Varcarolis Chapter 6 - Legal & Ethical Quiz

Questions and Answers

There are fewer persons with mental illness, so less hospital beds are needed.

True

Most people with mental illness are still in psychiatric institutions.

False

Psychiatric institutions violated patients' rights.

True

What should the nurse do regarding the technician's comment to the patient experiencing psychosis?

Refer the matter to the charge nurse to resolve. Signup and view all the answers

Which documentation of a patient's behavior best demonstrates a nurse's observations?

Wore four layers of clothing. States, 'I need protection from evil bacteria trying to pierce my skin.' Signup and view all the answers

Which individual diagnosed with a mental illness may need involuntary hospitalization?

An individual who takes 38 acetaminophen tablets after the person's stock portfolio becomes worthless. Signup and view all the answers

Which actions violate the civil rights of a psychiatric patient? (Select all that apply)

Opens and reads a letter a patient left at the nurse's station to be mailed. Signup and view all the answers

The nurse must obtain ______________ before releasing information regarding a patient diagnosed with a mental illness.

a signed consent by the patient for release of information stating specific information to be released. Signup and view all the answers

In which situations would a nurse have the duty to intervene and report? (Select all that apply)

A team member violates relationship boundaries with a patient. Signup and view all the answers

What is required for documentation of administration of a prn medication?

The nurse should document it promptly. Signup and view all the answers

Which action by a psychiatric nurse best applies the ethical principle of autonomy?

Exploring alternative solutions with the patient, who then makes a choice. Signup and view all the answers

A nurse finds a psychiatric advance directive in the medical record of a patient currently experiencing psychosis. The directive was executed during a period when the patient was stable and competent. The nurse should

Ensure that the directive is respected in treatment planning. Signup and view all the answers

Two hospitalized patients fight whenever they are together. During a team meeting, a nurse asserts that safety is of paramount importance, so treatment plans should call for both patients to be secluded to keep them from injuring each other. This assertion

Violates the civil rights of both patients. Signup and view all the answers

In a team meeting, a nurse expresses concern about whether they are behaving ethically by using restraint to prevent one patient from self-mutilation, while the care plan for another self-mutilating patient requires one-on-one supervision. Which ethical principle most clearly applies to this situation?

Justice Signup and view all the answers

Select the example of a tort.

A nurse gives a prn dose of an antipsychotic drug to an agitated patient because the unit is short-staffed. Signup and view all the answers

What is the legal significance of a nurse's action when a patient verbally refuses medication and the nurse gives the medication over the patient's objection? The nurse

Can be charged with battery. Signup and view all the answers

Which nursing intervention demonstrates false imprisonment?

A patient has been irritating and attention seeking much of the day. A nurse escorts the patient down the hall saying, 'Stay in your room, or you'll be put in seclusion.' Signup and view all the answers

Which patient meets criteria for involuntary hospitalization for psychiatric treatment? The patient who

Threatens to harm self and others. Signup and view all the answers

A nurse prepares to administer a scheduled intramuscular injection of an antipsychotic medication to an outpatient diagnosed with schizophrenia. As the nurse swabs the site, the patient shouts, 'Stop! I don't want to take that medicine anymore. I hate the side effects.' Select the nurse's best action.

Stop the medication administration procedure and say to the patient, 'Tell me more about the side effects you've been having.' Signup and view all the answers

A nurse is concerned that an agency's policies are inadequate. Which understanding about the relationship between substandard institutional policies and individual nursing practice should guide nursing practice?

Agency policies do not exempt an individual nurse of responsibility to practice according to professional standards of nursing care. Signup and view all the answers

A newly admitted acutely psychotic patient is a private patient of the medical director and a private-pay patient. To whom does the psychiatric nurse assigned to the patient owe the duty of care?

Patient Signup and view all the answers

Which action by a nurse constitutes a breach of a patient's right to privacy?

Releasing information to the patient's employer without consent. Signup and view all the answers

An adolescent hospitalized after a violent physical outburst tells the nurse, 'I'm going to kill my father, but you can't tell anyone.' Select the nurse's best response.

'I am obligated to share that information with the treatment team.' Signup and view all the answers

A voluntarily hospitalized patient tells the nurse, 'Get me the forms for discharge. I want to leave now.' Select the nurse's best response.

