[Verified Answer]: A 13-year-old patient is refusing to…

A 13-year-old patient is refusing to attend school due to the requirement that they participate in gymnastics class and perform routines in front of their peers. The school refers them to a psychiatric nurse practitioner, and they are diagnosed with social anxiety disorder, started on low-dose sertraline (Zoloft) after informed consent, and referred to cognitive behavioral therapy with the consent of the parents and assent of the child. They report some suicidal ideation but do not have a current plan or intent to harm themself. A safety plan is developed with the child and parents. The nurse practitioner sends a copy of the evaluation and safety plan to the therapist who will be providing treatment. The child is hospitalized in a psychiatric unit 1 week later after trying to overdose on 20 tablets of sertraline (Zoloft). In reviewing the case, it is learned that the parents decided not to use the therapist who had been arranged through the nurse practitioner due to concerns about copayments. Instead, they elected to use the school counselor, who also happens to be the gymnastics teacher. Which of the following raises the most concern with regard to the child’s care?Boundary violationCompetencyCDual roleDInformed consent