ATI Engage Mental Health RN: Foundations of Mental Health Nursing - Client and Mental Health Team Member Safety: Legal & Ethical Considerations

A nurse is caring for a client who is agitated and requires chemical restraints. Which of the following types of medications should the nurse expect the provider to prescribe?

Sedative The nurse should expect the provider to prescribe a sedative. Sedatives are frequently used to calm clients who are agitated. They act fast and are usually well tolerated.

A nurse is discussing scope of practice related to mental health with a peer. Which of the following statements by the nurse explains practice focus for a mental health nurse?

"It is important to consider mental health needs related to population health are based on the social determinants of health." Nurses should focus their practice and expand their responsibilities to include care of clients in all populations related to mental health needs as outlined by the social determinants of health.

A nurse on a mental health unit is discussing types of admission with a newly licensed nurse. Which of the following statements should the nurse make?

"Most states require two providers to assess a client and confirm the need for an involuntary admission." An involuntary admission, or assisted inpatient treatment, is when a client is admitted without their request or consent. It is initiated when a client is exhibiting severe manifestations or is considered to be a danger to themselves or others.

A nurse on a pediatric mental health unit is discussing the importance of setting boundaries with another nurse. Which of the following statements by the nurse explains why setting boundaries is important?

"Setting boundaries increases a child's sense of security through knowing the consequences of behaviors." Research indicates that setting boundaries increases a child's sense of security. Setting boundaries reduces any misunderstanding, establishes expected behaviors, and provides an understanding of consequences.

A nurse should identify that which of the following is a U.S. congressional act that mandates mental health parity?

Affordable Care Act of 2010 The Affordable Care Act of 2010 mandates mental health parity. Parity is equal coverage for physical and mental health care, which is guaranteed under the Affordable Care Act of 2010.

A nurse encourage each client in a group session to speak and be heard. The nurse should identify that this is an example of which of the following ethical principles?

Justice. The nurse should identify that this is an example of justice. Justice involves caring for all clients equally and with the same level of fairness.

A nurse on a mental health unit is discussing laws that guide the care of clients on the unit with a newly hired staff member. Which of the following statements by the staff member indicates an understanding?

"A physical injury does not need to occur for a client to make a claim of battery." Battery is making contact with another person without their consent. The person does not need to be injured for battery to occur; the contact must simply be unwanted or offensive to the person.

A nurse is discussing milieu therapy with a group of newly licensed nurses. Which of the following statements should the nurse make?

"Create an environment that is safe and beneficial for recovery." The nurse should create an environment that promotes safety for the client and others and is beneficial for promoting recovery of the client. These elements are the foundation for maintaining a therapeutic milieu.

A nurse is discussing the purpose of ethics with a newly licensed nurse. Which of the following statements should the nurse make?

"Ethics provides a system of moral principles or standards for governing conduct." Ethics provides the nurse with a set of moral principles and standards, and is a basis for determining intentions, motives, and actions. A nurse's ethics is the basis from which conduct, including practices and decisions, is made.

A charge nurse on a mental health unit is discussing the concept of client competency with a group of newly licensed nurses. Which of the following information should the charge nurse include?

A client is considered mentally competent until deemed incompetent by a judge in a legal hearing. The nurse should include that clients are considered to be competent until following a hearing and a decision by a judge.

A nurse is planning an in-service about client confidentiality for a group of newly hired nurses. Which of the following examples should the nurse include when discussing exceptions for maintaining client confidentiality? (Select all that apply.)

A client tells a nurse that they intend to kill a coworker is correct. A nurse is subpoenaed to testify in court about a client they cared for is correct. An older adult client reports their caregiver allows them to eat one meal per day is correct. A client tells a nurse that they stole a watch from a friend's house is incorrect. A client tells a nurse that they plan to hang themselves when they are discharged is correct.

A nurse is caring for a group of children who have experienced trauma. During group therapy, the children create drawings representing their family and community. Which of the following interprofessional team members is likely leading this group?

Art therapist. An art therapist is likely leading this group. An art therapist uses different media, including painting, drawing, and pottery, to help clients explore their experiences and express their feelings.

A nurse is sitting with a client who is extremely anxious until they fall asleep. The nurse should identify that this is an example of which of the following ethical principles?

Beneficence. The nurse should identify that this is an example of beneficence. Beneficence involves acting in a manner that is "for the good" or in a way that benefits others.

A nurse is discussing false imprisonment with a group of newly hired staff members. Which of the following information should the nurse include?

Claims of false imprisonment are most often made in reference to the use of seclusion or restraints. False imprisonment is the confinement of a client when there is no legal reason to do so. Most claims of false imprisonment result from the use of seclusion or restraints.

A nurse is caring for several children who experienced trauma. One of the children goes to group therapy wearing a cape and pretending to be a superhero. The nurse should identify that which of the following interprofessional team member should lead the group session?

Drama therapist. A drama therapist encourages clients to act out feelings that may be difficult for them to express in words. Therefore, the nurse should identify that a drama therapist should lead the group session.

A nurse is discussing responsibilities in milieu therapy with a group of newly hired nurses. Which of the following should the nurse include? (Select all that apply.)

