NSG 323 Exam 1
In a team meeting a nurse says, "I'm concerned about whether we are behaving ethically in
using restraint to prevent one patient from engaging in self-mutilating behavior while the care
plan for another self-mutilating patient calls for one-on-one supervision." Which ethical principle
most clearly applies to this situation?
A) Beneficence
B) Autonomy
C) Fidelity
D) Justice - ANS-D) Justice
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) The nurse has been negligent.
B) The nurse has committed malpractice.
C) The nurse has fulfilled the standard of care.
D) The nurse can be charged with battery. - ANS-D) The nurse can be charged with battery.
battery - ANS-the harmful or offensive touching of another person
A nurse at the mental health center prepares to administer a scheduled injection of haloperidol
decanoate (Haldol depot) to a client with schizophrenia. As the nurse swabs the site, the client
shouts, "Stop, stop. I don't want to take that medicine anymore because I hate the side effects."
What is the best nurse's response?
A) Assemble other staff for a show of force and proceed with the injection, using restraint if
necessary.
B) Stop the medication administration procedure and say to the client, "Tell me more about the
side effects you've had.
C) Proceed with the injection but explain to the client that there are medications that will help
reduce the unpleasant side effects.
D) Say to the client, "Since I've already drawn the medication in the syringe, I'm required to give
it but let's talk to the doctor about delaying next month's dose." - ANS-B) Stop the medication
administration procedure and say to the client, "Tell me more about the side effects you've had.
Select the example of a tort.
A) The plan of care for a client is not completed within 24 hours of their admission.
B) A nurse gives a PRN dose of an antipsychotic drug to an agitated patient 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 subsided. - ANS-B) A nurse gives a PRN dose of an antipsychotic drug to an
agitated patient because the unit is short staffed.
A voluntary hospitalized patient tells the nurse, "Get me the forms for discharge. I want to leave
now." What is the nurse's best response?
A) "I will get the forms for you right now and bring them to your room."
B) "Since you signed your consent for treatment, you may leave if you desire."
C) "I will get them for you, but let's talk about your decision to leave treatment."
D) "I cannot give you those forms without your health care provider's knowledge." - ANS-C) "I
will get them for you, but let's talk about your decision to leave treatment."
Which individual with mental illness may need emergency or involuntary hospitalization for
mental illness?
A)The person who resumes using heroin while still taking naltrexone (ReVia).
B) The person who reports hearing angels playing harps during thunderstorms.
C) The person who does not keep an outpatient appointment with the mental health nurse.
D) The person who throws a heavy plate at a waiter at the direction of command hallucinations.
- ANS-D) The person who throws a heavy plate at a waiter at the direction of command
hallucinations.
A person in the community asks, "Why aren't people with mental illness kept in state institutions
anymore?"
A) "Less restrictive settings are available now to care for individuals with mental illness."
B) "There are fewer persons with mental illness, so less hospital beds are needed."
C) "Most people with mental illness are still in psychiatric institutions."
D) "Psychiatric institutions violated client's rights." - ANS-A) "Less restrictive settings are
available now to care for individuals with mental illness."
A client with psychosis became aggressive, struck another client, and required seclusion. Which
documentation below is the best?
A) Client struck another client who attempted to leave day room to go to the bathroom.
Seclusion necessary at 1415. Plan: Maintain seclusion for 8 hours and keep these two clients
away from each other for 24 hours.
B) Seclusion ordered by physician at 1415 after command hallucinations told the client to hit
another client. Careful monitoring of client maintained during period of seclusion.
C) Seclusion ordered by MD for aggressive behavior. Begun at 1415. Maintained for 2 hours
without incident. Outcome: Client calmer and apologized for outburst.
D) Client pacing, shouting. Haloperidol 5 mg given PO at 1300. No effect by 1315. At 1415
client yelled, "I'll punch anyone who gets near me," and struck another client with fist. Physically
placed in seclusion at 1420. Seclusion order obtained fro - ANS-D) Client pacing, shouting.
Haloperidol 5 mg given PO at 1300. No effect by 1315. At 1415 client yelled, "I'll punch anyone
who gets near me," and struck another client with fist. Physically placed in seclusion at 1420.
Seclusion order obtained from MD at 1430.
