Mental Health: chapter 6-Ethics, standards, and nursing frameworks

A nurse recruiter is interviewing 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? Associate's degree Bachelor's degree Master's degree Doctoral degree

Bachelor's degree

Which function would a psychiatric-mental health registered nurse be able to perform? Select all that apply. Prescribe medication Conduct psychotherapy Engage in consultation Implement the care plan Identify outcomes

Implement the care plan Identify outcomes

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

Justice

When assessing if a procedural risk to a client is justified, the ethical principle underlying the dilemma is known as what? Nonmaleficence Informed consent Self-determination Pro-choice

Nonmaleficence

Which of these activities are beyond the standards of practice of the psychiatric mental health (PMH) registered nurse and are reserved for the PMH advanced practice registered nurse? Select all that apply. Ordering a reduced dosage of a client's sustained serotonin reuptake inhibitor Structuring milieu therapy Planning and providing a health promotion activity Providing individual psychotherapy Providing group psychotherapy

Ordering a reduced dosage of a client's sustained serotonin reuptake inhibitor Structuring milieu therapy Providing individual psychotherapy Providing group psychotherapy

The concept of "least-restrictive environment" indicates that clients with mental health disorders have a right to be treated with programs or services that ... allow complete freedom of activities. achieve the highest level of functioning are based entirely on the client's symptoms. are effective at a low cost.

achieve the highest level of functioning

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 beneficence justice paternalism

autonomy

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

justice

A psychiatric-mental health nurse is assessing a client who has come to the community mental health clinic for an evaluation. Assessment reveals that the client has been sleeping only 1 to 2 hours per night due to nightmares. The client reports feeling "really tired, not being very hungry, and not eating much during the day." The client also describes intrusive thoughts and feeling like there is no end in sight. The client lives alone and rarely goes out with friends. When documenting the client's assessment, which information would the nurse interpret as relevant to the biologic domain? Select all that apply. Sleep problems Loss of appetite Intrusive thoughts Living alone Fatigue level

Sleep problems Loss of appetite Fatigue level

A nurse is implementing interventions that address a client's psychological domain. Which intervention would be most appropriate? Teaching the client about sleep hygiene Assisting with behavior therapy Encouraging support from the family Linking the client with community resources

Assisting with behavior therapy

The nurse identifies the standards of practice in psychiatric nursing to be organized around which of the following? Federal law State law Nursing process State board of nursing

Nursing process

A nurse is assessing a psychiatric client using the biopsychosocial model. Which area would the nurse address with the biologic domain? Family structure Behavior Nutritional patterns Cognitive level

Nutritional patterns

A psychiatric-mental health nurse is reviewing the medical record of a client with depression admitted to the acute inpatient facility because of a suicide attempt. Which statement by the client would the nurse correlate with the psychological domain of the biopsychosocial framework? "I live with my wife and 2 children in the suburbs." "I've lost any feelings of pleasure that I had with life." "I have absolutely no appetite for any food." "I haven't taken my medicines for about a week or more."

"I've lost any feelings of pleasure that I had with life."

A nursing instructor is teaching about the three domains of the biopsychosocial model. When discussing the social domain, the instructor recognizes a need for further education when a student states which of the following? "The social domain includes theories that account for the influence of social forces." "Social factors usually cause psychiatric disorders." "Family support can improve treatment outcomes." "Community forces can help shape a patient's response to treatment."

"Social factors usually cause psychiatric disorders."

What is provided in the Code of Ethics for Nurses of the American Nurses Association (ANA)? A description of case studies featuring ethical dilemmas A guideline for nurses regarding ethical conduct Information about what to do when confronted with an ethical dilemma Pathways to follow for each of the ethical principles

A guideline for nurses regarding ethical conduct

A nurse is reading a journal article about professional psychiatric nursing organziations. The nurse learns that these organizations are responsible for helping to shape mental health care in the United States. Which organization would the nurse most likely find as being described in the article? Select all that apply. ANA APNA AORN ISPN ACCN

ANA APNA ISPN

A nurse working in psychiatric-mental health who is a licensed registered nurse but also educationally prepared at the master's level and certified as a specialist is also known as which of the following? APN DNP PhD DNS

APN

The nurse is providing care for a client with a diagnosis of depression. How can the nurse best address the client's needs in the biologic domain? Administering the client's scheduled dose of citalopram Evaluating the client's response to milieu therapy Teaching the client communication techniques Encouraging the client to join a support group

Administering the client's scheduled dose of citalopram

Which role of the nurse-client relationship is being exhibited when the nurse informs the client and then supports him or her in whatever decision he or she makes? Advocate Caregiver Teacher Parent surrogate

Advocate

What action by a nurse best promotes the ethical principle of justice? Advocating for enhanced mental health services in an underserved neighborhood Informing a client who is competent that the client has the right to discontinue treatment Clearly describing the potential adverse effects of a client's new pharmacologic treatment Obtaining written, informed consent from a client who has agreed to be in a research study

Advocating for enhanced mental health services in an underserved neighborhood

A client who has bipolar disorder stops taking medication because the client says the client likes how the client feels in a manic state. The client is exercising which principle? Paternalism Autonomy Justice Veracity

Autonomy

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? Justice Beneficence Autonomy Veracity

Autonomy

Which ethical principle is being addressed when the nurse encourages an older, cognitively impaired client to select the food the client will be served for dinner? Justice Autonomy Beneficence Nonmaleficence

