Question 1

The nurse is answering a phone call in which the person is asking if a client has recently been admitted to a psychiatric facility. Which nursing response reflects appropriate legal and ethical obligations?

A) The nurse refuses to give any information to the caller, citing rules of confidentiality.
B) The nurse immediately hangs up on the caller.
C) The nurse confirms that the person has been at the facility but adds no additional information.
D) The nurse suggests that the caller speak to the client's therapist.

Accepted Answer

The nurse's refusal to give any information to the caller, citing rules of confidentiality, reflects appropriate legal and ethical obligations to protect the privacy of the client.

Question 2

The unit manager's policy is that clients can make a choice about whether or not to attend group therapy in an inpatient psychiatric unit. Which ethical principle does the unit manager's policy preserve?

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

Autonomy

Accepted Answer

The unit manager's policy of allowing clients to make their own decisions about attending group therapy preserves the ethical principle of autonomy, which recognizes a person's right to make independent decisions about their own care and treatment.

Question 3

An inpatient psychiatric physician refuses to treat clients without insurance and prematurely discharges those whose insurance benefits have expired. Which ethical principle would a nurse determine has been violated based on these actions?

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

Justice

Accepted Answer

The ethical principle that has been violated is justice, as the physician is not providing care to all patients equally and fairly based on their insurance status.

Question 4

Which situation reflects a violation of the ethical principle of veracity?&#10;A) A nurse discusses with a client another client's impending discharge.&#10;B) A nurse refuses to give information to a physician who is not responsible for the client's care.&#10;C) A nurse tricks a client into seclusion by asking the client to carry linen to the seclusion room.&#10;D) A nurse does not treat all of the clients equally, regardless of illness severity.&#10;

Accepted Answer

The ethical principle of veracity requires nurses to tell the truth and not deceive clients. Trickery and deception, as in the case of the nurse asking the client to carry linen to the seclusion room, violates this principle. A violates confidentiality, B is related to confidentiality but not veracity, and D is related to the principle of justice, not veracity.

Question 5

A client who will be receiving electroconvulsive therapy (ECT) must provide informed consent. Which situation would cause a nurse to question the validity of the informed consent?&#10;A) The client is paranoid.&#10;B) The client is 87 years old.&#10;C) The client incorrectly reports his or her spouse's name, date, and time of day.&#10;D) The deaf client relies on his or her spouse to interpret the information&#10;

Accepted Answer

DInformed consent requires that the person giving consent has the capacity to understand the information presented to them. A client who incorrectly reports basic information such as his or her spouse's name, date, and time of day (C) may be disoriented or have impaired cognitive function, questioning their capacity to give informed consent. Similarly, a deaf client relying on a spouse for interpretation (D) raises concerns about the accuracy and completeness of the information being communicated, potentially compromising the validity of the consent if the spouse is not a certified interpreter ensuring accurate and unbiased information transfer.

Question 6

Which potential client would a nurse identify as a candidate for involuntary commitment?&#10;A) The client living under a bridge&#10;B) The client threatening to commit suicide&#10;C) The client who never bathes and wears a wool hat in the summer&#10;D) The client who eats waste out of a garbage can&#10;

Accepted Answer

Involuntary commitment is considered when a patient poses a danger to themselves or others. Clients who are threatening to commit suicide fall under this category as they pose a danger to themselves. Clients living under a bridge, not bathing and wearing a wool hat in the summer, and eating waste out of a garbage can may indicate possible mental health issues, but do not necessarily meet the criteria for involuntary commitment.

Question 7

A client requests information on several medications in order to make an informed choice about management of depression. A nurse would provide this information to facilitate which ethical principle?&#10;A) Autonomy&#10;B) Beneficence&#10;C) Nonmaleficence&#10;D) Justice&#10;

Accepted Answer

Providing information about medications to the client allows them to make an informed choice and exercise their autonomy, which is an ethical principle related to respecting an individual's right to make decisions about their own health care. Beneficence (doing good) and nonmaleficence (avoiding harm) are also important ethical principles, but they are not directly related to providing information to the client about medications. Justice (fairness) is also an important ethical principle, but it is not directly related to this situation.

Question 8

Which situation exemplifies both assault and battery?&#10;A) The nurse becomes angry, calls the client offensive names, and withholds treatment.&#10;B) The nurse threatens to &#34;tie down&#34; the client and then does so, against the client's wishes.&#10;C) The nurse hides the client's clothes and medicates the client to prevent elopement.&#10;D) The nurse restrains the client without just cause and communicates this to family.&#10;

Accepted Answer

Assault is the threat of bodily harm or injury, while battery is the actual harmful or offensive touching of another person without consent. In this scenario, the nurse not only threatened to tie down the client but went through with it against their wishes, thus demonstrating both assault and battery. Option A exemplifies verbal abuse, option C exemplifies false imprisonment, and option D may exemplify an inappropriate use of restraints, but not assault and battery.

Question 9

In response to a student's question regarding choosing a psychiatric specialty, a charge nurse states, "Mentally ill clients need to feel compassion and care. If I were in that position, I'd want a caring nurse also." From which ethical framework is the charge nurse operating?

