Chapter 12 My Nursing Test Banks

 

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank
Chapter 12

Question 1

Type: MCSA

For a nurse studying bioethics, which of the following statements would indicate that learning has occurred regarding autonomy?

1. All clients should be given their due.

2. Part of our profession is doing good things for others.

3. We must always be honest with clients.

4. After I provide information, I will respect my clients right to make a decision.

Correct Answer: 4

Rationale 1: Autonomy is the freedom to choose a course of action, to act on that choice, and to live with the consequences of that choice. Nurses help clients by providing them with the information they need in order to choose, helping them to understand and sort through the information, and supporting their choice. The statement, All clients should be given their due demonstrates justice. The statement, Part of our profession is doing good things for others demonstrates beneficence. The statement, We must always be honest with clients demonstrates veracity.

Rationale 2: Autonomy is the freedom to choose a course of action, to act on that choice, and to live with the consequences of that choice. Nurses help clients by providing them with the information they need in order to choose, helping them to understand and sort through the information, and supporting their choice. The statement, All clients should be given their due demonstrates justice. The statement, Part of our profession is doing good things for others demonstrates beneficence. The statement, We must always be honest with clients demonstrates veracity.

Rationale 3: Autonomy is the freedom to choose a course of action, to act on that choice, and to live with the consequences of that choice. Nurses help clients by providing them with the information they need in order to choose, helping them to understand and sort through the information, and supporting their choice. The statement, All clients should be given their due demonstrates justice. The statement, Part of our profession is doing good things for others demonstrates beneficence. The statement, We must always be honest with clients demonstrates veracity.

Rationale 4: Autonomy is the freedom to choose a course of action, to act on that choice, and to live with the consequences of that choice. Nurses help clients by providing them with the information they need in order to choose, helping them to understand and sort through the information, and supporting their choice. The statement, All clients should be given their due demonstrates justice. The statement, Part of our profession is doing good things for others demonstrates beneficence. The statement, We must always be honest with clients demonstrates veracity.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Relate the six principles of bioethics to the practice of psychiatricmental health nursing.

Question 2

Type: MCSA

A nurse observes an acutely psychotic client scratching at his arms with his fingernails until his arms bleed. When asked what is happening, the client states he is trying to let the evil spirits out of his body. He is easily redirected by the nurse, but resumes scratching when the nurse leaves his side. The nurse orders 1:1 supervision of the client to keep him from harming himself. Which principle of bioethics was applied in this situation?

1. Justice

2. Fidelity

3. Beneficence

4. Veracity

Correct Answer: 3

Rationale 1: The nurses actions are taken to protect the client from harming himself. The client requires 1:1 supervision because his mental status is contributing to self-harm. Fidelity is loyalty and commitment to clients. Veracity is the intention to tell the truth. Justice is the principle of treating others fairly and equally.

Rationale 2: The nurses actions are taken to protect the client from harming himself. The client requires 1:1 supervision because his mental status is contributing to self-harm. Fidelity is loyalty and commitment to clients. Veracity is the intention to tell the truth. Justice is the principle of treating others fairly and equally.

Rationale 3: The nurses actions are taken to protect the client from harming himself. The client requires 1:1 supervision because his mental status is contributing to self-harm. Fidelity is loyalty and commitment to clients. Veracity is the intention to tell the truth. Justice is the principle of treating others fairly and equally.

Rationale 4: The nurses actions are taken to protect the client from harming himself. The client requires 1:1 supervision because his mental status is contributing to self-harm. Fidelity is loyalty and commitment to clients. Veracity is the intention to tell the truth. Justice is the principle of treating others fairly and equally.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Relate the six principles of bioethics to the practice of psychiatricmental health nursing.

Question 3

Type: MCSA

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

1. Veracity

2. Beneficence

3. Fidelity

4. Justice

Correct Answer: 3

Rationale 1: Fidelity is loyalty and commitment to clients. The nurse demonstrates fidelity when advocating for the best interests of the client. Veracity is the intention to tell the truth. Beneficence is the principle of attempting to do things that promote the good of others. Justice is the principle of treating others fairly and equally.

Rationale 2: Fidelity is loyalty and commitment to clients. The nurse demonstrates fidelity when advocating for the best interests of the client. Veracity is the intention to tell the truth. Beneficence is the principle of attempting to do things that promote the good of others. Justice is the principle of treating others fairly and equally.

Rationale 3: Fidelity is loyalty and commitment to clients. The nurse demonstrates fidelity when advocating for the best interests of the client. Veracity is the intention to tell the truth. Beneficence is the principle of attempting to do things that promote the good of others. Justice is the principle of treating others fairly and equally.

