A client made threats to harm his parents if they come too close to him. The parents called 911, and the client is now held involuntarily for a psychiatric evaluation. During this time of involuntary admission, the client retains all client rights except for which of the following?

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Right to freedom. The client, who made threats to harm his parents and is held involuntarily for a psychiatric evaluation, temporarily loses the right to freedom due to concerns for safety. This loss of freedom is necessary to ensure the safety of both the client and others. Confidentiality (option A) is a fundamental right in healthcare, including behavioral health nursing care. However, in situations where harm is imminent, the duty to warn supersedes confidentiality. Periodic treatment review (option C) is typically part of the involuntary admission process. It ensures that the client's treatment is regularly reviewed and adjusted as necessary, but it does not involve the right to freedom. Choice of providers (option D) is an important aspect of client-centered care, but in situations where safety is a concern, the priority is to ensure appropriate care and management of the client's condition. Educationally, understanding the limits to client rights in situations involving imminent harm is crucial for nurses working in behavioral health settings. It highlights the balance between respecting client autonomy and ensuring safety for all individuals involved. This knowledge is essential for providing effective and ethical care to clients in crisis situations.

Correct Answer: D

Rationale: The nurse respects the client's autonomy through client's rights, informed consent, and encouraging the client to make choices about his or her health care. The nurse has a duty to take actions that promote the client's health (beneficence) and that do not harm the client (nonmaleficence). The nurse must treat all clients fairly (justice), be truthful and honest (veracity), and honor all duties and commitments to clients and families (fidelity).

Correct Answer: A

Rationale: The nurse must balance patient confidentiality with the need for team communication. Option A respects the patient’s privacy while clarifying that staff collaboration is necessary for care, aligning with ethical and legal standards. Option B inaccurately suggests total secrecy, Option C delays clarity and erodes trust, and Option D blurs boundaries by suggesting a mutual problem-solving relationship.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) discuss the anger with a clinician during a supervisory session. This option is the most appropriate because it promotes self-awareness, reflection, and professional growth. It allows the nurse to explore their feelings in a safe and supportive environment, gain insight into the underlying causes of their emotions, and develop strategies to manage them effectively. Option A) suppress the angry feelings is not advisable as it can lead to emotional burnout, affect the quality of care provided, and potentially harm the nurse-patient relationship. Emotions that are suppressed tend to resurface in other ways and may impact the nurse's well-being. Option B) express the anger openly and directly with the patient is not recommended as it can escalate the situation, undermine trust, and compromise the therapeutic relationship. It is essential for nurses to maintain professionalism and emotional regulation in their interactions with patients. Option C) tell the nurse manager to assign the patient to another nurse is not the best course of action as it avoids addressing the underlying issue and does not promote professional growth or self-reflection. It is important for nurses to develop skills in managing challenging situations and emotions as part of their professional development. In an educational context, it is crucial for nurses to recognize and manage their emotions effectively to provide high-quality patient care. Discussing challenging emotions with supervisors or colleagues can help nurses process their feelings, gain new perspectives, and enhance their emotional intelligence. By engaging in reflective practices and seeking support when needed, nurses can improve their self-awareness and interpersonal skills, leading to better outcomes for both themselves and their patients.

Correct Answer: A

Rationale: The correct answer is A) boundary blurring. This statement by the nurse suggests a lack of professional boundaries as they are expressing a level of involvement and understanding that goes beyond what is appropriate in a therapeutic relationship. This blurring of boundaries can be detrimental to both the patient and the nurse's ability to provide effective care. Option B) sexual harassment is incorrect as there is no indication of any sexual behavior or advances in the nurse's statement. Option C) positive regard is also incorrect as the statement does not necessarily reflect a positive attitude towards the patient, but rather an over-identification with them. Option D) advocacy is incorrect because while the nurse may believe they are advocating for the patient, the statement actually demonstrates a lack of objectivity and professional distance. In an educational context, understanding the concept of boundary blurring is essential for nurses in providing effective and ethical care. It is important for nurses to maintain appropriate boundaries to ensure the therapeutic relationship remains focused on the patient's needs and not on the nurse's personal feelings or biases. Recognizing and addressing boundary issues is crucial for maintaining professionalism and promoting positive patient outcomes in behavioral health nursing care.