Nokea
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.
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In a team meeting, a nurse says, 'I'm concerned whether we are behaving ethically by using restraint to prevent one patient from self-mutilation while the care plan for another patient who has also self-mutilated calls for one-on-one supervision.' Which ethical principle most clearly applies to this situation?
- A. Beneficence
- B. Autonomy
- C. Fidelity
- D. Justice
Correct Answer: D
Rationale: The nurse's concern about differing treatments for similar behaviors reflects justice, ensuring fair and equitable care. Beneficence promotes good, autonomy supports self-determination, and fidelity upholds loyalty.
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.
After leaving work, a staff nurse realizes that documentation of the administration of a medication to a patient was omitted. This off-duty nurse telephones the unit and tells the nurse, 'Please document the administration of the medication I forgot to do. My password is alphal.' What action should the on-duty nurse take?
- A. Suggest the nurse return and document.
- B. Refer the matter to the charge nurse to resolve.
- C. Access the record and document the information.
- D. Report the request to the patient's health care provider.
Correct Answer: B
Rationale: Referring to the charge nurse ensures policy compliance and proper documentation without risking unauthorized access.
In which situations does a nurse have a duty to intervene and report?
- A. A peer is unable to write behavioral outcomes.
- B. A health care provider consults the Physicians' Desk Reference.
- C. A peer tries to provide patient care in an alcohol-impaired state.
- D. A team member has violated the boundaries of a vulnerable patient.
- E. A patient refuses a medication prescribed by a licensed health care provider.
Correct Answer: C,D
Rationale: Impaired care and boundary violations jeopardize safety, requiring intervention. Other situations are less critical or acceptable.
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.