MH: CH3

For a nurse or health care provider to be found negligent, what requirements must the provider's misconduct meet? (Select all that apply.) a. The provider owed a duty to the client. b. The provider breached a duty to the client. c. The provider had intent to harm the client. d. The provider caused injury to the client by action or inaction. e. The provider caused loss or damage through his or her actions.

-The provider owed a duty to the client. -The provider breached a duty to the client. -The provider caused injury to the client by action or inaction. -The provider caused loss or damage through his or her actions.

If a person is perceived to be a threat to himself or others, who can implement an involuntary commitment to a mental health facility? (Select all that apply.) a. Family members b. Police c. Physicians d. Social workers e. Representatives of a county administrator

-police -physicians -representatives of a county administrator

If a client is involuntarily committed to a mental health care facility indefinitely, the law requires that the case must be reviewed every:

12 months rationale:Although the case is being reviewed constantly by the mental health care team, the court must review the indefinite commitment on a yearly basis

Which of the following circumstances, when it occurs on an inpatient mental health unit, would be considered false imprisonment

An alert and oriented client is confined to his room after being loud and argumentative with another client in the recreation area. rationale:The client cannot be confined to his room if he did not pose a threat to himself or others, or if no contract was made with the client regarding consequences for inappropriate behavior. All of the other options are appropriate because they follow guidelines for client safety.

A male client is being argumentative during a group therapy session. The psychiatric technician warns the client that if he does not cooperate with the nurse, he will be physically restrained and taken to his room for the remainder of the day. For which action could the technician be held liable?

Assault rationale:The technician is engaging in assault, which is any act that threatens a client. Battery of a client occurs when any physical act of touching occurs without the client's permission. Privacy refers to issues related to the body and confidentiality, and fraud is giving false information.

The nurse encounters a client crying in her room. Upon talking to the client, it is discovered that she is upset because a new nursing assistant made her go out for a walk with the group even though the client informed her that she waits for her daughter to go for her walk. This is a potential violation of which ethical principle?

Autonomy rationale:Autonomy refers to the right of people to act for themselves and make personal choices. The principle of beneficence refers to actively doing good, and maleficence refers to doing no harm. Confidentiality is not violated in this situation

An important responsibility of the nurse in a mental health facility is to ensure that clients do not __________ from the facility without a discharge order, by carefully supervising and accurately documenting client behaviors and therapeutic actions.

Elope rationale:The appropriate terminology used when a client runs away from a facility without a discharge order is elopement. In the event of elopement, the caregiver can be held liable if a client becomes injured.

The client is feeling very anxious and has requested that a prn. antianxiety medication be ordered. The nurse informs the client that the medication can be administered only every 4 hours and was given 3 hours ago. The nurse promises to give the client the medication as soon as it is due, but the nurse goes to lunch 1 hour later without giving the client the medication. Which ethical principle did the nurse violate?

Fidelity rationale:Fidelity refers to the obligation to keep one's word. The nurse violated this principle in this situation, which leads to mistrust from the client. Veracity is the duty to tell the truth, confidentiality is the duty of keeping the client's information private, and justice indicates that all clients must be treated fairly, equally, and respectfully

If a female client tells the nurse of extensive plans, she has to harm the girlfriend of her ex-husband, what is the nurse's best action?

Inform the girlfriend of the intentions of the client. rationale:Health care providers have a duty to warn others when serious harm may occur as the result of actions taken by the client. This does not breach confidentiality because providers have an obligation to protect the public as well as the client. In addition to warning the client, the nurse should inform the client's physician and the nursing supervisor and must document the situation and actions taken. The other options are not adequate to meet the duty to warn or to prevent harm to the girlfriend

A male teenage client tells the nurse that his friends like to drink alcohol occasionally to get drunk. The client's friends see nothing wrong with their drinking habits. The client states that he was taught by his parents and agrees that underage drinking is not acceptable. Also, he has never seen his parents drunk; therefore, he refuses to drink with his friends. Which mode of transmission best describes how this client's particular value was formed?

