MENTAL HEALTH FINAL EXAM 1& 2
250 QUESTIONS AND ANSWERS
WITH RATIONALES
5. Under which conditions would it be in the client's best interest for the
court to appoint a conservator, or legal guardian? Select all that apply.
A) Gravely disabled
B) Mentally incompetent
C) Noncompliant
D) Unable to provide basic needs when resources exist
E) Act only on his or her own interests - ANSWER- Ans: A, B, D
Feedback:
The appointment of a conservator or legal guardian is a separate
process from civil commitment. People who are gravely disabled;
are found to be incompetent; cannot provide food, clothing, and
shelter for themselves even when resources exist; and cannot act in
their own best interests may require appointment of a conservator.
In these cases, the court appoints a person to act as a legal guardian
who assumes many responsibilities for the person.
,17. A nurse is questioning whether it is ethical to seclude a client
because of loud and intrusive behavior on the unit. What is the ethical
principle that will best guide the decision on appropriate use of
seclusion?
A) Autonomy
B) Beneficence
C) Justice
D) Veracity - ANSWER- Ans: A
Feedback:
Autonomy refers to the person's right to self-determination and
independence. Beneficence refers to one's duty to benefit or to
promote good for others. Justice refers to fairness, that is, treating
all people fairly and equally without regard for social or economic
status, race, sex, marital status, religion, ethnicity, or cultural
beliefs. Veracity is the duty to be honest or truthful.
19. An adult client is put in restraints after all other attempts to reduce
aggression have failed. Which of the following is required now that
restraints have been instituted?
A) Review of the appropriateness of restraints every 8 hours
B) A face-to-face evaluation by a licensed independent practitioner
within 1 hour of restraint.
C) A documented nursing assessment every 4 hours
D) Constant one-on-one supervision during the first hour and then video
monitoring - ANSWER- Ans: B
Feedback:
,For adult clients, use of restraint and seclusion requires a face-to-
face evaluation by a licensed independent practitioner within 1 hour
of restraint or seclusion and every 8 hours thereafter, a physician's
order every 4 hours, documented assessment by the nurse every 1 to
2 hours, and close supervision of the client. Staff must monitor a
client in restraints continuously on a 1:1 basis for the duration of the
restraint period. A client in seclusion is monitored 1:1 for the first
hour and then may be monitored by audio and video equipment.
23. Ensuring that the client has informed consent before agreeing to a
treatment regimen displays which of the following ethical principles?
A) Fidelity
B) Nonmaleficence
C) Justice
D) Autonomy - ANSWER- Ans: D
Feedback:
The nurse respects the client's autonomy through client's rights,
informed consent, and encouraging the client to make choices about
his or her health care. The nurse has a duty to take actions that
promote the client's health (beneficence) and that do not harm the
client (nonmaleficence). The nurse must treat all clients fairly
(justice), be truthful and honest (veracity), and honor all duties and
commitments to clients and families (fidelity).
26. Which of the following dilemmas involve the ethical principle of
fidelity? Select all that apply.
A) When the nurse is unable to agree with the policies or common
practices of an agency
, B) When the nurse is faced with a decision to violate a policy that is
harmful to the client
C) When the nurse is certain that clients of different racial and ethnic
backgrounds are being treated the same as other clients
D) When the nurse understands that a combative client must be secluded
against their will to prevent harm to others
E) When the client refuses to take medication and the nurse respects the
client's right to refuse medication - ANSWER- Ans: A, B
Feedback:
When the nurse is unable to agree with the policies or common
practices of an agency, the nurse is facing a dilemma about fidelity,
which refers to the obligation to honor commitments and contracts.
When the nurse is faced with a decision to violate a policy that is
harmful to the client, the nurse is facing a dilemma about fidelity—
that is, should the nurse be faithful to the employing agency or the
individual client being cared for. When the nurse is certain that
clients of different racial and ethnic backgrounds are being treated
the same as other clients, the nurse is acting in accord with the
ethical principle of justice. When the nurse understands that a
combative client must be secluded against his or her will to prevent
harm to others, the nurse is following the ethical principle of
utilitarianism. When a client refuses to take medications and the
nurse respects the client's right to refuse medication, the nurse is
enacting the ethical principle of autonomy.
28. The term "standards of care" refers to expectations of nursing
performance. Standards of care are developed from which of the
following? Select all that apply.
