A client was admitted to a psychiatric facility because he was ...

[rosent76]

A client was admitted to a psychiatric facility because he was found walking around the street naked and talking incoherently.
 
  He has no known next of kin and has been adjudicated incompetent for the first time following a thorough assessment. He refuses any antipsychotic medications but has not been harmful to himself or others. What action should the facility take?
  A) Initiate court proceedings to have a guardian named
  B) Convince the client of his need for care
  C) Continue custodial care
  D) Contact social services to find outpatient housing

Question 2

An adolescent client has refused to wash or change his clothes for several days. He smells and looks filthy.
 
  Three male staff members approach him to escort him to the shower. The client resists and becomes combative when staff members insist. They place the client in seclusion and restraints and tell him that they will release him when he is calm and willing to shower. The client's rights have been which of the following?
  A) Not been violated, because a degree of cleanliness is important
  B) Been violated, primarily because he should not be forced to shower
  C) Been violated, primarily because of the inappropriate use of restraints
  D) Not been violated, because his combative behavior warranted seclusion and restraint to protect others

[irishcancer18]

Answer to Question 1

Ans: A
Feedback:
When a client cannot give informed consent due to mental illness, health care providers must obtain substituted consent for necessary treatments or procedures. Substituted consent is authorization that another person gives on behalf of a client who needs a procedure or treatment but cannot provide such consent independently. Substituted consent can come from a court-appointed guardian or, in some instances, from the client's next of kin. If the client has not previously been adjudicated incompetent and if the law so permits and no next of kin are available to give substituted consent, the health care agency may initiate a court proceeding to appoint a guardian so that treatment professionals can carry out the procedure or treatment. The care team may or may not be able to convince the client that he needs care.

Answer to Question 2

Ans: C
Feedback:
Clients have the right to treatment in the least restrictive environment. No staff member can confine a person with mental illness who is not a threat to self or others. Nurses must assess a client's condition and status constantly so that health care professionals can initiate more or less restrictive treatment alternatives based on the client's evolving needs.