NURS 512 - Adult Gerontological Nurs II ALL
COURSE COVERED SOLUTION WITH REAL
QUESTIONS AND EXPLAINED ANSWERS
Binghamton University
,MOD 4B: THOUGHT DISORDERS..............................................................................................1
VARC CH06 – ETHICS............................................................................................................ 1
STUART CH08: LEGAL AND ETHICAL CONTEXT OF PSYCHIATRIC NURSING CARE. 11
VARC CH12 – SCHIZOPHRENIA...........................................................................................17
STUART CH20: NEUROBIOLOGICAL RESPONSES AND SCHIZOPHRENIA AND
PSYCHOTIC DISORDERS30 MOD 5A: VIOLENCE & ABUSE.................................................37
VARC CH27 – ANGER, AGGRESSION & VIOLENCE...........................................................37
STUART CH28: PREVENTING AND MANAGING AGGRESSIVE BEHAVIOR..................46
VARC CH28 – CHILD, OLDER ADULT, & INTIMATE PARTNER VIOLENCE........................57
VARC CH29 – SEXUAL ASSAULT.........................................................................................64
STUART CH38: CARE OF SURVIVORS OF ABUSE AND VIOLENCE..............................72
MOD 5B: CHILDHOOD DISORDERS........................................................................................78
VARC CH11—CHILDHOOD AND NEURODEVELOPMENTAL DISORDERS.......................78
STUART CH35: CHILD PSYCHIATRIC NURSING.............................................................87
STUART CH36: ADOLESCENT PSYCHIATRIC NURSING................................................96
VARC CH21 – IMPULSE CONTROL DISORDERS..............................................................104
STUART CH21: SOCIAL RESPONSES AND PERSONALITY DISORDERS....................112
MOD 6A: MOOD DISORDERS.................................................................................................121
VARC CH13 – BIPOLAR DISORDERS.................................................................................121
VARC CH14 – DEPRESSIVE DISORDERS.........................................................................132
STUART CH18: EMOTIONAL RESPONSES & MOOD DISORDERS...............................143
VARC CH18 – EATING AND FEEDING DISORDERS.........................................................151
STUART CH24: EATING REGULATION RESPONSES AND EATING DISORDERS.......161
VARC CH25 – SUICIDE AND SELF-INJURY.......................................................................168
STUART CH19: SELF-PROTECTIVE RESPONSES AND SUICIDAL BEHAVIOR...........177
MOD 6B: NEURO DISORDERS...............................................................................................184
VARC CH23 – NEUROCOGNITIVE DISORDERS................................................................184
STUART CH22: COGNITIVE RESPONSES AND ORGANIC MENTAL DISORDERS......194
MOD 7: SUBSTANCE USE/ABUSE.........................................................................................202
VARC CH22 SUBSTANCE/ADDICTIVE DISORDERS.........................................................202
STUART CH23: CHEMICALLY MEDIATED RESPONSES & SUBSTANCE DISORDERS 213
MOD 4B: THOUGHT DISORDERS
VARC CH06 – ETHICS
1. Which action by a psychiatric nurse best applies the ethical principle of autonomy?
a. Exploring alternative solutions with the client, who then makes a choice.
b. Suggesting that two clients who were fighting be restricted to the unit.
c. Intervening when a self-mutilating client attempts to harm self.
d. Staying with a client demonstrating a high level of anxiety.
ANS: A
Autonomy is the right to self-determination, that is, to make one’s own decisions. By
exploring alternatives with the client, the client is better equipped to make an
informed, autonomous decision. The distracters demonstrate beneficence, fidelity,
and justice.
,2. A nurse finds a psychiatric advance directive in the medical record of a client
currently experiencing psychosis. The directive was executed during a period when
the client was stable and competent. What is the appropriate nursing action?
a. review the directive with the client to ensure it is current.
b. ensure that the directive is respected in treatment planning.
c. consider the directive only if there is a cardiac or respiratory arrest.
d. encourage the client to revise the directive in light of the current health problem.
ANS: B
The nurse has an obligation to honor the right to self-determination. An advanced
psychiatric directive supports that goal. Since the client is currently psychotic, the
terms of the directive now apply.
3. Two hospitalized clients fight whenever they are together. During a team meeting, a
nurse asserts that safety is of paramount importance, so treatment plans should call
for both clients to be secluded to keep them from injuring each other. What would be
the outcome of this assertion?
a. reinforcement of the autonomy of the two clients.
b. violation of the civil rights of both clients.
c. commission of an intentional tort of battery.
d. Correct placement on emphasis on safety.
ANS: B
Clients have a right to treatment in the least restrictive setting. Safety is important, but
less restrictive measures should be tried first. Unnecessary seclusion may result in a
charge of false imprisonment. Seclusion violates the client’s autonomy. The principle
by which the nurse is motivated is beneficence, not justice. The tort represented is
false imprisonment.
