Psychiatric Mental Health Nursing, 6th EditionChapter 7: Legal and Ethical Aspects of Psychiatric-Mental Health Nursing Care,100% CORRECT

Psychiatric Mental Health Nursing, 6th EditionChapter 7: Legal and Ethical Aspects of Psychiatric-Mental Health Nursing Care 1. A standard of nursing practice is A) part of the state nurse practice act. B) a written document that outlines minimum expectations for safe nursing practice. C) unwritten but traditional practice that constitutes safe nursing practice. D) part of the federal nurse practice act. Ans: B Chapter: 07 Client Needs: A-1 Cognitive level: Knowledge Concepts & Processes: Nursing process Difficulty: Moderate Objective: 06 Feedback: Standards of nursing practice are written documents that outline minimum expectations for safe nursing care. They are used to guide and evaluate nursing care, and courts look to them for guidance when malpractice cases are deliberated. 2. A state's nurse practice act A) makes recommendations for how nurses should practice. B) defines the scope and limit of nursing practice. C) defines situations that constitute malpractice. D) follows federal laws about nursing practice. Ans: B Chapter: 07 Client Needs: A-1 Cognitive level: Knowledge Concepts & Processes: Nursing process Difficulty: Moderate Objective: 02 Feedback: The nurse practice act in each state defines nursing, describes its scope, and identifies its limits within that state. 3. Malpractice is proven when certain criteria have been met. Which of the following lists includes the correct criteria? A) Duty of care, professional performance, injury related to the nurse's action, action foreseeably could have caused the injury, and proven injury B) Duty of care, professional performance, injury related to the nurse's action, failure to document injury, and proven injury C) Professional performance, injury related to the nurse's action, action foreseeably could have caused the injury, and proven injury D) Duty of care, professional performance, injury related to the nurse's action, and action foreseeably could have caused the injury Ans: A Chapter: 07 Client Needs: A-1 Cognitive level: Knowledge Concepts & Processes: Caring Difficulty: Difficult Objective: 03 Feedback: Malpractice includes the following elements of nursing negligence: The nurse professional had a duty of due care toward the plaintiff; the nurse professional's performance fell below the standard of care and was, therefore, a breach of that duty; as a result of the failure to meet the standard of care, the plaintiff consumer was injured, and the nurse's action was the proximate cause of the injury; and the plaintiff consumer must prove his or her injuries. 4. One way that nurses can protect themselves from liability for malpractice is to A) know the statutory and professional standards. B) avoid documenting incriminating information. C) carry individual malpractice insurance. D) request legal consultation from the employer. Ans: A Chapter: 07 Client Needs: A-1 Cognitive level: Knowledge Concepts & Processes: Documentation Difficulty: Moderate Objective: 03 Feedback: To decrease their chances of liability for malpractice, psychiatric nurses must ensure that their professional practice is within the bounds of statutory and professional standards. 5. A physician would like to include a client with schizophrenia in a research study testing a new medication. The nurse's obligation is to A) assess the client's legal capacity when that client is asked to give consent. B) talk the client out of revoking consent once the study has started. C) obtain informed consent when the primary provider cannot be present. D) persuade the client to consent, because the new drug has shown promising results. Ans: A Chapter: 07 Client Needs: A-1 Cognitive level: Knowledge Concepts & Processes: Documentation Difficulty: Moderate Objective: 03 Feedback: The nurse serves as the client's advocate, the team's colleague, and the facility's excellent employee by continually evaluating the client's ability to give informed consent and his or her willingness to participate and continue with a treatment modality. Unless serving as the primary provider, the nurse is not responsible for obtaining informed consent: that is the role of the primary provider. 