'I will get them for you, but let's talk about your decision to leave treatment.' Signup and view all the answers

Insurance will not pay for continued private hospitalization of a mentally ill patient. The family considers transferring the patient to a public hospital but expresses concern that the patient will not get any treatment if transferred. Select the nurse's most helpful reply.

'By law, treatment must be provided. Hospitalization without treatment violates patients' rights.' Signup and view all the answers

Which individual diagnosed with mental illness may need emergency or involuntary admission? The individual who

Throws a heavy plate at a waiter at the direction of command hallucinations. Signup and view all the answers

A patient in alcohol rehabilitation reveals to the nurse, 'I feel terrible guilt for sexually abusing my 6-year-old before I was admitted.' Select the nurse's most important action.

Anonymously report the abuse by phone to the local child protection agency. Signup and view all the answers

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

If the patient threatens the life of another person. Signup and view all the answers

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

Withhold the medication and confer with the health care provider. Signup and view all the answers

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

Demonstrated the duty to warn and protect. Signup and view all the answers

A patient experiencing psychosis became aggressive, struck another patient, and required seclusion. Select the best documentation.

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. Signup and view all the answers

Why aren't people with mental illness kept in state institutions anymore?

Less restrictive settings are available now to care for individuals with mental illness. Signup and view all the answers

Study Notes

Ethical Principles in Psychiatric Nursing

Autonomy: Emphasizes the patient's right to make informed decisions regarding their treatment.
Beneficence: A duty to act for the benefit of patients and promote their well-being.
Justice: Focuses on fair treatment and distribution of care among patients.
Fidelity: Involves loyalty and maintaining trust with patients.

Advanced psychiatric directives should be respected, even during episodes of psychosis.
Patients possess a legal right to treatment in the least restrictive environment; unnecessary seclusion can result in legal repercussions.
Nurses must advocate for patient autonomy and engage in discussions about treatment decisions.

Legal Implications and Torts

Battery: Occurs when a nurse administers treatment against a patient's will, violating their rights.
False Imprisonment: Holding a patient against their will without medical necessity, especially of competent individuals.
Reporting suspected child abuse is often a legal requirement for nurses.

Involuntary Hospitalization Criteria

Involuntary hospitalization is warranted for patients posing danger to themselves or others and unable to care for basic needs.
Violent behaviors, such as threatening harm to others, signify a need for immediate intervention.

Documentation Standards

Accurate, concise, and specific documentation is essential in psychiatric nursing to capture patient behavior and treatment rationale.
Documentation of inappropriate comments from staff indicating disrespect or negligence must be addressed.

Confidentiality and Duty to Warn

Confidentiality may be breached when a patient expresses intentions to harm another person, necessitating communication to protect potential victims.
Duty to warn encompasses the responsibility of healthcare professionals to inform intended victims when threats are made.

Patient Admission and Discharge

Patients admitted voluntarily can demand their discharge; however, exploration of their decision is crucial for their best interests.
Policies within healthcare agencies do not exempt nurses from adhering to professional standards of care.

Rights and Responsibilities of Mental Health Professionals

Mental health professionals owe their primary duty of care to the patient, transcending institutional or supervisory obligations.
Care should be provided without discrimination and uphold the dignity of individuals with mental illness.

Community Care and Treatment Evolution

Mental health treatment has shifted from institutionalization towards community-based, less restrictive environments.
The change is driven by a broader understanding of patient rights and the negative impacts of prolonged institutional confinement.### Documentation in Nursing Practice
Nurses must strictly adhere to documentation protocols; fraudulent documentation is subject to disciplinary action by state boards.
Omitting documentation of medication administration necessitates reporting the incident to the charge nurse to follow hospital policy.

Involuntary Hospitalization Criteria

Involuntary hospitalization is required when individuals pose a danger to themselves or are unable to meet basic needs.
Overdose, such as taking 38 acetaminophen tablets, signals dangerous behavior justifying hospitalization.

Patient Rights in Dietary Choices

Patients' rights must always be respected; offering menu choices promotes individual dignity and autonomy.
Nurses should respond positively to suggestions while reinforcing the importance of patient individuality in treatment.

