A)

B)

C)

Which action is
a violation of a
1.
psychiatric
client's rights?
A client is paid
minimum wage
for working in
the hospital
kitchen.
A paranoid
client with
delusions about
his family is told
that if he makes
a will, it might
not be valid.
Staff members
confiscate
letters written
by a committed
client that are
addressed to a
local newspaper.

D)

The nurse
removes an
expensive watch
from the client's
room and tells
the client it is
being locked in
the hospital
safe.
2. A 22-year-old
client has been
manipulative of
staff and
disruptive in the
milieu. Although
she is not
dangerous to
herself or
others, she has
created
problems on the

A)

B)

C)

unit and clearly

is not making
progress. The
nurses offer
prescribed
medication, but
she consistently
refuses any
drugs. The staff
realizes that
legally this
client can
Be coerced to
accept
treatment
Be committed
by her family to
receive needed
treatment
Have her family
sign permission
for treatment

D)

A)

Continue to
refuse treatment
A client who had
agreed to be
hospitalized for
stress-related
problems has
decided now
that she wants
3.
to leave the
hospital. The
mental health
staff caring for
her realizes that
at present she
can legally
Be discharged if
evaluated
through
administrative
hearings.

B)

C)

D)

Be retained in
the hospital
against her will.
Leave the
hospital after
giving written
notice of her
intent to do so.
Leave without
discussing the
situation with
anyone.
4. Two nurses are
discussing the
rights of
hospitalized
psychiatric
clients. Which of
the following
statements is in

A)

B)

C)

error?
Confidentiality
allows for the
disclosure of
information
under specific
circumstances.
If a committed
client is also
found to be
incompetent, he
loses his rights
under the
Patient's Bill of
Rights.
Privileged
communication
does not apply
to medical
records, and
they can be
used in court.

D)

A)
B)
C)

The hospital is
not responsible
for the safety of
a client's
belongings.
Placing a client
in restraints
before using
5. other methods
of intervention
violates the
client's right to
Receive
confidential and
respectful care
Provide
informed
consent
Refuse
treatment

D)

A)
B)
C)
D)

Receive
treatment in the
least restrictive
environment
When is a nurse
legally obligated
6.
to breach
confidentiality?
At any time a
client is
threatening
If threats are
made to an
outside party
Whenever the
client becomes
aggressive
When the client
violates the
nurse's

boundaries

A)

A client was
brought to the
emergency
department by
police after
neighbors
complained he
was loud and
disruptive. The
7. client is
paranoid and
upset and
states, No one
can be trusted.
Which of the
criteria for
involuntary
admission does
this client meet?
Dangerous to

B)
C)
D)

self
Dangerous to
others
Gravely disabled
He does not
meet any of the
necessary
criteria.
8. The nurse has a
physician's
order for
haloperidol
(Haldol) 10 mg
for a severely
psychotic client.
The client
refuses the
medication.
Which nursing
intervention is

A)
B)

C)

D)

an appropriate
response?
Accept the
client's decision
Obtain a
discharge order
for
noncompliance
Tell the client
that he is too
sick to refuse
Restrain the
client and give
the medication
IM
9. Disclosure of
client
information
beyond the
interdisciplinary

A)
B)
C)
D)

A)

team without
consent of the
client is a
breach of
Beneficence
Confidentiality
Duty
Veracity
A depressed,
suicidal client is
scheduled for
electroconvulsiv
e therapy (ECT),
10.
which requires
consent. Legally,
who should sign
the consent for
this treatment?
A member of the
treatment team

B)
C)
D)

The client
The client's
spouse
The psychiatrist
11. A patient made
threats to harm
his parents if
they come too
close to him.
The parents
called 911 and
the patient is
now held
involuntarily for
a psychiatric
evaluation.
During this time
of involuntary
admission, the
patient retains

A)
B)
C)
D)

all patient rights

except for which
of the following?
Confidentiality
Right to freedom
Periodic
treatment
review
Choice of
providers
12. A depressed
patient is
admitted to
treatment on a
voluntary basis.
While in the
hospital, the
patient makes
several
comments about

A)

B)
C)

wanting to end
it all. The
patient decides
one day to leave
against medical
advice. The
most
appropriate
action by the
nursing staff is
to:
call security to
detain the
patient.
allow the patient
to leave with
community
resources for
follow-up care.
contact the
psychiatrist for
initiation of
commitment

D)

A)
B)

proceedings.
contact the
patients family
to request they
convince the
patient to stay.
Which of the
following
patients would
13. most likely be
mandated
outpatient
treatment?
A patient who is
addicted to
alcohol who has
2 DUI offenses
A patient with
schizophrenia
who lives in a

C)

D)

single family
home with
siblings
A patient with
bipolar disorder
that has quit 3
jobs in the last 6
months
A homeless
patient who has
been arrested
for petty theft of
groceries from a
convenience
store.
14. Under which
conditions would
it be in the
patients best
interest for the

A)
B)
C)
D)
E)

court to appoint
a conservator,
or legal
guardian?
(Select all that
apply)
Gravely disabled
Mentally
incompetent
Noncompliant
Unable to
provide basic
needs when
resources exist
Act only on their
own interests
15. An adolescent
on the unit is
argumentative
with staff and

A)

B)

peers. The nurse

tells the
adolescent,
Arguing is not
allowed. One
more word and
you will have to
stay in your
room the rest of
the day. The
nurses directive
is:
inappropriate;
room restriction
is not treatment
in the least
restrictive
environment.
inappropriate;
the adolescent
should be
offered a
sedative before

C)

D)

room restriction.
appropriate;
room restriction
is an effective
behavior
modification
technique.
appropriate; the
adolescent
should not have
conflicts with
others.
16. The nurse on an
addictive
disorders unit
receives a
phone call
inquiring about
the status of a
patient. The

