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Legal And Ethical Basis For Practice

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Question 1
Free
Multiple Choice

A psychiatric nurse best implements the ethical principle of autonomy when he or she:

Choose correct answer/s
A

intervenes when a self-mutilating patient attempts to harm self.

B

stays with a patient who is demonstrating a high level of anxiety.

C

suggests that two patients who are fighting be restricted to the unit.

D

explores alternative solutions with a patient, who then makes a choice.

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Question 2
Free
Multiple Choice

Which action by a psychiatric nurse best supports a patient's right to be treated with dignity and respect?

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A

Consistently addressing a patient by title and surname.

B

Strongly encouraging a patient to participate in the unit milieu.

C

Discussing a patient's condition with another health care provider in the elevator.

D

Informing a treatment team that a patient is too drowsy to participate in care planning.

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Question 3
Free
Multiple Choice

Two hospitalized patients fight when they are in the same room. During a team meeting, a nurse asserts that safety is of paramount importance and therefore the treatment plans should call for both patients to be secluded to prevent them from injuring each other. This assertion:

Choose correct answer/s
A

reveals that the nurse values the principle of justice.

B

reinforces the autonomy of the two patients.

C

violates the civil rights of the two patients.

D

represents the intentional tort of battery.

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Question 4
Free
Multiple Choice

In a team meeting, a nurse says, "I'm concerned whether we are behaving ethically by using restraint to prevent one patient from self-mutilation while the care plan for another patient who has also self-mutilated calls for one-on-one supervision." Which ethical principle most clearly applies to this situation?

Choose correct answer/s
A

Beneficence

B

Autonomy

C

Fidelity

D

Justice

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Question 5
Free
Multiple Choice

Which scenario is an example of a tort?

Choose correct answer/s
A

The primary nurse does not complete the plan of care for a patient within 24 hours of the patient's admission.

B

An advanced practice nurse recommends that a patient who is dangerous to self and others be voluntarily hospitalized.

C

A patient's admission status is changed from involuntary to voluntary after the patient's hallucinations subside.

D

A nurse gives an as-needed dose of an antipsychotic drug to a patient to prevent violence because a unit is short staffed.

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Question 6
Multiple Choice

A nurse's neighbor asks, "Why aren't people with mental illness kept in state institutions anymore?" What is the nurse's best response?

Choose correct answer/s
A
"Many people are still in psychiatric institutions. Inpatient care is needed because many people who are mentally ill are violent."
B
"Less restrictive settings are now available to care for individuals with mental illness."
C
"Our nation has fewer persons with mental illness; therefore fewer hospital beds are needed."
D
"Psychiatric institutions are no longer popular as a consequence of negative stories in the press."
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Question 7
Multiple Choice

Which nursing intervention demonstrates false imprisonment?

Choose correct answer/s
A
A confused and combative patient says, "I'm getting out of here and no one can stop me." The nurse restrains this patient without a health care provider's order and then promptly obtains an order.
B
A patient has been irritating, seeking the attention of nurses most of the day. Now a nurse escorts the patient down the hall, saying, "Stay in your room or you'll be put in seclusion."
C
An involuntarily hospitalized patient with suicidal ideation runs out of the psychiatric unit. A nurse rushes after the patient and convinces the patient to return to the unit.
D
An involuntarily hospitalized patient with suicidal ideation attempts to leave the unit. A nurse calls the security team and uses established protocols to prevent the patient from leaving.
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Question 8
Multiple Choice

A patient should be considered for involuntary commitment for psychiatric care when he or she:

Choose correct answer/s
A
is noncompliant with the treatment regimen.
B
sells and distributes illegal drugs.
C
threatens to harm self and others.
D
fraudulently files for bankruptcy.
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Question 9
Multiple Choice

A nurse at the mental health center prepares to administer a scheduled injection of haloperidol decanoate (Haldol depot) to a patient with schizophrenia. As the nurse swabs the site, the patient shouts, "Stop! I don't want to take that medicine anymore. I hate the side effects." Select the nurse's best initial action.

Choose correct answer/s
A
Stop the medication administration procedure and say to the patient, "Tell me more about the side effects you've been having."
B
Say to the patient, "Since I've already drawn the medication in the syringe, I'm required to give it, but let's talk to the doctor about skipping next month's dose."
C
Proceed with the injection but explain to the patient that other medications are available that may help reduce the unpleasant side effects.
D
Notify other staff members to report to the room for a show of force and proceed with the injection, using restraint if necessary.
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Question 10
Multiple Choice

Several nurses are concerned that agency policies related to restraint and seclusion are inadequate. Which statement about the relationship of substandard institutional policies and individual nursing practice should guide nursing practice?

