Condensed Exam 2 Mental Health PDF

CHAPTER 7 1. What is the significance of informed consent in mental health care? Informed consent ensures that patients are fully aware of their treatment options, risks, and benefits, allowing them to make educated decisions about their care. The Standards of practice for Nursing in Mental Heal...

CHAPTER 7 1. What is the significance of informed consent in mental health care? Informed consent ensures that patients are fully aware of their treatment options, risks, and benefits, allowing them to make educated decisions about their care. The Standards of practice for Nursing in Mental Health 1. Assessment (Understand Cultural Language Barriers) 2. Diagnosis 3. Outcomes/Identification 4. Planning 5. Implementation 6. Evaluation Documentation: documentation is crucial in the legal and medical field documentation should be precise and accurate. REMEMBER use nonadherence and instead of non compliant 2. as Mr. S\'s sister has suspected Mr. S sometimes forgets to eat in which part of the nursing care plan would the nurse expect to find this statement offer snacks and finger foods frequently A assessment B diagnosis C Planning and outcomes identification D implementation E evaluation 3. You teach Mr. S\'s sister about important precautions associated with the new prescription afterwards she accurately summarizes major self-management strategies associated with this drug which step of the nursing process applies to her summarization a assessment B analysis C planning outcomes identification D intervention E evaluation Language barriers **interpreter** is someone who interprets spoken words of a foreign language speaking person or someone who uses American Sign Language **translator** someone who speaks one or more languages in addition to English and translates written words **Types of nursing diagnosis** **Problem**\--, or unmet need, describes the state of the patient at present. Problems that are within the nurse's domain to treat are termed nursing diagnoses. The nursing diagnostic label indicates what should change. **probable cause** \--Probable cause is linked to the diagnostic label with the words "related to". Probable causes usually indicate what needs to be addressed to bring about change through nursing interventions. **supporting data**\--supporting data include signs (objective and measurable) and symptoms (subjective and reported by the patient). All types of nursing diagnoses use supporting data. 4. Q, what is the purpose of health insurance portability and accountability act HIPAA a ensuring that an individual\'s health information is protected B providing third party players with access to patients medical records C facilitating the movement of a patients medical information to the interested parties D guaranteeing that all those in need of health care coverage have opinions or have options to obtain it E allow healthcare providers to obtain health information to provide high quality health care 5. Which intervention demonstrates a nurse\'s understanding of the initial action associated with the assessment of a patient\'s spiritual beliefs a offering to pray with the patient B providing a consult with the facilities chaplain C asking the patient what role spirituality plays in his daily life D arranging for care to be provided with respect to religious practices 6. Which nursing interventions best demonstrate and understanding of the quality and safety education and nurses Houston competencies select all that apply a. Asking the patient what she expects from the treatment she is receiving b. seeking recertification for cardio pulmonary resuscitation c. assessing the Internet to monitor social media related to opinions on healthcare d. consulting with a dietitian to discuss a patients cultural food preferences and restrictions e. reviewing the literature regarding the best way to monitor a patient for a fluid imbalance 7. During an interview with a non-english speaking middle-aged woman recently diagnosed with major depressive disorder the patient\'s husband states she is happy now and doing very well the patient however sits motionless looking at the floor and ringing her hands a professional interpreter would provide better information due to the fact that the male member in the interpreter role may A close to accurately capture the meaning of the patients mood B sensor the patient\'s thoughts and words C avoid interpretation D leave out unsavory details 8. A nurse identified a nursing diagnosis of self mutilation for a female diagnosed with borderline personality disorder the patient has multiple self-inflicted cuts on her forearms and inner thighs what is the most important patient outcome for this nursing diagnosis a. the patient will a identify triggers to self mutilation b. refrained from self harm c. describes strategies to increase socialization on the unit or d. describe 2 strategies to increase self care 9. Medical records are considered legal documents proper documentation needs to reflect the patient\'s condition along with changes it should also be based on professional standards designated by the State Board of nursing regulatory agencies and reimbursement requirements proper documentation can be enhanced by a using only objective data B using the nursing process as a guide C using language