Ch 6 Legal & Ethical Guidelines for Safe Practice

2 (Battery is the harmful, nonconsensual touching of another's person. Forceful administration of medication constitutes battery.)

A patient who presents no danger to him- or herself or to others is forced to take medication against his or her will. This situation represents 1 Assault 2 Battery 3 Defamation 4 Invasion of privacy

A nurse is concerned that an agency's policies are inadequate. Which understanding about the relationship between substandard institutional policies and individual nursing practice should guide nursing practice? a. Agency policies do not exempt an individual nurse of responsibility to practice according to 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. Faced with substandard policies, a nurse has a responsibility to inform the supervisor and discontinue patient care immediately. d. Interpretation of policies by the judicial system is rendered on an individual basis and therefore cannot be predicted.

A

A patient in alcohol rehabilitation reveals to the nurse, "I feel terrible guilt for sexually abusing my 6-year-old before I was admitted." Select the nurse's most important action. a. Anonymously report the abuse by phone to the local child protection agency. b. Reply, "I'm glad you feel comfortable talking to me about it." c. File a written report with the agency's ethics committee. d. Respect nurse-patient relationship confidentiality.

A

A person in the community asks, "Why aren't people with mental illness kept in state institutions anymore?" Select the nurse's best response. a. "Less restrictive settings are available now to care for individuals with mental illness." b. "There are fewer persons with mental illness, so less hospital beds are needed." c. "Most people with mental illness are still in psychiatric institutions." d. "Psychiatric institutions violated patients' rights."

A

A psychiatric nurse best applies the ethical principle of autonomy by: a. exploring alternative solutions with a patient, who then makes a choice. b. suggesting that two patients who were fighting be restricted to the unit. c. intervening when a self-mutilating patient attempts to harm self. d. staying with a patient demonstrating a high level of anxiety.

A

In order to release information to another health care facility or third party regarding a patient diagnosed with a mental illness, the nurse must obtain: a. a signed consent by the patient for release of information stating specific information to be released. b. a verbal consent for information release from the patient and the patient's guardian or next of kin. c. permission from members of the health care team who participate in treatment planning. d. approval from the attending psychiatrist to authorize the release of information.

A

Insurance will not pay for continued private hospitalization of a mentally ill patient. The family considers transferring the patient to a public hospital but expresses concern that the patient will not get any treatment if transferred. Select the nurse's most helpful reply. a. "By law, treatment must be provided. Hospitalization without treatment violates patients' rights." b. "All patients in public hospitals have the right to choose both a primary therapist and a primary nurse." c. "You have a justifiable concern because the right to treatment extends only to provision of food, shelter, and safety." d. "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."

A

1,2,3,4 (When a patient is incompetent, guardians may be chosen for the patient. A spouse gets the first preference, followed by adult children or adult grandchildren, parents, and then adult siblings. )

A nurse is caring for a mentally ill patient who cannot make an informed decision about medical care. The patient's family consists of the spouse, two adult children, a sibling, and parents. If no legal guardian had been prearranged, in which order would family members be chosen to act as the patient's legal guardian? Arrange the family members in the order of the selection. 1. Spouse 2. Adult children 3. Parents 4. Adult siblings

2 (Veracity means the duty to communicate truthfully, which is exhibited by educating the patient about all the possible side effects of the medicine. Justice is the duty performed to distribute patient care and resources equally to all patients. Dilemma is a result of conflict between two or more favorable and unfavorable actions. Beneficence is the duty to act for the benefit or good of the patient.)

A nurse is educating a patient about the possible side effects of the long-term use of a prescribed medication. Which ethical concept is the nurse applying? 1 Justice 2 Veracity 3 Dilemma 4 Beneficence

4 (According to the principle of fidelity, the nurse should use nursing skills to give instructions to patients on good hygiene and encourage patients to maintain it. According to the principle of justice, the nurse should pay equal attention to all the patients on the ward and should not favor any specific patient. According to the principle of veracity, the nurse should give complete information about medications. The nurse should not give false assurance that medications are safe. The nurse should indicate the side effects and the precautions which should be followed while administering the medications. According to the principle of autonomy, the nurse should respect the decision of the patient. The nurse should find other ways to promote sleep such as encouraging the patient to perform physical exercises. )

A patient with borderline personality disorder is treated with antipsychotic medications. The patient does not maintain good hygiene and avoids drinking warm milk at night. According to the principles of fidelity, which appropriate action does the nurse adopt while caring for the patient? 1 The nurse gives maximum attention to the patient. 2 The nurse informs that the medications are very safe. 3 The nurse very firmly instructs the patient to drink milk. 4 The nurse gives instructions to the patient to maintain good hygiene.