Choose correct answer/s
A
The policies do not absolve an individual nurse of the responsibility to practice according to the professional standards of nursing care.
B
Agency policies are the legal standard by which a professional nurse must act and therefore override other standards of care.
C
In an institution with substandard policies, the nurse has a responsibility to inform the supervisor and leave the premises.
D
Interpretation of policies by the judicial system is rendered on an individual basis and therefore cannot be predicted.
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Question 11
Multiple Choice

A newly admitted patient who is acutely psychotic is a private patient of the senior psychiatrist. To whom does the psychiatric nurse who is assigned to this patient owe the duty of care?

Choose correct answer/s
A
Health care provider
B
Profession
C
Hospital
D
Patient
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Question 12
Multiple Choice

An example of a breach of a patient's right to privacy occurs when a nurse:

Choose correct answer/s
A
asks a family to share information about a patient's prehospitalization behavior.
B
discusses the patient's history with other staff members during care planning.
C
documents the patient's daily behaviors during hospitalization.
D
releases information to the patient's employer without consent.
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Question 13
Multiple Choice

An adolescent hospitalized after a violent physical outburst tells the nurse, "I'm going to kill my father, but you can't tell anyone." Select the nurse's best response.

Choose correct answer/s
A
"You're right. Federal law requires me to keep that information private."
B
"Those kinds of thoughts will make your hospitalization longer."
C
"You really should share this thought with your psychiatrist."
D
"I am required to share information with the treatment team."
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Question 14
Multiple Choice

A voluntarily hospitalized patient tells the nurse, "Get me the forms for discharge against medical advice so I can leave now." What is the nurse's best initial response?

Choose correct answer/s
A
"I can't give you those forms without your health care provider's knowledge."
B
"I will get them for you, but let's talk about your decision to leave treatment."
C
"Since you signed your consent for treatment, you may leave if you desire."
D
"I'll get the forms for you right now and bring them to your room."
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Question 15
Multiple Choice

The family of a patient whose insurance will not pay for continuing hospitalization considers transferring the patient to a public psychiatric hospital. The family expresses concern that the patient will "never get any treatment." Which reply by the nurse would be most helpful?

Choose correct answer/s
A
"Under the law, treatment must be provided. Hospitalization without treatment violates patients' rights."
B
"That's a justifiable concern because the right to treatment extends only to the provision of food, shelter, and safety."
C
"Much will depend on other patients, because the right to treatment for a psychotic patient takes precedence over the right to treatment of a patient who is stable."
D
"All patients in public hospitals have the right to choose both a primary therapist and a primary nurse."
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Question 16
Multiple Choice

Which individual with a mental illness may need emergency or involuntary hospitalization for mental illness? The individual who:

Choose correct answer/s
A
resumes using heroin while still taking methadone.
B
reports hearing angels playing harps during thunderstorms.
C
throws a heavy plate at a waiter at the direction of command hallucinations.
D
does not show up for an outpatient appointment with the mental health nurse.
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Question 17
Multiple Choice

A patient being treated in an alcohol rehabilitation unit reveals to the nurse, "I feel terrible guilt for sexually abusing my 6-year-old child before I was admitted." Based on state and federal law, the best action for the nurse to take is to:

Choose correct answer/s
A
anonymously report the abuse by telephone to the local child abuse hotline.
B
reply, "I'm glad you feel comfortable talking to me about it."
C
respect the nurse-patient relationship of confidentiality.
D
file a written report on the agency letterhead.
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Question 18
Multiple Choice

The spouse of a patient who has delusions asks the nurse, "Are there any circumstances under which the treatment team is justified in violating the patient's right to confidentiality?" The nurse must reply that confidentiality may be breached:

Choose correct answer/s
A
under no circumstances.
B
at the discretion of the psychiatrist.
C
when questions are asked by law enforcement.
D
if the patient threatens the life of another person.
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Question 19
Multiple Choice

A nurse cares for an older adult patient admitted for treatment of depression. The health care provider prescribes an antidepressant medication, but the dose is more than the usual adult dose. The nurse should:

Choose correct answer/s
A
implement the order.
B
consult a drug reference.
C
give the usual geriatric dosage.
D
hold the medication and consult the health care provider.
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Question 20
Multiple Choice

A patient diagnosed with schizophrenia believes evil spirits are being summoned by a local minister and verbally threatens to bomb a local church. The psychiatrist notifies the minister. The psychiatrist has:

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A
released information without proper authorization.
B
demonstrated the duty to warn and protect.
C
violated the patient's confidentiality.
D
avoided charges of malpractice.
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