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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.
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A psychiatric-mental health nurse is adhering to the standards of practice. When engaging in clinical decision making, the nurse is integrating which of the following as the foundation?
- A. Developmental issues
- B. Nursing process
- C. Commitment
- D. Accountability
Correct Answer: B
Rationale: The nursing process (assessment, diagnosis, planning, implementation, evaluation) is the foundational framework for clinical decision-making in psychiatric-mental health nursing, ensuring systematic and evidence-based care. Developmental issues inform care but are not the foundation, while commitment and accountability are professional qualities, not decision-making frameworks.
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.
A nursing student is initiating a relationship with an assigned patient. After meeting and spending approximately 20 minutes talking with the patient, the student makes arrangements to visit again after lunch. After lunch, fellow classmates invite the student to go to the gym with them and a group of patients to play volleyball. The student starts to go with them but then remembers the promise to meet with the patient. The student decides to stay behind and talk to with her patient. The student?s decision reflects which ethical principle?
- A. Autonomy
- B. Beneficence
- C. Fidelity
- D. Veracity
Correct Answer: C
Rationale: Fidelity refers to keeping promises and maintaining loyalty to commitments. By choosing to honor the promise to meet with the patient instead of joining the volleyball game, the student demonstrates fidelity. Autonomy relates to respecting the patient?s decision-making, beneficence involves promoting well-being, and veracity pertains to truthfulness, none of which are as directly relevant.
A nurse is engaged in exercises to develop self-awareness. The nurse is using which tool?
- A. Interdisciplinary care
- B. Reflection
- C. Plan of care
- D. Clinical reasoning
Correct Answer: B
Rationale: Reflection is the process of introspection and self-examination, which is essential for developing self-awareness in nursing. Interdisciplinary care involves collaboration, a plan of care is a structured approach to patient care, and clinical reasoning is a cognitive process for decision-making, none of which directly target self-awareness.
When applying the biopsychosocial model to client care, the nurse integrates the psychological domain when involved with which of the following?
- A. Behavior therapy
- B. Family support
- C. Nutritional therapy
- D. Sleep hygiene measures
Correct Answer: A
Rationale: The biopsychosocial model integrates biological, psychological, and social domains. The psychological domain focuses on mental processes, emotions, and behaviors. Behavior therapy directly addresses psychological aspects by modifying maladaptive behaviors and thought patterns, making it the correct choice. Family support relates to the social domain, while nutritional therapy and sleep hygiene measures primarily address the biological domain.