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Varcarolis Chapter Six on Ethical and Legal Issues Problem Solving Exam Questions and With Distinction level Marking scheme updated 2024/2025$11.49
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Varcarolis Chapter Six on Ethical and Legal Issues Problem Solving Exam Questions and With Distinction level Marking scheme updated 2024/2025
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Varcarolis Chapter Six on Ethical and Legal Issues Problem Solving Exam Questions and With Distinction level Marking scheme updated 2024/2025
A family member of a patient with delusions of persecution asks the nurse, "Are there any circumstances under which the treatment team is justified in vio...
Varcarolis Chapter Six on Ethical and Legal
Issues Problem Solving Exam Questions and
With Distinction level Marking scheme
updated 2024/2025
A family member of a patient with delusions of persecution asks
the nurse, "Are there any circumstances under which the
treatment team is justified in violating a patient's right to
confidentiality?" The nurse should reply that confidentiality may
be breached
a. under no circumstances.
b. at the discretion of the psychiatrist.
c. when questions are asked by law enforcement.
d. if the patient threatens the life of another person. - correct
answer D
The duty to warn a person whose life has been threatened by a
psychiatric patient overrides the patient's right to confidentiality.
The right to confidentiality is not suspended at the discretion of
the therapist or for legal investigations.
A new antidepressant is prescribed for an elderly patient
diagnosed with major depressive disorder, but the dose is more
than the usual geriatric dose. The nurse should
a. consult a reliable drug reference.
b. teach the patient about possible side effects and adverse
effects.
c. withhold the medication and confer with the health care
provider.
d. encourage the patient to increase oral fluids to reduce drug
concentration. - correct answer C
,The dose of antidepressants for elderly patients is often less than
the usual adult dose. The nurse should withhold the medication
and consult the health care provider who wrote the order. The
nurse's duty is to practice according to professional standards as
well as intervene and protect the patient.
A patient diagnosed with schizophrenia believes a local minister
stirred evil spirits. The patient threatens to bomb a local church.
The psychiatrist notifies the minister. Select the answer with the
correct rationale. The psychiatrist
a. released information without proper authorization.
b. demonstrated the duty to warn and protect.
c. violated the patient's confidentiality.
d. avoided charges of malpractice. - correct answer B
It is the health care professional's duty to warn or notify an
intended victim after a threat of harm has been made. Informing
a potential victim of a threat is a legal responsibility of the health
care professional. It is not a violation of confidentiality.
A patient experiencing psychosis became aggressive, struck
another patient, and required seclusion. Select the best
documentation.
a. Patient struck another patient who attempted to leave day
room to go to bathroom. Seclusion necessary at 1415. Plan:
Maintain seclusion for 8 hours and keep these two patients away
from each other for 24 hours.
b. Seclusion ordered by physician at 1415 after command
hallucinations told the patient to hit another patient. Careful
monitoring of patient maintained during period of seclusion.
,c. Seclusion ordered by MD for aggressive behavior. Begun at
1415. Maintained for 2 hours without incident. Outcome: Patient
calmer and apologized for outburst.
d. Patient pacing, shouting. Haloperidol 5 mg given PO at 1300.
No effect by 1315. At 1415 patient yelled, "I'll punch anyone who
gets near me," and struck another patient with fist. Physically
placed in seclusion at 1420. Seclusion order obtained from MD at
1430. - correct answer D
Documentation must be specific and detail the key aspects of
care. It should demonstrate implementation of the least
restrictive alternative. Justification for why a patient was
secluded should be recorded, along with interventions attempted
in an effort to avoid seclusion. Documentation should include a
description of behavior and verbalizations, interventions tried
and their outcomes, and the name of the health care provider
ordering the use of seclusion.
A person in the community asks, "Why aren't people with mental
illness kept in state institutions anymore?" Select the nurse's
best response.
a. "Less restrictive settings are available now to care for
individuals with mental illness."
b. "There are fewer persons with mental illness, so less hospital
beds are needed."
c. "Most people with mental illness are still in psychiatric
institutions."
d. "Psychiatric institutions violated patients' rights." - correct
answer A
The community is a less restrictive alternative than hospitals for
treatment of persons with mental illness. The distracters are
incorrect and part of the stigma of mental illness.
, A patient experiencing psychosis asks a psychiatric technician,
"What's the matter with me?" The technician replies, "Nothing is
wrong with you. You just need to use some self-control." The
nurse who overheard the exchange should take action based on
a. the technician's unauthorized disclosure of confidential clinical
information.
b. violation of the patient's right to be treated with dignity and
respect.
c. the nurse's obligation to report caregiver negligence.
d. the patient's right to social interaction. - correct answer B
Patients have the right to be treated with dignity and respect.
The technician's comment disregards the seriousness of the
patient's illness. The Code of Ethics for Nurses requires
intervention. Patient emotional abuse has been demonstrated,
not negligence. An interaction with the technician is not an
aspect of social interaction.
Which documentation of a patient's behavior best demonstrates a
nurse's observations?
a. Isolates self from others. Frequently fell asleep during group.
Vital signs stable.
b. Calmer-- more cooperative. Participated actively in group. No
evidence of psychotic thinking.
c. Appeared to hallucinate. Frequently increased volume on
television, causing conflict with others.
d. Wore four layers of clothing. States, "I need protection from
evil bacteria trying to pierce my skin." - correct answer D
The documentation states specific observations of the patient's
appearance and the exact statements made. The other options
are vague or subjective statements and can be interpreted in
different ways.
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