Ethical & Legal Issues in Mental Health Nursing
Gracie's roommate has left, and the nurse begins to talk with her. When asked if she had any questions before signing the consent form, which response indicates the need for nursing action?
"After I sign this, I want to go home, because I know I will do better at my own house."
A client admitted to the mental health unit asks the nurse to be the client's power of attorney. How should the nurse respond?
"I would like to understand more about your thoughts." "I am sorry, but that isn't appropriate since I am involved in your care."
Which ethical theory best fits the nursing scenario presented?
A nurse unintentionally causes pain when attempting to draw blood from a client.: KANTIANISM Wrong medication for depression was given by the nurse but the client had no adverse effects.: UTILITARIANISM A client with multiple personalities will only communicate with the nurse if the partner is present. The nurse discreetly sneaks the partner in despite no visitation rules.: ETHICAL EGOISM A client diagnosed with terminal pancreatic cancer and schizophrenia is discharged from hospice; the nurse prays for the client and family.: CHRISTIAN ETHICS A nurse sees a colleague take a narcotic medication rather than wasting it; the nurse innately feels compelled to report it.: NATURAL LAW THEORY
A nurse reviews the plan of care for a client admitted with a new diagnosis of bipolar disorder. What is the priority nursing intervention for this client?
Answer all client questions with factual information
Which ethical principle best matches the definition given?
Autonomy: Client has personal choice and ability to make decisions about care Beneficence: Advocating for client, doing what is in client's best interest Nonmaleficence: Ensuring client safety and absence of harm Justice: providing the same care to all clients Veracity: Being truthful, providing client with information unless it inhibits recovery
Of the client findings present, which are the 5 most important?
Erratic Behavior and Flat Affect History of Depression & Anxiety Refusal to Eat and Care for Self Increased Stress Level Sertraline 50 mg Daily
A nurse puts a client in a room alone, without potentially dangerous items. What is this action considered?
Seclusion
Which ethical principle is most applicable to the example given?
client prescribed medication but refuses to take it: AUTONOMY nurse intervenes when family member makes harmful decision on behalf of client: BENEFICENCE nurse removes restraints from a calm client: NONMALEFICENCE nurse cares for homicidal client in the same manner as all others: JUSTICE explain schizophrenia is a lifelong mental illness and has no cure: VERACITY
The nurse continues discussing potential stressors with Gracie, and she shares that she had an abortion a month ago. When the nurse asks follow up questions, Gracie becomes out of control and begins hitting her head on the cement floor. Despite trying all other interventions, the provider orders restraints to promote safety. What solutions are appropriate? Select all that apply.
Apply soft, padded wrist restraints to the client in bed Administer medication to assist in sedating Gracie temporarily Have a nurse sit with Gracie in the room to assess
A mental health client tells the nurse of plans to harm a neighbor using a knife and leaves the facility without treatment or admission. Based on what is known about privacy laws regarding sharing protected client information, what is the appropriate nursing action? Select all that apply.
Carefully document the client's words in exact quotes Notify the healthcare provider (HCP) and call local police per facility protocol
The nurse cares for Gracie and has the following actions. Which actions increase or decrease the risk of liability?
Discontinuing restraints when client is resting quietly: DECREASE LIABILITY Shares information about Gracie's violent behavior with a colleague in the elevator: INCREASE LIABILITY Completes bath after Gracie refuses: INCREASE LIABILITY Searching Gracie's purse for clues to her behavior without permission: INCREASE LIABILITY
The healthcare provider prescribes several things for Gracie. In which order should they be performed?
Establish IV Access Administer Alprazolam 1 mg IV Monitor VS q 15 minutes Draw blood for CBC and Electrolytes Consult Case Management for Discharge Planning
Which is a nursing care error that violates the Health Insurance Portability and Accountability Act (HIPAA)?
Leaving the computer logged in to the client's demographic information
Which ethical theory best fits the description listed?
Evaluates the motivation behind the decision and action taken out of duty: KANTIANISM Human nature and innate knowledge of right and wrong are self-evident: NATURAL LAW THEORY Decisions are based on what is best for the client without regard to rules or others: ETHICAL EGOISM Focuses on the end result and is often called "The Happiness Principle": UTILITARIANISM Uses the principle of doing unto others what you'd have done unto you: CHRISTIAN ETHICS
A nurse cares for a client and is performing vital signs and uses a blood pressure cuff that is too small. The client reports pain in the arm, but the nurse repeats the blood pressure to check the abnormal result. This occurs several times and the client files a lawsuit citing permanent nerve damage in the arm. For what can the nurse potentially be held liable? Select all that apply.
Negligence Malpractice
Based on the information provided about Gracie, the nurse should focus on ___________________ to provide the information she needs about her condition. Additionally, it is important to explain that Gracie's health information can be provided to legal authorities will remain _________________.
Veracity Will Remain Confidential
