A patient is involuntarily committed without a court order. The nurse understands that the emergency short-term hospitalization can occur for which time frame?
- A. A maximum of 24 hours
- B. 48 to 92 hours
- C. 3 to 5 days
- D. One week
Correct Answer: B
Rationale: Emergency short-term involuntary hospitalization, often under a psychiatric hold, typically lasts 48 to 72 hours (up to 92 hours in some jurisdictions) for evaluation, pending a court hearing.
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After teaching a class of nursing students about the rights of persons receiving mental health services, the instructor determines a need for additional instruction when the students identify which of the following as a right?
- A. Freedom from restraints or seclusion
- B. Access to one?s own mental health records on request
- C. An individualized written treatment plan
- D. Refuse treatment during an emergency situation
Correct Answer: D
Rationale: Patients have rights to freedom from unnecessary restraints, access to their mental health records, and an individualized treatment plan, but they cannot refuse treatment in emergencies if they pose a danger to themselves or others.
The nurse is providing care to a male patient who is hospitalized with a diagnosis of schizophrenia. Which of the following would be appropriate for the nurse to include in the patient?s medical record?
- A. Patient states that he had a good night with no complaints.
- B. Complained of being unable to sleep because he heard voices throughout the night.
- C. Had a typical night without incidence of insomnia or nightmares.
- D. Acted crazily throughout the night; kept hearing voices and noises.
Correct Answer: B
Rationale: Documentation should be specific, objective, and reflect patient statements or symptoms, such as reporting inability to sleep due to hearing voices, which is relevant to schizophrenia. Terms like ?crazily? are unprofessional.
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.
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 nurse working on the psychiatric unit receives a telephone call from the employer of one of the patients on the unit. The employer asks to be sent a copy of Mr. Murray?s latest laboratory work and psychological testing results so Mr. Murray?s medical records in employee health can be kept up to date. Based on the nurse?s knowledge about issues surrounding breach of confidentiality, which response would be the most appropriate?
- A. I?m sorry; we?re not allowed to give out that information about our patient.
- B. I?ll have to get the patient?s signed consent before we can send that information to you.
- C. I am unable to acknowledge whether or not a Mr. Murray is a patient on this unit.
- D. Sure, give me your address, and I will see that the information is sent to you.
Correct Answer: C
Rationale: Under HIPAA, nurses cannot confirm or deny a patient?s presence without consent, as this protects patient privacy. Acknowledging a patient?s presence or sharing records requires written authorization.
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