Nokea
A psychiatric-mental health nurse determines that a patient is competent when he is able to do which of the following?
- A. Speak coherent English.
- B. Communicate his or her choices.
- C. Write a living will.
- D. Comply with the medical regimen.
Correct Answer: B
Rationale: Competency is determined by a patient?s ability to understand relevant information, appreciate their situation, and communicate choices effectively, not merely by language fluency, ability to write, or compliance.
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A nurse is explaining advance care directives, or living wills, to a patient and the ascendancy spouse. Which of the following would the nurse include in the description?
- A. The document tells what treatment is to be omitted if the patient is unable to make the decision.
- B. It requires that the patient sign the living will document while an attorney is present.
- C. The patient?s physician must act as a witness when the patient signs the document.
- D. An attorney draws up the papers to be given to the patient and his or her family.
Correct Answer: A
Rationale: An advance care directive, or living will, specifies a patient?s preferences for medical treatment, including what treatments to omit, in cases where they are unable to make decisions due to incapacity.
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.
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 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.
A group of nursing students are reviewing information about internal rights protection systems. The students demonstrate understanding of this information when they identify which of the following as an example?
- A. American Hospital Association
- B. American Public Health Association
- C. State mental health provider
- D. The Joint Commission
Correct Answer: D
Rationale: The Joint Commission is an example of an internal rights protection system, as it sets standards for patient rights and safety within healthcare facilities, including mental health settings.