RNSG-Mental Health Unit 1 & Unit 2 Exam Practice (Client & Mental Health Safety: Legal & Ethical Considerations)
The removal of hazardous personal items would be an example of what component of milieu therapy?
safety
This type of prevention involves minimizing the early symptoms of a mental illness.
secondary prevention
Using mammogram for early detection of breast cancer can be best described as_______________ prevention.
secondary prevention
This act addresses the nation's opioid crisis and is a federal act:
SUPPORT ACT
What are the regular intervals that a client that is restrained or secluded must be checked ?
at least every 15 minutes
A clients participation in treatment would be an example of what component of milieu therapy?
autonomy
A person's right to self determination in order to make decisions about one's own care without undue interference to coercion from others
autonomy
This means an individual's voluntary agreement to participate in treatment or medical procedures based on their understanding of the risks and benefits as well as any alternative methods:
informed consent
Who should advance directives be given to ?
mental health -professionals, family members/loved ones, and the client's lawyer
This is defined as the range of mental-well being with excellent mental health at one end and mental disruptions or mental illness at the other end
mental health continuum
This is a principle rooted in keeping promises to clients and showing faithfulness while displaying integrity
fidelity
The nurse and client discussing a recent incident on the unit would be an example of what component of milieu therapy?
mutual respect
What is the most common unintentional tort:
negligence
A principle based on the nursing practice "do no harm"
nonmaleficence
A daily schedule posted on the unit would be an example of what component of milieu therapy?
predictability
Holding a class to encourage student to avoid drug use is an example of what type of prevention:
primary prevention
Immunizations are a form of what type of prevention?
primary prevention
This focuses on the prevention of a mental illness by focusing on both the individual client and their environment:
primary prevention
This happens when a person views you negatively because of a personal trait orcharpacteristic that they think is a disadvantage
stigma
For a client with diabetes if a nurse teaches the patient how to control their blood sugar, and does frequent examination on their feet then what type of prevention is this ?
tertiary prevention
Place the interventions in order from least restrictive to most restrictive: De-escalation, Seclusion, Time-out, Physical/Chemical restraint
1) De-escalation 2) Time out 3) Seclusion 4) Physical or Chemical restraint
A nurse is discussing responsibilities in milieu therapy with a group of newly hired nurses. Which of the following should the nurse include? (Select all that apply) A: Explain unit rules, including expectations, and client rights B: Provide orientation, including a tour of the unit, rules, and expectations. C: Select activities based on preferences of available staff D: Ensure that culturally-sensitive care is provided E: Use a trauma-informed approach to client care.
A,B,D,E
Which of the following situations allow exceptions to client privacy and confidentiality: A: A client tells a nurse they plan to shoot a previous business associate. B: A client tells a nurse they stole money from their partner. C: An older adult client tells a nurse that their adult children no longer visit. D: An older adult client tells a nurse they were shoved by a caregiver. E: A client tells a nurse they purchased a handgun to end their life.
A,D,E
A nurse is describing outpatient mental health settings. Which of the following are considered outpatient settings? A: Day treatment center B: Residential alcohol rehabilitation C: Emergency department D: Crisis stabilization bed
A: Day treatment center
Which of the following types of care you;d a nurse recommend for a client who has been recently released from prison with a serious mental illness and requires assistance with daily living? A: Forensic care program B: Geriatric care center C: Long-term care facility D: Crisis stabilization unit
A: Forensic care program
A nurse is discussing burnout among nurses with a colleague. Which of the following is a strategy to reduce burnout? A: Self-scheduling shifts B: Keeping to oneself at work C: Working extra shifts during staff shortages D: Skipping shared governance meetings
A: Self-scheduling shifts
Documentation in the client record must be appropriate: (sort the following into appropriate vs inappropriate documentation) A: The client was throwing chairs in the day room B: The client said "I am so angry" C: The client wanted to hurt another client D: The client was behaving badly.
Appropriate: The client was throwing chairs in the day room The client said "I am so angry" Inappropriate: The client wanted to hurt another client The client was behaving badly
A nurse is caring for a client who has schizophrenia and has recently been diagnosed with a terminal illness. The client's inter professional team should recommend which of the following for a client? A:Urgent care B:Dementia Care C:Experimental Therapy D:Hospice care
D:Hospice Care, because hospice focuses on the care, comfort, and quality of life for a person who has a terminal illness and is approaching the end of life.
