Nokea
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.
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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.
A nurse is explaining the distinction between confidentiality and privacy. Which of the following would the nurse include as reflecting privacy?
- A. Part of personal life not governed by society?s laws
- B. Ethical duty for nondisclosure
- C. Involvement of two individuals
- D. Knowledge of treatment costs and benefits
Correct Answer: A
Rationale: Privacy refers to an individual?s right to control personal information and aspects of their life not governed by laws, whereas confidentiality is the ethical and legal duty to protect disclosed information.
A patient is going to be discharged this afternoon from the mental health unit. The patient asks the nurse if a copy of his medical record could be sent to the psychologist he will be seeing on an outpatient basis. Which response by the nurse would be most appropriate?
- A. Sure, we?ll have that information sent out in today?s mail.
- B. You will need to sign written authorization for us before we can do this.
- C. I think it would just be best if you just told your psychologist everything he needs to know.
- D. How are you feeling about being discharged this afternoon?
Correct Answer: B
Rationale: HIPAA requires written patient authorization to release medical records to another provider, ensuring confidentiality and patient control over their health information.
A group of students are preparing a class presentation about negligence. Which of the following would the group include as an element required for proving negligence?
- A. Duty to provide care
- B. Proximate cause
- C. Resultant damages
- D. Breach of duty
- E. Cause in fact
- F. Evidence of mistake
Correct Answer: A,B,C,D,E
Rationale: Proving negligence requires establishing a duty to provide care, breach of that duty, cause in fact (the breach caused harm), proximate cause (the harm was foreseeable), and resultant damages.
A psychiatric-mental health nurse is documenting information in a patient?s medical record. Which of the following would be least likely to increase the nurse?s legal liability?
- A. Patient reported that he was feeling better today than yesterday.
- B. Administered haloperidol 10 mg IM stat as ordered for agitation.
- C. Patient was talking with another staff member and started screaming.
- D. Applied restraints to all four patient extremities.
Correct Answer: A
Rationale: Documenting a patient?s subjective report of feeling better is factual and low-risk, whereas administering medication, describing behavior, or applying restraints carries higher legal risk if not properly justified or executed.