Nokea
A patient diagnosed with schizophrenia believes evil spirits are being summoned by a local minister and verbally threatens to bomb a local church. What principle governs the proper action in this situation?
- A. Need for authorization
- B. Duty to warn and protect
- C. Patient right to confidentiality
- D. Patient's right to self-actualization
Correct Answer: B
Rationale: The duty to warn protects potential victims, overriding confidentiality when threats are made.
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Which scenario is an example of a tort?
- A. The primary nurse completes the plan of care for a patient but takes a full 24 hours after the admission to do so.
- B. An advanced practice nurse recommends that a patient who has a history of danger to self and others be voluntarily hospitalized when reporting audio hallucinations.
- C. A patient's admission status is changed from involuntary to voluntary after the patient's hallucinations subside after medication is started.
- D. A nurse gives an as-needed dose of an antipsychotic drug to a patient to prevent any possible violence because the unit is short staffed.
Correct Answer: D
Rationale: Giving unnecessary medication for staff convenience is a tort, akin to false imprisonment, violating patient rights. The other scenarios do not involve rights violations.
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 patient should be considered for involuntary commitment for psychiatric care when demonstrating what behavior?
- A. Nonadherent with the treatment regimen.
- B. Sells and distributes illegal drugs.
- C. Threatens to harm self and others.
- D. Fraudulently files for bankruptcy.
Correct Answer: C
Rationale: Involuntary commitment is warranted for danger to self or others, as in threats of harm. Other behaviors, while problematic, do not meet this criterion.
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.
The spouse of a patient who experiences delusions asks the nurse, 'Are there any circumstances under which the treatment team is justified in violating the patient's right to confidentiality?' What is the nurse's best response?
- A. We can't violate that confidence under any circumstances.'
- B. We can do that only at the discretion of the psychiatrist.'
- C. We are obligated to answer questions asked by law enforcement.'
- D. We are not bound if the patient threatens the life of another person.'
Correct Answer: D
Rationale: The duty to warn overrides confidentiality when a patient threatens harm, as per legal standards.