Mental Health: chapter 4 Patient rights and legal issues

The inappropriate use of restraints or seclusion is considered which form of intentional tort? False imprisonment Battery Assault Causation

False imprisonment

The nurse is detaining the client from leaving the hospital by refusing to allow him to take his personal items. This is an example of which of the following? False imprisonment Seclusion Restraint Slander

False imprisonment

During rounds, a client with depression is discovered to have completed a suicide attempt in the bathroom. The staff members on the inpatient psychiatric unit have been very busy and fell behind on periodic assessment for this client. The client's family decides to pursue legal action against the staff and facility. The client's family would most likely claim: Malpractice Battery Assault False imprisonment

Malpractice

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? Assault Malpractice Failure of duty to warn Incompetence

Malpractice

All of the following are civil rights afforded to all people receiving mental health care except which of the following? Right to leave the hospital when involuntarily committed Right to refuse treatment Right to send and receive sealed mail Right to have or refuse visitors

Right to leave the hospital when involuntarily committed

Which of the following rights could the psychiatric client lose when admitted to a locked, inpatient psychiatric treatment facility? Right to communicate with an attorney Right to schedule his or her own time Right to send and receive mail without censorship Right to safety from harm

Right to schedule his or her own time

Which action is a violation of a psychiatric client's rights? A client is paid minimum wage for working in the hospital kitchen. A paranoid client with delusions about his family is told that if he makes a will, it might not be valid. Staff members confiscate letters written by a committed client that are addressed to a local newspaper. The nurse removes an expensive watch from the client's room and tells the client it is being locked in the hospital safe.

Staff members confiscate letters written by a committed client that are addressed to a local newspaper.

A malpractice lawsuit was filed after a nurse restrained the client for screaming at and attempting to strike anyone who was within striking distance. The nurse followed agency procedures that were consistent with Joint Commission Standards. For which reason is this malpractice lawsuit most likely to be unsuccessful? The nurse did not have a duty. The nurse did not breach duty. The client did not suffer some type of loss, damage, or injury. There was no evidence that a breach of duty was a direct cause of the loss, damage, or injury.

The nurse did not breach duty.

A client has been admitted to the psychiatric facility for the treatment of depression. The client has told the emergency department staff that she would like a close friend to make decisions surrounding her care until she "feels better." In order to identify the legal basis for the client's preference, the nurse should: determine whether a durable power of attorney has been established. explain the provisions of the Patient Self-Determination Act (PSDA) to the client and the friend. assess the competency and motivations of the friend in order to protect the client's interests. refer the case to the facility's ethics review board.

determine whether a durable power of attorney has been established.

An adolescent on the unit is argumentative with staff and peers. The nurse tells the adolescent, "Arguing is not allowed. One more word and you will have to stay in your room the rest of the day." The nurse's directive is: inappropriate; room restriction is not treatment in the least restrictive environment. inappropriate; the adolescent should be offered a sedative before room restriction. appropriate; room restriction is an effective behavior modification technique. appropriate; the adolescent should not have conflicts with others.

inappropriate; room restriction is not treatment in the least restrictive environment.

A client who has attempted suicide with a drug overdose has been released from an inpatient setting and has returned to school. The client continues to need routine psychiatric services. The nurse should explain to the client that she or he will most likely be referred to which of the following services? partial hospitalization program. in-home mental health care. intensive outpatient program. crisis center in the community.

intensive outpatient program.

The client just received a diagnosis of end-stage renal disease. After hearing options, the client visited a lawyer and documented what treatment is to be held in the event that the client is unable to make decisions. The nurse asks for a copy of this document for the chart. The name of this document is: living will durable power of attorney patient rights informed consent

living will

A nurse is reviewing medical records to look for violations of client rights. What finding would signal a violation of client rights? no documentation of benefits of treatment or treatment options client belongings searched at admission physical restraint used to prevent harm to self client was placed on one-to-one continuous observation

no documentation of benefits of treatment or treatment options

The nurse has a physician's order for haloperidol (Haldol) 10 mg for a severely psychotic client. The client refuses the medication. Which nursing intervention is an appropriate response? Accept the client's decision. Obtain a discharge order for noncompliance. Tell the client that he is too sick to refuse. Restrain the client and give the medication IM.

