Which client would a nurse determine to be the most likely candidate for involuntary commitment?
A teenager who refuses to participate in the planned therapy
A 24-year-old client who refuses to take the prescribed medication
A 45-year-old client who is homeless and has been diagnosed with a mental disorder
An elderly client who is confused, screaming obscenities in the street, and disturbing neighbors
The Correct Answer is D
Choice A reason:
A teenager who refuses to participate in the planned therapy does not necessarily meet the criteria for involuntary commitment. Refusal to participate in therapy can be addressed through other means, such as motivational interviewing or adjusting the treatment plan to better engage the client.
Choice B reason:
A 24-year-old client who refuses to take the prescribed medication also does not automatically qualify for involuntary commitment. Non-compliance with medication can be managed through education, support, and exploring the reasons behind the refusal. Involuntary commitment is typically reserved for situations where the client poses a danger to themselves or others.
Choice C reason:
A 45-year-old client who is homeless and has been diagnosed with a mental disorder may need support and resources, but homelessness and a mental health diagnosis alone do not justify involuntary commitment. The focus should be on providing housing and mental health services rather than involuntary hospitalization.
Choice D reason:
An elderly client who is confused, screaming obscenities in the street, and disturbing neighbors is exhibiting behavior that may pose a risk to themselves or others. This situation suggests a level of acute distress or potential danger that could warrant involuntary commitment to ensure the client’s safety and provide necessary treatment.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Choice A reason:
The 24-year-old only being the client would imply that the therapy session is focused solely on the individual issues of the 24-year-old. However, the context of the therapy session, which includes multiple family members, suggests that the focus is on addressing family dynamics and conflicts. Family therapy typically involves working with the entire family unit to improve relationships and resolve conflicts, rather than focusing on a single individual.
Choice B reason:
The entire family being the client is the correct answer because family therapy aims to address issues within the family system as a whole. By involving the 24-year-old, his sister, his mother, and the mother’s live-in boyfriend, the therapy session is designed to explore and resolve conflicts that affect the entire family. This approach recognizes that individual issues are often interconnected with family dynamics, and addressing these dynamics can lead to more effective and lasting solutions.
Choice C reason:
The 24-year-old and his mother being the clients would limit the scope of the therapy to the relationship between these two individuals. While this might address some aspects of the family conflict, it would not provide a comprehensive approach to resolving issues that involve other family members, such as the sister and the mother’s live-in boyfriend. Family therapy is most effective when all relevant members are included in the process.
Choice D reason:
The sister, mother, and 24-year-old being the clients would exclude the mother’s live-in boyfriend, who is also part of the family dynamic. Excluding any family member who is involved in the conflict can limit the effectiveness of the therapy. Family therapy aims to include all relevant members to fully understand and address the issues affecting the family as a whole. Therefore, this option is not as comprehensive as involving the entire family.
Correct Answer is C
Explanation
Choice A reason:
Delusions of grandeur are a type of delusion where an individual believes they have exceptional abilities, wealth, or fame. This is not the correct answer because the client’s reaction of thinking others are making fun of them does not align with the belief of having grandiose qualities. Delusions of grandeur typically involve an inflated sense of self-importance, which is not evident in the scenario described.
Choice B reason:
Loose association refers to a thought disorder where ideas are presented with little or no logical connection. This is not the correct answer because the client’s reaction is more about misinterpreting the actions of others rather than displaying disorganized thinking. Loose associations would manifest as speech that is difficult to follow due to the lack of coherent connections between thoughts.
Choice C reason:
Ideas of reference involve the belief that insignificant remarks, events, or objects in one’s environment have personal meaning or significance. This is the correct answer because the client believes that the group’s laughter is directed at them, interpreting it as a personal attack. This misinterpretation of external events is a hallmark of ideas of reference, which is a common symptom in schizophrenia.
Choice D reason:
Magical thinking involves believing that one’s thoughts, words, or actions can cause or prevent specific outcomes in a way that defies the laws of cause and effect. This is not the correct answer because the client’s reaction does not involve any belief in their own ability to influence events through supernatural means. Instead, the reaction is based on a misinterpretation of the group’s behavior.
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