Test 1 study questions - ch 1-5
(Varcarolis + Evolve), Ethical and Legal
Issues in Psychiatric/Mental Health
Nursing, Varcarolis Ch 6 -- Legal &
Ethical, Varcarolis Ch. 9: Therapeutic
Relationships and the Clinical Interview,
Varcarolis Ch 9 -- Thera...
.When asked to explain what a psychosocial rehabilitation program is, the nurse
responds best when sharing
A "The concept started in the 1960s and provides psychiatric care for those without
private insurance."
B "The individual program can provide medication, therapies, and social services for the
mentally ill."
C "Referrals from inpatient and intensive outpatient facilities are provided with long-term
care that focuses on desired goals."
D "It is a multidisciplinary team approach that is composed of nurses, psychiatrics,
social workers, and psychologists." - ANSWER-C
A 14-year-old belongs to a neighborhood gang, engages in sexually promiscuous
behavior, and has a history of school truancy but reports that her parents are just old-
fashioned and don't understand her. The assessment data supports that the client is
displaying what type of behavior? - ANSWER-deviant
A black patient says to a white nurse, "There's no sense talking about how I feel. You
wouldn't understand because you live in a white world." The nurse's best action would
be to
a. explain, "Yes, I do understand. Everyone goes through the same experiences."
b. say, "Please give an example of something you think I wouldn't understand."
c. reassure the patient that nurses interact with people from all cultures.
d. change the subject to one that is less emotionally disturbing. - ANSWER-B
Having the patient speak in specifics rather than globally will help the nurse understand
the patient's perspective. This approach will help the nurse engage the patient.
Reassurance and changing the subject are not therapeutic techniques.
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?
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 - ANSWER-ANS: C
,Test 1 study questions - ch 1-5
(Varcarolis + Evolve), Ethical and Legal
Issues in Psychiatric/Mental Health
Nursing, Varcarolis Ch 6 -- Legal &
Ethical, Varcarolis Ch. 9: Therapeutic
Relationships and the Clinical Interview,
Varcarolis Ch 9 -- Thera...
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.
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.
B. Tell the client that if the medication is refused, hospitalization will occur.
C. Arrange with a relative to add medication to the client's morning orange juice.
D. Call for help to hold the client down while the injection is administered. - ANSWER-
ANS: A
It is ethically 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.
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. When the client makes inappropriate sexual innuendos to a staff member
B. When the client constantly demands inappropriate attention from the nurse
C. When the client physically attacks another client after being confronted in group
therapy
D. When the client refuses to bathe or perform hygienic activities - ANSWER-ANS: C
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.
A client is concerned that information given to the nurse remains confidential. Which is
the nurse's best response?
A. "Your information is confidential. It will be kept just between you and I."
B. "I will share the information with staff members only with your approval."
C. "If the information impacts your care, I will need to share it with the treatment team."
,Test 1 study questions - ch 1-5
(Varcarolis + Evolve), Ethical and Legal
Issues in Psychiatric/Mental Health
Nursing, Varcarolis Ch 6 -- Legal &
Ethical, Varcarolis Ch. 9: Therapeutic
Relationships and the Clinical Interview,
Varcarolis Ch 9 -- Thera...
D. "You can make the decision whether your physician needs this information or not." -
ANSWER-ANS: C
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.
A client reporting gastric pain, tells the nurse, "I think my symptoms started when a
neighbor cast a spell on me." The assessment the nurse can make is that the client
a has a major mental illness.
b is expressing a culture-bound illness.
c requires hospitalization to protect the neighbor.
d will probably not respond to Western medical treatment. - ANSWER-b
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?
A. Autonomy
B. Beneficence
C. Nonmaleficence
D. Justice - ANSWER-ANS: A
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.
A client tells the mental health nurse "I am terribly frightened! I hear whispering that
someone is going to kill me." The nurse assesses that this patient is lacking in appraisal
of ____________. - ANSWER-reality
A client was admitted to the behavioral health unit for evaluation and diagnosis after
being found wandering the streets. His personal hygiene is poor, and his responses to
questions are bizarre and inappropriate. The client's constitutional rights are violated
when the nurse states:
A "We will help you make decisions that will keep you safe."
, Test 1 study questions - ch 1-5
(Varcarolis + Evolve), Ethical and Legal
Issues in Psychiatric/Mental Health
Nursing, Varcarolis Ch 6 -- Legal &
Ethical, Varcarolis Ch. 9: Therapeutic
Relationships and the Clinical Interview,
Varcarolis Ch 9 -- Thera...
B "I am going to help you shower, so you will not smell so bad."
C "Your pocket knife and nail clippers will be kept in the nurses' station."
D "You will be having a number of tests to help us learn about your condition." -
ANSWER-B
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?
A. The client is paranoid.
B. The client is 87 years old.
C. The client incorrectly reports his or her spouse's name, date, and time of day.
D. The client relies on his or her spouse to interpret the information. - ANSWER-ANS: C
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.
A community mental health nurse has worked with a patient for 3 years but is moving
out of the city and terminates the relationship. A new nurse who begins work with this
patient will:
a. begin at the orientation phase.
b. resume the working relationship.
c. enter into a social relationship.
d. return to the emotional catharsis phase. - ANSWER-a. begin at the orientation phase.
After the termination of a long-term relationship, the patient and new nurse usually have
to begin at ground zero, the orientation phase, to build a new relationship. If termination
is successfully completed, then the orientation phase sometimes progresses quickly to
the working phase. Other times, even after successful termination, the orientation phase
may be prolonged.
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.
