Which of the following situations may put a nurse on an inpatient unit in legal jeopardy for battery? Select all that apply.

Correct Answer: B

Rationale: The correct answer is B: A client is injured while being forcibly placed in four-point restraints because of low staffing. Rationale: 1. Battery is the intentional harmful or offensive touching of another without consent. 2. Forcibly placing a client in restraints without proper justification or consent can be considered harmful touching, potentially leading to legal jeopardy for battery. 3. Low staffing does not justify improper use of restraints, as it is the responsibility of the nurse to ensure safe and appropriate care for the client. Summary of Incorrect Choices: A. Threatening a client with bodily harm is intimidation and coercion, not physical touching, which is required for battery. C. Giving excess medication due to an error is a medication error, not battery. Reporting and addressing the error is crucial to prevent harm. D. Holding a client against their will due to nonadherence may be related to ethical or legal issues, but it does not involve direct physical touching that constitutes battery.

Correct Answer: C

Rationale: The correct answer is C: Abdominal rigidity. Abdominal rigidity can indicate a serious issue such as peritonitis, which may be caused by a malfunctioning NG tube allowing leakage of gastric contents into the peritoneal cavity. This requires immediate intervention. Choices A, B, and D are not indicative of NG tube malfunction. Greenish-yellow drainage is normal post-surgery, an aspirate pH of 3 is within the normal range for gastric contents, and air bubbles in the NG tube are common and do not necessarily indicate malfunction.

Correct Answer: D

Rationale: The correct answer is D because confronting the staff member and reporting concerns to a supervisor immediately is crucial for addressing the issue promptly and ensuring patient safety. This approach allows for professional intervention and support. Choice A is incorrect as it may compromise patient care. Choice B may enable the behavior and is not a professional response. Choice C could be appropriate, but immediate action is needed to address the potential risk to patients and the staff member.

Correct Answer: C

Rationale: The correct answer is C because there is a historical link between the first nursing program to admit male students and the first training school for psychiatric nursing. This is important to include in a discussion of the history of psychiatric-mental health nursing as it highlights the progressive nature of nursing education and the integration of male nurses into psychiatric nursing. This connection showcases the evolution of psychiatric nursing training and its significance within the broader history of nursing education. Choices A, B, and D are incorrect: A: Certification for the psychiatric-mental health nursing specialty was not first emphasized by Mary Adelaide Nutting. This statement does not align with the historical development of psychiatric nursing education. B: Psychiatric nurses' role in deinstitutionalization and community mental health centers is not directly related to the history of psychiatric-mental health nursing education, making this choice irrelevant. D: The establishment of the first graduate program in psychiatric nursing in response to psychiatric nursing specialty journals is not historically accurate, as the first training school for psychiatric nursing

Correct Answer: B

Rationale: The correct answer is B: A client is injured while being forcibly placed in four-point restraints because of low staffing. Rationale: 1. Battery is the intentional harmful or offensive touching of another without consent. 2. Forcibly placing a client in restraints without proper justification or consent can be considered harmful touching, potentially leading to legal jeopardy for battery. 3. Low staffing does not justify improper use of restraints, as it is the responsibility of the nurse to ensure safe and appropriate care for the client. Summary of Incorrect Choices: A. Threatening a client with bodily harm is intimidation and coercion, not physical touching, which is required for battery. C. Giving excess medication due to an error is a medication error, not battery. Reporting and addressing the error is crucial to prevent harm. D. Holding a client against their will due to nonadherence may be related to ethical or legal issues, but it does not involve direct physical touching that constitutes battery.

Correct Answer: B

Rationale: The correct answer is B: Boundary setting. When working with a client diagnosed with antisocial personality disorder, it is crucial for the nurse to focus on teaching the family about setting boundaries. This is important because individuals with this disorder often have difficulty respecting others' boundaries and may engage in manipulative or harmful behaviors. By establishing clear boundaries, the family can protect themselves and the client from potential harm or exploitation. Explanation of why the other choices are incorrect: A: Anger management - While anger management may be important in some cases, it is not the primary focus when dealing with antisocial personality disorder. The core issue lies in the individual's lack of empathy, disregard for rules, and manipulative behavior. C: Medication therapy - Medication may be used to manage certain symptoms associated with antisocial personality disorder, but it is not the primary intervention. The focus should be on behavioral and therapeutic approaches. D: Self-responsibility - While self-responsibility is important, individuals with antis

Correct Answer: C

Rationale: The correct answer is C: Obtain the patient's permission for the exchange of information. This is the case manager's first action because it ensures the patient's autonomy and right to privacy are respected. It is crucial to obtain the patient's permission before discussing their treatment plan with the family to maintain trust and confidentiality. Without the patient's consent, sharing sensitive information with the family could breach ethical and legal boundaries. In contrast: A: Determining an appropriate location is important but not the first step. B: Supporting the discussion with examples of the patient's behavior is relevant but not as critical as obtaining consent. D: Deciding which family members should participate is premature without the patient's approval.

Correct Answer: D

Rationale: The correct answer is D: Develop unconditional positive regard for the client. In Carl Rogers' theory, unconditional positive regard refers to the therapist's genuine acceptance and support of the client without judgment. This helps create a safe and trusting therapeutic relationship, leading to client growth and self-actualization. Providing validation of terminology (A) may be important but is not the primary focus. Focusing on instinctual drives (B) is more aligned with Freudian theory, not Rogers'. Recognizing basic needs (C) is essential, but it does not capture the essence of Rogers' emphasis on unconditional positive regard.

Correct Answer: C

Rationale: The correct answer is C: gustatory, which refers to hallucinations related to taste. This is the correct answer because hallucinations can involve all senses, including taste. Erotomanic (A) hallucinations involve believing someone is in love with you, referential (B) hallucinations involve attaching personal significance to random events, and tangential (D) hallucinations involve diverging from the main topic in conversation. These choices are incorrect because they do not pertain specifically to the sense of taste in hallucinations.