Legal NCLEX Qs Flashcards
Which determines the scope of practice for a registered nurse employed in a psychiatric in-patient facility?
- National Alliance of the Mentally Ill (NAMI).
- State law, which may vary from state to state.
- Federal law, which applies nationwide.
- National League of Nursing (NLN).
2.
The legal parameters of professional nursing are defined within each state by the state’s nurse practice act.
The right to determine one’s own destiny is to autonomy as the duty to benefit or promote the good of others is to:
- Nonmaleficence.
- Justice.
- Veracity.
- Beneficence
4.
Beneficence is the duty to benefit or promote the good of others
Which statement reflects the ethical principle of utilitarianism?
- “The end justifies the means.”
- “If you mean well you will be justified.”
- “Do unto others as you would have them do unto you.”
- “What is right is what is best for me.”
- Utilitarianism is the theoretical perspective that bases decisions on the viewpoint that looks at the results of the decision. Action would be taken based on the results that produced the most good (happiness) for the most people.
A nursing student observes an incorrect dosage of medication being given to a client receiving electroconvulsive therapy. To observe the ethical principle of veracity, which action would the nursing student take?
- Keep the information confidential to avoid harm to others.
- Inform the student’s instructor and the client’s primary nurse, and document the situation.
- Tell only the client about the incident because the decision about actions would be determined only by the client.
- Because the client was not harmed, the incident would not need to be reported.
- By applying the ethical principle of veracity, the student should tell the truth, and report and document the incident. The only limitation to the ethical principle of veracity is when telling the truth would knowingly produce harm. Veracity must be in the context of hospital policy and procedures and within the chain of command.
A nursing student states to the instructor, “I’m afraid of mentally ill clients. They are all violent.” Which statement would the instructor use to clarify this perception for the student?
- “Even though mentally ill clients are often violent, there are ways to de-escalate these behaviors.”
- “A very few clients with mental illness exhibit violent behaviors.”
- “There are medications that can be given to clients to avoid violent behaviors.”
- “Only paranoid clients exhibit violent behaviors.”
2.
It is true that a very few clients with mental illness exhibit violent behaviors.
Which action should be taken by the clinician when there is reasonable certainty that a client is going to harm someone? Select all that apply.
- Assess the threat of violence toward another.
- Identify the person being threatened.
- Notify the identified victim.
- Notify only law enforcement authorities to protect confidentiality.
- Consider petitioning the court for continued commitment.
- It is important and necessary to assess the client’s potential for violence toward others.
- It is necessary to confirm the identification of the intended victim.
- The Tarasoff ruling makes it mandatory to notify an identified victim.
- Because the client is a danger toward others, the court should be petitioned for continued involuntary commitment.
In which situation does a health-care worker have a duty to warn a potential victim?
- When clients manipulate and split the staff and are a danger to self.
- When clients curse at family members during visiting hours.
- When clients exhibit paranoid delusions and auditory or visual hallucinations.
- When clients make specific threats toward someone who is identifiable.
- When a client makes specific threats toward someone who is identifiable, it is the duty of the health-care worker to warn the potential victim. The nurse should bring this information to the treatment team and document the report.
A client’s husband is visiting his wife during visiting hours. A nurse walking by hears him verbally abuse the client. Which nursing response is appropriate?
- Ask the client to ask her husband to leave the unit.
- Remind the client’s husband of the unit rules.
- Ask the husband to come to the nurse’s station to talk about his feelings.
- Sit with the client and her husband to begin discussing anger issues.
- Reminding the client’s husband of the rules of the unit addresses the inappropriate behavior. If the husband’s behavior continues, it is the nurse’s responsibility to ask the visitor to leave. The incident should be documented, and the treatment team should be notified.
Which of the following clients retains the right to give informed consent?
- A 21-year-old client who is hearing and seeing things that others do not.
- A 32-year-old voluntarily admitted client who is severely mentally retarded.
- A 65-year-old client declared legally incompetent.
- A 14-year-old client with attention-deficit disorder (ADD).
1.
A diagnosis of psychosis does not mean that a client is unable to consent to treatment.
The treatment team is recommending disulfiram (Antabuse) for a client who has had multiple admissions for alcohol detoxification. Which nursing question directed to the treatment team would protect this client’s right to informed consent?
- “Does this client have the cognitive ability to be prescribed this medication?”
- “Will this client be compliant with this medication?”
- “Will the team be liable if this client is harmed by this medication?”
- “Is this the least restrictive means of meeting this client’s needs?”
- The ability to take disulfiram (Antabuse) safely depends on a client’s understanding of the effects of ingesting alcohol while taking disulfiram (Antabuse). If the client does not have the cognitive ability to understand the teaching related to disulfiram (Antabuse), the client could be placed at high risk for injury
Which client does not have the ability to refuse medications or treatments?
- An involuntarily committed client.
- A voluntarily committed client.
- A client who has been deemed incompetent by the court.
- A client who has an Axis II diagnosis of antisocial personality disorder.
- When a client is declared incompetent, the client has a mental disorder resulting in a defect in judgment, and this defect makes the client incapable of handling personal affairs. A guardian is appointed. The guardian makes decisions for the client, and the client loses the right to refuse medications.
A client on an in-patient psychiatric unit has been admitted involuntarily. The nurse is about to administer the client’s antianxiety medication, when the client strikes the nurse, curses, and states, “I’m going to kill you!” Which nursing action is most appropriate at this time?
- The nurse decides not to administer the medication.
- The nurse initiates the ordered, forced medication protocol.
- The nurse initiates legal action to get the client declared incompetent.
- The nurse teaches the client the pros and cons of medication compliance
2.
Because this client is an imminent danger to others, it is the duty of the nurse to initiate a forced medication protocol to protect the nurse and other clients in the milieu.
When a client makes a written application to be admitted to a psychiatric facility, which statement about this client applies?
- The client may retain none, some, or all of his or her civil rights depending on state law.
- The client cannot make discharge decisions. These are initiated by the hospital or court or both.
- The client has been determined to be a danger to self or others.
- The client makes decisions about discharge, unless he or she is determined to be a danger to self or others.
4.
A voluntarily admitted client can make decisions about discharge, unless the client has been determined to be a danger to self or others. If the treatment team determines that a voluntarily admitted client is a danger to self or others, the client is held for a court hearing, and the client’s admission status is changed to involuntary.
A client has been involuntarily committed to the acute care psychiatric unit. During the delivery of the evening dinner trays, the client elopes from the unit, gets on a bus, and crosses into a neighboring state. Which nursing intervention is appropriate in this situation?
- Call the psychiatric facility located in the neighboring state and have them try to involuntarily admit the client to their facility.
- Notify the client’s physician, document the incident, and review elopement precautions.
- Send a therapeutic assistant out to relocate the client and bring him or her back to the facility.
- Notify the police in the neighboring state and have them pick the client up and readmit the client to the facility.
2.
Elopement occurs when a client leaves the hospital without permission. In this situation, all the nurse can do is notify the client’s physician and document the incident. Elopement precautions should be reviewed and actions taken to prevent a future occurrence.
A client has been deemed a danger to self by a court ruling. Which might the court mandate for this client?
- Voluntary commitment to a locked psychiatric facility.
- Involuntary commitment to an out-patient mental health clinic.
- Declaration of incompetence with mandatory medication administration.
- Declaration of emergency seclusion.
2.
Involuntary commitment to an out-patient mental health clinic is an option of the court when a client has been declared a danger to self. If the client fails to appear at regularly scheduled appointments, the client can be seized and involuntarily committed to an in-patient psychiatric unit.
