A psychiatric nurse best implements the ethical principle of ...

[KWilfred]

A psychiatric nurse best implements the ethical principle of autonomy when he or she:
 
  a. intervenes when a self-mutilating patient attempts to harm self.
  b. stays with a patient who is demonstrating a high level of anxiety.
  c. suggests that two patients who are fighting be restricted to the unit.
  d. explores alternative solutions with a patient, who then makes a choice.

Question 2

A community member asks a nurse, People with mental illnesses used to go to a state hospital. Why has that changed? Select the nurse's accurate responses. Select all that apply.
 
  a. Science has made significant improvements in drugs for mental illness, so now many people may live in their communities.
  b. A better selection of less restrictive settings is now available in communities to care for individuals with mental illness.
  c. National rates of mental illness have declined significantly. The need for state institutions is actually no longer present.
  d. Most psychiatric institutions were closed because of serious violations of patients' rights and unsafe conditions.
  e. Federal legislation and payment for treatment of mental illness have shifted the focus to community rather than institutional settings.

[alvinum]

Answer to Question 1

ANS: D
Autonomy is the right to self-determination, that is, to make one's own decisions. When the nurse explores alternatives with the patient, the patient is better equipped to make an informed, autonomous decision. Staying with a highly anxious patient or intervening with a self-mutilating patient demonstrates beneficence and fidelity. Suggesting that two fighting patients be restricted to the unit demonstrates the principles of fidelity and justice.

Answer to Question 2

ANS: A, B, E
The community is a less restrictive alternative than hospitals for the treatment of people with mental illness. Funding for treatment of mental illness remains largely inadequate but now focuses on community rather than institutional care. Antipsychotic medications improve more symptoms of mental illness; hence, management of psychiatric disorders has improved. Rates of mental illness have increased, not decreased. Hospitals were closed because funding shifted to the community. Conditions in institutions have
improved.