Chap 9-Legal & Ethical Issues
A physician would like to include a client with schizophrenia in a research study testing a new medication. The nurse's obligation is to do what?
Assess the client's legal capacity when that client is asked to give consent.
A new graduate nurse demonstrates understanding that developing and maintaining competency is crucial to giving adequate and safe care to all psychiatric clients. To whom would the new graduate assign this responsibility for maintaining this standard of professional performance?
The graduate nurse
Which role of the nurse-client relationship is being exhibited when the nurse informs the client and then supports him or her in whatever decision he or she makes?
Advocate
A nurse working on a psychiatric unit receives a telephone call from the employer of one of the clients on the unit. The employer asks to be sent a copy of the client's latest laboratory work and psychological testing results so the client's medical records in employee health can be kept up to date. Based on the nurse's knowledge about issues surrounding breach of confidentiality, which response would be the most appropriate?
"I am unable to acknowledge whether or not this client is a client on this unit."
A nurse is providing care to a male client who is hospitalized with a diagnosis of schizophrenia. Which would be appropriate for the nurse to include in the client's medical record?
"Reports being unable to sleep because the client heard voices throughout the night."
When a 23-year-old client, after attempting suicide, asks to speak with the nurse but wants assurance that the conversation will remain confidential, the nurse responds how?
"Will this conversation involve your desire to harm yourself?"
A psychiatric-mental health nurse is conducting a review class about legal liability and psychiatric-mental health nursing. Which element would the nurse most likely include as being required to prove negligence on the part of a health care professional? Select all that apply.
-Duty -Cause in fact -Damages -Cause in proximity
Which are functions of assertive community treatment? Select all that apply.
-Reduces inpatient service use -Promotes continuity of outpatient care -Increases the stability of people with serious mental illnesses
The nurse is assessing whether a room is fit for seclusion of clients. What are the requirements of a seclusion room? Select all that apply.
-The room should have facility for direct visual monitoring. -The room should not have any sharp objects. -The room should have a bed that is bolted to the floor.
Which client of a forensic nurse has most likely been found not guilty but mentally ill (not guilty by reason of insanity) following the commission of a serious crime?
A client who is being held involuntarily in a secure psychiatric setting
The Tarasoff decision has resulted in the mental health clinician having a responsibility to do what?
A duty to warn
As a result of the increasing severity of delusions and consequent unsafe behavior, a client has been admitted to a psychiatric facility and judged incompetent to make decisions. Who will now make decisions for the client?
A guardian appointed by the court
What is provided in the Code of Ethics for Nurses of the American Nurses Association (ANA)?
A guideline for nurses regarding ethical conduct
A nurse understands the importance of protecting clients' rights of self-determinism. Self-determinism is similar to which ethical principle?
Autonomy
A 22-year-old client with schizophrenia is refusing antipsychotic medication. The client states, "I don't like the dopey way it makes me feel. I feel like I'm walking underwater when I take it." The nurse explains to the client, "Your schizophrenia is caused by a chemical imbalance in your brain, and this medication helps fix that chemical imbalance. You need to take it so your symptoms will get better." This conversation reflects a conflict between which two types of ethical principles?
Autonomy and beneficence
A nurse recruiter is interveiwing a nurse for a psychiatric-mental health nursing position at the community clinic. When reviewing the applicant's educational background, the recruiter would identify which as the preferred level of preparation?
Bachelor's degree
A client is being seen in the mental health clinic because of relapse. The client has been nonadherent with the medication regimen. The nurse reinforces the advantages of taking medications. The nurse is using which ethical principle?
Beneficence
Providing milieu therapy is an example of the use of which ethical principle?
Beneficence
The nurse is teaching a client about the importance of adhering to a medication regimen. The client does not believe that it is important. The nurse is communicating which ethical principle?
Beneficence
A client admitted with a psychiatric disorder has a problem sharing private thoughts and innermost feelings with the nurse. The client says that there still is societal stigma about mental illness and the client fears the nurse might be tempted to breach what?
Confidentiality
Which client behavior would prompt the nurse manager to discuss the duty to warn with staff members?
Danger to others.
