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Ethics and Values NCLEX questions and answers 2023
When dealing with an organ transplant dilemma, which is most important: Ethics of care, Justice, Respect for autonomy, or accountability. Justice because ... [Show More] the first and greatest question in this situation is how to determine the just distribution of resources. The point of the ethical principal to "do no harm" is an agreement to reassure the public that in all ways the health care team not only works to heal patients but agree to do this in the least painful and harmful way possible. Which principle describes this agreement? Nonmaleficence A child's immunization may cause discomfort during administration, but the benefits of protection from disease, both for the individual and society, outweigh the temporary discomforts. Which principle is involved in this situation? Beneficence When a nurse assesses a patient for pain and offers a plan to manage the pain, which principal is used to encourage the nurse to monitor the patient's response to the pain? Fidelity because it is requiring a return to the patient to evaluate the effectiveness of an intervention exemplifies keeping a promise What is the best example of the nurse practicing patient advocacy? Assess the patient's point of view and prepare to articulate it Successful ethical discussion depends on people who have a clear sense of personal values. When a group of people share many of the same values, it may be possible to refer for guidance to philosophical principals of utilitarianism. This philosophy proposes which of the following? -The value of something is determined by its usefulness to society. - People's values are determined by religious leaders. -The decision to perform a liver transplant depends on a measure of the moral life that the patient has led so far. -The best way to determine the solution to an ethical dilemma is to refer the case to the attending physician or health care provider. The value of something is determined by its usefulness to society. The philosophy sometimes called the ethics of care suggests that ethical dilemmas can best be solved by attention to which of the following? Patients Relationships Ethical principles Code of ethics for nurses Relationships because the foundation of the ethics of care is its attention to relationships In most ethical dilemmas in health care, the solution to the dilemma requires negotiation among members of the health care team. Why is the nurse's point of view valuable? Nurses develop a relationship to the patient that is unique among all professional health care providers. Ethical dilemmas often arise over a conflict of opinion. What is the critical first step in negotiating the difference of opinion? Gather all relevant information regarding the clinical, social, and spiritual aspects of the dilemma. The ANA code of nursing ethics articulates that the nurse "promotes, advocates for, and strives to protect the health, safety, and rights of the patient." This includes the protection of patient privacy. On the basis of this principal, if you participate in a public online social network such as Facebook, could you post images of a patient's x-ray film if you deleted all patient identifiers? No because, even though patient identifiers are removed, someone could identify the patient based on other comments that you make online about his or her condition and your place of work When an ethical dilemma occurs on your unit, can you resolve the dilemma by taking a vote? No because an ethical dilemma involves the resolution of conflicting values and principals rather than simply the identification of what people want to do Resolution of an ethical dilemma involves discussion with the patient, the patient's family, and participants from all health care disciplines. What is the role of the nurse in the resolution of ethical dilemmas? To articulate his or her unique point of view, including knowledge based on clinical and psychosocial observations [Show Less]
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Chapter 22 Ethics NCLEX QUIZ correctly answered 2023
1. Four patients in labor all request epidural analgesia to manage their pain at the same time. Which ethical principle is compromised when only one nurse... [Show More] anesthetist is on call? • Justice • Nonmaleficence • Beneficence • Fidelity 1. Four patients in labor all request epidural analgesia to manage their pain at the same time. Which ethical principle is compromised when only one nurse anesthetist is on call? • Justice Correct • Nonmaleficence • Beneficence • Fidelity 2. The patient tells the nurse that she is afraid to speak up regarding her desire to end care for fear of upsetting her husband and children. Which principle in the nursing code of ethics ensures that the nurse will promote the patient's cause? • Responsibility • Advocacy • Confidentiality • Accountability 2. The patient tells the nurse that she is afraid to speak up regarding her desire to end care for fear of upsetting her husband and children. Which principle in the nursing code of ethics ensures that the nurse will promote the patient's cause? • Responsibility • Advocacy Correct • Confidentiality • Accountability 3. The patient's son requests to view the documentation in his mother's medical record. What is the nurse's best response to this request? • "I'll be happy to get that for you." • "You will have to talk to the physician about that." • "You will need your mother's permission." • "You are not allowed to see it." 3. The patient's son requests to view the documentation in his mother's medical record. What is the nurse's best response to this request? • "I'll be happy to get that for you." • "You will have to talk to the physician about that." • "You will need your mother's permission." Correct • "You are not allowed to see it." 4. When people work together to solve ethical dilemmas, individuals must examine their own values. This step is crucial to ensure that: • The group identifies the one correct solution. • Fact is separated from opinion. • Judgmental attitudes are not provoked. • Different perspectives are respected. 