6: Legal and Ethical Guidelines for Safe Practice - Varcarolis (7th)
with Complete Solutions Graded A
A psychiatric nurse best applies the ethical asserts that safety is of paramount importance,
principle of autonomy by: so treatment plans should call for both patients to
be secluded to keep them from injuring each
A.exploring alternative solutions with a patient, other. This assertion:
who then makes a choice.
B.suggesting that two patients who were fighting A.reinforces the autonomy of the two patients.
be restricted to the unit. B.violates the civil rights of both patients.
C.intervening when a self-mutilating patient C.represents the intentional tort of battery.
attempts to harm self. D.correctly places emphasis on safety. -
D.staying with a patient demonstrating a high ANSWER -B
level of anxiety. - ANSWER -A Patients have a right to treatment in the least
Autonomy is the right to self-determination, that restrictive setting. Safety is important, but less
is, to make one's own decisions. By exploring restrictive measures should be tried first.
alternatives with the patient, the patient is better Unnecessary seclusion may result in a charge of
equipped to make an informed, autonomous false imprisonment. Seclusion violates the
decision. The distracters demonstrate patient's autonomy. The principle by which the
beneficence, fidelity, and justice. nurse is motivated is beneficence, not justice.
The tort represented is false imprisonment.
A nurse finds a psychiatric advance directive in
the medical record of a patient experiencing In a team meeting a nurse says, "I'm concerned
psychosis. The directive was executed during a about whether we are behaving ethically by using
period when the patient was stable and restraint to prevent one patient from self-
competent. The nurse should: mutilation, while the care plan for another self-
mutilating patient requires one-on-one
A.review the directive with the patient to ensure it supervision." Which ethical principle most clearly
is current. applies to this situation?
B.ensure that the directive is respected in
treatment planning. A.Beneficence
C.consider the directive only if there is a cardiac B.Autonomy
or respiratory arrest. C.Fidelity
D.encourage the patient to revise the directive in D.Justice - ANSWER -D
light of the current health problem. - The nurse is concerned about justice, that is, fair
ANSWER -B distribution of care, which includes treatment with
The nurse has an obligation to honor the right to the least restrictive methods for both patients.
self-determination. An advanced psychiatric Beneficence means promoting the good of
directive supports that goal. Since the patient is others. Autonomy is the right to make one's own
currently psychotic, the terms of the directive decisions. Fidelity is the observance of loyalty
now apply. and commitment to the patient.
Two hospitalized patients fight whenever they Select the example of a tort.
are together. During a team meeting, a nurse
1/8
, 6: Legal and Ethical Guidelines for Safe Practice - Varcarolis (7th)
with Complete Solutions Graded A
A.The plan of care for a patient is not completed getting out of here, and no one can stop me." The
within 24 hours of the patient's admission. nurse restrains this patient without a health care
B.A nurse gives a PRN dose of an antipsychotic provider's order and then promptly obtains an
drug to an agitated patient because the unit is order.
short-staffed. B. A patient has been irritating and attention-
C.An advanced practice nurse recommends seeking much of the day. A nurse escorts the
hospitalization for a patient who is dangerous to patient down the hall saying, "Stay in your room,
self and others. or you'll be put in seclusion."
D.A patient's admission status changed from C. An involuntarily hospitalized patient with
involuntary to voluntary after the patient's suicidal ideation runs out of the psychiatric unit.
hallucinations subside. - ANSWER -B The nurse rushes after the patient and convinces
A tort is a civil wrong against a person that the patient to return to the unit.
violates his or her rights. Giving unnecessary D. An involuntarily hospitalized patient with
medication for the convenience of staff controls homicidal ideation attempts to leave the facility. A
behavior in a manner similar to secluding a nurse calls the security team and uses
patient; thus, false imprisonment is a possible established protocols to prevent the patient from
charge. The other options do not exemplify torts. leaving. - ANSWER -B
False imprisonment involves holding a competent
person against his or her will. Actual force is not
a requirement of false imprisonment. The
What is the legal significance of a nurse's action individual needs only to be placed in fear of
when a patient verbally refuses medication and imprisonment by someone who has the ability to
the nurse gives the medication over the patient's carry out the threat. If a patient is not competent
objection? The nurse: (confused), then the nurse should act with
beneficence. Patients admitted involuntarily
A. has been negligent. should not be allowed to leave without
B. committed malpractice. permission of the treatment team.
C. fulfilled the standard of care.
D. can be charged with battery. -
ANSWER -D
Battery is an intentional tort in which one Which patient meets criteria for involuntary
individual violates the rights of another through hospitalization for psychiatric treatment? The
touching without consent. Forcing a patient to patient who:
take medication after the medication was refused
constitutes battery. The charge of battery can be A. is noncompliant with the treatment regimen.
brought against the nurse. The medication may B. fraudulently files for bankruptcy.
not necessarily harm the patient; harm is a C. sold and distributed illegal drugs.
component of malpractice. D. threatens to harm self and others. -
ANSWER -D
Involuntary hospitalization protects patients who
are dangerous to themselves or others and
Which nursing intervention demonstrates false cannot care for their own basic needs.
imprisonment? Involuntary commitment also protects other
individuals in society. The behaviors described in
A. A confused and combative patient says, "I'm the other options are not sufficient to require
2/8
with Complete Solutions Graded A
A psychiatric nurse best applies the ethical asserts that safety is of paramount importance,
principle of autonomy by: so treatment plans should call for both patients to
be secluded to keep them from injuring each
A.exploring alternative solutions with a patient, other. This assertion:
who then makes a choice.
