Emerging Care-Management Issues 36 of 50 Question 1 A client with a history of major depression established a psychiatric advance directive that was deemed legally valid. The directive specified that the client did not want electroconvulsive therapy (ECT) at any time. The client is legally competent and has expressed a renewed interest in trying ECT. The nurse should anticipate what event? You Selected: The advance directive may only be overturned by a court order. Correct response: The client may revoke or amend the terms of the advance directive. Rationale: During times of legal competency, a client may revoke or amend a psychiatric advance directive. The care team cannot make this decision for the client during times of competency. A court order or the appointment of a person with power of attorney is unnecessary. Question 2 A newly-admitted client has told the nurse, "I always take a thyroid pill each morning but I do not think I have been prescribed it here in the hospital." The nurse confirms that the client's medication orders do not include this. What is the nurse's best action? You Selected: Contact the client's provider, and discuss the fact that the client normally takes thyroid supplements. Correct response: Contact the client's provider, and discuss the fact that the client normally takes thyroid supplements. Rationale: The nurse's priority action is to make the provider aware of this potential oversight. Family members should not bring medications that have not been prescribed in the hospital. Thyroid supplements should be taken daily. Question 3 A nurse has discovered a colleague pocketing a partial dose of an opioid despite documenting it as a waste. When confronted, the colleague acknowledges the behavior. What is the nurse's best action? You Selected: Explain to the colleague that this is a serious violation of policy. Correct response: Report the colleague's actions because of legal and ethical obligations. Rationale: Nurses have a duty to report substance misuse among colleagues. It is appropriate to seeks solutions with the colleague, but the priority is to ensure that the event is not kept a secret between the two nurses. Question 4 The nurse is assessing a client with a history of mental illness who has been brought to the emergency department by first responders. What characteristic of the client's status would most justify involuntary admission? You Selected: The client demonstrates a serious risk of self-harm. Correct response: The client demonstrates a serious risk of self-harm. Rationale: Involuntary admission is often prompted by an individual's realistic risk of self-harm. A history of mental illness, lack of support, or history of nonadherence would not provide sufficient legal basis for involuntary admission.
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- Spring '17
- mrs. Vargovich
- Nursing, attorney, Correct Response