Comprehensive exams for Mental Health Q 113
Upon evaluation of the patient’s record, the nurse sees the admission was voluntary. Based on this data, the nurse expects which patient behavior?
A. Fearfulness regarding treatment measures.
B. Anger and aggressiveness directed toward others.
C. An understanding of the pathology and symptoms of the diagnosis.
D. A willingness to participate in the planning of the care and treatment plan.
Correct Answer: D. A willingness to participate in the planning of the care and treatment plan.
In general, patients seek voluntary admission. If a patient seeks voluntary admission, the most likely expectation is the patient will participate in the treatment program since they are actively seeking help. There are advantages and disadvantages of being a voluntary patient. The client has greater control and say over their life. For some people, this is very important and can improve wellbeing. The client has more freedom. They are able to leave the ward when they want, within reason. They should also have less restrictions placed on them, like having their mail checked on the ward or having access to their possessions.
Option A: The client can refuse treatment, including medication. This means that they can have more discussions with their care team, which leads to better understanding and they are more likely to take the medication. Dispel misconceptions and myths. These include catastrophic fears—often based on stereotypes—about coercive treatment and indefinite confinement. Clarifying what a patient can expect with voluntary admission with regard to the probable length of stay, participation in the milieu, visitation, and discharge planning is helpful for allaying such fears.
Option B: Anger and aggressiveness are more characteristic of involuntary admission. Maintain an empathic stance. For many patients, psychiatric admission evokes considerable distress. Remain sensitive to the situational concerns that typically arise, such as disruption to family and job responsibilities, insurance coverage, and whether there will be an outpatient plan in place at discharge.
Option C: The remaining options are not characteristics of this type of admission. Voluntary admission does not guarantee a patient’s understanding of their illness, only of their desire for help. Provide a compelling rationale. Stress the need for immediate, specialized, and intensive services. If the patient is receiving outpatient mental health care, advise him that these services have been unsuccessful in achieving safety and clinical stability and that it is not possible to quickly establish a modified outpatient plan or a day hospital placement that would meet his needs. For a patient who is not receiving outpatient care, explain that it is not feasible to implement a workable plan “from the ground up” in a timely manner.