A nurse is planning care for a client who has chronic substance use disorder. Which of the following is the most therapeutic response to help the client cease alcohol consumption?
"Let me tell you how I struggled to stop drinking whiskey over the years, but finally succeeded."
"You have stopped drinking, haven't you?"
"The physician has ordered you to stop drinking all alcoholic beverages. Are you going to make us happy?"
"Let's work together on a plan that includes medication, group support, and counseling."
The Correct Answer is D
Rationale:
A. Sharing personal experiences can be supportive, but it may not be the most therapeutic or professional approach in this situation.
B. This question is leading and doesn't encourage an open dialogue. It may also induce guilt or defensiveness in the client.
C. This statement is authoritative and may come across as coercive, which can be counterproductive in encouraging the client to take responsibility for their recovery.
D. Collaborating with the client on a comprehensive plan that includes medication, group support, and counseling is a therapeutic approach that empowers the client to actively participate in their recovery, offering them the best chance of success.
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Correct Answer is D
Explanation
Rationale:
A. Beneficence refers to actions that promote the well-being of others, which is not the primary focus of this scenario.
B. Nonmaleficence involves the duty to do no harm, which is important in all nursing actions but is not specifically demonstrated here.
C. Justice involves fairness and equality in providing care, which is not the central ethical principle in this context.
D. Autonomy refers to respecting a client's right to make their own decisions. By asking the client to choose between morning or afternoon group therapy, the nurse is supporting the client's autonomy by allowing them to make decisions about their care.
Correct Answer is B
Explanation
Rationale:
A. Offering reassurance without addressing the client's immediate concerns may minimize the severity of the situation and delay necessary interventions.
B. Asking the client about the lethality of their plan is crucial for assessing the level of risk and determining the urgency of the intervention required. This information is essential for planning appropriate care and ensuring the client's safety.
C. Allowing the client to be alone is not appropriate when they have expressed suicidal intent, as this could increase the risk of self-harm.
D. Encouraging the client to focus on the positive aspects of life may be part of long-term therapy, but in the acute phase, the priority is to assess and address the immediate risk of suicide.