What is the primary goal of psychiatric legal and ethical practice?
Protect individual rights while maintaining public safety.
Why are ethics and laws not always identical?
Ethical obligations guide moral decisions, while laws establish legally enforceable standards.
What is beneficence?
The obligation to promote the well-being of others.
What is autonomy?
The client's right to make informed decisions about their own care.
What is justice?
Providing fair and equal treatment without discrimination.
What is fidelity?
Remaining loyal to professional responsibilities and commitments.
What is nonmaleficence?
The duty to avoid causing harm.
What is veracity?
Providing truthful and accurate information.
What ethical principle supports a client's right to refuse treatment?
Autonomy.
Which ethical principle emphasizes honesty in nurse-client interactions?
Veracity.
Which ethical principle requires equal care regardless of personal feelings?
Justice.
Which ethical principle requires equal care regardless of personal feelings?
Justice.
Which ethical principle focuses on keeping promises and maintaining trust?
Fidelity.
Which ethical principle focuses on keeping promises and maintaining trust?
Fidelity.
Which ethical principle requires acting in the client's best interest?
Beneficence.
Which ethical principle requires acting in the client's best interest?
Beneficence.
What is informed consent?
Voluntary agreement to treatment after receiving adequate information.
What is informed consent?
Voluntary agreement to treatment after receiving adequate information.
When may informed consent be provided by another individual?
When a court-appointed guardian has legal authority.
When may informed consent be provided by another individual?
When a court-appointed guardian has legal authority.
What legal right allows competent clients to refuse treatment?
The right to informed refusal.
What civil rights do psychiatric clients retain?
The same constitutional rights as all other citizens unless legally restricted.
What civil rights do psychiatric clients retain?
The same constitutional rights as all other citizens unless legally restricted.
What is confidentiality?
Protecting private client information from unauthorized disclosure.
What is confidentiality?
Protecting private client information from unauthorized disclosure.
Who may receive confidential client information?
Individuals directly involved in the client's care or those authorized by the client.
Who may receive confidential client information?
Individuals directly involved in the client's care or those authorized by the client.
What federal law protects health information privacy?
HIPAA.
What federal law protects health information privacy?
HIPAA.
When may confidentiality legally be breached?
When required to protect others or report legally mandated situations.
When may confidentiality legally be breached?
When required to protect others or report legally mandated situations.
What is the Tarasoff duty?
The legal obligation to protect identifiable individuals from credible threats.
What is the Tarasoff duty?
The legal obligation to protect identifiable individuals from credible threats.
What three responsibilities are included in the duty to warn?
Assess the threat, identify potential victims, and take protective action.
What three responsibilities are included in the duty to warn?
Assess the threat, identify potential victims, and take protective action.
Which situations require mandatory reporting?
Suspected child abuse, dependent adult abuse, and elder abuse.
Which situations require mandatory reporting?
Suspected child abuse, dependent adult abuse, and elder abuse.
What is a voluntary psychiatric admission?
Admission initiated with the client's consent.
What is a voluntary psychiatric admission?
Admission initiated with the client's consent.
Can voluntarily admitted clients request discharge?
Yes, unless criteria for involuntary detention are met.
Can voluntarily admitted clients request discharge?
Yes, unless criteria for involuntary detention are met.
What is an involuntary admission?
Admission without consent because legal commitment criteria are met.
What is an involuntary admission?
Admission without consent because legal commitment criteria are met.
What criteria commonly justify involuntary hospitalization?
Danger to self, danger to others, or grave disability.
What criteria commonly justify involuntary hospitalization?
Danger to self, danger to others, or grave disability.
Are involuntarily admitted clients automatically incompetent?
No. They generally retain decision-making rights unless ruled otherwise.
What is grave disability?
Inability to provide food, clothing, or shelter because of mental illness.
What is grave disability?
Inability to provide basic needs because of mental illness.
What is the purpose of emergency hospitalization?
Immediate stabilization when safety is at risk.
What is a psychiatric advance directive?
A document outlining future mental health treatment preferences.
What is a psychiatric advance directive?
A document outlining future mental health treatment preferences.
What is the least restrictive principle?
Use the intervention that provides safety while limiting personal freedom as little as possible.
What is the least restrictive principle?
Use the intervention that provides safety while limiting personal freedom as little as possible.
