MH Prep U 4: rights & legal issues

The nurse is detaining the client from leaving the hospital by refusing to allow him to take his personal items. This is an example of which of the following?

False imprisonment

Two nurses are discussing the rights of hospitalized psychiatric clients. Which statement is an error?

If a committed client is also found to be incompetent, the client loses the client's rights under the Patient's Bill of Rights.

A client who had agreed to be hospitalized for depression has decided that he/she wants to leave the hospital. The mental health staff caring for the client realizes that at present the client can legally:

leave even if doing so is against medical advice (AMA).

A psychiatric treatment team is planning care for a client who was involuntarily admitted for treatment of depression and suicide ideation. When planning care, of what legal parameters of care must the nurse be aware?

The client can refuse medication.

A client with a longstanding history of depression created a psychiatric advance directive (PAD) several months ago that explicitly ruled out the use of electroconvulsive therapy (ECT). After dialoguing with the care team, the client has changed his mind and is willing to consider ECT. The nurse should inform the client that:

the PAD can be cancelled, providing the client is legally competent.

Which of the following is an example of the nurse breaching the client's right to confidentiality?

Releasing information to a client's employer when his Human Resources Director calls to check on his status

A client made threats to harm the client's parents if they come too close to the client. The parents called 911, and the client is now held involuntarily for a psychiatric evaluation. During this time of involuntary admission, the client retains all client rights except for what?

Right to freedom

Which of the following rights could the psychiatric client lose when admitted to a locked, inpatient psychiatric treatment facility?

Right to schedule his or her own time

The nurse is threatening to give the client an injection in order to restrain the client for inappropriate behavior. This is an example of

Assault

The nurse is reading a journal article that describes legal action brought against a nurse because the nurse touched a client without consent. The nurse interprets this legal action as an example of which tort?

battery

A nurse is talking with a psychiatric-mental health nurse practitioner and says, "I know I need to maintain a client's privacy and confidentiality, but is there a difference between these two?" Which response by the nurse practictioner would be most appropriate?

"Confidentiality affords the client privacy."

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?

"It could be construed as assault"

The nurse is admitting a client to the hospital. The nurse gives the client information about client 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."

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?

A client who is being held involuntarily in a secure psychiatric setting

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

When describing an external advocacy system, which agency would the nurse most likely include? Select all that apply.

American Hospital Association American Healthcare Association American Public Health Association

The nurse recognizes that the difference between a voluntary and an involuntary commitment is what?

An involuntarily committed client may not initiate his or her own discharge

A psychiatric-mental health nurse is admitting a client to the facility. How should the nurse best apply the principles of the Patient Self-Determination Act (PSDA) during this process?

Ask the client about any advance care directives that that the client has established

A client who has depression is admitted to treatment on a voluntary basis. While in the hospital, the client makes several comments about wanting to "end it all." The client decides one day to leave against medical advice. Which would be the most appropriate action by the nursing staff?

Contacting the psychiatrist for initiation of commitment proceedings

Which is an accurate statement regarding an advance care directive?

It must be witnessed by two people and notarized.

A client has lived independently prior to being admitted to an inpatient unit. The client will be unable to return home following discharge. Which environment would be most appropriate for the client?

Least restrictive

Placing a client in restraints before using other methods of intervention violates the client's right to ...

Receive treatment in the least restrictive environment

Which action is a violation of a psychiatric client's rights?

Staff members confiscate letters written by a committed client that are addressed to a local newspaper.

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?

Tarasoff v. Regents of the University of California

A client with schizophrenia has a psychiatric advance directive (PAD) which rules out the use of antipsychotics. The care team would be justified in disregarding the provisions of the PAD in which circumstance?

The PAD is verbal, not written.

A client has been voluntarily admitted to the hospital. The nurse knows that which of the following statements is inconsistent with this type of hospitalization?

The client cannot be released without medical advice.

A psychiatric-mental health client has been admitted to the emergency department following an episode of psychotic behavior. The client has presented a written psychiatric advance directive (PAD) that exhaustively details many aspects of her desired care. What factor should prompt the care team to disregard the provisions of the PAD?

The client had been deemed legally incompetent when she created the document

Which nursing intervention constitutes false imprisonment?

The client has been "pesky," seeking the attention of nurses in the nurses' station much of the day. Now the nurse escorts the client to the room and tells the client to stay there or be put into seclusion.

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? Select all that apply.

autism traumatic brain injury orthopedic impairment

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.

Which element of malpractice occurs when the nurse does not act as a reasonable, prudent person would have acted in a similar circumstance?

breach of duty

A client has been admitted to the psychiatric facility for the treatment of depression. The client has told the emergency department staff that she would like a close friend to make decisions surrounding her care until she "feels better." In order to identify the legal basis for the client's preference, the nurse should:

determine whether a durable power of attorney has been established.

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?

durable power of attorney

In which type of involuntary commitment does the judicial system often remit the client to a state psychiatric setting until further notice?

extended

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

The inappropriate use of restraints or seclusion is considered which form of intentional tort?

false imprisonment

A client who has attempted suicide with a drug overdose has been released from an inpatient setting and has returned to school. The client continues to need routine psychiatric services. The nurse should explain to the client that she or he will most likely be referred to which of the following services?

intensive outpatient program.

A client diagnosed with depression tells the psychiatric-mental health nurse that the client wants to use an herbal supplement to treat the symptoms rather than an antidepressant. The nurse interprets this information as demonstrating which concept?

self-determinism

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

During rounds, a client with depression is discovered to have completed a suicide attempt in the bathroom. The staff members on the inpatient psychiatric unit have been very busy and fell behind on periodic assessment for this client. The client's family decides to pursue legal action against the staff and facility. The client's family would most likely claim:

malpractice

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

A nurse is reviewing medical records to look for violations of client rights. What finding would signal a violation of client rights?

no documentation of benefits of treatment or treatment options

Samuel has been committed involuntarily to a psychiatric-mental health facility to allow time to determine an appropriate diagnosis. What is this type of involuntary commitment known as?

observational

To care for clients in the least restrictive environment, treatment is usually delivered in which care setting?

outpatient

A nurse in the emergency department is planning for a client with mental illness to be placed in an inpatient hospitalization. Which is a condition of this type of admission?

present a clear danger to self or others