Rationale 4: Fidelity is loyalty and commitment to clients. The nurse demonstrates fidelity when advocating for the best interests of the client. Veracity is the intention to tell the truth. Beneficence is the principle of attempting to do things that promote the good of others. Justice is the principle of treating others fairly and equally.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Relate the six principles of bioethics to the practice of psychiatricmental health nursing.

Question 4

Type: MCSA

The nurse conducts ongoing evaluation of the crisis situation to ensure the clients right to the least restrictive intervention. This means the assessment factor receiving the highest priority is:

1. The clients condition in comparison to the adequacy of the environment designed to prevent injury.

2. The clients mental status.

3. The clientstaff ratio.

4. The comfort level of the environment.

Correct Answer: 1

Rationale 1: Decisions that impact the clients individual freedom are moral decisions. There must be consideration of what other interventions were attempted and what possibly could work, whether the clients behavior warrants a particular level of restrictive intervention, and how the level of the intervention will affect the client and the milieu. The clientstaff ratio will not be a priority in determining the level of intervention. The clients mental status will be considered in conjunction with the environment. The comfort level of the milieu will not be a priority.

Rationale 2: Decisions that impact the clients individual freedom are moral decisions. There must be consideration of what other interventions were attempted and what possibly could work, whether the clients behavior warrants a particular level of restrictive intervention, and how the level of the intervention will affect the client and the milieu. The clientstaff ratio will not be a priority in determining the level of intervention. The clients mental status will be considered in conjunction with the environment. The comfort level of the milieu will not be a priority.

Rationale 3: Decisions that impact the clients individual freedom are moral decisions. There must be consideration of what other interventions were attempted and what possibly could work, whether the clients behavior warrants a particular level of restrictive intervention, and how the level of the intervention will affect the client and the milieu. The clientstaff ratio will not be a priority in determining the level of intervention. The clients mental status will be considered in conjunction with the environment. The comfort level of the milieu will not be a priority.

Rationale 4: Decisions that impact the clients individual freedom are moral decisions. There must be consideration of what other interventions were attempted and what possibly could work, whether the clients behavior warrants a particular level of restrictive intervention, and how the level of the intervention will affect the client and the milieu. The clientstaff ratio will not be a priority in determining the level of intervention. The clients mental status will be considered in conjunction with the environment. The comfort level of the milieu will not be a priority.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Apply ethical guidelines in reconciling crucial ethical dilemmas.

Question 5

Type: MCSA

The client is concerned that the information given to the nurse remains confidential. Which is the nurses best response?

1. If the information is important to your care, I will need to share it with the staff.

2. We can keep the information just between the two of us if you prefer.

3. I will share the information with staff members only with your approval.

4. You can make the decision concerning whether your physician needs this information for your care.

Correct Answer: 1

Rationale 1: The nurse is obligated to share with the client the limits of confidentiality in their exchanges. Information gathering and sharing are part of the mental health nurses role and the expectation is that the nurse will accurately portray and convey data about the client. The nurse would not keep information from the rest of the mental health team.

Rationale 2: The nurse is obligated to share with the client the limits of confidentiality in their exchanges. Information gathering and sharing are part of the mental health nurses role and the expectation is that the nurse will accurately portray and convey data about the client. The nurse would not keep information from the rest of the mental health team.

Rationale 3: The nurse is obligated to share with the client the limits of confidentiality in their exchanges. Information gathering and sharing are part of the mental health nurses role and the expectation is that the nurse will accurately portray and convey data about the client. The nurse would not keep information from the rest of the mental health team.

Rationale 4: The nurse is obligated to share with the client the limits of confidentiality in their exchanges. Information gathering and sharing are part of the mental health nurses role and the expectation is that the nurse will accurately portray and convey data about the client. The nurse would not keep information from the rest of the mental health team.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Apply ethical guidelines in reconciling crucial ethical dilemmas.

Question 6

Type: MCSA

The nurse educator is teaching a group of students about the ethical dilemma of involuntary commitment. Which of the following would the educator use as a situation that would support the use of an involuntary commitment?

1. The client uses profanity when angry

2. The client self-medicates with marijuana

3. The client has threatened family members

4. The client reports auditory hallucinations

Correct Answer: 3

Rationale 1: Involuntary commitment is reserved for those individuals who are dangerous to self or others or unable to meet their basic needs. The threats to the clients family are considered a danger to others. The clients use of profanity, reports of auditory hallucinations, or the use of marijuana are not criteria for involuntary commitment.

Rationale 2: Involuntary commitment is reserved for those individuals who are dangerous to self or others or unable to meet their basic needs. The threats to the clients family are considered a danger to others. The clients use of profanity, reports of auditory hallucinations, or the use of marijuana are not criteria for involuntary commitment.

