PSYCH Final Exam Questions and
Answers Latest Versions 2025 Top Rated
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1. A newly admitted patient who is acutely psychotic is a private patient of the senior psychiatrist. To
whom does the psychiatric nurse who is assigned to this patient owe the duty of care?
a. Health care provider
b. Profession
c. Hospital
d. Patient ans: ANS: D
Although the nurse is accountable to the health care provider, the agency, the patient, and the
profession, the duty of care is owed to the patient.
2. An example of a breach of a patient's right to privacy occurs when a nurse:
a. asks a family to share information about a patient's prehospitalization behavior.
b. discusses the patient's history with other staff members during care planning.
c. documents the patient's daily behaviors during hospitalization.
d. releases information to the patient's employer without consent. ans: ANS: D
The release of information without patient authorization violates the patient's right to privacy. The
other options are acceptable nursing practices.
3. An adolescent hospitalized after a violent physical outburst tells the nurse, "I'm going to kill my father,
but you can't tell anyone." Select the nurse's best response.
a. "You're right. Federal law requires me to keep that information private."
b. "Those kinds of thoughts will make your hospitalization longer."
c. "You really should share this thought with your psychiatrist."
d. "I am obligated to share information with the treatment team." ans: ANS: D
Breach of nurse-patient confidentiality does not pose a legal dilemma for nurses in these circumstances
because a team approach to the delivery of psychiatric care presumes communication of patient
information to other staff members to develop treatment plans and outcome criteria. The patient
should know that the team may have to warn the father of the risk for harm.
4. A voluntarily hospitalized patient tells the nurse, "Get me the forms for discharge against medical
advice so I can leave now." What is the nurse's best initial response?
a. "I can't give you those forms without your health care provider's knowledge."
b. "I will get them for you, but let's talk about your decision to leave treatment."
c. "Since you signed your consent for treatment, you may leave if you desire."
d. "I'll get the forms for you right now and bring them to your room." ans: ANS: B
A patient who has been voluntarily admitted as a psychiatric inpatient has the right to demand and
obtain release in most states. However, as a patient advocate, the nurse is responsible for weighing
factors related to the patient's wishes and best interests. By asking for information, the nurse may be
,able to help the patient reconsider the decision. The statement that discharge forms cannot be given
without the health care provider's knowledge is not true. Facilitating discharge without consent is not in
the patient's best interest before exploring the reason for the request.
5. The family of a patient whose insurance will not pay for continuing hospitalization considers
transferring the patient to a public psychiatric hospital. The family expresses concern that the patient
will "never get any treatment." Which reply by the nurse would be most helpful?
a. "Under the law, treatment must be provided. Hospitalization without treatment violates patients'
rights."
b. "That's a justifiable concern because the right to treatment extends only to the provision of food,
shelter, and safety."
c. "Much will depend on other patients because the right to treatment for a psychotic patient takes
precedence over the right to treatment of a patient who is stable."
d. "All patients in public hospitals have the right to choose both a primary therapist and a primary
nurse." ans: ANS: A
The right to medical and psychiatric treatment was conferred on all patients hospitalized in public
mental hospitals with the enactment of the federal Hospitalization of Mentally Ill Act in 1964. Stating
that the concern is justifiable supports the family's erroneous belief. The provisions mentioned in the
third and fourth options are not part of this or any other statute governing psychiatric care.
6. Which individual with a mental illness may need emergency or involuntary hospitalization for mental
illness? The individual who:
a. resumes using heroin while still taking methadone.
b. reports hearing angels playing harps during thunderstorms.
c. throws a heavy plate at a waiter at the direction of command hallucinations.
d. does not show up for an outpatient appointment with the mental health nurse. ans: ANS: C
Throwing a heavy plate is likely to harm the waiter and is evidence of being dangerous to others. This
behavior meets the criteria for emergency or involuntary hospitalization for mental illness. The
behaviors in the other options evidence mental illness but not dangerousness.
