A nurse is developing a plan of care for a client who has paranoid personality disorder. Which of the following actions should the nurse include in the plan?
Provide written information about the client's treatment plan.
Encourage countertransference when developing the nurse-client relationship.
Monitor the client for splitting behaviors.
Isolate the client from social or group interactions.
The Correct Answer is A
A. Providing written information about the treatment plan promotes transparency and helps to establish trust with the client, which is important in the care of individuals with paranoid personality disorder.
B. Encouraging countertransference can blur professional boundaries and may exacerbate distrust or suspicion in clients with paranoid personality disorder.
C. Monitoring for splitting behaviors is important in personality disorders but does not directly address the client's needs or promote therapeutic engagement.
D. Isolating the client from social or group interactions can exacerbate feelings of paranoia and may not be therapeutic or appropriate.
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Correct Answer is D
Explanation
A. Administering medications, such as atropine, requires nursing judgment and assessment of the client's condition, which should not be delegated to assistive personnel.
B. Witnessing the client's signature on the consent form ensures that the client provides informed consent for the procedure and requires nursing judgment.
C. Assessing the client's condition after the procedure involves monitoring vital signs, level of consciousness, and potential adverse reactions, which require nursing assessment and judgment.
D. Assisting the client to ambulate after the procedure is a task that can be safely delegated to assistive personnel, as long as the client's condition is stable and there are no contraindications to ambulation.
Correct Answer is C
Explanation
A. Coercing the client into treatment violates the client's autonomy and rights. Involuntary commitment does not mean the client loses the right to refuse treatment.
B. Involving the client's family without their consent or participation in decision-making may not be appropriate and could breach confidentiality.
C. Documenting the client's refusal of treatment ensures that the decision is appropriately recorded in the medical record and facilitates communication among the healthcare team members. It also protects the client's autonomy and legal rights.
D. Informing the client that ECT does not require consent is incorrect. While laws regarding involuntary treatment vary by jurisdiction, clients generally have the right to refuse treatment, even if they are involuntarily committed.
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