A charge nurse on a mental health unit is preparing an in-service for staff members about client rights. Which of the following information should the nurse include?
Clients who have a severe mental illness cannot request psychiatric advance directives.
Clients who are violent require a prescription prior to initiation of restraints.
Client withdrawal of prior consent must be done in writing.
Client confidentiality is not maintained when there is a duty to warn.
The Correct Answer is D
Choice A reason: Clients with severe mental illness retain the right to create psychiatric advance directives unless legally deemed incompetent. Denying this right violates autonomy and federal protections.
Choice B reason: While a provider’s order is required for restraints, the priority is immediate safety. In emergencies, restraints may be applied first with a verbal order followed by a written one.
Choice C reason: Clients may withdraw consent verbally or in writing. Requiring written withdrawal exclusively is overly restrictive and not supported by ethical or legal standards.
Choice D reason: Confidentiality is a core principle, but exceptions exist. The duty to warn—such as when a client poses a serious threat to others—requires disclosure to protect potential victims, aligning with legal precedents like Tarasoff v. Regents.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: While clients have the right to avoid unnecessary treatment, this option is vague and does not directly address medication refusal.
Choice B reason: Informed consent involves understanding risks and benefits, but the act of refusal is better captured by the right to decline treatment.
Choice C reason: Clients have the legal and ethical right to refuse medication unless they are deemed incompetent or under involuntary treatment. This is the most accurate and specific answer.
Choice D reason: Legal review of care plans is not a standard right in routine care and is not relevant to medication refusal.
Correct Answer is D
Explanation
Choice A reason: Assessing social support is important but not the priority when suicide risk is suspected.
Choice B reason: Assessing for a plan is critical but should follow confirmation of current suicidal ideation.
Choice C reason: Past attempts are relevant for risk stratification but secondary to current ideation.
Choice D reason: Determining current suicidal thoughts is the first and most urgent step in suicide risk assessment to guide immediate safety interventions.
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