Chapter 5

Question 1

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?
A.
Kantianism
B.
Christian ethics
C.
Ethical egoism
D.
Utilitarianism

Answer 1

B

Question 2

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

Answer 2

B

Question 3

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 repercussion. What is the ethical interpretation of the coworker’s lack of involvement?
A.
Taking no action is still considered an unethical action by the coworker.
B.
Taking no action releases the coworker from ethical responsibility.
C.
Taking no action is advised when potential adverse consequences are foreseen.
D.
Taking no action is acceptable because the coworker is only a bystander.

Answer 3

A

Question 4

Group therapy is strongly encouraged, but not mandatory, on 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?
A.
Justice
B.
Autonomy
C.
Veracity
D.
Beneficence

Answer 4

B

Question 5

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

Answer 5

B

Question 6

An involuntarily committed client is verbally abusive to the staff and 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?
A.
Verbally redirect the client, and then limit one-on-one interaction.
B.
Involve the hospital’s security division as soon as possible.
C.
Notify the client that documenting personal staff information is against hospital policy.
D.
Continue professional attempts to establish a positive working relationship with the client.

Answer 6

D

Question 7

Which statement should a nurse identify as correct regarding a client’s right to refuse treatment?
A.
Clients can refuse pharmacological but not psychological treatment.
B.
Clients can refuse any treatment at any time.
C.
Clients can refuse only electroconvulsive therapy (ECT).
D.
Professionals can override treatment refusal if the client is actively suicidal or homicidal.

Answer 7

D

Question 8

Which client should a nurse identify as a potential candidate for involuntary commitment?
A.
A client living under a bridge in a cardboard box
B.
A client threatening to commit suicide
C.
A client who never bathes and wears a wool hat in the summer
D.
A client who eats waste out of a garbage can

Answer 8

B

Question 9

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?
A.
When the client makes inappropriate sexual innuendos to a staff member
B.
When the client constantly demands inappropriate attention from the nurse
C.
When the client physically attacks another client after being confronted in group therapy
D.
When the client refuses to bathe or perform hygienic activities

Answer 9

C

Question 10

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?
A.
Refusing to give any information to the caller, citing rules of confidentiality
B.
Refusing to give any information to the caller by hanging up
C.
Affirming that the person has been seen at the facility but providing no further information
D.
Suggesting that the caller speak to the client’s therapist

Answer 10

A

Question 11

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?
A.
Autonomy
B.
Beneficence
C.
Nonmaleficence
D.
Justice

Answer 11

A

Question 12

An inpatient psychiatric physician refuses to treat clients without insurance and prematurely discharges those whose insurance benefits have expired. Which violation of an ethical principle should a nurse recognize in this situation?
A.
Autonomy
B.
Beneficence
C.
Nonmaleficence
D.
Justice

Answer 12

D

Question 13

Which situation reflects the ethical principle of veracity?
A.
A nurse provides a client with outpatient resources to benefit recovery.
B.
A nurse refuses to give information to a physician who is not responsible for the client’s care.
C.
A nurse tricks a client into seclusion by asking the client to carry linen to the seclusion room.
D.
A nurse treats all of the clients equally regardless of illness severity.

Answer 13

C

Question 14

A client who will be receiving electroconvulsive therapy (ECT) must provide informed consent. Which situation should cause a nurse to question the validity of the informed consent?
A.
The client is paranoid.
B.
The client is 87 years old.
C.
The client incorrectly reports his or her spouse’s name, date, and time of day.
D.
The client relies on his or her spouse to interpret the information.

Answer 14

C

Question 15

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?
A.
Allow the client to decline the medication and document.
B.
Tell the client that if the medication is refused, hospitalization will occur.
C.
Arrange with a relative to add medication to the client’s morning orange juice.
D.
Call for help to hold the client down while the injection is administered.

Answer 15

A

Question 16

Which situation exemplifies both assault and battery?
A.
The nurse becomes angry, calls the client offensive names, and withholds treatment.
B.
The nurse threatens to “tie down” the client and then does so against the client’s wishes.
C.
The nurse hides the client’s clothes and medicates the client to prevent elopement.
D.
The nurse restrains the client without just cause and communicates this to family.