the specific patient can understand or D avoiding legal jargon 10. Armada is the 40 year old African national being treated in a psychiatric outpatient setting due to a court order armani\'s medical record is limited in scope so where can the nurse find or obtain more data on armani\'s condition within legal parameters a emergency department records B police records related to the offense resulting in court order for treatment C calling his family in Africa for details about armada\'s medical health or D past medical records in the current facility 11. What is the purpose for a psychiatric health assessment Establish rapport Obtain an understanding of the current problem or chief complaint Review the patient's physical status and obtain baseline vital signs Assess for risk factors affecting the safety of the patient or others Perform a mental status examination Assess psychosocial status Identify mutual goals for treatment Formulate a plan of care Document data in a retrievable format 12. What is Milieu therapy? **Milieu r**efers to a physical and social environment. Milieu therapy is a psychiatric philosophy that involves a secure environment including people, settings, structure, and emotional climate to support recovery. Milieu therapy takes naturally occurring events in the environment and uses them as learning opportunities for patients. A consistent routine and structure are maintained to provide predictability and trust. **Milieu management includes the following:** Orienting patients to their rights and responsibilities Providing culturally sensitive care Selecting activities (both individual and group) that meet the patient's physical and mental health needs Using the least restrictive environment CHAPTER 8 **patient-centered care** as the gold standard. 13. What are the core concepts of patient- and family-centered care consist of 14. What does therapeutic-self mean? In a therapeutic relationship, the nurse maximizes communication skills, understanding of human behaviors, and personal strengths to enhance the patient's growth. Patients more easily engage in the relationship when the clinician's interactions address their concerns, respect patients as partners in decision-making, and use straightforward language. These interactions are evidence that the focus of the relationship is on the patient's ideas, experiences, and feelings. Inherent in a therapeutic relationship is addressing issues introduced by the patient the relationship is consistently focused on the patient's problem and needs. Nurses' needs are met outside the relationship. Nurses who want the patient to "like me," "do as I suggest," or "give me recognition" devalue the needs of the patient. 15. What are boundaries? 16. Examples of boundary crossing? **Transference** occurs when the patient unconsciously and inappropriately displaces (transfers) onto the nurse feelings and behaviors related to significant figures in the patient's past. **Countertransference** is transference in reverse. It occurs when the nurse unconsciously displaces feelings related to significant figures in the nurse's past onto the patient. **Peplau's Model of the Nurse-Patient Relationship** **1. Preorientation phase** **2. Orientation phase** **3. Working phase** **4. Termination phase** **preorientation phase** begins with preparing for your assignment. The chart is a rich source of information, including mental and physical evaluation, progress notes, and patient orders. **orientation phase** can last for a few meetings or extend over a longer period. It is the first time the nurse and the patient meet and is the phase in which the nurse conducts the initial interview A strong working relationship allows the patient to safely experience increased levels of anxiety and recognize dysfunctional responses. New and more adaptive coping behaviors can be practiced within the context of the **working phase**. **termination phase** is the final, integral phase of the nurse-patient relationship. You discuss termination during the first meeting and again during the working stage at appropriate times. **Factors that Promote Patients' Growth** **Genuineness** **Empathy** **Positive Regard** **Empathy vs. Sympathy---** **Sympathetic response: "I feel so bad for you (tearing up). I know how close you are to your mom. She is such an amazing person. Oh, I am so sorry." (You hug your friend.)** **Empathetic response: "This must be devastating for you (silence). It must seem so unfair. What thoughts and feelings are you having?" (You stay with your patient and listen.)** **1.** Which statement made by either the nurse or the patient demonstrates an ineffective patient-nurse relationship? a\. "I've given a lot of thought about what triggers me to be so angry." b\. "Why do you think it's acceptable for you to be so disrespectful to staff?" c\. "Will your spouse be available to attend tomorrow's family group session?" 2\. The patient expresses sadness at "being all alone with no one to share my life with." Which response by the nurse demonstrates the existence of a therapeutic relationship? a\. "Loneliness can be a very painful and difficult emotion." b\. "Let's talk and see if you and I have any interests in common." c\. "I use Facebook to find people who share my love of cooking." d\. "Loneliness is managed by getting involved with people." 