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Foundations of Mental Health Care 4e by Morrison-Valfre Test Bank
Morrison-Valfre: Foundations of Mental Health Care, 4th Edition
Test Bank
Chapter 1: The History of Mental Health Care
MULTIPLE CHOICE
a. | Freud |
b. | Pinel |
c. | Fisher |
d. | Rush |
ANS: A
Sigmund Freud believed that mental illness was, in part, caused by forces both within and outside the personality. Philippe Pinel advocated acceptance of mentally ill individuals as human beings in need of medical assistance. Alice Fisher was a Florence Nightingale nurse who cared for the mentally ill, and Dr. Benjamin Rush was the author of the book, Diseases of the Mind.
DIF: Cognitive Level: Comprehension REF: Page 5 | Page 6
OBJ: 2 TOP: Early Years of Mental Health
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
a. | Confused |
b. | Disoriented |
c. | Mentally healthy |
d. | Mentally ill |
ANS: D
Mentally ill individuals cannot perform activities of daily living easily, nor do they have good judgment or perceive things realistically. Confused and disoriented people differ from mentally ill people in that they typically are not oriented to who they are, where they are, or the general time frame. Mentally healthy individuals are able to perform activities of daily living, to problem solve, and to adapt to change, and they are in touch with reality.
DIF: Cognitive Level: Comprehension REF: Page 1 OBJ: 1
TOP: Mental Illness KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
a. | Classifications |
b. | Diagnosing |
c. | Treatment |
d. | Education |
ANS: A
Classification of abnormal behaviors did not begin until this time, after the practice of more accurate recording of behaviors was begun. Diagnoses, treatment guidelines, and any education regarding mental health disorders were not available during this period.
DIF: Cognitive Level: Knowledge REF: Page 3 OBJ: 3
TOP: Mental Illness During the Renaissance
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
a. | Dix |
b. | Beers |
c. | Pinel |
d. | Carter |
ANS: C
Philippe Pinel advocated acceptance of the mentally ill, as well as proper treatment. Dorothea Dix crusaded for construction of mental health hospitals. Clifford Beers wrote the book, A Mind That Found Itself. President Jimmy Carter established the Presidents Commission on Mental Health in 1978.
DIF: Cognitive Level: Knowledge REF: Page 4 OBJ: 4
TOP: Mental Illness in the Eighteenth Century
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
a. | Sigmund Freud |
b. | John Cade |
c. | Florence Nightingale |
d. | Dorothea Dix |
ANS: D
Dorothea Dix spent 20 years surveying facilities that housed mentally ill individuals and is credited with major changes in the care of the mentally ill. Sigmund Freud introduced the concept of psychoanalysis, John Cade discovered lithium carbonate for the treatment of bipolar disorder, and Florence Nightingale trained nurses in England in the 1800s.
DIF: Cognitive Level: Knowledge REF: Page 5 OBJ: 4
TOP: Mental Illness in the Nineteenth Century
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
a. | Early detection of symptoms of mental illness |
b. | Education of caregivers |
c. | Current treatment options |
d. | Removing the stigma attached to mental illness |
ANS: D
Clifford Beers book reflected on his attempt at suicide followed by the deplorable care he received for the next 3 years in mental hospitals. Beers work and book raised the consciousness of people throughout the country regarding prevention and removal of the stigma of having a mental illness. Early detection of symptoms, education of caregivers, and current treatment options regarding mental illness were not the focus of his book, nor were they a priority for the Committee for Mental Hygiene.
DIF: Cognitive Level: Knowledge REF: Page 5 OBJ: 4
TOP: Mental Illness in the Twentieth Century
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
a. | Psychoanalysis |
b. | Insanity |
c. | Lunacy |
d. | Mental illness |
ANS: A
Psychoanalysis is the observation of and theory behind how mental illness occurs. Insanity, lunacy, and mental illness are terms that are considered synonyms.
