1.

Which action is a violation of a psychiatric client's rights?

A)

A client is paid minimum wage for working in the hospital kitchen.

B)

A paranoid client with delusions about his family is toldthat if he makes a will, it might not be valid.

C)

Staff members confiscate letters written by a committed client that are addressed to a local newspaper.

D)

The nurse removes an expensive watchfrom the client's room and tells the client it is being locked in the hospital safe.

2. A 22-year-old client has been manipulative of staff and disruptive in themilieu. Althoughshe is not dangerous to herself or others, she has created problems on the

unit and clearly is not making progress. The nurses offer prescribed medication, but she consistently refuses “any drugs.” The staffrealizes that legally this client can

A)Be coerced to accept treatment

B)

Be committed by her family to receive needed treatment

C)Have her family sign permission for treatment

D)Continue to refuse treatment

3.

A client who hadagreed to be hospitalized for stress-related problems has decided now that she wants to leave the hospital. The mental health staff caring for her realizes thatat present she can legally

A)

Be discharged if evaluated through administrative hearings.

B)Be retained in the hospital against her will.

C)

Leave the hospital after giving written notice of her intent to do so.

D)

Leave without discussing the situation with anyone.

4. Two nurses are discussing the rights of hospitalized psychiatric clients. Which ofthe following statements is in

error?

A)

Confidentiality allows for the disclosure of information under specific circumstances.

B)

If a committed client is also found to be incompetent, heloses his rights under the Patient's Bill of Rights.

C)

Privileged communication does not apply to medical records, and they can be used in court.

D)

The hospital is not responsible for the safety of a client's belongings.

5.

Placing a client in restraints before using other methods of intervention violates the client's right to

A)Receive confidential and respectful care

B)Provide informed consent

C)Refuse treatment

D)

Receive treatment in theleast restrictive environment

6.

When is a nurse legally obligatedto breach confidentiality?

A)At any time a client is threatening

B)If threats are made to an outside party

C)Whenever the client becomes aggressive

D) When the client violates the nurse's

boundaries

7.

A client was brought to the emergency department by police after neighbors complained he was loud and disruptive. The client is paranoid and upset and states, “No one can be trusted.” Which of the criteria for involuntary admission does this client meet?

A) Dangerous to

self

B) Dangerous to others

C) Gravely disabled

D)

He does not meet any of the necessary criteria.

8. The nurse has a physician's order for haloperidol (Haldol) 10 mg for a severely psychotic client. The client refuses the medication. Which nursing intervention is

an appropriate response?

A)Accept the client's decision

B)

Obtain a discharge order for noncompliance

C)Tell the client that he is too sick to refuse

D)

Restrain the client and give the medication IM

9. Disclosure of client information beyond the interdisciplinary

team without consent of the client is a breach of

A) BeneficenceB) ConfidentialityC) DutyD) Veracity

10.

A depressed, suicidal client is scheduled for electroconvulsive therapy (ECT),which requires consent. Legally,who should sign the consent for this treatment?

A)A member of thetreatment team

B) The client

C) The client's spouse

D) The psychiatrist

11. A patient made threats to harm his parents if they come too close to him. The parents called 911 and the patient is now held involuntarily for a psychiatric evaluation. During this time of involuntary admission, the patient retains

all patient rightsexcept for whichof the following?

A) ConfidentialityB) Right to freedom

C)Periodic treatment review

D)Choice of providers

12. A depressed patient is admitted to treatment on a voluntary basis. While in the hospital, the patient makes several comments about

wanting to “end it all”. The patient decides one day to leaveagainst medical advice. The most appropriate action by the nursing staff is to:

A)call security to detain the patient.

B)

allow the patientto leave with community resources for follow-up care.

C) contact the psychiatrist for initiation of commitment

proceedings.

D)

contact the patient’s family to request they convince the patient to stay.

13.

Which of the following patients would most likely be mandated outpatient treatment?

A)

A patient who is addicted to alcohol who has 2 DUI offenses

B) A patient with schizophrenia who lives in a

single family home with siblings

C)

A patient with bipolar disorder that has quit 3 jobs in the last 6months

D)

A homeless patient who has been arrested for petty theft ofgroceries from aconvenience store.

14. Under which conditions wouldit be in the patient’s best interest for the

court to appoint a conservator, or legal guardian? (Select all that apply)

A) Gravely disabled

B) Mentally incompetent

C) Noncompliant

D)

Unable to provide basic needs when resources exist

E)Act only on theirown interests

15. An adolescent on the unit is argumentative with staff and

peers. The nursetells the adolescent, “Arguing is not allowed. One more word and you will have to stay in your room the rest of the day.” The nurse’s directiveis:

A)

inappropriate; room restriction is not treatment in the least restrictive environment.

B) inappropriate; the adolescent should be offered a sedative before

room restriction.

C)

appropriate; room restriction is an effective behavior modification technique.

D)

appropriate; the adolescent should not have conflicts with others.