4. When people work together to solve ethical dilemmas, individuals must examine their own values. This step is crucial to ensure that: • The group identifies the one correct solution. • Fact is separated from opinion. • Judgmental attitudes are not provoked. • Different perspectives are respected. Correct 5. Ethical dilemmas are common occurrences when caring for patients. The nurse understands that dilemmas are a result of: • Presence of conflicting values. • Hierarchical systems. • Judgmental perceptions of patients. • Poor communication with the patient. 5. Ethical dilemmas are common occurrences when caring for patients. The nurse understands that dilemmas are a result of: • Presence of conflicting values. Correct • Hierarchical systems. • Judgmental perceptions of patients. • Poor communication with the patient. 6. The nurse questions a physician's order to administer a placebo to the patient. The nurse's action is based on which ethical principle? • Autonomy • Beneficence • Justice • Fidelity 6. The nurse questions a physician's order to administer a placebo to the patient. The nurse's action is based on which ethical principle? • Autonomy Correct • Beneficence • Justice • Fidelity 7. The nurse finds it difficult to care for a patient whose advance directive states that no extraordinary resuscitation measures should be taken. Which step may help the nurse to find resolution in this assignment? • Call for an ethical committee consult. • Decline the assignment on religious grounds. • Scrutinize her own personal values. • Convince the family to challenge the directive. 7. The nurse finds it difficult to care for a patient whose advance directive states that no extraordinary resuscitation measures should be taken. Which step may help the nurse to find resolution in this assignment? • Call for an ethical committee consult. • Decline the assignment on religious grounds. • Scrutinize her own personal values. Correct • Convince the family to challenge the directive. 8. The nurse values autonomy above all other principles. Which patient assignment will the nurse find most difficult to accept? • Teenager in labor who requests epidural anesthesia • Middle-aged father of three with an advance directive declining life support • Elderly patient who requires dialysis • Family elder who is making the decisions for a 30-year-old female member 8. The nurse values autonomy above all other principles. Which patient assignment will the nurse find most difficult to accept? • Teenager in labor who requests epidural anesthesia • Middle-aged father of three with an advance directive declining life support • Elderly patient who requires dialysis • Family elder who is making the decisions for a 30-year-old female member Correct 9. Which philosophy of health care ethics would be particularly useful when making ethical decisions about vulnerable populations? • Feminist ethics • Deontology • Bioethics • Utilitarianism 9. Which philosophy of health care ethics would be particularly useful when making ethical decisions about vulnerable populations? • Feminist ethics Correct • Deontology • Bioethics • Utilitarianism 10. A nurse argues that we need to reform our health care system because we have a large number of people who are uninsured and end up needing expensive emergent care when low-cost measures could have prevented their illnesses. What ethical framework is she using to make this case? • Deontology • Ethics of care • Feminist ethics • Utilitarianism 10. A nurse argues that we need to reform our health care system because we have a large number of people who are uninsured and end up needing expensive emergent care when low-cost measures could have prevented their illnesses. What ethical framework is she using to make this case? • Deontology • Ethics of care • Feminist ethics • Utilitarianism Correct 11. The nurse has become aware of missing narcotics in the patient care area. Which ethical principle obligates the nurse to report the missing medications? • Advocacy • Responsibility • Confidentiality • Accountability 11. The nurse has become aware of missing narcotics in the patient care area. Which ethical principle obligates the nurse to report the missing medications? • Advocacy • Responsibility Correct • Confidentiality • Accountability 12. A young woman who is pregnant with a fetus exposed to multiple teratogens consents to have her fetus undergo serial PUBS (percutaneous umbilical blood sampling) to examine how exposure affects the fetus over time. Although these tests will not improve the fetus' outcomes and will expose it to some risks, the information gathered may help infants in the future. Which ethical principle is at greatest risk? • Autonomy • Fidelity • Nonmaleficence • Beneficence 12. A young woman who is pregnant with a fetus exposed to multiple teratogens consents to have her fetus undergo serial PUBS (percutaneous umbilical blood sampling) to examine how exposure affects the fetus over time. Although these tests will not improve the fetus' outcomes and will expose it to some risks, the information gathered may help infants in the future. Which ethical principle is at greatest risk? • Autonomy • Fidelity • Nonmaleficence Correct • Beneficence • [Show Less]
