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A voluntarily hospitalized patient tells the nurse, 'Get me the forms I need to sign so I can leave this place now.' What is the nurse's best initial response?
- A. I can't give you those forms without your health care provider's knowledge.'
- B. I will get them for you, but let's talk about your decision to leave treatment.'
- C. Since you signed your consent for treatment, you may leave if you desire.'
- D. I'll get the forms for you right now and bring them to your room.'
Correct Answer: B
Rationale: Discussing the decision respects patient rights while advocating for their best interests. Immediate discharge without exploration may neglect underlying issues.
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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.
How does a psychiatric nurse best implement the ethical principle of autonomy?
- A. By intervening when a self-mutilating patient attempts to harm self.
- B. Staying with a patient who is demonstrating a high level of anxiety
- C. Suggesting that two patients who are fighting be restricted to the unit.
- D. Exploring alternative options with a patient, regarding medications.
Correct Answer: D
Rationale: Exploring options with the patient supports autonomy by enabling informed, self-determined decisions. Intervening with self-mutilation or staying with an anxious patient reflects beneficence and fidelity, while restricting fighting patients aligns with fidelity and justice.
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.
A nurse at the mental health center prepares to administer a scheduled injection of haloperidol decanoate to a patient diagnosed with schizophrenia. As the nurse swabs the site, the patient shouts, 'Stop! I don't want to take that medicine anymore. I hate the side effects.' Select the nurse's best initial action.
- A. Stop the medication administration procedure and say to the patient, 'Tell me more about the side effects you've been having.'
- B. Say to the patient, 'Since I've already drawn the medication in the syringe, I'm required to give it, but let's talk to the doctor about skipping next month's dose.'
- C. Proceed with the injection but explain to the patient that other medications are available that may help reduce the unpleasant side effects.
- D. Notify other staff members to report to the room for a show of force and proceed with the injection, using restraint if necessary.
Correct Answer: A
Rationale: Stopping to discuss side effects respects the patient's rights and autonomy, absent evidence of dangerousness. Forcing medication violates civil rights.