Complete Test Bank With Answers
Sample Questions Posted Below
| 1. |
A client undergoing a colonoscopy tomorrow is receiving preoperative teaching regarding the procedure. Which of the following nursing tasks best describes the explanation of the procedure and the associated risks and benefits? |
| A) |
Ascertaining the client’s privacy |
| B) |
Acquiring informed consent |
| C) |
Encouraging the client to be self-determined |
| D) |
Acting in a beneficent manner |
| Ans: |
B |
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Feedback: |
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Informing the client of the risks and benefits of a procedure is best described as obtaining informed consent. Informed consent involves the client’s right of self-decision. Client privacy is defined as the right to be left alone and free from intrusion or control by the health care providers. Self-determination allows the client to indicate what treatments he would accept or refuse. Acting in a beneficent manner encompasses doing good acts by the nurse. |
| 2. |
A client has just been explained the reason that he must undergo an MRI. When the nurse asks the client if he understands the teaching, he correctly describes what has been said to him. The client is said to be what? |
| A) |
Logical |
| B) |
Congruent |
| C) |
Competent |
| D) |
Autonomous |
| Ans: |
C |
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Feedback: |
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Competence involves the ability of the client to understand and make decisions based on information given. |
| 3. |
When promoting client safety on an inpatient psychiatric unit, which of the following interventions would be used as the measure of last resort? |
| A) |
Surveillance |
| B) |
Seclusion |
| C) |
Room restriction |
| D) |
Four-point restraint |
| Ans: |
D |
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Feedback: |
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Four-point restraint is the most restrictive of the interventions mentioned above, with surveillance being the least. When promoting safety, the method of last resort would be the most restrictive measure. |
| 4. |
An 86-year-old male admitted for appendectomy is being discharged to a nursing care facility. He has been diagnosed with depression during this hospitalization. According to the Omnibus Reconciliation Act (OBRA), regarding placement of clients in long-term care (LTC) facilities, which of the following statements is accurate? |
| A) |
He may be placed into an LTC facility if there is an open bed. |
| B) |
He must go home to recover prior to placement in an LTC facility. |
| C) |
He must be placed in an inpatient psychiatric–mental health acute care facility until his depression has resolved. |
| D) |
He may not be placed into a long-term nursing care facility at this time because he is diagnosed with a psychiatric disorder. |
| Ans: |
D |
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Feedback: |
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OBRA of 1987 stated that an LTC care facility must not admit, on or after January 1, 1989, any new resident needing active treatment for mental illness or mental retardation. A screening document called the Preadmission Screening and Annual Resident Review (PSARR) determines whether the client needs active psychiatric treatment. |
| 5. |
The depressed client is deciding which type of treatment would be beneficial for him. The nurse would document that the patient is utilizing which of the following ethical principles in this situation? |
| A) |
Justice |
| B) |
Beneficence |
| C) |
Autonomy |
| D) |
Veracity |
| Ans: |
C |
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Feedback: |
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The American Nurses’ Association identified four primary principles to guide ethical decisions. These principles include the client’s right to autonomy, the right to beneficence (doing good) by the nurse, the right to justice or fair treatment, and the right to veracity (the truth) regarding the client’s condition and treatment. |
| 6. |
A mental health nurse is caring for a client with an anxiety and substance use disorder. The family is requesting to see the client’s records. The nurse understands that this would be a violation of which law? |
| A) |
Occupational Safety and Health Administration (OSHA) |
| B) |
Health Insurance Portability and Accountability Act (HIPAA) |
| C) |
American Nurses’ Association (ANA) |
| D) |
Joint Commission on Accreditation of Healthcare Organizations (JCAHO) |
| Ans: |
B |
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Feedback: |
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The HIPAA Privacy Provisions Rule states that patient records are secure and not readily available to those who do not need them to carry out treatment, payment, or health care operations activities. This situation would not include a violation of OSHA, ANA, or JCAHO. |
| 7. |
Malpractice is a type of negligence. The nurse recognizes the elements constituting malpractice as including all of the following except which one of the following? |
| A) |
Approximate cause |
| B) |
Failure to conform to the required standard of care |
| C) |
Failure to act in an acceptable way |
| D) |
Occurrence of potential damage |
| Ans: |
D |
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Feedback: |
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All of the above are elements of malpractice except for the correct answer. There must be an occurrence of actual damage. |
| 8. |
An agitated client has been put in restraints against his will because of inadequate staffing. The nurse determines this as which form of malpractice? |
| A) |
Battery |
| B) |
False imprisonment |
| C) |
Defamation |
| D) |
Assault |
| Ans: |
B |
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Feedback: |
