A nurse is assessing a client who has Alzheimer's disease. Which of the following findings should the nurse identity as the priority?

Rationale for correct choice:

• Clarify the antibiotic prescription with the provider: The client has a known penicillin allergy, and ceftriaxone is a cephalosporin, which may cross-react with penicillin. The nurse should clarify this prescription to prevent a potential allergic reaction.
• Penicillin allergy: Due to the client's penicillin allergy, it’s essential to ensure that no antibiotics containing penicillin or related compounds are administered. Ceftriaxone should be verified with the provider to avoid causing an allergic reaction.

Rationale for incorrect choices:

• Perform medication reconciliation: While important, medication reconciliation is not as urgent as clarifying the antibiotic prescription to avoid a potential allergic reaction to ceftriaxone.
• Request a prescription for doxycycline: Doxycycline is not needed in this situation, as the prescribed antibiotics are appropriate for treating common STIs following sexual assault. The client is also allergic to doxycycline.
• Potential HIV exposure: HIV post-exposure prophylaxis (PEP) should be considered, but the priority here is to clarify the antibiotics. PEP can be addressed later with informed consent and appropriate protocols.
• Need for prophylaxis for human papillomavirus (HPV): HPV prophylaxis is not part of standard post-sexual assault care. Focus should be on preventing STIs, pregnancy, and HIV rather than HPV at this stage.

A. Client withdrawal of prior consent must be done in writing: While clients can withdraw consent, it does not always need to be done in writing, depending on the situation. Verbal withdrawal is often sufficient unless specified otherwise.

B. Clients can refuse to attend group therapy: Clients have the right to refuse treatments and therapies, including group therapy, unless they pose a direct threat to themselves or others. This is part of respecting client autonomy.

C. Clients who are involuntarily committed do not maintain access to legal counsel: Clients who are involuntarily committed still have the right to access legal counsel. They have the right to challenge their commitment and consult with an attorney.

D. Clients who have a severe mental illness cannot request a psychiatric advance directive: Clients, regardless of the severity of their mental illness, can request a psychiatric advance directive. This document helps ensure that their treatment preferences are known if they are unable to communicate them during a crisis.