DIF: Cognitive Level: Knowledge REF: Page 5 OBJ: 5
TOP: Mental Illness in the Twentieth Century
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
a. | Electroconvulsive therapy |
b. | Insulin therapy |
c. | Humoral therapy |
d. | Amphetamine therapy |
ANS: B
Insulin therapy was believed to successfully treat schizophrenia in the early 1900s. Amphetamines were used to treat depression, and electroconvulsive therapy was used for severe depression. Humoral therapy, which originated in ancient Greece and Rome, was a belief that mental illness resulted from an imbalance of the humors of air, fire, water, and earth.
DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 5
TOP: Influences of War on Mental Health Therapies
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
a. | Schizophrenia |
b. | Bipolar disorder |
c. | Severe depression |
d. | Violent behavior |
ANS: C
ECT was found to be an effective treatment for severe depression in the 1930s. During this period, schizophrenia was treated with insulin therapy, and violent behavior was treated with a lobotomy. In 1949, lithium carbonate was discovered as a treatment for bipolar disorder.
DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 5
TOP: Influences of War on Mental Health Therapies
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
a. | A procedure that delivers an electrical stimulus to the frontal lobes of the brain |
b. | A surgical procedure that drills holes in the front of the skull to drain fluid |
c. | A surgical procedure that severs the frontal lobes of the brain from the thalamus |
d. | A surgical procedure that inserts implants into the frontal lobes of the brain |
ANS: C
A frontal lobotomy is a surgical procedure in which the frontal lobes of the brain are severed from the thalamus.
DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 5
TOP: Influences of War on Mental Health Therapies
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
a. | SSRIs |
b. | Tricyclic antidepressants |
c. | MAOIs |
d. | Amphetamines |
ANS: D
In the 1930s, amphetamines were found to boost the spirits of depressed people. SSRIs, tricyclic antidepressants, and MAOIs are antidepressant agents, but they were not discovered until much later.
DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 5
TOP: Influences of War on Mental Health Therapies
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
a. | Research on drugs for the treatment of mental health disorders |
b. | Training of mental health professionals |
c. | Construction of psychiatric units in facilities throughout North America |
d. | Development of community mental health clinics |
ANS: C
The Hill-Burton Act provided money for the construction of psychiatric units in the United States. Research on drugs was not a part of the Hill-Burton Act. Training of mental health professionals was funded by the National Mental Health Act of 1946, and community mental health centers were not instituted until the 1960s.
DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 5 | 9
TOP: Influences of War on Mental Health Therapies
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
a. | Development of mental health clinics in the community |
b. | Training of mental health professionals |
c. | Treatment for veterans suffering from mental health disorders |
d. | Educating the public about mental illness |
ANS: B
The National Mental Health Act of 1946 provided much needed training for individuals who cared for patients with mental health disorders. Community mental health clinics were initiated in the 1960s, treatment for veterans was not funded by this act, and education of the public occurred later.
DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 5 | 9
TOP: Influences of War on Mental Health Therapies
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
a. | Depression |
b. | Bipolar disorder |
c. | Posttraumatic stress disorder |
d. | Paranoid schizophrenic disorder |
ANS: C
Posttraumatic stress disorder was initially discovered in veterans who had been involved in armed conflicts. The other disorders also occur in veterans but were not first recognized in soldiers who were fighting wars.
DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 5
TOP: Influences of War on Mental Health Therapies
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
a. | Psychotherapeutic drugs |
b. | Community mental health clinics |
c. | Residential treatment centers |
d. | State mental health facilities |
ANS: A
Psychotherapeutic drugs allowed for better control of behaviors than did other therapies alone during the 1950s. Patients were being released from state mental health facilities as a result of psychotherapeutic drug therapy, and community mental health clinics and residential treatment centers resulted from the deinstitutionalization of patients.
DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 6
TOP: Introduction of Psychotherapeutic Drugs
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
a. | Insulin therapy |
b. | Water/ice therapy |
c. | Lithium carbonate therapy |
d. | Electroconvulsive therapy |
ANS: C
To this day, lithium is a treatment that is used to effectively balance the manic states and depressive states of bipolar disorder. None of the other therapies listed are effective for bipolar disorder.