A)

B)

C)

caller is not on
the patients
allowed contact
list. Which of the
following is the
appropriate
response by the
nurse to the
caller?
I cannot
confirm or deny
the existence of
any patient
here.
You will need to
be placed on the
patients contact
list before I can
discuss any
information with
you.
The person you
are asking for is

D)

A)
B)

not a patient
here.
Hold one
minute while I
get the patient
for you.
Which of the
following patient
situations most
urgently
17. requires the
nurse to break
confidentiality
and warn a third
party?
An abused
woman states, I
have dreams
that he is dead.
A mother states,

C)

D)

Sometimes I
feel like killing
my kids!
A paranoid
woman states,
Ill get them
before they get
me.
A jealous man
states, I getting
my gun and
going to shoot
my wifes
lover!
18. A nurse is
questioning
whether it is
ethical to
seclude a
patient because

A)
B)
C)
D)

of loud and
intrusive
behavior on the
unit. The ethical
principle that
will best guide
this decision on
the appropriate
use of seclusion
is the principle
of:
Autonomy
Beneficence
Justice
Veracity
19. A nurse is
performing
safety
assessments on
a patient in

A)

B)
C)

mechanical
restrains
according to
policy. Which
action by the
nurse
demonstrates
the ethical
principle of
nonmaleficence
?
Explaining the
behavioral
requirements for
release of
restraint to the
patient
Assuring that
the restraints
are not causing
harm to the
patient
Applying

D)

restraints based
solely on
assessment
findings and not
on attitude
toward the
patient
Releasing the
patient when
stated
behavioral
control is
achieved
20. An adult patient
is put in
restraints after
all other
attempts to
reduce
aggression have
failed. Which of

A)

B)

C)
D)

the following is
required now
that restraints
have been
instituted?
Review of the
appropriateness
of restraints
every eight
hours
A face-to-face
evaluation by an
independent
practitioner
within one hour
A documented
nursing
assessment
every 4 hours
Constant oneon-one
supervision

during the first

hour, then video
monitoring
21. A patient is
suing a nurse for
malpractice
claiming the
nurse did not
perform safety
checks
according to
policy during a
period when the
patient was
placed in
restraints. The
nurse did check
circulation every
15 minutes as
per policy,
documenting full

A)
B)

movement,
palpable pulses,
and pale skin.
The patient
claims that ever
since the event
he has had
numbness in his
fingers. Which of
the following is
the probable
outcome of the
suit?
The nurse is not
guilty as there
were palpable
pulses during
the assessment
The nurse is not
guilty as the
procedure for
circulation
checks was

C)

D)

followed
The nurse may
be found guilty
since the patient
suffered injury
The nurse may
be found guilty
as she was
practicing
outside of the
capacity of a
nurse
22. Ensuring that
the patient has
informed
consent before
agreeing to a
treatment
regimen
displays which

A)
B)
C)
D)

of the following
ethical
principles?
Fidelity
Nonmaleficence
Justice
Autonomy
23. The nurse is
attending an inservice training
on safe takedown
techniques for
aggressive
patients.
Preparation for
safe physical
handling
prepares the
nurse to

A)
B)
C)
D)

practice which
ethical
principle?
Fidelity
Nonmaleficence
Justice
Autonomy
24. A nurse is faced
with the
dilemma of
whether to
support a
patient care
practice that
can be viewed
as violating a
patients right to
autonomy.
Identify, in
order, the steps

A)
B)
C)

D)
E)

the nurse should

take to make an
ethical decision
on a course of
action.
Clarify the
nurses personal
feelings about
the situation
Identify other
possible options
Gather
information
about the
practice
Consider legal
and practical
constraints to
other options
Complete an
analysis and
arrive at a

decision

A)

B)
C)

Ethical
dilemmas in
mental health
practice are
25.
especially
challenging for
the nurse
because:
ethical
dilemmas are
often charged
with emotion.
there are no
clear ethical
codes
established for
guidance.
a multitude of
laws must be

D)

understood to
make a clear
decision.
patients are not
familiar with the
ethical code
which nurses
must follow.
The term
standards of
care refers to
expectations of
nursing
performance.
26. Standards of
care are
developed from
which of the
following?
(Select all that
apply)

A)
B)
C)
D)
E)

Code of Ethics
for Nurses with
Interpretive
Statements
Licensure
examinations
State Nurse
Practice Acts
Agency job
descriptions
Professional
nursing
organizations
27. A patient
underwent a
procedure
before the nurse
verified the
patients
signature on the

A)
B)
C)
D)

consent form.
The patient
actually did not
sign the form
before the
procedure. If the
patient is
dissatisfied with
the outcome of
the procedure
and files a suit
against the
health care
team, which
kind of case can
the patient file?
Negligence
Malpractice
Battery
False
Imprisonment

A)

The staff on an
inpatient
psychiatric unit
is very busy and
fall behind on
periodic
assessment of a
severely
depressed
patient. During
28. the rounds the
patient is
discovered to
have completed
a suicide
attempt in the
bathroom.
Which type of
lawsuit could
the patients
family file?
Malpractice

B)
C)
D)

A)
B)
C)
D)

Breach of Duty
Assault
Injury or
Damage
Which of the
following is
described as a
29. wrongful act
that results in
injury, loss, or
damage?
Negligence
Tort
Malpractice
Ethical dilemma

Answer Key
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

C
D
C
B
D
B
D
A
B
B
B
C
A
A, B, D
A
A
D
A
B
B

21.
22.
23.
24.
25.
26.
27.
28.
29.

C
C
B
A, B, C, D, E
A
A, C, D, E
C
A
B