Modeling rationale:Modeling best describes how the teenage client developed this value because his parents not only discussed this issue but also behaved in a way for the teen to copy. Moralizing sets standards of right and wrong with no choices allowed; the reward-punishment model rewards valued behavior and punishes undesired behavior; and the laissez-faire model imposes no restriction or direction on choices.

A client preparing for discharge from an inpatient unit asks a nurse which psychiatrist she would recommend to use for follow-up as an outpatient. The nurse responds, "There are several good physicians on your list. Make sure you do not use Dr. Smith. I have heard some terrible things about his methods of treatment." This is an example of which type of potential liability?

Slander rationale:Slander is verbal defamation, which is false communication, and can result in harm to the psychiatrist's practice. Libel is written defamation, and assault is threat of bodily harm. Invasion of privacy pertains to confidential information and is not pertinent in this case.

The psychiatrist asks the nurse to perform a procedure that she is not familiar with, and the nurse is unsure whether this is something within the scope of practice. Where can the nurse find the answer to her question?

State nurse practice act rationale:Each state's board of nursing determines the scope of practice in that state through a series of regulations that are called nurse practice acts. It is the nurse's responsibility to know his or her scope of practice. The other options do not exist.

A female client becomes combative when the nurse attempts to administer routine medications. The nurse would like to ignore the client but chooses to talk with the client to calm her. The nurse is successful in calming the client, and the client takes her medications. What process best describes how the nurse decided on the course of action taken?

Values clarification rationale:Values clarification consists of the steps of choosing, prizing, and acting. This most accurately describes how the nurse made the proper decision. The nurse chose the best action, reaffirmed the choice, and then enacted the choice. The nurse's rights were not violated, and beliefs and morals do not describe the entire decision-making process that occurred.

A male client is seeking help in a mental health clinic for anger management problems. He voices that he is fearful that his wife may divorce him because of his anger problem, and he is willing to do "whatever it takes" to control his anger. Later in the week, the client's wife also seeks assistance because she is going to divorce her husband. The nurse who is caring for both of these clients tries to decide the correct action to take. The nurse is experiencing:

an ethical conflict (or dilemma). rationale:This is an example of an ethical conflict or ethical dilemma. The nurse wants to help both clients but must maintain confidentiality for each. Use of guidelines for ethical decision-making can assist the nurse in making an ethical decision. A moral dilemma is simply a dilemma associated with making a decision between right and wrong. Value clarification is a process that helps to identify an individual's values

A client frequently wanders around the unit, and the staff frequently needs to reorient the client to the environment and remind her not to walk into the rooms of other clients on the unit. Due to short staffing, the decision is made to use a restraint device to prevent this from occurring. This action may constitute:

false imprisonment rationale:The application of protective devices and restraints may constitute false imprisonment. Restraints must be used only to protect the client, not for staff convenience. All less restrictive measures should first be attempted and documente

Twenty-three states have enacted mental health parity laws. The most accurate description of these laws is that they require insurance companies to:

include coverage for mental illness that is equal to coverage for physical illness rationale:The mental health parity laws require insurance companies to include coverage for mental illness that is equal to coverage for physical illness. Only nine states include treatment for substance abuse in their parity laws.

The nurse often assists in the process of obtaining informed consent from the client for treatment and/or procedures. Who has the responsibility of providing information to the client so he can give informed consent?

physician rationale:The physician is responsible for providing the client with the information necessary to give informed consent, including expectations and risks involved. The nurse can assist by obtaining the written documentation necessary for informed consent.

Standards of nursing practice for mental health can best be described as helping to ensure:

quality and effectiveness of care rationale:Most health care disciplines have standards of practice documented as guidelines with measurable criteria that can be used to evaluate the quality and effectiveness of care provided. All clients have the right to receive care, so standards of nursing practice would not address who receives care. Although proper documentation and proper medication administration might be part of the evaluation process, they do not provide complete evaluation of quality and effectiveness of care.