3\. Which patient outcome is directly associated with the goals of a therapeutic nurse-patient relationship? a\. Patient will be respectful of other patients on the unit. b\. Patient will identify suicidal feelings to staff whenever they occur. c\. Patient will engage in at least one social interaction with the unit population daily. d\. Patient will consume a daily diet to meet both nutritional and hydration needs. 4\. What is the greatest trigger for the development of a patient's nurse-focused transference? a\. The similarity between the nurse and someone the patient already dislikes b\. The nature of the patient's diagnosed mental illness c\. The history the patient has with the patient's parents d\. The degree of authority the nurse has over the patient 5\. Which patient statement demonstrates a value held regarding children? a\. "Nothing is more important to me than the safety of my children." b\. "I believe my spouse wants to leave both me and our children." c\. "I don't think my child's success depends on going to college." d\. "I know my children will help me through my hard times." 6\. Mary is a 39-year-old attending a psychiatric outpatient clinic. Mary believes that her husband, sister, and son cause her problems. Listening to Mary describe the problems, the nurse displays therapeutic communication in which response? a\. "I understand you are in a difficult situation." b\. "Thinking about being wronged repeatedly does more harm than good." d\. "It must be so difficult to live with uncaring people." 7\. A registered nurse is caring for an older male who reports depressive symptoms since his wife of 54 years died suddenly. He cries, maintains closed body posture, and avoids eye contact. Which nursing action describes attending behavior? a\. Reminding the patient gently that he will "feel better over time" b\. Using a soft tone of voice for questioning c\. Sitting with the patient and taking cues for when to talk or when to remain silent d\. Offering medication and bereavement services 8\. A male patient frequently inquires about the female student nurse's boyfriend, social activities, and school experiences. Which is the best initial response by the student? a\. The student requests assignment to a patient of the same gender as the student. c\. The student shares information to make the therapeutic relationship more equal. d\. She explains that if he persists in focusing on her, she cannot work with him. 9\. Morgan is a third-year nursing student in her psychiatric clinical rotation. She is assigned to an 80-year-old widow admitted for major depressive disorder. The patient describes many losses and sadness. Morgan becomes teary and says meaningfully, "I am so sorry for you." Morgan's instructor overhears the conversation and says, "I understand that getting tearful is a human response. Yet, sympathy isn't helpful in this field." The instructor urges Morgan to focus on: a\. "Adopting the patient's sorrow as your own" b\. "Maintaining pure objectivity" c\. "Using empathy to demonstrate respect and validation of the patient's feelings" d\. "Using touch to let her know that everything is going to be alright" 10\. Emily is a 28-year-old nurse who works on a psychiatric unit. She is assigned to work with Jenna, a 27-year-old who was admitted with major depressive disorder. Emily and Jenna realize that they graduated from the same high school and each has a 2-year-old daughter. Emily and Jenna discuss getting together for a play date with their daughters after Jenna is discharged. This situation reflects: a\. Successful termination b\. Promoting interdependence c\. Boundary blurring d\. A strong therapeutic relationship CHAPTER 9 **Verbal communication** consists of all the words a person speaks. We live in a society of symbols, and our main social symbols are words. Words are the symbols for emotions and mental images. The tone of voice, emphasis on certain words, and the manner in which a person paces speech are examples of **nonverbal communication** **Incongruent Messages\--**They are characterized by two or more mutually contradictory messages given by a person in power. Opting for either choice will result in displeasure of the person in power. Such messages may be a mix of content (what is said) and process (what is conveyed nonverbally) that has both nurturing and hurtful aspects. **Therapeutic Communication Techniques** **They include words and actions that help to achieve health-related goals. Some useful techniques for nurses when communicating with their patients are** silence, active listening, clarifying techniques, questions. **Open-ended**\-- encourage patients to share information about experiences, perceptions, or responses to a situation. For example: "What do you perceive as your biggest problem right now?" "What is an example of some of the stresses you are under right now?" "How would you describe your relationship with your wife?" **Closed-ended\--** a "yes" or "no" response **Nontherapeutic Communication** Excessive Questioning Giving approval or disapproval Giving advice Asking "why" questions **Cultural Considerations** **Communicating across cultures poses many challenges for healthcare workers.