A nurse is caring for a client who is involuntarily admitted for major depressive disorder and refuses to take a prescribed oral antianxiety medication. Which of the following actions should the nurse take?

Implement consequences until the client takes the medication.

Inform the client that he does not have the right to refuse the medication.

Offer the client the medication at the next scheduled dose time.

Administer the medication to the client via IM injection.

Answer and Explanation

The Correct Answer is C

A. Implement consequences until the client takes the medication:
Punitive measures should never be used in healthcare, especially in the context of mental health treatment. Coercion and punitive consequences can lead to mistrust and hinder the therapeutic relationship, which is crucial in mental health care.

B. Inform the client that he does not have the right to refuse the medication:
While it's important for the client to understand the potential consequences of refusing medication, it's also crucial to respect the client's autonomy and right to make decisions about their own treatment. Involuntary admission doesn't negate the individual's right to be informed and involved in their care decisions to the extent they are able.

C. Offer the client the medication at the next scheduled dose time:
Respecting the client's autonomy is a fundamental ethical principle in nursing care. The nurse should continue to offer the medication to the client at the scheduled times. It's essential to maintain open communication with the client, addressing concerns and attempting to build trust, which can sometimes lead to the client accepting the medication voluntarily.

D. Administer the medication to the client via IM injection:
Administering medication against a patient's will is ethically and legally questionable without proper authorization, especially if the patient is not an immediate danger to themselves or others. This approach should be avoided whenever possible.

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Correct Answer is A

Explanation

A. Reassure staff members that the debriefing is confidential:
Explanation: This step is crucial in establishing trust among the participants. Reassuring confidentiality encourages individuals to express their feelings and experiences openly. It helps create a safe environment where people can share their emotions without fear of judgment or repercussions.

B. Have staff members discuss their involvement in the event:
Explanation: After establishing confidentiality, it might be appropriate to encourage participants to discuss their involvement in the event. This allows individuals to share their perspectives and experiences, helping others understand the situation from different angles. Sharing experiences can provide insights into how different people were affected and how they coped.

C. Ask staff members to describe their most traumatic memories of the event:
Explanation: While it might be a natural inclination to immediately delve into the most traumatic memories, it's generally not the first step in a critical incident stress debriefing. Encouraging participants to share their most traumatic memories right away could be overwhelming and retraumatizing. The process usually begins with establishing trust and then progresses to discussing individual experiences, gradually leading to more specific and potentially distressing details.

D. Provide stress-management exercises to the staff members:
Explanation: Stress-management exercises are valuable and often an essential part of the debriefing process. However, introducing stress-management techniques usually comes after participants have had the opportunity to express their feelings and experiences. These exercises can include relaxation techniques, breathing exercises, or mindfulness practices, which help individuals manage their stress and anxiety effectively.

A. A family member of the client B. A translator of the same gender as the client C. A unit secretary who speaks the same language as the client D. Another client who speaks the same language as the client

Correct Answer is B

Explanation

A. A family member of the client:
Using a family member might seem like a natural choice, but it could lead to issues of confidentiality, especially if the client does not want their family to know about their situation. Moreover, there could be bias or hesitancy to discuss certain matters in the presence of a family member.

B. A translator of the same gender as the client:
This choice is ideal because individuals might feel more comfortable discussing personal and sensitive topics with someone of the same gender due to cultural or personal reasons. This can foster trust and open communication, crucial in support groups addressing sensitive matters like substance use disorders.

C. A unit secretary who speaks the same language as the client:
While this person might be fluent in the language, their role as a unit secretary might create discomfort for the client. They may not feel as at ease discussing personal issues with someone in a different professional role, even if they share the same language.

D. Another client who speaks the same language as the client:
While peer support can be beneficial, using another client as a translator can compromise the confidentiality and professionalism of the support group. It’s important to maintain boundaries and ensure that communication is facilitated by a professional translator or staff member, especially in sensitive and confidential settings like therapy or support groups.

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