3 (Confidentiality extends to death and beyond. Nurses should never disclose information after the death of a patient that they would have kept confidential while the patient was alive.)

After the death of a patient, what rule of confidentiality should be followed by nurses who provided care for the individual? 1 Confidentiality is now reserved to the immediate family. 2 Only human immunodeficiency virus (HIV) status continues to be protected and privileged. 3 Nothing may be disclosed that would have been kept confidential before death. 4 The nurse must confer with the next of kin before divulging confidential, sensitive information.

3 (Patients have the legal right to self-determination as well as an ethical right to autonomy. Patients have the right to receive treatment and the right to refuse it, including medication in most instances. The nurse should stop the procedure and discuss the patient's feelings before taking any other action. Patients may withhold or withdraw consent at any time.)

As a community mental health nurse prepares to administer a regularly scheduled antipsychotic medication injection to a patient diagnosed with schizophrenia, the patient stands and says, "I'm leaving. I don't want anymore of that medicine." Which initial action by the nurse is appropriate? 1 Postpone the injection and reschedule the patient's visit in one week. 2 Confer with the pharmacist about preparing the medication in oral form. 3 Stop with the procedure and say to the patient, "I'd like to talk with you about how you are feeling about this matter." 4 Say to the patient, "You have been taking this medication for two years and have never had any problems with it in the past."

A nurse finds a psychiatric advance directive in the medical record of a patient experiencing psychosis. The directive was executed during a period when the patient was stable and competent. The nurse should: a. review the directive with the patient to ensure it is current. b. ensure that the directive is respected in treatment planning. c. consider the directive only if there is a cardiac or respiratory arrest. d. encourage the patient to revise the directive in light of the current health problem.

B

A nurse prepares to administer a scheduled injection of haloperidol decanoate (Haldol depot) to an outpatient 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 action. a. Assemble other staff for a show of force and proceed with the injection, using restraint if necessary. b. Stop the medication administration procedure and say to the patient, "Tell me more about the side effects you've been having." c. Proceed with the injection but explain to the patient that there are medications that will help reduce the unpleasant side effects. d. 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 delaying next month's dose."

B

A patient diagnosed with schizophrenia believes a local minister stirred evil spirits. The patient threatens to bomb a local church. The psychiatrist notifies the minister. Select the answer with the correct rationale. The psychiatrist: 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.

B

A patient experiencing psychosis asks a psychiatric technician, "What's the matter with me?" The technician replies, "Nothing is wrong with you. You just need to use some self-control." The nurse who overheard the exchange should take action based on: a. the technician's unauthorized disclosure of confidential clinical information. b. violation of the patient's right to be treated with dignity and respect. c. the nurse's obligation to report caregiver negligence. d. the patient's right to social interaction.

B

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. a. "You are right. Federal law requires me to keep clinical information private." b. "I am obligated to share that information with the treatment team." c. "Those kinds of thoughts will make your hospitalization longer." d. "You should share this thought with your psychiatrist."

B

An aide in a psychiatric hospital says to the nurse, "We don't have time every day to help each patient complete a menu selection. Let's tell dietary to prepare popular choices and send them to our unit." Select the nurse's best response. a. "Thanks for the suggestion, but that idea may not work because so many patients take MAOI (monoamine oxidase inhibitor) antidepressants." b. "Thanks for the idea, but it's important to treat patients as individuals. Giving choices is one way we can respect patients' individuality." c. "Thank you for the suggestion, but the patients' bill of rights requires us to allow patients to select their own diet." d. "Thank you. That is a very good idea. It will make meal preparation easier for the dietary department."

