Question 1

In response to a student's question regarding choosing a psychiatric specialty, a charge nurse states, "Mentally ill clients need special 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

Christian ethics

Accepted Answer

The charge nurse's response reflects Christian ethics, which emphasizes treating others as one would like to be treated, aligning with the principle of love and care for others.

Question 2

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?&#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 client relies on his or her spouse to interpret the information.&#10;

Accepted Answer

Informed consent requires that the client is oriented and able to understand the information provided. If the client cannot correctly report basic information like their spouse's name, date, and time, it may indicate cognitive impairment, questioning the validity of their consent.

Question 3

Which situation reflects 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 nurse tricking the client into seclusion violates the ethical principle of veracity, which involves being truthful and honest with clients. By tricking the client, the nurse is not being honest and not providing truthful information to the client.

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?&#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

Monitoring the client with an ankle bracelet is the least restrictive alternative because it allows the client to move freely but ensures that staff knows their location and can intervene if they wander into a dangerous area. Placing the client in seclusion, a geriatric chair with tray, or soft Posey restraints would all limit the client's movement and potentially cause physical and emotional harm.

Question 5

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 harmful or offensive contact, while battery is the actual harmful or offensive contact. In this scenario, the nurse both threatened to tie down the client (assault) and then actually did so against the client's wishes (battery).

Question 6

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

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

Accepted Answer

By refusing to treat clients without insurance and prematurely discharging those whose insurance benefits have expired, the inpatient psychiatric physician is violating the principle of justice which requires fair and equitable treatment for all individuals regardless of their financial status.

Question 7

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

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

Accepted Answer

The unit manager's policy preserves the ethical principle of autonomy, which refers to a client's right to make their own decisions and have control over their own treatment. By allowing clients to choose whether or not to attend group therapy, the unit manager is upholding this principle.

Question 8

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.

Unlock Deck

Unlock for access to all 21 flashcards in this deck.

Unlock Deck

k this deck

Accepted Answer

All clients have the right to refuse medication, including those diagnosed with schizophrenia. As a nurse, it is our responsibility to respect the client's autonomy and document the decision. It is not appropriate to use coercion, such as threatening hospitalization or restraining the client, or to administer medication without the client's consent. It may be helpful to explore the reasons for the client's refusal and provide education on the benefits of the medication, but ultimately the decision is up to the client.

Question 9

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 10

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?&#10;A) The nurse refuses to give any information to the caller, citing rules of confidentiality.&#10;B) The nurse hangs up on the caller.&#10;C) The nurse confirms that the person has been at the facility but adds no additional information.&#10;D) The nurse suggests that the caller speak to the client's therapist.&#10;

Accepted Answer

The nurse should refuse to give any information to the caller, citing rules of confidentiality, to protect the client's privacy and adhere to legal and ethical obligations.

Question 11

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 12

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

A) Allow the client to decline the medication and document the decision.
B) Tell the client that if the medication is refused, hospitalization will occur.
C) Arrange with a relative to add the medication to the client's morning orange juice.
D) Call for help to hold the client down while the injection is administered.

Accepted Answer

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

Question 13

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

Accepted Answer

The answer of A client requests information on several medications...

Question 14

Which potential client should a nurse identify as a candidate for involuntarily commitment?&#10;A) The client living under a bridge in a cardboard box&#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

The answer of Which potential client should a nurse identify...

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 retaliation. What is the ethical interpretation of the coworker's lack of involvement?

A) Taking no action is still considered an unethical 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 only a bystander.

Accepted Answer

The answer of Without authorization, a nurse administers an extra...

Question 16

Which statement should 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 should a nurse identify as...

Question 17

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 a physician to consider involuntary commitment?

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 18

During a hiring interview, which response by a nursing applicant should 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 19

An involuntarily committed client is verbally abusive to the staff, repeatedly threatening 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 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 20

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 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