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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.
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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 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.
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.
Which action by a psychiatric nurse best supports a patient's right to be treated with dignity and respect?
- A. Consistently addressing a patient by title and surname
- B. Strongly encouraging a patient to participate in the unit milieu
- C. Discussing a patient's condition with another health care provider in the elevator
- D. Informing a treatment team that a patient is too drowsy to participate in care planning
Correct Answer: A
Rationale: Addressing a patient by title and surname shows respect. Discussing a patient's condition in an elevator breaches confidentiality, informing the team about drowsiness violates autonomy, and encouraging participation reflects beneficence and fidelity.
An adolescent hospitalized after a violent physical outburst tells the nurse, 'I'm going to kill my father, but I know you can't tell anyone.' What is the nurse's best response?
- A. You're right. Federal law requires me to keep that information private.'
- B. Those kinds of thoughts will make your hospitalization even longer.'
- C. You really should share these kinds of thoughts with your psychiatrist.'
- D. I am required to share information like this with your treatment team.'
Correct Answer: D
Rationale: Threats of harm must be shared with the treatment team to ensure safety, overriding confidentiality.