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What action by a nurse constitutes a breach of a patient's right to privacy?
- A. Asking a family to share information about a patient's prehospitalization behavior.
- B. Discussing the patient's history with other staff members during care planning.
- C. Documenting the patient's daily behaviors during hospitalization.
- D. Releasing unauthorized information to the patient's employer.
Correct Answer: D
Rationale: Releasing information without authorization violates privacy. Other actions are part of standard care.
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A nurse cares for an older adult patient admitted for treatment of depression. The health care provider prescribes an antidepressant medication, but the dose is more than the usual adult dose. The nurse is obligated to take what action?
- A. Implement the order as written but document the concern.
- B. Hold the medication and then notify the health care provider.
- C. Consult a drug reference if a pharmacist is not available.
- D. Give the usual geriatric dosage at the scheduled times.
Correct Answer: B
Rationale: Holding the medication and consulting the provider protects the patient, as geriatric doses are typically lower.
The family of a patient whose insurance will not pay for continuing hospitalization considers transferring the patient to a public psychiatric hospital. The family expresses concern that the patient will 'never get any treatment.' Which reply by the nurse would be most helpful?
- A. Under the law, treatment must be provided. Hospitalization without treatment violates patients' rights.'
- B. That's a justifiable concern because the right to treatment extends only to the provision of food, shelter, and safety.'
- C. Much will depend on other patients, because the right to treatment for a psychotic patient takes precedence over the right to treatment of a patient who is stable.'
- D. All patients in public hospitals have the right to choose both a primary therapist and a primary nurse.'
Correct Answer: A
Rationale: The 1964 Hospitalization of Mentally Ill Act ensures treatment rights in public hospitals, reassuring the family.
Which scenario is an example of a tort?
- A. The primary nurse completes the plan of care for a patient but takes a full 24 hours after the admission to do so.
- B. An advanced practice nurse recommends that a patient who has a history of danger to self and others be voluntarily hospitalized when reporting audio hallucinations.
- C. A patient's admission status is changed from involuntary to voluntary after the patient's hallucinations subside after medication is started.
- D. A nurse gives an as-needed dose of an antipsychotic drug to a patient to prevent any possible violence because the unit is short staffed.
Correct Answer: D
Rationale: Giving unnecessary medication for staff convenience is a tort, akin to false imprisonment, violating patient rights. The other scenarios do not involve rights violations.
Which individual diagnosed with a mental illness may need emergency or involuntary hospitalization for mental illness?
- A. The patient who resumes using heroin while still taking methadone.
- B. The patient who reports hearing angels playing harps during thunderstorms.
- C. The patient who throws a heavy plate at a waiter at the direction of command hallucinations.
- D. The patient who does not show up for an outpatient appointment with the mental health nurse.
Correct Answer: C
Rationale: Throwing a plate due to hallucinations indicates danger to others, justifying involuntary hospitalization.
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.