Psych Restraint Quiz: Do You Know The Rules?

1. A restrained patient refuses meals and fluids. What is the nurse's responsibility?

Force-feed if medically necessary

Respect refusal and document; report to physician

Continue offering at regular intervals

Remove restraints to encourage eating

2. What is the primary ethical principle guiding restraint use in psychiatric nursing?

Beneficence: using restraints for patient benefit as last resort

Autonomy: always respecting patient choice

Justice: treating all patients equally

Non-maleficence: avoiding all interventions

3. A restrained patient's family requests to visit. Should the visit be allowed?

No; family cannot visit while restraints are in place

Yes; visits support therapeutic relationships and should be encouraged

Only if the patient is calm

Only with physician permission

4. Which statement about chemical restraints is accurate?

They are safer than physical restraints

They require the same physician order and monitoring as physical restraints

They can be given without consent in any situation

They eliminate the need for documentation

5. Informed consent for restraint use is ideally obtained when?

After restraints are applied

During the admission process when patient is stable

Only in non-emergency situations

Never; consent is not required

6. A patient in seclusion becomes unresponsive. What is the first action?

Leave the patient undisturbed

Call for help and assess vital signs and responsiveness

Document the change and wait for next check

Contact family immediately

7. What psychological effect can prolonged seclusion have on patients?

Improved behavior and reduced agitation

Increased anxiety, sensory deprivation, and potential trauma

Better compliance with treatment

No significant effect

8. A family member demands restraints be used on their psychiatric relative. How should the nurse respond?

Comply with family wishes

Explain that restraints require medical justification and physician order

Use restraints to maintain peace

Ignore the family request

9. Which type of restraint is safest for a patient at risk of self-harm?

Leather restraints

Soft fabric restraints applied to limbs

Jacket restraint alone

Chemical restraint with sedatives

10. When must a physician evaluate a patient in restraints or seclusion?

Within 1 hour of initiation

Only if complications occur

At the end of each shift

Once weekly

11. Which federal regulation primarily governs the use of restraints and seclusion in psychiatric facilities?

CMS Conditions of Participation (CoPs)

OSHA safety standards

State board of nursing rules only

HIPAA privacy requirements

12. De-escalation techniques are preferred over restraints. Which is an effective de-escalation strategy?

Remaining calm, using quiet voice, and offering choices

Explaining consequences of non-compliance

Isolating the patient from staff

Immediately calling security

13. A patient in restraints reports numbness in their hand. What should the nurse assess immediately?

Patient's anxiety level

Circulation, skin color, and temperature distal to restraint

Whether the patient is malingering

The patient's baseline neurological status

14. Which documentation element is NOT required for restraint use?

Reason for restraint

Patient's room number

Alternatives attempted

Time restraint applied and removed

15. What is the maximum duration a restraint order is typically valid without renewal?

4 hours for adults

24 hours

One week

Until discharge

16. Under what circumstance may restraints be used without a physician's order?

Never; physician order is always required

In emergencies to prevent immediate danger; order needed within one hour

Nurse judgment alone if patient is violent

When family requests it for safety

17. A restrained patient becomes agitated and combative. What is the priority nursing action?

Tighten the restraints for safety

Assess for medical causes and call for help if needed

Administer sedatives immediately

Document the behavior and continue monitoring

18. Which is a key difference between restraints and seclusion?

Restraints restrict movement; seclusion isolates in a room

Seclusion requires physician order; restraints do not

Restraints are used only for combative patients

Seclusion is less restrictive than restraints

19. How often must a restrained patient be assessed for circulation, skin integrity, and psychological status?

Every 2 hours

Every 30 minutes

Once per shift

Only when the patient requests

20. A physician orders restraints for a patient without documenting medical justification. What should the nurse do?

Apply restraints as ordered

Question the order and request written justification

Wait until the physician rounds to clarify

Document the order and apply restraints

Psych Restraint Quiz: Do You Know the Rules?