Rationale 3: Involuntary commitment is reserved for those individuals who are dangerous to self or others or unable to meet their basic needs. The threats to the clients family are considered a danger to others. The clients use of profanity, reports of auditory hallucinations, or the use of marijuana are not criteria for involuntary commitment.

Rationale 4: Involuntary commitment is reserved for those individuals who are dangerous to self or others or unable to meet their basic needs. The threats to the clients family are considered a danger to others. The clients use of profanity, reports of auditory hallucinations, or the use of marijuana are not criteria for involuntary commitment.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: Apply ethical guidelines in reconciling crucial ethical dilemmas.

Question 7

Type: MCSA

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?

1. Were admitting another schizophrenic who hears God talking.

2. A 19-year-old who reports hearing voices is being admitted with a diagnosis of psychosis not otherwise specified.

3. Were admitting another crazy client.

4. Theyve added another paranoid to the unit.

Correct Answer: 2

Rationale 1: It is the nurses role to address the stigma associated with diagnostic labeling. It is essential that clients not be referred to by their disease or in ways that discredit their social identity.

Rationale 2: It is the nurses role to address the stigma associated with diagnostic labeling. It is essential that clients not be referred to by their disease or in ways that discredit their social identity.

Rationale 3: It is the nurses role to address the stigma associated with diagnostic labeling. It is essential that clients not be referred to by their disease or in ways that discredit their social identity.

Rationale 4: It is the nurses role to address the stigma associated with diagnostic labeling. It is essential that clients not be referred to by their disease or in ways that discredit their social identity.

Global Rationale:

Cognitive Level: Creating

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Describe how psychiatricmental health nurses can avoid indirectly contributing to the stereotypes associated with psychiatric diagnostic categories.

Question 8

Type: MCSA

The nurse is having lunch with colleagues from a medical-surgical unit. One of the medical-surgical nurses states, I dont know how you can work with psych patients! They scare the heck out of me. How should the nurse respond?

1. Its not that bad, and most of the clients are not that scary.

2. The clients I work with have physical disorders just like the clients you work with.

3. I dont know; sometimes I wonder what I am doing.

4. I must have better nursing skills than you do.

Correct Answer: 2

Rationale 1: The stigma associated with psychiatric diagnostic labels has to be confronted directly. It is important that the nurse communicate to peers that the clients have physical disorders that are no different from those physical disorders found on the medical-surgical unit.

Rationale 2: The stigma associated with psychiatric diagnostic labels has to be confronted directly. It is important that the nurse communicate to peers that the clients have physical disorders that are no different from those physical disorders found on the medical-surgical unit.

Rationale 3: The stigma associated with psychiatric diagnostic labels has to be confronted directly. It is important that the nurse communicate to peers that the clients have physical disorders that are no different from those physical disorders found on the medical-surgical unit.

Rationale 4: The stigma associated with psychiatric diagnostic labels has to be confronted directly. It is important that the nurse communicate to peers that the clients have physical disorders that are no different from those physical disorders found on the medical-surgical unit.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Describe how psychiatricmental health nurses can avoid indirectly contributing to the stereotypes associated with psychiatric diagnostic categories.

Question 9

Type: MCSA

A psychiatricmental health nurse is attending a seminar. The speaker discusses how certain psychiatric diagnoses are associated with stereotypes. Which of the following actions ensures that the clients social identity is not discredited?

1. Refer to a client as delusional and psychotic.

2. Refer to a client as a schizophrenic.

3. Refer to a client as a paranoid.

4. Refer to a client as X who has a diagnosis of schizophrenia.

Correct Answer: 4

Rationale 1: There are many negative stereotypes attached to the diagnostic label of schizophrenia. It is essential that clients not be referred to by their disease or in ways that discredit their social identity.

Rationale 2: There are many negative stereotypes attached to the diagnostic label of schizophrenia. It is essential that clients not be referred to by their disease or in ways that discredit their social identity.

Rationale 3: There are many negative stereotypes attached to the diagnostic label of schizophrenia. It is essential that clients not be referred to by their disease or in ways that discredit their social identity.

Rationale 4: There are many negative stereotypes attached to the diagnostic label of schizophrenia. It is essential that clients not be referred to by their disease or in ways that discredit their social identity.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Describe how psychiatricmental health nurses can avoid indirectly contributing to the stereotypes associated with psychiatric diagnostic categories.

Question 10

Type: MCSA

A client becomes upset when touched by a staff member who is attempting to assess the clients blood pressure. The nurse recognizes that there is a problem with:

1. Confidentiality.

2. Staff control.

3. Duty to protect.

4. Informed consent.

Correct Answer: 4

Rationale 1: A client has the right to understand the treatment process prior to consenting to treatment. This is called informed consent and is required by all states. Staff members do not control clients, but work with clients. Duty to protect is a safeguard that is an exception to confidentiality and privilege. Confidentiality is the mechanism to ensure the clients privacy.

