A nurse in a mental health unit is discussing restraints and seclusion with a group of newly hired nurses. At which of the following times should a nurse discuss the restraint and seclusion policy with a client?
Upon admission
While administering chemical or physical restraints
When a client becomes agitated
During debriefing after restraint removal
The Correct Answer is A
A. Upon admission: The best time to discuss policies on restraints and seclusion is at admission, when clients are calm and able to understand their rights.
B. While administering chemical or physical restraints : Explaining the policy during restraint use can increase client distress and agitation.
C. When a client becomes agitated: Discussing restraint policies while a client is already agitated is ineffective and could escalate distress.
D. During debriefing after restraint removal : While debriefing is important, waiting until after restraints are removed does not allow for proactive education.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Administering medications: Mental health nurses can administer psychiatric medications, including antipsychotics, mood stabilizers, and antidepressants.
B. Performing surgical procedures: Surgical procedures are outside a nurse’s scope of practice and are performed by surgeons, not nurses.
C. Diagnosing mental illnesses: Only advanced practice registered nurses (APRNs), psychiatrists, and psychologists can diagnose mental illnesses.
D. Providing therapeutic communication: Mental health nurses use therapeutic communication techniques like active listening, validation, and open-ended questioning.
Correct Answer is C
Explanation
A. "Implied consent cannot be assumed if a client is unable to communicate their wishes in an emergency situation." In emergencies, implied consent is assumed if immediate treatment is necessary to prevent harm.
B. "A nurse can explain the benefits and risks of treatment to a client to obtain informed consent." Only the provider (physician, NP, or PA) can obtain informed consent; the nurse can reinforce and clarify information but not obtain it.
C. "Informed consent must include information about potential alternative treatments that are available to the client." Informed consent requires the provider to discuss potential alternative treatments, risks, benefits, and consequences of refusal.
D. "Implied consent cannot be assumed until a client verbalizes their desire to receive treatment." Implied consent can be assumed based on actions, such as extending an arm for a blood draw.
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