Accept the client's decision.

A nurse in the emergency department is planning for a client with mental illness to be placed in an inpatient hospitalization. Which is a condition of this type of admission? is noncompliant with medication at home present a clear danger to self or others develops new symptoms of the illness has no support systems in the community

present a clear danger to self or others

A client diagnosed with depression tells the psychiatric-mental health nurse that the client wants to use an herbal supplement to treat the symptoms rather than an antidepressant. The nurse interprets this information as demonstrating which concept? competency self-determinism confidentiality informed consent

self-determinism

The client is diagnosed with fibroid tumors and the surgeon states the uterus must come out. The nurse understands that the client's signature may be obtained on consent, but obtaining informed consent for the surgery is the responsibility of whom? supervisor manager surgeon OR technician

surgeon

A nurse is talking with a psychiatric-mental health nurse practitioner and says, "I know I need to maintain a client's privacy and confidentiality, but is there a difference between these two?" Which response by the nurse practitioner would be most appropriate? "Actually, in most cases, privacy and confidentiality are the same issues." "Privacy is governed by the laws of the state." "Confidentiality affords the client privacy." "Confidentiality protects an individual from intrusion."

"Confidentiality affords the client privacy."

The nurse on an addictive disorders unit receives a phone call inquiring about the status of a client. The caller is not on the client's allowed contact list. Which is the appropriate response by the nurse to the caller? "I cannot confirm or deny the existence of any client here." "You will need to be placed on the client's contact list before I can discuss any information with you." "The person you are asking for is not a client here." "Hold one minute while I get the client for you."

"I cannot confirm or deny the existence of any client here."

The nurse is complaining about a client that has dementia. The client is mobile and slaps the nurse on the gluteus maximus each time he passes by. The nurse tells the client, "If you don't behave yourself, I am going to throw you out and you won't have anywhere to go." The charge nurse overhears the nurse, and states "Do you realize what your statement could be construed as?" What is the best statement for the nurse to respond? "It could be construed as battery" "It could be construed as assault" "It could be construed as negligence" "It could be construed as unintentional harm"

"It could be construed as assault"

The nurse is admitting a client to the hospital. The nurse gives the client information about client rights while in the hospital. Which statement by the client indicates that more teaching is needed? "I can get a copy of my medical record if I want to read it." "You can not give any information to anyone unless I agree." "The doctor can copy my information and send it to my son." "You can not tell a caller that I am in the hospital."

"The doctor can copy my information and send it to my son."

The charge nurse is discussing a process in healthcare that reflect's dedication and commitment to meeting standards, and demonstrate a higher level of performance and patient care. The charge nurse asks the staff nurses, "What process am I speaking of ?" Which process should the staff nurse choose? "The process of standardization depicts the process of dedication and commitment to meeting standards and demonstrating high patient care performance." "The process of accreditation depicts the process of dedication and commitment to meeting standards and demonstrating high patient care performance." "The process of registration depicts the process of dedication and commitment to meeting standards and demonstrating high patient care performance." "The process of incorporation depicts the process of dedication and commitment to meeting standards and demonstrating high patient care performance."

"The process of accreditation depicts the process of dedication and commitment to meeting standards and demonstrating high patient care performance."

Which client would most likely be mandated outpatient treatment? A client who is addicted to alcohol who has two driving under the influence offenses A client with schizophrenia who lives in a single family home with siblings A client with bipolar disorder who has quit three jobs in the last 6 months A homeless client who has been arrested for petty theft of groceries from a convenience store.

