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A group of nursing students are reviewing information about internal rights protection systems. The students demonstrate understanding of this information when they identify which of the following as an example?
- A. American Hospital Association
- B. American Public Health Association
- C. State mental health provider
- D. The Joint Commission
Correct Answer: D
Rationale: The correct answer is D: The Joint Commission. The Joint Commission is an independent, nonprofit organization that accredits and certifies healthcare organizations based on quality and safety standards. It establishes and enforces internal rights protection systems to ensure patient rights are respected. The other choices do not specifically focus on accrediting and certifying healthcare organizations or ensuring internal rights protection systems. The American Hospital Association and American Public Health Association are professional organizations that advocate for healthcare policies. State mental health providers typically focus on delivering mental health services rather than accrediting healthcare organizations.
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A nurse is providing care to a patient with a mental disorder classified by the DSM- IV-TR. The nurse understands that although the first three axes appear to contain all the diagnostic information about a patient, a truly accurate picture of the client is incomplete without considering other factors such as an estimate of current functioning and:
- A. Life stressors
- B. Cultural background
- C. Marital status
- D. Genetic history
Correct Answer: A
Rationale: Step 1: Consideration of life stressors is crucial in understanding the impact on the patient's mental health.
Step 2: Life stressors can significantly affect the course and severity of mental disorders.
Step 3: Evaluating life stressors provides insight into triggers and exacerbating factors.
Step 4: Cultural background, marital status, and genetic history are important but may not directly influence current functioning as much as life stressors.
Summary: A is correct as it directly impacts current functioning, while B, C, and D are important but may not provide as much insight into the patient's current state.
A 22-year-old patient with schizophrenia is refusing his antipsychotic medication. He states, `I don’t like the dopey way it makes me feel. I feel like I’m walking under water when I take it. The nurse explains to him, `Your schizophrenia is caused by a chemical imbalance in your brain, and this medication helps fix that chemical imbalance. You need to take it so your symptoms will get better. This conversation reflects a conflict between which two types of ethical principles?
- A. Autonomy and justice
- B. Paternalism and veracity
- C. Justice and nonmaleficence
- D. Autonomy and beneficence
Correct Answer: D
Rationale: The correct answer is D: Autonomy and beneficence. Autonomy refers to the patient's right to make decisions about their own healthcare. In this case, the patient is refusing medication based on how it makes them feel, which reflects their autonomy. Beneficence refers to the healthcare provider's duty to act in the patient's best interest. The nurse is trying to persuade the patient to take the medication by explaining its benefits for treating the chemical imbalance associated with schizophrenia. This reflects the conflict between respecting the patient's autonomy while also promoting their well-being through beneficence.
Choices A, B, and C are incorrect:
A: Autonomy and justice do not directly apply to the conflict in the scenario.
B: Paternalism involves overriding a patient's autonomy for their own good, but veracity (truthfulness) is not a central issue in this scenario.
C: Justice and nonmaleficence are not the primary ethical principles in conflict; the focus is on autonomy and benef
A nurse is caring for a patient who is hospitalized for a mental disorder. The nurse is legally obligated to breach the patient’s confidentiality if the patient states which of the following?
- A. `I think that the federal government is spying on me.
- B. `I get really ‘turned on’ by your appearance.
- C. `That doctor I had today really made me angry.
- D. `When I get out of here, I’m going to kill my neighbor.
Correct Answer: D
Rationale: Rationale: The correct answer is D because the nurse has a duty to breach confidentiality if the patient expresses an intent to harm themselves or others. In this case, the patient's statement about killing their neighbor indicates a serious threat that must be reported to ensure safety. Choices A, B, and C do not pose an immediate threat to the patient or others, so they do not require breaching confidentiality.
Mrs. Green is a patient on a psychiatric unit. At the time of her admission, her dog was killed when a car accidentally ran over it; in addition to that, she just found out that her mother has been diagnosed with colon cancer. This information would be addressed in which DSM-IV axis?
- A. Axis I
- B. Axis II
- C. Axis III
- D. Axis IV
Correct Answer: D
Rationale: Rationale:
1. Axis I: Focuses on clinical disorders; Mrs. Green's experiences are not related to a specific mental disorder.
2. Axis II: Focuses on personality disorders and mental retardation; not applicable to Mrs. Green's situation.
3. Axis III: Focuses on general medical conditions; Mrs. Green's mother's cancer diagnosis falls under this axis.
4. Axis IV: Focuses on psychosocial and environmental stressors; Mrs. Green's trauma from her dog's death and mother's illness fits here.
During assessment, a patient tells the nurse that he follows Buddhist beliefs. The nurse would integrate understanding of which of the following when developing the patient’s plan of care?
- A. Desire is the cause of all human suffering and misery.
- B. Self-indulgence is necessary to reach nirvana.
- C. Present behavior is based on current unhappiness.
- D. Salvation is achieved through faith and humility.
Correct Answer: A
Rationale: The correct answer is A: Desire is the cause of all human suffering and misery. In Buddhism, it is believed that desire and attachment lead to suffering. By understanding this principle, the nurse can develop a plan of care that focuses on helping the patient let go of attachments and desires that may be causing distress. This approach aligns with Buddhist teachings of mindfulness and non-attachment, promoting overall well-being.
Choice B is incorrect because self-indulgence is not a concept in Buddhism, and nirvana is achieved through the cessation of desires, not indulging in them. Choice C is incorrect as Buddhism emphasizes the impermanence of all things, including happiness and unhappiness, rather than basing present behavior solely on current unhappiness. Choice D is incorrect because salvation in Buddhism is attained through one's own efforts, not through faith or humility in a higher power.