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NUR 517 Sherpath Lesson Assessments
1. CHAPTER 6 - Patient and Societal Rights Chapter 6, Legal and Ethical
Considerations Which mental health patient rights are important for the nurse to maintain? Select all that apply
A. The patient has the right to receive visitors.
B. To participate in recreation and exercise
C. To send and receive unopened mail.
D. To refuse a court-ordered treatment.
E. To call emergency medical services to free the patient from a legal hold.: A, B, C
2. Which legal tool is used when the mental health patient is unable to partic- ipate in
the decision-making process regarding his or her own care?
A. Patient's civil rights
B. Patient's basic rights
C. Patient's bill of rights
D. Patient's psychiatric advance directives: D
3. A patient is refusing to take a court-ordered psychotropic medication. How should
the nurse proceed?
A. Seclude the patient
B. Admonish the patient
C. De-escalate the patient
D. Temporarily restrain the patient with the designated team: D
4. A patient is undergoing court-ordered ECT as a treatment for severe depres- sion.
The patient is refusing psychotropic medication. What should the nurse do?
A. Hide the medication in the patient's food.
B. Honor the patient's refusal and document it.
C. Briefly restrain the patient to administer the medication.
D. Inform the patient that the court has mandated the medication.: B
5. A patient's out-of-control behavior necessitated emergency medication and
seclusion. What are the nursing goals for this patient? Select all that apply.
A. Assist the patient to re-establish control.
B. Monitor the other patients' reactions to the seclusion.
C. Maintain the seclusion to keep other patients safe.
D. Discontinue seclusion as soon as it is safely possible.
E. Administering additional medications, despite patient refusal, to maintain
therapeutic blood levels.: A, D
B. Patient's refusal of a psychotropic medication. C. Patient's demand for a psychiatric advance directive. D. Patient's use of the telephone to notify local police of desire to be dis- charged.: A
9. A patient with paranoid schizophrenia who lives with her mother states to the nurse
that she has rigged her bedroom door at home with explosives. Which action is urgently indicated?
A. Notify the psychiatrist and the police of the danger.
B. Reassure the patient of her confidentiality on the unit.
C. Administer a single dose of a psychotropic medication.
D. Assure the patient of her right to refuse any visitor, including her mother.: A
10. The nurse is reviewing discharge paperwork with the patient when the patient
states, "I am eager to have vengeance upon my neighbor for triggering this admission." Which nursing intervention is indicated?
A. Discharge the patient as ordered.
B. Medicate the patient to stabilize his mood.
C. Remind the patient of coping skills learned during hospitalization.
D. Explore the potential for violence and confer with the psychiatrist about the need to
delay discharge.: D
11. A highly seductive patient reports the decision to stop the sexual relation- ship with
the outpatient therapist and asks the nurse for a date after discharge. Which responses
by the nurse would be appropriate? Select all that apply.
A. Decisively decline the date.
B. Kindly explain that the nurse can only offer friendship to the patient.
C. Tell the patient the date will depend on status upon discharge.
D. Closely monitor the patient for sexual interactions with other patients on the unit.
E. Initiate an investigation into the report of sexual activity between the
outpatient therapist and the patient.: A, D, E
12. When does disposition begin for psychiatric patients admitted to the
emergency department (ED)? Upon entry to ED At discharge from ED Upon placement to a crisis house At acceptance to a day treatment program: a
13. Which patient admitted to the emergency department is most likely to be admitted
to the inpatient psychiatric unit? An anxious patient who cannot sleep A depressed patient who lacks motivation A medicated patient with bipolar disorder who occasionally hallucinates A paranoid patient with schizophrenia who is aggressive toward the ED nurse-
end of PHP At the beginning of PHP When medication is decreased or discontinued After 90 consecutive days of PHP participation: a
18. Which patients are well suited for referral to PHP? Select
all that apply. A homeless patient An acutely suicidal patient A patient who needs help improving coping skills A patient who needs more structure than day treatment A patient being discharged from an inpatient unit after a lengthy hospitaliza- tion: c, d, e
19. Which are components of PHP aftercare?
Select all that apply. Inpatient follow-up Outpatient therapy Psychiatric home care Day treatment program Medication management: b, d, e
20. Which is the major treatment challenge associated with community mental health?
Access to health care Lack of adequate resources Availability of
psychotherapy Adherence to medication regimen: d
21. Which treatment strategies are often used in dual diagnosis/co-occurring disorders
programs? Select all that apply. ACT Self-help groups Psychiatric home care
Patients who are in PHP Patients who are homeless Patients who are chronically ill Patients who are acutely suicidal: c
25. Which type of theoretical perspective is the nurse using when assisting the
patient to work on reframing his or her thoughts in a realistic manner? Psychodynamic theory Developmental theory Cognitive-behavioral theory Humanistic psychology theory: c
26. Which disorders can be improved by animal-assisted therapy? Select
all that apply. Autism Anxiety Schizophrenia Personality disorder Post-traumatic stress disorder (PTSD): a, b, e
27. Which patient is most appropriate for electroconvulsive therapy (ECT)? A patient
with resistant depression A patient with borderline personality disorder A patient with post-traumatic stress disorder (PTSD) A patient with attention deficit hyperactivity disorder (ADHD): a
28. Which nursing actions align with the mental health recovery model? Select
all that apply. Focus on the expectation of recovery. Focus on the disability of the patient. Empower the patient to make decisions. Encourage the patient to learn self-regulation. Encourage the patient to allow family members to make care decisions.: a, c, d
29. Which interventions can the nurse perform in the mental health setting? Select all
that apply. Lead a psychotherapy group Inform patients of their rights while hospitalized Prepare an education session to teach patients about their treatment modali- ties Use communication techniques to build a relationship with a depressed pa- tient Discontinue medications that may be causing dangerous side effects in pa- tients: b, c, d