DIF: Cognitive Level: Knowledge REF: Page 6 OBJ: 6
TOP: Introduction of Psychotherapeutic Drugs
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
a. | Psychotherapeutic drugs |
b. | State mental health care systems |
c. | Community mental health centers |
d. | Deinstitutionalization of patients |
ANS: C
The emergence of community mental health centers was necessary, in part because of the massive deinstitutionalization of patients from state mental health care facilities after the introduction of psychotherapeutic drugs in the 1950s.
DIF: Cognitive Level: Knowledge REF: Page 7 OBJ: 7
TOP: Introduction of Psychotherapeutic Drugs
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
a. | Election of a new president |
b. | Appointment of a new Surgeon General |
c. | Rapid expansion of community centers |
d. | National Alliance for Mental Illness (NAMI) surveys |
ANS: A
The election of a new president and his administration led to drastic cuts in federal funding for mental health programs. None of the other three choices were a part of the Mental Health Systems Act of 1980.
DIF: Cognitive Level: Knowledge REF: Page 7 OBJ: 9
TOP: Congressional Actions KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
a. | Nursing homes |
b. | State mental health facilities |
c. | Residential treatment centers |
d. | Homeless shelters |
ANS: A
Many mentally ill, especially elderly, people were inappropriately placed in nursing homes with personnel who were not trained to care for these people. OBRA prevented this practice. State mental health facilities, residential treatment centers, and homeless shelters were not addressed in the OBRA of 1987.
DIF: Cognitive Level: Knowledge REF: Page 7 OBJ: 9
TOP: Congressional Actions KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
a. | Withdrew |
b. | Increased |
c. | Decreased |
d. | Added |
ANS: A
Unfortunately, insurance companies followed the trend of the national government to the point of actually dropping coverage for psychiatric care.
DIF: Cognitive Level: Knowledge REF: Page 7 OBJ: 9
TOP: Congressional Actions KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
a. | A |
b. | B |
c. | C |
d. | D |
ANS: D
The NAMI gave a grade of D to the mental health care system based on poor funding, limited availability of care, and patients lack of access to mental health care.
DIF: Cognitive Level: Knowledge REF: Page 7 OBJ: 9
TOP: Congressional Actions KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
a. | Imbalance of fundamental elements |
b. | Possession by the devil |
c. | Rational soul controlling the irrational soul |
d. | Chemical imbalances within the body |
ANS: B
The belief that mental illness occurred as the result of possession by the devil accounted for the need for demonical exorcisms during the Middle Ages. Theories on an imbalance of fundamental elements and beliefs involving the rational and irrational soul were popular in ancient Greece and Rome. Chemical imbalance was determined to be a cause of some mental illness in more recent times.
DIF: Cognitive Level: Knowledge REF: Page 2 OBJ: 2 | 3
TOP: Mental Illness in the Dark Ages KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
COMPLETION
ANS:
Bedlam
Bedlam was the nickname for Bethlehem Hospital, which prevented burning of mentally ill people at the stake but provided poor care for the mentally ill.
DIF: Cognitive Level: Knowledge REF: Page 3 OBJ: 3
TOP: Mental Illness in the Middle Ages KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
MULTIPLE RESPONSE
a. | Kindness |
b. | Clean conditions |
c. | Good air, lighting, and food |
d. | Proper administration of psychotherapeutic drugs |
ANS: A, B, C
Dr. Rush advocated all of these conditions. Psychotherapeutic drugs were not introduced until the 1950s.
DIF: Cognitive Level: Knowledge REF: Page 4 OBJ: 4
TOP: Mental Illness in the Nineteenth Century
KEY: Nursing Process Step: Assessment MSC: Client Needs: Psychosocial Integrity
a. | Avoid stressors during activities of daily living |
b. | Respond to stress with effective behaviors |
c. | Develop effective coping mechanisms |
d. | Set realistic goals for themselves |
ANS: B, C, D
A mentally healthy individual responds effectively to stress, is able to develop coping mechanisms in response to stress, and can set realistic goals in his life while continually fluctuating between states of wellness and illness. No one can avoid stressors, but how one responds to stressors is an important part of mental health.
