A nurse is contributing to the plan of care for a client who has bipolar disorder and whose admission was voluntary. For which of the following interventions should the nurse confirm that the client has given informed consent?

Attending a cognitive behavioral therapy class

Taking an experimental medication

Participating in a group exercise program

Receiving light therapy

Answer and Explanation

The Correct Answer is B

A.   Cognitive behavioral therapy (CBT) is a commonly used psychotherapy approach for bipolar disorder. Attending a CBT class typically does not require specific informed consent beyond the general consent for treatment, as it involves non-invasive, non-experimental therapeutic techniques aimed at improving coping skills and managing symptoms. In most cases, attending therapy sessions like CBT is considered part of routine care for mental health conditions.
B.   Experimental medications involve drugs or treatments that are not yet approved by regulatory agencies (such as the FDA in the United States) for general use. For a client to participate in a clinical trial or receive an experimental medication, they must provide explicit informed consent after being informed about the potential risks, benefits, and uncertainties associated with the treatment. This process ensures that the client understands they are participating in research and not receiving standard care.
C.   Participating in a group exercise program is generally considered a routine therapeutic intervention aimed at promoting physical health and well-being. While informed consent is important for all interventions, including exercise programs, it typically involves providing general information about the program's goals, activities, and any potential risks. Clients are not consenting to experimental treatments or procedures that go beyond standard exercise protocols.

D.   Light therapy, also known as phototherapy, is a treatment often used for seasonal affective disorder (SAD) and other mood disorders. It involves exposure to specific wavelengths of light to regulate circadian rhythms and improve mood. While light therapy is a specialized treatment, it is a standard intervention for mood disorders and does not typically require separate informed consent beyond what is provided for standard medical treatments.

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Correct Answer is A

Explanation

A. Verbal de-escalation involves using calm, non-confrontational communication techniques to help calm the client. This can include speaking softly, using non-threatening body language, and actively listening to the client's concerns. It is the first-line intervention for managing escalating behavior because it aims to reduce agitation without the use of physical or chemical restraints.
B. Haloperidol is an antipsychotic medication that may be prescribed for acute agitation and aggression in some situations. However, obtaining a prescription requires provider authorization and should not be the first intervention unless the client's agitation poses an immediate threat to safety and verbal de- escalation has been ineffective. It is typically used when other interventions have not successfully managed agitation.

C. Physical restraints should only be used as a last resort and in accordance with institutional policies and legal guidelines. Restraints are intended to prevent harm to the client or others when all other methods of de-escalation have failed and there is an imminent risk of harm. Placing a client in restraints without attempting verbal de-escalation first can escalate the situation further.
D. Seclusion is also a restrictive intervention that should be used judiciously and only when necessary to protect the client or others from harm. It involves placing the client in a designated, secure area where they can be monitored closely. Similar to physical restraints, seclusion should be considered only after attempts at verbal de-escalation have been unsuccessful and there is a clear risk of harm.

A. Reinforcing information on the potential adverse effects of a medication with the client B. Respecting the client's right to refuse to attend a group therapy session C. Encouraging the client to attend a daily exercise program on the unit D. Maintaining the client's confidentiality about a substance use disorder

Correct Answer is A

Explanation

A. Veracity involves providing accurate and truthful information to the client. By reinforcing information about potential adverse effects of a medication, the nurse ensures that the client is fully informed. This aligns with the principle of veracity because it involves transparency and honesty in discussing the potential risks associated with treatment.
B. Respecting the client's autonomy and right to make decisions about their treatment plan relates more to the ethical principle of autonomy rather than veracity. While respecting autonomy is essential, it doesn't directly address truthfulness or honesty in communication.
C. Encouraging a client to participate in a daily exercise program supports their physical well-being and can be beneficial for their recovery. However, it doesn't specifically relate to the ethical principle of veracity, which focuses on truthful communication.
D. Confidentiality is another ethical principle that pertains to protecting the client's privacy and maintaining confidentiality of their health information. While important, it doesn't directly relate to veracity, which is about honesty and truthfulness in communication with the client.

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A nurse is contributing to the plan of care for a client who has bipolar disorder and whose admission was voluntary. For which of the following interventions should the nurse confirm that the client has given informed consent?

Nursing Test Bank

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Correct Answer is A

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