7. A patient being treated in an alcohol rehabilitation unit reveals to the nurse, "I feel terrible guilt for
sexually abusing my 6-year-old child before I was admitted." Based on state and federal law, the best
action for the nurse to take is to:
a. anonymously report the abuse by telephone to the local child abuse hotline.
b. reply, "I'm glad you feel comfortable talking to me about it."
c. respect nurse-patient relationship of confidentiality.
d. file a written report on the agency letterhead. ans: ANS: A
Laws regarding reporting child abuse discovered by a professional during a suspected abuser's alcohol or
drug treatment differ by state. Federal law supersedes state law and prohibits disclosure without a court
order except in instances in which the report can be made anonymously or without identifying the
abuser as a patient in an alcohol or drug treatment facility. Anonymously reporting the abuse by
telephone to the local child abuse hotline meets federal criteria. Respecting nurse-patient
confidentiality and replying, "I'm glad you feel comfortable talking to me about it" do not accomplish
reporting. Filing a written report on agency letterhead violates federal law.
8. The spouse of a patient who has delusions asks the nurse, "Are there any circumstances under which
the treatment team is justified in violating the patient's right to confidentiality?" The nurse must reply
that confidentiality may be breached:
,a. under no circumstances.
b. at the discretion of the psychiatrist.
c. when questions are asked by law enforcement.
d. if the patient threatens the life of another person. ans: ANS: D
The duty to warn a person whose life has been threatened by a patient under psychiatric treatment
overrides the patient's right to confidentiality. The right to confidentiality is not suspended at the
discretion of the therapist or for legal investigations.
9. A nurse cares for an older adult patient admitted for the treatment of depression. The health care
provider prescribes an antidepressant medication, but the dose is more than the usual adult dose. The
nurse should:
a. implement the order.
b. consult a drug reference.
c. give the usual geriatric dosage.
d. hold the medication and consult the health care provider. ans: ANS: D
The dose of an antidepressant medication for older adult patients is often less than the usual adult dose.
The nurse should withhold the medication and consult the health care provider who wrote the order.
The nurse's duty is to intervene and protect the patient. Consulting a drug reference is unnecessary
because the nurse already knows the dose is excessive. Implementing the order is negligent. Giving the
usual geriatric dose would be wrong; a nurse without prescriptive privileges cannot change the dose.
10. A patient with paranoid schizophrenia believes evil spirits are being summoned by a local minister
and verbally threatens to bomb a local church. The psychiatrist notifies the minister. The psychiatrist
has:
a. released information without proper authorization.
b. demonstrated the duty to warn and protect.
c. violated the patient's confidentiality.
d. avoided charges of malpractice. ans: ANS: B
The duty of a health care professional is to warn or notify an intended victim after a threat of harm has
been made. Informing a potential victim of a threat is a legal responsibility of the health care
professional and not considered a violation of confidentiality.
11. A psychiatric nurse best implements the ethical principle of autonomy when he or she:
a. intervenes when a self-mutilating patient attempts to harm self.
b. stays with a patient who is demonstrating a high level of anxiety.
c. suggests that two patients who are fighting be restricted to the unit.
d. explores alternative solutions with a patient, who then makes a choice. ans: ANS: D
Autonomy is the right to self-determination, that is, to make one's own decisions. When the nurse
explores alternatives with the patient, the patient is better equipped to make an informed, autonomous
decision. Staying with a highly anxious patient or intervening with a self-mutilating patient demonstrates
beneficence and fidelity. Suggesting that two fighting patients be restricted to the unit demonstrates the
principles of fidelity and justice.
12. Which action by a psychiatric nurse best supports patients' rights to be treated with dignity and
respect?
a. Consistently addressing each patient by title and surname.
, b. Strongly encouraging a patient to participate in the unit milieu.
c. Discussing a patient's condition with another health care provider in the elevator.
d. Informing a treatment team that a patient is too drowsy to participate in care planning. ans: ANS: A
A simple way of showing respect is to address the patient by title and surname rather than assuming
that the patient would wish to be called by his or her first name. Discussing a patient's condition with a
health care provider in the elevator violates confidentiality. Informing a treatment team that the patient
is too drowsy to participate in care planning violates patient autonomy. Encouraging a patient to
participate in the unit milieu exemplifies beneficence and fidelity.
