Question 1

Which nursing intervention demonstrates false imprisonment?

Accepted Answer

A)  A confused and combative patient says, "I'm getting out of here, and no one can stop me." The nurse restrains this patient without a health care provider's order and then promptly obtains an order. 
B)  A patient has been irritating and attention-seeking much of the day. A nurse escorts the patient down the hall saying, "Stay in your room, or you'll be put in seclusion." 
C)  An involuntarily hospitalized patient with suicidal ideation runs out of the psychiatric unit. The nurse rushes after the patient and convinces the patient to return to the unit. 
D)  An involuntarily hospitalized patient with homicidal ideation attempts to leave the facility. A nurse calls the security team and uses established protocols to prevent the patient from leaving.

Question 2

A family member of a patient with delusions of persecution asks the nurse, "Are there any circumstances under which the treatment team is justified in violating a patient's right to confidentiality?" The nurse should reply that confidentiality may be breached in which of the following circumstances, if any?

Accepted Answer

A)  Under no circumstances 
B)  At the discretion of the psychiatrist 
C)  When questions are asked by law enforcement 
D)  If the patient threatens the life of another person

Question 3

Select the response that is an example of a tort.

Accepted Answer

A)  The plan of care for a patient is not completed within 24 hours of the patient's 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 patient who is dangerous to self and others. 
D)  A patient's admission status change from involuntary to voluntary after the patient's hallucinations subside.

Question 4

What is the legal significance of a nurse's action when a patient verbally refuses medication and the nurse gives the medication over the patient's objection?

Accepted Answer

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.

Question 5

Which individual with mental illness may need emergency or involuntary admission?

Accepted Answer

A)  An individual who resumes using heroin while still taking naltrexone (ReVia). 
B)  An individual who reports hearing angels playing harps during thunderstorms. 
C)  An individual who does not keep an outpatient appointment with the mental health nurse. 
D)  An individual who throws a heavy plate at a waiter at the direction of command hallucinations.

Question 6

A nurse prepares to administer a scheduled injection of haloperidol decanoate (Haldol) to an outpatient with schizophrenia. As the nurse swabs the site, the patient shouts, "Stop! I don't want to take that medicine anymore. I hate the side effects." Select the nurse's best action.

Accepted Answer

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 patient, "Tell me more about the side effects you've been having." 
C)  Proceed with the injection but explain to the patient that there are medications that will help reduce the unpleasant side effects. 
D)  Say to the patient, "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."

Question 7

Which action by a nurse constitutes a breach of a patient's right to privacy?

Accepted Answer

A)  Documenting the patient's daily behaviour during hospitalization 
B)  Releasing information to the patient's employer without consent 
C)  Discussing the patient's history with other staff during care planning 
D)  Asking family to share information about a patient's pre-hospitalization behaviour

Question 8

Two hospitalized patients 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 patients to be secluded to keep them from injuring each other. This assertion does which of the following?

Accepted Answer

A)  Reinforces the autonomy of the two patients 
B)  Violates the civil rights of both patients 
C)  Represents the intentional tort of battery 
D)  Correctly places emphasis on safety

Question 9

In which situations would a nurse have the duty to intervene and report?

Accepted Answer

A)  A peer has difficulty writing measurable outcomes. 
B)  A health care provider gives a telephone order for medication. 
C)  A peer tries to provide patient care in an alcohol-impaired state. 
D)  A team member violates relationship boundaries with a patient. 
E)  A patient refuses medication prescribed by a licensed health care provider.

Question 10

A patient with psychosis became aggressive, struck another patient, and required seclusion. Select the best documentation.

Accepted Answer

A)  Patient struck another patient who attempted to leave day room to go to bathroom. Seclusion necessary at 1415. Plan: Maintain seclusion for 8 hours and keep these two patients away from each other for 24 hours. 
B)  Seclusion ordered by physician at 1415 after command hallucinations told the patient to hit another patient. Careful monitoring of patient maintained during period of seclusion. 
C)  Seclusion ordered by physician for aggressive behaviour. Begun at 1415. Maintained for 2 hours without incident. Outcome: Patient calmer and apologized for outburst. 
D)  Patient pacing, shouting. Haloperidol 5 mg given PO at 1300. No effect by 1315. At 1415 patient yelled, "I'll punch anyone who gets near me," and struck another patient with fist. Physically placed in seclusion at 1420. Seclusion order obtained from physician at 1430.

Exam 7: Ethical Responsibilities and Legal Obligations for Psychiatric Mental Health Nursing Practice