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Ch.3 Law and Ethics NCLEX style questions and answers latest 2023
A client is received in a postoperative nursing unit after undergoing abdominal surgery. During this time the nurse failed to recognize the significance of... [Show More] abdominal swelling, which significantly increased during the next 6 hours. Later, the client had to undergo emergency surgery. The lack of action on the nurse's part is liable for action. Which legal term describes the case? a) Felony b) Battery c) Tort d) Misdemeanor c) Tort A tort is a litigation in which one person asserts that a physical, emotional, or financial injury was a consequence of another person's actions or failure to act. The lack of action on the nurse's part truly indicates unintentional tort. A misdemeanor or felony would be an offense under criminal law, and neither is applicable in this case. Battery is unlawful physical contact. A nurse enters the client's room and finds the client lying on the floor with ongoing seizures. The nurse helps the client to get up, makes him comfortable, and then informs the physician. The physician advises the nurse to prepare an incident report. What is the purpose of an incident report? a) to evaluate the immediate care provided by the nurse to the client b) to provide information to local, state, and federal agencies c) to provide a method of deciding the nurse's fault in the incident d) to evaluate quality care and potential risks for injury to the client d) To evaluate quality care and potential risks for injury to the client. An incident report is a written account of an unusual, potentially injurious event involving a client, employee, or visitor. Incident reports determine how to prevent hazardous situations and serve as a referencei that the nurse acted reasonably or appropriately in the circumstances. It may not always serve as a method of determining the nurse's fault in the incident. The document does not evaluate the immediate care provided to the client, rather states the actions taken. Incase of future litigation. Accurate and detailed documentation often helps to prove Which situation is an example of battery that the nurse may experience while performing her duties at the health care facility? a) witnessing a procedure done on a client without his consent b) performing a surgical procedure without getting consent c) telling the client that he cannot leave the hospital d) taking the client's photographs without consent b) Performing a surgical procedure without getting consent. Performing a surgical procedure without the client's consent is an example of battery. To protect health care workers from being charged with battery, adult clients are asked to sign a general permission for care and treatment during admission, and additional written consent forms for tests, procedures, or surgery. Telling the client not to leave the hospital is a false imprisonment. Taking the client's photographs without his permission and witnessing a procedure done on him without consent is violation of the client's privacy. Two nurses meet at their home, where one of the nurses discusses a client who had been physically abused. The next day, the client is shifted to another nursing unit after a surgical procedure and becomes the care of the second nurse who had been part of the original discussion. Nurse No. 2 asks the client about the physical abuse. The client discovers that his original nurse revealed the information and is hurt. What would be the charges if the client files a suit? a) The nurses could be charged for libel. b) No charges are valid because the revelation took place in off-duty hours. c)The nurses could be charged for slander. d) No charges are valid because Nurse No. 2 is also involved in client care. c) The nurses could be charged for slander. Slander is the character attack uttered orally in the presence of others. The injury is considered to occur because the derogatory remarks attacks a person's character and good name. In this case, the nurse can be charged with slander. If the defamation had been written, it would be libel. Even if the discussion took place at home and Nurse No. 2 was involved in the care, the revelation was without the client's consent. Even if the nurse is off- duty or may not be directly involved in the client's care, the nurse can still be charged with slander. A client is unhappy with the health care provided to him. He approaches the nurse and informs her that he is leaving the facility. The client has not been discharged by the physician. The nurse finds that the client has dressed and is ready to go. What would the nurse's action be in this situation? a) The nurse should get the client restrained and call the physician. b) The nurse should let the client go because she cannot do anything. c) The nurse should warn the client that he cannot come to the hospital again. d) The nurse should call the nursing supervisor and inform her about the situation. d) The nurse should call the nursing supervisor