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A nurse is explaining the distinction between confidentiality and privacy. Which of the following would the nurse include as reflecting privacy?
- A. Part of personal life not governed by society?s laws
- B. Ethical duty for nondisclosure
- C. Involvement of two individuals
- D. Knowledge of treatment costs and benefits
Correct Answer: A
Rationale: Privacy refers to an individual?s right to control personal information and aspects of their life not governed by laws, whereas confidentiality is the ethical and legal duty to protect disclosed information.
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A patient?s psychiatrist informs her that he thinks she needs to participate in a 3-month outpatient aftercare program after her discharge. Which of the following would protect the patient?s right to request a second opinion before agreeing to this suggestion?
- A. Self-determinism
- B. Least restrictive environment
- C. Confidentiality
- D. Mandates to inform
Correct Answer: A
Rationale: Self-determinism refers to a patient?s right to make autonomous decisions about their treatment, including seeking a second opinion before agreeing to a recommended treatment plan.
After teaching a class about competency and how it is assessed, the nursing instructor determines the need for additional instruction when the class identifies which ability as being evaluated?
- A. Communication of choices
- B. Understanding of relevant information
- C. Appreciation for situation and consequences
- D. Discussion of what is right and wrong
Correct Answer: D
Rationale: Competency assessment evaluates the ability to communicate choices, understand relevant information, and appreciate the situation and consequences, not moral judgments about right and wrong.
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).
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.