# A competent adult client says, "I am leaving now," despite the provider's recommendation to stay. What is the nurse's best action?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=394103&lang=en  
> language: en  
> subject: Advance Directives  
> category: MOC

## Question

A competent adult client says, "I am leaving now," despite the provider's recommendation to stay. What is the nurse's best action?

## Option

1. Tell the client leaving is illegal.
2. Assess understanding of risks and notify the provider. **✔ Correct answer**
3. Hide the client's clothes until the provider arrives.
4. Call security to restrain the client.

**Correct answer: 2**

## Explanation

A competent adult has the right to refuse treatment and leave, but the nurse should assess understanding, explain risks, notify the provider, and document according to policy. Detaining or restraining a competent client without legal basis is inappropriate. Safety planning and follow-up instructions should be offered.

## In-depth explanation

Clinical Judgment
Autonomy does not remove the nurse's duty to assess understanding and communicate risk.

Memory Tip
AMA: assess, inform, notify, document.

## Clinical scenario

Clinical Practice Guide
Against-medical-advice situations require capacity awareness, risk communication, provider notification, documentation, and harm-reduction discharge instructions.

Caution
Do not use coercion when the client is competent and not legally detained.

## Key concepts

- **Autonomy** — The client's right to make informed decisions about care.
- **Capacity** — The ability to understand information and make a health decision.
- **AMA** — Leaving or refusing care against medical advice.

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