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A group of students is reviewing the functions of psychiatric nurses. The students demonstrate understanding of the information when they identify which of the following as an advanced practice level function?
- A. Milieu therapy
- B. Promotion of self-care
- C. Psychopharmacology interventions
- D. Health promotion activities
Correct Answer: C
Rationale: Advanced practice psychiatric nurses have specialized training, often including prescriptive authority and expertise in managing medications. Psychopharmacology interventions, which involve prescribing and managing psychotropic medications, are specific to advanced practice roles. Milieu therapy, self-care promotion, and health promotion activities are typically within the scope of basic-level psychiatric nursing.
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A psychiatric nursing class is discussing current trends in mental health care. A student voices the opinion that there should be equitable access to mental health care and resources for those who live in rural areas, for those without health insurance, and for those with very little income. The student nurse?s opinion most closely reflects which ethical principle?
- A. Nonmaleficence
- B. Paternalism
- C. Veracity
- D. Justice
Correct Answer: D
Rationale: The ethical principle of justice emphasizes fairness and equitable distribution of resources and opportunities. The student?s opinion about equitable access to mental health care for underserved populations directly aligns with this principle. Nonmaleficence focuses on avoiding harm, paternalism involves making decisions for others, and veracity pertains to truthfulness, none of which fit as closely.
A nursing instructor is describing the impact of technology and electronic health records on psychiatric-mental health care. Which of the following would the instructor identify as a major challenge associated with it?
- A. Maintaining confidentiality
- B. Establishing educational models
- C. Decreasing fragmented care
- D. Defining professional standards more clearly
Correct Answer: A
Rationale: Electronic health records (EHRs) improve access to patient data but pose significant challenges in maintaining confidentiality due to risks of unauthorized access, data breaches, or improper sharing. This is a well-documented concern in psychiatric care, where sensitive mental health information requires stringent protection. The other options are less directly related to EHR challenges: educational models and professional standards are broader issues, and EHRs typically reduce fragmented care.
A nursing instructor has prepared a lecture about the scope and standards of practice of psychiatric nurses. The instructor determines that the teaching was effective when the students identify which of the following as common to both basic and advanced level practice?
- A. Case management
- B. Program development
- C. Clinical supervision
- D. Community interventions
Correct Answer: A
Rationale: Case management is a core function in psychiatric nursing, common to both basic and advanced practice levels, as it involves coordinating care to meet patient needs. Program development, clinical supervision, and community interventions are typically advanced practice functions, requiring specialized skills or leadership roles.
A nurse is faced with an ethical dilemma involving a patient. Which question would be most important for the nurse to ask first when engaging in the process of ethical decision making?
- A. What are my own feelings about the situation?
- B. What assumptions am I making that need more data?
- C. What do I know about the situation?
- D. What do I know about the patient?s values?
Correct Answer: C
Rationale: Ethical decision-making begins with gathering facts to understand the situation fully, making 'What do I know about the situation?' the most important first question. This ensures decisions are based on accurate information. While feelings, assumptions, and patient values are important, they are secondary to establishing the factual context.
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 patient?s refusal of medication reflects autonomy (self-determination), while the nurse?s insistence on medication to improve symptoms reflects beneficence (acting for the patient?s benefit). This creates an ethical conflict, as the nurse?s approach prioritizes the patient?s well-being over their right to choose. The other options do not accurately capture this dynamic: justice involves fairness, paternalism involves overriding autonomy, veracity involves truthfulness, and nonmaleficence involves avoiding harm.