Rationale 2: A client has the right to understand the treatment process prior to consenting to treatment. This is called informed consent and is required by all states. Staff members do not control clients, but work with clients. Duty to protect is a safeguard that is an exception to confidentiality and privilege. Confidentiality is the mechanism to ensure the clients privacy.

Rationale 3: A client has the right to understand the treatment process prior to consenting to treatment. This is called informed consent and is required by all states. Staff members do not control clients, but work with clients. Duty to protect is a safeguard that is an exception to confidentiality and privilege. Confidentiality is the mechanism to ensure the clients privacy.

Rationale 4: A client has the right to understand the treatment process prior to consenting to treatment. This is called informed consent and is required by all states. Staff members do not control clients, but work with clients. Duty to protect is a safeguard that is an exception to confidentiality and privilege. Confidentiality is the mechanism to ensure the clients privacy.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Explain why psychiatricmental health nurses need to be knowledgeable about the mental health statutes and regulations in the state in which they practice.

Question 11

Type: MCSA

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 clients verbal admission warrants:

1. A report to appropriate government authorities.

2. A report to the nursing supervisor.

3. A report to the physician.

4. A report to the chief of staff.

Correct Answer: 1

Rationale 1: Nurses are legally obligated to report suspected child abuse to the proper government authorities. This is part of the duty to protect. The information will also be communicated to the nursing supervisor, the physician, and the chief staff, but the priority notification is to the government authorities.

Rationale 2: Nurses are legally obligated to report suspected child abuse to the proper government authorities. This is part of the duty to protect. The information will also be communicated to the nursing supervisor, the physician, and the chief staff, but the priority notification is to the government authorities.

Rationale 3: Nurses are legally obligated to report suspected child abuse to the proper government authorities. This is part of the duty to protect. The information will also be communicated to the nursing supervisor, the physician, and the chief staff, but the priority notification is to the government authorities.

Rationale 4: Nurses are legally obligated to report suspected child abuse to the proper government authorities. This is part of the duty to protect. The information will also be communicated to the nursing supervisor, the physician, and the chief staff, but the priority notification is to the government authorities.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Explain why psychiatricmental health nurses need to be knowledgeable about the mental health statutes and regulations in the state in which they practice.

Question 12

Type: MCSA

A client who was admitted voluntarily to the unit verbally refuses his medication. The nurse proceeds to give the medication over the clients objections. What is the legal significance of the nurses actions?

1. The nurse could be charged with malpractice.

2. The nurse could be charged with negligence.

3. The nurse cannot be held liable.

4. The nurse could be charged with battery.

Correct Answer: 4

Rationale 1: Medication can be administered against the clients wishes only if there is a treatment order from a judge or the client is a danger to self or others. Malpractice refers to the negligent acts of health care professionals when they fail to act in a responsible and prudent manner. Negligence occurs when a nurse fails to act in a manner in which most reasonable and prudent people would act. The nurse is liable for her actions.

Rationale 2: Medication can be administered against the clients wishes only if there is a treatment order from a judge or the client is a danger to self or others. Malpractice refers to the negligent acts of health care professionals when they fail to act in a responsible and prudent manner. Negligence occurs when a nurse fails to act in a manner in which most reasonable and prudent people would act. The nurse is liable for her actions.

Rationale 3: Medication can be administered against the clients wishes only if there is a treatment order from a judge or the client is a danger to self or others. Malpractice refers to the negligent acts of health care professionals when they fail to act in a responsible and prudent manner. Negligence occurs when a nurse fails to act in a manner in which most reasonable and prudent people would act. The nurse is liable for her actions.

Rationale 4: Medication can be administered against the clients wishes only if there is a treatment order from a judge or the client is a danger to self or others. Malpractice refers to the negligent acts of health care professionals when they fail to act in a responsible and prudent manner. Negligence occurs when a nurse fails to act in a manner in which most reasonable and prudent people would act. The nurse is liable for her actions.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Explain why psychiatricmental health nurses need to be knowledgeable about the mental health statutes and regulations in the state in which they practice.

Question 13

Type: MCSA

A 15-year-old girl is brought by her mother to see a psychiatric nurse practitioner. The clients 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?

1. Involuntary admission for the daughter

2. Therapy for the daughter

3. Outpatient therapy for the mother and daughter

4. Therapy for the mother

Correct Answer: 3

Rationale 1: The client has the right to treatment in the least restrictive environment. The client does not quality for an involuntary commitment. Outpatient therapy for the client and her mother provides the best treatment alternative.

