Nokea
A nurse volunteers for a committee that must revise the hospital policies and procedures for suicide precautions. Which resources would provide the best guidance?
- A. Diagnostic and Statistical Manual of Mental Disorders (fifth edition) (DSM-5)
- B. State's nurse practice act
- C. State and federal regulations that govern hospitals
- D. Summary of common practices of several local hospitals
- E. American Nurses Association Scope and Standards of Practice
Correct Answer: C,E
Rationale: Hospital regulations set minimum standards, and ANA standards elevate practice. DSM-5 and nurse practice acts are irrelevant, and local practices may not comply with best standards.
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After leaving work, a staff nurse realizes that documentation of the administration of a medication to a patient was omitted. This off-duty nurse telephones the unit and tells the nurse, 'Please document the administration of the medication I forgot to do. My password is alphal.' What action should the on-duty nurse take?
- A. Suggest the nurse return and document.
- B. Refer the matter to the charge nurse to resolve.
- C. Access the record and document the information.
- D. Report the request to the patient's health care provider.
Correct Answer: B
Rationale: Referring to the charge nurse ensures policy compliance and proper documentation without risking unauthorized access.
Several nurses are concerned that agency policies related to restraint and seclusion are inadequate. Which statement about the relationship of substandard institutional policies and individual nursing practice should guide nursing practice?
- A. The policies do not absolve an individual nurse of the responsibility to practice according to the professional standards of nursing care.
- B. Agency policies are the legal standard by which a professional nurse must act and therefore override other standards of care.
- C. In an institution with substandard policies, the nurse has a responsibility to inform the supervisor and leave the premises.
- D. Interpretation of policies by the judicial system is rendered on an individual basis and therefore cannot be predicted.
Correct Answer: A
Rationale: Nurses must uphold ANA standards, even if agency policies are substandard. Agency policies do not override professional standards, and leaving or judicial interpretation are not primary guides.
A patient diagnosed with mental illness asks a psychiatric technician, 'What's the matter with me?' The technician replies, 'Your wing nuts need tightening.' The nurse who overheard the exchange should take action based on what principle?
- A. Violation of the patient's right to be treated with dignity and respect
- B. The nurse's obligation to report caregiver negligence
- C. Preventing defamation of the patient's character
- D. Supervisory liability
Correct Answer: A
Rationale: The technician's response violates the patient's right to respectful treatment, constituting emotional abuse.
In which situations does a nurse have a duty to intervene and report?
- A. A peer is unable to write behavioral outcomes.
- B. A health care provider consults the Physicians' Desk Reference.
- C. A peer tries to provide patient care in an alcohol-impaired state.
- D. A team member has violated the boundaries of a vulnerable patient.
- E. A patient refuses a medication prescribed by a licensed health care provider.
Correct Answer: C,D
Rationale: Impaired care and boundary violations jeopardize safety, requiring intervention. Other situations are less critical or acceptable.
A nurse's neighbor asks, 'Why aren't people with mental illness kept in state institutions anymore?' What is the nurse's best response?
- A. Many people are still in psychiatric institutions. Inpatient care is needed because many people who are mentally ill are violent.'
- B. Less restrictive settings are now available to care for individuals with mental illness.'
- C. Our nation has fewer persons with mental illness; therefore, fewer hospital beds are needed.'
- D. Psychiatric institutions are no longer popular as a consequence of negative stories in the press.'
Correct Answer: B
Rationale: Community-based, less restrictive settings are preferred for mental health care, reducing institutionalization. The other options perpetuate stigma or are factually incorrect.