What client right requires participation in treatment planning?
The right to collaborate in developing and reviewing the care plan.
What client right guarantees respectful treatment?
The right to receive care with dignity and without discrimination.
What client right includes access to interpreters?
The right to effective communication.
What client right protects communication with attorneys and family?
The right to outside communication unless legally restricted.
What does a 5150 hold authorize in California?
Up to 72 hours of involuntary psychiatric evaluation for danger to self, danger to others, or grave disability.
What is the purpose of a 5250 hold?
Extends involuntary treatment for up to 14 additional days when legal criteria continue.
What is a 5270 hold?
Provides up to 30 additional days of treatment for clients who remain gravely disabled.
What is an LPS conservatorship?
A court-appointed conservatorship for clients with persistent grave disability.
Can clients under LPS conservatorship refuse psychiatric medications?
No, when authorized by the court.
What is a probable cause hearing?
A legal review to determine whether continued involuntary detention is justified.
What is a writ of habeas corpus?
A request for judicial review of the legality of involuntary detention.
What is a Riese hearing (Riese petition)?
A court hearing to determine a client's capacity to refuse psychiatric medications.
What interventions should always be attempted before restraints?
Verbal de-escalation, redirection, environmental modification, and PRN medication when appropriate.
What environmental intervention may reduce agitation?
Lowering stimulation by decreasing noise, activity, or distractions.
When may seclusion or restraints be used?
Only when less restrictive interventions fail and safety is threatened.
What are acceptable reasons for restraints?
Preventing immediate harm to the client or others.
Who can initiate emergency restraints?
A registered nurse during an emergency according to policy.
How soon must the provider evaluate an adult after emergency restraints are initiated?
Within one hour.
How long is a restraint order valid for an adult?
Up to four hours before reassessment.
When should restraints be discontinued?
As soon as the client is calm and no longer poses an immediate danger.
What should be monitored during restraints?
Safety, circulation, respiratory status, hydration, nutrition, elimination, skin integrity, and vital signs.
What documentation is required for restraints?
Reason, alternatives attempted, assessments, interventions, monitoring, and time of release.
What is a timeout?
A voluntary period away from stimulation requested or accepted by the client.
What is a chemical restraint?
Medication used primarily to control dangerous behavior rather than treat the condition.
Why should PRN medication be offered before mechanical restraints when appropriate?
It is considered a less restrictive intervention.
What nursing priority guides every intervention with an aggressive client?
Protection of the client, staff, and others.
What is a tort?
A civil wrong that can result in financial compensation for the injured party.
What is an intentional tort?
A deliberate action that violates a client's rights or causes harm.
What is an unintentional tort?
An injury resulting from failure to meet the expected standard of care.
What is assault?
An act that creates a reasonable fear of immediate harmful or offensive contact.
What is battery?
Intentional physical contact performed without the client's consent.
What is false imprisonment?
Unlawfully restricting a client's freedom of movement without legal justification.
What actions can lead to false imprisonment in psychiatric care?
Improper use of restraints, seclusion, or refusing discharge without legal authority.
What is negligence?
Failure to act as a reasonably prudent nurse would under similar circumstances.
What is malpractice?
Professional negligence that causes harm to a client.
What are the required elements of malpractice?
Duty, breach of duty, causation, proximate cause, and damages.
What is breach of duty?
Failure to meet the accepted standard of nursing care.
What is proximate cause?
Proof that the nurse's actions directly caused the client's injury.
What information should be documented during a behavioral emergency?
Client behavior, staff interventions, provider notification, orders received, and client response.
What is the nurse's duty to intervene?
Take action whenever client safety is at risk.
What should a nurse do if a provider's order appears unsafe?
Question the order and follow the chain of command if concerns remain.
What is the nurse's responsibility toward suicidal clients?
Protect the client from self-harm through appropriate observation and interventions.
What is the nurse's responsibility toward aggressive clients?
Protect everyone involved while using the least restrictive interventions possible.
What is the priority when caring for a restrained client?
Maintain safety through continuous assessment and monitoring.
Why are sexual relationships with clients prohibited?
They exploit the therapeutic relationship and violate ethical and legal standards.
What is boundary crossing?
A brief deviation from professional boundaries that may be clinically appropriate.
What is a boundary violation?
An action that exploits or harms the therapeutic relationship.