The health care provider prescribes haloperidol 10 mg for a client with severe psychosis but the client refuses the medication. Which nursing action is appropriate?

Accept the client's decision and continue to maintain safety.

Obtain a discharge order for nonadherence to the medication regimen.

Restrain the client and give the medication intramuscularly.

Inform the client that refusing the medication means not getting any better.

Answer and Explanation

The Correct Answer is A

Every individual has the right to refuse medical treatment, including medications, as long as they are competent to make that decision. It is essential to respect the client's autonomy and right to make decisions about their own health care. When a client refuses medication, the nurse should document the refusal, inform the healthcare provider, and explore the reasons behind the refusal if possible.

The other options are not appropriate for the following reasons:

B- Obtaining a discharge order for nonadherence: While it is essential to address nonadherence to medication, discharging the client solely for refusing the medication may not be the best course of action. Instead, the nurse should work collaboratively with the healthcare team to address the client's concerns and explore alternative treatment options.

C- Restraining the client and giving the medication intramuscularly: Restraints should only be used as a last resort when a client presents an imminent danger to themselves or others, and it must be done in accordance with facility policies and legal regulations. Using restraints to administer medication against a client's will is a violation of their rights and is not an appropriate response to medication refusal.

D-Informing the client that refusing the medication means not getting any better: This response may be seen as coercive and manipulative. It is not ethical to use fear or guilt to persuade a client to take medication against their will. Instead, the nurse should provide information about the potential benefits and risks of the medication and address the client's concerns or fears about the treatment. Ultimately, the decision to take the medication should be left to the client after they have been fully informed about their options.

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Correct Answer is A

Explanation

This is the best response because it acknowledges the client’s statement while providing realistic, evidence-based information. According to the National Institute of Mental Health (NIMH) and domestic violence research, the period immediately after leaving an abusive partner is often the most dangerous, as abusers may escalate threats or violence when they feel a loss of control. This response validates the client’s concerns, offers safety awareness, and opens the door for further discussion about creating a safety plan.

option B generalizes that all batterers never change, which may not be true for all situations and individuals.

Option C suggeststhat leaving will make the partner change is inappropriate and unsafe. This could give the client false hope that the abuser’s behavior will improve, when evidence shows that abusive partners rarely change without intensive intervention.

Option D may imply a threat or ultimatum, which is not appropriate and can be disempowering for the client. The most important aspect of supporting someone in an abusive relationship is to provide a non-judgmental, understanding, and empowering environment where they can explore their options and make decisions that are best for their safety and well-being.

A. The nurse should examine their personal attitudes related to loss and grieving. B. The nurse will evaluate previous methods of interventions that were beneficial. C. The nurse will establish the goals for the process and present to the client. D. The nurse will share personal information for the client related to the loss experienced by the nurse

Correct Answer is A

Explanation

Prior to meeting with a client who is experiencing complicated grieving, the nurse should engage in self-reflection and examine their own attitudes, biases, and emotional responses related to loss and grieving. This is important because the nurse's own experiences and beliefs can influence their ability to provide empathetic and non-judgmental care to the client. By acknowledging and understanding their own feelings and reactions, the nurse can better support the client in their grieving process.

The other options are not appropriate for the following reasons:

B- Evaluating previous methods of interventions: While it is essential for the nurse to have knowledge and skills related to grief counseling and interventions, focusing solely on previous methods may not be helpful for the client's unique situation. Each individual's grieving process is different, and what worked for one client may not work for another.

C- Establishing goals for the process and presenting them to the client: While setting goals for the therapeutic relationship is important, it should be a collaborative process between the nurse and the client. The nurse should work with the client to identify their needs and goals related to the grieving process and develop a plan of care together.

D- Sharing personal information related to loss experienced by the nurse: It is not appropriate for the nurse to share their own personal experiences of loss with the client. The focus of the therapeutic relationship should be on the client's needs and experiences, not the nurse's. Sharing personal information can shift the focus away from the client and may not be helpful or therapeutic for them.

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The health care provider prescribes haloperidol 10 mg for a client with severe psychosis but the client refuses the medication. Which nursing action is appropriate?

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