There is one bed available on an inpatient psychiatric unit. For which client should a nurse advocate emergency commitment?

Question

There is one bed available on an inpatient psychiatric unit. For which client should a nurse advocate emergency commitment??  
A. An individual who is persistently mentally ill and evicted from an apartment  
B. An individual treated in the emergency department (ED) for generalized anxiety disorder  
C. An individual who is delusional and has a plan to kill his wife  
D. An individual who rates mood 4/10 and is participating in a no-harm safety plan

NursesPath · Accepted Answer

Correct Answer: (C)An individual who is delusional and has a plan to kill his wife. 
Rationale: The interpretation supported by the scenario is An individual who is delusional and has a plan to kill his wife.A. An individual who is persistently mentally ill and evicted from an apartmentThis might be chosen when the idea in “An individual who is persistently mentally ill and evicted from an apartment” addresses a different mechanism or priority than the one emphasized by the stem The wording does not track the stem’s main cue, so selecting it would shift the nurse away from the most precise interpretation or priority.B. An individual treated in the emergency department (ED) for generalized anxiety disorderThis would apply in a different scenario where the idea in “An individual treated in the emergency department (ED) for generalized anxiety disorder” addresses a different mechanism or priority than the one emphasized by the stem The wording does not track the stem’s main cue, so selecting it would shift the nurse away from the most precise interpretation or priority.C. An individual who is delusional and has a plan to kill his wifeThis matches the stem because The criteria for involuntary emergency commitment include danger to self and/or others. Of the four clients considered, the client who is delusional and has a plan to kill his wife meets this criterion as a danger to others. Need: Safe and Effective Care Environment The underlying principle in the stem is best addressed by choosing the response that is both specific to the cue provided and consistent with evidence-informed psychiatric nursing practice. From a nursing standpoint, this selection guides assessment and interventions toward what is most clinically meaningful in the moment—risk reduction, safety, accurate appraisal, and support for adaptive coping.D. An individual who rates mood 4/10 and is participating in a no-harm safety planThis could seem tempting if the idea in “An individual who rates mood 4/10 and is participating in a no-harm safety plan” addresses a different mechanism or priority than the one emphasized by the stem The wording does not track the stem’s main cue, so selecting it would shift the nurse away from the most precise interpretation or priority.ConclusionThe scenario is best handled by identifying what the nurse must interpret or prioritize first and then choosing the statement that fits that requirement with the least distortion. The distractors have surface appeal, but they do not align as tightly with the clinical cue embedded in the stem.

There is one bed available on an inpatient psychiatric unit. For which client should a nurse advocate emergency commitment?

The interpretation supported by the scenario is An individual who is delusional and has a plan to kill his wife.

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