Nokea
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.
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Which patient would the nurse determine to be the most likely a candidate for involuntary commitment?
- A. The client who refuses to take the prescribed medication
- B. The client who is screaming in the street disturbing neighbors
- C. The client who refuses to participate in the planned therapy
- D. The client with a mental disorder who is homeless
Correct Answer: B
Rationale: Involuntary commitment is warranted when a patient poses a danger to themselves or others or is gravely disabled due to mental illness. Screaming in the street and disturbing others suggests potential danger or severe impairment.
A psychiatric-mental health patient has an advance care directive on his medical record. A clinician provides treatment that disregards the patient?s directive. The clinician would be liable for which of the following?
- A. Assault
- B. Battery
- C. Medical battery
- D. False imprisonment
Correct Answer: C
Rationale: Disregarding an advance care directive and providing unauthorized treatment constitutes medical battery, a specific type of battery involving non-consensual medical intervention.
A patient receives a court order for commitment. Which of the following best exemplifies the concept of least restrictive environment?
- A. Involuntary commitment to an outpatient community mental health center
- B. Medication administration for sedation so the patient cannot get out of bed
- C. Placing the patient in a locked padded room in response to threats of self-harm
- D. Allowing the patient to make the decision about whether treatment is necessary
Correct Answer: A
Rationale: The least restrictive environment principle requires that treatment occur in the least confining setting possible, such as outpatient community mental health care, unless more restrictive measures are necessary for safety.
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 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.