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After teaching a class about competency and how it is assessed, the nursing instructor determines the need for additional instruction when the class identifies which ability as being evaluated?
- A. Communication of choices
- B. Understanding of relevant information
- C. Appreciation for situation and consequences
- D. Discussion of what is right and wrong
Correct Answer: D
Rationale: Competency assessment evaluates the ability to communicate choices, understand relevant information, and appreciate the situation and consequences, not moral judgments about right and wrong.
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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 nursing instructor is preparing a class discussion on the topic of self-determinism. Which of the following would the instructor expect to include?
- A. Personal autonomy as a key value
- B. Choices based on pleasing others
- C. Activities reflect personal goals
- D. Right to refuse treatment
- E. Lack of empowerment
Correct Answer: A,C,D
Rationale: Self-determinism involves personal autonomy, activities reflecting personal goals, and the right to refuse treatment, emphasizing patient control over their healthcare decisions.
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 caring for a patient who is hospitalized for a mental disorder. The nurse is legally obligated to breach the patient?s confidentiality if the patient states which of the following?
- A. I think that the federal government is spying on me.
- B. I get really ?turned on? by your appearance.
- C. That doctor I had today really made me angry.
- D. When I get out of here, I?m going to kill my neighbor.
Correct Answer: D
Rationale: Nurses are legally obligated to breach confidentiality when there is a credible threat of harm to others, such as a statement of intent to kill someone, under the duty to warn (Tarasoff principle).
After teaching a class of nursing students about the rights of persons receiving mental health services, the instructor determines a need for additional instruction when the students identify which of the following as a right?
- A. Freedom from restraints or seclusion
- B. Access to one?s own mental health records on request
- C. An individualized written treatment plan
- D. Refuse treatment during an emergency situation
Correct Answer: D
Rationale: Patients have rights to freedom from unnecessary restraints, access to their mental health records, and an individualized treatment plan, but they cannot refuse treatment in emergencies if they pose a danger to themselves or others.