The health care provider prescribes haloperidol 10 mg for a client with severe psychosis but the client refuses the medication. Which nursing action is appropriate?
Accept the client's decision and continue to maintain safety.
Obtain a discharge order for nonadherence to the medication regimen.
Restrain the client and give the medication intramuscularly.
Inform the client that refusing the medication means not getting any better.
The Correct Answer is A
Every individual has the right to refuse medical treatment, including medications, as long as they are competent to make that decision. It is essential to respect the client's autonomy and right to make decisions about their own health care. When a client refuses medication, the nurse should document the refusal, inform the healthcare provider, and explore the reasons behind the refusal if possible.
The other options are not appropriate for the following reasons:
B- Obtaining a discharge order for nonadherence: While it is essential to address nonadherence to medication, discharging the client solely for refusing the medication may not be the best course of action. Instead, the nurse should work collaboratively with the healthcare team to address the client's concerns and explore alternative treatment options.
C- Restraining the client and giving the medication intramuscularly: Restraints should only be used as a last resort when a client presents an imminent danger to themselves or others, and it must be done in accordance with facility policies and legal regulations. Using restraints to administer medication against a client's will is a violation of their rights and is not an appropriate response to medication refusal.
D-Informing the client that refusing the medication means not getting any better: This response may be seen as coercive and manipulative. It is not ethical to use fear or guilt to persuade a client to take medication against their will. Instead, the nurse should provide information about the potential benefits and risks of the medication and address the client's concerns or fears about the treatment. Ultimately, the decision to take the medication should be left to the client after they have been fully informed about their options.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The potential issue that the nursing staff and hospital may have to defend against in this scenario is A. "malpractice."
Explanation: Malpractice refers to a legal claim that can be made against healthcare professionals, including nurses and hospitals, when they fail to provide the standard of care expected in their profession, resulting in harm or injury to a patient. In this case, the lack of documentation that the client was assessed every hour as prescribed can be seen as a failure to meet the standard of care for a client with depression, especially one at risk for self-harm or suicide. If the client attempted suicide in the bathroom and sustained an injury, it could be argued that the lack of proper assessment and monitoring contributed to the client's harm, and this failure to provide appropriate care might be considered malpractice.
The other options, "battery," "false imprisonment," and "assault," do not directly relate to the situation described in the scenario:
B- Battery refers to the intentional harmful or offensive contact with a person without their consent. There is no indication that this occurred in the scenario.
C- False imprisonment refers to the unlawful restraint or restriction of a person's freedom of movement without proper justification. There is no indication of false imprisonment in the scenario.
D- Assault refers to the intentional act of threatening or causing fear of harm to another person. While the client did sustain an injury, there is no indication that it was due to an intentional act of assault in this scenario.
In summary, the potential issue of malpractice arises from the failure to properly assess and monitor a client at risk for self-harm, resulting in harm to the client. The nursing staff and hospital may have to defend against this claim if it is determined that they did not meet the standard of care expected in such a situation.
Correct Answer is C
Explanation
Option C demonstrates empathy and active listening. By acknowledging the client's emotions and expressing concern, the nurse creates a safe and supportive environment for the client to share their feelings. This response encourages the client to open up and express what they are going through, allowing the nurse to better understand the situation and provide appropriate care and support.
Options A and D are also empathetic but may not prompt the client to share their feelings or concerns as effectively as Option C.
Option B is not appropriate as it minimizes the client's emotions and may discourage them from expressing their feelings further.
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