PNU 128 Videbeck PrepU Chapter 9: Legal and Ethical Issues

A nursing student identifies which as the most important tool of psychiatric nursing?

Self

A psychiatric-mental health nurse is looking for information about the parameters of professional psychiatric-mental health nursing practice, specifically information that provides the framework for nursing practice. The nurse would most likely seek out which source?

Standards of Practice

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

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?

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

Student nurses are learning about the ethical treatment of clients. The nursing educator asks the students about the meaning of non-maleficence. Which response by the student nurse is best?

"The nurse must pay attention to the client's advanced directives."

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

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 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 client informs the nurse that the client is feeling better and does not want to take antidepressant medication. This client is exhibiting which ethical principle when making this decision?

Autonomy

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 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

A psychiatric mental health facility is undergoing a change from paper-based health records to electronic records. What action should the nurse prioritize in order to ensure client rights are protected?

Being vigilant to identify any potential threats to client confidentiality

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

A client who was deemed to be at high risk for suicide was ordered visual checks every 15 minutes. The nurse had been performing these checks since the beginning of a shift but neglected to pass off this responsibility to a colleague before leaving the unit for a scheduled break. As a result, the client made a suicide attempt while the nurse was off the unit. Which ethical principle has the nurse most clearly violated?

Beneficence

Which client behavior would prompt the nurse manager to discuss the duty to warn with staff members?

Danger to others.

What term is used to identify the situation when ethical principles conflict or when there is not one clear course of action in a given situation?

Ethical dilemma

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 brought to the emergency department by police after neighbors reported him being loud and disruptive. The client is agitated and is extremely upset. The client states, "No one can be trusted." Which decision about about whether to involuntarily admit the client would be most appropriate?

Involuntary admission is inappropriate because the client does not meet the necessary criteria.

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

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

Which ethical principle focuses on the duty to do no harm?

Nonmaleficence

A nurse is reviewing that standards of practice. Which component would the nurse identify as appropriate?

Outcomes identification

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 psychiatric treatment team is planning care for a client who was involuntarily admitted for treatment of depression and suicide ideation. When planning care, of what legal parameters of care must the nurse be aware?

The client can refuse medication.

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

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 thedifferences between these two types of admissions?

They have agreed to the hospitalization.

Professional regulations and laws that govern nursing practice are in place for what reason?

To protect the safety of the public

The nursing instructor is discussing the Individuals with Disabilities Education Act and various disablities 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.

autism traumatic brain injury orthopedic impairment

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

The client has not been on speaking terms with the client's parents for several years. The parents have expressed a desire to reunite with the client. At first, the client agreed to a family meeting, and then decided not to meet with the parents. The nurse has encouraged the client to attend the family meeting knowing that the family's support would be valuable. What ethical principles are in conflict in this situation?

autonomy and beneficence

Providing milieu therapy is an example of the use of which ethical principle?

beneficence

The nurse is caring for a client after having various diagnostic tests. The client discusses a proxy being in attendance for the health care provider's diagnosis. The nurse requests a copy for the file, and allows the proxy to be in attendance with what type of document?

durable power of attorney

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

After spending 45 minutes talking with an assigned patient, the student nurse promises to visit again after lunch. After lunch, the nursing student returns and talks with her client. The student's action reflects which ethical principle?

fidelity

Which ethical principles become an issue in mental health when a segment of a population does not have access to health care?

justice