Question 1

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?

Accepted Answer

The most appropriate action by the nurse is to refuse to give any information to the caller.Admission to the facility would be considered protected health information (PHI)and should not be disclosed by the nurse without prior client consent.

Question 2

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

Accepted Answer

The nurse should question the validity of informed consent when the client incorrectly reports the spouse's name,date,and time of day.This indicates that this client is disoriented and may not be competent to make informed choices.

Question 3

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

Accepted Answer

The nurse has violated the Health Insurance Portability and Accountability Act (HIPAA)by revealing that the client had been admitted to the psychiatric unit.The nurse should not have provided any information without proper consent from the client.

Question 4

During a hiring interview,which response by a nursing applicant should indicate that the applicant operates from an ethical egoism framework?

Accepted Answer

The applicant's comment reflects an ethical egoism framework.This framework promotes the idea that decisions are based on what is good for the individual and may not take the needs of others into account.

Question 5

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

Accepted Answer

The least restrictive alternative for this client would be monitoring by an ankle bracelet.The client does not pose a direct dangerous threat to self or others,so neither physical restraints nor seclusion would be justified.

Question 6

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?

Accepted Answer

The charge nurse is operating from a Christian ethics framework.A basic principle in Christian ethics is to "do unto others as you would have them do unto you." Kantianism states that decisions should be based on moral law and that actions are bound by a sense of moral duty.Utilitarianism holds that decisions should be made with a focus on the end result being happiness.Ethical egoism promotes the idea that what is right is good for the individual.

Question 7

An involuntarily committed client is verbally abusive to the staff and 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?

Accepted Answer

The most appropriate nursing action is to continue professional attempts to establish a positive working relationship with the client.The involuntarily committed client should be respected and has the right to assert grievances if rights are infringed.

Question 8

An inpatient client,whom the treatment team has determined to be a danger to self,gives notice of intention to leave the hospital.What information should the nurse recognize as having an impact on the treatment team's next action?

Accepted Answer

Most states commonly cite that in an emergency a client who is dangerous to self or others may be involuntarily hospitalized.

Question 9

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?

Accepted Answer

The nurse should provide the information to support the client's autonomy.A client who is capable of making independent choices should be permitted to do so.In instances when clients are incapable of making informed decisions,a legal guardian or representative would be asked to give consent.

Question 10

Which is an example of an intentional tort?

Accepted Answer

A tort is a violation of civil law in which an individual has been wronged and can be intentional or unintentional.A nurse who physically places an irritating client in restraints has touched the client without consent and has committed an intentional tort.Examples of unintentional torts are malpractice and negligence actions.

Question 11

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?

Accepted Answer

The nurse would have the right to medicate a client against his or her wishes if the client physically attacks another client.This client poses a significant risk to safety and is incapable of making rational choices.The client's refusal to accept treatment can be challenged because the client is endangering the safety of others.

Question 12

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?

Accepted Answer

The coworker's lack of involvement can be interpreted as an action taken.The coworker is experiencing an ethical dilemma in which a decision needs to be made between two unfavorable alternatives.Although the coworker may be struggling with ethical decision making,he or she has witnessed another nurse dispensing medication outside of the scope of practice; therefore,from a legal perspective,this should be reported.

Question 13

Which situation contradicts the ethical principle of veracity?

Accepted Answer

The nurse who tricks a client into seclusion has violated the ethical principle of veracity.The principle of veracity refers to one's duty to always be truthful and not intentionally deceive or mislead clients.

Question 14

Which statement should a nurse identify as correct regarding a client's right to refuse treatment?

Accepted Answer

The nurse should understand that health-care professionals can override treatment refusal when a client is actively suicidal or homicidal.A suicidal or homicidal client who refuses treatment may be a danger to self or others.This situation should be treated as an emergency,and treatment may be performed without informed consent.

Question 15

Which situation exemplifies both assault and battery?

Accepted Answer

The nurse in this situation has committed both the acts of assault and battery.Assault refers to an action that results in fear and apprehension that the person will be touched without consent.Battery is the touching of another person without consent.

Question 16

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?

Accepted Answer

It is ethically and legally appropriate for the nurse to allow the client to decline the medication and provide accurate documentation.The client's right to refuse treatment should be upheld unless the refusal puts the client or others in harm's way.

Question 17

An inpatient psychiatric physician refuses to treat clients without insurance and prematurely discharges those whose insurance benefits have expired.Which violation of an ethical principle should a nurse recognize in this situation?

Accepted Answer

The nurse should determine that the ethical principle of justice has been violated by the physician's actions.The principle of justice requires that individuals should be treated equally regardless of race,sex,marital status,medical diagnosis,social standing,economic level,or religious belief.

Question 18

A client is concerned that information given to the nurse remains confidential.Which is the nurse's best response?

Accepted Answer

Basic to the psychiatric client's hospitalization is his or her right to confidentiality and privacy.When admitted to an inpatient psychiatric facility,a client gives implied consent for information to be shared with health-care workers specifically involved in the client's care.

Question 19

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

Accepted Answer

The nurse should identify the client threatening to commit suicide as eligible for involuntary commitment.The suicidal client who refuses treatments is a danger to self and requires emergency treatment.

Question 20

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 or not to attend group therapy.Which ethical principle does the unit manager's policy preserve?

Accepted Answer

The unit manager's policy regarding voluntary client participation in group therapy preserves the ethical principle of autonomy.The principle of autonomy presumes that individuals are capable of making independent decisions for themselves and that health-care workers must respect these decisions.

Quiz 4: Ethical and Legal Issues