Question 1

A new antidepressant is prescribed for an elderly patient with major depression, but the dose is more than the usual geriatric dose. What should the nurse do?

Accepted Answer

A)  Consult a reliable drug reference. 
B)  Teach the patient about possible side effects and adverse effects. 
C)  Withhold the medication and confer with the health care provider. 
D)  Encourage the patient to increase oral fluids to reduce drug concentration.

Question 2

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 3

Which of the following patients meets criteria for involuntary hospitalization for psychiatric treatment?

Accepted Answer

A)  The patient who is noncompliant with the treatment regimen 
B)  The patient who fraudulently files for bankruptcy 
C)  The patient who sold and distributed illegal drugs 
D)  The patient who threatens to harm self and others

Question 4

A patient in alcohol rehabilitation reveals to the nurse, "I feel terrible guilt for sexually abusing my 6-year-old before I was admitted." Select the nurse's most important action.

Accepted Answer

A)  Report the abuse to the local child welfare agency. 
B)  Reply, "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-patient relationship confidentiality.

Question 5

In order to release information to another health care facility or third party regarding a patient diagnosed with a mental illness, the nurse must obtain which of the following?

Accepted Answer

A)  A signed consent by the patient for release of information stating specific information to be released. 
B)  A verbal consent for information release from the patient and the patient's guardian or next of kin. 
C)  Permission from members of the health care team who participate in treatment planning. 
D)  Approval from the attending psychiatrist to authorize the release of information.

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

A voluntarily hospitalized patient tells the nurse, "Get me the forms for discharge. I want to leave now." Select the nurse's best response.

Accepted Answer

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 permission."

Question 8

A nurse is concerned that an agency's policies are inadequate. Which understanding about the relationship between substandard institutional policies and individual nursing practice should guide nursing practice?

Accepted Answer

A)  Agency policies do not exempt an individual nurse of responsibility to practice according to professional standards of nursing care. 
B)  Agency policies are the legal standard by which a professional nurse must act and therefore override other standards of care. 
C)  Faced with substandard policies, a nurse has a responsibility to inform the supervisor and discontinue patient care immediately. 
D)  Interpretation of policies by the judicial system is rendered on an individual basis and therefore cannot be predicted.

Question 9

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 10

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

Exam 8: Ethical Responsibilities and Legal Obligations for Psychiatric Mental Health Nursing Practice