For which of the following clients is a nurse considered a mandated reporter to the appropriate agency?
A client who reports lying to their provider about having suicidal ideation.
A client who reports that they enjoy smoking marijuana on weekends.
A client who reports that they took $20 from the cash register where they work.
A client who reports that their partner ties their child to a bed as punishment.
The Correct Answer is D
Choice A reason:
A client lying about suicidal ideation to their provider does not fall under mandatory reporting unless there is evidence or suspicion of harm to self or others. In this case, the client has reported lying, which indicates there is no actual suicidal ideation or intent.
Choice B reason:
While smoking marijuana may be illegal in some jurisdictions, it does not typically require mandatory reporting by a nurse unless it directly affects patient care or involves minors.
Choice C reason:
Theft from an employer is a legal issue but does not require mandatory reporting by a nurse unless it involves stealing medication or other actions that could harm patients.
Choice D reason:
This choice clearly involves child abuse, which is a reportable offense. Nurses are mandated reporters for any suspected child abuse or neglect. Tying a child to a bed as punishment can cause physical and emotional harm, and it is the nurse's duty to report this to the appropriate agency to ensure the child's safety.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
Choice A reason:
Allowing the client to focus on the delusion for as long as they want is not recommended. This approach can reinforce the delusion and make it more entrenched. It is important to engage the client in reality-based activities and conversations to help them connect with the world around them.
Choice B reason:
Reinforcing the importance of controlling impulses is a general strategy that can be beneficial for clients with schizophrenia. However, it does not directly address the issue of delusions. Impulse control is more about managing behaviors that could be harmful or disruptive.
Choice C reason:
Contradicting the client's delusional beliefs can be confrontational and may lead to increased anxiety or aggression. It is generally not effective to argue with a client about their delusions because these beliefs are very real to them. The nurse should acknowledge the client's experience without agreeing with the delusion.
Choice D reason:
Asking the client to describe their beliefs about the delusion can be a therapeutic approach. It allows the nurse to understand the client's perspective and build a therapeutic relationship based on empathy and trust. This approach does not validate the delusion but rather opens a dialogue that can be used to gently challenge the delusion with evidence from the client's environment.
Correct Answer is C
Explanation
Choice A reason:
Telling the client that they will be admitted to an inpatient care facility if they do not take their medication can be perceived as a threat and may damage the therapeutic relationship. It is not an effective strategy for improving medication adherence, as it does not address the underlying reasons for the client's struggle with taking the medication.
Choice B reason:
Discussing the provider's goals for the client's care is important, but it does not directly address the issue of medication adherence. While understanding the treatment plan can be beneficial, it is more crucial to engage the client in a conversation about their experiences and concerns with the medication.
Choice C reason:
Asking the client if the medication is causing adverse effects is a direct approach to understanding potential barriers to medication adherence. Adverse effects can be a significant reason why clients may be reluctant to take their medication regularly. Addressing these concerns can lead to adjustments in the medication regimen that may improve adherence.
Choice D reason:
Requesting the provider to prescribe a second antipsychotic medication is not an appropriate first step without first understanding the reasons for non-adherence. Adding another medication could complicate the regimen and potentially lead to more adverse effects or interactions.
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