A) Code of Ethics for Nurses with Interpretive Statements
250 QUESTIONS AND ANSWERS
WITH RATIONALES
5. Under which conditions would it be in the client's best interest for the
court to appoint a conservator, or legal guardian? Select all that apply.
A) Gravely disabled
B) Mentally incompetent
C) Noncompliant
D) Unable to provide basic needs when resources exist
E) Act only on his or her own interests - ANSWER- Ans: A, B, D
Feedback:
The appointment of a conservator or legal guardian is a separate
process from civil commitment. People who are gravely disabled;
are found to be incompetent; cannot provide food, clothing, and
shelter for themselves even when resources exist; and cannot act in
their own best interests may require appointment of a conservator.
In these cases, the court appoints a person to act as a legal guardian
who assumes many responsibilities for the person.
,17. A nurse is questioning whether it is ethical to seclude a client
because of loud and intrusive behavior on the unit. What is the ethical
principle that will best guide the decision on appropriate use of
seclusion?
A) Autonomy
B) Beneficence
C) Justice
D) Veracity - ANSWER- Ans: A
Feedback:
Autonomy refers to the person's right to self-determination and
independence. Beneficence refers to one's duty to benefit or to
promote good for others. Justice refers to fairness, that is, treating
all people fairly and equally without regard for social or economic
status, race, sex, marital status, religion, ethnicity, or cultural
beliefs. Veracity is the duty to be honest or truthful.
19. An adult client is put in restraints after all other attempts to reduce
aggression have failed. Which of the following is required now that
restraints have been instituted?
A) Review of the appropriateness of restraints every 8 hours
B) A face-to-face evaluation by a licensed independent practitioner
within 1 hour of restraint.
C) A documented nursing assessment every 4 hours
D) Constant one-on-one supervision during the first hour and then video
monitoring - ANSWER- Ans: B
Feedback:
,For adult clients, use of restraint and seclusion requires a face-to-
face evaluation by a licensed independent practitioner within 1 hour
of restraint or seclusion and every 8 hours thereafter, a physician's
order every 4 hours, documented assessment by the nurse every 1 to
2 hours, and close supervision of the client. Staff must monitor a
client in restraints continuously on a 1:1 basis for the duration of the
restraint period. A client in seclusion is monitored 1:1 for the first
hour and then may be monitored by audio and video equipment.
23. Ensuring that the client has informed consent before agreeing to a
treatment regimen displays which of the following ethical principles?
A) Fidelity
B) Nonmaleficence
C) Justice
D) Autonomy - ANSWER- Ans: D
Feedback:
The nurse respects the client's autonomy through client's rights,
informed consent, and encouraging the client to make choices about
his or her health care. The nurse has a duty to take actions that
promote the client's health (beneficence) and that do not harm the
client (nonmaleficence). The nurse must treat all clients fairly
(justice), be truthful and honest (veracity), and honor all duties and
commitments to clients and families (fidelity).
26. Which of the following dilemmas involve the ethical principle of
fidelity? Select all that apply.
A) When the nurse is unable to agree with the policies or common
practices of an agency
, B) When the nurse is faced with a decision to violate a policy that is
harmful to the client
C) When the nurse is certain that clients of different racial and ethnic
backgrounds are being treated the same as other clients
D) When the nurse understands that a combative client must be secluded
against their will to prevent harm to others
E) When the client refuses to take medication and the nurse respects the
client's right to refuse medication - ANSWER- Ans: A, B
Feedback:
When the nurse is unable to agree with the policies or common
practices of an agency, the nurse is facing a dilemma about fidelity,
which refers to the obligation to honor commitments and contracts.
When the nurse is faced with a decision to violate a policy that is
harmful to the client, the nurse is facing a dilemma about fidelity—
that is, should the nurse be faithful to the employing agency or the
individual client being cared for. When the nurse is certain that
clients of different racial and ethnic backgrounds are being treated
the same as other clients, the nurse is acting in accord with the
ethical principle of justice. When the nurse understands that a
combative client must be secluded against his or her will to prevent
harm to others, the nurse is following the ethical principle of
utilitarianism. When a client refuses to take medications and the
nurse respects the client's right to refuse medication, the nurse is
enacting the ethical principle of autonomy.
28. The term "standards of care" refers to expectations of nursing
performance. Standards of care are developed from which of the
following? Select all that apply.
A) Code of Ethics for Nurses with Interpretive Statements
