isolate themselves. This is an early warning.” This response is informative and helps the client understand that social withdrawal can be an early sign of schizophrenia. It provides a clear explanation and validates the client’s experience.

Choice C reason:

“Do you think of yourself as more of an introvert? That makes a difference with how you socialize.” This response shifts the focus to the client’s personality rather than addressing the specific concern about social withdrawal related to schizophrenia. It may not provide the clarity the client is seeking.

Choice D reason:

“Were you avoiding your friend so that you could hear the voices more clearly?” This response is speculative and could be perceived as judgmental. It does not address the underlying issue of social withdrawal as an early symptom of schizophrenia.

Choice A reason:

“It is now time for you to bathe. Do you want to wear the red or green shirt?” This statement is therapeutic as it provides clear instructions and offers the client a choice, promoting autonomy and cooperation. It addresses the need for hygiene in a respectful and supportive manner.

Choice B reason:

“Do you really think it is okay not to bathe? What is going on with you?” This statement is confrontational and judgmental. It may make the client feel defensive or ashamed, which can hinder the therapeutic relationship and the client’s willingness to engage in self-care.

Choice C reason:

“This is it! You are getting a bath! There are three of us here to bathe you!” This statement is coercive and does not respect the client’s autonomy. Forcing the client to bathe without their consent can escalate the situation and damage trust between the client and the nurse.

Choice D reason:

“I’m going to ignore your lack of self-care because it is an aspect of the disorder.” Ignoring the client’s hygiene issues is not therapeutic. While it is important to understand that self-care deficits can be part of the disorder, the nurse should still address these issues in a supportive and respectful manner.