B.suggesting that two patients who were fighting A.reinforces the autonomy of the two patients.
be restricted to the unit. B.violates the civil rights of both patients.
C.intervening when a self-mutilating patient C.represents the intentional tort of battery.
attempts to harm self. D.correctly places emphasis on safety. -
D.staying with a patient demonstrating a high ANSWER -B
level of anxiety. - ANSWER -A Patients have a right to treatment in the least
Autonomy is the right to self-determination, that restrictive setting. Safety is important, but less
is, to make one's own decisions. By exploring restrictive measures should be tried first.
alternatives with the patient, the patient is better Unnecessary seclusion may result in a charge of
equipped to make an informed, autonomous false imprisonment. Seclusion violates the
decision. The distracters demonstrate patient's autonomy. The principle by which the
beneficence, fidelity, and justice. nurse is motivated is beneficence, not justice.
The tort represented is false imprisonment.
A nurse finds a psychiatric advance directive in
the medical record of a patient experiencing In a team meeting a nurse says, "I'm concerned
psychosis. The directive was executed during a about whether we are behaving ethically by using
period when the patient was stable and restraint to prevent one patient from self-
competent. The nurse should: mutilation, while the care plan for another self-
mutilating patient requires one-on-one
A.review the directive with the patient to ensure it supervision." Which ethical principle most clearly
is current. applies to this situation?
B.ensure that the directive is respected in
treatment planning. A.Beneficence
C.consider the directive only if there is a cardiac B.Autonomy
or respiratory arrest. C.Fidelity
D.encourage the patient to revise the directive in D.Justice - ANSWER -D
light of the current health problem. - The nurse is concerned about justice, that is, fair
ANSWER -B distribution of care, which includes treatment with
The nurse has an obligation to honor the right to the least restrictive methods for both patients.
self-determination. An advanced psychiatric Beneficence means promoting the good of
directive supports that goal. Since the patient is others. Autonomy is the right to make one's own
currently psychotic, the terms of the directive decisions. Fidelity is the observance of loyalty
now apply. and commitment to the patient.
Two hospitalized patients fight whenever they Select the example of a tort.
are together. During a team meeting, a nurse
1/8
, 6: Legal and Ethical Guidelines for Safe Practice - Varcarolis (7th)
with Complete Solutions Graded A
A.The plan of care for a patient is not completed getting out of here, and no one can stop me." The
within 24 hours of the patient's admission. nurse restrains this patient without a health care
B.A nurse gives a PRN dose of an antipsychotic provider's order and then promptly obtains an
drug to an agitated patient because the unit is order.
short-staffed. B. A patient has been irritating and attention-
C.An advanced practice nurse recommends seeking much of the day. A nurse escorts the
hospitalization for a patient who is dangerous to patient down the hall saying, "Stay in your room,
self and others. or you'll be put in seclusion."
D.A patient's admission status changed from C. An involuntarily hospitalized patient with
involuntary to voluntary after the patient's suicidal ideation runs out of the psychiatric unit.
hallucinations subside. - ANSWER -B The nurse rushes after the patient and convinces
A tort is a civil wrong against a person that the patient to return to the unit.
violates his or her rights. Giving unnecessary D. An involuntarily hospitalized patient with
medication for the convenience of staff controls homicidal ideation attempts to leave the facility. A
behavior in a manner similar to secluding a nurse calls the security team and uses
patient; thus, false imprisonment is a possible established protocols to prevent the patient from
charge. The other options do not exemplify torts. leaving. - ANSWER -B
False imprisonment involves holding a competent
person against his or her will. Actual force is not
a requirement of false imprisonment. The
What is the legal significance of a nurse's action individual needs only to be placed in fear of
when a patient verbally refuses medication and imprisonment by someone who has the ability to
the nurse gives the medication over the patient's carry out the threat. If a patient is not competent
objection? The nurse: (confused), then the nurse should act with
beneficence. Patients admitted involuntarily
A. has been negligent. should not be allowed to leave without
B. committed malpractice. permission of the treatment team.
C. fulfilled the standard of care.
D. can be charged with battery. -
ANSWER -D
Battery is an intentional tort in which one Which patient meets criteria for involuntary
individual violates the rights of another through hospitalization for psychiatric treatment? The
touching without consent. Forcing a patient to patient who:
take medication after the medication was refused
constitutes battery. The charge of battery can be A. is noncompliant with the treatment regimen.
brought against the nurse. The medication may B. fraudulently files for bankruptcy.
not necessarily harm the patient; harm is a C. sold and distributed illegal drugs.
component of malpractice. D. threatens to harm self and others. -
ANSWER -D
Involuntary hospitalization protects patients who
are dangerous to themselves or others and
Which nursing intervention demonstrates false cannot care for their own basic needs.
imprisonment? Involuntary commitment also protects other
individuals in society. The behaviors described in
A. A confused and combative patient says, "I'm the other options are not sufficient to require
2/8