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False imprisonment is the intentional and unjustifiable detention of a person against his or her will. Detention can occur with the use of physical restraint, barriers, or threats of harm. Battery is unlawful touching of another without consent. Defamation involves injury to a person’s reputation or character through oral (slander) or written (libel) communications to a third party. Assault is an act that puts another person in apprehension of being touched or of bodily harm without consent. |
| 9. |
According to the Tarasoff vs. Regents of the University of California decision, which of the following takes precedence when a client admits to wanting to kill another person? |
| A) |
Duty to client autonomy |
| B) |
Duty to be culturally congruent |
| C) |
Duty to warn |
| D) |
Duty to protect client confidentiality |
| Ans: |
C |
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Feedback: |
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The landmark Supreme Court case, Tarasoff vs. Regents of the University of California, has reshaped the configuration of psychiatric practice and altered the relationship between clinicians and public authorities. The duty to warn takes precedence over the duty to protect confidentiality. |
| 10. |
A client with mental retardation has been accused of first-degree murder. There has been a plea of diminished capacity. Which of the following describes diminished capacity? |
| A) |
Used by individuals who are informed of their legal rights |
| B) |
Entered in the presence of a mental disease at the time of the commission of an alleged criminal act |
| C) |
The criminal act occurred because of the client’s illness but the client is not responsible for his or her behavior |
| D) |
Because of a mental impairment, the defendant could not form the mental state required for a particular offense |
| Ans: |
D |
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Feedback: |
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Diminished capacity asserts that because of the mental impairment, such as mental retardation, the defendant could not form the specific mental state required for a particular offense, such as first-degree murder. Informing individuals of their legal rights describes the Miranda warning. Entered in the presence of a mental disease relates to not guilty by reason of insanity. A criminal act committed because of the client’s illness but without responsibility describes the plea of guilty but mentally ill. |
| 11. |
A client who was deemed to be at high risk for suicide was ordered visual checks every 15 minutes. Nurse K. had been performing these checks since the beginning of her shift but neglected to pass off this responsibility to a colleague before leaving the unit for her scheduled break. As a result, the client made a suicide attempt while Nurse K. was off the unit. Which ethical principle has Nurse K. most clearly violated? |
| A) |
Autonomy |
| B) |
Beneficence |
| C) |
Fidelity |
| D) |
Veracity |
| Ans: |
C |
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Feedback: |
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The ethical principle of fidelity implies that the nurse is faithful to duties, obligations, and promises when providing care for the client. Autonomy is related to independence in decision making, while beneficence is doing good and veracity is telling the truth. |
| 12. |
Matt is a 41-year-old client who has a long history of intravenous heroin and cocaine use. He has been admitted to the hospital for the treatment of endocarditis and is adamant that his current pain control regimen is inadequate. Some nurses on the unit are suspicious of Matt’s motives and suspect that he is “drug seeking.” How should the nurse begin the process of applying Chally and Loriz’s model for resolving ethical dilemmas? |
| A) |
Seek assistance from impartial informants. |
| B) |
Create a list of plausible alternatives. |
| C) |
Clarify exactly what the ethical dilemma is. |
| D) |
Ask if the client himself believes there to be an ethical dilemma. |
| Ans: |
C |
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Feedback: |
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The first step in Chally and Loriz’s six-step model for resolving ethical dilemmas is clarifying the ethical dilemma. |
| 13. |
Bella is a client with a complex medical and psychiatric history. Her current hospital admission is for the treatment of traumatic injuries that she received when she was hit by a car. Bella consistently rates her pain level at 10/10, and most members of the care team suspect that she overstates her pain. Which of the following considerations should be the highest priority in the management of Bella’s pain? |
| A) |
Verifying Bella’s complaints of pain |
| B) |
Limiting the liability of the care providers |
| C) |
Preventing the risk of adverse effects of long-term opiate use |
| D) |
Relieving Bella’s pain |
| Ans: |
D |
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Feedback: |
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While there are many considerations and potential ethical dilemmas surrounding the assessment and treatment of pain, the ultimate priority is to effectively treat the client’s pain. |
| 14. |
Rebecca, a 30-year-old client, has been asked to participate in a drug trial. Which of Rebecca’s following statements suggests a possible violation of ethical standards? |
| A) |
“I’m not that keen on this, but my brother’s a scientist so he really wants me to take part in the study.” |
| B) |
“Overall, I’m pretty suspicious of drug companies but I suppose I’ll participate in the study.” |
| C) |
“A research assistant came and explained things to me but I still haven’t met the doctor who’s organizing the test.” |
| D) |
“They haven’t told me exactly how many other people are participating in the drug study.” |
| Ans: |
A |
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Feedback: |