30. Which is part of the nurse's role during the diagnosis stage of the nursing process?
Assigning the patient a medical diagnosis Selecting only diagnoses that apply to currently existing problems Planning the patient outcomes prior to selecting the nursing diagnoses Selecting the nursing diagnoses after completing a thorough assessment of the patient: d
patient to a medical surgical unit where different benefits apply. Maintain the patient on inpatient psychiatric care with a high level of suicide observation.: d
34. A patient admitted on involuntary status is now calm, cooperative, alert, oriented,
and is requesting to be discharged. What is the best response by the nurse? "You can sign out against medical advice when you are ready to leave. "You will not be able to leave because you are here on a court order." "You will be evaluated by a psychiatrist shortly and she will work with you to make a determination about your discharge." "Because you are here on an involuntary hold, it is mandatory that you stay here for at least 48 hours. You cannot be released before your time is up.": c
35. A nurse is providing education on the psychiatric involuntary commitment process.
Which is true of involuntary commitment? Select all that apply. It is time-limited. It is determined by state law. It is for an indefinite time period. The person must be a threat to self or others. Anyone can place another under commitment. The court system is not involved in the process.: a, b, d
36. The nurse receives orders from a new resident psychiatrist for a patient being
held on an involuntary short-term commitment petition. Which order should the nurse question? Change diet to regular. Begin sertraline 25 mg po daily. Administer acetaminophen 325 mg po now for headache. Allow patient to be accompanied by staff to attend son's graduation.: d
patient calls to reschedule her appointment at the clinic. The patient had 3 admissions within 2 months due to psychiatric treatment noncompliance. The patient requires a long-term injectable antipsychotic to manage his con- dition and has demonstrated noncompliance in the past.: c, e, f
40. The nurse is evaluating a patient's chart for evidence that supports the need for a
long-term involuntary commitment of an inpatient psychiatric pa- tient. Which evidence supports the need for a court petition? Select all that apply. The patient attends group therapy. The patient is compliant with medications. The patient sometimes responds to unseen stimuli. The patient continues to require 1:1 care due to suicidality on day 10 of inpatient care. The patient ranks his depression as a 10 on a scale of 1-10 with 10 being the worse and is actively suicidal. The patient has threatened to harm people at her place of employment if she leaves the hospital and has verbalized a working plan.: d, e, f
41. A patient in inpatient psychiatric treatment has a conservatee who is not one of her
sons or daughter. The nurse receives a call from her son requesting his mother be moved to a different facility. Which is the priority action of the nurse?
Notify the other children of the wishes of the son. Facilitate a meeting with the children and the conservator to discuss the change of facility. Do not discuss the care of Mrs. Smith with her son without the consent of the conservator. Organize a family meeting with Mrs. Smith's children to discuss the care plan for the patient.: c
42. A patient who was found wandering in the community, disoriented, and not wearing
proper clothing for the weather conditions was brought to the ED. She was also not carrying any identification. Once she is cleared medically, it is determined that she suffers from mental illness. Which type of legal procedure is most appropriate for this patient? Civil commitment Conservatorship Voluntary observation Mandated involuntary outpatient treatment: b
43. A patient in the mental health facility has been charged with a crime. The
psychiatrist must evaluate the patient to determine competency to stand trial and the individual indicates that a plea will be entered as not guilty by reason of insanity. Which criteria are used to determine the plea of insanity? Select all that apply.
46. Which behavior management options are most helpful when treating ado- lescents
who are harming themselves or others? Select all that apply. Group home setting Skills training groups Redirecting attention Time-out and seclusion One-to-one staff supervision: b, d, e
47. Which is the most effective care environment for an adolescent patient with a
history of substance abuse, but no history of mental illness? Medical psychiatric unit Inpatient psychiatric unit Inpatient substance abuse unit Outpatient substance abuse treatment: c
48. Which are the most common diagnoses expected to be seen in patients on
geropsychiatric units? Select all that apply. Delirium Depression Anorexia nervosa Alzheimer's disease Borderline personality disorder: a, b, d
49. When the nurse is formulating a discharge plan, what is the most appro- priate
placement option for an uninsured older adult patient diagnosed with severe schizophrenia who requires long-term care? State psychiatric hospital Outpatient treatment center Residential treatment facility Home with community resources: c
50. Which substance abuse treatment program is best for the patient who can commit
to one month of detoxification treatment? State psychiatric hospital Psychiatric inpatient program Long- term treatment program Short-term treatment program: d
51. Which is the best placement option for a long-term prison inmate with
diagnosable, severe mental illness who has been deemed too dangerous to remain in the prison? Rehabilitation facility State forensic hospital State psychiatric hospital Large maximum security prison: b
