Several nurses are concerned that agency policies related to restraint and seclusion are inadequate. Which statement about the relationship of substandard institutional policies and individual nursing practice should guide nursing practice?
The policies do not absolve an individual nurse of the responsibility to practice according to professional standards of nursing care
In an institution with substandard policies, the nurse has a responsibility to inform the supervisor and leave the premises
Agency policies are the legal standard by which a professional nurse must act and therefore override other standards of care
Interpretation of policies by the judicial system is rendered on an individual basis and therefore cannot be predicted
The Correct Answer is A
Choice A reason: Nurses must adhere to professional standards, ensuring safe care despite substandard policies. Restraint use, for example, must minimize harm and respect patient dignity, regardless of policy. This aligns with ethical principles and evidence-based practices for managing agitation linked to neurotransmitter imbalances, upholding nurse accountability.
Choice B reason: Leaving the premises after informing a supervisor abandons patients, violating ethical duties. Professional standards require nurses to advocate for safe practices, like appropriate restraint use for dopamine-driven agitation, within the system. This option is impractical and neglects patient care responsibilities, making it incorrect.
Choice C reason: Agency policies do not override professional standards. Nurses are accountable to evidence-based practices, ensuring interventions like restraints for severe agitation are safe and ethical. Policies may guide but cannot excuse deviations from standards addressing neurobiological safety needs, making this option scientifically and ethically incorrect.
Choice D reason: Judicial interpretation varies, but nursing practice is guided by professional standards, not unpredictable legal outcomes. Standards ensure safe, ethical care, like minimizing restraint use for serotonin-related agitation, regardless of policy or judicial variability. This option is irrelevant to guiding daily nursing practice.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Active suicidality, linked to severe serotonin deficits, requires inpatient hospitalization for constant monitoring to ensure safety. Partial hospitalization is insufficient for acute risk, as it lacks 24-hour supervision, making this patient inappropriate for this less intensive care setting.
Choice B reason: Agoraphobia and panic episodes, driven by norepinephrine surges, benefit from partial hospitalization’s structured psychoeducation and therapy. Relaxation techniques reduce amygdala hyperactivity, supporting outpatient management with daily support, making this patient suitable for partial hospitalization’s intensive, non-residential treatment.
Choice C reason: Stable lithium levels indicate controlled bipolar disorder, not requiring partial hospitalization. Regular follow-up manages neurotransmitter balance, suitable for outpatient care. Partial hospitalization is for active symptoms, not stable patients, making this an incorrect referral choice.
Choice D reason: Alcohol use concerns suggest outpatient substance abuse programs, not partial hospitalization. While dopamine reward pathways are involved, partial hospitalization targets acute psychiatric symptoms, not substance issues alone, making this patient unsuitable for this level of care.
Correct Answer is C
Explanation
Choice A reason: Denying problems reflects resistance, typical in the orientation phase, where trust is not yet established. Anger management, linked to amygdala-driven impulsivity, requires a therapeutic alliance. This statement indicates avoidance, not readiness for the working phase’s collaborative problem-solving.
Choice B reason: Questioning therapy’s value shows skepticism, common in the orientation phase. The working phase involves active goal-setting, like managing anger tied to serotonin dysregulation. This statement reflects a lack of engagement, not the transition to collaborative therapeutic work, making it incorrect.
Choice C reason: Expressing a goal to manage anger indicates readiness for the working phase, where collaborative problem-solving occurs. Anger, linked to amygdala hyperactivity and serotonin deficits, requires active intervention. This statement shows commitment to addressing neurobiological issues, marking the transition to the working phase.
Choice D reason: Difficulty discussing problems reflects orientation phase challenges, where trust is building. The working phase involves active engagement, like addressing anger’s neurobiological basis. This statement indicates discomfort, not readiness for collaborative work, making it incorrect for the phase transition.
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