DIF: Cognitive Level: Comprehension REF: Page 1 OBJ: 1
TOP: Mental Health KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
Morrison-Valfre: Foundations of Mental Health Care, 4th Edition
Test Bank
Chapter 3: Ethical and Legal Issues
MULTIPLE CHOICE
a. | Moralizing |
b. | Modeling |
c. | Reward-punishment |
d. | Laissez-faire |
ANS: B
Modeling best describes how the teenage client developed this value because his parents not only discussed this issue but behaved in a way for the teen to copy. Moralizing sets standards of right and wrong with no choices allowed; the reward-punishment model rewards valued behavior and punishes undesired behavior; and the laissez-faire model imposes no restriction or direction on choices.
DIF: Cognitive Level: Application REF: Page 20 OBJ: 1
TOP: Acquiring Values KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity
a. | Values clarification |
b. | Nurses rights |
c. | Beliefs |
d. | Morals |
ANS: A
Values clarification consists of the steps of choosing, prizing, and acting. This most accurately describes how the nurse made the proper decision. The nurse chose the best action, reaffirmed the choice, and then enacted the choice. The nurses rights were not violated, and beliefs and morals do not describe the entire decision-making process that occurred.
DIF: Cognitive Level: Application REF: Page 20 OBJ: 1
TOP: Values Clarification KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
a. | Confidentiality of records |
b. | Freedom from restraint or seclusion |
c. | Humane treatment environment |
d. | Referral to other mental health providers on discharge |
ANS: B
A client could lose the right of freedom from restraint or seclusion in emergency situations, such as being a threat to himself or others. The other rights must be upheld at all times.
DIF: Cognitive Level: Knowledge REF: Page 21 OBJ: 2
TOP: Client Rights KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
a. | Include coverage for mental illness |
b. | Include coverage for substance abuse treatment |
c. | Include coverage for mental illness that is equal to coverage for physical illness |
d. | Include coverage for outpatient therapy for individuals with substance abuse |
ANS: C
The mental health parity laws require insurance companies to include coverage for mental illness that is equal to coverage for physical illness. Only nine states include treatment for substance abuse in their parity laws.
DIF: Cognitive Level: Knowledge REF: Page 21 OBJ: 2
TOP: Client Rights KEY: Nursing Process Step: Assessment
MSC: Client Needs: Safe and Effective Care Environment
a. | Fair pay |
b. | Fair benefits from employers |
c. | Refuse to care for individuals who may cause harm to the care provider |
d. | Respect as individuals |
ANS: D
In addition to the right to respect as individuals, the rights of the care provider include the rights to safety, competent assistance, set standards for quality and development of policies that affect client care, and full and equal participation as a member of the health care team. Fair pay and benefits are not addressed by care provider rights. A care provider has the right to safety but cannot refuse to care for an individual because he may fear harm from the client. Proper safety measures must be implemented.
DIF: Cognitive Level: Knowledge REF: Page 21 OBJ: 1
TOP: Care Provider Rights KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Safe and Effective Care Environment
a. | Rights |
b. | Morals |
c. | Nonmaleficence |
d. | Prudence |
ANS: C
Nonmaleficence is the fourth main concept of the Nurses Code of Ethics. The concept is that the nurse must do no harm to the client. Rights are a power or privilege that a person has just claim to, morals are a persons belief regarding what is right or wrong, and prudence refers to the ability to judge between virtuous and vicious actions.
DIF: Cognitive Level: Knowledge REF: Page 21 OBJ: 3
TOP: Ethical Principles KEY: Nursing Process Step: Assessment
MSC: Client Needs: Safe and Effective Care Environment
a. | Fidelity |
b. | Veracity |
c. | Confidentiality |
d. | Justice |
ANS: A
Fidelity refers to the obligation to keep ones word. The nurse violated this principle in this situation, which leads to mistrust from the client. Veracity is the duty to tell the truth, confidentiality is the duty of keeping the clients information private, and justice indicates that all clients must be treated fairly, equally, and respectfully.
