A nurse is caring for a group of clients at a mental health facility. Which of the following findings should the nurse identify as requiring completion of an incident report?

Choice A reason: A client with obsessive-compulsive disorder who washes their hands excessively is demonstrating a symptom of their psychiatric condition. While this behavior requires monitoring and therapeutic intervention, it does not constitute an incident that requires formal reporting. Incident reports are typically reserved for events that involve safety concerns, errors, or deviations from prescribed care. Choice B reason: A client who believes staff are poisoning their food is exhibiting paranoid delusions, which are common in certain psychiatric disorders such as schizophrenia. This finding requires therapeutic communication and psychiatric intervention, but it does not represent a procedural error or safety incident that necessitates an incident report. Instead, it should be documented in the client’s medical record and addressed through treatment planning. Choice C reason: A client with an eating disorder refusing meals is displaying a symptom of their illness. While refusal to eat is clinically significant and must be documented and addressed through nutritional and psychiatric interventions, it is not considered an incident requiring a formal report. Incident reports are not used to document expected manifestations of a disorder. Choice D reason: A client who did not receive their prescribed antipsychotic medication represents a medication error or omission. This is a deviation from the standard of care and poses a direct risk to the client’s health and safety. Failure to administer prescribed medication can lead to relapse, worsening of psychiatric symptoms, or acute destabilization. Because this is a preventable error, it requires completion of an incident report to ensure accountability, identify system failures, and implement corrective measures. This makes it the correct answer.