Chapter 6 legal ethical

1,3,4

Legally what is required for a long-term involuntary client admission? Select all that apply. 1 Judicial review 2 Client consent 3 Medical certification 4 Administrative action 5 Need for client observation

unintentional tort

the unintended act of causing injury or harm to another person

Slander

used to describe the liability issue of sharing confidential documents with nonmedical

60-80 days

long-term involuntary client admission

Objectives

objectives

Veracity

one's duty to communicate truthfully

autonomy

respecting the rights of others to make their own decisions. Acknowledging the patient's rights to refuse medication .

ethical dilemma

results when there is a conflict between two or more courses of action, each carrying favorable and unfavorable consequences.

False Imprisonment

the arbitrary holding of a client against his or her will.

Habeas Corpus

the procedural mechanism used to challenge unlawful detention by the government (such as involuntary mental health commitments

1,2,3,4

How is a client's medical record used in legal cases? Select all that apply. 1 To support a claim that medical or nursing treatment has resulted in personal injury 2 To determine the extent of injuries resulting from physical or sexual abuse 3 To identify the amount of existing mental disability to determine competency 4 To determine the rehabilitative potential in workers' compensation cases 5 To support reimbursement claims for services provided by facilities

2

In response to a student's question regarding choosing a psychiatric specialty, a charge nurse states, "Mentally ill clients need special care. If I were in that position, I'd want a caring nurse also." From which ethical framework is the charge nurse operating? 1. Kantianism 2. Christian ethics 3. Ethical egoism 4. Utilitarianism

If a client is placed in seclusion and held there for 24 hours without a written prescription or examination by a health care provider, what has the client experienced? 1 Battery 2 Defamation of character 3 False imprisonment 4 Assault

3

1

A psychiatric nurse working on an inpatient unit receives a call asking if an individual has been a client in the facility. Which nursing response reflects appropriate legal and ethical obligations? 1. The nurse refuses to give any information to the caller, citing rules of confidentiality. 2. The nurse hangs up on the caller. 3. The nurse confirms that the person has been at the facility but adds no additional information. 4. The nurse suggests that the caller speak to the client's therapist.

beneficence, autonomy, justice, fidelity, veracity

5 principles of bioethics

3

A brother calls to speak to his sister, who has been admitted to a psychiatric unit. The nurse connects him to the community phone, and the sister is summoned. Later the nurse realizes that the brother was not on the client's approved call list. What law has the nurse broken? 1. The National Alliance for the Mentally Ill Act 2. The Tarasoff Ruling 3. The Health Insurance Portability and Accountability Act 4. The Good Samaritan Law

1

A client diagnosed with schizophrenia receives fluphenazine decanoate (Prolixin Decanoate) from a home-health nurse. The client refuses medication at one regularly scheduled home visit. Which nursing intervention is ethically appropriate? 1. Allow the client to decline the medication and document the decision. 2. Tell the client that if the medication is refused, hospitalization will occur. 3. Arrange with a relative to add the medication to the client's morning orange juice. 4. Call for help to hold the client down while the injection is administered.

3

A client diagnosed with schizophrenia refuses to take medication, citing the right of autonomy. Under which circumstance would a nurse have the right to medicate the client against the client's wishes? 1. A client makes inappropriate sexual innuendos to a staff member. 2. A client constantly demands attention from the nurse by begging, "Help me get better." 3. A client physically attacks another client after being confronted in group therapy. 4. A client refuses to bathe or perform hygienic activities.

1

A client requests information on several medications in order to make an informed choice about management of depression. A nurse should provide this information to facilitate which ethical principle? 1. Autonomy 2. Beneficence 3. Nonmaleficence 4. Justice

3

A client who will be receiving ECT must provide informed consent. Which situation should cause a nurse to question the validity of the informed consent? 1. The client is paranoid. 2. The client is 87 years old. 3. The client incorrectly reports his or her spouse's name, date, and time of day. 4. The client relies on his or her spouse to interpret the information.

