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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.
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Which documentation of a patient's behavior best demonstrates a nurse's observations?
- A. Isolates self from others. Frequently fell asleep during group. Vital signs stable.
- B. Calmer and more cooperative. Participated actively in group. No evidence of psychotic thinking.
- C. Appeared to hallucinate. Patient frequently increased volume on television, causing conflict with others
- D. Wears four layers of clothing. States, 'I need protection from dangerous bacteria trying to penetrate my skin.'
Correct Answer: D
Rationale: Specific observations and direct quotes provide clear, objective documentation, unlike vague or subjective options.
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 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.
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.
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.