** Communication style. Use of eye contact. Perception of touch. Cultural filters. **Telehealth technologies** **Disadvantages** confidentiality, documentation, informed consent, record maintenance, and the safety of transmitted information are all impacted by technology. **Advantages** **provide access to people who otherwise might not receive good medical or psychosocial help.** Patients in rural areas chronically ill, homebound, underserved individuals. **Preparing for the Interview** Pace---Let the patient set the pace Setting\--Establishing a setting that enhances feelings of security is important to the therapeutic relationship. Seating\--the nurse should be in the same vertical space (height) as the patient, that is, standing or sitting. The patient should not be positioned between the nurse and the door 1\. Which statement made by the nurse demonstrates the best understanding of nonverbal communication? a\. "The patient's verbal and nonverbal communication is often different." b\. "When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response." c\. "If a patient is slumped in the chair, I can be sure he's angry or depressed." d\. "It's easier to interpret verbal communication than to interpret nonverbal communication." 2\. Which nursing statement is an example of reflection? a\. "I think this feeling will pass." b\. "So you are saying that life has no meaning." c\. "I'm not sure I understand what you mean." d\. "You look sad." 3\. When should a nurse be most alert to the possibility of communication errors resulting in harm to the patient? a\. Change of shift report b\. Admission interviews c\. One-on-one conversations with patients d\. Conversations with patients' families 4\. During an admission assessment and interview, which channels of information communication should the nurse be monitoring? Select all that apply. a\. Auditory b\. Visual c\. Written d\. Tactile e\. Olfactory 5\. What principle about nurse-patient communication should guide a nurse's fear about "saying the wrong thing" to a patient? a\. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation. b\. The patient is more interested in talking to you than listening to what you have to say and so is not likely to be offended. c\. Considering the patient's history, there is little chance that the comment will do any actual harm. d\. Most people with a mental illness have by necessity developed a high tolerance of forgiveness. 6\. You have been working closely with a patient for the past month. Today, he tells you he is looking forward to meeting with his new psychiatrist but frowns and avoids eye contact while reporting this to you. Which of the following responses would most likely be therapeutic? a\. "A new psychiatrist is a chance to start fresh; I'm sure it will go well for you." b\. "You say you look forward to the meeting, but you appear anxious or unhappy." c\. "I notice that you frowned and avoided eye contact just now. Don't you feel well?" d\. "I get the impression you don't really want to see your psychiatrist---can you tell me why?" 7\. Which student behavior is consistent with therapeutic communication? a\. Offering your opinion when asked to convey support. b\. Summarizing the essence of the patient's comments in your own words. c\. Interrupting periods of silence before they become awkward for the patient. d\. Telling the patient he did well when you approve of his statements or actions. 8\. James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for your day shift and anxiously reports, "Last night, demons came to my room and tried to rape me." Which response would be most therapeutic? a\. "There are no such things as demons. What you saw were hallucinations." b\. "It is not possible for anyone to enter your room at night. You are safe here." c\. "You seem upset. Please tell me more about what you experienced last night." d\. "That must have been frightening, but we'll check on you at night and you'll be safe." 9\. Therapeutic communication is the foundation of a patient-centered interview. Which of the following techniques is not considered therapeutic? a\. Restating b\. Encouraging description of perception c\. Summarizing d\. Asking "why" questions 10\. Carolina is surprised when her patient does not show up for a regularly scheduled appointment. When contacted, the patient states, "I don't need to come see you anymore. I have found a therapy app on my phone that I love." How should Carolina respond to this news? a\. "That sounds exciting, would you be willing to visit and show me the app?" b\. "At this time, there is no real evidence that the app can replace our therapy." c\. "I am not sure that is a good idea right now; we are so close to progress." d\. "Why would you think that is a better option than meeting with me?" CHAPTER 34 **Therapeutic Groups** **Advantages and Disadvantages of Therapeutic Groups** **Advantages** ** ** Multiple members can be in treatment at the same time, thereby reaching more patients and reducing personnel costs. Members of a therapeutic group benefit from the knowledge, insights, and life experiences of both the leader and the participants. A therapeutic group can be a safe setting to learn new ways of relating to other people and to practice new communication skills. Groups can promote feelings of cohesiveness. **Disadvantages** Individual members may feel cheated of participation time, particularly in large groups. Concerns over privacy. Disruptive group members reduce a group's effectiveness. Group norms may discourage personal opinions. Not all patients benefit from group treatment. **Therapeutic and Curative** **Curative Factors in Group Work** **Instillation of hope \--** The leader shares optimism about the successes of group treatment, and members share their improvements. **Universality\--**Members realize that they are not alone with their problems, feelings, or thoughts. **Imparting of information\--** Participants receive formal teaching by the leader or advice from peers. **.