6. An adolescent client has refused to wash or change his clothes for several days. He smells and looks filthy. Three male staff members approach him to escort him to the shower. The client resists and becomes combative when staff members insist. They place the client in seclusion and restraints and tell him that they will release him when he is calm and willing to shower. The client's rights have A) not been violated, because a degree of cleanliness is important. B) been violated, primarily because he shouldn't be forced to shower. C) been violated, primarily because of the inappropriate use of restraints. D) not been violated, because his combative behavior warranted seclusion and restraint to protect others. Ans: C Chapter: 07 Client Needs: A-1 Cognitive level: Analysis Concepts & Processes: Documentation Difficulty: Difficult Objective: 04 Feedback: Clients have the right to treatment in the least restrictive environment. No staff can confine a person with mental illness who is not a threat to self or others. Nurses must assess a client's condition and status constantly so that healthcare professionals can initiate more or less restrictive treatment alternatives based on the client's evolving needs. 7. A client was admitted to a psychiatric facility because he was found walking around naked and talking incoherently. He has no known next of kin and has been adjudicated incompetent. He refuses any antipsychotic medications but has not been harmful to himself or others. What action should the facility take? A) Initiate court proceedings to have a guardian named. B) Give the client medications by depot injection without his consent. C) Continue custodial care. D) Contact social services to find outpatient housing. Ans: A Chapter: 07 Client Needs: A-1 Cognitive level: Application Concepts & Processes: Documentation Difficulty: Moderate Objective: 05 Feedback: When a client cannot give informed consent due to mental illness, healthcare providers must obtain substituted consent for necessary treatments or procedures. Substituted consent is authorization that another person gives on behalf of a client who needs a procedure or treatment but cannot provide such consent independently. Substituted consent can come from a court-appointed guardian or in some instances from the client's next of kin. If the client has not previously been adjudicated incompetent and if the law so permits and no next of kin are available to give substituted consent, the healthcare agency may initiate a court proceeding to appoint a guardian so that treatment professionals can carry out the procedure or treatment. 8. From a legal standpoint, clients hospitalized as voluntary admissions differ from other types of admissions in that A) they can leave the hospital whenever they want. B) they are considered competent. C) they are not considered a danger to themselves or others. D) they cannot refuse treatment. Ans: B Chapter: 07 Client Needs: A-1 Cognitive level: Knowledge Concepts & Processes: Documentation Difficulty: Moderate Objective: 05 Feedback: Voluntary clients have certain rights that differ from those of other hospitalized clients. Specifically, they are considered competent (unless otherwise adjudicated) and therefore have the absolute right to refuse treatment, including psychotropic medications, unless they are dangerous to themselves or others, as in a violent destructive episode within the treatment unit. 9. A 25-year-old man is seen standing on a rooftop. His employer calls the police and tells them the man had been behaving strangely. When the police arrive, the man states that he has special healing powers and no harm will come to him. The man believes the police have been provided to him as a courtesy, and he willingly accompanies them to a psychiatric facility. His admission is considered a(n) A) involuntary admission. B) voluntary admission. C) coerced admission. D) emergency admission. Ans: D Chapter: 07 Client Needs: A-1 Cognitive level: Knowledge Concepts & Processes: Documentation Difficulty: Moderate Objective: 05 Feedback: Clients are considered to have emergency admission status when they act in a way that indicates that they are mentally ill and, due to the illness, likely to harm themselves or others. 10. A client with persistent depression is considering electroconvulsive therapy (ECT). The nurse has seen ECT be effective in other cases. When the client expresses fear and doubt about undergoing ECT, the nurse tries to talk him into taking it, because she truly believes it will help him. Which two ethical concepts are in conflict? A) Beneficence and fidelity B) Fidelity and paternalism C) Paternalism and autonomy D) Beneficence and autonomy Ans: C Chapter: 07 Client Needs: A-1 Cognitive level: Analysis Concepts & Processes: Caring Difficulty: Difficult Objective: 11 Feedback: Paternalism and autonomy are in conflict. Paternalism is practicing with the intent to do good; however, professionals define how to do good, which may override the wishes and self- determination of the client. Autonomy is the patient's right to make decisions for himself or herself. Beneficence is the principle of the nurse doing good, not harm. Fidelity is the nurse's faithfulness to duties, obligations, and promises. 