Rationale 2: The client has the right to treatment in the least restrictive environment. The client does not quality for an involuntary commitment. Outpatient therapy for the client and her mother provides the best treatment alternative.

Rationale 3: The client has the right to treatment in the least restrictive environment. The client does not quality for an involuntary commitment. Outpatient therapy for the client and her mother provides the best treatment alternative.

Rationale 4: The client has the right to treatment in the least restrictive environment. The client does not quality for an involuntary commitment. Outpatient therapy for the client and her mother provides the best treatment alternative.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare admission and release procedures for voluntary admission and involuntary commitment.

Question 14

Type: MCSA

The relative of a chronically mentally ill woman requests that the mentally ill woman be committed because of her history of 12 previous hospitalizations and because she sits around the house all day refusing to get dressed. The nurse tells the relative that the woman cannot be committed because:

1. It is less than two weeks since her most recent hospital discharge.

2. She has used up her hospital coverage.

3. She has not voluntarily requested hospitalization.

4. There is no evidence that she is a danger to self or others.

Correct Answer: 4

Rationale 1: The woman does not meet the criteria for involuntary commitment as she is not a danger to herself or others. If the client met the criteria for hospitalization, she could be admitted even if she did not have hospital coverage or had recently been hospitalized. The criteria for involuntary hospitalization does not include the clients request for hospitalization.

Rationale 2: The woman does not meet the criteria for involuntary commitment as she is not a danger to herself or others. If the client met the criteria for hospitalization, she could be admitted even if she did not have hospital coverage or had recently been hospitalized. The criteria for involuntary hospitalization does not include the clients request for hospitalization.

Rationale 3: The woman does not meet the criteria for involuntary commitment as she is not a danger to herself or others. If the client met the criteria for hospitalization, she could be admitted even if she did not have hospital coverage or had recently been hospitalized. The criteria for involuntary hospitalization does not include the clients request for hospitalization.

Rationale 4: The woman does not meet the criteria for involuntary commitment as she is not a danger to herself or others. If the client met the criteria for hospitalization, she could be admitted even if she did not have hospital coverage or had recently been hospitalized. The criteria for involuntary hospitalization does not include the clients request for hospitalization.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare admission and release procedures for voluntary admission and involuntary commitment.

Question 15

Type: MCSA

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

1. The client gave informed consent for hospitalization.

2. The client has signed away all civil rights.

3. The client will need a court hearing within seven days.

4. The client has to remain hospitalized for three days.

Correct Answer: 1

Rationale 1: Voluntary admission occurs when the client has completed a written application for admission. The client retains all civil rights and will not require a court hearing. The length of stay will vary, but the client can give written notice of intent to terminate treatment.

Rationale 2: Voluntary admission occurs when the client has completed a written application for admission. The client retains all civil rights and will not require a court hearing. The length of stay will vary, but the client can give written notice of intent to terminate treatment.

Rationale 3: Voluntary admission occurs when the client has completed a written application for admission. The client retains all civil rights and will not require a court hearing. The length of stay will vary, but the client can give written notice of intent to terminate treatment.

Rationale 4: Voluntary admission occurs when the client has completed a written application for admission. The client retains all civil rights and will not require a court hearing. The length of stay will vary, but the client can give written notice of intent to terminate treatment.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Compare admission and release procedures for voluntary admission and involuntary commitment.

Question 16

Type: MCSA

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?

1. Hospital policy

2. State law

3. Insurer

4. Federal law

Correct Answer: 2

Rationale 1: As the word voluntary implies, the client has a right to demand and obtain release. Depending on the state, the client agrees to give notice, usually in writing, of the intention to leave during a grace period of from 24 hours to 15 days. The grace period is justified on the grounds that the hospital staff needs time to examine the client to determine whether a change to involuntary status is indicated.

Rationale 2: As the word voluntary implies, the client has a right to demand and obtain release. Depending on the state, the client agrees to give notice, usually in writing, of the intention to leave during a grace period of from 24 hours to 15 days. The grace period is justified on the grounds that the hospital staff needs time to examine the client to determine whether a change to involuntary status is indicated.

Rationale 3: As the word voluntary implies, the client has a right to demand and obtain release. Depending on the state, the client agrees to give notice, usually in writing, of the intention to leave during a grace period of from 24 hours to 15 days. The grace period is justified on the grounds that the hospital staff needs time to examine the client to determine whether a change to involuntary status is indicated.

