A client with depression is admitted for voluntary treatment. While in the hospital, the client makes several comments about leaving the facility and kiling themselves with their gun. Which is the most appropriate action by the nurse when the client requests to leave against medical advice?
Call security and ask them to detain the client from leaving.
Contact the client's family to request they convince the client to stay.
Allow the client to leave, with a referral to community resources for follow-up care.
Contact the psychiatrist for initiation of commitment proceedings.
The Correct Answer is D
In this situation, the client's safety is of utmost importance. Expressing a desire to leave the facility and harm oneself with a gun raises serious concerns about the client's safety and the risk of harm to themselves. Initiating commitment proceedings, also known as involuntary hospitalization or psychiatric hold, allows the facility to legally detain the client temporarily for their protection and evaluation by mental health professionals. This allows for a thorough assessment of the client's mental health status and the formulation of a comprehensive treatment plan to ensure their safety.
Options A, B, and C are not appropriate in this situation:
A. Calling security to detain the client may escalate the situation and could potentially lead to increased risk of harm.
B. Contacting the client's family may not be enough to ensure the client's safety, and it is essential to involve mental health professionals in evaluating the client's risk.
C. Allowing the client to leave without addressing their expressed suicidal ideation is not safe, as the client may be at high risk for self-harm or suicide. Simply referring them to community resources without further evaluation and intervention is not sufficient to address the immediate safety concern.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Anticipatory grief refers to the emotional response and mourning that occurs before an actual loss or death. In this case, the client is grieving the loss of the pregnancy due to the decision to have an elective abortion. The grief arises from the anticipation of not being able to have the child at this time, even though they may want to have children in the future.
B- Disenfranchised grief: Disenfranchised grief refers to a type of grief that is not openly acknowledged or socially validated. It occurs when a person experiences a loss that is not commonly recognized or is not socially accepted. In this case, the client's grief is not disenfranchised because the loss of an unintended pregnancy through elective abortion is openly acknowledged and socially accepted.
C- Complicated grief: Complicated grief, also known as prolonged grief or unresolved grief, occurs when a person experiences intense, prolonged, or incapacitating grief that doesn't seem to improve over time. It can be a result of traumatic loss or when the person has difficulty accepting the reality of the loss. The client's grief over the elective abortion does not necessarily indicate complicated grief since it is a normal response to the loss of the pregnancy.
D- Absence of grief: Absence of grief would mean that the client is not experiencing any emotional response or sorrow after the elective abortion, which is unlikely in this situation. The client is crying and expressing emotions, indicating the presence of grief.
In summary, the most appropriate choice for the client's experience is "Anticipatory grief" since the client is grieving the loss of the pregnancy before it actually occurred due to the timing of the pregnancy not aligning with their plans.
Correct Answer is A
Explanation
The potential issue that the nursing staff and hospital may have to defend against in this scenario is A. "malpractice."
Explanation: Malpractice refers to a legal claim that can be made against healthcare professionals, including nurses and hospitals, when they fail to provide the standard of care expected in their profession, resulting in harm or injury to a patient. In this case, the lack of documentation that the client was assessed every hour as prescribed can be seen as a failure to meet the standard of care for a client with depression, especially one at risk for self-harm or suicide. If the client attempted suicide in the bathroom and sustained an injury, it could be argued that the lack of proper assessment and monitoring contributed to the client's harm, and this failure to provide appropriate care might be considered malpractice.
The other options, "battery," "false imprisonment," and "assault," do not directly relate to the situation described in the scenario:
B- Battery refers to the intentional harmful or offensive contact with a person without their consent. There is no indication that this occurred in the scenario.
C- False imprisonment refers to the unlawful restraint or restriction of a person's freedom of movement without proper justification. There is no indication of false imprisonment in the scenario.
D- Assault refers to the intentional act of threatening or causing fear of harm to another person. While the client did sustain an injury, there is no indication that it was due to an intentional act of assault in this scenario.
In summary, the potential issue of malpractice arises from the failure to properly assess and monitor a client at risk for self-harm, resulting in harm to the client. The nursing staff and hospital may have to defend against this claim if it is determined that they did not meet the standard of care expected in such a situation.
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