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: Informing the client about potential nurse reprimands is coercive and inappropriate, as it prioritizes the nurse’s interests over patient autonomy. This approach fails to explore the client’s reasons for refusal, which may involve side effects or mistrust, and does not support therapeutic communication or ethical care.

Choice B reason: Documenting refusal is necessary but not the first action. Exploring the reason for refusal allows the nurse to address concerns, potentially resolving issues like misunderstanding or side effects. Documentation follows after attempts to understand and educate, ensuring a therapeutic approach before recording the refusal.

Choice C reason: Asking the reason for refusal respects autonomy and initiates therapeutic communication. It identifies barriers like side effect fears or lack of understanding, enabling education or alternative solutions. This approach aligns with patient-centered care, addressing underlying issues to promote adherence while respecting the client’s rights.

Choice D reason: Stating that refusal is not permitted is coercive and violates autonomy. Clients have the right to refuse medication unless under involuntary treatment orders. This approach damages trust, escalates resistance, and contradicts ethical principles, making it an inappropriate initial response to medication refusal.

A. 201 B. 303 C. 302 D. 301

Correct Answer is A

Explanation

Choice A reason: A 201 status indicates voluntary admission to a mental health facility, where the client can request discharge by signing a withdrawal form, typically with a 72-hour notice period. This matches the client’s statement, as voluntary patients retain control over their discharge, consistent with mental health laws.

Choice B reason: A 303 status involves extended involuntary commitment for ongoing treatment, typically after a court hearing. It does not allow self-initiated discharge by signing a form, as the client’s statement suggests, making this status incompatible with the described ability to request withdrawal.

Choice C reason: A 302 status is an involuntary commitment for imminent danger, requiring medical or legal approval for discharge, not a simple request form. The client’s ability to sign for withdrawal indicates voluntary status, making 302 incorrect for this scenario.

Choice D reason: A 301 status is not a standard term in mental health commitment laws (e.g., Pennsylvania’s Mental Health Procedures Act). The client’s ability to request discharge aligns with voluntary (201) status, not an undefined or involuntary category, making this option incorrect.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assigned to administer oral medications to a client. Which action will the nurse do first if a client refuses to take prescribed oral medications?

Correct Answer is C

Explanation

The client states, “I understand that in order to leave, I must sign a request to withdraw from treatment.” What is the client’s legal status?

Correct Answer is A

Explanation

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