B

Select the example of a tort. a. The plan of care for a patient is not completed within 24 hours of the patient's admission. b. A nurse gives a PRN dose of an antipsychotic drug to an agitated patient because the unit is short-staffed. c. An advanced practice nurse recommends hospitalization for a patient who is dangerous to self and others. d. A patient's admission status changed from involuntary to voluntary after the patient's hallucinations subside.

B

Two hospitalized patients fight whenever they are together. During a team meeting, a nurse asserts that safety is of paramount importance, so treatment plans should call for both patients to be secluded to keep them from injuring each other. This assertion: a. reinforces the autonomy of the two patients. b. violates the civil rights of both patients. c. represents the intentional tort of battery. d. correctly places emphasis on safety.

B

Which action by a nurse constitutes a breach of a patient's right to privacy? a. Documenting the patient's daily behavior during hospitalization b. Releasing information to the patient's employer without consent c. Discussing the patient's history with other staff during care planning d. Asking family to share information about a patient's pre-hospitalization behavior

B

Which nursing intervention demonstrates false imprisonment? 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 and attention-seeking much of the day. 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. The nurse rushes after the patient and convinces the patient to return to the unit. d. An involuntarily hospitalized patient with homicidal ideation attempts to leave the facility. A nurse calls the security team and uses established protocols to prevent the patient from leaving.

B

A new antidepressant is prescribed for an elderly patient with major depression, but the dose is more than the usual geriatric dose. The nurse should: a. consult a reliable drug reference. b. teach the patient about possible side effects and adverse effects. c. withhold the medication and confer with the health care provider. d. encourage the patient to increase oral fluids to reduce drug concentration.

C

A voluntarily hospitalized patient tells the nurse, "Get me the forms for discharge. I want to leave now." Select the nurse's best response. a. "I will get the forms for you right now and bring them to your room." b. "Since you signed your consent for treatment, you may leave if you desire." c. "I will get them for you, but let's talk about your decision to leave treatment." d. "I cannot give you those forms without your health care provider's permission."

C

After leaving work, a nurse realizes documentation of administration of a PRN medication was omitted. This off-duty nurse phones the nurse on duty and says, "Please document administration of the medication for me. My password is alpha1." The nurse receiving the call should: a. fulfill the request promptly. b. document the caller's password. c. refer the matter to the charge nurse to resolve. d. report the request to the patient's health care provider.

C

The intervention that will be most effective in preventing a nurse from making decisions that will lead to legal difficulties is a. asking a peer to review nursing intervention related decisions. b. balancing the rights of the client and the rights of society. c. maintaining currency in state laws affecting nursing practice. d. seeking value clarification about fundamental ethical principles.

C

Which individual diagnosed with a mental illness may need involuntary hospitalization? An individual: a. who has a panic attack after her child gets lost in a shopping mall b. with visions of demons emerging from cemetery plots throughout the community c. who takes 38 acetaminophen tablets after the person's stock portfolio becomes worthless d. diagnosed with major depression who stops taking prescribed antidepressant medication

C

What is the legal significance of a nurse's action when a patient verbally refuses medication and the nurse gives the medication over the patient's objection? The nurse: a. has been negligent. b. committed malpractice. c. fulfilled the standard of care. d. can be charged with battery.

D

In which situations would a nurse have the duty to intervene and report? Select all that apply. a. A peer has difficulty writing measurable outcomes. b. A health care provider gives a telephone order for medication. c. A peer tries to provide patient care in an alcohol-impaired state. d. A team member violates relationship boundaries with a patient. e. A patient refuses medication prescribed by a licensed health care provider.

C, D

Which actions violate the civil rights of a psychiatric patient? The nurse: (select all that apply) a. performs mouth checks after overhearing a patient say, "I've been spitting out my medication." b. begins suicide precautions before a patient is assessed by the health care provider. c. opens and reads a letter a patient left at the nurse's station to be mailed. d. places a patient's expensive watch in the hospital business office safe. e. restrains a patient who uses profanity when speaking to the nurse.

C, E

A family member of a patient with delusions of persecution asks the nurse, "Are there any circumstances under which the treatment team is justified in violating a patient's right to confidentiality?" The nurse should reply that confidentiality may be breached: 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.

