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Which nursing intervention demonstrates false imprisonment?
- A. A confused and combative patient says, 'I'm getting out of here and no one can stop me.' The nurse restrains this patient without a health care provider's order and then promptly obtains an order.
- B. A nurse escorts the patient down the hall, saying, 'Stay in your room or you'll be put in seclusion.'
- C. An involuntarily hospitalized patient with suicidal ideation runs out of the psychiatric unit. A nurse rushes after the patient and convinces the patient to return to the unit.
- D. An involuntarily hospitalized patient with suicidal ideation attempts to leave the unit. A nurse calls the security team uses established protocols to prevent the patient from leaving.
Correct Answer: B
Rationale: Threatening seclusion without justification creates fear of confinement, constituting false imprisonment. The other scenarios involve justified actions for patient safety or incompetence.
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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.
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.
In which situations does a nurse have a duty to intervene and report?
- A. A peer is unable to write behavioral outcomes.
- B. A health care provider consults the Physicians' Desk Reference.
- C. A peer tries to provide patient care in an alcohol-impaired state.
- D. A team member has violated the boundaries of a vulnerable patient.
- E. A patient refuses a medication prescribed by a licensed health care provider.
Correct Answer: C,D
Rationale: Impaired care and boundary violations jeopardize safety, requiring intervention. Other situations are less critical or acceptable.
A nurse's neighbor asks, 'Why aren't people with mental illness kept in state institutions anymore?' What is the nurse's best response?
- A. Many people are still in psychiatric institutions. Inpatient care is needed because many people who are mentally ill are violent.'
- B. Less restrictive settings are now available to care for individuals with mental illness.'
- C. Our nation has fewer persons with mental illness; therefore, fewer hospital beds are needed.'
- D. Psychiatric institutions are no longer popular as a consequence of negative stories in the press.'
Correct Answer: B
Rationale: Community-based, less restrictive settings are preferred for mental health care, reducing institutionalization. The other options perpetuate stigma or are factually incorrect.
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.