A nurse should identify that which of the following is a U.S. congressional act that mandates mental health parity? A: Health Insurance Portability and Accountability Act B: Affordable Care Act of 2010 C: No Surprises Act D: Nurse Practice Act
B: Affordable Care Act of 2010- This act mandates mental health parity, which allows for equal coverage for physical and mental health care.
A nurse is caring for a group of children who have experienced trauma. During group therapy, the children create drawings representing their family and community. Which of the following inter professional team members is likely leading this group? A: Psychologist B: Art therapist C: Social worker D: Registered nurse
B: Art therapist-an art therapist is likely leading this group. An art therapist uses different media, including painting, drawing, and pottery, to help clients explore their experiences and express their feelings.
A nurse is discussing milieu therapy with a group of newly licensed nurses. Which of the following statements should the nurse make? A: "Create an environment where structure is promoted over autonomy." B:"Create an environment that is safe and beneficial for recovery." C:"The mental health provider is responsible for the structure and maintenance of the therapeutic milieu. D:"Ensure spontaneous changes in activities throughout the client's daily schedule"
B: Create an environment that is safe and beneficial for recovery.
A nurse is collaborating on an aftercare plan with a client who was recently discharged from inpatient treatment and creates a list of local support groups for grief services. Which of the following nursing roles does this demonstrates? A: Consultant B: Educator C: Case manager D: Therapist
C: Case manager- case management addresses the client's specific needs by assessing the client, working on a plan of care, and providing local community mental health services for follow-up care.
A nurse is discussing the purpose of ethics with a newly licensed nurse. Which of the following statements should the nurse make? A: Ethics describe a conflict between two or more actions where each action has a favorable and unfavorable consequence. B: Ethics involves reasoning about what one should do as guide for what one actually does. C: Ethics provide a system of moral principles or standards for governing conduct. D: Ethics explains the moral inquiry into issues raised by advances in medicine and the life sciences
C: Ethics provides a system of moral principles or standards for governing conduct.
A nurse is preparing a client who has schizophrenia for a magnetic resonance imaging (MRI) of their head to determine if they have a brain injury or a new onset of dementia. The nurse should identify that which of the following members of the inter professional team that likely prescribed the MRI? A: Licensed clinical social worker B: Psychologist C: Psychiatrist D: Occupational therapist
C: Psychiatrist- The nurse should identify that a psychiatrist likely prescribed the MRI, because they are medical doctors who can diagnose and prescribe medical procedures, tests, and medications.
A client who has bipolar disorder is experiencing increased depression along with low energy and describes themself as "not feeling anything at all." The client has missed several days of work in the past three weeks. Which of the following phases describes the client's current mental status? A: in crisis B: thriving C: struggling D: Surviving
C: struggling
Teams that are made up of several teams: for example: advocacy workers, therapists, social workers, counselors.
Interprofessional team
These are composed of member of same discipline: ex: LPN and Registered nurses working together on a unit towards the same task.
Intraprofessional team
This is equal coverage for physical and mental health care
Parity
This means equal coverage for mental and physical health in accessibility to health insurance.
Parity
A nurse is caring for a client who is in physical restraints. The nurse should identify that which of the following complications can result from inadequate monitoring of the client? (Select all that apply) A: Positional asphyxia B: Food aspiration C: Cardiac arrest D: Infection E: Somnolence
Positional asphyxia is correct, because a client can assume positions in restraints that will allow the the ability t not be able to breathe. Food aspiration Cardiac arrest
This type of prevention concentrates on reducing any long-term or debilitating effects of severe and chronic mental illnesses
Tertiary prevention
What act in 2010 mandated that mental health care be included in insurance policies?
The Affordable Care Act of 2010
Which of the following elements should a nurse incorporate into a therapeutic milieu to promote reality and assist with improving client outcomes? (Select all that apply) A: There should be an adequate number of clocks and calendars displayed throughout the unit. B: Doors on the unit should have labels to indicate the function of each room. C: Common furniture should be arranged in conversational groupings. D: Staff should wear name tags displaying their first name and job title. E: Clients' rooms should have the occupants' first names clearly displayed.
