Chapter 03: Legal Issues

Chapter 03: Legal Issues

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Considering that a state uses the M’Naghten Rule when an individual is on trial for a crime, what would be most important to document for a nurse caring for a patient who will soon be tried on murder charges?

a.	The patient’s participation in treatment planning
b.	The patient’s comments about commission of the crime
c.	Examples of behaviors that support psychiatric diagnoses
d.	The patient’s perceptions of the need for hospitalization and treatment

 

 

ANS:  B

The M’Naghten Rule states that to be held legally accountable for his or her actions, a person with mental illness must be able to understand the nature and implications of the crime. Although each of the options refers to data that should be documented, the patient’s comments about the crime would be of most importance to the trial.

 

DIF:    Cognitive level: Applying                REF:   p. 21

TOP:   Nursing process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

2. A patient tells the nurse, “You better take good care of me or I’ll sue you using the precedent established in Wyatt v. Stickney.” The nurse can interpret this as:

a.	intellectualization.
b.	concern about rights to adequate treatment.
c.	a warning about being coerced into treatment.
d.	a request for immediate discharge from the facility.

 

 

ANS:  B

Wyatt v. Stickney was a case in which the court ruled that patients had the right to adequate treatment while hospitalized. Intellectualizing is a defense mechanism. Right to refuse treatment and commitment issues were not the focus of Wyatt v. Stickney.

 

DIF:    Cognitive level: Understanding        REF:   p. 21               TOP:   Nursing process: Planning

MSC:  NCLEX: Safe, Effective Care Environment

 

3. A patient shouts, “I’m holding you responsible for mistreatment based on Rogers v. Orkin.” The nurse can conclude that the patient is objecting to:

a.	loss of privileges to leave the unit.
b.	inability to make phone calls.
c.	taking medication.
d.	hospitalization.

 

 

ANS:  C

Rogers v. Orkin was a case in which the court ruled that nonviolent patients could not be forced to take medication. It did not have implications related to hospitalization or application of patient privileges.

 

DIF:    Cognitive level: Understanding        REF:   p. 21

TOP:   Nursing process: Assessment           MSC:  NCLEX: Safe, Effective Care Environment

 

4. To help preserve patients’ rights to freedom from restraint and seclusion, the most important interventions that the nurse can use are based on which principle?

a.	Therapeutic management
b.	Reality-based communication
c.	Confidentiality of documentation
d.	Effective use of ancillary personnel

 

 

ANS:  A

Attention to the nurse–patient relationship, the therapeutic milieu, and principles of pharmacologic management can reduce the need for restrictive measures. The other options are important aspects of care but do not relate directly to the use of restraint and seclusion.

 

DIF:    Cognitive level: Understanding        REF:   p. 28

TOP:   Nursing process: Implementation     MSC:  NCLEX: Safe, Effective Care Environment

 

5. A nurse finds a psychiatric advance directive in the medical record of a patient experiencing psychosis. The directive was executed during a period in which the patient was stable and competent. The nurse should:

a.	ensure that the directives are respected in treatment planning.
b.	review the directive with the patient to ensure that it is current.
c.	consider the directive only if there is a cardiac or respiratory arrest.
d.	realize that such directives address only the use of psychotropic medication.

 

 

ANS:  A

Advance directives for psychiatric care might be given by competent patients. They are considered binding and should be considered in planning treatment. Advance directives address several issues including psychotropic medication. Review is not required. A psychiatric advance directive relates specifically to mental health services, not cardiac or respiratory problems.

 

DIF:    Cognitive level: Applying                REF:   p. 30

TOP:   Nursing process: Implementation     MSC:  NCLEX: Safe, Effective Care Environment