The 45-year-old son of a client calls the PMHNP to ask her to write a letter declaring his mother incompetent, and therefore unable to make medical decisions for herself. What is the most appropriate response?
"Your mother is perfectly competent."
"Competence is a legal concept, not a medical one. I have no authority to do such a thing."
"I have been worrying about your mother for a while; I'm glad you are taking steps to get her help."
"I can't help you, but I can direct you to someone who can."
The Correct Answer is B
Choice A reason: This statement is dismissive and lacks clinical and legal assessment. Competence cannot be determined over the phone or without a formal evaluation. It also assumes facts not in evidence.
Choice B reason: Competence is a legal determination made by a judge, not a medical provider. While clinicians can assess decision-making capacity, they cannot declare someone legally incompetent. This response is accurate and maintains professional boundaries.
Choice C reason: This statement implies agreement with the son’s concern without proper evaluation. It may be interpreted as bias and could compromise the therapeutic relationship or legal standing.
Choice D reason: While offering a referral is helpful, it does not address the core issue of legal authority. The PMHNP must clarify that competence is a legal matter, which is best done in option B.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: A score of 2 or more on the CAGE screening tool suggests clinically significant alcohol use and warrants further evaluation. The tool is designed to identify potential alcohol problems, and a score of 2 is the threshold for concern.
Choice B reason: A score of 0 or 1 is generally considered negative and may not require further evaluation unless other clinical signs are present. A score of 2 does not fall into this category.
Choice C reason: While a score of 2 may suggest mild alcohol use disorder, the CAGE tool itself does not diagnose severity. It is a screening instrument, and further assessment is needed to determine the level of disorder.
Choice D reason: This choice is incorrect because a score of 2 is not considered normal or indicative of no problems. It signals the need for further assessment.
Correct Answer is D
Explanation
Choice A reason: Generalized anxiety disorder is a risk factor for suicide, but it is less predictive than depression. Anxiety may contribute to distress, but without comorbid depression or other high-risk behaviors, the risk is moderate.
Choice B reason: Breakups can be emotionally distressing, especially in adolescence, but without signs of depression or suicidal ideation, the risk remains lower. Emotional resilience and support systems play a role in mitigating risk.
Choice C reason: LGBTQ+ youth face elevated suicide risk due to stigma, discrimination, and potential rejection. However, without additional risk factors like depression, suicidal ideation, or previous attempts, the risk is not as high as in someone with active depressive symptoms.
Choice D reason: Depression is the most significant predictor of suicide in adolescents. A recent diagnosis suggests active symptoms, and the presence of mood disorder increases the likelihood of suicidal ideation and behavior, making this individual the highest risk.
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