13. Two hospitalized patients fight when they are in the same room. During a team meeting, a nurse
asserts that safety is of paramount importance and therefore the treatment plans should call for both
patients to be secluded to prevent them from injuring each other. This assertion:
a. reveals that the nurse values the principle of justice.
b. reinforces the autonomy of the two patients.
c. violates the civil rights of the two patients.
d. represents the intentional tort of battery. ans: ANS: C
Patients have a right to treatment in the least restrictive setting. Less restrictive measures should be
tried first. Unnecessary seclusion may result in a charge of false imprisonment. Seclusion removes the
patient's autonomy. The principle by which the nurse is motivated is beneficence, not justice. The tort
represented is false imprisonment, not battery.
14. In a team meeting a nurse says, "I'm concerned whether we are behaving ethically by using restraint
to prevent one patient from self-mutilation while the care plan for another patient who has also self-
mutilated calls for one-on-one supervision." Which ethical principle most clearly applies to this
situation?
a. Beneficence
b. Autonomy
c. Fidelity
d. Justice ans: ANS: D
The nurse is concerned about justice, that is, the fair treatment with the least restrictive methods for
both patients. Beneficence means promoting the good of others. Autonomy is the right to make one's
own decisions. Fidelity is the observance of loyalty and commitment to the patient.
15. Which scenario is an example of a tort?
a. The primary nurse does not complete the plan of care for a patient within 24 hours of the patient's
admission.
b. An advanced practice nurse recommends that a patient who is dangerous to self and others be
voluntarily hospitalized.
c. A patient's admission status is changed from involuntary to voluntary after the patient's hallucinations
subside.
d. A nurse gives an as-needed dose of an antipsychotic drug to a patient to prevent violent acting-out
because a unit is short staffed. ans: ANS: D
A tort is a civil wrong against a person that violates his or her rights. Giving unnecessary medication for
the convenience of staff members controls behavior in a manner similar to secluding a patient; thus
false imprisonment is a possible charge. The other options do not exemplify torts.
16. A nurse's neighbor asks, "Why aren't people with mental illness kept in state institutions anymore?"
What is the nurse's best response?
Answers Latest Versions 2025 Top Rated
A+
1. A newly admitted patient who is acutely psychotic is a private patient of the senior psychiatrist. To
whom does the psychiatric nurse who is assigned to this patient owe the duty of care?
a. Health care provider
b. Profession
c. Hospital
d. Patient ans: ANS: D
Although the nurse is accountable to the health care provider, the agency, the patient, and the
profession, the duty of care is owed to the patient.
2. An example of a breach of a patient's right to privacy occurs when a nurse:
a. asks a family to share information about a patient's prehospitalization behavior.
b. discusses the patient's history with other staff members during care planning.
c. documents the patient's daily behaviors during hospitalization.
d. releases information to the patient's employer without consent. ans: ANS: D
The release of information without patient authorization violates the patient's right to privacy. The
other options are acceptable nursing practices.
3. An adolescent hospitalized after a violent physical outburst tells the nurse, "I'm going to kill my father,
but you can't tell anyone." Select the nurse's best response.
a. "You're right. Federal law requires me to keep that information private."
b. "Those kinds of thoughts will make your hospitalization longer."
c. "You really should share this thought with your psychiatrist."
d. "I am obligated to share information with the treatment team." ans: ANS: D
Breach of nurse-patient confidentiality does not pose a legal dilemma for nurses in these circumstances
because a team approach to the delivery of psychiatric care presumes communication of patient
information to other staff members to develop treatment plans and outcome criteria. The patient
should know that the team may have to warn the father of the risk for harm.
4. A voluntarily hospitalized patient tells the nurse, "Get me the forms for discharge against medical
advice so I can leave now." What is the nurse's best initial response?
a. "I can't give you those forms without your health care provider's knowledge."
b. "I will get them for you, but let's talk about your decision to leave treatment."
c. "Since you signed your consent for treatment, you may leave if you desire."
d. "I'll get the forms for you right now and bring them to your room." ans: ANS: B
A patient who has been voluntarily admitted as a psychiatric inpatient has the right to demand and
obtain release in most states. However, as a patient advocate, the nurse is responsible for weighing
factors related to the patient's wishes and best interests. By asking for information, the nurse may be
,able to help the patient reconsider the decision. The statement that discharge forms cannot be given
without the health care provider's knowledge is not true. Facilitating discharge without consent is not in
the patient's best interest before exploring the reason for the request.