4

A geriatric client is confused and wandering in and out of every door. Which scenario reflects the least restrictive alternative for this client? 1. The client is placed in seclusion. 2. The client is placed in a geriatric chair with tray. 3. The client is placed in soft Posey restraints. 4. The client is monitored by an ankle bracelet.

intentional tort

A wrongful act knowingly committed.

1,4,5

After disturbing the peace, an aggressive, disoriented, unkempt, homeless individual is escorted to an emergency department. The client threatens suicide. Which of the following criteria would enable a physician to consider involuntary commitment? (Select all that apply.) 1. Being dangerous to others 2. Being homeless 3. Being disruptive to the community 4. Being gravely disabled and unable to meet basic needs 5. Being suicidal

4

An inpatient psychiatric physician refuses to treat clients without insurance and prematurely discharges those whose insurance benefits have expired. Which ethical principle should a nurse determine has been violated based on these actions? 1. Autonomy 2. Beneficence 3. Nonmaleficence 4. Justice

2

An inpatient psychiatry facility provides unique passwords to each nurse to allow access to the selected client records. A nurse administrator forgets the password and wants to access the records using a co-worker nurse's password. What is the most appropriate action by the co-worker nurse? 1 Allow the nurse administrator to use the password to access the records. 2 Help the nurse administrator retrieve the password using appropriate sources. 3 Access the client records and provide required information to the nurse administrator. 4 Get permission from the nursing supervisor to share the password.

4

An involuntarily committed client is verbally abusive to the staff, repeatedly threatening to sue. The client records the full names and phone numbers of the staff. Which nursing action is most appropriate to decrease the possibility of a lawsuit? 1. Verbally redirect the client, and then refuse one-on-one interaction. 2. Involve the hospital's security division as soon as possible. 3. Notify the client that documenting personal staff information is against hospital policy. 4. Continue professional attempts to establish a positive working relationship with the client.

1

During a counseling session with an advanced practice psychiatric nurse, a client verbally threatens to assassinate a local politician. The nurse notifies the politician of the threat. Which analysis of the event is correct? 1 The nurse demonstrated the duty to warn. 2 The nurse violated the client's confidentiality. 3 The nurse released information without proper authorization. 4 The nurse should have notified law enforcement rather than the politician.

2

During a hiring interview, which response by a nursing applicant should indicate that the applicant operates from an ethical egoism framework? 1. "I would want to be treated in a caring manner if I were mentally ill." 2. "This job will pay the bills, and the workload is light enough for me." 3. "I will be happy caring for the mentally ill. Working in med/surg kills my back." 4. "It is my duty in life to be a psychiatric nurse. It is the right thing to do."

2

Group therapy is strongly encouraged, but not mandatory, in an inpatient psychiatric unit. The unit manager's policy is that clients can make a choice about whether or not to attend group therapy. Which ethical principle does the unit manager's policy preserve? 1. Justice 2. Autonomy 3. Veracity 4. Beneficence

Fidelity

Maintaining loyalty & commitment to the patient & doing no wrong to the patient.

Bioethics

Refers to the ethical questions that arose in health care

unconditional release

The discharge procedure is generally by an order of the court or an order of the medical authorities, like an administrative officer.

Beneficence

The duty to act so as to benefit or promote the good of others. Spending extra time to help a patient is

Justice

The duty to distribute resources or care equally , regardless of attributes, Ex. When ICU nurse devotes equal attention to pt who attempted suicide & suffered brain aneurysm

3

The nurse reads the medical record and learns that a client has agreed to receive treatment and abide by hospital rules. This information implies the client was admitted under which condition? 1 Per legal requirements 2 For a nonemergency 3 Voluntarily 4 Involuntarily

Ethics

The study of philosophical beliefs about what is considered right or wrong in society

3

What nursing intervention demonstrates an understanding of the concept of client autonomy? 1 Ordering the client to take medication 2 Convincing the client to take medication 3 Respecting the client's decision about medication 4 Asking the family to administer medication to the client