16. The nurse on an addictive disorders unit receives a phone call inquiring about the status of a patient. The

caller is not on the patient’s allowed contact list. Which of thefollowing is the appropriate response by the nurse to the caller?

A)

“I cannot confirm or deny the existence of any patient here.”

B)

“You will need tobe placed on thepatient’s contactlist before I can discuss any information withyou.”

C) “The person youare asking for is

not a patient here.”

D)

“Hold one minute while I get the patient for you.”

17.

Which of the following patientsituations most urgently requires the nurse to break confidentiality and warn a thirdparty?

A)

An abused woman states, “Ihave dreams that he is dead.”

B) A mother states,

“Sometimes I feel like killing my kids!”

C)

A paranoid woman states, “I’ll get them before they get me.”

D)

A jealous man states, “I gettingmy gun and going to shoot my wife’s lover!”

18. A nurse is questioning whether it is ethical to seclude a patient because

of loud and intrusive behavior on the unit. The ethical principle that will best guide this decision on the appropriate use of seclusion is the principle of:

A) AutonomyB) BeneficenceC) JusticeD) Veracity

19. A nurse is performing safety assessments on a patient in

mechanical restrains according to policy. Which action by the nurse demonstrates the ethical principle of nonmaleficence?

A)

Explaining the behavioral requirements forrelease of restraint to the patient

B)

Assuring that the restraints are not causing harm to the patient

C) Applying

restraints based solely on assessment findings and not on attitude toward the patient

D)

Releasing the patient when stated behavioral control is achieved

20. An adult patient is put in restraints after all other attempts to reduce aggression havefailed. Which of

the following is required now that restraints have been instituted?

A)

Review of the appropriateness of restraints every eight hours

B)

A face-to-face evaluation by anindependent practitioner within one hour

C)

A documented nursing assessment every 4 hours

D) Constant one-on-one supervision

during the first hour, then videomonitoring

21. A patient is suing a nurse formalpractice claiming the nurse did not perform safety checks according to policy during a period when thepatient was placed in restraints. The nurse did check circulation every15 minutes as per policy, documenting full

movement, palpable pulses, and pale skin. The patient claims that ever since the event he has had numbness in his fingers. Which ofthe following is the probable outcome of the suit?

A)

The nurse is not guilty as there were palpable pulses during the assessment

B) The nurse is not guilty as the procedure for circulation checks was

followed

C)

The nurse may be found guilty since the patientsuffered injury

D)

The nurse may be found guilty as she was practicing outside of the capacity of a nurse

22. Ensuring that the patient has informed consent before agreeing to a treatment regimen displays which

of the following ethical principles?

A) FidelityB) NonmaleficenceC) JusticeD) Autonomy

23. The nurse is attending an in-service training on safe take-down techniques for aggressive patients. Preparation for safe physical handling prepares the nurse to

practice which ethical principle?

A) FidelityB) NonmaleficenceC) JusticeD) Autonomy

24. A nurse is faced with the dilemma of whether to support a patient care practice that can be viewed as violating a patient’s right toautonomy. Identify, in order, the steps

the nurse shouldtake to make an ethical decision on a course of action.

A)

Clarify the nurse’s personalfeelings about the situation

B) Identify other possible options

C)

Gather information about the practice

D)

Consider legal and practical constraints to other options

E) Complete an analysis and arrive at a

decision

25.

Ethical dilemmas in mental health practice are especially challenging for the nurse because:

A)

ethical dilemmas are often charged with emotion.

B)

there are no clear ethical codes established for guidance.

C) a multitude of laws must be

understood to make a clear decision.

D)

patients are not familiar with theethical code which nurses must follow.

26.

The term standards of care refers to expectations of nursing performance. Standards of care are developed from which of the following? (Select all that apply)

A)

Code of Ethics for Nurses with Interpretive Statements

B)Licensure examinations

C)State Nurse Practice Acts

D)Agency job descriptions

E)Professional nursing organizations

27. A patient underwent a procedure before the nurseverified the patient’s signature on the

consent form. The patient actually did not sign the form before the procedure. If thepatient is dissatisfied with the outcome of the procedure and files a suit against the health care team, which kind of case can the patient file?

A) NegligenceB) MalpracticeC) Battery

D) False Imprisonment

28.

The staff on an inpatient psychiatric unit is very busy andfall behind on periodic assessment of a severely depressed patient. During the rounds the patient is discovered to have completed a suicide attempt in the bathroom. Which type of lawsuit could the patient’s family file?

A) Malpractice

B) Breach of DutyC) Assault

D)Injury or Damage

29.

Which of the following is described as a wrongful act that results in injury, loss, or damage?

A) NegligenceB) TortC) MalpracticeD) Ethical dilemma

Answer Key

1. C2. D3. C4. B5. D6. B7. D8. A9. B

10. B11. B12. C13. A14. A, B, D15. A16. A17. D18. A19. B20. B

21. C22. C23. B24. A, B, C, D, E25. A26. A, C, D, E27. C28. A29. B