A client who is addicted to alcohol who has two driving under the influence offenses

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 A client with a history of mental illness who is serving a lengthy term in a federal prison A client who is receiving care involuntarily on a community hospital's psychiatric unit A client who has been released into the community with strict limits on activity

A client who is being held involuntarily in a secure psychiatric setting

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? The client's primary nurse The client's psychiatrist A hospital-appointed interdisciplinary committee A guardian appointed by the court

A guardian appointed by the court

Which of the following are criteria for instituting the short-term use of restraint or seclusion? Select all that apply. The client is aggressive. The client is being punished. The client is imminently dangerous to the self or to others. The client is physically and emotionally self-controlled. All other means of calming the client have been unsuccessful.

All other means of calming the client have been unsuccessful. The client is aggressive. The client is imminently dangerous to the self or to others.

The nurse recognizes that the difference between a voluntary and an involuntary commitment is what? An involuntarily committed client may not initiate his or her own discharge The voluntarily committed client is usually less aggressive An involuntarily committed client may refuse all treatment The voluntarily committed client usually has good insight into his or her mental health problem

An involuntarily committed client may not initiate his or her own discharge

The nurse is threatening to give the client an injection in order to restrain the client for inappropriate behavior. This is an example of Assault Battery False imprisonment Abuse

Assault

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. Talk the client out of revoking consent once the study has started. Obtain informed consent when the primary provider cannot be present. Persuade the client to consent, because the new drug has shown promising results.

Assess the client's legal capacity when that client is asked to give consent.

Which element of malpractice occurs when the nurse does not act as a reasonable, prudent person would have acted in a similar circumstance? Duty Breach of duty Injury or damage Causation

Breach of duty

A psychiatric-mental health nurse is providing outpatient care to a patient with a history of anxiety. Which behavior would the nurse interpret as reflecting self-determinism? Client asks the nurse to decide which treatment option to follow. Client seeks a second opinion about condition and proposed treatment. Client chooses a treatment to please the nursing staff. Client relies on clinic staff for direction and guidance.

Client seeks a second opinion about condition and proposed treatment.

A client has just been explained the reason that he must undergo an MRI. When the nurse asks the client if he understands the explanation, he correctly describes what has been said to him. The client is said to be what? Logical Congruent Competent Autonomous

Competent

A client who has depression is admitted to treatment on a voluntary basis. While in the hospital, the client makes several comments about wanting to "end it all." The client decides one day to leave against medical advice. Which would be the most appropriate action by the nursing staff? Calling security and asking them to detain the client Allowing the client to leave with community resources for follow-up care Contacting the psychiatrist for initiation of commitment proceedings Contacting the client's family to request they convince the client to stay

Contacting the psychiatrist for initiation of commitment proceedings

The nurse is caring for a client who is legally competent and who has been receiving outpatient treatment for schizophrenia. The client has been responding favorably to treatment but has now declared her intention to exclusively pursue alternative medicine. What is the nurse's most appropriate response? Educate the client about the benefits of continuing the existing treatment Document the client's statement and include it in a request for a court order Inform the client that this proposed action would likely result in being declared incompetent Inform the client that she cannot make this decision without consulting the care team

Educate the client about the benefits of continuing the existing treatment

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? Battery False imprisonment Defamation Assault

False imprisonment

When is a nurse legally obligated to breach confidentiality? At any time a client is threatening If threats are made to an outside party Whenever the client becomes aggressive When the client violates the nurse's boundaries

If threats are made to an outside party

Which is an accurate statement regarding an advance care directive? It must be witnessed by two people and notarized. It needs to be written by an attorney. It applies to those who can make their own decisions. It needs to be signed by an attorney.

It must be witnessed by two people and notarized.

Samuel has been committed involuntarily to a psychiatric-mental health facility to allow time to determine an appropriate diagnosis. What is this type of involuntary commitment known as? Emergency Observational Extended Outpatient

Observational

A client is being discharged but still needs close supervision. Which type of involuntary commitment would be appropriate for this client? Outpatient Emergency Extended Observational

Outpatient

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 Patient Self-Determination Act The Mental Health Systems Act of 1980 Public Law 99-319, The Protection and Advocacy for Mentally Ill Individuals Act of 1986

Tarasoff v. Regents of the University of California

A client has been voluntarily admitted to the hospital. The nurse knows that which of the following statements is inconsistent with this type of hospitalization? The client can sign a written request for discharge. The client cannot be released without medical advice. The client retains all of his or her rights. The client has a right to leave if not a danger to self or others.

