Legal and Ethical Issues - EXAM I

Question 1

Clients who have a mental health disorder diagnoses or who are receiving acute care for mental health disorder are guaranteed the same civil rights as any other citizen. These include the following:

Answer 1

1. the right to humane treatment and care, such as medical and dental care
2. the right to vote
3. the rights related to granting, forfeiture, or denial of a driver’s license
4. the right to due process of law, including the right to press legal charges against another person.

Question 2

specific rights that a client with a mental health diagnoses include the following:

Answer 2

1. informed consent and the right to refuse treatment
2. confidentiality
3. a written care of plan of care/treatment
4. communication with people outside the mental health facility
5. care provided with respect, dignity, and without discrimination
6. freedom from harm related to physical or pharmacological restraint, seclusion, and physical and mental abuse
7. psychiatric advance directive in case they are an involuntary admit
8. provision of care with the least restrictive intervention necessary

Question 3

wrongful act or injury committed by an entity or person against another person or another person’s property.

Answer 3

Tort

Question 4

philosophical ideas regarding right and wrong.

Answer 4

ethical issues

Question 5

the quality of doing good; can be described as charity.

Answer 5

beneficence

Question 6

the client’s right to maker her own decisions. But the client must accept the consequences of those decisions. The client must also respect the decisions of others.

Answer 6

autonomy

Question 7

fair and equal treatment for all

Answer 7

justice

Question 8

loyalty and faithfulness to the client and to one’s duty.

Answer 8

fidelity

Question 9

honesty when dealing with a client.

Answer 9

veracity

Question 10

the client or client’s guardian chooses admission to a mental health facility in order to obtain treatment. A _______ _______ client has the right to apply for release at any time. This client is considered competent, and so has the right to refuse medication and treatment.

Answer 10

Voluntary admission

Question 11

the client is admitted for emergent mental health care due to the inability to make decisions regarding care. The medical healthcare provider may initiate the admission which is then evaluated by a mental healthcare provider. The length of this type of admission varies by the client’s need and state laws but often is not to exceed 15 days.

Answer 11

temporary emergency admission

Question 12

the client enters the mental health facility against her will for an indefinite period of time. the admission is based on the client’s need for psychiatric treatment, the risk of harm to self and others, or the inability to provide self care.

Answer 12

Involuntary admission

Question 13

an involuntary admission is limited to ___ days at which time a psychiatric and legal review of the admission is required.

Answer 13

60

Question 14

How many physicians ( in most cases) are required to certify that the client’s conditions requires commitment. Which can be imposed by a family member, legal guardian, primary care provider, or a mental health provider

Answer 14

2

Question 15

are clients committed involuntarily still considered competent, and given the right to refuse treatment, and medications. Once judged incompetent a temporary of a permanent guardian is appointed by the court in which they will provide informed consent for the client. This guardian is expected to consider what the client would want had they been competent.

Answer 15

Yes

Question 16

a type of admission that is similar to temporary commitment but must be imposed by the courts. Time of commitment varies, but is usually 60 to 180 days. Sometimes, there is no set release date.

Answer 16

Long-term involuntary admission

Question 17

what are the less restrictive measures taken before seclusion and restraint become an option?

Answer 17

1. verbal interventions such as telling the client to calm down
2. diversion or redirection
3. providing a calm, quiet environment
4. offering a PRN medication (chemical restraint but considered less restrictive than a mechanical restraint.

Question 18

the nurse should never use seclusion or restraint for : ?

Answer 18

1. convenience of the staff
2. punishment of the client
3. clients who are extremely physically or mentally unstable
4. clients who cannot tolerate the decreased stimulation of a seclusion room

Question 19

The provider must prescribe the seclusion or restraint in writing within __ hours of the nurse initiating the emergency treatment.

Answer 19

4 (the book notes within the first hour the treatment was initiated however Hilton states that the general rule of thumb is 4 hours)

Question 20

confining a client to a specific area, such as a seclusion room, is _____ ________ if the reason for such confinement is for the convenience of the staff.

Answer 20

false imprisonment

Question 21

making a threat to a client’s person, such as approaching the client in a threatening manner with a syringe in hand.

Answer 21

assault

Question 22

touching a client in a harmful or offensive way is considered _____. This would occur if the nurse threatening the client with a syringe actually grabbed the client and gave an injection.

Answer 22

battery

Question 23

What should be documented in the event of a violent or unusual episodes?

Answer 23

1. client behavior in a clear and objective manner
2. staff response to the behavior (timeline and the extent of the response)
3. time the nurse notified the provider (an any prescriptions received.)

Question 24

what should be included in a mental health assessment?

Answer 24

Psychosocial history
Cultural beliefs and practices
Spiritual and religious beliefs
Mental status examination (MSE)
Physical appearance
Behavior 
Cognitive and Intellectual beliefs

Question 25

a client’s ____ provides information about the emotion that she is feeling.

Answer 25

mood

Question 26

a clients ____ is an objective expression of mood, such as a flat affect or a lack of facial expression

Answer 26

affect

Question 27

published by the American Psychiatric Association, and used as a diagnostic tool to identify mental health diagnoses. It is used by mental health professionals for clients who have mental health disorders.

Answer 27

The Diagnostic and Statistical Manual of Mental Disorders

Question 28

requires outpatient treatment for a specified period to determine the patients adherence with medication protocols, ability to meet basic needs, and ability to reintegrate into the community.

Answer 28

conditional release

Question 29

…or discharge, is the termination of the patient - institution relationship. This release may be court ordered or administratively ordered by institutional officials.

Answer 29

unconditional release

Question 30

in some case’s there is a disagreements with mental health care providers and patients.

Answer 30

release against medical advice (AMA)

Question 31

defendant executed the wrong doing act on purpose or with intent.

Answer 31

intentional tort

Question 32

direct wrong of a personal nature. Injures the feelings of the person and does not take into account the effect of revealed information on the reputation of the person in the community.

Answer 32

invasion of privacy

Question 33

communication that is false of made with a careless disregard for the truth, and results in injury to the reputation of the person.

Answer 33

defamation

Question 34

defamation of character by means of print

Answer 34

libel

Question 35

defamation of character by spoken word

Answer 35

slander

Question 36

negligence/professional negligence

Answer 36

unintentional tort

Question 37

misconduct that is below the standard of what is expected of an ordinary, reasonable and prudent person.

Answer 37

negligence

Question 38

involves extreme lack of knowledge, skill, or decision making that the person clearly should have known would put others at risk.

Answer 38

gross negligence

Question 39

“professional negligence” that is negligence that occurs while the person was performing as a professional. Six elements must be present for a case of nursing professional negligence to be proven; duty, breach of duty, forseeability, causation, harm or injury, and damages.

Answer 39

malpractice

Question 40

lists psychiatric diagnosis/diagnoses (ex. Major Depressive Disorder)

Answer 40

Axis I of DSM IV

Question 41

personality disorders and intellectual disability (ex. borderline personality disorder)

Answer 41

Axis II of DSM IV

Question 42

medical conditions that may or may not have influence on mental health diagnoses. (ex. coronary heart disease)

Answer 42

Axis III of DSM IV

Question 43

Psychosocial stressors (economic, spiritual, environmental stressors) ex. homelessness

Answer 43

Axis IV of DSM IV

Question 44

Global Assessment of Functioning (GAF) Score, rated from 1-100 and indicated patient’s level of functioning. The higher the score the higher level of functioning.

Answer 44

Axis V of DSM V

Question 45

what does right of Habeas Corpus mean?

Answer 45

protection from unlawful detention (due process in civil commitment