Mental Health Ch. 6 EVOLVE

The use of seclusion or restraint to control the behavior of a client who is at risk of harming self or others gives rise to conflict between which ethical principles?

Autonomy and beneficence Autonomy refers to self-determination and beneficence refers to doing good. When a client is restrained or secluded, the need to do good and prevent harm outweighs the client's autonomy.

A client who presents no danger to himself or to others is forced to take medication against his will. This situation represents

battery Battery is the harmful, nonconsensual touching of another person. Forceful administration of medication constitutes battery.

Which hospitalized patient should the nurse identify as being a candidate for the appropriate use of a release from hospitalization known as against medical advice (AMA)?

A 37-year-old patient scheduled for discharge in 24 hours wishes to be discharged immediately AMS discharges are sometimes used when the patient does not agree with the provider, as long as the patient is not a danger to himself or herself or to others. The patient with dementia and the patient who is actively suicidal would pose a safety risk and would be not allowed to be discharged AMA. A patient who wishes to stay in the hospital can make that decision; a family member's opinion doesn't impact an AMA discharge.

Which scenarios describe a HIPAA violation associated with a nurse's behavior?

A nurse on the cardiac unit gives report to the nurse on the step-down unit while transporting a client in the staff elevator Discussing a patient's information in public places where it may be overheard is a violation of a patient's confidentiality. The other options describe appropriate interactions for patient continuity of care and support of the treatment plan by the health care team.

Which ethical principle refers to the individual's right to make his or her own decisions?

Autonomy Autonomy refers to self-determination, or the right to make one's own decisions

When considering the civil rights of persons diagnosed with mental illness and hospitalized for treatment, which statement is true?

They are assured the same as those for any other citizen. Civil rights are not lost because of hospitalization for mental illness

If a client is placed in seclusion and held there for 24 hours without a written order or examination by a physician, the client has experienced which illegal act?

False imprisonment False imprisonment is the arbitrary holding of a client against his or her will. When seclusion is ordered, it is not invoked arbitrarily, but after other less restrictive measures have failed. If the client is secluded without the medical order, the measure cannot be proven as instituted for medically sound reasons.

If a nurse is charged with leaving a suicidal client unattended, it is being suggested that the nurse's behavior has violated which ethical principle?

Fidelity Fidelity refers to being "true" or faithful to one's obligations to the client. Client abandonment would be a violation of fidelity.

After the death of a client, what rule of confidentiality should be followed by nurses who provided care for the individual?

Nothing may be disclosed that would have been kept confidential before death. Confidentiality extends to death and beyond. Nurses should never disclose information after the death of a client that they would have kept confidential while the client was alive.

A client reports to the nurse that once he is released he will make sure his wife will never again be able to have him committed to a psychiatric hospital. What action should the nurse take?

Report the incident to the client's therapist The Tarasoff ruling makes it necessary for nurses to report client statements that imply the client may harm another person or persons. The nurse reports to the treatment team, and the mandated reporter (usually the professional leader of the team) is responsible for notifying the person against whom the threat was made.

The nurse is caring for an admitted client with a history of becoming aggressive when angry and has caused physical injury to another client and two staff members. When this client begins to demonstrate signs of anger while in the day room what intervention should the nurse implement to address the safety of the milieu?

Request that the client accompany the nurse to the client's room Least restrictive alternative doctrine requires using the least drastic means of achieving a specific goal. By first attempting to remove the client to a safer location, the nurse is respecting the client's right to treatment that is less restrictive than the other options.

Which right of the client has been violated if he is medicated without being asked for his permission?

Right to informed consent Before being given medication, the client should be fully informed about the reason for, the expected outcomes of, and any side effects of the medication. The client has the right to refuse medication. If, in a nonemergency situation, he is given medication after refusing it, his right to informed consent has been violated.

When considering the duty to warn and protect third parties, which client statement should the nurse report to the treatment team members?

That judge is going to really regret putting me in here." The duty to protect is an ethical and legal obligation of health care workers to protect patients from physically harming themselves or others. This duty arises when the patient presents a serious danger to another.

What assumption can be made about the client who has been admitted on an involuntary basis? (Select all that apply.)

The client has failed to agree to fully participate in treatment and care planning. The client is a danger to self or others or unable to meet basic needs. The commitment was court ordered. Involuntary admission which is court ordered implies that the client did not consent to the admission. The usual reasons for admitting a client over his or her objection is if the client presents a clear danger to self or others or is unable to meet even basic needs independently.

When considering client rights, which client can be legally medicated against his or her wishes?

The client may cause imminent harm to himself or others. A patient may be medicated against his or her will without a court hearing in an emergency if the patient poses a danger to himself or herself or to others.

The nurse reads the medical record and learns that a client has asked for treatment, agreed to receive treatment, and to abide by hospital rules. The nurse may correctly assume that the client has met the criteria for which type of admission?

Voluntarily Voluntary admission occurs when the client seeks treatment and is willing to be admitted and agrees to comply with hospital and unit rules

What nursing action supports a client's right to autonomy?

Witnessing the informed consent for electroconvulsive therapy from a client Autonomy refers to self-determination. One way to exercise self-determination is to make decisions about one's care. Witnessing the client's informed consent demonstrates attention to the client's right to autonomy