An agitated client has been put in restraints against the client's will because of inadequate staffing. The nurse determines this as which form of malpractice?
False imprisonment
The inappropriate use of restraints or seclusion is considered which form of intentional tort?
False imprisonment
A nurse tells a client that the nurse will bring the client pain medicine in 5 minutes after checking on another client. The nurse returns in 5 minutes and administers the medication as planned. The nurse is practicing which principle by returning as promised?
Fidelity
A nursing student is initiating a relationship with an assigned client. After meeting and spending approximately 20 minutes talking with the client, the student makes arrangements to visit again after lunch. After lunch, fellow classmates invite the student to go to the gym with them and a group of clients to play volleyball. The student starts to go with them but then remembers the promise to meet with the client. The student decides to forgo volleyball and talk with the client. The student's decision reflects which ethical principle?
Fidelity
Earlier in the shift, the nurse promised to help a client acquire some paper and a pen and draft a letter to a family member later in the day. The nurse became increasingly busy during the shift but has now taken some time to assist the client in this way. What ethical principle has the nurse best exemplified?
Fidelity
A client in a psychiatric facility has ideations about killing the client's spouse. This client requests to be discharged from the facility. Which represents the most appropriate action? The health care provider should:
File for a civil commitment to detain.
A client was admitted to a psychiatric facility because the client was found walking around naked and talking incoherently. The client has no known next of kin and has been adjudicated incompetent. The client refuses any antipsychotic medications but has not been harmful to the self or others. What action should the facility take?
Initiate court proceedings to have a guardian named
A client comes to the emergency department with severe depression and suicidal ideation. Staff members determine that the client does not have adequate insurance to cover inpatient psychiatric services at their facility, so they discharge the client with some prescriptions for medication. Which principle is being ignored by discharging this client?
Justice
A psychiatric nursing class is discussing current trends in mental health care. A student voices the opinion that there should be equitable access to mental health care and resources for those who live in rural areas, for those without health insurance, and for those with very little income. The student nurse's opinion most closely reflects which ethical principle?
Justice
Which ethical principle is in jeopardy when segments of the mentally ill population do not have access to care?
Justice
Which ethical principles become an issue in mental health when a segment of a population does not have access to health care?
Justice
One way that nurses can protect themselves against liability from malpractice is to do what?
Know the statutory and professional standards.
While performing the admission assessment of a new client, the nurse observed that the client brought a bottle of over-the-counter pain medication to the hospital. The nurse failed to document this or remove the medication from the room. Subsequently, the client experienced a serious adverse drug reaction as a result of the interaction between this drug and one of the drugs that the client was prescribed in the hospital. This nurse may be guilty of what?
Malpractice
When assessing if a procedural risk to a client is justified, the ethical principle underlying the dilemma is known as what?
Nonmaleficence
A psychiatric-mental health nurse is practicing at the advanced level. Which function would this nurse be able to perform based on the nurse's advanced level of preparation?
Psychotherapy
A nursing student identifies which as the most important tool of psychiatric nursing?
Self
Which court decision or act states that psychotherapists have a duty to exercise reasonable care in protecting the foreseeable victims of their clients' violent actions?
Tarasoff v. Regents of the University of California.
The interdisciplinary team is discussing the best approach to planning the care for a client with complex psychiatric-mental health needs. When determining which tasks can be performed by the psychiatric-mental health registered nurse (PMH-RN) and which must be performed by the psychiatric-mental health advanced practice registered nurse (PMH-APRN), the team should prioritize guidelines from what source?
The American Nurses Association Standards of Practice
When it is discovered that a nurse did not act reasonably when providing care in accordance with the standards of professional practice, which factor would confirm the nurse has been negligent?
The nurse was responsible for client injury
What is the therapeutic goal of seclusion?
To give the client the opportunity to regain physical and emotional self-control.
Professional regulations and laws that govern nursing practice are in place for what reason?
To protect the safety of the public
A client with schizophrenia will not take medication because the client is gaining weight. This client is exercising which ethical principle?
autonomy
A client was admitted for electroconvulsive therapy (ECT). The physician performing the procedure failed to obtain informed consent before the ECT was administered. The physician could be charged with what?
battery