** **Altruism\--**Members gain or profit from giving support to others, leading to improved self-esteem. **Corrective recapitulation of the primary family group Members\--**repeat patterns of behavior in the group that they learned in their families; from the safety of the group with feedback from the leader and peers, they learn about their own behavior. **Development of socializing techniques\--**Members learn new social skills based on others' feedback and modeling. **Imitative behavior\--**Members may copy the behavior of the leader or peers and thus can adopt healthier habits. **Interpersonal Learning\--**The group itself is a laboratory for trying out new interpersonal skills. **Group cohesiveness\--**This factor arises in a mature group when members feels connected to one another, the leader, and the group as a whole. **Catharsis\--**A genuine expression of feelings that can be interpreted by both the patient and the group. **Existential factors\--**Members examine aspects of life---such as loss, meaning, and mortality---that affect everyone in constructing meaning. **Groups** **Heterogeneous group:** A group in which a range of differences exists among members**.** **Homogeneous group:** A group in which members share central traits (e.g., men's group, individuals with bipolar disorder). **Closed group:** A group in which membership is restricted; no new members are added even when others leave. **Open group:** A group in which new members are added as others leave (e.g., inpatient group with transient membership)**.** **Subgroup:** Dyads or a small group within a larger group. Members of a subgroup may have greater loyalty, more similar goals, or more perceived similarities to one another than they do to the larger group. **Phases of Group Development** **Planning Phase**\-- The group leader or leaders identify the following attributes: The name of the group Objectives of the group Types of individuals (e.g., diagnoses, age, gender) for inclusion Group schedule (frequency, times of meetings) Physical setting Seating configuration Description of leader and member responsibilities Methods or means of evaluating outcomes **Orientation Phase**\-- The group leader's role is active in structuring an atmosphere of respect, confidentiality, and trust. During the first session, the group leader begins by providing a personal introduction **Working Phase**\-- the leader facilitates communication, the flow of group processes, and group conduct. **Termination Phase**\-- the leader ensures that each member summarizes personal accomplishments, shares new insights, and identifies future goals **Evaluation and Follow-up**\-- Objective measures are valuable in quantifying the group's effectiveness by identifying what patients found helpful or not helpful. A screenshot of a computer Description automatically generated  1\. Which outcome would be appropriate for a group session on medication education? Select all that apply. a\. Patient will identify three side effects of prescribed medication. b\. Patient will verbalize the purpose of taking the medication. c\. Patient will acknowledge and accept the financial cost of prescribed medications. d\. Patient will correctly identify time of day and dose for each prescribed medication. e\. Patient will list two potential drug--drug and drug--food interactions for prescribed medications. 2\. What question by the nurse leader is helpful in managing a monopolizing member of a group? a\. "You seem angry. Is there something you want to discuss with the group?" b\. "Would it be helpful if you had time to think about the question?" c\. "Would you tell us about experiences that have frightened you?" d\. "Who else would like to share feelings about this issue?" 3\. What advantages does group therapy have over individual therapy? Select all that apply. a\. Groups are less expensive than one-on-one therapy. b\. Groups provide an opportunity to learn from others. c\. Groups are homogeneous in composition. d\. Feedback is available from the group leader and group members. e\. Interpersonal skills can be practiced in a safe environment. 