Exam one

Question 1

What rights do clients retain while receiving mental health services?

Answer 1

All civil rights except the right to leave the hospital in case of involuntary commitment

This includes rights outlined in the Mental Health Patient’s Bill of Rights.

Question 2

What is the purpose of the Principles for the Provision of Mental Health and Substance Abuse Treatment Services?

Answer 2

To guide the treatment and rights of mental health patients as established by the American Psychiatric Association

Refer to the APA for comprehensive guidelines.

Question 3

What is involuntary hospitalization?

Answer 3

A process where a person is committed until no longer a danger to self or others

This is based on the health care professional’s respect for the client’s wishes.

Question 4

How long can a person be detained in a psychiatric facility on an emergency basis?

Answer 4

48 to 72 hours

This is typically done to assess the immediate danger to self or others.

Question 5

What rights do clients have regarding voluntary hospitalization?

Answer 5

Right to request discharge at any time unless danger to self or others is present

If danger is present, commitment proceedings are initiated.

Question 6

What does mandated outpatient treatment involve?

Answer 6

Continued participation in treatment on an involuntary basis after release, including:
* Taking prescribed medications
* Keeping appointments with health care providers
* Attending specific treatment programs or groups

This ensures ongoing support and monitoring.

Question 7

What is conservatorship/guardianship?

Answer 7

A legal guardianship separate from civil commitment, typically for those with grave disability or incompetency

This includes inability to provide self with food, clothing, shelter.

Question 8

Define ‘Least Restrictive Environment’ in mental health treatment.

Answer 8

A principle ensuring that clients are treated in the least restrictive setting possible

This includes using restraints or seclusion only when absolutely necessary.

Question 9

What is the definition of restraint?

Answer 9

Direct application of physical force to a person without permission

Can be human or mechanical.

Question 10

What is seclusion in mental health care?

Answer 10

Involuntary confinement in a specially constructed, locked room for monitoring

This is used only when a client is imminently aggressive or dangerous.

Question 11

What are the evaluation requirements for clients in restraints or seclusion?

Answer 11

Face-to-face evaluation within 1 hour, every 8 hours (every 4 hours for children)
* Physician’s order every 4 hours (every 2 hours for children)
* Documented assessment by a nurse every 1 to 2 hours depending on age

These measures ensure safety and appropriate monitoring.

Question 12

What is the Health Insurance Portability and Accountability Act (HIPAA)?

Answer 12

Legislation that provides civil and criminal penalties for violation of client privacy

It includes a duty to warn third parties as an exception to confidentiality.

Question 13

Define ‘insanity’ in a legal context.

Answer 13

A condition where a person is unable to control actions or understand the wrongfulness of an act (M’Naghten Rule)

This legal definition does not have a medical equivalent.

Question 14

What are the elements required to prove malpractice?

Answer 14

• Duty
• Breach of duty
• Injury or damage
• Causation

These elements must be established to hold a nurse legally accountable.

Question 15

List the types of intentional torts.

Answer 15

• Assault
• Battery
• False imprisonment

Each type involves willful acts that cause harm.

Question 16

What is ethics in the context of mental health?

Answer 16

The branch of philosophy dealing with values of human conduct, including rightness and wrongness of actions

Ethical considerations guide decision-making in mental health care.

Question 17

What are the key principles of deontology?

Answer 17

• Autonomy
• Beneficence
• Nonmaleficence
• Justice
• Veracity
• Fidelity

These principles guide ethical decision-making in nursing and mental health.

Question 18

What constitutes an ethical dilemma in mental health?

Answer 18

A conflict of ethical principles with no clear course of action

Many dilemmas involve the client’s right to autonomy.

Question 19

What should nurses do to address self-awareness issues related to ethics?

Answer 19

Talk to colleagues, seek supervision, and reflect on personal values and beliefs

Engaging in discussions about ethical concerns is essential.

Question 21

What does the therapeutic communication technique ‘Accepting’ indicate?

Answer 21

Indicates the nurse has heard and followed the train of thought

Examples include responses like ‘Yes’ or nodding.

Question 22

What is the purpose of ‘Broad openings’ in therapeutic communication?

Answer 22

Allows the client to take the initiative in introducing the topic

Examples include questions like ‘Is there something you’d like to talk about?’

Question 23

Define ‘Consensual validation’ in therapeutic communication.

Answer 23

Searching for mutual understanding of the meaning of words

Example: ‘Tell me whether my understanding of it agrees with yours.’

Question 24

What does ‘Encouraging comparison’ involve?

Answer 24

Asking that similarities and differences be noted

Examples include questions like ‘Was it something like…?’

Question 25

What is meant by 'Encouraging description'?

Answer 25

Asking the client to verbalize what they perceive ## Footnote Examples include 'Tell me when you feel anxious.'

Question 26

What does 'Encouraging expression' ask the client to do?

Answer 26

Appraise the quality of their experiences ## Footnote Examples include 'What are your feelings regarding…?'

Question 27

What is the goal of 'Exploring' in therapeutic communication?

Answer 27

Delving further into a subject or idea ## Footnote Example: 'Tell me more about that.'

Question 28

What does 'Focusing' encourage the client to do?

Answer 28

Concentrate on a single point ## Footnote Example: 'This point seems worth looking at more closely.'

Question 29

What is the purpose of 'Formulating a plan of action'?

Answer 29

Asking the client to consider appropriate behaviors in future situations ## Footnote Example: 'What could you do to let your anger out harmlessly?'

Question 30

What do 'General leads' indicate in a therapeutic setting?

Answer 30

Encouragement to continue ## Footnote Examples include 'Go on.'

Question 31

What does 'Giving information' involve?

Answer 31

Making available the facts that the client needs ## Footnote Examples include stating one's name or medication information.

