The nurse recognizes that the difference between a voluntary and an involuntary commitment is what?

The voluntarily committed client usually has good insight into their mental health problems

An involuntarily committed client may not initiate their own discharge

An involuntarily committed client may refuse treatment

The voluntarily committed client is usually more aggressive

Answer and Explanation

The Correct Answer is B

Choice A reason: Insight into mental health problems varies individually and is not a defining feature of voluntary versus involuntary commitment. Both types of patients may lack insight, especially in severe mental illness, making this statement inaccurate as a legal or procedural distinction between commitment types.

Choice B reason: Involuntary commitment, under laws like a 302, restricts a client’s ability to initiate discharge due to assessed danger to self or others. Voluntary clients can request discharge, though medical advice may apply. This legal distinction defines the difference, making it the correct answer.

Choice C reason: Involuntary clients cannot universally refuse treatment, as court-ordered interventions may apply in cases of imminent danger. Both voluntary and involuntary clients have rights to refuse non-emergent treatment, but this is not the primary legal distinction between commitment types, making this option incorrect.

Choice D reason: Aggression is not a defining characteristic of voluntary commitment. Both voluntary and involuntary clients may exhibit aggression, depending on their mental health condition. The distinction lies in legal control over discharge, not behavior, making this statement inaccurate for defining commitment types.

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Correct Answer is C

Explanation

Choice A reason: Allowing a client with suicidal comments to leave against medical advice is unsafe, as it risks self-harm without immediate intervention. Providing resources does not address acute suicide risk, which requires inpatient stabilization to ensure safety, making this action inappropriate in the context of expressed suicidal ideation.

Choice B reason: Contacting family to persuade the client to stay does not address immediate suicide risk. While family support may be helpful, it lacks legal authority to prevent discharge and does not ensure safety, making it less effective than initiating a commitment for a client with suicidal intent.

Choice C reason: A 302 involuntary commitment is appropriate for a client expressing suicidal ideation, indicating imminent danger to self. This legal action ensures safety through inpatient evaluation and treatment, preventing self-harm. Mental health laws prioritize protection in such cases, making this the most appropriate nursing action.

Choice D reason: Calling security to detain the client is coercive and lacks legal basis without a formal commitment process. It may escalate agitation and violate autonomy. A 302 commitment is the proper legal mechanism to ensure safety for a suicidal client, making detention by security inappropriate.

A. Because your kidneys no longer produce urine, fluid can build up quickly and lead to complications like high blood pressure or difficulty breathing B. You should actually drink more fluids to stay hydrated since you’re not urinating C. As long as you’re attending all your dialysis sessions, your fluid intake doesn’t need to be restricted D. It’s not the fluids that are harmful, it’s the foods that are high in potassium and phosphorus

Correct Answer is A

Explanation

Choice A reason: In ESRD, anuria means no urine output, so excess fluid accumulates in the body, increasing intravascular volume. This can cause hypertension, pulmonary edema, and respiratory distress. Educating the client about these risks emphasizes the importance of fluid restrictions to prevent life-threatening complications between dialysis sessions, addressing their frustration accurately.

Choice B reason: Advising increased fluid intake is incorrect for anuric ESRD patients, as their kidneys cannot excrete fluid. This would exacerbate fluid overload, leading to hypertension, heart failure, or pulmonary edema. Hydration is managed through dialysis, not increased oral intake, which could overwhelm the body’s limited fluid-handling capacity.

Choice C reason: Stating that fluid intake is unrestricted with dialysis is incorrect. Even with regular dialysis, excessive fluid intake between sessions can lead to overload, causing hypertension or pulmonary edema. Dialysis removes a limited amount of fluid per session, requiring strict restrictions to maintain safe fluid balance and prevent complications.

Choice D reason: While potassium and phosphorus restrictions are critical in ESRD to prevent hyperkalemia and hyperphosphatemia, the client’s question focuses on fluid restrictions. This response does not address fluid overload risks like hypertension or pulmonary edema, which are direct consequences of excessive fluid intake in anuric patients, making it irrelevant to the query.

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The nurse recognizes that the difference between a voluntary and an involuntary commitment is what?

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Naxlex Comprehensive Predictor Exams

Correct Answer is C

Explanation

Correct Answer is A

Explanation

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