A nurse is talking with a patient, and 5 minutes remain in the session. The patient has been silent for most of the session. Another patient comes to the door of the room, interrupts, and says, “I really need to talk to you right now.” The nurse should:

Say to the interrupting patient, “I am not available to talk with you at the present time”

End the unproductive session with the current patient and spend time with the patient who has just interrupted

Invite the interrupting patient to join in the session with the current patient

Tell the patient who interrupted, “This session will be 5 more minutes; then, I will talk with you”

Answer and Explanation

The Correct Answer is D

Choice A reason: Bluntly stating unavailability dismisses the interrupting patient’s needs without offering a solution, potentially escalating distress. This approach lacks therapeutic communication, as it fails to acknowledge the patient’s urgency or provide a clear plan, which is critical in maintaining trust in a mental health setting.

Choice B reason: Ending the current session prematurely disrespects the silent patient’s therapeutic process. Silence may reflect processing or discomfort, requiring time to build trust. Abruptly shifting focus undermines the current patient’s care, potentially worsening their mental health and disrupting the therapeutic relationship.

Choice C reason: Inviting the interrupting patient to join violates confidentiality and disrupts the current patient’s safe space. Combining sessions without consent breaches ethical principles, potentially causing discomfort or mistrust, which hinders therapeutic progress for both patients in a mental health context.

Choice D reason: Acknowledging the interruption and scheduling a follow-up in 5 minutes respects both patients’ needs. It maintains the current patient’s therapeutic time while addressing the interrupting patient’s urgency, ensuring fairness and trust. This approach upholds ethical care and supports a therapeutic environment for mental health treatment.

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Correct Answer is D

Explanation

Choice A reason: Legislation changing civil commitment procedures occurred later, notably in the 1960s–1970s, with deinstitutionalization movements. In the 1950s, institutional care was still prevalent, and legislative reforms were not the primary change in mental health treatment, making this option incorrect for that decade.

Choice B reason: Community support services expanded significantly during the 1960s with deinstitutionalization, not the 1950s. While some early community efforts existed, they were not the hallmark change of the 1950s, when institutional care dominated, and psychotropic drugs revolutionized treatment approaches for mental illness.

Choice C reason: The Patient’s Bill of Rights was formalized in the 1970s, not the 1950s. While patient advocacy began to emerge later, the 1950s focused primarily on medical advancements like psychotropic drugs, not legal frameworks for patient rights, making this option incorrect.

Choice D reason: In the 1950s, psychotropic drugs like chlorpromazine were introduced, revolutionizing mental health treatment. These medications effectively managed psychosis, reducing symptoms and enabling outpatient care, decreasing reliance on long-term institutionalization. This marked a significant shift in psychiatric care, making it the key change of the decade.

A. When the client violates the nurse’s boundaries B. If threats are made to an identifiable third party C. Whenever the client becomes aggressive D. At any time a client does not agree with the nurse

Correct Answer is B

Explanation

Choice A reason: Violating a nurse’s boundaries, such as inappropriate behavior, does not legally mandate breaching confidentiality. Ethical responses involve setting boundaries or reporting within the care team, but confidentiality is protected unless harm to others is threatened, making this situation insufficient for a legal breach.

Choice B reason: Nurses are legally obligated to breach confidentiality when a client makes credible threats to harm an identifiable third party (Tarasoff duty). This protects potential victims by ensuring warnings or interventions occur, balancing patient confidentiality with public safety, as harm prevention takes precedence in mental health law.

Choice C reason: Client aggression does not automatically warrant breaching confidentiality unless it involves specific threats to identifiable individuals. Aggression is managed within the care setting, and confidentiality is maintained unless legal criteria, like imminent harm to others, are met, making this option incorrect.

Choice D reason: Disagreement with the nurse does not justify breaching confidentiality. Ethical care respects client autonomy, and confidentiality is protected unless legal exceptions, like threats or court orders, apply. Disagreement is managed through therapeutic communication, not by disclosing private information, making this an invalid reason for breach.

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A nurse is talking with a patient, and 5 minutes remain in the session. The patient has been silent for most of the session. Another patient comes to the door of the room, interrupts, and says, “I really need to talk to you right now.” The nurse should:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which significant change in the treatment of people with mental illness occurred in the 1950s?

Correct Answer is D

Explanation

When is a nurse legally obligated to breach confidentiality?

Correct Answer is B

Explanation

The nurse is caring for a client who is in the oliguric phase of acute kidney injury (AKI). During this phase of AKI, the nurse might anticipate which of the following findings?

Which of the following is true regarding mental health and mental illness?

The healthcare provider prescribes haloperidol 10 mg for a client with severe psychosis, but the client refuses the medication. Which initial nursing action is appropriate?

The nurse is caring for a group of clients in the mental health outpatient clinic. Which client is most likely to be mandated by a criminal court for outpatient treatment?

Which of the following would the nurse expect to find when reviewing the laboratory test results of a client with renal failure?

A nurse and client are engaged in a discussion. The client says, “I feel really close to you. You are my only true friend.” Which response by the nurse would be most therapeutic?

The nurse is evaluating clients in the emergency department (ED) for pending mental health admissions. Which client will be admitted for involuntary hospitalization?