Explain unit rules, including expectations and client rights is correct. Provide orientation, including a tour of the unit, rules, and expectations is correct. Select activities based on preferences of available staff is incorrect. Ensure that culturally-sensitive care is provided is correct. Use a trauma-informed approach to client care is correct.

A nurse is discussing privacy and confidentiality with a client. Which of the following is a U.S. congressional act that sets the standards for client privacy and confidentiality?

Health Insurance Portability and Accountability Act. The Health Insurance Portability and Accountability Act (HIPAA) protects the privacy and confidentiality of a client's health information.

A nurse is caring for a client who has schizophrenia and has recently been diagnosed with a terminal illness. The client's interprofessional team should recommend which of the following for the client?

Hospice care. The interprofessional team should recommend hospice care for this client. Hospice care focuses on the care, comfort, and quality of life for a person who has a terminal illness and is approaching the end of life.

A nurse overhears unit staff workers making jokes about a nursing student. This is an example of which of the following?

Incivility. This is an example of incivility. Incivility is an act or behavior that shows disrespect and lack of courtesy. Such acts, whether intended or unintended, are considered acts of aggression and can affect the well-being of the individual and negatively impact the work environment.

A nurse is discussing what to do about feeling of burnout with a group of nurses. Which of the following is the best strategy the nurse should implement?

Meet with other nurses to create a plan to support each other. Having a supportive team helps prevent burnout and has been identified as the most effective strategy for reducing burnout. Other strategies that help to prevent burnout include shared governance, supportive leadership, a good professional identity, and consistent self-care.

A nurse is caring for a newly admitted client who expresses concern that their insurance will not over their care. The nurse should identify that which of the following is a U.S. congressional act that requires providers to inform their clients of the cost for treatment and whether their insurance will cover it?

No Surprises Act. In December 2021, Congress passed the No Surprises Act, which requires providers to inform clients of the cost of treatment and whether providers are covered by their insurance.

A nurse is discussing the effects of workplace violence by clients and their family members on health care professionals with a peer. The nurse should identify that which of the following organizations provides oversight for nurses regarding workplace violence?

Occupational Safety and Health Administration. OSHA is the organization that is tasked with ensuring worker safety, including providing oversight for workplace violence.

A nurse is caring for a client who is in physical restraints. The nurse should identify that which of the following complications can result from inadequate monitoring of the client? (Select all that apply.)

Positional asphyxia is correct. Food aspiration is correct. Cardiac arrest is correct. Infection is incorrect. Somnolence is incorrect.

A nurse is preparing a client who has schizophrenia for a magnetic resonance imaging (MRI) of their head to determine if they have a brain injury or a new onset of dementia. The nurse should identify that which of the following members of the interprofessional team likely prescribe the MRI?

Psychiatrist. The nurse should identify that a psychiatrist likely prescribed the MRI. Psychiatrists are medical doctors who can diagnose and prescribe medical procedures, tests, and medications.

A nurse is discussing burnout among nurses with a colleague. Which of the following is a strategy to reduce burnout?

Self-scheduling work shifts. Self-scheduling work shifts allows nurses to have more control over work-life balance and helps reduce burnout. Strategies for reducing burnout include engagement in shared governance, effective communication, supportive teams, supportive leadership, and consistent self-care.

A nurse in the emergency department is caring for a client who experienced abuse by an intimate partner and is scared to return home. To which of the following interprofessional team members should the nurse refer the client?

Social worker. The nurse should refer the client to a social worker. Social workers provide client support and advocacy related to living situations.

A nurse is leading a group session when a client begins cursing and running around the room shouting. Which of the following actions should the nurse take?

Suggest the client go someplace quiet and compose themselves. Suggesting the client go someplace quiet and compose themselves indicates that the nurse will not tolerate their behavior. This is an example of a less restrictive alternative to restraints and will give the client a chance to change their behavior prior to returning to the group.

A newly hired nurse confides in another nurse that desperate trying to be hopeful, they feel very depressed. Which of the following actions should the nurse take?

Suggest the newly hired nurse contact a mental health professional. When a fellow nurse or client confides that they are experiencing manifestations of burnout, depression, or another mental health concern, it is appropriate to encourage them to seek professional mental health care.

A nurse on a mental helaht unit is caring for a client who becomes agitated. The nurse encourages the client to return to their room to calm down. Which of the following de-escalation techniques is the nurse using?

Time out. The nurse is using the de-escalation technique of time out. Time out involves giving the client time to regain control of their emotions, calm down, and end the behavior.

A nurse is beginning a debrief with staff about a behavioral emergency that resulted in physically restraining a client. The nurse should identify that which of the following is the purpose of debriefing?

To improve the quality of future responses. The purpose of debriefing is to review what happened and determine what should be done to improve the quality of future responses. Debriefing provides staff and clients with the opportunity to discuss how the situation evolved, their feelings, and to promote recovery for the client.

A nurse tells a client that they will return in 30 minutes with their medication. The nurse returns 30 minutes later with the client's medications. Which of the following ethical principles is the nurse demonstrating?

Veracity The nurse is demonstrating veracity. Veracity involves being truthful and honoring the verbal commitment made to a client.