During an appointment with his psychiatric-mental health nurse practitioner (PMHNP), a 35-year-old man makes a credible threat to murder the ex-husband of his girlfriend. Of the following, what should the PMHNP do?
Call the police to inform them of the threat.
Call the potential victim to warn him of the threat.
Call the girlfriend to warn her of the threat, so she can let her ex-husband know.
Do nothing; this would violate confidentiality.
The Correct Answer is A
Choice A reason: When a patient makes a credible threat of serious harm to an identifiable individual, the PMHNP has a duty to warn and protect. This includes notifying law enforcement to prevent potential violence. This action is supported by legal precedents such as the Tarasoff ruling and aligns with ethical obligations to protect third parties.
Choice B reason: While warning the potential victim may seem appropriate, it is not the most secure or legally sound method. Law enforcement is better equipped to assess and manage threats, and direct contact with the victim may pose risks or violate procedural safeguards.
Choice C reason: Indirectly warning the victim through a third party is unreliable and may delay intervention. It also risks breaching confidentiality without ensuring the threat is properly addressed.
Choice D reason: Doing nothing in the face of a credible threat violates both ethical and legal responsibilities. Confidentiality has limits, especially when public safety is at risk.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Reflective practice involves self-examination of one’s clinical decisions and experiences to improve future performance. While it supports evidence-based practice, it does not specifically refer to the systematic use of research findings to change clinical practice.
Choice B reason: Research utilization is the process of applying research findings to clinical practice. It involves synthesizing, disseminating, and implementing evidence to improve patient outcomes. This term specifically describes the operational aspect of evidence-based practice where knowledge is translated into action.
Choice C reason: Critical thinking is a cognitive process used to analyze information, make decisions, and solve problems. It is essential in evaluating research but does not encompass the full process of applying research findings to practice.
Choice D reason: Integration refers broadly to combining various elements into a unified whole. In evidence-based practice, it may describe the merging of clinical expertise, patient preferences, and research evidence, but it does not specifically denote the process of applying research findings.
Correct Answer is B
Explanation
Choice A reason: Impaired LES function and TLESRs are associated with gastroesophageal reflux disease (GERD), not pancreatitis. These mechanisms involve esophageal sphincter relaxation and acid reflux, which are unrelated to pancreatic inflammation.
Choice B reason: Acute pancreatitis involves autodigestion of pancreatic tissue due to premature activation of pancreatic enzymes. This leads to exocrine cell destruction and infiltration by inflammatory cells, resulting in edema, necrosis, and systemic inflammatory response. Alcohol is a major etiologic factor that disrupts acinar cell function and promotes enzyme activation within the pancreas.
Choice C reason: These mechanisms are characteristic of inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease. They involve mucosal barrier dysfunction and immune dysregulation in the colon, not the pancreas.
Choice D reason: This describes multifactorial contributors to diverticular disease and irritable bowel syndrome. While relevant to colonic health, these factors do not explain the pathophysiology of acute pancreatitis.
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