1

When a nurse fails to apply ordinary care in performing nursing responsibilities, which unethical act has the nurse committed? 1 Negligence 2 Malpractice 3 Breach of duty 4 Intentional tort

1,2,3,5

When considering mental health services, which statement regarding habeas corpus is true? Select all that apply. 1 This is the process to challenge an involuntary admission as being illegal. 2 This is a law that protects an individual's Fifth Amendment rights. 3 This process is associated with "due process" as required by the 14th Amendment. 4 All mental health admissions are dependent upon this legal process. 5 This process supports an individual's right to treatment in the least restrictive form.

2

Which discharge procedure involves the release of a client from the hospital based on a court order? 1 Conditional 2 Unconditional 3 Release against medical advice (AMA) 4 Involuntary outpatient commitment

2

Which is an example of an intentional tort? 1. A nurse fails to assess a client's obvious symptoms of neuroleptic malignant syndrome. 2. A nurse physically places an irritating client in four-point restraints. 3. A nurse makes a medication error and does not report the incident. 4. A nurse gives patient information to an unauthorized person.

1

Which legal issue involves sharing confidential documents with people other than those involved in nursing care? 1 Slander 2 Punitive damages 3 Supervisory liability 4 False imprisonment

2

Which potential client should a nurse identify as a candidate for involuntarily commitment? 1. The client living under a bridge in a cardboard box 2. The client threatening to commit suicide 3. The client who never bathes and wears a wool hat in the summer 4. The client who eats waste out of a garbage can

2

Which situation exemplifies both assault and battery? 1. The nurse becomes angry, calls the client offensive names, and withholds treatment. 2. The nurse threatens to "tie down" the client and then does so, against the client's wishes. 3. The nurse hides the client's clothes and medicates the client to prevent elopement. 4. The nurse restrains the client without just cause and communicates this to family.

3

Which situation reflects violation of the ethical principle of veracity? 1. A nurse discusses with a client another client's impending discharge. 2. A nurse refuses to give information to a physician who is not responsible for the client's care. 3. A nurse tricks a client into seclusion by asking the client to carry linen to the seclusion room. 4. A nurse does not treat all of the clients equally, regardless of illness severity.

1,2,3,5

Which statement accurately describes characteristics of an ethical dilemma? Select all that apply. 1 There is no clear solution to the dilemma. 2 There are two or more possible ways to resolve the dilemma. 3 There is a disagreement regarding beliefs among those involved in the dilemma. 4 The possible solutions to the dilemma rarely involve unpopular consequences. 5 The values of the facility and those of the care provider can at times be in conflict.

1

Which statement accurately describes negligence toward a client? 1 It is a failure to act in a way that a responsible employee would act. 2 It applies only when the client is abandoned or mistreated. 3 It is an action that puts the client in fear of being harmed by the employee. 4 It means the employee has given malicious false information about the client.

1

Which statement describes an unintentional tort? 1 An unplanned act that causes injury or harm to another person 2 The lack of ordinary care in a professional situation 3 An act that results in the breaching of professional duty 4 A purposeful act that violate a person's rights

4

Which statement should a nurse identify as correct regarding a client's right to refuse treatment? 1. Clients can refuse pharmacological but not psychological treatment. 2. Clients can refuse any treatment at any time. 3. Clients can refuse only electroconvulsive therapy (ECT). 4. Professionals can override treatment refusal by an actively suicidal or homicidal client.

1

Without authorization, a nurse administers an extra dose of narcotic tranquilizer to an agitated client. The nurse's coworker observes this action but does nothing for fear of retaliation. What is the ethical interpretation of the coworker's lack of involvement? 1. Taking no action is still considered an unethical action by the coworker. 2. Taking no action releases the coworker from ethical responsibility. 3. Taking no action is advised when potential adverse consequences are foreseen. 4. Taking no action is acceptable, because the coworker is only a bystander.