Rationale 4: As the word voluntary implies, the client has a right to demand and obtain release. Depending on the state, the client agrees to give notice, usually in writing, of the intention to leave during a grace period of from 24 hours to 15 days. The grace period is justified on the grounds that the hospital staff needs time to examine the client to determine whether a change to involuntary status is indicated.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Deliver psychiatricmental health nursing care in a manner that preserves and protects client rights, dignity, and autonomy.

Question 17

Type: MCSA

The staff are discussing the competency of a client who was recently involuntary admitted to the unit. Which of the following statements about competency is inaccurate?

1. Competency is affected by client compliance with treatment.

2. Competency is a medical determination made by the clients physician.

3. A guardian is appointed to make decisions on the persons behalf when the client is determined to be incompetent.

4. A competent client means the client can make reasonable judgments and decisions.

Correct Answer: 2

Rationale 1: Competency is a legal determination that can only be determined by a judge.

Rationale 2: Competency is a legal determination that can only be determined by a judge.

Rationale 3: Competency is a legal determination that can only be determined by a judge.

Rationale 4: Competency is a legal determination that can only be determined by a judge.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Deliver psychiatricmental health nursing care in a manner that preserves and protects client rights, dignity, and autonomy.

Question 18

Type: MCSA

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?

1. Problems that all other clients have had in the study

2. Risks that can be encountered

3. All aspects of the research study

4. Cost of the research

Correct Answer: 2

Rationale 1: A client has the right to understand the treatment process prior to consenting to treatment. This is called informed consent and is required by all states. The main purpose of the doctrine of informed consent is to encourage individual autonomy and sound decision making.

Rationale 2: A client has the right to understand the treatment process prior to consenting to treatment. This is called informed consent and is required by all states. The main purpose of the doctrine of informed consent is to encourage individual autonomy and sound decision making.

Rationale 3: A client has the right to understand the treatment process prior to consenting to treatment. This is called informed consent and is required by all states. The main purpose of the doctrine of informed consent is to encourage individual autonomy and sound decision making.

Rationale 4: A client has the right to understand the treatment process prior to consenting to treatment. This is called informed consent and is required by all states. The main purpose of the doctrine of informed consent is to encourage individual autonomy and sound decision making.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Deliver psychiatricmental health nursing care in a manner that preserves and protects client rights, dignity, and autonomy.

Question 19

Type: MCSA

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

1. Conditions under which life support will be discontinued

2. A legal representative for power of attorney

3. Do not resuscitate (DNR) requests

4. List of persons who can make decisions on the clients behalf

Correct Answer: 4

Rationale 1: Psychiatric advance directives (PADs) are modeled after advance directives for end-of-life care. They are legal instruments that allow competent persons to document their preferences regarding mental health treatment. Any person can prepare a PAD as a contingency plan to be put in place and used if the person is incapacitated, found to be incompetent, or unable to make reliable decisions about psychiatric care. PADs do not address medical needs such as DNR orders or life support.

Rationale 2: Psychiatric advance directives (PADs) are modeled after advance directives for end-of-life care. They are legal instruments that allow competent persons to document their preferences regarding mental health treatment. Any person can prepare a PAD as a contingency plan to be put in place and used if the person is incapacitated, found to be incompetent, or unable to make reliable decisions about psychiatric care. PADs do not address medical needs such as DNR orders or life support.

Rationale 3: Psychiatric advance directives (PADs) are modeled after advance directives for end-of-life care. They are legal instruments that allow competent persons to document their preferences regarding mental health treatment. Any person can prepare a PAD as a contingency plan to be put in place and used if the person is incapacitated, found to be incompetent, or unable to make reliable decisions about psychiatric care. PADs do not address medical needs such as DNR orders or life support.

Rationale 4: Psychiatric advance directives (PADs) are modeled after advance directives for end-of-life care. They are legal instruments that allow competent persons to document their preferences regarding mental health treatment. Any person can prepare a PAD as a contingency plan to be put in place and used if the person is incapacitated, found to be incompetent, or unable to make reliable decisions about psychiatric care. PADs do not address medical needs such as DNR orders or life support.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Partner with clients and their families in developing a psychiatric advance directive.

Question 20

Type: MCSA

The nurse and a client talk about the signs and symptoms of acute mania. The client states, When I am feeling really good and dont 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:

1. Competency.

2. Psychiatric advance directive (PAD).

3. Right to treatment.

4. Informed consent.

Correct Answer: 2

Rationale 1: Psychiatric advance directives (PADs) are modeled after advance directives for end-of-life care. They are legal instruments that allow competent persons to document their preferences regarding mental health treatment. Any person can prepare a PAD as a contingency plan to put in place should the person be incapacitated, found to be incompetent, or unable to make reliable decisions about psychiatric care. Informed consent is the right to understand the treatment process prior to consenting to treatment. Being competent means that a client must be cognitively able to understand the situation and the implications of treatment. Right to treatment ensures that clients are not in a treatment setting for custodial purposes only.