and inform her about the situation. The nurse should call the nursing supervisor and inform her about the situation. The client should be made to sign the document stating that he is responsible for his own actions. The nurse cannot keep the client restrained because that would be false imprisonment. Likewise, the nurse cannot overlook the incident because there is a responsibility for client care. Additionally, the nurse cannot warn the client that he will not be allowed to come back to the hospital because it is the client's right to access health care whenever required. A client is brought to the emergency department in an unconscious state with a head injury. The client requires surgery to remove a blood clot. What would be the appropriate nursing intervention in keeping with the policy of informed consent prior to a surgical procedure? a) The nurse informs the family about the living will. b) The nurse ensures that the client signs the consent form. c) The nurse ensures that the client's family signs the consent form. d) The nurse informs the family about advance directives. c) The nurse ensures that the client's family signs the consent form. The nurse should ensure that the client's family signs the consent form. However, in some states and health care facilities, it is the physician who ensures that the client's family signs the consent form. The client cannot sign the consent form if he is not in an alert state or is unable tocommunicate. If the client is not in a condition to the sign the consent, a family member can sign the consent on his behalf. Advance directives are written statements identifying a competent person's wishes concerning terminal care and are not applicable here. A living will is an instructive form of advance directive; that is, it is a written document that identifies a person's preferences regarding medical interventions to use in a terminal condition, irreversible coma, or persistent vegetative state with no hope of recovery. A nurse witnesses a 50-year-old woman go into cardiac arrest while traveling in a train and attempts to resuscitate her. In spite of the nurse's eforts, the woman dies, and the family members file a suit against the nurse. Which of the following statements about Good Samaritan Laws is applicable here? a) The Good Samaritan Law will protect the nurse if she was negligent in her action. b) The Good Samaritan Law will likely protect the nurse because she acted in the woman's best interests. c) The Good Samaritan Law is not applicable to nurses and health professionals. d) The Good Samaritan Law will protect the nurse from any lawsuit filed by family members. b) The Good Samaritan Law will likely protect the nurse because she acted in the woman's best interests. The Good Samaritan Law provides legal immunity to passersby who provide emergency first aid to victims of accidents. Although these laws are helpful, no Good Samaritan law provides absolute exemption from prosecution in the event of injury. The law is applicable to health professionals as well. A physician is called to see a client with angina. During the visit the physician advises the nurse to decrease the client's atenolol to 12.5 mg daily. However, since the physician is late for another visit, the physician requests that the nurse write down the order and sign it. What should be the appropriate nursing action in this situation? a) The nurse should ask the physician to come back and write the order. b) The nurse should discuss the order with a pharmacist. c The nurse should inform the client of the change in medication. d) The nurse should implement the order and monitor the client closely a) The nurse should ask the physician to come back and write the order. The nurse should ask the physician to come back later and write down the order. Nurses are generally discouraged from following verbal orders, except in an emergency. The nurse should never write and sign an order on a physician's behalf. The client should be informed about the change of medications, but this is not an appropriate action. The order should not be implemented without appropriate documentation. A nurse has been assigned to the ICU by a supervisor because of a number of sick calls. However, the nurse is not highly experienced in providing intensive nursing care. What would be the most appropriate action by the nurse? a) To report to the nurse-in-charge for duty but explain the nurse's practice limitations b) To refuse to go to the ICU and keep working in the previously assigned unit c)To call the lawyer and seek advice regarding the sudden change d) To report to the ICU and take leave on the pretext of some illness a) To report to the nurse-in-charge for duty but explain the nurse's practice limitations. The most appropriate action that the nurse could take is to go to the ICU and inform the nurse-in-charge about the concerns. The nurse may help with the task if competent to do so. The nurse cannot take a legal action against the order because it is not legally wrong to change the duties as per requirement. It would be ethically wrong to take leave on the pretext of illness. Also, it would be disobedience to wholly disregard the order. Recent staffing shortages on a hospital unit have resulted in unlicensed care providers being assigned to duties that are beyond their scope of practice. This has resulted in a number of near misses involving client safety. How should a nurse best respond to this trend in care? a) Take on an