Role of the Psych Nurse

The nurse assists the physician with electroconvulsive therapy on his patient who has refused to give consent. With which of the following legal actions might the nurse be charged because of this nursing action?

• Assault

• Battery

• False imprisonment

• Breach of confidentiality

Answer explanation

Battery is the unconsented touching of another person.

A competent, voluntary client has stated that he wants to leave the hospital. The nurse hides his clothes in an effort to keep him from leaving. Which of the following legal actions might the nurse be charged because of this nursing action?

• Assault

• Battery

• False imprisonment

• Breach of confidentiality

Answer explanation

False imprisonment is the deliberate and unauthorized confinement of a competent person with the intent to prevent them from leaving the hospital; this includes use of threats or medications that interfere with the client’s ability to leave the facility.

Joe is very restless and is pacing a lot. The nurse says to Joe, “If you don’t sit down in the chair and be still, I’m going to put you in restraints!” With which of the following legal actions might the nurse be charged because of this nursing action?

• Defamation of character

• Battery

• Breach of confidentiality

• Assault

Answer explanation

Assault is an act that results in a person’s genuine fear and apprehension that they will be touched without consent.

An individual may be considered gravely disabled for which of the following reasons? (Select all that apply.)

• A person, because of mental illness, cannot fulfill basic needs.

• A mentally ill person is in danger of physical harm based on inability to care for self.

• A mentally ill person lacks the resources to provide the necessities of life.

• A mentally ill person is unable to make use of available resources to meet daily living requirements.

Answer explanation

Gravely disabled is generally defined as a condition in which an individual, as a result of mental illness, is in danger of serious physical harm resulting from an inability to provide for basic needs such as food, clothing, shelter, medical care, and personal safety. Inability to care for oneself cannot be established by showing that an individual lacks the resources to provide the necessities of life. Rather, it is established by showing the individual’s inability to make use of available resources.

Which of the following statements is correct regarding the use of restraints? (Select all that apply.)

• Restraints may never be initiated without a physician’s order.

• Orders for restraints must be reissued by a physician every 2 hours for children and adolescents.

• Clients in restraints must be observed and assessed every hour for issues regarding circulation, nutrition, respiration, hydration, and elimination.

• An in-person evaluation must be conducted within 1 hour of initiating restraints.

Answer explanation

Restraint refers not only to physical restraints but also to any manual method or medication used to restrict a person’s freedom of movement.

Attempting to calm an angry client by using “talk therapy” is an example of which of the following clients’ rights?

• The right to privacy

• The right to refuse medication

• The right to the least restrictive treatment alternative

• The right to confidentiality

Answer explanation

The right to the least restrictive treatment alternative means that clients who can be adequately treated in an outpatient setting should not be hospitalized, and if they are hospitalized, they should not be sedated, restrained, or secluded unless other less restrictive measures were found to be unsuccessful. In other words, clients have a right to whatever level of treatment is effective and least restricts their freedom.

Which of the following are basic assumptions of milieu therapy? (Select all that apply.)

• Each individual owns his or her own environment.

• Each individual owns his or her behavior.

• Peer pressure is a useful and powerful tool.

• Inappropriate behaviors are punished immediately.

Answer explanation

Milieu therapy is a scientific structuring of the environment in order to effect behavioral changes and improve the psychological health and functioning of the individual.

Patient teaching is an important nursing function in milieu therapy. Which of the following statements by the patient indicates the need for knowledge and a readiness to learn?

• “Get away from me with that medicine! I’m not sick!”

• “I don’t need psychiatric treatment. It’s my migraine headaches that I need help with.”

• “I’ve taken Valium every day of my life for the last 20 years. I’ll stop when I’m good and ready!”

• “The doctor says I have bipolar disorder. What does that really mean?”

On the milieu unit, duties of the registered nurse include which of the following? (Select all that apply.)

• Medication administration

• Patient teaching

• Medical diagnosis

• Reality orientation

• Relationship development

Examples of primary prevention include? (Select all that apply.)

• Education to prevent substance abuse.

• Community suicide awareness.

• Screening for depression.

• Outpatient support for a patient following a hospitalization related to a mental health disorder or crisis.

Answer explanation

Primary prevention focuses on the prevention of mental health disorders in the community before they occur. This level of prevention aims to decrease risk factors and increase protective factors in order to prevent a mental health disorder from occurring in the first place.