NR 443 CHAPTER 09: LEGAL AND
ETHICAL ASPECTS IN CLINICAL
PRACTICE
Fortinash: Psychiatric Mental Health Nursing, 5th Edition
Chapter 09: Legal and Ethical Aspects in Clinical Practice
Test Bank
MULTIPLE CHOICE
1. An advanced practice nurse evaluates a patient for emergency commitment because
of the likelihood the patient will do serious harm to others. Which statement best
reflects the nurse’s role as patient advocate during the assessment process?
a. “Tell me about any delusions you are experiencing.”
b. “I understand you have had some difficulty today.”
c. “Tell me why you need to threaten or hurt others around you.”
d. “Threatening to hurt others will require that you be committed to the hospital.”
ANS: B
The advocacy role of nurses to help patients to obtain, maintain, and fully make use of
mental health benefits is critical. Assessment for commitment requires data collection
from the patient. This statement is the most neutral of the options given and the most
open ended; therefore it will be most likely to elicit a response. It is an unfounded
assumption that the patient is delusional. “Why” questions will usually elicit
rationalizations from the patient. Making a statement about the resulting
hospitalization is not information gathering.
DIF: Cognitive Level: Application REF: Page 169
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Management of Care,
Psychological Integrity
, 2. A patient was placed in restraints for 2 hours in order to help manage impulsive,
destructive, unsafe behavior. Which statement made by the charge nurse during a
meeting to discuss the incident shows an understanding of the need to use restraints
only as a last resort?
a. “How did this situation get so out of control?”
b. “You all know that restraints are used only as a last resort.”
c. “Can anyone tell me why restraints were used on this patient?”
d. “Let’s review what exactly happened that led to the use of restrains.”
ANS: D
To facilitate an open, honest review of the incident that will permit learning to take
place, the charge nurse must not place the staff on the defensive. Reviewing the events
leading up to the patient being restrained in a nonaccusatory manner shows an
understanding of proper restraint use. The other options imply the nurse manager does
not believe the situation was handled in an appropriate way.
DIF: Cognitive Level: Application REF: Page 173
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Management of Care,
Psychological Integrity
3. The nurse is explaining the advantage of advanced directives to a patient diagnosed
with schizophrenia. Which psychiatric outcome is a result of such preplanning?
a. Allows healthcare providers to manage the patient’s mental health care
b. Decreases the possibility that the patient will be committed involuntarily
c. Directly impacts the type of care the patient will receive as the disease progresses
d. Assures that the patient will retain continued autonomy and independence of living
ANS: B
The implementation of psychiatric advance directives significantly decreases
involuntary commitments. Healthcare management and treatments are not affected by
ETHICAL ASPECTS IN CLINICAL
PRACTICE
Fortinash: Psychiatric Mental Health Nursing, 5th Edition
Chapter 09: Legal and Ethical Aspects in Clinical Practice
Test Bank
MULTIPLE CHOICE
1. An advanced practice nurse evaluates a patient for emergency commitment because
of the likelihood the patient will do serious harm to others. Which statement best
reflects the nurse’s role as patient advocate during the assessment process?
a. “Tell me about any delusions you are experiencing.”
b. “I understand you have had some difficulty today.”
c. “Tell me why you need to threaten or hurt others around you.”
d. “Threatening to hurt others will require that you be committed to the hospital.”
ANS: B
The advocacy role of nurses to help patients to obtain, maintain, and fully make use of
mental health benefits is critical. Assessment for commitment requires data collection
from the patient. This statement is the most neutral of the options given and the most
open ended; therefore it will be most likely to elicit a response. It is an unfounded
assumption that the patient is delusional. “Why” questions will usually elicit
rationalizations from the patient. Making a statement about the resulting
hospitalization is not information gathering.
DIF: Cognitive Level: Application REF: Page 169
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Management of Care,
Psychological Integrity
, 2. A patient was placed in restraints for 2 hours in order to help manage impulsive,
destructive, unsafe behavior. Which statement made by the charge nurse during a
meeting to discuss the incident shows an understanding of the need to use restraints
only as a last resort?
a. “How did this situation get so out of control?”
b. “You all know that restraints are used only as a last resort.”
c. “Can anyone tell me why restraints were used on this patient?”
d. “Let’s review what exactly happened that led to the use of restrains.”
ANS: D
To facilitate an open, honest review of the incident that will permit learning to take
place, the charge nurse must not place the staff on the defensive. Reviewing the events
leading up to the patient being restrained in a nonaccusatory manner shows an
understanding of proper restraint use. The other options imply the nurse manager does
not believe the situation was handled in an appropriate way.
DIF: Cognitive Level: Application REF: Page 173
TOP: Nursing Process: Implementation
MSC: NCLEX: Safe, Effective Care Environment: Management of Care,
Psychological Integrity
3. The nurse is explaining the advantage of advanced directives to a patient diagnosed
with schizophrenia. Which psychiatric outcome is a result of such preplanning?
a. Allows healthcare providers to manage the patient’s mental health care
b. Decreases the possibility that the patient will be committed involuntarily
c. Directly impacts the type of care the patient will receive as the disease progresses
d. Assures that the patient will retain continued autonomy and independence of living
ANS: B
The implementation of psychiatric advance directives significantly decreases
involuntary commitments. Healthcare management and treatments are not affected by
