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?

Answer 1

B. Christian ethics

Question 2

During a hiring interview, which response by a nursing applicant should indicate that the applicant operates from an ethical egoism framework?

Answer 2

B. “This job will pay the bills, and the workload is light enough for me.”

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?

Answer 3

A. Taking no action is still considered an action by the coworker.

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?

Answer 4

B. Autonomy

Question 5

Which is an example of an intentional tort?

Answer 5

B. A nurse physically places an irritating client in four-point restraints.

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?

Answer 6

D. Continue professional attempts to establish a positive working relationship with the client.

Question 7

Which statement should a nurse identify as correct regarding a client’s right to refuse treatment?

Answer 7

D. Professionals can override treatment refusal if the client is actively suicidal or homicidal.

Question 8

Which client should a nurse identify as a potential candidate for involuntarily commitment?

Answer 8

B. A client threatening to commit suicide

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?

Answer 9

C. When the client physically attacks another client after being confronted in group therapy

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?

Answer 10

A. Refusing to give any information to the caller, citing rules of confidentiality

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?

Answer 11

A. Autonomy

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?

Answer 12

D. Justice

Question 13

Which situation contradicts the ethical principle of veracity?

Answer 13

C. A nurse tricks a client into seclusion by asking the client to carry linen to the seclusion room.

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?

Answer 14

C. The client incorrectly reports his or her spouse’s name, the date, and the time of day.

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?

Answer 15

A. Allow the client to decline the medication and document.

Question 16

Which situation exemplifies both assault and battery?

Answer 16

B. The nurse threatens to “tie down” the client and then does so against the client’s wishes.

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?

Answer 17

D. The client is monitored by an ankle bracelet.

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?

Answer 18

C. The Health Insurance Portability and Accountability Act

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?

Answer 19

A. State law determines how long a psychiatric facility can hold a client.

Question 20

A client is concerned that information given to the nurse remains confidential. Which is the nurse’s best response?

Answer 20

C. “If the information impacts your care, I will need to share it with the treatment team.”

Question 21

The nursing staff is discussing the concept of competency. Which information about competency should a nurse recognize as true?

Answer 21

C. A competent client has the ability to make reasonable judgments and decisions.

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?

Answer 22

C. “The Nurse Practice Act contains detailed statements that describe the scope of practice for registered nurses (RNs).”

Question 23

Which is an accurate description of a common law?

Answer 23

D. A common law would be invoked to deal with a nurse’s refusal to provide care for a specific client.

Question 24

The experience of being physically restrained can be traumatic. Which nursing intervention would best help the client deal with this experience?

Answer 24

B. Talking to the client at brief but regular intervals while the client is restrained

Question 25

There is one bed available on an inpatient psychiatric unit. For which client should a nurse advocate emergency commitment?

Answer 25

C. An individual who is delusional and has a plan to kill his wife

Question 26

What is the legal significance of a nurse’s action when a nurse threatens a demanding client with restraints?

Answer 26

A. The nurse can be charged with assault.

Question 27

In the situation presented, which nursing intervention constitutes false imprisonment?

Answer 27

B. The client has been consistently seeking the attention of the nurses much of the day. The nurse institutes seclusion.

Question 28

After disturbing the peace, an aggressive, disoriented, unkempt, homeless individual is escorted to an emergency department by police. The client threatens suicide. Which criteria would enable a physician to consider involuntary commitment? Select all that apply.

A. Being dangerous to others
B. Being homeless
C. Being disruptive to the community
D. Being gravely disabled and unable to meet basic needs
E. Being suicidal

Answer 28

A, D, E