Release of Health Information

To share patient information with other facilities or third parties, a signed consent from the patient specifying the information is essential.
Nurses are responsible for maintaining the confidentiality and privacy of patient records.

Duty to Intervene in Nursing

Nurses must intervene in clear cases that endanger patient safety, such as a peer providing care while impaired or violating relationship boundaries with a patient.
Situations like difficulty with documentation or a patient refusing medication do not meet the threshold for mandated reporting.

Violations of Psychiatric Patients' Rights

Patients have the right to send and receive mail freely, and opening personal letters without consent violates this right.
Restraining a patient simply for using profanity is inappropriate and infringes on their civil rights.

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Test your knowledge of legal and ethical principles in psychiatric nursing with this quiz based on Varcarolis Chapter 6. Focus on the ethical principle of autonomy and its application in nursing practice. Understand how autonomy influences patient decision-making and nursing interventions.

Varcarolis Chapter 6 - Legal & Ethical Quiz

Questions and Answers

There are fewer persons with mental illness, so less hospital beds are needed.

Most people with mental illness are still in psychiatric institutions.

Psychiatric institutions violated patients' rights.

What should the nurse do regarding the technician's comment to the patient experiencing psychosis?

Which documentation of a patient's behavior best demonstrates a nurse's observations?

Which individual diagnosed with a mental illness may need involuntary hospitalization?

Which actions violate the civil rights of a psychiatric patient? (Select all that apply)

The nurse must obtain ______________ before releasing information regarding a patient diagnosed with a mental illness.

In which situations would a nurse have the duty to intervene and report? (Select all that apply)

What is required for documentation of administration of a prn medication?

Which action by a psychiatric nurse best applies the ethical principle of autonomy?

A nurse finds a psychiatric advance directive in the medical record of a patient currently experiencing psychosis. The directive was executed during a period when the patient was stable and competent. The nurse should

Two hospitalized patients fight whenever they are together. During a team meeting, a nurse asserts that safety is of paramount importance, so treatment plans should call for both patients to be secluded to keep them from injuring each other. This assertion

Select the example of a tort.

What is the legal significance of a nurse's action when a patient verbally refuses medication and the nurse gives the medication over the patient's objection? The nurse

Which nursing intervention demonstrates false imprisonment?

Which patient meets criteria for involuntary hospitalization for psychiatric treatment? The patient who

A nurse is concerned that an agency's policies are inadequate. Which understanding about the relationship between substandard institutional policies and individual nursing practice should guide nursing practice?

A newly admitted acutely psychotic patient is a private patient of the medical director and a private-pay patient. To whom does the psychiatric nurse assigned to the patient owe the duty of care?

Which action by a nurse constitutes a breach of a patient's right to privacy?

An adolescent hospitalized after a violent physical outburst tells the nurse, 'I'm going to kill my father, but you can't tell anyone.' Select the nurse's best response.

A voluntarily hospitalized patient tells the nurse, 'Get me the forms for discharge. I want to leave now.' Select the nurse's best response.

Insurance will not pay for continued private hospitalization of a mentally ill patient. The family considers transferring the patient to a public hospital but expresses concern that the patient will not get any treatment if transferred. Select the nurse's most helpful reply.

Which individual diagnosed with mental illness may need emergency or involuntary admission? The individual who

A patient in alcohol rehabilitation reveals to the nurse, 'I feel terrible guilt for sexually abusing my 6-year-old before I was admitted.' Select the nurse's most important action.

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 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 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 patient experiencing psychosis became aggressive, struck another patient, and required seclusion. Select the best documentation.

Why aren't people with mental illness kept in state institutions anymore?

Study Notes

Ethical Principles in Psychiatric Nursing

Informed Consent and Patient Rights

Legal Implications and Torts

Involuntary Hospitalization Criteria

Documentation Standards

Confidentiality and Duty to Warn

Patient Admission and Discharge

Rights and Responsibilities of Mental Health Professionals

Community Care and Treatment Evolution

Involuntary Hospitalization Criteria

Patient Rights in Dietary Choices

Release of Health Information

Duty to Intervene in Nursing

Violations of Psychiatric Patients' Rights

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Description

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