Question 32

What is the effect of 'Giving recognition'?

Answer 32

Acknowledges and indicates awareness of the client ## Footnote Examples include greeting the client by name.

Question 33

What does 'Making observations' entail?

Answer 33

Verbalizing what the nurse perceives ## Footnote Example: 'You appear tense.'

Question 34

What does 'Offering self' mean in therapeutic communication?

Answer 34

Making oneself available to the client ## Footnote Example: 'I’ll sit with you awhile.'

Question 35

What is the goal of 'Placing events in time or sequence'?

Answer 35

Clarifying the relationship of events in time ## Footnote Example: 'What seemed to lead up to…?'

Question 36

What does 'Presenting reality' involve?

Answer 36

Offering consideration of what is real ## Footnote Example: 'I see no one else in the room.'

Question 37

What is 'Reflecting' in therapeutic communication?

Answer 37

Directing client actions, thoughts, and feelings back to the client ## Footnote Example: Client: 'Do you think I should tell the doctor?' Nurse: 'Do you think you should?'

Question 38

What does 'Restating' accomplish?

Answer 38

Repeating the main idea expressed by the client ## Footnote Example: Client: 'I can’t sleep.' Nurse: 'You have difficulty sleeping.'

Question 39

What is the purpose of 'Seeking information'?

Answer 39

Making clear that which is not meaningful or vague ## Footnote Example: 'I’m not sure that I follow. Could you tell me more?'

Question 40

What does 'Silence' achieve in therapeutic communication?

Answer 40

Allows the client to put thoughts or feelings into words ## Footnote Silence encourages the client to verbalize.

Question 41

What is the goal of 'Suggesting collaboration'?

Answer 41

Offering to share and work with the client for their benefit ## Footnote Example: 'Perhaps you and I can discuss your anxiety triggers.'

Question 42

What does 'Summarizing' do in a therapeutic context?

Answer 42

Organizes and sums up the discussion ## Footnote Examples include 'So, in summary…' or 'Have I got this straight?'

Question 43

What is the purpose of 'Translating into feelings'?

Answer 43

Verbalizing client’s feelings expressed indirectly ## Footnote Example: Client: 'I’m dead.' Nurse: 'Are you suggesting that you feel lifeless?'

Question 44

What does 'Verbalizing the implied' involve?

Answer 44

Voicing what the client has hinted or suggested ## Footnote Example: Client: 'I can’t talk to you.' Nurse: 'Do you feel that no one understands?'

Question 45

What does 'Voicing doubt' express?

Answer 45

Uncertainty about the reality of the client’s perception ## Footnote Examples include questions like 'Isn’t that unusual?'

Question 46

What are 'Open-ended comments' designed to do?

Answer 46

Prompt the client to continue talking ## Footnote Examples include 'Tell me more about your pain.'

Question 47

What is the role of 'Clarifying' in communication?

Answer 47

Makes the meaning of the client’s message clear ## Footnote Example: 'Tell me what is making you upset?'

Question 48

What does 'Confronting' address in therapeutic communication?

Answer 48

Incongruence between client’s words and actions ## Footnote Example: 'You said you are angry, yet you are smiling?'

Question 49

What is the purpose of 'Setting limits'?

Answer 49

Stating expectations for appropriate behavior ## Footnote Example: 'It seems you are feeling unsure of how to behave right now.'

Question 50

What characterizes 'Non-Therapeutic communication'?

Answer 50

Involves words, phrases, actions, and tones that make patients feel uncomfortable ## Footnote This can increase stress and worsen wellbeing.

Question 51

What is an example of a non-therapeutic response related to reassurance?

Answer 51

'I would not worry about that.' ## Footnote This indicates there is no cause for anxiety.

Question 52

What does 'Giving approval' imply in a non-therapeutic context?

Answer 52

That the behavior being praised is the only acceptable one ## Footnote Example: 'That’s good!'

Question 53

What does 'Rejecting' communicate?

Answer 53

Refusing to consider or showing contempt for the client’s ideas ## Footnote Example: 'Let’s not discuss that!'

Question 54

What does 'Disapproving' signify?

Answer 54

Denouncing the client’s ideas or behavior ## Footnote Example: 'That’s bad!'

Question 55

What does 'Agreeing' indicate?

Answer 55

Indicating accord with the client ## Footnote Examples include 'That’s right!'

Question 56

What does 'Disagreeing' express?

Answer 56

Opposing the client’s idea ## Footnote Examples include 'I definitely disagree with what you’re saying!'

Question 57

What does 'Advising' involve?

Answer 57

Telling the client what to do ## Footnote Example: 'I think you should…'

Question 58

What is the effect of 'Probing or persistent questioning'?

Answer 58

It is invasive and uncomfortable for clients ## Footnote Example: 'Tell me more about your love story!'

Question 59

What does 'Indicating the existence of an external source' imply?

Answer 59

Attributing the source of thoughts, feelings, and behavior to others ## Footnote Example: 'Who told you that you were God?!'

Question 60

What does 'Belittling feelings expressed' do?

Answer 60

Misjudges the degree of client’s discomfort ## Footnote Example: 'Everybody gets down in the dumps!'

Question 61

What does 'Using denial' entail?

Answer 61

Refusing to admit that a problem exists ## Footnote Example: Client: 'I’m nothing!' Nurse: 'Don’t be silly!'

Question 62

What does 'Interpreting' seek to do?

Answer 62

Make conscious what is unconscious ## Footnote Examples include 'What you really mean is…' or 'Unconsciously, you’re saying….'

Question 63

What does 'Introducing an unrelated topic' signify?

Answer 63

Changing the subject away from the client's concerns ## Footnote Example: Client: 'I’d like to die!' Nurse: 'Did you have visitors this weekend?'