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?

Autonomy

Beneficence

Justice

Nonmaleficence

Answer and Explanation

The Correct Answer is C

Choice A reason: Autonomy involves respecting a patient’s right to make decisions. While relevant in mental health, the scenario focuses on differing treatments for similar conditions, not patient choice, making autonomy less directly applicable than the principle of fair treatment across patients.

Choice B reason: Beneficence emphasizes promoting patient well-being. Both restraints and supervision aim to prevent harm, fulfilling beneficence, but the concern is about unequal treatment, not the intent to benefit, making this principle less relevant than justice.

Choice C reason: Justice involves fair and equitable treatment for all patients. Using restraints for one self-mutilating patient and supervision for another raises concerns about consistency and fairness in care, directly aligning with the ethical principle of justice, making this the correct choice.

Choice D reason: Nonmaleficence focuses on avoiding harm. Both interventions aim to prevent self-mutilation, fulfilling this principle, but the ethical issue is about equitable application, not harm avoidance, making justice the more relevant principle in this scenario.

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Correct Answer is B

Explanation

Choice A reason: A provider giving a telephone order is a standard practice in healthcare, not inherently requiring reporting unless the order is unsafe. It does not indicate negligence or ethical violations, unlike impaired practice or boundary issues, making it incorrect for mandatory intervention and reporting.

Choice B reason: A peer under the influence of alcohol compromises patient safety due to impaired judgment and coordination, a serious ethical and professional violation. Nurses are obligated to report such behavior to protect patients, aligning with nursing ethics and safety protocols, making this a correct choice.

Choice C reason: Violating relationship boundaries with a patient, such as inappropriate personal interactions, breaches ethical standards and risks patient harm. Nurses must report this to ensure patient safety and maintain professional integrity, aligning with mental health care ethics, making this a correct choice.

Choice D reason: A licensed provider prescribing medication is a routine clinical action, not requiring reporting unless the prescription is unsafe or inappropriate. This choice does not inherently indicate a need for intervention, unlike impaired practice or boundary violations, making it incorrect.

A. Recommend immediate electroconvulsive therapy B. Initiate cognitive behavioral therapy techniques C. Administer a high-dose benzodiazepine D. Encourage the patient to avoid social interactions

Correct Answer is B

Explanation

Choice A reason: Electroconvulsive therapy (ECT) is reserved for severe, treatment-resistant depression or acute suicidal ideation, not general hopelessness. It involves significant risks and requires specialist oversight, making it inappropriate as a first-line intervention for this symptom, which can be addressed with less invasive methods.

Choice B reason: Cognitive behavioral therapy (CBT) targets negative thought patterns, such as hopelessness, by restructuring cognitions, a core feature of depression. Evidence-based for mood disorders, CBT reduces symptoms through structured interventions, making it the most appropriate choice for addressing hopelessness in a mental health assessment.

Choice C reason: High-dose benzodiazepines treat acute anxiety or agitation, not hopelessness, which is a depressive symptom. They risk sedation and dependence without addressing cognitive distortions, making them inappropriate for this symptom and contrary to evidence-based psychiatric nursing practice.

Choice D reason: Avoiding social interactions may worsen hopelessness by increasing isolation, a risk factor for depression. Evidence-based practice encourages social engagement to improve mood and support networks, making this intervention counterproductive and incorrect for addressing the patient’s reported symptom.

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Naxlex Comprehensive Predictor Exams

In which situations would a nurse have the duty to intervene and report? (Select all that apply)

Correct Answer is B

Explanation

A nurse is conducting a mental health assessment for a patient reporting persistent feelings of hopelessness. Which intervention best aligns with evidence-based practice for addressing this symptom?

Correct Answer is B

Explanation

A nurse is caring for patients receiving clozapine, lithium, fluoxetine, and venlafaxine. Which patient should the nurse be most alert for problems associated with fluid and electrolyte imbalance?

When considering the suggestions of Hildegard Peplau, which activity should the nurse regularly engage in that supports the theory of interpersonal relations?

Silence can be a helpful therapeutic tool for group participants by giving each an opportunity to contemplate what has transpired, weigh alternatives, and formulate ideas. Which statement best supports this?

An adolescent hospitalized after a physical outburst tells the nurse, "I’m going to kill my father, but you can’t tell anyone." Select the nurse’s best response.

What must the nurse obtain from the patient in order for medical information to be released to another health care facility or third party regarding a patient diagnosed with a mental illness?

A patient begins therapy with clozapine medication. What teaching should the nurse provide related to the drug’s strong dopaminergic effect?

A nurse is working with a patient diagnosed with schizophrenia who is experiencing auditory hallucinations. Which intervention best supports the patient in managing these symptoms?

The plan of care for a patient is not completed within 24 hours of the patient’s admission due to the unit being short-staffed. Which action should the nurse prioritize?