ANCC IQ Domain 5: Ethical and Legal Principles (72 questions with rationales)
You have students from local psychiatric nurse practitioner programs
follow you in your clinical practice to show them what you do as a
Psychiatric Nurse Practitioner. This is called being a:
a. Preceptor
b. Mentor
c. Professor
d. Teacher A
A Psychiatric Mental Health Nurse Practitioner providing psychiatric
consultation makes a home visit after the police found an 86-year-old
widow wandering the streets at 4AM after emergency call from her
daughter. The woman has been living with her daughter for the past ten
years, after her husband died. Her daughter is a 66-year-old, single, retired
schoolteacher, appears thin, exhausted, and reports little sleep for past
two years trying to care for her mother. The daughter reports that her
mother becomes increasingly confused every evening and wanders the
house unable to sleep at night. The daughter is unable to leave her mother
alone for even a short period of time because unsupervised her mother will
turn on the gas stove burner, leave it unattended, and she escapes the
house at every chance to wander the neighborhood. Her mother is socially
,pleasant, disoriented to time and place, and does not recognize her
daughter. Her mother thinks that the daughter is a housekeeper intent on
stealing her money and possessions, which is upsetting to the daughter.
What is the most important in determining the level of care needed for this
elderly client?
A. Appraisal of daughter's health and her ability and willingness to
continue caring for mother in home.
B. Modification of environment such as bright lights in evening,
identification bracelet, and safety lock on stove.
C. Trial of low-dose atypical antipsychotic to reduce paranoid ideation,
help sleep, and decrease wandering.
D. Linkage with home health aide 4 to 6 hours, three times per week, and
community resources for respite care. A
As a psychiatric nurse practitioner, you evaluate your patients for health
concerns and beyond, in a holistic manner. your current patient has a
blood sugar of 186 and a hemoglobin A1C of 6.7. You refer this patient to
an internal medicine practitioner with whom you frequently share patients.
You have just violated:
A. The DATA Act
B. The Adams Act
C. No statute
,D. The Stark law C
Which of the following is not insured by the Universal Bill of Rights for
Mental Health Patients?
A. The right to refuse a particular mode of treatment regardless of
informed, voluntary, written consent, or situation.
B. The right to freedom from restraint or seclusion, other than as a mode of
treatment during an emergency situation.
C. The right to be given a reasonable explanation of one's general mental
and physical condition, the objectives of treatment, and the possible
adverse effects of recommended treatment.
D. The right to ongoing participation in the planning of mental health
services provided in a manner appropriate to a person's capabilities. A
During an outpatient medication evaluation a depressed client reports
persistent anger toward his former boss after losing his job due to
arguments and assaultive behavior toward co-workers. The client has been
waiting outside the plant in the afternoon, watching for the boss to leave to
confront him regarding his terminated employment. What responsibility
does the PMHNP have in this situation?
A. Contact the client's boss to notify him of potential harm.
B. Ask the client to sign a "no harm to others" agreement and document in
chart.
, C. Consult state board of nursing regarding state law requirements on
reporting potential harm.
D. Advise the client to stop going to the plan and avoid any contact with
his former boss. C
Your patient is a 32-year-old who is diagnosed with major depression-
recurrent, insomnia, and chronic lower back pain. The patient has seen you
for three medication management sessions over the last two months.
During the fourth medication management session, the patient states that
money is tight and an appointment is required with the general practice
(GP) physician every time a refill of the Hydrocodone (pain medication) is
needed. The patient asks you to refill the Hydrocodone to save the cost of
another medical visit. you:
A. State that you certification is for psychiatric care only and refer him
back to his GP.
B. State that you are willing to discuss alternative medications to manage
his pain.
C. State that you can refill this prescription just once.
D. State that you would be willing to call his GP to discuss the issues and
help him out. A
You are a nurse practitioner (NP) who performs psychotherapy. your
patient is distraught, and you call in the NP who is performing the
You have students from local psychiatric nurse practitioner programs
follow you in your clinical practice to show them what you do as a
Psychiatric Nurse Practitioner. This is called being a:
a. Preceptor
b. Mentor
c. Professor
d. Teacher A
A Psychiatric Mental Health Nurse Practitioner providing psychiatric
consultation makes a home visit after the police found an 86-year-old
widow wandering the streets at 4AM after emergency call from her
daughter. The woman has been living with her daughter for the past ten
years, after her husband died. Her daughter is a 66-year-old, single, retired
schoolteacher, appears thin, exhausted, and reports little sleep for past
two years trying to care for her mother. The daughter reports that her
mother becomes increasingly confused every evening and wanders the
house unable to sleep at night. The daughter is unable to leave her mother
alone for even a short period of time because unsupervised her mother will
turn on the gas stove burner, leave it unattended, and she escapes the
house at every chance to wander the neighborhood. Her mother is socially
,pleasant, disoriented to time and place, and does not recognize her
daughter. Her mother thinks that the daughter is a housekeeper intent on
stealing her money and possessions, which is upsetting to the daughter.
What is the most important in determining the level of care needed for this
elderly client?
A. Appraisal of daughter's health and her ability and willingness to
continue caring for mother in home.
B. Modification of environment such as bright lights in evening,
identification bracelet, and safety lock on stove.
C. Trial of low-dose atypical antipsychotic to reduce paranoid ideation,
help sleep, and decrease wandering.
D. Linkage with home health aide 4 to 6 hours, three times per week, and
community resources for respite care. A
As a psychiatric nurse practitioner, you evaluate your patients for health
concerns and beyond, in a holistic manner. your current patient has a
blood sugar of 186 and a hemoglobin A1C of 6.7. You refer this patient to
an internal medicine practitioner with whom you frequently share patients.
You have just violated:
A. The DATA Act
B. The Adams Act
C. No statute
,D. The Stark law C
Which of the following is not insured by the Universal Bill of Rights for
Mental Health Patients?
A. The right to refuse a particular mode of treatment regardless of
informed, voluntary, written consent, or situation.
B. The right to freedom from restraint or seclusion, other than as a mode of
treatment during an emergency situation.
C. The right to be given a reasonable explanation of one's general mental
and physical condition, the objectives of treatment, and the possible
adverse effects of recommended treatment.
D. The right to ongoing participation in the planning of mental health
services provided in a manner appropriate to a person's capabilities. A
During an outpatient medication evaluation a depressed client reports
persistent anger toward his former boss after losing his job due to
arguments and assaultive behavior toward co-workers. The client has been
waiting outside the plant in the afternoon, watching for the boss to leave to
confront him regarding his terminated employment. What responsibility
does the PMHNP have in this situation?
A. Contact the client's boss to notify him of potential harm.
B. Ask the client to sign a "no harm to others" agreement and document in
chart.
, C. Consult state board of nursing regarding state law requirements on
reporting potential harm.
D. Advise the client to stop going to the plan and avoid any contact with
his former boss. C
Your patient is a 32-year-old who is diagnosed with major depression-
recurrent, insomnia, and chronic lower back pain. The patient has seen you
for three medication management sessions over the last two months.
During the fourth medication management session, the patient states that
money is tight and an appointment is required with the general practice
(GP) physician every time a refill of the Hydrocodone (pain medication) is
needed. The patient asks you to refill the Hydrocodone to save the cost of
another medical visit. you:
A. State that you certification is for psychiatric care only and refer him
back to his GP.
B. State that you are willing to discuss alternative medications to manage
his pain.
C. State that you can refill this prescription just once.
D. State that you would be willing to call his GP to discuss the issues and
help him out. A
You are a nurse practitioner (NP) who performs psychotherapy. your
patient is distraught, and you call in the NP who is performing the
