In a team meeting a nurse says. "I'm concerned about whether we are behaving ethically by using restraints to prevent one patient from self-mutilation, while the care plan for another self-mutilating patient requires one-on-one supervision." Which ethical principle most clearly applies to this situation?

Justice

Fidelity

Beneficence

Autonomy

Answer and Explanation

The Correct Answer is A

A. Justice refers to fairness and equality in the distribution of care and resources. The nurse is concerned about whether patients exhibiting similar behaviors (self-mutilation) are being treated consistently and fairly, which directly relates to the principle of justice.

B. Fidelity involves keeping promises and commitments to patients, which is not the primary concern in this scenario.
C. Beneficence involves acting in the patient’s best interest to promote well-being. While relevant to care decisions, the main ethical issue here is fairness between patients.
D. Autonomy involves respecting a patient’s right to make their own decisions, which is not the central issue in comparing the care of two patients.

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Correct Answer is D

Explanation

A. Chronic deterioration refers to a gradual, long-term decline in functioning, not the sudden emergence of new or worsening psychotic symptoms.

B. While relapse can sometimes be related to nonadherence, there is no direct evidence here that the patient has stopped taking medication, so this cannot be assumed.

C. Psychoeducation may be helpful, but the immediate concern is the reemergence of psychotic symptoms, not just a lack of understanding about the illness.

D. The patient is displaying insomnia, tension, difficulty concentrating, and paranoid delusions, which are early warning signs of a psychotic relapse in schizophrenia. Prompt intervention is necessary to prevent full exacerbation.

A. Countertransference B. Catastrophic reaction C. Defensive coping reaction D. Transference

Correct Answer is A

Explanation

A. This occurs when the nurse projects personal feelings about someone from their own life onto the patient (e.g., comparing the patient to a grandparent and feeling sadness).

B. This refers to severe emotional outbursts in cognitively impaired patients, not nurse behavior.

C. This would involve the nurse using defense mechanisms to protect themselves from anxiety, not relating to the patient as a grandparent.

D. Transference is when the patient projects feelings onto the nurse, not the other way around.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A nurse assesses a confused older adult. The nurse experiences sadness and reflects. This patient is like one of my grandparents... so helpless." Which response is the nurse demonstrating?

Correct Answer is A

Explanation

The parent of a 6-year-old says. "My child is in constant motion and talks all the time. My child isn't interested in toys but is out of bed every morning before me." The child's behavior is most consistent with diagnostic criteria for

A nurse cares for a patient experiencing an opioid overdose. Which focused assessment has the highest priority?

An adult patient assaulted another patient and was then restrained. One hour later, which statement by the restrained patient requires the nurse's immediate attention?

A patient discloses several concerns and associated feelings. If the nurse wants to seek clarification, which comment would be appropriate?

Which rationale best explains why a nurse should be aware of personal feelings while working with a family experiencing family violence?

After several therapeutic encounters with a patient who recently attempted suicide, which occurrence should cause the nurse to consider the possibility of countertransference?

Select an example of a tort.

A nurse in a substance abuse clinic is assessing a client who was recently prescribed disulfiram. The patient suddenly stopped taking this medication and is now complaining of severe nausea and vomiting. What should the nurse suspect is likely the cause of the client's distress?