Question 1

The nurse is working with a client who has just stated that she beats her toddler with a wooden paddle. The nurse determines that the client's verbal admission warrants:

Accepted Answer

The nurse is mandated by law to report suspicion of child abuse to appropriate government authorities. This includes physical, sexual, and emotional abuse or neglect. Reporting to the physician or nursing supervisor may not ensure that the child is protected, and may be a breach of confidentiality. Reporting to the chief of staff may not be necessary in this case.

Question 2

When a client gives written notice of intention to leave the hospital after a voluntary admission, what determines the number of hours or days between the notice and the discharge?

Accepted Answer

State law determines the number of hours or days between the notice and the discharge after a client gives written notice of intention to leave the hospital following a voluntary admission. This is because mental health laws, including those governing hospital discharge, vary by state.

Question 3

When comparing forensic nursing practice with correctional mental health nursing practice, the nurse correctly identifies that correctional mental health nurses focus on:

Accepted Answer

Correctional mental health nurses focus on the client's present needs, such as assessing and treating mental health issues and providing support for reintegration into society. This is different from forensic nursing, which may involve criminal investigative analysis and offering consulting services on legal matters. The past state of mind of the client may be relevant in both practices, but it is not the main focus of correctional mental health nursing.

Question 4

The nurse acts on the client's behalf as an advocate for the client's needs and best interests. What principle of bioethics is being demonstrated by the nurse?

Accepted Answer

The answer of The nurse acts on the client's behalf...

Question 5

A 15-year-old female is brought by her mother to see a psychiatric nurse practitioner. The client's mother demands that her daughter be admitted for treatment of "behavioral problems." Her mother states that the daughter stays out until 4 a.m. and is hanging out with "bad" kids. The nurse will recommend which of the following?

Accepted Answer

Outpatient therapy for both the mother and daughter is recommended to address the behavioral concerns and improve their relationship and communication. Involuntary admission is not indicated based on the information provided.

Question 6

The staff are discussing competency. Which of the following statements about competency is inaccurate?

Accepted Answer

Competency is not solely a medical determination made by the client's physician. Competency is a legal determination made by a court or other legal authority. Physicians may provide input and evaluations, but the final decision on competency is made by the legal system.

Question 7

Which situation would support the use of involuntary commitment?

Accepted Answer

Involuntary commitment may be necessary when the client poses a danger to themselves or others, such as when they have made threats to family members. The other options are not necessarily sufficient reasons for involuntary commitment. Using profanity when angry may not be a cause for concern, reporting auditory hallucinations does not necessarily mean the client is a danger to themselves or others, and self-medicating with marijuana may not pose an immediate threat.

Question 8

A client is voluntarily admitted to the mental health unit. The nurse knows that this means:

Accepted Answer

Voluntary admission means that the client has given informed consent and has the right to leave the hospital at any time, unless they are deemed a danger to themselves or others. It does not mean the client has signed away civil rights or has to remain hospitalized for a specific amount of time. A court hearing is only necessary for involuntary admission.

Question 9

The nurse is attempting to obtain informed consent for the administration of electroconvulsive treatment for a depressed client. The client expresses some fears and concerns regarding the treatment. The nurse should:

Accepted Answer

It is important to provide the client with additional information and ensure they fully understand the treatment and potential risks before obtaining informed consent. If the client is not yet able to give informed consent, any scheduled treatments should be cancelled until the client is fully informed and able to provide consent. It is also important to notify the physician of the client's concerns and questions. Simply reassuring the client and having them sign the consent form without addressing their concerns would not be ethical or respectful of the client's autonomy. If the client chooses to refuse ECT, this should be respected and documented accordingly.

Question 10

A client with schizophrenia has decided to develop a psychiatric advance directive. What would be included in this document?

Accepted Answer

A psychiatric advance directive typically includes a list of persons authorized to make decisions on the client's behalf, instructions for treatment preferences, and other specific requests related to the client's psychiatric care. It does not generally include legal matters such as power of attorney or medical orders such as DNR requests.

Question 11

A client tells the nurse, "My therapist stroked my face and asked me to come to his house for a romantic evening." What action should the nurse take?