Autonomy

A new nursing student is studying ethics in nursing and informs a client who wants to stop medication about its benefits and how the client will continue to feel better only if use of the drug continues. Which concept is the nursing student using? Beneficence Autonomy Veracity Justice

Beneficence

A client with persistent depression is considering electroconvulsive therapy (ECT). The nurse has seen ECT be effective in other cases. When the client expresses fear and doubt about undergoing ECT, the nurse tries to talk the client into it, because the nurse truly believes it will help the client. Which two ethical concepts are in conflict? Beneficence and fidelity Fidelity and paternalism Justice and autonomy Beneficence and autonomy

Beneficence and autonomy

A psychiatric-mental health nurse is conducting a review course for a group of psychiatric-mental health nurses. The topic of the course is ethics in psychiatric nursing. The nurse determines that additional review is needed when the group identifies which concept as an ethical principle? Competency Veracity Fidelity Justice

Competency

A new graduate practicing in a psychiatric center has learned that there are two levels of practice: basic and advanced. The graduate correctly identifies which of the following as used to help differentiate these levels? Select all that apply. Educational preparation Personal preferences Complexity of practice Performance of nursing function Personal desires of the patient

Complexity of practice Performance of nursing function Educational preparation

A client's plan of care includes revoking privileges for inappropriate behavior, based on a contract between the client and the nurse who wrote the plan. Another nurse decides to ignore this because the client promises that the client will adhere to the contract in the future. The second nurse's behavior may have violated which ethical principle? Veracity Beneficence Autonomy Fidelity

Fidelity

A nurse tells a client that the nurse will bring the client pain medicine in 5 minutes after checking on another client. The nurse returns in 5 minutes and administers the medication as planned. The nurse is practicing which principle by returning as promised? Autonomy Nonmaleficence Paternalism Fidelity

Fidelity

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 Veracity Nonmaleficence Beneficence

Fidelity

A psychiatric-mental health nurse is working as part of an interdisciplinary team providing care to people with mental illnesses. When assisting with the development of plans of care, which aspect would be most important for the nurse to do related to the nursing plan of care? Include interventions outside the scope of nursing practice. Make the interventions individualized to the client's needs. Have nursing interventions be subsumed by other disciplines. Ensure that the other disciplines take control of the interventions.

Make the interventions individualized to the client's needs.

A psychiatric-mental health nurse practitioner is one of several nurses representing their employment facility at a local job fair in the community. One of the attendees approaches the nurse practitioner and asks about the nurse practitioner role. When describing this role, which educational level would the nurse practitioner cite as being the minimum requirement? Baccalaureate degree in nursing Doctorate in Nursing Science Master's degree in Nursing Associate's degree in Nursing

Master's degree in Nursing

A psychiatric-mental health nurse is conducting an in-service program for a group of nurses which includes a review about the American Nurses Association standards of practice for psychiatric-mental health nursing. After describing these standards, the nurse determines that the teaching was successful when the group identifies which information? Prescriptive authority is granted to any psychiatric-mental health registered nurses. All aspects of the standard for implementation apply to psychiatric-mental health registered nurses. Advanced practice nurses have a different set of standards from those of the psychiatric-mental health registered nurse. Psychiatric-mental health advanced practice nurses are the only ones who may provide psychotherapy.

Psychiatric-mental health advanced practice nurses are the only ones who may provide psychotherapy.

The advanced practice psychiatric nurse is working with a client who has generalized anxiety disorder. The nurse is teaching the client skills at identifying and managing the thoughts that exacerbate his anxiety. What domain is this nurse primarily addressing? Psychological Biologic Social Affective

Psychological

While caring for a client with insomnia, the nurse teaches the client to use guided imagery. This intervention is an example of which domain? Biologic Psychological Social All of the above

Psychological

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? Health promotion Counseling Psychotherapy Intake screening

Psychotherapy

When working with clients with mental illness, a psychiatric-mental health nurse examines the nurse's own interactions with clients to improve communication skills. The nurse is using which tool? Self Clinical reasoning Reflection Care planning

Reflection

A nursing student identifies which as the most important tool of psychiatric nursing? Clinical reasoning Reflection Self Plan of care

Self

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 The policies and procedures manual of the institution The recognized norms in the jurisdiction where the team is working The World Health Organization Guidelines for Nursing Practice

The American Nurses Association Standards of Practice

The nurse is working with a client who has expressed a desire to discontinue treatment. The care team knows that this decision would have negative consequences for the client and is discussing the ethics of the situation. In order to best address the situation, the nurse should first: ask reflective questions in order to fully understand the situation. enlist the assistance of the institution's legal team. ask the client to describe his wishes in writing. inform the client that agreeing with his decision would violate the principle of nonmaleficence.

ask reflective questions in order to fully understand the situation.

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 veracity and fidelity non-maleficence and autonomy justice and beneficence

autonomy and beneficence

Providing milieu therapy is an example of the use of which ethical principle? beneficence veracity fidelity autonomy

beneficence

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? beneficence non-maleficence fidelity veracity

fidelity

Which is an activity of an advanced practice registered nurse and beyond the scope of practice of a registered nurse? psychotherapy case management milieu therapy complementary interventions

psychotherapy

When providing care to a patient with major depression, what is the most important tool the nurse would use? self client physician client's family

self