Review Practice Exercise 3

Types of Mental Health Admissions and Discharges > Mental Health

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Practice Exercise 3

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Total Questions : 5

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Question 1:

A nurse is educating a client on his or her legal rights. Which of the following may a client still do even if he or she has been involuntarily committed to an inpatient psychiatric unit? (Select all that apply.)

A. The right to refuse psychotropic medications B. The right to leave the hospital against medical advice C. The right to the least restrictive treatment alternative D. The right to make a will E. The right to enter into contracts F. The right to due process

Answer and Explanation

Choice A:

Refusal rights and autonomy are preserved unless the client is declared incompetent or poses an imminent risk. Involuntary commitment does not automatically remove the right to refuse psychotropic medications unless a court mandates treatment.

Choice B:

Involuntarily committed clients cannot leave against medical advice. Their discharge must be authorized by the treatment team or court, based on safety and clinical evaluation. Leaving AMA is a right reserved for voluntary admissions.

Choice C:

Least restrictive treatment is a legal and ethical standard. Even under involuntary commitment, clients must be treated in the least restrictive environment appropriate to their condition.

Choice D:

Legal autonomy includes the right to make a will unless the client lacks testamentary capacity. This right is not revoked by involuntary status unless proven otherwise.

Choice E:

Choice F:

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Question 2:

An involuntarily admitted client is suspected of concealing a weapon. What action should the nurse take?

A. Search the client and the room without permission. B. Ask the client’s permission to search the room and belongings. C. Notify security to search the client in private. D. Wait until the client is asleep to conduct a search.

Answer and Explanation

Choice A:

Searching without permission in a public or unstructured manner violates patient rights and may provoke aggression. Even in emergencies, searches must follow protocol.

Choice B:

Asking permission may delay necessary action when a weapon is suspected. Safety concerns override consent in high-risk situations.

Choice C:

private search by security ensures safety while respecting the client’s dignity. When a weapon is suspected, immediate intervention is justified, but must occur in a controlled, private environment to avoid escalation and preserve rights.

Choice D:

Waiting until the client is asleep compromises safety and violates ethical standards. Searches must be timely and transparent, not covert.

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Question 3:

Which situation justifies breaching a client’s confidentiality?

A. The client has committed a crime in the past B. The client is rude to staff C. The client threatens to harm a specific person D. The client refuses to take medications

Answer and Explanation

Choice A:

Past crimes do not justify breaching confidentiality. Disclosure is only permitted when there is current risk or legal obligation.

Choice B:

Rudeness is a behavioral issue, not a safety threat. It does not meet the threshold for breaching confidentiality.

Choice C:

Specific threat to another person activates the duty to warn. This legal and ethical obligation overrides confidentiality to protect potential victims from imminent harm.

Choice D:

Refusing medication is a client’s right unless court-ordered. It does not justify breaching confidentiality.

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Question 4:

A nurse can be charged with assault for:

A. Verbally threatening to medicate a patient against their will B. Restraining a patient who is trying to leave the unit C. Administering a sedative without consent during a crisis D. Locking a patient in a quiet room without food

Answer and Explanation

Choice A:

verbal threat to medicate without consent qualifies as assault because it instills fear of forced treatment. Even without physical contact, the threat violates patient autonomy and can be legally actionable.

Choice B:

Restraining a patient may be justified if they pose an immediate risk to themselves or others. When done according to protocol, it is not considered assault.

Choice C:

Administering a sedative during a crisis may be permissible under emergency protocols if the patient is a danger. It must be documented and follow legal guidelines.

Choice D:

Seclusion without food violates ethical and legal standards but is classified as abuse or neglect rather than assault. Assault requires a threat or act that causes fear of harm.

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Question 5:

A client has been diagnosed with a mental illness. Which of the following criteria must be met to legally deem this client to be “gravely disabled”?

A. The client is in danger of harming self or others. B. The client is unable to provide for his or her basic needs. C. The client is unable to make rational decisions regarding treatment. D. All of the above.

Answer and Explanation

Choice A:

Danger to self or others is a separate criterion for involuntary commitment. It does not define grave disability, which focuses on inability to care for oneself due to psychiatric symptoms.

Choice B:

Basic needs and psychiatric impairment define grave disability. The client must be unable to provide for essential needs due to mental illness. This is the legal threshold for grave disability and supports involuntary intervention when autonomy is compromised.

Choice C:

Inability to make rational decisions may indicate impaired judgment but does not alone meet the legal standard for grave disability unless it results in failure to meet basic survival needs.

Choice D:

All of the above is incorrect because not all listed criteria are required to establish grave disability. Only the inability to provide for basic needs due to mental illness is necessary.

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Practice Exercise 3

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