A charge nurse on a mental health unit is preparing an in-service for staff members about client rights. Which of the following information should the nurse include?

Clients who have a severe mental illness cannot request psychiatric advance directives.

Clients who are violent require a prescription prior to initiation of restraints.

Client withdrawal of prior consent must be done in writing.

Client confidentiality is not maintained when there is a duty to warn.

Answer and Explanation

The Correct Answer is D

Choice A reason: Clients with severe mental illness retain the right to create psychiatric advance directives unless legally deemed incompetent. Denying this right violates autonomy and federal protections.

Choice B reason: While a provider’s order is required for restraints, the priority is immediate safety. In emergencies, restraints may be applied first with a verbal order followed by a written one.

Choice C reason: Clients may withdraw consent verbally or in writing. Requiring written withdrawal exclusively is overly restrictive and not supported by ethical or legal standards.

Choice D reason: Confidentiality is a core principle, but exceptions exist. The duty to warn—such as when a client poses a serious threat to others—requires disclosure to protect potential victims, aligning with legal precedents like Tarasoff v. Regents.

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Correct Answer is ["A","C","D","E"]

Explanation

Choice A reason: Placing the mattress on the floor reduces the risk of injury from falls out of bed, especially for clients who are prone to wandering or disorientation at night.

Choice B reason: Encouraging physical activity before bedtime may increase agitation and disrupt sleep patterns in clients with dementia. Calming routines are preferred.

Choice C reason: Sensor devices on doors help monitor wandering behavior and alert caregivers, enhancing safety and preventing elopement.

Choice D reason: Removing loose rugs and clutter minimizes tripping hazards and supports a safer environment for clients with impaired mobility and judgment.

Choice E reason: Adequate lighting reduces confusion and helps prevent falls, especially during nighttime trips to the bathroom or when navigating unfamiliar spaces.

A. A nurse checks a sleeping client’s blankets for safety. B. A nurse takes the arm of a client to redirect them after they wander into another client’s room. C. A nurse tells a client they have been depressed due to a recent divorce. D. A nurse reminds a client of their medication schedule.

Correct Answer is C

Explanation

Choice A reason: Checking blankets for safety is a routine and appropriate nursing action. It ensures the client’s well-being without breaching boundaries.

Choice B reason: Redirecting a client with gentle physical guidance is acceptable when done respectfully and for safety purposes. It does not constitute a boundary violation.

Choice C reason: Sharing personal emotional experiences with a client crosses professional boundaries. It shifts focus from the client’s needs and may blur therapeutic roles.

Choice D reason: Reminding a client about medication is part of routine care and does not involve personal disclosure or inappropriate behavior.

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A charge nurse on a mental health unit is preparing an in-service for staff members about client rights. Which of the following information should the nurse include?

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Naxlex Comprehensive Predictor Exams

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