Deck 5: Ethical and Legal Issues

Question 1

A client requests information on several medications 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 1

Autonomy

Question 2

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 2

The nurse threatens to "tie down" the client and then does so against the client's wishes.

Question 3

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)Refuse to give any information to the caller and cite confidentiality.
B)Refuse to give any information to the caller and hanging up.
C)Affirm only that the person has been seen at the facility.
D)Suggest the caller contact the client's psychiatrist.

Answer 3

Refuse to give any information to the caller and cite confidentiality.

Question 4

A geriatric client is confused and wandering in and out of every door.Which scenario reflects the least restrictive alternative for this client?

A)Place the client in seclusion.
B)Place the client in a geriatric chair that has a tray.
C)Place the client in soft Posey restraints.
D)Place a monitoring bracelet on the client's ankle.

Question 5

A client diagnosed with schizophrenia receives fluphenazine decanoate (Prolixin Decanoate)from a home health nurse.The client refuses the medication during one regularly scheduled home visit.Which nursing intervention is ethically appropriate?

A)Allow the client to decline the medication and document the refusal.
B)Tell the client that hospitalization will be needed if the medication is refused.
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.

Question 6

A man calls the psychiatric unit to speak to his sister.The nurse connects him to the community phone and the sister is summoned.The nurse later realizes that the brother was not on the client's approved call list.What law has the nurse broken?

A)National Alliance for the Mentally Ill Act
B)Tarasoff Ruling
C)Health Insurance Portability and Accountability Act (HIPAA)
D)Good Samaritan Law

Question 7

An inpatient client,whom the treatment team has determined to be a danger to self,gives notice of intent 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 the length of time a psychiatric facility can hold a client.
B)Federal law determines if the client is competent enough to be discharged.
C)The client's family will be involved to determine if discharge is possible.
D)Hospital policies will determine treatment team actions.

Question 8

A client who will be receiving ECT must provide informed consent.Which situation should cause a nurse to question the validity of the informed consent?

A)The client is demonstrating symptoms of paranoia.
B)The client is 87 years old.
C)The client is not oriented to person,date,or time.
D)The client relies on the spouse to interpret the information.

Question 9

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

A)A client living under a bridge in a cardboard box
B)A client verbalizing intent to commit suicide
C)A homeless client refusing to bathe
D)A client who eats waste out of a garbage can

Question 10

Which response by a nursing applicant during a hiring interview indicates 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.Lifting patients hurts my back."
D)"It is my duty in life to be a psychiatric nurse because it's the right thing to do."

Question 11

Which statement should the 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 type of psychiatric treatment at any time.
C)The only treatment a client can refuse is electroconvulsive therapy (ECT).
D)Professionals can override treatment refusal if the client is actively suicidal or homicidal.

Question 12

An involuntarily committed client is verbally abusive to the staff and repeatedly threatens 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 limit one-on-one interaction.
B)Involve the hospital's security division.
C)Inform the client that hospital policy prohibits documenting personal staff information.
D)Continue professional attempts to establish a positive working relationship.

Question 13

Which is an example of an intentional tort?

A)A nurse fails to assess a client with rigid muscles and an elevated temperature.
B)A nurse physically places a client in restraints without the client's consent.
C)A nurse makes a medication error and does not report the incident.
D)A nurse gives confidential patient information to an unauthorized person.

Question 14

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?

A)Makes inappropriate sexual innuendos to a staff member
B)Repeatedly demands constant attention from the nurse
C)Physically attacks another client during group therapy
D)Refuses to bathe or attend to personal hygiene

Question 15

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 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 a bystander.

Question 16

A psychiatrist working on an inpatient unit refuses to treat clients who do not have health insurance coverage and also prematurely discharges clients whose health insurance benefits have expired.The nurse recognizes the psychiatrist is violating which ethical principle?

A)Autonomy
B)Beneficence
C)Nonmaleficence
D)Justice

Question 17

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 to attend group therapy.Which ethical principle does the unit manager's policy preserve?

A)Justice
B)Autonomy
C)Veracity
D)Beneficence

Question 18

Which situation contradicts 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 a 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 clients equally,regardless of the acuity of their illness.

Question 19

A nursing student asked the charge nurse on the psychiatric unit why she chose psychiatric nursing.The charge nurse replied,"Mentally ill clients need special care.If I were in that position,I'd want a caring nurse also." The charge nurse's choice reflects which ethical framework?

A)Kantianism
B)Christian ethics
C)Ethical egoism
D)Utilitarianism

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 and will be kept just between us."
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."

Question 21

Which of the following nursing interventions would best help a client who is physically restrained cope with the experience?

A)Administer a tranquilizing medication before applying the restraints.
B)Talk to the client at brief,but regular,intervals while the client is restrained.
C)Leave the client alone most of the time to decrease stimuli.
D)Check on the client infrequently to meet documentation requirements.

Question 22

What is the legal significance of a nurse's action when the nurse threatens to restrain a client physically?

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.

Question 23

The psychiatric nurse is teaching a patient about side effects of amlodipine besylate (Norvasc).The nurse's action is within the nurse's scope of practice in the state.Which type of law defines nursing scope of practice?

A)Common law
B)Statutory law
C)Criminal law
D)Civil law

Question 24

There is one bed available on an inpatient psychiatric unit.The nurse should advocate for emergency commitment of which individual?

A)An individual who is persistently mentally ill and was evicted from an apartment
B)An individual treated in the emergency department 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

Question 25

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

A)The client is a danger to others.
B)The client is homeless.
C)The client is disruptive to the community.
D)The client is gravely disabled and unable to meet basic needs.
E)The client is suicidal.

Question 26

The nursing supervisor reassigned the psychiatric nurse to the surgical intensive care unit (SICU)4 hours into his shift.The nurse is observing an actively suicidal client who requires one-to-one observation.The charge nurse informs the nurse there is no other staff member available to take over the one-to-one observation.The nurse does not feel qualified to care for patients in the SICU.Which of the following represents the nurse's situation?

A)Conflict between personal beliefs
B)Violation of the standard of nursing care
C)Ethical dilemma
D)Breach of duty

Question 27

Which of the following is indicative of serious critical thinking about how individuals should treat others?

A)Values
B)Rights
C)Morals
D)Ethics

Question 28

For the following situations,which nursing intervention constitutes false imprisonment?

A)The nurse seeks the physician's order after restraining a combative client who states,"No one can stop me from leaving."
B)The nurse institutes seclusion of a client who has been consistently seeking the attention of the nurses much of the day.
C)The nurse runs after an involuntarily admitted psychotic client who runs off the unit and then agrees to return.
D)The nurse calls the security team to prevent an involuntarily admitted client from leaving.

Question 29

The nurse understands which description of a common law to be accurate?

A)A common law would be invoked to deal with a nurse who threatens a client with restraints without justification.
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 who refuses to provide care for a specific client.

Question 30

A nursing instructor is lecturing on the provisions of the nurse practice act.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."
D)"The nurse practice act lists the general authority and powers of the state board of nursing."

Question 31

The nursing staff is discussing the concept of competency.The nurse recognizes which information about competency 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.