A community mental health nurse has been working for 6 months to establish a trusting relationship
with a delusional and suspicious client. The client recently lost his job, stopped taking medication
because he had no money, and then decompensated.
The client states "only a traitor would make me
go to the hospital.". The nurse must decide whether to arrange for hospitalization or try to provide
medication so he can remain at home. The solution most in keeping with current practices in health
care calls for
a. hospitalization for up to a week.
b. negotiating a way to provide medication.
c. hospitalization until he is asymptomatic.
d. arranging for a bed in a homeless shelter.
ANS: B
Although no absolutely "right" answer exists, hospitalization will damage the nurse-client
relationship even if it provides an opportunity for rapid stabilization. If medication can be obtained
and restarted, the client can possibly be stabilized in the home setting, even if it takes a little longer.
Option D: A homeless shelter is inappropriate and unnecessary.
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