Which patient would the nurse determine to be the most likely a candidate for involuntary commitment?
- A. The client who refuses to take the prescribed medication
- B. The client who is screaming in the street disturbing neighbors
- C. The client who refuses to participate in the planned therapy
- D. The client with a mental disorder who is homeless
Correct Answer: B
Rationale: Involuntary commitment is warranted when a patient poses a danger to themselves or others or is gravely disabled due to mental illness. Screaming in the street and disturbing others suggests potential danger or severe impairment.
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The nurse is providing care to a male patient who is hospitalized with a diagnosis of schizophrenia. Which of the following would be appropriate for the nurse to include in the patient?s medical record?
- A. Patient states that he had a good night with no complaints.
- B. Complained of being unable to sleep because he heard voices throughout the night.
- C. Had a typical night without incidence of insomnia or nightmares.
- D. Acted crazily throughout the night; kept hearing voices and noises.
Correct Answer: B
Rationale: Documentation should be specific, objective, and reflect patient statements or symptoms, such as reporting inability to sleep due to hearing voices, which is relevant to schizophrenia. Terms like ?crazily? are unprofessional.
A psychiatric-mental health nurse determines that a patient is competent when he is able to do which of the following?
- A. Speak coherent English.
- B. Communicate his or her choices.
- C. Write a living will.
- D. Comply with the medical regimen.
Correct Answer: B
Rationale: Competency is determined by a patient?s ability to understand relevant information, appreciate their situation, and communicate choices effectively, not merely by language fluency, ability to write, or compliance.
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).
A psychiatric-mental health patient has an advance care directive on his medical record. A clinician provides treatment that disregards the patient?s directive. The clinician would be liable for which of the following?
- A. Assault
- B. Battery
- C. Medical battery
- D. False imprisonment
Correct Answer: C
Rationale: Disregarding an advance care directive and providing unauthorized treatment constitutes medical battery, a specific type of battery involving non-consensual medical intervention.
A group of nursing students are reviewing information about internal rights protection systems. The students demonstrate understanding of this information when they identify which of the following as an example?
- A. American Hospital Association
- B. American Public Health Association
- C. State mental health provider
- D. The Joint Commission
Correct Answer: D
Rationale: The Joint Commission is an example of an internal rights protection system, as it sets standards for patient rights and safety within healthcare facilities, including mental health settings.
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