Question 1

A nurse engaging in which behavior demonstrates a need for addition education regarding the release of patient information without expressed written consent?

Accepted Answer

The nurse should not disclose a patient's estimated date of discharge to anyone without the patient's expressed written consent. This is considered private health information that is protected by HIPAA regulations. The other options are appropriate behaviors for a nurse and do not violate patient privacy.

Question 2

A patient diagnosed with bipolar disorder is admitted involuntarily during a manic phase. Lithium 300 mg PO t.i.d. is prescribed. The patient refuses the morning dose. What are the nurse's best actions? (Select all that apply.)

Accepted Answer

C) Educating the patient about the importance of lithium in stabilizing mood is crucial for compliance and understanding of the treatment plan. D) Allowing the patient to refuse medication and documenting the refusal respects the patient's autonomy and rights, even in an involuntary admission scenario.

Question 3

An adolescent hospitalized after a violent physical outburst tells the nurse, "I'm going to kill my parents, but you can't tell them." Select the nurse's initial response.

Accepted Answer

The nurse has a legal and ethical obligation to report any threat of harm to oneself or others. The treatment team must be made aware of the situation and develop a plan to ensure the safety of both the patient and their parents.

Question 4

A nurse at the mental health center prepares to administer a scheduled injection of haloperidol decanoate to a patient diagnosed with schizophrenia. As the nurse swabs the site, the patient shouts, "Stop, stop. I don't want to take that medicine anymore. I hate the side effects." What action should the nurse take?

Accepted Answer

The nurse should stop the medication administration and address the patient's concerns by actively listening to their complaints about the medication's side effects. The nurse can then report these concerns to the healthcare provider, who may recommend alternative treatments or adjust the medication dose. It is important to involve the patient in their care and address their concerns to promote cooperation and trust in the healthcare team.

Question 5

Which interventions should the nurse apply to the care plan of a patient requiring involuntary secluded? (Select all that apply.)

Accepted Answer

The answer of Which interventions should the nurse apply to...

Question 6

A patient's insurance will not pay for continuing hospitalization at a private facility, so the family considers transferring the patient to a public psychiatric hospital. They express concern that the patient will "never get any treatment." Select the nurse's most helpful reply to their concern.

Accepted Answer

The nurse's response should address the patients' concerns about the quality of care at a public facility. Option A is the most helpful because it reassures the family that their loved one has the right to treatment even at a public hospital. This helps alleviate their concerns and encourages them to transfer the patient to the public psychiatric facility.

Question 7

A patient diagnosed with paranoid schizophrenia believes that evil spirits are being stirred by a local minister and verbally threatens to bomb a local church. Considering the rights of this patient, what is the initial nursing responsibility?

Accepted Answer

The initial nursing responsibility is to recognize and act upon the duty to warn and protect in cases where a patient poses a threat to others. Failure to do so could result in harm to both the patient and others, and could also open the nurse to legal and ethical liabilities. While protecting patient confidentiality is important, the duty to warn and protect takes precedence in instances where harm to self or others is a possibility. Obtaining the patient's permission to release information to the police may not be necessary if there is an imminent threat, as failure to act could lead to harm. Reviewing the criteria associated with malpractice is not the initial nursing responsibility in this situation.

Quiz 3: Legal Issues