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If the client indicates perceived coercion by others, the nurse is responsible for alerting the program research investigator of such statements because they may constitute a violation of ethical principles. It is not unusual for a participant not to have contact with the primary researcher or to be unaware of the total number of study participants. |
| 15. |
While performing the admission assessment of a new client, the nurse observed that the client brought a bottle of over-the-counter pain medication to the hospital. The nurse failed to document this or remove the medication from the room. Subsequently, the client experienced a serious adverse drug reaction as a result of the interaction between this drug and one of the drugs that she was prescribed in the hospital. This nurse may be guilty of what? |
| A) |
Assault |
| B) |
Malpractice |
| C) |
Failure of duty to warn |
| D) |
Incompetence |
| Ans: |
B |
|
Feedback: |
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The four elements of nursing malpractice are evident in this scenario. Assault is an act that puts another person in apprehension of being touched or of bodily harm without consent, and failure of duty to warn surrounds a client’s threat to harm another person. Incompetence, in the legal sense, surrounds a client’s right to autonomy. |
| 16. |
Susan, aged 22, has voluntarily sought treatment for an eating disorder at a residential facility in an isolated rural location. Despite a promising start, she has been involved in recent conflicts with staff members and insists that she wants to leave the facility. Staff members have refused to facilitate her transportation from the facility and have stated that they will not return her money and identification that were held when she was admitted. Staff at the treatment facility may be guilty of false imprisonment because of what fact? |
| A) |
Susan’s diagnosis is not terminal. |
| B) |
The facility is in an inaccessible location. |
| C) |
Susan’s diagnosis is not psychiatric in etiology. |
| D) |
Susan is legally competent. |
| Ans: |
D |
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Feedback: |
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False imprisonment is the intentional and unjustifiable detention of a person against his or her will. If a person is deemed incompetent, however, detention may be legally justified. The client’s prognosis and the location of facility are not among the criteria for false imprisonment. Eating disorders are psychiatric illnesses. |
| 17. |
A hospital patient has attributed his long-standing struggle with depression to the fact that he was sexually abused by his father as a child and early adolescent. The patient has admitted to the nurse that he intends to seek out his father and “do some justice.” What is the nurse’s primary responsibility in response to the patient’s threat? |
| A) |
Document that the patient is experiencing delusions. |
| B) |
Note the statement mentally but maintain silence to protect the patient’s confidentiality. |
| C) |
Inform the patient that threats of violence will not be tolerated in the health care facility. |
| D) |
Report the patient’s threat to the appropriate authorities. |
| Ans: |
D |
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Feedback: |
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Nurses have a duty to report threats of harm so that appropriate action may be taken. This action may vary from state to state, but the duty to report threats of violence supersedes the patient’s right to privacy. |
| 18. |
Which of the following clients most likely has the legal right to refuse treatment? |
| A) |
Mrs. Crane, who committed an assault while she was experiencing delusions |
| B) |
Terrance, a 20-year-old man who has been admitted to the hospital for the treatment of depression after a suicide attempt |
| C) |
Mrs. Lepke, a homeless woman with schizophrenia who was admitted to the hospital with dehydration after refusing to eat for several days |
| D) |
Mr. Modesto, who voluntarily entered a substance abuse treatment facility to address his addiction to alcohol |
| Ans: |
D |
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Feedback: |
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Many people who are psychiatric inpatients have been admitted involuntarily as a result of the threat they pose to themselves or others. Competent clients who admit themselves voluntarily have the right to refuse any treatment prescribed and may initiate their own discharge at any time. |
| 19. |
Ali has been admitted to the hospital involuntarily for the treatment of depression. Which of the following criteria provides legal justification for Ali’s involuntary admission? |
| A) |
Ali’s treatment will require pharmacologic interventions. |
| B) |
Ali poses a threat to himself. |
| C) |
Ali’s primary care provider is a psychiatrist. |
| D) |
Ali’s family is unable to manage his care. |
| Ans: |
B |
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Feedback: |
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The form for involuntary admission usually states that there is substantial likelihood that in the near future, the person will inflict serious bodily harm on himself or another person. The need for drug therapy, care under a psychiatrist, or the inability of family members to care for the individual is not a legal justification for involuntary admission. |
| 20. |
As a result of the increasing severity of her delusions and consequent unsafe behavior, a client has been admitted to a psychiatric facility and judged incompetent to make decisions. Who will now make decisions for the client? |
| A) |
The client’s primary nurse |
| B) |
The client’s psychiatrist |
| C) |
A hospital-appointed interdisciplinary committee |
| D) |
A guardian appointed by the court |
| Ans: |
D |
|
Feedback: |
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If individuals admitted to a psychiatric facility are judged to be incompetent to make decisions, the court will appoint a guardian to make decisions for them. |
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