Foundations of Psychiatric Mental Health Nursing A Clinical Approach, 5th Edition by Elizabeth M. Varcarolis
Foundations of Psychiatric Mental Health Nursing A Clinical Approach, 5th Edition by Elizabeth M. Varcarolis
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Chapter 8: Legal and Ethical Guidelines for Safe Practice
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
1)Â Â The intervention by a psychiatric nurse that implements the ethical principle of autonomy is when the nurse
| A. | explores alternative solutions with the client, who later chooses one alternative. |
| B. | stays with a client who is demonstrating a high level of anxiety. |
| C. | intervenes when a self-mutilating client attempts to slash her wrists. |
| D. | suggests that two clients who were fighting be restricted to the unit. |
ANS:Â Â A
Autonomy is the right to self-determination, that is, to make one’s own decisions. By exploring alternatives with the client, the client is better equipped to make an informed, autonomous decision. Options B and C: These actions demonstrate beneficence and fidelity. Option D demonstrates the principles of fidelity and justice.
DIF:   Cognitive Level: Analysis                 REF:   Text Page: 116, Text Page: 117
TOP:Â Â Â Nursing Process: Implementation
MSC:Â Â NCLEX: Safe, Effective Care Environment;
2)  The action by a psychiatric nurse that supports the client’s right to be treated with dignity and respect is when the nurse
| A. | addresses the client by his title and surname (e.g., Mr. Jones). |
| B. | discusses the client’s condition with his physician as they have lunch in the cafeteria. |
| C. | tells the treatment team that the client is too drowsy to be consulted about the plan of care. |
| D. | strongly encourages the client to participate in recreational activities available on the unit. |
ANS:Â Â A
A simple way of showing respect is to address the client by title and surname rather than assume that the client would wish to be called by his first name. Option B violates confidentiality. Option C violates client autonomy. Option D exemplifies beneficence and fidelity.
DIF:   Cognitive Level: Application            REF:   Text Page: 118, Text Page: 119
TOP:Â Â Â Nursing Process: Implementation
MSC:Â Â NCLEX: Safe, Effective Care Environment;
3)Â Â Two psychotic clients in the inpatient unit get into fights when they are in the same room. During a team meeting, one nurse suggests the safety of the two clients is of paramount importance and that their treatment plans should call for both to be placed in seclusion to keep them from injuring each other. The suggestion is significant because it
| A. | violates the civil rights of the two clients. |
| B. | reinforces the autonomy of the two clients. |
| C. | reveals that the nurse values the principle of justice. |
| D. | represents the intentional tort of battery. |
ANS:Â Â A
Clients have a right to treatment in the least restrictive setting. Less restrictive measures should be tried first. Unnecessary seclusion may result in a charge of false imprisonment. Option B: Seclusion removes the client’s autonomy. Option C: The principle by which the nurse is motivated is beneficence, not justice. Option D: The tort represented is false imprisonment.
DIF:   Cognitive Level: Analysis                 REF:   Text Page: 119
TOP:Â Â Â Nursing Process: Planning
MSC:Â Â NCLEX: Safe, Effective Care Environment;
4)Â Â In a treatment team planning meeting a nurse states her concern about whether the staff is behaving ethically in using restraint to prevent one client from engaging in self-mutilating behavior when the care plan for another self-mutilating client calls for one-on-one supervision. The ethical principle that should govern the situation is
| A. | beneficence. |
| B. | autonomy. |
| C. | fidelity. |
| D. | justice. |
ANS:Â Â D
The nurse is concerned about justice, that is, fair treatment with the least restrictive methods for both clients. Option A: Beneficence means promoting the good of others. Option B: Autonomy is the right to make one’s own decisions. Option C: Fidelity is the observance of loyalty and commitment to the client.
DIF:   Cognitive Level: Analysis                 REF:   Text Page: 116, Text Page: 117
TOP:Â Â Â Nursing Process: Planning
MSC:Â Â NCLEX: Safe, Effective Care Environment;
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