4\. What group would benefit most from a laissez-faire leader? a\. Art group b\. Grief group c\. Social skills group d\. Anger management group 5\. The nurse describes the purpose of psycho-educational groups as providing group members with the knowledge and skills necessary to manage psychiatric symptoms. Which phase of group development is represented? a\. Planning (formation) phase b\. Orientation phase c\. Working phase d\. Termination phase 6\. Group dynamics can vary widely, and sometimes members disrupt the group process. Which of the following participant traits may indicate a need for additional support for a new nurse facilitator? Select all that apply. a\. A member with paranoid delusions b\. A quietly tearful participant expressing suicidal thoughts c\. An angry woman who raises her voice d\. A calm but ineffective communicator 7\. The advanced practice nurse is assigned a group of patients. Which patient would not be appropriate to consider for inpatient group therapy? (Select all that apply.) The patient who a\. Has limited financial and social resources b\. Is experiencing acute mania c\. Has few friends on the unit d\. Is preparing for discharge tomorrow e\. Does not speak up often yet listens to others 8\. Group members are having difficulty deciding what topic to cover in today's session. Which nurse leader response reflects autocratic leadership? a\. "We are talking about fear of rejection today." b\. "Let's go around the room and make suggestions for today's topic." c\. "I will let you come to a conclusion together about what to talk about." d\. "I'll work with you to find a suitable topic for today." 9\. A patient continues to dominate the group conversation despite having been asked to allow others to speak. What is the group leader's most appropriate response? a\. "You are monopolizing the conversation." b\. "When you talk constantly, it makes everyone feel angry." c\. "You are supposed to allow others to speak also." d\. "When you speak out of turn, I am concerned that others will not be able to participate equally." 10\. The nurse is planning the care of patients on her unit, which includes a dual-diagnosis group. Which patient would be appropriate for this group? The patient with a\. Major depression disorder and a history of recurrent suicidal ideation b\. Generalized anxiety disorder and frequent migraine headaches c\. Bipolar disorder and anorexia nervosa d\. Schizophrenia and alcohol use disorder CHAPTER 6 **Autonomy:** Respecting the rights of others to make their own decisions (e.g., acknowledging the patient's right to refuse medication supports autonomy). **Beneficence:** The duty to act to benefit or promote the health and well-being of others (e.g., spending extra time to help calm an anxious patient). **Nonmaleficence:** Doing no harm to the patient (e.g., protecting confidential information about a patient). **Justice:** The duty to distribute resources or care equally, regardless of personal attributes (e.g., an intensive care unit \[ICU\] nurse devotes equal attention to someone who has attempted suicide as to someone who suffered a brain aneurysm). **Fidelity:** Maintaining loyalty and commitment to the patient and doing no wrong to the patient (e.g., maintaining expertise in nursing skill through continuing nurse education). **Veracity:** The duty to communicate truthfully (e.g., describing the purpose and side effects of psychotropic medications in a truthful and non-misleading way). **Voluntary admissions** \--occur when patients apply in writing for admission to the facility. Voluntarily admitted patients have the right to request and obtain release. **Involuntary commitment\--**also known as assisted inpatient psychiatric treatment, is a court-ordered admission to a facility without the patient's approval. 1\. Diagnosed with mental illness 2\. Posing a danger to self or others 4\. In need of treatment and the mental illness itself prevents voluntary help-seeking **Patients' Rights Under the Law** **RIGHT TO TREATMENT** **RIGHT TO REFUSE TREATMENT** **RIGHT TO INFORMED CONSENT** **RIGHTS REGARDING PSYCHIATRIC ADVANCED DIRECTIVES** **RIGHTS REGARDING RESTRAIN AND SECLUSION** **RIGHTS REGARDING CONFIDENTIALITY\--** **Exceptions to the Rule** Duty to warn and protect third parties The California Supreme Court in its 1974 landmark decision Tarasoff v. Regents of University of California ruled that a therapist has a duty to warn a patient's potential victim of potential harm. This duty to warn is an obligation to warn third parties when they may be in danger from a patient. A **tort** is defined as any wrongful act, intentional or accidental, that results in an injury to another. **intentional torts:** which are willful or intentional acts that violate another person's rights or property assault battery false imprisonment **Unintentional torts**: are unintended acts against another person that produce injury or harm. Negligence Malpractice **Standards for Nursing Care** Nurses are held to a basic standard of care. This standard is based on what other nurses who possess the same degree of skill or knowledge in the same or similar circumstances would do. **State Boards of Nursing** **Professional Associations** **Institutional Policies and Procedures** **Custom as a Standard of Care** **Objective Documentation** Potential threats from the patient's family or friends present another source of concern for patient safety. Patients may come from families where domestic violence is common. The nurse may witness controlling behavior by these family members that is based in fear, anxiety, and possibly guilt. The nurse can promote safety by remaining calm, listening carefully, and assuring family members of the importance of their contributions to the patient's welfare. If a patient reports domestic violence to the nurse or the nurse witnesses it, **objective documentation** of the information or event is also necessary and for reporting to authorities.