Mental Health Prep U Ch 9

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:

advance directive

Which client most likely has the legal right to refuse treatment?

A client who voluntarily entered a substance abuse treatment facility to address an addiction to alcohol pg. 142

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 pg. 147

One way that nurses can protect themselves against liability from malpractice is to do what?

Know the statutory and professional standards. pg. 146

A nurse working on a psychiatric unit receives a telephone call from a client's employer. The employer asks for a copy of the client's latest laboratory work and psychological testing results so that client's medical records in employee health can be updated. Based on the nurse's knowledge of breach of confidentiality, which response would be appropriate?

"I am unable to acknowledge whether or not your employee is a client on this unit." pg. 144-145

The nurse is working with a client who is manic and is in the partial hospitalization program, stabilized, and then given referrals for therapy and support groups. The significant other asks the nurse why the client was not admitted to the hospital? What is the best response from the nurse? Select all that apply.

"The partial hospitalization program is the least restrictive environment appropriate to meet the client's needs." pg. 143

The nurse is caring for a group of clients in a treatment and recovery facility. Which client statement(s) does the nurse determine best shows motivation for recovery? Select all that apply.

*"I like to make my own decisions." *"I make choices based on my personal goals." *"I like having my own space and independence in my relationships."

The nursing ethics committee is reviewing the ethical principle of justice. One committee member states, "What are some examples of justice?" Which statement(s) by the nurse exemplifies justice? Select all that apply.

*"Nurses should be fair when they distribute care among the clients that they are assigned." *"Nurses should make sure that all clients have a meal if they are permitted to eat." pg. 146-147

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 pg. 143

What is provided in the Code of Ethics for Nurses of the American Nurses Association (ANA)?

A guideline for nurses regarding ethical conduct pg. 146

What action by a nurse best promotes the ethical principle of justice?

Advocating for enhanced mental health services in an underserved neighborhood pg. 147

Which is the most important reason for psychiatric nurses to understand law, legislation, and legal processes that relate to professional nursing practice?

Because doing so gives the nurse the ability to provide quality care that will safeguard the rights and safety of clients.

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 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 pg. 146-147

A client with persistent depression is considering electroconvulsive therapy (ECT). The nurse has seen ECT be effective in other cases. When the client expresses fear and doubt about undergoing ECT, the nurse tries to talk the client into it, because the nurse truly believes it will help the client. Which two ethical concepts are in conflict?

Beneficence and autonomy pg. 146-147

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

Danger to others pg. 145

A client is admitted to the behavioral health facility involuntarily. The client is scheduled to undergo electroconvulsive therapy. Which action does the nurse take before the procedure?

Ensure the client has given informed consent pg. 146, 147

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 pg. 146

What is the therapeutic goal of seclusion?

Give the client the opportunity to gain self-control pg. 143

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 pg. 146-147

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 pg. 147

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. pg. 142

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. pg. 142

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 pg. 146

When assessing if a procedural risk to a client is justified, the ethical principle underlying the dilemma is known as what?

Nonmaleficence pg. 147

The nurse is admitting a client to the hospital. The nurse gives the client information about patient 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 pg. 144-145

A client with a psychiatric illness has become extremely aggressive and the nurse decides that the client needs to be restrained. Which action would be considered human restraint?

The nurse and a group of paramedics hold the client pg. 143-144

A client who is involuntarily admitted to the psychiatric facility refuses to take a psychotropic medication. The nurse holds the client down to give the medication. Which statement is true regarding this situation?

The nurse may be held legally liable pg. 146

A client with bipolar disorder has been following the prescribed medication regimen. The client indicates to the nurse a desire to stop the medication now that the client is feeling better. The nurse tells the client that most likely the client will have to remain on the medication for life to keep the condition under control. The nurse is practicing which principle?

Veracity pg. 147

An adolescent client has refused to wash or change clothes for several days. The client's hair is greasy, the client's clothes are stained, and the client has a strong malodor. Three male staff members approach the client to escort the client to the shower. The client resists and becomes combative with staff members. The client is placed in seclusion and is told the client will be released when the client is calm and willing to shower. Which is an accurate statement of the client's rights in this situation?

Violated, primarily because of the inappropriate use of restraints pg. 144

A nurse sitting with a client in a therapy session with the psychotherapist hears the client state, "I have had it with this marriage. I'm telling you, and not that I ever would do it, but I feel like hiring a hit man to kill my spouse!" Which action is the nurse obligated to take?

Warn the client's spouse, based on the Tarasoff rule. pg. 145

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

beneficence pg. 146-147

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 pg. 146-147

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

A psychiatric-mental health nurse is reviewing the medical record of a client who was involuntarily committed to the mental health unit of the hospital. The nurse determines that the client was most likely involuntarily committed for which reason?

ranting and waving a loaded gun in a crowded mall pg. 142

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

self

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 pg. 146

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 pg. 147