A 29-year-old client with schizophrenia is brought to the emergency department by police after being found wandering into traffic while shouting about government surveillance. The client is disoriented, agitated, and refuses treatment, stating, "You're trying to poison me with your drugs. Based on legal and clinical criteria for involuntary psychiatric admission, which of the following best justifies the nurse's support for initiating involuntary commitment?
The client has a history of noncompliance with medication and frequent psychiatric hospitalizations.
The client refuses treatment and does not acknowledge their mental illness.
The client's family reports erratic behavior and wants them admitted for evaluation.
The client is a danger to self or others due to disorganized thinking and impaired judgment
The Correct Answer is D
Rationale:
A. While medication noncompliance and repeated hospitalizations are concerning, they do not alone meet the threshold for involuntary admission without immediate risk.
B. Refusal of treatment and lack of insight (anosognosia) are common in schizophrenia but do not justify involuntary admission unless there is risk of harm.
C. Family concerns are important but not sufficient by themselves to justify involuntary commitment.
D. Involuntary admission is legally justified when a person poses a danger to themselves or others due to mental illness. Wandering into traffic while disoriented and paranoid demonstrates an imminent safety risk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","D","E"]
Explanation
Rationale:
A. To prove malpractice, it must be shown that a duty of care existed—meaning the nurse had a legal responsibility to provide care to the client.
B. A voluntary act is not a required legal element for malpractice; professional negligence can occur even without intentional acts.
C. Willful intent is not necessary for malpractice; it is based on negligence, not intent.
D. The family must show that the nurse breached the standard of care, meaning the nurse failed to act as a reasonable nurse would under similar circumstances.
E. There must be evidence that the client suffered harm as a direct result of the nurse’s breach in care.
Correct Answer is B
Explanation
Rationale:
A. While the intent is to calm the client, commanding the client to "sit down and relax" may escalate agitation, especially when they feel threatened or mistrustful.
B. This response is calm, nonthreatening, and nonjudgmental, and it acknowledges the client’s fear while inviting collaboration, which helps in de-escalating aggression.
C. Asking for a history of the paranoid feelings is not appropriate in the moment of crisis and may increase frustration or confusion.
D. This question could be interpreted as challenging or sarcastic, potentially escalating paranoia and agitation.
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