Accepted Answer

The nurse has a duty to report any possible abuse or misconduct by a therapist towards a client to the appropriate authority. This is important for ensuring the safety and well-being of the client and for preventing any further harm. It is not appropriate to do nothing or to call the police without first reporting the claims to the appropriate authority, which could include the medical director or a regulatory agency that oversees therapists or mental health professionals.

Question 12

A client tells the nurse, "I considered it my goal to burn down my neighbor's house with him in it to pay him back for what he has done to me." The nurse is confronted with:

Accepted Answer

The nurse has a duty to warn the potential victim, as the client's statement suggests intent to harm someone. This duty overrides confidentiality. The nurse should report this to the appropriate authorities to prevent harm.

Question 13

The nurse at the unit desk answers the telephone. The caller asks for permission to speak to a specific client. The nurse responds, "The client is busy in a meeting, and I don't see your name on the client's telephone list." The nurse can best be described as:

Accepted Answer

The nurse, by revealing that the client is in a meeting, has inadvertently shared information about the client's activities or status without their explicit consent, which breaches confidentiality principles. The correct approach would be to neither confirm nor deny the client's presence or status without authorization.

Question 14

The nurse is having lunch with colleagues from a medical-surgical unit. One of the medical-surgical nurses states, "I don't know how you can work with psych patients! They scare the heck out of me." How should the nurse respond?

Accepted Answer

This response highlights the fact that clients with mental health disorders have physical issues just like clients on a medical-surgical unit. It helps to reduce the stigma associated with mental health disorders and emphasizes the need for holistic care. It also avoids belittling or challenging the colleague's personal fears or nursing skills.

Question 15

When comparing forensic nursing practice with correctional mental health nursing practice, the student nurse identifies that correctional mental health nurses:

Accepted Answer

The answer of When comparing forensic nursing practice with correctional...

Question 16

The nurse and a client talk about the signs and symptoms of acute mania. The client states, "When I am feeling really good and don't need to sleep, I am manic, but the last thing I want is treatment." The nurse recognizes that this experience is indicative of the need for:

Accepted Answer

A Psychiatric Advance Directive (PAD) is a legal document that allows individuals with mental illness to outline their preferences for treatment in advance of a crisis. In this scenario, the client's acknowledgment of their manic state and reluctance to seek treatment during such episodes indicates the need for a PAD to ensure their treatment preferences are respected even when they might not be in a state to make decisions.

Question 17

The student nurse is learning how to reduce the stigma associated with mental illness. Which of the following statements by the student nurse reflects that learning has taken place?

Accepted Answer

This statement uses appropriate and respectful language when describing a patient with symptoms of mental illness. Using terms like "paranoid," "crazy," and "schizophrenic" can contribute to stigma and dehumanize people with mental illness. It is important for healthcare professionals to use person-first language and avoid using diagnostic labels as descriptors.

Question 18

A unit has a protocol for research on medications. The protocol identifies essential items that must be shared with clients to ensure ethical nursing practice. Which of the following factors should be shared with clients?

Accepted Answer

It is important to inform clients of the risks that can be encountered during the medication research study to ensure informed consent and ethical nursing practice. However, disclosing all aspects of the study or problems experienced by other clients may compromise privacy and confidentiality. Cost of the research is also not relevant information to be shared with clients.

Question 19

Which change in mental status is consistently seen in delirious individuals that differentiates it from dementia?

Accepted Answer

Clouding of consciousness is consistently seen in delirious individuals, while it may or may not be present in dementia. Disorientation to self, impaired short-term memory, and apraxia may also be present in delirium, but they are not consistently seen and can also be present in other conditions such as dementia.

Question 20

A client is 72 years old and has Alzheimer's dementia. Her husband of 50 years is no longer able to safely care for her at home and has her placed in a long-term care facility. When her husband visits her, she smiles and talks about their many travels around the world. Intrigued, the nurse asks the husband to describe his travels. The husband laughs and says, "We've never been out of the states." The client's tales are an example of:

Accepted Answer

Confabulation is a common feature of Alzheimer's dementia. It is the production of fabricated, distorted, or misinterpreted memories about oneself or the world, often without the intent to deceive. In this scenario, the client's stories about traveling are likely confabulations.

Quiz 2: Psychiatric-Mental Health Nursing Processes, and Clients With Mental Disorders