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Module 2: Assessment/Ethics Questions With
Complete Solutions
Open-ended questions designed to encourage a full, meaningful, and deliberate answer using the subject's own knowledge and/or feelings. preferred in most cases when working with patients (in any mental or medical setting) in order to get the most amount of information from the patient Close-ended questions if client cannot organize their thoughts or has difficulty answering open-ended questions. answered with single words such as "yes/no" or "fill-in-the- blank" answers Questions about Suicide MOST appropriate to use Close-ended questions ("Yes or No" answers) History Age Developmental stage
Cultural considerations Spiritual beliefs Previous history General Appearance/motor behavior Hygiene/grooming Appropriate dress Posture Eye contact Unusual movements/mannerisms: Automatisms, psychomotor retardation, waxy flexibility Speech: Neologisms (words invented by the patient that do not make sense to others). Psychomotor Retardation overall slowed movements Waxy Flexibility maintenance of posture or position over time even when it is awkward or uncomfortable Mood/affect Assess for consistency Blunted Affect showing little or a slow-to-respond facial expression
Loose associations disorganized thinking that jumps from one idea to another with little or no evident relation between the thoughts Word Salad flow of unconnected words that convey no meaning to the listener Assessment of suicide or harm toward others Ask client directly Anger, hostility, or threats toward another person- Specific threats or plans to harm someone Sensorium/intellectual processes Orientation Memory Ability to concentrate Abstract thinking and intellectual abilities Abnormal sensory experiences or misperceptions Sensory or perceptual alterations Hallucinations: Can involve the 5 senses (auditory hallucinations are most common but may include visual,olfactory, tactile.). Perceived as "real" by the individual Judgment and insight
Ability to interpret environment Ability to understand true nature of one's situation Self-concept Personal worth and dignity Description of physical characteristics/body image Emotions the client frequently experiences Roles and relationships Current roles Ability to fulfill roles Changes in roles Satisfaction with relationships Online activity/social media Categories of family assessment Physiological and self-care considerations Eating habits Sleep patterns Major or chronic health problems Use of drugs and/or alcohol Noncompliance with prescribed medications Intelligence Tests determine Cognitive abilities and Intellectual functioning Personality tests
Involuntary Hospitalization Health care professionals respect client's wishes to not be treated unless danger to self or others Person can be detained in psychiatric facility for 48 to 72 hours on emergency basis Voluntary hospitalization right to request discharge at any time. Release unless danger to self or others; if such danger present, then commitment proceedings instituted Mental health clinicians can be held liable for criminal actions of client for medication taken Mandatory Outpatient Treatment Continued participation in treatment on involuntary basis after release- Meds, appointments, and groups Clients given several opportunities for voluntary compliance Conservatorship/Guardianship separate from civil commitment Consent to be obtained from legal guardian who speaks for client
Least Restrictive Environment Right to treatment in least restrictive environment appropriate to meet client's needs Free of restraint or seclusion unless necessary Restraint direct application of physical force to person without permission Human or Mechanical Seclusion involuntary confinement in specially constructed, locked room equipped with security window or camera for direct visual monitoring Restraint/seclusion for shortest time necessary Permitted only when client is imminently aggressive/dangerous Short-term use of restraints and seclusion Face-to-face evaluation within 1 hour, every 8 hours (every 4 hours for children) Physician's order every 4 hours (every 2 hours for children) Documented assessment by nurse every 1 to 2 hours Close supervision of client, one-to-one monitoring for the first
Duty, Breach of duty, Injury or damage, Causation Assault Intentional Tort Involves any action that causes a person to fear being touched in a way that is offensive, insulting, or physically injurious without consent or authority Battery Intentional Tort involves harmful or unwarranted contact with a client; actual harm or injury may or may not have occurred False Imprisonment Intentional Tort unjustifiable detention of a client, such as the inappropriate use of restraint or seclusion. Prove liability Willful, voluntary act, Intention to bring about consequences or injury and Act was a substantial factor in injury or consequences Utilitarianism decisions based on the greatest good for the greatest number
Deontology decisions based on whether action is morally right or wrong, with no regard for Autonomy right to self-determination, independence Beneficence duty to benefit others or promote good Nonmaleficence requirement to do no harm Justice fairness Veracity honesty, truthfulness Fidelity obligation to honor commitments and contracts Ethical Dilemmas in Mental Health client's right to autonomy, utilitarianism No clear course of action (no "win-win" option). Automatisms
