A 74-year-old client with advanced dementia is hospitalized for aggressive behavior and medication noncompliance. The psychiatric team determines the client lacks decision-making capacity. The client's adult son presents a court order granting him full legal guardianship. During discharge planning, the client refuses to go to the recommended memory care facility and insists on returning home alone. Which of the following best reflects the nurse's legal and ethical responsibility in this situation?
Follow the legal guardian's decision for discharge, despite the client's refusal
Delay discharge until the client agrees to the plan, to avoid violating the client's rights
Arrange discharge home with home health services to compromise with the client
Respect the client's autonomy and support their decision to return home
The Correct Answer is A
Rationale:
A. When a court has legally declared a person incompetent and appointed a legal guardian, the guardian has the authority to make decisions on the client’s behalf, including discharge planning. The nurse must honor the legal decision of the guardian, even if the client refuses.
B. Delaying discharge for agreement from a client who has been legally deemed unable to consent is not appropriate or legally required.
C. Compromising with an incompetent client may undermine the guardian’s legal authority and could put the client at risk.
D. While respecting autonomy is important, incompetent clients do not retain full decision-making rights, and safety and legal guidance must take precedence.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rationale:
A. Impaired judgment and poor impulse control are more commonly associated with frontal lobe damage.
B. The occipital lobe is responsible for visual processing. Damage here can cause visual disturbances, hallucinations, or agnosia (inability to recognize visual stimuli).
C. Balance and coordination issues, such as a wide-based gait, are typically related to cerebellar dysfunction, not occipital lobe injury.
D. Inability to comprehend language with fluent but nonsensical speech suggests Wernicke’s aphasia, which involves the temporal lobe, not the occipital lobe.
Correct Answer is B
Explanation
Rationale:
A. While respecting autonomy is important, avoiding further discussion may neglect the nurse’s role in promoting the client’s well-being.
B. Beneficence involves actions that promote good and reduce harm. Educating the client empowers informed decision-making while promoting their best interest.
C. Insisting on treatment disregards the client’s autonomy and may damage the therapeutic relationship, despite good intent.
D. Covert administration is unethical and violates the client's rights, even if the intention is to help.
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