Author Question: A highly suspicious client who has delusions of persecution about being poisoned has refused all ... (Read 48 times)

mspears3 · **on:** Jul 19, 2018

A highly suspicious client who has delusions of persecution about being poisoned has refused all
hospital meals for 3 days. Assuming all interventions listed are possible, the one likely to be most
acceptable to the client is

a. allowing the client to contact a local restaurant to deliver his meals.
b. offering to taste each portion on the tray for the client.
c. allowing the client supervised access to lobby food machines.
d. providing tube feedings or total parenteral nutrition.

Question 2

A male adolescent was admitted to a psychiatric unit after a violent physical outburst. He asks the
nurse to promise to keep confidential a plan he has to kill his father. The nurse should respond by
saying

a. Those kinds of thoughts will make your hospitalization longer..
b. I can make that promise to you based on nurse-client privilege..
c. You really should share this thought with your psychiatrist..
d. I am obligated to share information with the treatment team..

at · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

C
The client who is delusional about his food being poisoned is likely to believe restaurant food might
still be poisoned and to say that the staff member tasting the food has taken an antidote to the poison
before tasting. Attempts to tube feed or give nutrition intravenously are seen as aggressive and
usually promote violence. Clients perceive foods in sealed containers, packages, or natural shells as
being safer.

Answer to Question 2

ANS: D
Breach of nurse-client confidentiality does not pose a legal dilemma for nurses in these
circumstances because a team approach to delivery of psychiatric care presumes communication of
client information to other staff members to develop treatment plans and outcome criteria.