DIF: Cognitive Level: Application REF: Page 22 OBJ: 3
TOP: Ethical Principles KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
a. | A moral dilemma |
b. | Value clarification |
c. | An ethical conflict |
d. | A breach of confidentiality |
ANS: C
This is an example of an ethical conflict or ethical dilemma. The nurse wants to help both clients but must maintain confidentiality for each. Use of guidelines for ethical decision making can assist the nurse in making an ethical decision. A moral dilemma is simply a dilemma associated with making a decision between right and wrong. Value clarification is a process that helps to identify an individuals values.
DIF: Cognitive Level: Application REF: Page 22 | Page 23
OBJ: 3 TOP: Ethical Conflict
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
a. | National nurse practice act |
b. | State nurse practice act |
c. | Regional nurse practice act |
d. | Community nurse practice act |
ANS: B
Each states board of nursing determines the scope of practice in that state through a series of regulations that are called nurse practice acts. It is the nurses responsibility to know his or her scope of practice. The other options do not exist.
DIF: Cognitive Level: Comprehension REF: Page 23 OBJ: 4
TOP: Legal Concepts in Health Care KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
a. | Call the physician to ask for clarification |
b. | Check the states nurse practice act again |
c. | Contact the nursing supervisor for approval to carry out the treatment |
d. | Refer to the facilitys policy and procedure to determine the course of action |
ANS: D
Because this treatment is covered under the state nurse practice act, the next step is to refer to the facilitys policy and procedure manual to determine whether the ordered treatment is allowed by the facility. Calling the physician is not necessary because there was no question about how the order was written, and the states nurse practice act has already been checked. Contacting the nursing supervisor would be acceptable only after the facilitys policy has been checked.
DIF: Cognitive Level: Application REF: Page 23 | Page 24
OBJ: 4 TOP: Legal Concepts in Health Care
KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
a. | That certain clients receive care |
b. | Quality and effectiveness of care |
c. | Proper documentation |
d. | Proper medication administration |
ANS: B
Most health care disciplines have standards of practice documented as guidelines with measurable criteria that can be used to evaluate the quality and effectiveness of care provided. All clients have the right to receive care, so standards of nursing practice would not address who receives care. Although proper documentation and proper medication administration might be part of the evaluation process, they do not provide complete evaluation of quality and effectiveness of care.
DIF: Cognitive Level: Comprehension REF: Page 24 OBJ: 4
TOP: Legal Concepts in Health Care KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Safe and Effective Care Environment
a. | 3 months |
b. | 6 months |
c. | 12 months |
d. | 15 months |
ANS: C
Although the case is being reviewed constantly by the mental health care team, the court must review the indefinite commitment on a yearly basis.
DIF: Cognitive Level: Knowledge REF: Page 25 OBJ: 5
TOP: Adult Psychiatric Admissions KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
a. | Libel |
b. | Slander |
c. | Invasion of privacy |
d. | Assault |
ANS: C
Confidentiality is included in a clients right to privacy, and a breach in confidentiality is considered a liability issue. Invasion of privacy can result in a criminal case and/or job termination. Libel refers to written defamation, and slander is verbal defamation of character. Assault is an act that threatens another individual.
DIF: Cognitive Level: Application REF: Page 25 OBJ: 6
TOP: Areas of Potential Liability KEY: Nursing Process Step: Evaluation
MSC: Client Needs: Safe and Effective Care Environment
a. | Assault |
b. | Battery |
c. | Privacy |
d. | Fraud |
ANS: A
The technician is engaging in assault, which is any act that threatens a client. Battery of a client occurs when any physical act of touching occurs without the clients permission. Privacy refers to issues related to the body and confidentiality, and fraud is giving false information.
