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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.
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Which situations qualify as abandonment on the part of a nurse?
- A. The nurse allows a patient with acute mania to refuse hospitalization without taking further action.
- B. The nurse terminates employment without referring a seriously mentally ill patient for aftercare.
- C. The nurse calls police to bring a suicidal patient to the hospital after a suicide attempt.
- D. The nurse refers a patient with persistent paranoid schizophrenia to community treatment.
- E. The nurse asks another nurse to provide a patient's care because of concerns about countertransference.
Correct Answer: A,B
Rationale: Failing to ensure continued care for acutely ill patients constitutes abandonment. Other actions provide for patient safety or self-awareness.
A newly admitted patient who is acutely psychotic is a private patient of the senior psychiatrist. To whom does the psychiatric nurse who is assigned to this patient owe the duty of care?
- A. Health care provider
- B. Profession
- C. Hospital
- D. Patient
Correct Answer: D
Rationale: The primary duty of care is owed to the patient, despite accountability to others.
A nurse at the mental health center prepares to administer a scheduled injection of haloperidol decanoate to a patient diagnosed with schizophrenia. As the nurse swabs the site, the patient shouts, 'Stop! I don't want to take that medicine anymore. I hate the side effects.' Select the nurse's best initial action.
- A. Stop the medication administration procedure and say to the patient, 'Tell me more about the side effects you've been having.'
- B. Say to the patient, 'Since I've already drawn the medication in the syringe, I'm required to give it, but let's talk to the doctor about skipping next month's dose.'
- C. Proceed with the injection but explain to the patient that other medications are available that may help reduce the unpleasant side effects.
- D. Notify other staff members to report to the room for a show of force and proceed with the injection, using restraint if necessary.
Correct Answer: A
Rationale: Stopping to discuss side effects respects the patient's rights and autonomy, absent evidence of dangerousness. Forcing medication violates civil rights.
A nurse cares for an older adult patient admitted for treatment of depression. The health care provider prescribes an antidepressant medication, but the dose is more than the usual adult dose. The nurse is obligated to take what action?
- A. Implement the order as written but document the concern.
- B. Hold the medication and then notify the health care provider.
- C. Consult a drug reference if a pharmacist is not available.
- D. Give the usual geriatric dosage at the scheduled times.
Correct Answer: B
Rationale: Holding the medication and consulting the provider protects the patient, as geriatric doses are typically lower.
An adolescent hospitalized after a violent physical outburst tells the nurse, 'I'm going to kill my father, but I know you can't tell anyone.' What is the nurse's best response?
- A. You're right. Federal law requires me to keep that information private.'
- B. Those kinds of thoughts will make your hospitalization even longer.'
- C. You really should share these kinds of thoughts with your psychiatrist.'
- D. I am required to share information like this with your treatment team.'
Correct Answer: D
Rationale: Threats of harm must be shared with the treatment team to ensure safety, overriding confidentiality.