The client cannot be released without medical advice.

Following an assault, a client with mental illness has been declared unfit to stand trial. The nurse should draw what conclusion from this fact? The client cannot comprehend the legal proceedings The client committed an act that a person without mental illness would not have committed The client poses a significant risk to reoffend The client is openly hostile to investigators and/or the legal team

The client cannot comprehend the legal proceedings

A psychiatric-mental health client has been admitted to the emergency department following an episode of psychotic behavior. The client has presented a written psychiatric advance directive (PAD) that exhaustively details many aspects of her desired care. What factor should prompt the care team to disregard the provisions of the PAD? The client had been deemed legally incompetent when she created the document The provisions of the PAD are contrary to the long-term health of the client The PAD rules out treatments that are evidence-based and likely beneficial The client has a history of involuntary inpatient treatment

The client had been deemed legally incompetent when she created the document

Which nursing intervention constitutes false imprisonment? The client is confused, combative, and insists that no one can stop him from leaving. The nurse restrains the client without a physician's order, then seeks the order. The client has been "pesky," seeking the attention of nurses in the nurses' station much of the day. Now the nurse escorts the client to the room and tells the client to stay there or be put into seclusion. A psychotic client is admitted as an involuntary client and runs out of the psychiatric unit. The nurse runs after the client and succeeds in talking the client into returning to the unit. A client is hospitalized as an involuntary admission and attempts to leave the unit. The nurse calls the security team per hospital protocol. They prevent the client from leaving.

The client has been "pesky," seeking the attention of nurses in the nurses' station much of the day. Now the nurse escorts the client to the room and tells the client to stay there or be put into seclusion.

A nurse is reviewing a journal article about mental health care and voluntary and involuntary treatment. After reading the article, the nurse demonstrates a need for additional review when the nurse identifies which element as being most commonly included as part of the statute? The client must be mentally disordered. The client must be a danger to self or others. The client must be refusing medication. The client is unable to provide for basic needs.

The client must be refusing medication.

A psychiatric-mental health nurse is providing care to several clients. Some of the clients have been voluntarily admitted while others have been involuntarily admitted. Which description about voluntary admissions demonstrates that the nurse understands the differences between these two types of admissions? They can leave the hospital whenever they want. They have agreed to the hospitalization. They are not considered a danger to themselves or others. They cannot refuse treatment.

They have agreed to the hospitalization.

The accused individual being not fully capable of instructing legal counsel refers to ... Not criminally responsible Community treatment order Court diversion program Unfit to stand trial

Unfit to stand trial

The client is brought to the hospital in a coma. The nurse understands that when a person is incapacitated, the document used to dictate the patient's written instructions for health care is called: patient rights durable power of attorney advance directive informed consent

advance directive

A student nurse is caring for a client admitted to the mental health center. The primary nurse wants to determine if the client is competent to give informed consent, the nurse instructs the student that the client should be able to do what? Select all that apply. appreciate the situation and it's consequences understand relevant information use logical thought processes to compare risks/benefits of treatment communicate choices develop a dialogue

appreciate the situation and it's consequences understand relevant information use logical thought processes to compare risks/benefits of treatment communicate choices

A student nurse is assigned to administer oral medications to a client. Which of these actions should a student nurse take if a client refuses to take prescribed oral medications? tell the client that the nurse will receive a poor grade if he or she does not administer the medication tell the client that refusal is not permitted and staff will require the client to take the medication document the client's refusal on the medication administration record without comment ask the client's reason for refusing and report it to the primary care nurse

ask the client's reason for refusing and report it to the primary care nurse

The nursing instructor is discussing the Individuals with Disabilities Education Act and various disabilities that have the right to education in the least restrictive environment. The instructor asks whom this applies to, clients with which problems? Which examples should the student nurse choose? Select all that apply. flu autism traumatic brain injury pneumonia orthopedic impairment

autism traumatic brain injury orthopedic impairment