DIF: Cognitive Level: Application REF: Page 25 OBJ: 6
TOP: Areas of Potential Liability KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
a. | An alert and oriented client is confined to his room after repeatedly being loud and argumentative with another client in the recreation area. |
b. | Restraints are placed on a client who has been admitted in a lethargic state because of misuse of medications and who has fallen three times since admission. |
c. | A client is housed in a private room with visual monitors after attempting suicide at home on the previous day. |
d. | An alert and oriented client who was admitted for a 72-hour involuntary commitment is prevented from leaving the facility 2 days after admission. |
ANS: A
The client cannot be confined to his room if he did not pose a threat to himself or others, or if no contract was made with the client regarding consequences for inappropriate behavior. All of the other options are appropriate because they follow guidelines for client safety.
DIF: Cognitive Level: Analysis REF: Page 25 OBJ: 6
TOP: Areas of Potential Liability KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
a. | 5; 2 |
b. | 15; 2 |
c. | 5; 4 |
d. | 15; 4 |
ANS: B
Appropriate guidelines include monitoring every 15 minutes and exercising every 2 hours to prevent circulatory, muscle, and nerve impairment. Either the nurse or a delegate of the nurse must perform these interventions, and the nurse is responsible for ensuring proper implementation of the interventions.
DIF: Cognitive Level: Knowledge REF: Page 26 OBJ: 6
TOP: Areas of Potential Liability KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
a. | Social worker |
b. | Nurse |
c. | Physician |
d. | Facilitys legal representative |
ANS: C
The physician is responsible for providing the client with the information necessary to give informed consent, including expectations and risks involved. The nurse can assist by obtaining the written documentation necessary for informed consent.
DIF: Cognitive Level: Knowledge REF: Page 26 OBJ: 8
TOP: Care Providers Responsibilities KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
a. | Escape |
b. | Abandon |
c. | Flee |
d. | Elope |
ANS: D
The appropriate terminology for when a client runs away from a facility without a discharge order is elopement. In the event of elopement, the caregiver can be held liable if a client becomes injured.
DIF: Cognitive Level: Knowledge REF: Page 26 OBJ: 8
TOP: Care Providers Responsibilities KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
a. | Try to talk with the client to convince her not to harm the girlfriend |
b. | Have the client sign a contract with you stating that she will not harm the girlfriend |
c. | Inform the ex-husband of the intentions of the client |
d. | Inform the girlfriend of the intentions of the client |
ANS: D
Health care providers have a duty to warn others when serious harm may occur as the result of actions taken by the client. This does not breach confidentiality because providers have an obligation to protect the public as well as the client. In addition to warning the client, the nurse should inform the clients physician and the nursing supervisor and must document the situation and actions taken. The other options are not adequate to meet the duty to warn or to prevent harm to the girlfriend.
DIF: Cognitive Level: Application REF: Page 26 OBJ: 8
TOP: Care Providers Responsibilities KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
a. | I am not sure, but I will find out. |
b. | Risperdal has no documented side effects |
c. | Risperdal does have some side effects. |
d. | Lets talk to your physician about potential side effects. |
ANS: B
The ethical concept of veracity refers to the duty of being truthful with the client, within the scope of ones practice. Stating that the drug has no side effects is not a truthful statement because the medication does have side effects.
DIF: Cognitive Level: Application REF: Page 22 OBJ: 2
TOP: Ethical Principles KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
MULTIPLE RESPONSE
a. | Family members |
b. | Police |
c. | Physicians |
d. | Social workers |
e. | Representatives of a county administrator |
ANS: B, C, E
Police, physicians, and representatives of a county administrator are the only individuals who can implement an involuntary admission to a mental health facility. An involuntary admission can last from days to years, depending on the need. A court order is necessary for extended involuntary admissions.
DIF: Cognitive Level: Knowledge REF: Page 24 OBJ: 5
TOP: Adult Psychiatric Admissions KEY: Nursing Process Step: Intervention
MSC: Client Needs: Safe and Effective Care Environment
a. | The provider owed a duty to the client. |
b. |
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