In a team meeting a nurse says, "I'm concerned about whether we are behaving ethically in
using restraint to prevent one patient from engaging in self-mutilating behavior while the care
plan for another self-mutilating patient calls for one-on-one supervision." Which ethical principle
most clearly applies to this situation?
A) Beneficence
B) Autonomy
C) Fidelity
D) Justice - ANS-D) Justice
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) The nurse has been negligent.
B) The nurse has committed malpractice.
C) The nurse has fulfilled the standard of care.
D) The nurse can be charged with battery. - ANS-D) The nurse can be charged with battery.
battery - ANS-the harmful or offensive touching of another person
A nurse at the mental health center prepares to administer a scheduled injection of haloperidol
decanoate (Haldol depot) to a client with schizophrenia. As the nurse swabs the site, the client
shouts, "Stop, stop. I don't want to take that medicine anymore because I hate the side effects."
What is the best nurse's response?
A) Assemble other staff for a show of force and proceed with the injection, using restraint if
necessary.
B) Stop the medication administration procedure and say to the client, "Tell me more about the
side effects you've had.
C) Proceed with the injection but explain to the client that there are medications that will help
reduce the unpleasant side effects.
D) Say to the client, "Since I've already drawn the medication in the syringe, I'm required to give
it but let's talk to the doctor about delaying next month's dose." - ANS-B) Stop the medication
administration procedure and say to the client, "Tell me more about the side effects you've had.
Select the example of a tort.
A) The plan of care for a client is not completed within 24 hours of their admission.
B) A nurse gives a PRN dose of an antipsychotic drug to an agitated patient 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 subsided. - ANS-B) A nurse gives a PRN dose of an antipsychotic drug to an
agitated patient because the unit is short staffed.
A voluntary hospitalized patient tells the nurse, "Get me the forms for discharge. I want to leave
now." What is the nurse's best response?
A) "I will get the forms for you right now and bring them to your room."
B) "Since you signed your consent for treatment, you may leave if you desire."
C) "I will get them for you, but let's talk about your decision to leave treatment."
D) "I cannot give you those forms without your health care provider's knowledge." - ANS-C) "I
will get them for you, but let's talk about your decision to leave treatment."
Which individual with mental illness may need emergency or involuntary hospitalization for
mental illness?
A)The person who resumes using heroin while still taking naltrexone (ReVia).
B) The person who reports hearing angels playing harps during thunderstorms.
C) The person who does not keep an outpatient appointment with the mental health nurse.
D) The person who throws a heavy plate at a waiter at the direction of command hallucinations.
- ANS-D) The person who throws a heavy plate at a waiter at the direction of command
hallucinations.
A person in the community asks, "Why aren't people with mental illness kept in state institutions
anymore?"
A) "Less restrictive settings are available now to care for individuals with mental illness."
B) "There are fewer persons with mental illness, so less hospital beds are needed."
C) "Most people with mental illness are still in psychiatric institutions."
D) "Psychiatric institutions violated client's rights." - ANS-A) "Less restrictive settings are
available now to care for individuals with mental illness."
A client with psychosis became aggressive, struck another client, and required seclusion. Which
documentation below is the best?
A) Client struck another client who attempted to leave day room to go to the bathroom.
Seclusion necessary at 1415. Plan: Maintain seclusion for 8 hours and keep these two clients
away from each other for 24 hours.
B) Seclusion ordered by physician at 1415 after command hallucinations told the client to hit
another client. Careful monitoring of client maintained during period of seclusion.
C) Seclusion ordered by MD for aggressive behavior. Begun at 1415. Maintained for 2 hours
without incident. Outcome: Client calmer and apologized for outburst.
D) Client pacing, shouting. Haloperidol 5 mg given PO at 1300. No effect by 1315. At 1415
client yelled, "I'll punch anyone who gets near me," and struck another client with fist. Physically
placed in seclusion at 1420. Seclusion order obtained fro - ANS-D) Client pacing, shouting.
Haloperidol 5 mg given PO at 1300. No effect by 1315. At 1415 client yelled, "I'll punch anyone
who gets near me," and struck another client with fist. Physically placed in seclusion at 1420.
Seclusion order obtained from MD at 1430.
