PREP U 9 (4+)
acute inpatient care
After teaching a group of nursing students about the least restrictive environment, the instructor determines that the education was successful when the group identifies which as the most restrictive setting?
The room should not have any sharp objects. The room should have a bed that is bolted to the floor. The room should have facility for direct visual monitoring.
The nurse is assessing whether a room is fit for seclusion of clients. What are the requirements of a seclusion room?
the room should have a bed that is bolted to the floor. The room should not have any sharp objects. The room should have facility for direct visual monitoring.
The nurse is assessing whether a room is fit for seclusion of clients. What are the requirements of a seclusion room?
durable power of attorney
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?
anger is
a strong, uncomfortable, emotional response to a real or perceived provocation.
Refusal of treatment during an emergency situation
After educating a class of nursing students about the rights of persons receiving mental health services, the instructor determines a need for additional instruction when the students identify which as a right?
Acute inpatient care
After teaching a group of nursing students about the least restrictive environment, the instructor determines that the education was successful when the group identifies which as the most restrictive setting?
Iowa
Which state allows for an insanity defense?
it is rarely successful
Which statement accurately describes the insanity defense?
hostility
Which term is used to describe an emotion expressed through verbal abuse and violation of rules or norms?
outpatient involuntary commitment
A client is being discharged but still needs close supervision. Which type of involuntary commitment would be appropriate for this client?
Code of Ethics for Nurses
A new nursing student correctly identifies which as most essential for guiding psychiatric-mental health nursing actions?
justice
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?
Beneficence
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?
Involuntary commitment to an outpatient community mental health center
A client receives a court order for commitment. Which best exemplifies the concept of "least restrictive environment"?
Initiate court proceedings to have a guardian named.
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?
The nurse and a group of paramedics hold the client.
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?
veracity
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?
autonomy
A client with depression tells the nurse, "I want to stop taking my antidepressant medication because I don't like taking medications." The nurse discusses the benefits of adhering to the medication plan and strongly urges the client to use the medication. The nurse interprets the client's statement as reflecting which ethical principle?
Beneficence and autonomy
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?
The colleague had good motives but violated the principle of veracity
A client's estranged spouse has phoned the hospital unit several times seeking information about the client's admission and status. A nurse hears a colleague tell the client, "No, your spouse has not called as far as I know." When confronted by the nurse, the colleague states, "I'm just trying to look out for the client by protecting the client from stress." How should the colleague's actions be interpreted?
Beneficence
A new nursing student is studying ethics in nursing and informs a client who wants to stop medication about its benefits and how the client will continue to feel better only if use of the drug continues. Which concept is the nursing student using?
Development of a therapeutic relationship
A nurse is beginning the process of providing therapy to a client with anger management problems. When implementing this therapy, which should occur first to promote optimal effectiveness?
"You will need to sign a written request for discharge."
A nurse is caring for a voluntary client in the health care facility. The client doesn't show signs of suicidal idealization or pose harm to others. The client states, "I would really like to leave tonight and sleep in my own bed." Although the client wants discharge tonight, the physician at this time. What is the most appropriate response of the nurse?
The client must be injured physically as a result of the nurse's action.
A nurse is reviewing a journal article about malpractice and the elements required to prove negligence. The nurse demonstrates a need for additional review when the nurse identifies which element as being necessary?
communication
A nurse is reviewing the Standards of Professional Performance. Which area would the nurse most likely find being addressed?
Bachelor's Degree
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?
Constantly for the first hour
A psychiatric nurse is assigned to perform observation of a client in restraints. The nurse knows that this client must be checked on how often?
American Psychiatric Nurses Association
A psychiatric-mental health nurse interested in joining a professional organization asks the psychiatric-mental health clinical nurse specialist about these organizations. Which organization would the clinical nurse specialist describe as the largest professional nursing organization focusing on mental health care?
Standards of Practice
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?
Violated, primarily because of the inappropriate use of restraints
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?
False Imprisonment
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?
crisis
In which phase of the aggression cycle can techniques of seclusion or restraint be used to deal with the aggression quickly?
community hospital, prison, or in the community.
Individuals found not guilty of a crime but mentally ill are normally held in a secure psychiatric setting, not a
Duty of care, professional performance, injury related to the nurse's action, action foreseeably could have caused the injury, and proven injury
Malpractice is proven when certain criteria have been met. Which list includes the correct criteria?
ethics
Principles that serve as codes of conduct about right and wrong behaviors to guide actions are known as what?
Beneficence
Providing milieu therapy is an example of the use of which ethical principle?
1 to 2 hours with close supervision of the client.
Seclusion. Documented assessment should take place by the nurse every
living will
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:
"It could be construed as assault"
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?
Teach the client to make "I" statements.
The nurse is counseling a client couple who are trying to reconcile and hold their marriage together. During therapy the wife states, "He makes me so mad when he spends all his weekend time with his friends instead of us. He makes me want to hurt him back." Using concepts from assertiveness training and effective communication techniques, the nurse implements which intervention after hearing the wife's remarks?
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?
"The partial hospitalization program is the least restrictive environment appropriate to meet the client's needs."
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?
Women are expected not to express so-called negative feelings like anger.
The nurse working in a psychology clinic finds that suppression of anger is more common in women than in men. What is the possible explanation for such a finding?
autism traumatic brain injury orthopedic impairment
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?
The nurse tells the client, "I will return to give you pain medication in 1 hour." The nurse returns in 1 hour.
Which situations depict a nurse employing the principles of fidelity while providing care?
outpatient
To care for clients in the least restrictive environment, treatment is usually delivered in which care setting?
The client is unable to act in the client's best interest. The client cannot provide food, clothing and shelter for self
What findings would lead the nurse to conclude that the client needs a conservator?
"Will this conversation involve your desire to harm yourself?"
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?
nonmeleficence
When assessing if a procedural risk to a client is justified, the ethical principle underlying the dilemma is known as what?
A client who is being held involuntarily in a secure psychiatric setting
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?
is screaming in the street and disturbing neighbors.
Which client would a nurse determine to be the most likely candidate for involuntary commitment? The client who:
Tarasoff v. Regents of the University of California
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?
nonmeleficence
Which ethical principle requires a nurse to prevent clients from harming themselves or others?
Documented assessment by the nurse every 3 to 4 hours
Which intervention does not meet the standard of care for the client in seclusion?
Hostility is
an emotion expressed through verbal abuse, lack of cooperation, violation of rules or norms, or threatening behavior
veracity
duty to be honest or truthful The client asks about a new medication, it's side effects, cost and if the drug is compatible with the other medication the client takes. The nurse answers all questions the client asks without withholding information. The nurse is guided by which ethical principle?
Catharsis
includes activities that provide a release of the anger.
Physical aggression
is behavior in which a person attacks or injures another person or that involves destruction of property.
A conservator
or a legal guardian is required for clients with psychiatric illness if they are not able to act in their own best interests or if they cannot provide food, clothing, and shelter for themselves (in spite of having resources).
deception violates
veracity, even if it is motivated by the client's interests. This deception would not be considered to be a justifiable example of paternalism. Fidelity focuses on obligations and duties. The colleague neglected the client's autonomy rather than promoting it.
