ATI RN
Behavioral Health Nursing Questions
Question 1 of 5
A client is admitted to the psychiatric unit and states, 'I am president of the largest corporation in the world. Everyone comes to me for advice.' The client is exhibiting which of the following?
Correct Answer: C
Rationale: The client has a delusion (a fixed false belief not based in reality) about his superiority over others. Flight of ideas is excessive amount and rate of speech composed of fragmented or unrelated ideas. Thought broadcasting is a delusional belief that others can hear or know what the client is thinking. Loose associations are disorganized thinking that jumps from one idea to another with little or no evident relation between the thoughts.
Question 2 of 5
A nurse is performing safety assessments on a client in mechanical restraints as required by policy. Which action by the nurse demonstrates the ethical principle of nonmaleficence?
Correct Answer: B
Rationale: Assuring that the restraints are not causing injury to the client is an example of nonmaleficence, or doing no harm. Explaining the behavioral requirements for release of restraint to the client is providing the client the autonomy to choose behaviors. Applying restraints based solely on assessment findings and not on attitude toward the client is displaying justice. Releasing the client when stated behavioral control is achieved is displaying veracity, or being honest and truthful.
Question 3 of 5
A client underwent a procedure before the nurse verified the client's signature on the consent form. The client actually did not sign the form before the procedure. If the client is dissatisfied with the outcome of the procedure and files a suit against the health-care team, which kind of case can the client file?
Correct Answer: C
Rationale: Battery involves harmful or unwarranted contact with a client. False imprisonment is defined as the unjustifiable detention of a client such as the inappropriate use of restraint or seclusion. Negligence is an unintentional tort that involves causing harm by failing to do what a reasonable and prudent person would do in similar circumstances. Clients or families can file malpractice lawsuits in any case of injury, loss, or death.
Question 4 of 5
A nurse introduces the matter of a contract during the first session with a new patient because contracts:
Correct Answer: B
Rationale: In Behavioral Health Nursing, establishing a therapeutic contract with a patient is crucial for setting clear expectations and boundaries from the beginning of the therapeutic relationship. Option B, which states that contracts spell out the participation and responsibilities of each party, is the correct answer. This is important because it helps in defining the roles of both the nurse and the patient, outlining what each party can expect from the other, and clarifying the goals and boundaries of the therapeutic relationship. Option A is incorrect because a therapeutic contract is not solely about what the nurse will do for the patient but rather about the mutual responsibilities and expectations of both parties. Option C is incorrect as well because the feeling tone between participants is important but not the primary focus of a therapeutic contract. Option D is incorrect because while contracts do establish boundaries, they are not binding in a legal sense and do not prevent either party from ending the therapeutic relationship if needed. Educationally, understanding the significance of establishing a therapeutic contract in behavioral health nursing is essential for students and practitioners to provide effective and ethical care to their patients. It sets the foundation for a collaborative and transparent relationship, promotes patient autonomy, and helps in achieving treatment goals in a structured and accountable manner.
Question 5 of 5
Which behavior shows that a nurse values autonomy? The nurse:
Correct Answer: C
Rationale: In the context of behavioral health nursing, valuing autonomy is crucial as it promotes patients' independence and decision-making. Option C, discussing options with the patient and helping them weigh consequences, demonstrates respect for the patient's autonomy by involving them in the decision-making process and supporting their self-determination. Option A, suggesting one-on-one supervision for a patient with suicidal thoughts, may prioritize safety but does not directly relate to autonomy as it involves more control and monitoring by the nurse. Option B, informing the patient that the spouse will not be present during visiting hours, limits the patient's social support but does not necessarily relate to autonomy. Option D, setting limits on a patient's romantic advances, is important for professional boundaries but does not directly demonstrate valuing the patient's autonomy in decision-making. Educationally, understanding and applying the principle of autonomy in nursing practice is essential for fostering therapeutic relationships, promoting patient-centered care, and upholding ethical standards. By empowering patients to be active participants in their care, nurses can enhance outcomes and respect the individuality and dignity of each patient.