D

A newly admitted acutely psychotic patient is a private patient of the medical director and a private-pay patient. To whom does the psychiatric nurse assigned to the patient owe the duty of care? a. Medical director b. Hospital c. Profession d. Patient

D

A patient with psychosis became aggressive, struck another patient, and required seclusion. Select the best documentation. a. Patient struck another patient who attempted to leave day room to go to bathroom. Seclusion necessary at 1415. Plan: Maintain seclusion for 8 hours and keep these two patients away from each other for 24 hours. b. Seclusion ordered by physician at 1415 after command hallucinations told the patient to hit another patient. Careful monitoring of patient maintained during period of seclusion. c. Seclusion ordered by MD for aggressive behavior. Begun at 1415. Maintained for 2 hours without incident. Outcome: Patient calmer and apologized for outburst. d. Patient pacing, shouting. Haloperidol 5 mg given PO at 1300. No effect by 1315. At 1415 patient yelled, "I'll punch anyone who gets near me," and struck another patient with fist. Physically placed in seclusion at 1420. Seclusion order obtained from MD at 1430.

D

In a team meeting a nurse says, "I'm concerned about whether we are behaving ethically by using restraint to prevent one patient from self-mutilation, while the care plan for another self-mutilating patient requires one-on-one supervision." Which ethical principle most clearly applies to this situation? a. Beneficence b. Autonomy c. Fidelity d. Justice

D

Which documentation of a patient's behavior best demonstrates a nurse's observations? a. Isolates self from others. Frequently fell asleep during group. Vital signs stable. b. Calmer; more cooperative. Participated actively in group. No evidence of psychotic thinking. c. Appeared to hallucinate. Frequently increased volume on television, causing conflict with others. d. Wore four layers of clothing. States, "I need protection from evil bacteria trying to pierce my skin."

D

Which individual with mental illness may need emergency or involuntary admission? The individual who: a. resumes using heroin while still taking naltrexone (ReVia). b. reports hearing angels playing harps during thunderstorms. c. does not keep an outpatient appointment with the mental health nurse. d. throws a heavy plate at a waiter at the direction of command hallucinations.

D

Which patient meets criteria for involuntary hospitalization for psychiatric treatment? The patient who: a. is noncompliant with the treatment regimen. b. fraudulently files for bankruptcy. c. sold and distributed illegal drugs. d. threatens to harm self and others.

D

3 (The least restrictive alternative doctrine mandates that the least drastic means be taken to achieve a specific purpose. Outpatient counseling is the least restrictive intervention. With the person's agreement, this intervention will provide services. Temporary admission is used for people who are so confused or demented they cannot make decisions on their own or are so ill they need emergency admission. Contacting the person's prior employer violates confidentiality. Involuntary admission is necessary when a person is in need of psychiatric treatment, presents a danger to self or others, or is unable to meet his or her own basic needs. This scenario does not fulfill those criteria.)

Family members are worried about a depressed relative whose job recently was terminated. The family requests hospitalization of this person. An assessment reveals the person is moderately depressed but without intent or thoughts about self-harm. Which action demonstrates application of the least restrictive alternative doctrine? 1 Hospitalize the person as a temporary admission. 2 Contact with the person's prior employer for additional information. 3 With the person's agreement, arrange for immediate outpatient counseling. 4 Admit the person involuntarily to an inpatient mental health treatment unit.

1 (The nurse ensures that the patient sign the informed consent form after being explained about the trial in detail. If the patient has impaired thoughts and memory, the nurse informs the patient's guardians about the risks and benefits of the treatment. The nurse informs the patient or their guardians about the alternative treatment options. The patient has the right to choose the appropriate treatment. The nurse does not give false assurance about the new drug being 100% safe, as no medication is 100% safe. The nurse indicates the probability of side effects and the success rate of the treatment. The patient has the right to refuse the treatment and can withdraw from the study at any time.)

