Professional Practice Exercises Answers

1. A client expressed concern regarding the confidentiality of her medical information. The nurse assures
the client that the nurse maintains client confidentiality by:
a. Summarizing the information, the client provides during assessments and documenting this
summary in the chart.
b. Explaining the exact limits of confidentiality in the exchanges between the client and the
nurse.
c. Limiting discussion about clients to the group room and hallways.
d. Sharing the information with all members of the health care team.

2. The physician asks the nurse to obtain written consent from the client for electroconvulsive therapy.
The client was medicated with lorazepam (Ativan) 30 minutes ago and is currently sleeping. In
order to obtain an informed consent, the nurse knows that:
a. The client has to have a high school education.
b. The client cannot have a diagnosed mental disorder or illness.
c. The client cannot receive any medication 15 minutes prior to signing the consent form.
d. The client cannot be under the influence of medication that may alter cognition.

3. A benefit to a psychiatric advance directive (PAD) is that it:

a. Provides the health care team with general consent to treat the client.
b. Provides clients with some control over their treatment and empowers them.
c. Eliminates the need for involuntary hospitalizations.
d. Identifies individuals who are at high risk for becoming incapacitated in the future.

4. The nurse restrains a client in a locked room for 3 hours until the client acknowledges who started a
fight in the group room last evening. The nurse’s behavior constitutes:
a. Contract of care
b. Standard of care practice
c. False imprisonment
d. Duty of care

5. The day staff nurse suspects that clients are more frequently restrained on the night shift when a
particular nurse is scheduled. What is the day nurse’s responsibility?
a. Discuss her concerns with the nurse manager.
b. Monitor the situation for 1 month to try to establish a pattern of behavior.
c. Review the records of restrained clients to determine if the restraints were warranted.
d. Discuss her concerns with the clients who were restrained.

6. Which of the following criteria must be met for an involuntary mental health commitment?
a. The client is unable to provide for basic needs.
b. The client is homeless.
c. The client requests admission to the hospital.
d. The client reports a history of depression.

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 7. The client is being involuntarily committed to the psychiatric unit after threatening to kill his
spouse and children. The involuntary commitment is an example of what bioethical principle?
a. Fidelity
b. Autonomy
c. Veracity
d. Beneficence

8. Which bioethical principle is crucial to informed consent?

a. Fidelity
b. Beneficence
c. Veracity
d. Autonomy

Exercises

1. The nurse takes a call from the emergency department regarding an involuntary admission. The client is
a 40-year-old male who is being admitted with a diagnosis of schizophrenia. The client has not been
eating or sleeping for several days and is currently expressing delusions about saving the world from
evil. He was picked up by the police after bathing nude in a public fountain in a local mall.

a. The emergency department staff escorts the client to the locked inpatient psychiatric unit. The
nurse meets them at the door and asks for the admission paperwork. She finds the involuntary
admission paperwork is incomplete and the emergency room physician has failed to sign the
medical certification document. What action should the nurse take?

b. What consequences could occur if the nurse allowed the client onto the locked inpatient unit
without the appropriate paperwork completed?

c. What criteria do the client exhibit that supports involuntary hospitalization?

d. The physician orders a psychotropic medication for the client. Does the client have the right to
refuse the medication?

2. A violent psychotic client is placed in seclusion. The nurse checks his extremities every 15 minutes as
pore hospital policy. The nurse notes that the clients hand is dusky, but his pulse is strong, and he is
able to move his fingers. She does not remove the restraint because the client is threatening her. At the
next 15 minute check the nurse notes that the client is unable to raise his wrist. The nurse removes the
restraint, but it is later determined that the client has suffered nerve injury to that hand. Is the nurse
guilty of malpractice? yes

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3. The nurse answers the unit phone, and a family member asks to speak with a client on the unit. The
nurse gives the family member the client’s pay phone number indicating the family member must call
the client on that phone.

4. What should the nurse do if a friend is admitted to the unit she works on?

5. A client has improved over the past four days during an inpatient hospital stay and is no longer a
danger to himself/ herself or others. This voluntary client asks to leave. How does the nurse respond to
this request?

6. Different states have different definitions of “dangerousness”. How does this create the potential for
abuse of power? Yes and different care providers as well. The use of restrictive methods-seclusion,
restraints, involuntary commitment will be used more frequently by those that consider lesser behaviors
as potentially dangerous