A nurse in an acute mental health unit is admitting a client diagnosed with bipolar disorder. The nurse recognizes which of the following findings supports the admitting diagnosis of acute mania?

Choice A rationale:

The ethical concept of autonomy centers on respecting an individual's right to make decisions about their own care, even if those decisions go against medical advice. By supporting the client's wish to refuse prescribed medications, the nurse is upholding the principle of autonomy. In mental health care, it is crucial to acknowledge and respect the client's right to make choices about their treatment, even if those choices might not align with the healthcare provider's recommendations. This action promotes patient empowerment and informed decision-making.

Choice B rationale:

While client feedback about satisfaction with the facility experience is important for quality improvement, it is not directly related to the ethical concept of autonomy. Autonomy pertains to the client's right to make decisions about their treatment and care, particularly when it comes to medical interventions and choices about their own body.

Choice C rationale:

Ensuring that the client understands expectations for client participation is more aligned with the principle of informed consent and effective communication rather than autonomy. While communication is important for respecting the client's autonomy, this choice does not directly demonstrate the core concept of allowing the client to make decisions about their treatment even if they differ from medical advice.

Choice D rationale:

Explaining unit rules and policies regarding unacceptable behaviors is related to maintaining a safe and structured environment within the psychiatric unit, but it does not directly reflect the ethical concept of autonomy. Autonomy pertains to decisions specifically related to the client's medical treatment and care, not just the rules of the unit.

The correct answer is choice D: "If suspicion of abuse exists, then reporting is mandatory."

Choice A rationale:

If the potential abuser commits to stopping the abuse, healthcare workers are not required to report it. Rationale: This statement is incorrect. Healthcare workers are mandated reporters, and their primary responsibility is to protect the safety and well-being of the child. Regardless of whether the potential abuser commits to stopping the abuse, suspicion of abuse requires reporting.

Choice B rationale:

Evidence must exist before reporting. Rationale: This statement is incorrect. While concrete evidence can strengthen a case, it is not a prerequisite for reporting suspected child abuse. Reporting is based on reasonable suspicion, not proof. Healthcare workers should err on the side of caution and report any concerns.

Choice C rationale:

I don't want to defame someone if the report is false. Rationale: This statement is incorrect. Reporting suspected child abuse is not about defaming someone, but rather about ensuring the safety of the child. Reporting is a part of the legal and ethical obligations of healthcare workers to protect vulnerable individuals.

Choice D rationale:

If suspicion of abuse exists, then reporting is mandatory. Rationale: This statement is correct. Healthcare workers are mandated reporters and have a duty to report suspected child abuse to appropriate authorities. Reporting is necessary when there is reasonable suspicion, even if definitive evidence is not yet present.