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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: Nurses are legally obligated to breach confidentiality when there is a credible threat of harm to others, such as a statement of intent to kill someone, under the duty to warn (Tarasoff principle).
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A psychiatric-mental health nurse determines that a patient is competent when he is able to do which of the following?
- A. Speak coherent English.
- B. Communicate his or her choices.
- C. Write a living will.
- D. Comply with the medical regimen.
Correct Answer: B
Rationale: Competency is determined by a patient?s ability to understand relevant information, appreciate their situation, and communicate choices effectively, not merely by language fluency, ability to write, or compliance.
A nursing instructor is preparing a class discussion on the topic of self-determinism. Which of the following would the instructor expect to include?
- A. Personal autonomy as a key value
- B. Choices based on pleasing others
- C. Activities reflect personal goals
- D. Right to refuse treatment
- E. Lack of empowerment
Correct Answer: A,C,D
Rationale: Self-determinism involves personal autonomy, activities reflecting personal goals, and the right to refuse treatment, emphasizing patient control over their healthcare decisions.
A nurse is explaining advance care directives, or living wills, to a patient and the ascendancy spouse. Which of the following would the nurse include in the description?
- A. The document tells what treatment is to be omitted if the patient is unable to make the decision.
- B. It requires that the patient sign the living will document while an attorney is present.
- C. The patient?s physician must act as a witness when the patient signs the document.
- D. An attorney draws up the papers to be given to the patient and his or her family.
Correct Answer: A
Rationale: An advance care directive, or living will, specifies a patient?s preferences for medical treatment, including what treatments to omit, in cases where they are unable to make decisions due to incapacity.
A group of students are preparing a class presentation about negligence. Which of the following would the group include as an element required for proving negligence?
- A. Duty to provide care
- B. Proximate cause
- C. Resultant damages
- D. Breach of duty
- E. Cause in fact
- F. Evidence of mistake
Correct Answer: A,B,C,D,E
Rationale: Proving negligence requires establishing a duty to provide care, breach of that duty, cause in fact (the breach caused harm), proximate cause (the harm was foreseeable), and resultant damages.
A psychiatric-mental health nurse is documenting information in a patient?s medical record. Which of the following would be least likely to increase the nurse?s legal liability?
- A. Patient reported that he was feeling better today than yesterday.
- B. Administered haloperidol 10 mg IM stat as ordered for agitation.
- C. Patient was talking with another staff member and started screaming.
- D. Applied restraints to all four patient extremities.
Correct Answer: A
Rationale: Documenting a patient?s subjective report of feeling better is factual and low-risk, whereas administering medication, describing behavior, or applying restraints carries higher legal risk if not properly justified or executed.