Answer 16

B

Question 17

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

Answer 17

D

Question 18

A brother calls to speak to his sister who has been admitted to the 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?
A.
The National Alliance for the Mentally Ill Act
B.
The Tarasoff Ruling
C.
The Health Insurance Portability and Accountability Act
D.
The Good Samaritan Law

Answer 18

C

Question 19

An inpatient client, whom the treatment team has determined to be a danger to self, gives notice of intention to leave the hospital. What information should the nurse recognize as having an impact on the treatment team’s next action?
A.
State law determines how long a psychiatric facility can hold a client.
B.
Federal law determines if the client is competent.
C.
The client’s family involvement will determine if discharge is possible.
D.
Hospital policies will determine treatment team actions.

Answer 19

A

Question 20

A client is concerned that information given to the nurse remains confidential. Which is the nurse’s best response?
A.
“Your information is confidential. It will be kept just between you and I.”
B.
“I will share the information with staff members only with your approval.”
C.
“If the information impacts your care, I will need to share it with the treatment team.”
D.
“You can make the decision whether your physician needs this information or not.”

Answer 20

C

Question 21

The nursing staff is discussing the concept of competency. Which information about competency should a nurse recognize as true?
A.
Competency is determined with a client’s compliance with treatment.
B.
Refusal of medication can initiate an incompetency hearing leading to forced medications.
C.
A competent client has the ability to make reasonable judgments and decisions.
D.
Competency is a medical determination made by the client’s physician.

Answer 21

C

Question 22

A nursing instructor is presenting content on the provisions of the nurse practice act as it relates to their state. Which student statement indicates a need for further instruction?
A.
“The nurse practice act provides a list of definitions of important terms including the definition of nursing.”
B.
“The nurse practice act lists education requirements for licensure and reciprocity.”
C.
“The nurse practice act contains detailed statements that describe the scope of practice for registered nurses (RNs).”
D.
“The nurse practice act lists the general authority and powers of the state board of nursing.”

Answer 22

C

Question 23

Which is an accurate description of a common law?
A.
A common law would be invoked to deal with a nurse who, without justification, threatens a client with restraints.
B.
A common law would be invoked to deal with a nurse who touches a client without the client’s consent.
C.
A common law would be invoked to deal with a hospital employee who steals drugs, hospital equipment, or both.
D.
A common law would be invoked to deal with a nurse’s refusal to provide care for a specific client.

Answer 23

D

Question 24

The experience of being physically restrained can be traumatic. Which nursing intervention would best help the client deal with this experience?
A.
Administering a tranquilizing medication before applying the restraints
B.
Talking to the client at brief but regular intervals while the client is restrained
C.
Decreasing stimuli by leaving the client alone most of the time
D.
Checking on the client infrequently, in order to meet documentation requirements

Answer 24

B

Question 25

There is one bed available on an inpatient psychiatric unit. For which client should a nurse advocate emergency commitment?
A.
An individual who is persistently mentally ill and evicted from an apartment
B.
An individual treated in the emergency department (ED) for generalized anxiety disorder
C.
An individual who is delusional and has a plan to kill his wife
D.
An individual who rates mood 4/10 and is participating in a no-harm safety plan

Answer 25

C

Question 26

What is the legal significance of a nurse’s action when the nurse threatens a demanding client with restraints?
A.
The nurse can be charged with assault.
B.
The nurse can be charged with negligence.
C.
The nurse can be charged with malpractice.
D.
The nurse can be charged with beneficence.

Answer 26

A

Question 27

In the situation presented, which nursing intervention constitutes false imprisonment?
A.
The client is combative and will not redirect stating, “No one can stop me from leaving.” The nurse seeks the physician’s order after the client is restrained.
B.
The client has been consistently seeking the attention of the nurse much of the day. The nurse institutes seclusion.
C.
A psychotic client, admitted in an involuntary status, runs off the psychiatric unit. The nurse runs after the client and the client agrees to return.
D.
A client hospitalized as an involuntary admission attempts to leave the unit. The nurse calls the security team and they prevent the client from leaving.

Answer 27

B