Test #3 - Chapter 9

The nurse is assessing whether a room is fit for seclusion of clients. What are the requirements of a seclusion room? Select all that apply.

The room should not have any sharp objects. The room should have a bed that is bolted to the floor. The room should have facility for direct visual monitoring.

The client is brought to the hospital in a coma. The nurse understands that when a person is incapacitated, the document used to dictate the patient's written instructions for health care is called:

advance directive

A client diagnosed with schizophrenia insists on stopping medication because it causes the client to gain weight. The client is exercising which ethical principle?

autonomy

A client with depression tells the nurse, "I want to stop taking my antidepressant medication because I don't like taking medications." The nurse discusses the benefits of adhering to the medication plan and strongly urges the client to use the medication. The nurse interprets the client's statement as reflecting which ethical principle?

autonomy

The nurse is caring for a client that is confused. The nurse, while giving the client a bed bath leaves the room to get supplies. The nurse returns to find the client on the floor with the bed in high position, and side rails down. What law has been broken?

negligence

The nursing student is learning about ethical principles paired with nursing practice. The nursing educator asks, "Which example of an ethical principle is correctly paired with nursing practice?" Which statement by the student would be correct?

"Fully answering the client's questions without withholding information."

The nurse manager is reviewing ethical principles at a staff meeting. The manager asks, "What examples of non-maleficence can you provide?" Which response(s) by the staff nurse are most appropriate? Select all that apply.

"Giving the client an injection for a sexually transmitted infection (STIs)" "Assisting with the client's bone marrow transplant" "Performing chest compressions for a client with no pulse"

A nurse working on a psychiatric unit receives a telephone call from the employer of one of the clients on the unit. The employer asks to be sent a copy of the client's latest laboratory work and psychological testing results so the client's medical records in employee health can be kept up to date. Based on the nurse's knowledge about issues surrounding breach of confidentiality, which response would be the most appropriate?

"I am unable to acknowledge whether or not this client is a client on this unit."

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

A nurse is providing care to a male client who is hospitalized with a diagnosis of schizophrenia. Which would be appropriate for the nurse to include in the client's medical record?

"Reports being unable to sleep because the client heard voices throughout the night."

Which statements made by the nurse demonstrate a need for additinal education regarding the use of seclusion? Select all that apply.

"Seclusion helps the client to be more active." "Seclusion minimizes the use of psychotropic drugs."

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."

What is provided in the Code of Ethics for Nurses of the American Nurses Association (ANA)?

A guideline for nurses regarding ethical conduct

A client with depression who is undergoing a colonoscopy tomorrow is receiving preoperative education regarding the procedure. Which nursing task best describes the explanation of the procedure and the associated risks and benefits?

Acquiring informed consent

A physician would like to include a client with schizophrenia in a research study testing a new medication. The nurse's obligation is to do what?

Assess the client's legal capacity when that client is asked to give consent.

The depressed client is deciding which type of treatment would be beneficial. The nurse would document that the client is utilizing which ethical principle in this situation?

Autonomy

A nurse recruiter is interveiwing a nurse for a psychiatric-mental health nursing position at the community clinic. When reviewing the applicant's educational background, the recruiter would identify which as the preferred level of preparation?

Bachelor's degree

A client was admitted for electroconvulsive therapy (ECT). The physician performing the procedure failed to obtain informed consent before the ECT was administered. The physician could be charged with what?

Battery

A client is being seen in the mental health clinic because of relapse. The client has been nonadherent with the medication regimen. The nurse reinforces the advantages of taking medications. The nurse is using which ethical principle?

Beneficence

Which is indicative of a voluntary admission?

Client makes an autonomous decision to seek inpatient treatment

A new nursing student correctly identifies which as most essential for guiding psychiatric-mental health nursing actions?

Code of Ethics for Nurses

Which client behavior would prompt the nurse manager to discuss the duty to warn with staff members?

Danger to others.

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

Earlier in the shift, the nurse promised to help a client acquire some paper and a pen and draft a letter to a family member later in the day. The nurse became increasingly busy during the shift but has now taken some time to assist the client in this way. What ethical principle has the nurse best exemplified?

Fidelity

A client in a psychiatric facility has ideations about killing the client's spouse. This client requests to be discharged from the facility. Which represents the most appropriate action? The health care provider should:

File for a civil commitment to detain.