The answer is all of the answers are correct
This means preventing harm by removing harmful conditions to benefit the client or others
beneficence
What are the five zones of the mental health continuum?
excelling, thriving,surviving,struggling,in crisis
Who must give an order for the restraint ?
the provider
This is a violation of a client's protected rights and represents a breach of the duty of the nurse:
tort
This approach is essential in creating a culture of empathy.
trauma-informed approach
This means dealing truthfully with clients and others during professional interactions
veracity
This principle considers being truthful and authentic with clients during nurse-client interactions
veracity
What must nurses document in quotation marks?
what the client says
What are the standards of practice for mental health nursing IN ORDER:
1)Assessment 2) Diagnosis 3) Outcomes Identification 4) Planning 5) Implementation 6) Evaluation
A nurse is screening a group of clients for mental health disorders. The nurse should identify that male clients have a higher risk than female clients of developing which of the following conditions? A: Substance use disorder B: Depression C: Somatic disorders D: Anxiety
A: Substance use disorder
A nurse is providing teaching about adverse effects of a newly prescribed medication to a client who lives 45 miles from the outpatient clinic. Which of the following resources should the nurse consider using for continued monitoring of the client? A: Telehealth services B: Mobile crisis team C: Day treatment center D: Peer services
A: Telehealth services
When are unit rules including behavioral expectations provided ? A: upon admission B: when the client gets agitated C: while the client is being applied with restraints
A: upon admission
A newly hired nurse confides in another nurse that despite trying to be hopeful, they feel very depressed. Which of the following actions should the nurse take? A: Suggest the newly hired nurse contact a mental health professional. B: Notify the employee assistance program about the newly hired nurse. C: Notify Risk Management D: Suggest the newly hired nurse try yoga
A:Suggest the newly hired nurse contact a mental health professional.
A nurse is discussing false imprisonment with a group of newly hired staff members. Which of the following information should the nurse include? A: A client cannot claim false imprisonment if they were restrained by use of injectable antipsychotic medication. B: Claims of false imprisonment can be made if a nurse verbally threatens to place a client in seclusion. C: Claims of false imprisonment are most often made in reference to the use of seclusion or restraints. D: A client cannot claim false imprisonment if they are voluntarily admitted without being assessed by a provider.
C: Claims of false imprisonment are most often made in reference to the use of seclusion or restraints.
A nurse is asked to evaluate a quantitative study to help prepare for an in-service about client aggression. Which of the following studies should the nurse evaluate? A: A formal research review of studies on IM medications for client aggression. B: A study surveying the opinions of the nursing staff who are administering fewer IM medications for client aggression. C: A study reporting a reduction in the use of IM medications for client aggression. D: A study looking at thoughts and feelings from clients who received IM medications for aggressions.
C: a study reporting a reduction in the use of IM medications for client aggression. (The nurse should select the study to evaluate because a quantitive study uses numbers to report results of data)
A nurse tells a client that they will return in 30 min with their medication. The nurse returns 30 min later with the client's medication. Which of the following ethical principles is the nurse demonstrating? A: Beneficence B: Autonomy C: Veracity D: Justice
C:Veracity- this involves the nurse being truthful and honoring the verbal commitment made to a client.
A nurse is sitting with a client who is extremely anxious until they fall asleep. The nurse should identify that this is an example of which of the following ethical principles? A: Justice B: Autonomy C: Nonmaleficence D: Beneficence
D: Beneficence- This involves acting in a manner that is "for the good" or in a way that benefits others.
A nurse is caring for a client who is in the excelling zone on the mental health continuum. Which of the following findings should the nurse expect to observe? A: The client reports successfully coping with manifestations of a mental illness B: The client reports dealing very well with stressful situations in their life. C: The client reports relying on positive self-care to balance the demanding workload. D: The client reports they are having positive experiences in they relationships at work and at home.
D: The client reports they are having positive experiences in their relationships at work and at home. (The excelling zone of the mental health continuum is the highest level of function when at client is at their peak of well-being, without any concerns.
A nurse is beginning a debrief with a staff about a behavioral emergency that resulted in physically restraining a client. The nurse should identify that which of the following is the purpose of debriefing? A: To determine what to say to the client about the incident. B: To determine which team members did not perform well. C: To carefully document the entire incident. D: To improve the quality of future responses.
D: to improve the quality of future responses.
A nurse is talking with a client who says that although they do not have any mental illness, they have felt extremely depressed, and have considered suicide lately. The nurse should.d identify that this client is in which of the following zones of the mental health continuum? A: Thriving B: Surviving C: Struggling D: Crisis
D:Crisis ( a client who is in the crisis zone experiences severe symptoms, even if they do not have diagnosis of a mental health illness, and might consider suicide as an option to cope. This client needs immediate intervention.
A nurse encourages each client in a group session to speak and be heard. The nurse should identify that this is an example of which of the following ethical principles? A: beneficence B: Autonomy C: Nonmaleficence D: Justice
D:Justice, because justice involves caring for all clients equally and with the same level of fairness.
This enhances a client's recovery process by organizing daily living in a safe therapeutic, social environment.
milieu therapy
