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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.
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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.
Which situations qualify as abandonment on the part of a nurse?
- A. The nurse allows a patient with acute mania to refuse hospitalization without taking further action.
- B. The nurse terminates employment without referring a seriously mentally ill patient for aftercare.
- C. The nurse calls police to bring a suicidal patient to the hospital after a suicide attempt.
- D. The nurse refers a patient with persistent paranoid schizophrenia to community treatment.
- E. The nurse asks another nurse to provide a patient's care because of concerns about countertransference.
Correct Answer: A,B
Rationale: Failing to ensure continued care for acutely ill patients constitutes abandonment. Other actions provide for patient safety or self-awareness.
A patient diagnosed with schizophrenia believes evil spirits are being summoned by a local minister and verbally threatens to bomb a local church. What principle governs the proper action in this situation?
- A. Need for authorization
- B. Duty to warn and protect
- C. Patient right to confidentiality
- D. Patient's right to self-actualization
Correct Answer: B
Rationale: The duty to warn protects potential victims, overriding confidentiality when threats are made.
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.
A patient being treated in an alcohol rehabilitation unit reveals to the nurse, 'I feel terrible guilt for sexually abusing my 6-year-old child before I was admitted.' Based on state and federal law, what action is the nurse expected to take?
- A. Anonymously report the abuse by telephone to the local child abuse hotline.
- B. Replying, 'I'm glad you feel comfortable talking to me about it.'
- C. Respecting the nurse-patient relationship of confidentiality.
- D. Filing a written report on the agency letterhead.
Correct Answer: A
Rationale: Federal law allows anonymous reporting of child abuse in treatment settings, balancing confidentiality and legal obligations.