4. In a team meeting a nurse says, “I’m concerned about whether we are behaving ethically by
using restraint to prevent one client from self-mutilation, while the care plan for another self-
mutilating client requires one-on-one supervision.” Which ethical principle most clearly applies to this situation?
a. Beneficence
b. Autonomy
c. Fidelity
d. Justice
ANS: D
The nurse is concerned about justice, that is, fair distribution of care, which includes
treatment with the least restrictive methods for both clients. Beneficence means
promoting the good of others. Autonomy is the right to make one’s own decisions.
Fidelity is the observance of loyalty and commitment to the client.
, 5. Which scenario best demonstrates an example of a tort.
a. The plan of care for a client is not completed within 24 hours of the client’s
admission.
b. A nurse gives a prn dose of an antipsychotic drug to an agitated client
because the unit is short-staffed.
c. An advanced practice nurse recommends hospitalization for a client
who is dangerous to self and others.
d. A client’s admission status changed from involuntary to voluntary after the client’s
hallucinations subside.
ANS: B
A tort is a civil wrong against a person that violates his or her rights. Giving
unnecessary medication for the convenience of staff controls behavior in a manner
similar to secluding a client; thus, false imprisonment is a possible charge. The other
options do not exemplify torts.
6. What is the legal significance of a nurse’s action when a client verbally refuses
medication and the nurse gives the medication over the client’s objection?
a. Negligence
b. Malpractice
c. Standard of care.
d. Battery.
ANS: D
Battery is an intentional tort in which one individual violates the rights of another
through touching without consent. Forcing a client to take medication after the
medication was refused constitutes battery. The charge of battery can be brought
against the nurse. The medication may not necessarily harm the client; harm is a
component of malpractice. Such an action is
not considered appropriate standard of care.
7. Which nursing intervention demonstrates false imprisonment?
a. A confused and combative client says, “I’m getting out of here, and no
one can stop me.” The nurse restrains this client without a health care
provider’s order and then promptly obtains an order.
b. A client has been irritating and attention seeking much of the day. A nurse escorts
the client down the hall saying, “Stay in your room, or you’ll be put in seclusion.”
c. An involuntarily hospitalized client with suicidal ideation runs out of the
psychiatric unit. The nurse rushes after the client and convinces the client to
return to the unit.
d. An involuntarily hospitalized client with homicidal ideation attempts to
leave the facility. A nurse calls the security team and uses established
protocols to prevent the client from leaving.
ANS: B
False imprisonment involves holding a competent person against his or her will.
Actual force is not a requirement of false imprisonment. The individual needs only to
be placed in fear of imprisonment by someone who has the ability to carry out the
threat. If a client is not
COURSE COVERED SOLUTION WITH REAL
QUESTIONS AND EXPLAINED ANSWERS
Binghamton University
,MOD 4B: THOUGHT DISORDERS..............................................................................................1
VARC CH06 – ETHICS............................................................................................................ 1
STUART CH08: LEGAL AND ETHICAL CONTEXT OF PSYCHIATRIC NURSING CARE. 11
VARC CH12 – SCHIZOPHRENIA...........................................................................................17
STUART CH20: NEUROBIOLOGICAL RESPONSES AND SCHIZOPHRENIA AND
PSYCHOTIC DISORDERS30 MOD 5A: VIOLENCE & ABUSE.................................................37
VARC CH27 – ANGER, AGGRESSION & VIOLENCE...........................................................37
STUART CH28: PREVENTING AND MANAGING AGGRESSIVE BEHAVIOR..................46
VARC CH28 – CHILD, OLDER ADULT, & INTIMATE PARTNER VIOLENCE........................57
VARC CH29 – SEXUAL ASSAULT.........................................................................................64
STUART CH38: CARE OF SURVIVORS OF ABUSE AND VIOLENCE..............................72
MOD 5B: CHILDHOOD DISORDERS........................................................................................78
VARC CH11—CHILDHOOD AND NEURODEVELOPMENTAL DISORDERS.......................78
STUART CH35: CHILD PSYCHIATRIC NURSING.............................................................87
STUART CH36: ADOLESCENT PSYCHIATRIC NURSING................................................96
VARC CH21 – IMPULSE CONTROL DISORDERS..............................................................104
STUART CH21: SOCIAL RESPONSES AND PERSONALITY DISORDERS....................112
MOD 6A: MOOD DISORDERS.................................................................................................121
VARC CH13 – BIPOLAR DISORDERS.................................................................................121
VARC CH14 – DEPRESSIVE DISORDERS.........................................................................132
STUART CH18: EMOTIONAL RESPONSES & MOOD DISORDERS...............................143
VARC CH18 – EATING AND FEEDING DISORDERS.........................................................151
STUART CH24: EATING REGULATION RESPONSES AND EATING DISORDERS.......161
VARC CH25 – SUICIDE AND SELF-INJURY.......................................................................168
STUART CH19: SELF-PROTECTIVE RESPONSES AND SUICIDAL BEHAVIOR...........177
MOD 6B: NEURO DISORDERS...............................................................................................184
VARC CH23 – NEUROCOGNITIVE DISORDERS................................................................184
STUART CH22: COGNITIVE RESPONSES AND ORGANIC MENTAL DISORDERS......194
MOD 7: SUBSTANCE USE/ABUSE.........................................................................................202
VARC CH22 SUBSTANCE/ADDICTIVE DISORDERS.........................................................202
STUART CH23: CHEMICALLY MEDIATED RESPONSES & SUBSTANCE DISORDERS 213
MOD 4B: THOUGHT DISORDERS
VARC CH06 – ETHICS
1. Which action by a psychiatric nurse best applies the ethical principle of autonomy?
a. Exploring alternative solutions with the client, who then makes a choice.
