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Questions/Advanced Practice Skills/Q0 of 246
hardinformed consentdecisional capacitymaniatreatment refusalpatient autonomylithium
A 62-year-old man with bipolar I disorder is brought to the outpatient psychiatric clinic by his adult daughter during an acute manic episode. He is grandiose, pressured in speech, and sleeping only 2 hours per night. The PMHNP recommends restarting lithium, which the patient previously discontinued against medical advice. The patient refuses lithium, stating, 'Lithium dulls my creativity and I don't need it — I've never felt better in my life.' His daughter insists the PMHNP prescribe lithium. Which of the following is the most appropriate approach to informed consent in this situation?
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