5. The family of a patient whose insurance will not pay for continuing hospitalization considers
transferring the patient to a public psychiatric hospital. The family expresses concern that the patient
will "never get any treatment." Which reply by the nurse would be most helpful?
a. "Under the law, treatment must be provided. Hospitalization without treatment violates patients'
rights."
b. "That's a justifiable concern because the right to treatment extends only to the provision of food,
shelter, and safety."
c. "Much will depend on other patients because the right to treatment for a psychotic patient takes
precedence over the right to treatment of a patient who is stable."
d. "All patients in public hospitals have the right to choose both a primary therapist and a primary
nurse." ans: ANS: A
The right to medical and psychiatric treatment was conferred on all patients hospitalized in public
mental hospitals with the enactment of the federal Hospitalization of Mentally Ill Act in 1964. Stating
that the concern is justifiable supports the family's erroneous belief. The provisions mentioned in the
third and fourth options are not part of this or any other statute governing psychiatric care.
6. Which individual with a mental illness may need emergency or involuntary hospitalization for mental
illness? The individual who:
a. resumes using heroin while still taking methadone.
b. reports hearing angels playing harps during thunderstorms.
c. throws a heavy plate at a waiter at the direction of command hallucinations.
d. does not show up for an outpatient appointment with the mental health nurse. ans: ANS: C
Throwing a heavy plate is likely to harm the waiter and is evidence of being dangerous to others. This
behavior meets the criteria for emergency or involuntary hospitalization for mental illness. The
behaviors in the other options evidence mental illness but not dangerousness.
7. A patient being treated in an alcohol rehabilitation unit reveals to the nurse, "I feel terrible guilt for
sexually abusing my 6-year-old child before I was admitted." Based on state and federal law, the best
action for the nurse to take is to:
a. anonymously report the abuse by telephone to the local child abuse hotline.
b. reply, "I'm glad you feel comfortable talking to me about it."
c. respect nurse-patient relationship of confidentiality.
d. file a written report on the agency letterhead. ans: ANS: A
Laws regarding reporting child abuse discovered by a professional during a suspected abuser's alcohol or
drug treatment differ by state. Federal law supersedes state law and prohibits disclosure without a court
order except in instances in which the report can be made anonymously or without identifying the
abuser as a patient in an alcohol or drug treatment facility. Anonymously reporting the abuse by
telephone to the local child abuse hotline meets federal criteria. Respecting nurse-patient
confidentiality and replying, "I'm glad you feel comfortable talking to me about it" do not accomplish
reporting. Filing a written report on agency letterhead violates federal law.
8. The spouse of a patient who has delusions asks the nurse, "Are there any circumstances under which
the treatment team is justified in violating the patient's right to confidentiality?" The nurse must reply
that confidentiality may be breached:
,a. under no circumstances.
b. at the discretion of the psychiatrist.
c. when questions are asked by law enforcement.
d. if the patient threatens the life of another person. ans: ANS: D
The duty to warn a person whose life has been threatened by a patient under psychiatric treatment
overrides the patient's right to confidentiality. The right to confidentiality is not suspended at the
discretion of the therapist or for legal investigations.
9. A nurse cares for an older adult patient admitted for the treatment of depression. The health care
provider prescribes an antidepressant medication, but the dose is more than the usual adult dose. The
nurse should:
a. implement the order.
b. consult a drug reference.
c. give the usual geriatric dosage.
d. hold the medication and consult the health care provider. ans: ANS: D
The dose of an antidepressant medication for older adult patients is often less than the usual adult dose.
The nurse should withhold the medication and consult the health care provider who wrote the order.
The nurse's duty is to intervene and protect the patient. Consulting a drug reference is unnecessary
because the nurse already knows the dose is excessive. Implementing the order is negligent. Giving the
usual geriatric dose would be wrong; a nurse without prescriptive privileges cannot change the dose.