For conducting clinical trials of a new drug, the nurse has been assigned to perform the initial screening to select the Alzheimer's patients with severe impairment of thoughts and memory. As the patients' advocate, the nurse ensures that patients are well-informed before signing the informed consent. Which information should be provided to the patients before obtaining informed consent? 1 The risk and benefits of the treatment 2 The unavailability of alternative treatment options 3 The 100% safety of the treatment for use 4 The inability to withdraw from the study after enrolling his or her name

2 (The legal context of care is important for all psychiatric nurses because it focuses concern on the rights of patients and the quality of care they receive. However, laws vary from state to state, and psychiatric nurses must become familiar with the laws of the state in which they practice. This knowledge enhances the freedom of both the nurse and the patient and ultimately results in legally appropriate care. Although patient education is an appropriate intervention, it cannot be done without first being knowledgeable of the patient's legal rights. Though an appropriate intervention, participating on the health care team will not necessarily assure the preservation of patient rights but rather holistic care. Though referring legal issues may be correct in some instances, it does not remove the nurse from being responsible for advocating for the patient.)

How can the nurse best assure that a psychiatric patient's rights are respected and preserved? 1 Educating each patient as to his or her legally protected rights 2 Being knowledgeable of the state laws that regulate patient rights 3 Participating as a member of the patient's multidisciplinary health care team 4 Referring all issues of a legal nature to the appropriate facility committee

3 (False imprisonment is the arbitrary holding of a patient against his or her will. When seclusion is prescribed, it is not invoked arbitrarily, but after other less restrictive measures have failed. If the patient is secluded without medical prescription, the measure cannot be proven as instituted for medically sound reasons.)

If a patient is placed in seclusion and held there for 24 hours without a written prescription or examination by a health care provider, the patient has experienced 1 Battery 2 Defamation of character 3 False imprisonment 4 Assault

3 (Issues such as sexual harassment by medical professionals is an example of abuse of the therapist-patient relationship in psychiatric care. Such patients may develop homicidal or suicidal tendencies. After the report is made, the nurse should listen to the patient attentively in order to assess the patient's mental status. The nurse will then inform the family members about their roles in caring for the patient to help the patient recover. This helps in providing moral support to the patient for effective crisis management. A nurse may or may not have witnessed the incident that the patient is reporting. If it was witnessed or reported by other staff, the nurse has a professional duty to immediately submit documented evidence of the incident to the authorities.)

In the course of psychiatric hospitalization, a patient reports an incident of sexual harassment from a health care professional. What should be the initial step taken by the nurse in caring for this patient? 1 Witness the incident that took place. 2 Report the incident to the authorities. 3 Listen to the patient with utmost attention. 4 Motivate family members to care for the patient.

4 (Civil rights are not lost because of hospitalization for mental illness.)

The civil rights of persons with mental illness who are hospitalized for treatment are 1 The same as those for any other citizen 2 Altered to prevent use of poor judgment 3 Always ensured by appointment of a guardian 4 Limited to provision of humane treatment

2 (The least restrictive alternative doctrine is described as using the least drastic means of achieving a specific goal. By doing the actions described the nurse possibly is preventing the more restrictive setting of seclusion or restraints. Writ of habeas corpus is a legal term meaning a written order "to free the person." Veracity is one of the five ethical principles or guidelines. Bioethics refers to ethics in a health care setting.)

The nurse is working on an inpatient psychiatric unit and caring for the patient, who is becoming agitated. The nurse speaks with the patient one to one in a private setting to find out the reason for the agitation, and then assists the patient with ways to calm down, possibly including as-needed medication to prevent further escalation of the patient's agitation, which could lead to seclusion or restraints. The nurse is making care decisions based on what concept? 1 Writ of habeas corpus 2 Least restrictive alternative doctrine 3 Veracity 4 Bioethics

1 (Abandonment happens when the nurse fails to ensure patient's safety despite knowing the risk of harm. If the patient has suicidal tendencies, and the nurse does not force the patient to seek treatment, the patient may commit suicide. This action amounts to abandonment of the patient. To prevent abandonment, the nurse should enlist the assistance of law for involuntary admission of the patient. This helps to prevent self-injury in the patient. Alternatively, the nurse may ensure safety of the patient's environment and ensure that the family members are informed of the patient's suicidal tendencies. )

The nurse pays a home visit to a mentally ill patient and finds that the patient has suicidal tendencies but refuses to seek treatment. Which nursing action may give rise to an abandonment issue? 1 The nurse respects the patient's right and does not force the patient to seek treatment. 2 The nurse enlists the assistance of law for involuntary admission of the patient. 3 The nurse ensures that the patient is in a safe environment with minimal risk for injury. 4 The nurse informs the family members and advises them to keep the patient safe.

