Question of the Week – September 15, 2021

Rationale:

Rationale: Assisting clients and families to become aware of available community support systems is a role and responsibility of the nurse. Observing that the client has begun to be confined to his room makes it necessary for the nurse to intervene legally and ethically, so option 3 is not appropriate and is passive in terms of advocacy. Option 2 suggests committing the client to a nursing home and is a premature action on the nurse’s part. Although the data provided tell the nurse that this client requires nursing care, the nurse does not know the extent of the nursing care required. Option 1 is incorrect and judgmental.

Test-Taking Strategy: Note the strategic words, most important. Using principles related to the ethical and legal responsibility of the nurse and knowledge of the nurse’s role will direct you to the correct option. Option 1 is a non-therapeutic statement, option 2 is a premature action, and option 3 avoids the situation

Additional Info: 

Level of Cognitive Ability: Applying
Client Needs: Safe and Effective Care Environment
Integrated Process: Nursing Process—Implementation
Content Area: Developmental Stages: Early Adulthood to Later Adulthood
Health Problem: Mental Health: Abusive Behaviors
Priority Concepts: Ethics; Health Care Law