A nurse is working with a client who is the caregiver of a family member who has a serious mental illness. Which of the following statements by the client indicates acceptance of the role change?

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. The client is experiencing anisognosia: Anisognosia, a lack of awareness of one's own illness, is common in various psychiatric disorders, particularly in psychotic disorders like schizophrenia. While it is concerning, it does not typically require immediate reporting.

B. The client is experiencing command hallucinations: Command hallucinations, where the client hears voices telling them to take harmful actions, pose a direct safety risk. These should be immediately reported to the provider for further evaluation and intervention.

C. The client is exhibiting concrete thinking: Concrete thinking is common in individuals with certain psychiatric conditions, such as schizophrenia or intellectual disabilities. While it limits abstract thought, it is not an immediate cause for alarm.

D. The client is exhibiting a blunted affect: A blunted affect, or reduced emotional expression, is a common symptom in various mental health disorders. It is important for diagnosis and treatment planning but is not an immediate emergency or urgent situation.