A nurse is caring for a client diagnosed with a mental illness. Which of the following actions by the nurse demonstrates the ethical concept of autonomy?
Supporting the client's wish to refuse prescribed medications.
Making sure the client understands expectations for client participation.
Explaining unit rules and policies regarding unacceptable behaviors.
Encouraging client feedback about satisfaction with the facility experience.
Calmly speaking the client's name out of the car window may seem like a non-threatening action, but it involves direct engagement with the client while he is holding a weapon. This could put the nurse at risk if the client reacts unpredictably or feels threatened.
The Correct Answer is A
Choice A Reason:
Supporting the client's wish to refuse prescribed medications is a direct demonstration of respecting the client's autonomy. Autonomy in nursing is the right to self-determination, where patients are provided with adequate information to make their own decisions based on their beliefs and values. By supporting the client's decision, the nurse acknowledges the client's capacity to make informed choices about their own health care, even if the choice is different from what the medical team suggests.
Choice B Reason:
Ensuring that the client understands expectations for participation is more about informed consent and education rather than autonomy. While it is related to autonomy, it does not directly demonstrate the ethical concept since it does not involve a decision made by the client.
Choice C Reason:
Explaining unit rules and policies about unacceptable behaviors is part of the education process and setting boundaries within the healthcare environment. This action is necessary for all clients but does not specifically address the client's autonomy in making personal health decisions.
Choice D Reason:
Encouraging client feedback about satisfaction with the facility experience is a way to involve clients in the evaluation process of the facility's services. While this can be seen as respecting the client's opinions, it is not a direct action of supporting the client's autonomous decisions regarding their treatment plan
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Related Questions
Correct Answer is D
Explanation
Choice A Reason:
Passive-aggressive communication involves expressing negative feelings indirectly rather than openly addressing them. It often manifests as sarcasm, backhanded compliments, or subtle digs. In this scenario, the client is directly stating their preference without any indirect negativity, so it is not passive-aggressive.
Choice B Reason:
Aggressive communication is characterized by speaking in a way that violates or disrespects others. It often includes yelling, interrupting, or demeaning language. The client's statement does not display any of these characteristics; instead, it is a straightforward expression of their wish.
Choice C Reason:
Nonassertive communication, also known as passive communication, occurs when individuals fail to express their thoughts or feelings, or they do so without confidence. The client in the garden is clearly stating their desire to plant the sunflower, which is not indicative of a nonassertive pattern.
Choice D Reason:
Assertive communication is the act of expressing one's opinions, feelings, and needs in a clear, direct, and respectful way. It involves standing up for oneself while also considering the rights and feelings of others. The client's statement, "I would really like to plant the sunflower," is a clear, direct expression of their preference, making it an assertive form of communication.
Correct Answer is A
Explanation
Choice A reason:
The statement correctly identifies that a therapeutic milieu encompasses both the physical and psychosocial aspects of the environment. This holistic approach is designed to support the recovery and well-being of clients by ensuring that all aspects of the unit's environment are conducive to therapy.
Choice B reason:
While personalization of space can be part of a therapeutic milieu, this statement alone does not capture the full essence of the concept. Therapeutic milieu involves more than just personal items; it includes the structured management of the environment to promote positive interactions and therapeutic outcomes.
Choice C reason:
Positioning chairs around the perimeter of the day room may be a part of the environmental setup, but it does not fully represent the therapeutic milieu. The therapeutic milieu is about creating an environment that encourages interaction, communication, and community among clients, which may or may not involve specific furniture arrangements.
Choice D reason:
Unstructured programming is not a characteristic of therapeutic milieu. In fact, therapeutic milieu typically involves a structured schedule of activities and programs that are designed to promote therapeutic engagement, skill development, and social interaction among clients.
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