4 (Involuntary admission implies that the patient did not consent to the admission. The usual reasons for admitting a patient over his or her objection is if the patient presents a clear danger to self or others or is unable to meet even basic needs independently.)

What assumption can be made about the patient who has been admitted on an involuntary basis? 1 The patient can be discharged from the unit on demand. 2 For the first 48 hours, the patient can be given medication over objection. 3 The patient has agreed to fully participate in treatment and care planning. 4 The patient is a danger to self or others or is unable to meet basic needs.

3 (Autonomy is the duty to respect patients' rights to take their own decisions about medical care. Ordering the patient to take medication is not an appropriate action as the nurse should acknowledge the patient's right to make a decision. Convincing the patient to take medication or asking the family to give medications to the patient does not reflect autonomy.)

When caring for a patient, the nurse considers the concept of autonomy. What action should the nurse perform to follow this concept? 1 Order the patient to take medication. 2 Convince the patient to take medication. 3 Respect the patient's decision about medication. 4 Ask the family to administer medication to the patient

1 (Medicare is an agency which provides federal funding to patients from 18 to 65 years old. These patients include those who have physical or mental limitations that restrict their ability to carry out normal activities or to protect themselves. Medicare provides funding to patients who are victims of elder abuse, neglect, and those who have substance abuse. It does not provide funding to patients younger than 18 years old.)

Which age group of patients can receive funds for treatment from Medicare? 1 18 to 65 years 2 1 month to 2 years 3 14 to 15 years 4 2 to 10 years

1 (Based on Rogers v. Okin, a guardian can make the treatment decisions for a patient who has impaired decision-making ability. The mentally ill patient has the right to make treatment decisions. The health care professionals must include the patient while making treatment decisions, as it enhances the patient's self-esteem. The decision of protecting the patient's rights by judicial determination of competency was made by federal court of appeals after the Rogers v. Okin case. If a patient is aggressive and has the potential to cause physical harm to others, the nurse can forcibly administer medications to the patient to prevent the patient from harming others.)

Which decision regarding the treatment and care of patients with severe mental illness was made by the federal district court in the Rogers v. Okin case? 1 A guardian can make treatment decisions for a patient with impaired decision-making. 2 A mentally ill patient does not have the right and competency to make treatment decisions. 3 A patient's rights must be protected by judicial determination of competency. 4 Forcible administration of medications to patients who may harm others must be avoided.

3 (Discussing a patient's information in public places where it may be overheard is a violation of a patient's confidentiality. Giving another nurse a report on the patient, calling the health care provider to obtain a list of current medications, and giving another nurse discharge information describe appropriate interactions for patient continuity of care and support of the treatment plan by the health care team.)

Which of the following scenarios describe a Health Insurance Portability and Accountability Act (HIPAA) violation? 1 The emergency department nurse gives a report to the nurse on the intensive care unit regarding a patient who is being admitted. 2 A nurse on the medical-surgical floor calls the patient's primary health care provider to obtain a list of current medications. 3 A nurse on the cardiac unit gives a report to the nurse on the step-down unit regarding the patient he or she will be transferring while they are walking in the hospital hallway 4 A nurse on the psychiatric unit gives discharge information to the counseling office where his or her patient will be going to outpatient treatment after discharge

1 (Against medical advice discharges are sometimes used when the patient does not agree with the health care provider, as long as the patient is not a danger to himself or herself or to others. The patient with dementia and the patient who is actively suicidal would pose a safety risk and would not be allowed to be discharged AMA. A patient who wishes to stay in the hospital can make that decision; a family member's opinion does not impact an AMA discharge.)

Which patient may be an appropriate candidate for a release from hospitalization known as against medical advice (AMA)? 1 A 37-year-old patient hospitalized for six days; the health care provider feels one more day would benefit the patient, but the patient doesn't agree and wishes to be discharged 2 A 75-year-old patient with dementia who demands to be allowed to go back to his or her own home 3 A 21-year-old actively suicidal patient on the psychiatric unit who wants to be discharged to home and do outpatient counseling 4 A 32-year-old female patient who wishes to stay in the hospital but whose husband demands that she be discharged into his care