MH TEST CH. 7
D
A 22-year-old client with schizophrenia is refusing antipsychotic medication. The client states, "I don't like the dopey way it makes me feel. I feel like I'm walking underwater when I take it." The nurse explains to the client, "Your schizophrenia is caused by a chemical imbalance in your brain, and this medication helps fix that chemical imbalance. You need to take it so your symptoms will get better." This conversation reflects a conflict between which two types of ethical principles? A) autonomy and justice B) paternalism and veracity C) justice and nonmaleficence D) autonomy and beneficence
C
Legal provisions requiring people with a mental illness to comply with a treatment plan while living in the community refer to: A) mandatory conditional leave. B) mandatory diversion treatment. C) mandatory outpatient treatment. D) community living right.
A
A client receives a court order for commitment. Which best exemplifies the concept of "least restrictive environment"? A) involuntary commitment to an outpatient community mental health centre B) medication administration for sedation so the client cannot get out of bed C) placement of client in a secured padded room in response to threats of self-harm D) admission of client to a locked inpatient psychiatric unit
B
A decision must be made whether individuals participating in research should be placed at risk by depriving them of the best known treatment in order to carry out a placebo-controlled study. Which approach to ethics would identify this act as inherently bad and a violation of a nurse's duty and obligations. A) virtue ethics B) deontology C) relational ethics D) utilitarianism
B
A nurse has requested permission from his or her employer to refrain from providing care because an aspect of it conflicts with the nurse's moral beliefs. On what basis is the nurse making this request? A) moral agent B) conscientious objection C) respect for autonomy D) beneficence
D
A nurse is caring for a client who is hospitalized for a mental disorder. The nurse is legally obligated to breach the client's confidentiality if the client states: A) "I think that the federal government is spying on me." B) "I get really 'turned on' by your appearance." C) "That doctor I had today really made me angry." D) "When I get out of here, I'm going to kill my neighbour."
B
A nurse is promoting a new program because it will bring about the best consequences for the greater number of people. The nurse is appealing to what principle? A) principlism B) utilitarianism C) justice D) beneficence
B
A nurse is trying to determine whether a client's consent for a treatment is valid. What variable should the nurse prioritize? A) the client's history B) the client's competence C) the client's diagnosis D) the client's future plans
B
A nurse is upset because his or her heavy workload does not allow him or her to provide the level of care that he or she believes his or her clients deserve. What is this nurse experiencing? A) reactive distress B) moral distress C) moral residue D) moral dilemma
D
A psychiatric nursing class is discussing current trends in mental health care. A student voices the opinion that there should be equitable access to mental health care and resources for those who live in rural areas and for those with very little income. The student nurse's opinion most closely reflects which ethical principle? A) nonmaleficence B) paternalism C) veracity D) justice
B
A psychiatric-mental health nurse is providing care to a client with depression. The nurse determines that a client is competent when the client is able to: A) speak coherent English. B) communicate his or her choice. C) write a "living will." D) comply with the medical regimen.
C,D,E
If a person is unable to consent to treatment because they are deemed not competent, a substitute decision-maker can be appointed. Which are possible substitute decision-makers? Select all that apply. A) an intraprofessional team B) the most responsible health care provider C) a state appointed person D) a guardian or relative E) a person who is appointed by the persons when competent
C
Psychiatric-mental health (PMH) nurses are responsible for understanding the Mental Health Act of their province and territory and to: A) advocate on behalf of the health profession the importance of the act. B) consider issues that affect individuals with medical problems. C) explain the act's basic provisions to people with mental illness and their families. D) support the provisions of the Mental Health Act and implement changes to the legislation.
D
The nurse is approaching a moral dilemma by identifying previous cases that are similar and the precedents that were set. The nurse is applying what principle? A) virtue ethics B) deontology C) principlism D) casuistry
D
The nurse is arguing that members of a community deserve assistance because they have experienced oppression and dominance in individual and societal-level relationships. What philosophy of ethics is the nurse appealing to? A) virtue ethics B) casuistry ethics C) relational ethics D) feminist ethics
D
The nurse is caring for a client who has a history of acting out violently against staff and other clients and who is once again seeking admission. The nurse is the shift supervisor and must decide whether the client is to be readmitted or if the client should be transferred to another setting. What phenomenon is this nurse experiencing? A) reactive distress B) moral distress C) moral residue D) moral dilemma
C
The nurse should intervene if others within the health care system fail to meet obligations when the obligation concerns what factor? A) client assignments B) information about colleagues C) confidentiality and privacy D) conscientious objection
B
What factor should be prioritized when a substitute decision-maker is making a decision for the client? A) precedent B) the client's best interests C) clinical practice guidelines D) low risk
D
What is the term for a type of psychiatric research study design that raises a particular ethical concern when the subject's medications are discontinued? A) placebo-controlled studies B) challenge studies C) questioning studies D) washout studies
A,B,C,D
Which are criteria for involuntary admission required by the Provincial and Territorial Mental Health Acts for all provinces and territories in Canada? Select all that apply. A) is not suitable as a voluntary inpatient B) meets the definition of a mental disorder C) meets the criteria for harm D) likely to suffer substantial mental or physical deterioration E) refusal of treatment by the person after admission
B,D,E
Which elements must be present in order to ensure an ethical health care environment? Select all that apply. A) nonquestioning B) compassion C) freedom from conflict D) empathy E) professionalism
A,C,E
Which factors are most likely to contribute to a nurse's moral distress? Select all that apply. A) lack of resources B) social isolation C) institutional demands D) diversity among coworkers E) demands from society that deviant behaviour be controlled
D
Which is an example of a type of information that may be disclosed without a client's consent? A) information that is not related to the client's health and well-being B) information regarding the boundaries requested by the client C) health information and care decisions shared among the team D) indicators of child abuse or abuse of adults in care
A
Which is the basis for the nurse's decision-making process to determine if the client is making a rational choice? A) capacity B) age C) diagnosis D) history
D
Which is the criterion for Involuntary Admission Criteria in clients determined to be in need of preventative detention in jurisdictions other than British Columbia, Saskatchewan, and Ontario? A) The client is deemed not competent to consent for treatment. B) The treatments are initiated by the client. C) The family members consider the client to be incompetent. D) The client is dangerous, but there is no treatment.
A
Which is true of the relationship between ethics and law? A) Law and ethics are separate domains. B) Ethics and law are the very same. C) Laws are always ethical. D) Ethics always guides the law.
A,E
Which questions should be considered when considering the ethical acceptability of a specific clinical genetic testing? Select all that apply. A) How predictive is the test? B) How long does the test take to administer? C) Who administers the test? D) Has the test been administered before? E) How stigmatized is the condition being tested for?
C
Which should be the first key question when the relational ethics decision-making framework is being used? A) What are the alternatives for ethical decision-making? B) What is the most fitting thing to do? C) What is happening here? D) What happened as the result of our action?
C
Which statement best described a nurse's fiduciary relationship with the public? A) Nurses are required to trust the public. B) In polls, nurses are consistently rated the most honest and ethical professionals. C) Nurses profess or claim they will honour to the public's trust as professionals. D) Nurses are only expected to display moral courage in times of crisis.
B,D,E
Which statements about ethics are true? Select all that apply. A) Ethics is defined as the practical application of law. B) Ethics is about values, relationships, principles, duties, rights, and responsibilities. C) Ethics and law belong to the same domain. D) Ethics is about learning how to reach our potential as human beings. E) Ethics needs to be an everyday part of our lives and build into our society.