Rationale 2: Psychiatric advance directives (PADs) are modeled after advance directives for end-of-life care. They are legal instruments that allow competent persons to document their preferences regarding mental health treatment. Any person can prepare a PAD as a contingency plan to put in place should the person be incapacitated, found to be incompetent, or unable to make reliable decisions about psychiatric care. Informed consent is the right to understand the treatment process prior to consenting to treatment. Being competent means that a client must be cognitively able to understand the situation and the implications of treatment. Right to treatment ensures that clients are not in a treatment setting for custodial purposes only.

Rationale 3: Psychiatric advance directives (PADs) are modeled after advance directives for end-of-life care. They are legal instruments that allow competent persons to document their preferences regarding mental health treatment. Any person can prepare a PAD as a contingency plan to put in place should the person be incapacitated, found to be incompetent, or unable to make reliable decisions about psychiatric care. Informed consent is the right to understand the treatment process prior to consenting to treatment. Being competent means that a client must be cognitively able to understand the situation and the implications of treatment. Right to treatment ensures that clients are not in a treatment setting for custodial purposes only.

Rationale 4: Psychiatric advance directives (PADs) are modeled after advance directives for end-of-life care. They are legal instruments that allow competent persons to document their preferences regarding mental health treatment. Any person can prepare a PAD as a contingency plan to put in place should the person be incapacitated, found to be incompetent, or unable to make reliable decisions about psychiatric care. Informed consent is the right to understand the treatment process prior to consenting to treatment. Being competent means that a client must be cognitively able to understand the situation and the implications of treatment. Right to treatment ensures that clients are not in a treatment setting for custodial purposes only.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Partner with clients and their families in developing a psychiatric advance directive.

Question 21

Type: MCSA

A client with a diagnosis of bipolar disorder has had several hospitalizations to treat this mental illness and feels that the care he received was not consistent with his best interests. The clients experience is indicative of which of the following needs?

1. Informed consent

2. Psychiatric advance directive (PAD)

3. Right to treatment

4. Competency

Correct Answer: 2

Rationale 1: Psychiatric advance directives (PADs) are modeled after advance directives for end-of-life care. They are legal instruments that allow competent persons to document their preferences regarding mental health treatment. Any person can prepare a PAD as a contingency plan to put in place should the person be incapacitated, found to be incompetent, or unable to make reliable decisions about psychiatric care. Informed consent is the right to understand the treatment process prior to consenting to treatment. Being competent means that a client must be cognitively able to understand the situation and the implications of treatment. Right to treatment ensures that clients are not in a treatment setting for custodial purposes only.

Rationale 2: Psychiatric advance directives (PADs) are modeled after advance directives for end-of-life care. They are legal instruments that allow competent persons to document their preferences regarding mental health treatment. Any person can prepare a PAD as a contingency plan to put in place should the person be incapacitated, found to be incompetent, or unable to make reliable decisions about psychiatric care. Informed consent is the right to understand the treatment process prior to consenting to treatment. Being competent means that a client must be cognitively able to understand the situation and the implications of treatment. Right to treatment ensures that clients are not in a treatment setting for custodial purposes only.

Rationale 3: Psychiatric advance directives (PADs) are modeled after advance directives for end-of-life care. They are legal instruments that allow competent persons to document their preferences regarding mental health treatment. Any person can prepare a PAD as a contingency plan to put in place should the person be incapacitated, found to be incompetent, or unable to make reliable decisions about psychiatric care. Informed consent is the right to understand the treatment process prior to consenting to treatment. Being competent means that a client must be cognitively able to understand the situation and the implications of treatment. Right to treatment ensures that clients are not in a treatment setting for custodial purposes only.

Rationale 4: Psychiatric advance directives (PADs) are modeled after advance directives for end-of-life care. They are legal instruments that allow competent persons to document their preferences regarding mental health treatment. Any person can prepare a PAD as a contingency plan to put in place should the person be incapacitated, found to be incompetent, or unable to make reliable decisions about psychiatric care. Informed consent is the right to understand the treatment process prior to consenting to treatment. Being competent means that a client must be cognitively able to understand the situation and the implications of treatment. Right to treatment ensures that clients are not in a treatment setting for custodial purposes only.

Global Rationale:

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Partner with clients and their families in developing a psychiatric advance directive.

Question 22

Type: MCSA

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?

1. Call the police.

2. Immediately report the clients claims to the appropriate authority.

3. Discuss the statements with the medical director.

4. Do nothing, as psychiatric clients often are unreliable.

Correct Answer: 2

Rationale 1: Clients with mental illness are particularly vulnerable to both physical and psychological abuse and often do not have the ability or power to defend themselves. Nurses must report suspected instances of client abuse. Calling the police may eventually be needed, but it is important to follow the chain of command when reporting.

