C HAPTER 06: L EGAL AND E THICAL
C ONSIDERATIONS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. Insurance will not pay for continued private hospitalization of a mentall y
ill patient. The family considers transferring the patient to a public
hospital but expresses concern that the patient will not get any tr eatment
if transferred. Select the nurses most helpful repl y.
a. By law, treatment must be provided. Hospitalization without
treatment violates patients rights.
b. All patients in public hospitals have the right to choose both a
primary therapist and a primary n urse.
c. You have a justifiable concern because the right to treatment
extends onl y to provision of food, shelter, and safet y.
d. Much will depend on other patients, because the right to treatment
for a psychotic patient takes precedence over the right to treatm ent
of a patient who is stable.
ANS: A
The right to medical and psychiatric treatment was conferred on all
patients hospitalized in public mental hospitals with the enactment of
the federal Hospitalization of Mentall y Il l Act in 1964.
, PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 94 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
2. Which individual with mental illness may need emergency or involuntary
admission? The individual who:
a. resumes using heroin while still taking naltrexone (ReVia).
b. reports hearing angels playing harps during thunderstorms.
c. does not keep an outpatient appointment with the mental health
nurse.
d. throws a heavy plate at a waiter at the direction of command
hallucinations.
ANS: D
Throwing a heavy plate is likel y to harm the waiter and is evidence of
dangerousness to others. This behavior meets the criteria for
emergency or involuntary hospitalization for mental illness. The
behaviors in the other options evidence mental illnes s but not
dangerousness. See related audience response question.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 93
TOP: Nursing Process: Implementation MSC: Client
Needs: Safe, Effective Care Environment
3. A patient in alcohol rehabilitation reve als to the nurse, I feel terrible guilt
for sexuall y abusing my 6 -year- old before I was admitted. Select the
nurses most important action.
a. Anonymousl y report the abuse by phone to the local child protection
agency.
, b. Repl y, Im glad you feel comfortable talk ing to me about it.
c. File a written report with the agencys ethics committee.
d. Respect nurse-patient relationship confidentialit y.
ANS: A
Laws regarding child abuse reporting discovered by a professional
during the suspected abusers alcohol or drug treatme nt differ by state.
Federal law supersedes state law and prohibits disclosure without a
court order except in instances in which the report can be made
anonymousl y or without identifying the abuser as a patient in an
alcohol or drug treatment facilit y.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 99 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
4. A famil y member of a patient with delusions of persecution asks the
nurse, Are there any circumstances unde r which the treatment team is
justified in violating a patients right to confidentialit y? The nurse should
repl y that confidentialit y may be breached:
a. under no circumstances.
b. at the discretion of the psychiatrist.
c. when questions are asked by law enforcemen t.
d. if the patient threatens the life of another person.
ANS: D
The dut y to warn a person whose life has been threatened by a
ps ychiatric patient overrides the patients right to confidentiality. The
C ONSIDERATIONS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. Insurance will not pay for continued private hospitalization of a mentall y
ill patient. The family considers transferring the patient to a public
hospital but expresses concern that the patient will not get any tr eatment
if transferred. Select the nurses most helpful repl y.
a. By law, treatment must be provided. Hospitalization without
treatment violates patients rights.
b. All patients in public hospitals have the right to choose both a
primary therapist and a primary n urse.
c. You have a justifiable concern because the right to treatment
extends onl y to provision of food, shelter, and safet y.
d. Much will depend on other patients, because the right to treatment
for a psychotic patient takes precedence over the right to treatm ent
of a patient who is stable.
ANS: A
The right to medical and psychiatric treatment was conferred on all
patients hospitalized in public mental hospitals with the enactment of
the federal Hospitalization of Mentall y Il l Act in 1964.
, PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 94 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
2. Which individual with mental illness may need emergency or involuntary
admission? The individual who:
a. resumes using heroin while still taking naltrexone (ReVia).
b. reports hearing angels playing harps during thunderstorms.
c. does not keep an outpatient appointment with the mental health
nurse.
d. throws a heavy plate at a waiter at the direction of command
hallucinations.
ANS: D
Throwing a heavy plate is likel y to harm the waiter and is evidence of
dangerousness to others. This behavior meets the criteria for
emergency or involuntary hospitalization for mental illness. The
behaviors in the other options evidence mental illnes s but not
dangerousness. See related audience response question.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 93
TOP: Nursing Process: Implementation MSC: Client
Needs: Safe, Effective Care Environment
3. A patient in alcohol rehabilitation reve als to the nurse, I feel terrible guilt
for sexuall y abusing my 6 -year- old before I was admitted. Select the
nurses most important action.
a. Anonymousl y report the abuse by phone to the local child protection
agency.
, b. Repl y, Im glad you feel comfortable talk ing to me about it.
c. File a written report with the agencys ethics committee.
d. Respect nurse-patient relationship confidentialit y.
ANS: A
Laws regarding child abuse reporting discovered by a professional
during the suspected abusers alcohol or drug treatme nt differ by state.
Federal law supersedes state law and prohibits disclosure without a
court order except in instances in which the report can be made
anonymousl y or without identifying the abuser as a patient in an
alcohol or drug treatment facilit y.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 99 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
4. A famil y member of a patient with delusions of persecution asks the
nurse, Are there any circumstances unde r which the treatment team is
justified in violating a patients right to confidentialit y? The nurse should
repl y that confidentialit y may be breached:
a. under no circumstances.
b. at the discretion of the psychiatrist.
c. when questions are asked by law enforcemen t.
d. if the patient threatens the life of another person.
ANS: D
The dut y to warn a person whose life has been threatened by a
ps ychiatric patient overrides the patients right to confidentiality. The