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

Accepted Answer

The charge nurse is operating from the ethical framework of Christian ethics, which emphasizes the importance of compassion and care for others, particularly those who are vulnerable and in need. This approach is often rooted in religious traditions, but can also be adopted by individuals who place a high value on empathy and kindness towards others.

Question 10

The client diagnosed with schizophrenia refuses medication at one regularly scheduled home visit from a home-health nurse. Which nursing intervention is ethically appropriate?&#10;A) Allow the client to decline the medication and document the decision.&#10;B) Tell the client that if the medication is refused, hospitalization will occur.&#10;C) Arrange with a relative to add the medication to the client's morning orange juice.&#10;D) Call for help to hold the client down while the injection is administered.&#10;

Accepted Answer

Allowing the client to decline the medication and documenting the decision is ethically appropriate as informed consent is a fundamental right of the client. It is important to respect the client's autonomy and right to make their own decisions, even if those decisions are deemed unwise by healthcare professionals. Coercion or the use of force to administer medication is not ethical unless the client is at risk of harming themselves or others. Working collaboratively with the client and their healthcare team to educate them on the benefits of medication, addressing any concerns or fears they may have, and exploring alternatives may help to improve adherence to medication over time.

Question 11

Which statement would a nurse identify as correct regarding a client's right to refuse treatment?&#10;A) Clients can refuse pharmacological but not psychological treatment.&#10;B) Clients can refuse any treatment at any time.&#10;C) Clients can refuse only electroconvulsive therapy (ECT).&#10;D) Professionals can override treatment refusal by an actively suicidal or homicidal client.&#10;

Accepted Answer

The answer of Which statement would a nurse identify as...

Question 12

A brother calls to speak to his sister, who has been admitted to a 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?

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

Accepted Answer

The answer of A brother calls to speak to his...

Question 13

An involuntarily committed client is verbally abusive to the staff, repeatedly threatening to sue. The client records the full names of the staff. Which nursing action is most appropriate to decrease the possibility of a lawsuit?

A) Verbally redirect the client and then refuse one-on-one interaction.
B) Involve the hospital's security division as soon as possible.
C) Notify the client that documenting personal staff information is against hospital policy.
D) Continue professional attempts to establish a positive working relationship with the client.

Accepted Answer

The answer of An involuntarily committed client is verbally abusive...

Question 14

During a hiring interview, which response by a nursing applicant would indicate that the applicant operates from an ethical egoism framework?&#10;A) &#34;I would want to be treated in a caring manner if I were mentally ill.&#34;&#10;B) &#34;This job will pay the bills, and the workload is light enough for me.&#34;&#10;C) &#34;I will be happy caring for the mentally ill. Working in med/surg kills my back.&#34;&#10;D) &#34;It is my duty in life to be a psychiatric nurse. It is the right thing to do.&#34;&#10;

Accepted Answer

The answer of During a hiring interview, which response by...

Question 15

A nurse applies extra physical restraints to a client who yells obscenities and threatens harm to the nurse. The nurse's coworker observes this action and feels that this is an inappropriate use of restraints, but fears of retaliation if action is taken against the nurse in question. Which is true about this scenario?

A) The coworker may experience a great deal of emotion.
B) The nurse values the client's autonomy.
C) The coworker is exhibiting beneficence.
D) The client values justice.

Accepted Answer

The answer of A nurse applies extra physical restraints to...

Question 16

Which is an example of an intentional tort?&#10;A) A nurse fails to assess a client's obvious symptoms of neuroleptic malignant syndrome.&#10;B) A nurse physically places an irritating client in four-point restraints.&#10;C) A nurse makes a medication error and does not report the incident.&#10;D) A nurse gives patient information to an unauthorized person.&#10;

Accepted Answer

The answer of Which is an example of an intentional...

Question 17

A geriatric client is confused and wandering in and out of every door of a care facility. Which scenario reflects the least restrictive alternative for this client?&#10;A) The client is placed in seclusion.&#10;B) The client is placed in a geriatric chair with tray.&#10;C) The client is placed in soft Posey restraints.&#10;D) The client is monitored by an ankle bracelet.&#10;

Accepted Answer

The answer of A geriatric client is confused and wandering...

Question 18

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?

A) A client makes inappropriate sexual innuendos to a staff member.
B) A client constantly demands attention from the nurse by begging, "Help me get better."
C) A client physically attacks another client after being confronted in group therapy.
D) A client refuses to bathe or perform hygienic activities.

Accepted Answer

The answer of A client diagnosed with schizophrenia refuses to...

Question 19

A valid, legally recognized claim or entitlement, encompassing both freedom from government interference or discriminatory treatment and an entitlement to a benefit or a service is defined as a _______________________.

Accepted Answer

The answer of A valid, legally recognized claim or entitlement,...

Question 20

After disturbing the peace, an aggressive, disoriented, unkempt, homeless individual is escorted to an emergency department. The client threatens suicide. Which of the following criteria would enable this client to be considered for 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

Accepted Answer

The answer of After disturbing the peace, an aggressive, disoriented,...

Question 21

A branch of philosophy that addresses methods for determining the rightness or wrongness of one's actions is defined as _______________________.

Accepted Answer

The answer of A branch of philosophy that addresses methods...

Deck 3: Ethical and Legal Issues