b. Suggesting that two clients who were fighting be restricted to the unit.
c. Intervening when a self-mutilating client attempts to harm self.
d. Staying with a client demonstrating a high level of anxiety.
ANS: A
Autonomy is the right to self-determination, that is, to make one’s own decisions. By
exploring alternatives with the client, the client is better equipped to make an
informed, autonomous decision. The distracters demonstrate beneficence, fidelity,
and justice.
,2. A nurse finds a psychiatric advance directive in the medical record of a client
currently experiencing psychosis. The directive was executed during a period when
the client was stable and competent. What is the appropriate nursing action?
a. review the directive with the client to ensure it is current.
b. ensure that the directive is respected in treatment planning.
c. consider the directive only if there is a cardiac or respiratory arrest.
d. encourage the client to revise the directive in light of the current health problem.
ANS: B
The nurse has an obligation to honor the right to self-determination. An advanced
psychiatric directive supports that goal. Since the client is currently psychotic, the
terms of the directive now apply.
3. Two hospitalized clients fight whenever they are together. During a team meeting, a
nurse asserts that safety is of paramount importance, so treatment plans should call
for both clients to be secluded to keep them from injuring each other. What would be
the outcome of this assertion?
a. reinforcement of the autonomy of the two clients.
b. violation of the civil rights of both clients.
c. commission of an intentional tort of battery.
d. Correct placement on emphasis on safety.
ANS: B
Clients have a right to treatment in the least restrictive setting. Safety is important, but
less restrictive measures should be tried first. Unnecessary seclusion may result in a
charge of false imprisonment. Seclusion violates the client’s autonomy. The principle
by which the nurse is motivated is beneficence, not justice. The tort represented is
false imprisonment.
4. In a team meeting a nurse says, “I’m concerned about whether we are behaving ethically by
using restraint to prevent one client from self-mutilation, while the care plan for another self-
mutilating client requires one-on-one supervision.” Which ethical principle most clearly applies to this situation?
a. Beneficence
b. Autonomy
c. Fidelity
d. Justice
ANS: D
The nurse is concerned about justice, that is, fair distribution of care, which includes
treatment with the least restrictive methods for both clients. Beneficence means
promoting the good of others. Autonomy is the right to make one’s own decisions.
Fidelity is the observance of loyalty and commitment to the client.
, 5. Which scenario best demonstrates an example of a tort.
a. The plan of care for a client is not completed within 24 hours of the client’s
admission.
b. A nurse gives a prn dose of an antipsychotic drug to an agitated client
because the unit is short-staffed.
c. An advanced practice nurse recommends hospitalization for a client
who is dangerous to self and others.
d. A client’s admission status changed from involuntary to voluntary after the client’s
hallucinations subside.
ANS: B
A tort is a civil wrong against a person that violates his or her rights. Giving
unnecessary medication for the convenience of staff controls behavior in a manner
similar to secluding a client; thus, false imprisonment is a possible charge. The other
options do not exemplify torts.
6. What is the legal significance of a nurse’s action when a client verbally refuses
medication and the nurse gives the medication over the client’s objection?
a. Negligence
b. Malpractice
c. Standard of care.
d. Battery.
ANS: D
Battery is an intentional tort in which one individual violates the rights of another
through touching without consent. Forcing a client to take medication after the
medication was refused constitutes battery. The charge of battery can be brought
against the nurse. The medication may not necessarily harm the client; harm is a
component of malpractice. Such an action is
not considered appropriate standard of care.
7. Which nursing intervention demonstrates false imprisonment?
a. A confused and combative client says, “I’m getting out of here, and no
one can stop me.” The nurse restrains this client without a health care
provider’s order and then promptly obtains an order.
b. A client has been irritating and attention seeking much of the day. A nurse escorts
the client down the hall saying, “Stay in your room, or you’ll be put in seclusion.”
c. An involuntarily hospitalized client with suicidal ideation runs out of the
psychiatric unit. The nurse rushes after the client and convinces the client to
return to the unit.
d. An involuntarily hospitalized client with homicidal ideation attempts to
leave the facility. A nurse calls the security team and uses established
protocols to prevent the client from leaving.
ANS: B
False imprisonment involves holding a competent person against his or her will.
Actual force is not a requirement of false imprisonment. The individual needs only to
be placed in fear of imprisonment by someone who has the ability to carry out the
threat. If a client is not
