Test bank for contemporary psychiatric mental health nursing 3rd edition by kneisl

Global Rationale: Cognitive Level: Analyzing Client Need: Safe Effective Care Environment Client Need Sub: Nursing/Integrated Concepts: Nursing Process: Evaluation Learning Outcome

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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 client’s 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

psychiatric–mental 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 nurse’s 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 nurse’s 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 nurse’s 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 nurse’s 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

psychiatric–mental health nursing

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

psychiatric–mental health nursing

receiving the highest priority is:

1 The client’s condition in comparison to the adequacy of the environment designed to prevent injury

2 The client’s mental status

3 The client–staff ratio

4 The comfort level of the environment

Correct Answer: 1

Rationale 1: Decisions that impact the client’s individual freedom are moral

decisions There must be consideration of what other interventions were attempted and what possibly could work, whether the client’s behavior warrants a particular level of restrictive intervention, and how the level of the intervention will affect the client and the milieu The client–staff ratio will not be a priority in determining the level of intervention The client’s 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 client’s individual freedom are moral

decisions There must be consideration of what other interventions were attempted and what possibly could work, whether the client’s behavior warrants a particular level of restrictive intervention, and how the level of the intervention will affect the client and the milieu The client–staff ratio will not be a priority in determining the level of intervention The client’s 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 client’s individual freedom are moral

decisions There must be consideration of what other interventions were attempted and what possibly could work, whether the client’s behavior warrants a particular

level of restrictive intervention, and how the level of the intervention will affect the client and the milieu The client–staff ratio will not be a priority in determining the level of intervention The client’s 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 client’s individual freedom are moral

decisions There must be consideration of what other interventions were attempted and what possibly could work, whether the client’s behavior warrants a particular level of restrictive intervention, and how the level of the intervention will affect the client and the milieu The client–staff ratio will not be a priority in determining the level of intervention The client’s 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

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 nurse’s 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 nurse’s 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 nurse’s 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 nurse’s 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 client’s family are considered a danger to others The client’s 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 client’s family are considered a danger to others The client’s 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 client’s family are considered a danger to others The client’s 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 client’s family are considered a danger to others The client’s 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

1 “We’re 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 “We’re admitting another crazy client.”

4 “They’ve added another paranoid to the unit.”

Correct Answer: 2

Rationale 1: It is the nurse’s 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 nurse’s 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 nurse’s 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 nurse’s 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 psychiatric–mental health nurses can avoid

indirectly contributing to the stereotypes associated with psychiatric diagnostic categories

1 “It’s 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 don’t 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 psychiatric–mental health nurses can avoid

indirectly contributing to the stereotypes associated with psychiatric diagnostic categories

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 psychiatric–mental health nurses can avoid

indirectly contributing to the stereotypes associated with psychiatric diagnostic categories

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 client’s 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 client’s 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 client’s 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 client’s 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 psychiatric–mental health nurses need to be

knowledgeable about the mental health statutes and regulations in the state in which they practice

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 psychiatric–mental 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 client’s objections What is the legal significance of the nurse’s 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 client’s 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 client’s 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 client’s 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 client’s 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: