Which client would a nurse determine to be the most likely candidate for involuntary commitment?

A teenager who refuses to participate in the planned therapy

A 24-year-old client who refuses to take the prescribed medication

A 45-year-old client who is homeless and has been diagnosed with a mental disorder

An elderly client who is confused, screaming obscenities in the street, and disturbing neighbors

Answer and Explanation

The Correct Answer is D

Choice A reason:

A teenager who refuses to participate in the planned therapy does not necessarily meet the criteria for involuntary commitment. Refusal to participate in therapy can be addressed through other means, such as motivational interviewing or adjusting the treatment plan to better engage the client.

Choice B reason:

A 24-year-old client who refuses to take the prescribed medication also does not automatically qualify for involuntary commitment. Non-compliance with medication can be managed through education, support, and exploring the reasons behind the refusal. Involuntary commitment is typically reserved for situations where the client poses a danger to themselves or others.

Choice C reason:

A 45-year-old client who is homeless and has been diagnosed with a mental disorder may need support and resources, but homelessness and a mental health diagnosis alone do not justify involuntary commitment. The focus should be on providing housing and mental health services rather than involuntary hospitalization.

Choice D reason:

An elderly client who is confused, screaming obscenities in the street, and disturbing neighbors is exhibiting behavior that may pose a risk to themselves or others. This situation suggests a level of acute distress or potential danger that could warrant involuntary commitment to ensure the client’s safety and provide necessary treatment.

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Free Nursing Study Resources

Correct Answer is B

Explanation

Choice A reason:

Having an empathetic relationship with the client is important, but it is not the most important principle. Empathy helps build trust and rapport, but the primary focus should always be on the client’s needs and experiences.

Choice B reason:

The client being the primary focus of the interaction is the most important principle in therapeutic communication. This ensures that the nurse’s attention and efforts are directed towards understanding and addressing the client’s concerns, promoting their well-being and recovery.

Choice C reason:

Self-disclosure by the nurse should be used sparingly and only when it benefits the client. While it can help build rapport, it is not the primary focus of therapeutic communication. The nurse’s primary role is to listen and support the client.

Choice D reason:

Recording the client’s conversations is not a standard practice in therapeutic communication and can breach confidentiality. The focus should be on creating a safe and trusting environment where the client feels comfortable sharing their thoughts and feelings.

A. “That is very interesting. We are not sure why people start to isolate themselves.” B. “Before symptoms of schizophrenia begin, people often isolate themselves. This is an early warning.” C. “Do you think of yourself as more of an introvert? That makes a difference with how you socialize.” D. “Were you avoiding your friend so that you could hear the voices more clearly?”

Correct Answer is B

Explanation

Choice A reason:

“That is very interesting. We are not sure why people start to isolate themselves.” This response is vague and does not provide the client with useful information. It may leave the client feeling uncertain and unsupported.

Choice B reason:

“Before symptoms of schizophrenia begin, people often isolate themselves. This is an early warning.” This response is informative and helps the client understand that social withdrawal can be an early sign of schizophrenia. It provides a clear explanation and validates the client’s experience.

Choice C reason:

“Do you think of yourself as more of an introvert? That makes a difference with how you socialize.” This response shifts the focus to the client’s personality rather than addressing the specific concern about social withdrawal related to schizophrenia. It may not provide the clarity the client is seeking.

Choice D reason:

“Were you avoiding your friend so that you could hear the voices more clearly?” This response is speculative and could be perceived as judgmental. It does not address the underlying issue of social withdrawal as an early symptom of schizophrenia.

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Which client would a nurse determine to be the most likely candidate for involuntary commitment?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

When engaged in therapeutic communication with a client who has been diagnosed with a mental disorder, which is the most important principle for a nurse to keep in mind?

Correct Answer is B

Explanation

A nurse is discussing schizophrenia spectrum disorders with a client. The client states, “My friend says that before I started hearing voices, I stopped hanging out with them. Why is that?” Which of the following responses should the nurse make?

Correct Answer is B

Explanation

After experiencing increasing conflict in the home, a social worker calls and schedules a therapy meeting. A 24-year-old, his sister, his mother, and the mother’s live-in boyfriend are asked to attend the therapy meeting. Who is the “client” who will be treated during this session?

A nurse is reviewing the medical record of a client who has a new prescription for chlorpromazine for the treatment of schizophrenia. Which of the following findings indicates a contraindication to chlorpromazine?

A nurse is caring for a client who is hospitalized for a mental disorder. The nurse is legally obligated to breach the client’s confidentiality if the client makes which statement?

A newly licensed nurse is applying prescribed wrist restraints on a client. Which of the following actions should the nurse take?

A nurse is developing a plan of care integrating Maslow’s hierarchy of needs. Which area would the nurse identify as the priority?

A nurse is performing an admission assessment for a client who has schizophrenia. Which of the following findings should the nurse identify as a negative symptom?