11. A client's plan of care includes revoking privileges for inappropriate behavior, based on a contract between the client and the nurse who wrote the plan. Another nurse decides to ignore this, because the client promises that she will adhere to the contract in the future. The second nurse's behavior may have violated the ethical principle of A) veracity. B) beneficence. C) autonomy. D) fidelity. Ans: D Chapter: 07 Client Needs: A-1 Cognitive level: Analysis Concepts & Processes: Caring Difficulty: Difficult Objective: 11 Feedback: Fidelity is the nurse's faithfulness to duties, obligations, and promises. Autonomy is the patient's right to make decisions for himself or herself. Veracity is a systematic behavior of honesty and truthfulness in speech. Beneficence is the principle of doing good, not harm. 12. A client asks if her medication has any possible negative side effects. The nurse considers the client highly suggestible, believes the medication will benefit the client, and, since the client has no history of cardiovascular disease, does not tell her of the potential for cardiac dysrhythmias. The nurse's actions involve a conflict between which two ethical principles? A) Veracity and justice B) Veracity and paternalism C) Veracity and beneficence D) Veracity and fidelity Ans: B Chapter: 07 Client Needs: A-1 Cognitive level: Comprehension Concepts & Processes: Caring Difficulty: Moderate Objective: 11 Feedback: The conflict is between veracity and paternalism. Veracity is a systematic behavior of honesty and truthfulness in speech. Paternalism is practicing with the intent to do good; however, professionals define how to do good, which may override the wishes and self-determination of the client. Justice in healthcare is seen as the equitableness of benefits, including the right to access care. Beneficence is the principle of doing good, not harm. Fidelity is the nurse's faithfulness to duties, obligations, and promises. 13. The concept of “everyday ethics” is best described as an approach to care that A) emphasizes respect, caring, and unconditional positive regard. B) focuses on maintaining the client's autonomy. C) emphasizes beneficence and fidelity in all nurse-client interactions. D) ensures that healthcare is provided justly. Ans: A Chapter: 07 Client Needs: A-1 Cognitive level: Knowledge Concepts & Processes: Caring Difficulty: Moderate Objective: 07 Feedback: “Everyday ethics” act as the center of nursing practice and give meaning and purpose to nursing care. They focus on interpersonal relationships, demand the confirmation of positive regard, and respect the search for human dignity. They involve not only caring “for” but also caring “about” the client. 14. The Code of Ethics for Nurses of the American Nurses Association (ANA) provides A) a description of case studies featuring ethical dilemmas. B) a guideline for nurses regarding ethical conduct. C) information about what to do when confronted with an ethical dilemma. D) definitions of ethical principles and how they relate to nursing practice. Ans: B Chapter: 07 Client Needs: A-1 Cognitive level: Knowledge Concepts & Processes: Caring Difficulty: Moderate Objective: 08 Feedback: The ANA's Code of Ethics for Nurses guides ethical decision making. 15. A nurse has been focusing on one particular client at work. She believes she sees a side of the client no one else on the treatment team can see. This demonstrates the nurse's A) caring and concern for the client. B) dedication to her job. C) failure to maintain appropriate boundaries. D) incompetence. Ans: C Chapter: 07 Client Needs: A-1 Cognitive level: Knowledge Concepts & Processes: Caring Difficulty: Easy Objective: 11 Feedback: Interpersonal boundaries protect clients from emotional harm that would impede their recovery. Boundary violations are usually insidious in their development. In the beginning, a healthcare provider may be unaware that the relationship is drifting from therapeutic interactions into a friendship or social relationship. As this relationship changes, the judgment of the healthcare provider becomes clouded and the therapeutic needs of the client slip from focus. During treatment, providers must conduct interactions with clients within appropriate guidelines and focus on the client's growth and movement toward wellness. Members of the healthcare team must recognize that stepping outside their professional boundaries can compromise a client's movement toward recovery.