10. A patient with paranoid schizophrenia believes evil spirits are being summoned by a local minister
and verbally threatens to bomb a local church. The psychiatrist notifies the minister. The psychiatrist
has:
a. released information without proper authorization.
b. demonstrated the duty to warn and protect.
c. violated the patient's confidentiality.
d. avoided charges of malpractice. ans: ANS: B
The duty of a health care professional is to warn or notify an intended victim after a threat of harm has
been made. Informing a potential victim of a threat is a legal responsibility of the health care
professional and not considered a violation of confidentiality.
11. A psychiatric nurse best implements the ethical principle of autonomy when he or she:
a. intervenes when a self-mutilating patient attempts to harm self.
b. stays with a patient who is demonstrating a high level of anxiety.
c. suggests that two patients who are fighting be restricted to the unit.
d. explores alternative solutions with a patient, who then makes a choice. ans: ANS: D
Autonomy is the right to self-determination, that is, to make one's own decisions. When the nurse
explores alternatives with the patient, the patient is better equipped to make an informed, autonomous
decision. Staying with a highly anxious patient or intervening with a self-mutilating patient demonstrates
beneficence and fidelity. Suggesting that two fighting patients be restricted to the unit demonstrates the
principles of fidelity and justice.
12. Which action by a psychiatric nurse best supports patients' rights to be treated with dignity and
respect?
a. Consistently addressing each patient by title and surname.
, b. Strongly encouraging a patient to participate in the unit milieu.
c. Discussing a patient's condition with another health care provider in the elevator.
d. Informing a treatment team that a patient is too drowsy to participate in care planning. ans: ANS: A
A simple way of showing respect is to address the patient by title and surname rather than assuming
that the patient would wish to be called by his or her first name. Discussing a patient's condition with a
health care provider in the elevator violates confidentiality. Informing a treatment team that the patient
is too drowsy to participate in care planning violates patient autonomy. Encouraging a patient to
participate in the unit milieu exemplifies beneficence and fidelity.
13. Two hospitalized patients fight when they are in the same room. During a team meeting, a nurse
asserts that safety is of paramount importance and therefore the treatment plans should call for both
patients to be secluded to prevent them from injuring each other. This assertion:
a. reveals that the nurse values the principle of justice.
b. reinforces the autonomy of the two patients.
c. violates the civil rights of the two patients.
d. represents the intentional tort of battery. ans: ANS: C
Patients have a right to treatment in the least restrictive setting. Less restrictive measures should be
tried first. Unnecessary seclusion may result in a charge of false imprisonment. Seclusion removes the
patient's autonomy. The principle by which the nurse is motivated is beneficence, not justice. The tort
represented is false imprisonment, not battery.
14. In a team meeting a nurse says, "I'm concerned whether we are behaving ethically by using restraint
to prevent one patient from self-mutilation while the care plan for another patient who has also self-
mutilated calls for one-on-one supervision." Which ethical principle most clearly applies to this
situation?
a. Beneficence
b. Autonomy
c. Fidelity
d. Justice ans: ANS: D
The nurse is concerned about justice, that is, the fair treatment with the least restrictive methods for
both patients. Beneficence means promoting the good of others. Autonomy is the right to make one's
own decisions. Fidelity is the observance of loyalty and commitment to the patient.
15. Which scenario is an example of a tort?
a. The primary nurse does not complete the plan of care for a patient within 24 hours of the patient's
admission.
b. An advanced practice nurse recommends that a patient who is dangerous to self and others be
voluntarily hospitalized.
c. A patient's admission status is changed from involuntary to voluntary after the patient's hallucinations
subside.
d. A nurse gives an as-needed dose of an antipsychotic drug to a patient to prevent violent acting-out
because a unit is short staffed. ans: ANS: D
A tort is a civil wrong against a person that violates his or her rights. Giving unnecessary medication for
the convenience of staff members controls behavior in a manner similar to secluding a patient; thus
false imprisonment is a possible charge. The other options do not exemplify torts.
16. A nurse's neighbor asks, "Why aren't people with mental illness kept in state institutions anymore?"
What is the nurse's best response?