When promoting client safety on an inpatient psychiatric unit, which interventions would be used as the measure of last resort?

Four-point restraint

What is the therapeutic goal of seclusion?

Give the client the opportunity to gain self-control

When staff members physically control the client and move him or her to a seclusion room, what form of restraint is being implemented?

Human

A psychiatric-mental health nurse is working with local government officials in establishing programs that allow access to services for all individuals in the community. The nurse is integrating which ethical principle?

Justice

Which ethical principle is in jeopardy when segments of the mentally ill population do not have access to care?

Justice

One way that nurses can protect themselves against liability from malpractice is to do what?

Know the statutory and professional standards.

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

When assessing if a procedural risk to a client is justified, the ethical principle underlying the dilemma is known as what?

Nonmaleficence

Which ethical principle focuses on the duty to do no harm?

Nonmaleficence

A psychiatric-mental health nurse is practicing at the advanced level. Which function would this nurse be able to perform based on the nurse's advanced level of preparation?

Psychotherapy

A nursing student identifies which as the most important tool of psychiatric nursing?

Self

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

The interdisciplinary team is discussing the best approach to planning the care for a client with complex psychiatric-mental health needs. When determining which tasks can be performed by the psychiatric-mental health registered nurse (PMH-RN) and which must be performed by the psychiatric-mental health advanced practice registered nurse (PMH-APRN), the team should prioritize guidelines from what source?

The American Nurses Association Standards of Practice

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 22-year-old client has voluntarily sought treatment for an eating disorder at a rural residential facility. Despite a promising start, the client has been involved in recent conflicts with staff members and insists that the client wants to leave the facility. Staff members have refused to facilitate the client's transportation from the facility and have stated that they will not return the client's money and identification that were held when the client was admitted. Staff at the treatment facility may be guilty of false imprisonment due to what?

The client voluntarily admitted for treatment.

When it is discovered that a nurse did not act reasonably when providing care in accordance with the standards of professional practice, which factor would confirm the nurse has been negligent?

The nurse was responsible for client injury

A client with a psychiatric illness has become extremely aggressive and the nurse decides that the client needs to be restrained. Which action would be considered human restraint?

The nurse and a group of paramedics hold the client.

Professional regulations and laws that govern nursing practice are in place for what reason?

To protect the safety of the public

A client with bipolar disorder has been following the prescribed medication regimen. The client indicates to the nurse a desire to stop the medication now that the client is feeling better. The nurse tells the client that most likely the client will have to remain on the medication for life to keep the condition under control. The nurse is practicing which principle?

Veracity

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.

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?

autonomy and beneficence

The client has not been on speaking terms with the client's parents for several years. The parents have expressed a desire to reunite with the client. At first, the client agreed to a family meeting, and then decided not to meet with the parents. The nurse has encouraged the client to attend the family meeting knowing that the family's support would be valuable. What ethical principles are in conflict in this situation?

autonomy and beneficence

Providing milieu therapy is an example of the use of which ethical principle?

beneficence

The nurse is teaching a client about the importance of adhering to a medication regimen. The client does not believe that it is important. The nurse is communicating which ethical principle?

beneficence

A nursing student is initiating a relationship with an assigned client. After meeting and spending approximately 20 minutes talking with the client, the student makes arrangements to visit again after lunch. After lunch, fellow classmates invite the student to go to the gym with them and a group of clients to play volleyball. The student starts to go with them but then remembers the promise to meet with the client. The student decides to forgo volleyball and talk with the client. The student's decision reflects which ethical principle?

fidelity

After spending 45 minutes talking with an assigned patient, the student nurse promises to visit again after lunch. After lunch, the nursing student returns and talks with her client. The student's action reflects which ethical principle?

fidelity

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, for those without health insurance, and for those with very little income. The student nurse's opinion most closely reflects which ethical principle?

justice

Which ethical principles become an issue in mental health when a segment of a population does not have access to health care?

justice

The nursing instructor is talking to a class of nursing students about the American's with Disabilities Act, and persons having various disabilities that have the right to education in the least restrictive environment. The nursing instructor asks the students, "what is the reason for the least restrictive environment?" Which example should the student nurse choose?

unique needs