Rationale 2: Clients with mental illness are particularly vulnerable to both physical and psychological abuse and often do not have the ability or power to defend themselves. Nurses must report suspected instances of client abuse. Calling the police may eventually be needed, but it is important to follow the chain of command when reporting.

Rationale 3: Clients with mental illness are particularly vulnerable to both physical and psychological abuse and often do not have the ability or power to defend themselves. Nurses must report suspected instances of client abuse. Calling the police may eventually be needed, but it is important to follow the chain of command when reporting.

Rationale 4: Clients with mental illness are particularly vulnerable to both physical and psychological abuse and often do not have the ability or power to defend themselves. Nurses must report suspected instances of client abuse. Calling the police may eventually be needed, but it is important to follow the chain of command when reporting.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Assist clients and families to develop skills for self-advocacy.

Question 23

Type: MCSA

A nurse is planning a presentation for psychiatric clients and their families on client rights. This would be an example of:

1. Maleficence.

2. Duty to warn.

3. Advocacy.

4. Competency.

Correct Answer: 3

Rationale 1: Psychiatricmental health nursing intervention directed at client rights education is an example of advocacy. Duty to warn is an exception to client confidentiality. Maleficence is the quality of being morally wrong in principle or practice. Competency refers to the individuals ability to understand a situation and the implications of treatment.

Rationale 2: Psychiatricmental health nursing intervention directed at client rights education is an example of advocacy. Duty to warn is an exception to client confidentiality. Maleficence is the quality of being morally wrong in principle or practice. Competency refers to the individuals ability to understand a situation and the implications of treatment.

Rationale 3: Psychiatricmental health nursing intervention directed at client rights education is an example of advocacy. Duty to warn is an exception to client confidentiality. Maleficence is the quality of being morally wrong in principle or practice. Competency refers to the individuals ability to understand a situation and the implications of treatment.

Rationale 4: Psychiatricmental health nursing intervention directed at client rights education is an example of advocacy. Duty to warn is an exception to client confidentiality. Maleficence is the quality of being morally wrong in principle or practice. Competency refers to the individuals ability to understand a situation and the implications of treatment.

Global Rationale:

Cognitive Level: Evaluating

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Assist clients and families to develop skills for self-advocacy.

Question 24

Type: MCSA

A nurse is learning how to advocate for populations with mental disorders. Which of the following statements by the nurse would reflect that learning has taken place?

1. We cannot provide service if there is no money to pay for treatment.

2. Nursing should monitor treatment planning and delivery of service for the abuse of client rights.

3. All psychiatric clients have delusions.

4. Policy is directed toward staff only.

Correct Answer: 2

Rationale 1: Psychiatricmental health nursing interventions that would promote advocacy include monitoring treatment planning and delivery of service for the abuse of client rights. Advocacy also includes evaluating policy for infringement of client rights, providing treatment for indigent clients, and speaking out if resource limitations threaten services for vulnerable individuals. Nurses who advocate for clients should also question their peers if care appears to be based on common stereotypes of illness rather than the clients individual needs.

Rationale 2: Psychiatricmental health nursing interventions that would promote advocacy include monitoring treatment planning and delivery of service for the abuse of client rights. Advocacy also includes evaluating policy for infringement of client rights, providing treatment for indigent clients, and speaking out if resource limitations threaten services for vulnerable individuals. Nurses who advocate for clients should also question their peers if care appears to be based on common stereotypes of illness rather than the clients individual needs.

Rationale 3: Psychiatricmental health nursing interventions that would promote advocacy include monitoring treatment planning and delivery of service for the abuse of client rights. Advocacy also includes evaluating policy for infringement of client rights, providing treatment for indigent clients, and speaking out if resource limitations threaten services for vulnerable individuals. Nurses who advocate for clients should also question their peers if care appears to be based on common stereotypes of illness rather than the clients individual needs.

Rationale 4: Psychiatricmental health nursing interventions that would promote advocacy include monitoring treatment planning and delivery of service for the abuse of client rights. Advocacy also includes evaluating policy for infringement of client rights, providing treatment for indigent clients, and speaking out if resource limitations threaten services for vulnerable individuals. Nurses who advocate for clients should also question their peers if care appears to be based on common stereotypes of illness rather than the clients individual needs.

Global Rationale:

Cognitive Level: Creating

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Assist clients and families to develop skills for self-advocacy.

Kneisl, Contemporary Psychiatric-Mental Health Nursing, 3/e Test Bank

Copyright 2012 by Pearson Education, Inc.

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