C HAPTER 06: L EGAL AND E THICAL
C ONSIDERATIONS
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Edition
MULTIPLE CHOICE
1. When private insurance will not pay f or continued private hospitalization
of a mentall y ill client, he famil y considers transferring the client to a
public hospital but expresses concern that the client will not get any
treatment if transferred. What is the nurse’s most helpful repl y?
a. “By law, treatment must be provided. Hospitalization without
treatment violates clients’ rights.”
b. “All clients in public hospitals have the right to choose both a
primary therapist and a primary nurse.”
c. “You have a justifiable concern because the right to treatme nt
extends onl y to provision of food, shelter, and safet y.”
d. “Much will depend on other clients, because the right to treatment
for a psychotic client takes precedence over the right to treatment of
a client who is stable.”
ANS: A
The right to medical and psychiatric treatment is conferred on all
clients hospitalized in public mental hospitals under federal law.
, PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation MSC: Client
Needs: Safe, Effective Care Environ ment
2. Which behavior demonstrated by an individual diagnosed with mental
illness may require emergency or involuntary admission?
a. Resuming the use of heroin while still taking naltrexone.
b. Reports hearing angels playing harps during thunderstorms.
c. Not keepin g an outpatient appointment with the mental health nurse.
d. Throwing 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 illness but not
dangerousness. See related audience response question.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis ) TOP:
Nursing Process: Implementation MSC: Client Needs: Safe,
Effective Care Environment
3. A client in alcohol rehabilitation reveals to the nurse, “I feel terrible guilt
for sexuall y abusing my 6 -year-old before I was admitted.” What is the
nurse’s most appropriate, initial action?
a. Reporting the abuse to the local child protection agency.
b. Repl y, “I’m glad you feel comfortable talking to me about it.”
c. File a written report with the agency’s ethics committee.
, d. Respect nurse–client relationship confidential it y.
ANS: A
Laws regarding child abuse reporting discovered by a professional
during the suspected abuser’s alcohol or drug treatment 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 client in an alcohol
or drug treatment facilit y.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Safe, Effective Care Environment
4. A famil y member of a client with delusions of persecution asks the nurse,
“Are there any circumstances under which the treatment team is justified
in violating a client’s right to confidentialit y?” What is the nurse’s best
response?
a. Under no circumstances.
b. At the discretion of the psychiatrist.
c. When questions are asked by law enforcement.
d. If the client threatens the life of another person.
ANS: D
The dut y to warn a person whose life has been threatened by a
ps ychiatric client overrides t he client’s right to confidentialit y. The
right to confidentiality is not suspended at the discretion of the
therapist or for legal investigations.
C ONSIDERATIONS
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Edition
MULTIPLE CHOICE
1. When private insurance will not pay f or continued private hospitalization
of a mentall y ill client, he famil y considers transferring the client to a
public hospital but expresses concern that the client will not get any
treatment if transferred. What is the nurse’s most helpful repl y?
a. “By law, treatment must be provided. Hospitalization without
treatment violates clients’ rights.”
b. “All clients in public hospitals have the right to choose both a
primary therapist and a primary nurse.”
c. “You have a justifiable concern because the right to treatme nt
extends onl y to provision of food, shelter, and safet y.”
d. “Much will depend on other clients, because the right to treatment
for a psychotic client takes precedence over the right to treatment of
a client who is stable.”
ANS: A
The right to medical and psychiatric treatment is conferred on all
clients hospitalized in public mental hospitals under federal law.
, PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation MSC: Client
Needs: Safe, Effective Care Environ ment
2. Which behavior demonstrated by an individual diagnosed with mental
illness may require emergency or involuntary admission?
a. Resuming the use of heroin while still taking naltrexone.
b. Reports hearing angels playing harps during thunderstorms.
c. Not keepin g an outpatient appointment with the mental health nurse.
d. Throwing 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 illness but not
dangerousness. See related audience response question.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis ) TOP:
Nursing Process: Implementation MSC: Client Needs: Safe,
Effective Care Environment
3. A client in alcohol rehabilitation reveals to the nurse, “I feel terrible guilt
for sexuall y abusing my 6 -year-old before I was admitted.” What is the
nurse’s most appropriate, initial action?
a. Reporting the abuse to the local child protection agency.
b. Repl y, “I’m glad you feel comfortable talking to me about it.”
c. File a written report with the agency’s ethics committee.
, d. Respect nurse–client relationship confidential it y.
ANS: A
Laws regarding child abuse reporting discovered by a professional
during the suspected abuser’s alcohol or drug treatment 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 client in an alcohol
or drug treatment facilit y.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Safe, Effective Care Environment
4. A famil y member of a client with delusions of persecution asks the nurse,
“Are there any circumstances under which the treatment team is justified
in violating a client’s right to confidentialit y?” What is the nurse’s best
response?
a. Under no circumstances.
b. At the discretion of the psychiatrist.
c. When questions are asked by law enforcement.
d. If the client threatens the life of another person.
ANS: D
The dut y to warn a person whose life has been threatened by a
ps ychiatric client overrides t he client’s right to confidentialit y. The
right to confidentiality is not suspended at the discretion of the
therapist or for legal investigations.