increased client assignment during shifts b) Remind the unlicensed care providers of their appropriate scope of practice c) Make the appropriate hospital authorities aware of this practice d) Inform clients family members of the risk that this poses to clients c) Make the appropriate hospital authorities aware of this practice. This practice is unethical andillegal. As such, the nurse first response should be to ensure that the appropriate supervisors and authorities are made aware. This is more important than educating the unlicensed care providers, who are not the originators of the problem. Taking an increased workload would not resolve this problem and it would be inappropriate to involve family members at this early stage A nurse has become aware of a conflict between a client's children, one of whom want to withhold the client's recent cancer diagnosis from her in the belief that the client would "give up hope" if she became aware of her condition. Which response to this situation most clearly represents a deontological perspective? a) The advantages and disadvantages of withholding this information should be weighed carefully b) Precedents from similar cases in the past should guide the nurse's decision-making c) The morality of the withholding information from a client is the primary concern d) The wishes of the majority of the client's children should be respected c) The morality of the withholding information from a client is the primary concern. Deontology is ethical study based on duty or moral obligations. It proposes that the outcome is not the primary issue; rather, decisions must be based on the morality of the act itself. Consequently, priority would not be placed on precedents or the wishes of the majority of family members. Following a neonatal death, a maternity nurse has become named in a malpractice suit. When evaluating the nurse's actions, the court will compare the nurse's actions to: a) the ethical principle of autonomy. b) the actions of a reasonable citizen. c) the judge's or jury's expectations of the nurse. d) the practice norms of nurses in similar circumstances. d) The practice norms of nurses in similar circumstances. Rather than being held accountable for acting as an ordinary, reasonable lay person, in a malpractice case the court determines whether a health care worker acted in a manner comparable to that of his or her peers. The judge's or jury's subjective expectations are not the point of reference and ethical principle of autonomy does not guide this form of legal decision-making. A nurse is completing required tasks prior to the end of a busy shift on a sub-acute geriatric unit. These tasks include the completion of documentation for each of the clients for whom the nurse provided care. What characteristics should be included in the nurse's documentation? (Select all that apply.) a) Documentation should be co-signed by another member of the care team whenever possible b) The nurse should ensure that handwritten documentation is legible c) Nursing actions should be documented subjectively d) Documentation should performed in the knowledge that it forms a legal record e) Documentation should be completed with the collaboration and input of the client b) The nurse should ensure that handwritten documentation is legible. d) Documentation should performed in the knowiedge that it forms a legal record. Documentation must be legible because it constitutes a legal record that may be presented in court if necessary. It should be objective and does not normally involve the direct participation of the client. It is not necessary to have another member of the care team co-sign documentation. A nurse is caring fora client following endotracheal intubation. Before applying soft wrist restraints to prevent the client from pulling out the endotracheal tube, what is the most appropriate action of the nurse? a) Get written consent. b) Obtain a medical order. c) Notify the family. d) Sedate the client. b) Obtain a medical order. Nurses must obtain a medical order before each and every instance in which they use restraints. Due to the severity of the client illness requiring endotracheal intubation, the client may not be able to provide a written consent. The client does not need to be sedated unless medically necessary, and although it is appropriate to notify the family, this is not the priority. A nurse has applied soft wrist restraints to a client following endotracheal intubation. Which documentation is essential while using restraints? (Select all that apply.) a) chest physiotherapy completed b) .9NS IV infusing at 100 ml/hr c)foley catheter draining clear yellow urine d) family at bedside e) patient assessment findings every 2 hours e) patient assessment findings every 2 hours, c) foley catheter draining clear yellow urine, b).9NS IV infusing at 100 ml/hr When restraints are applied, charting must indicate regular client assessment; provisions or administration of fluids, nourishment, and bowel and bladder elimination; and attempts to release the ient from the restraints for a trial period. Additional order completion and presence of family in the room are not required documentation for client restraint. A nurse caring for an older adult client following a total abdominal hysterectomy documents administration of morphine 4 mg intravenously for pain of 8 on 1-10 scale,bed in the lowest position, bed alarm on, side rails up times two, and call light in reach. After the nurse leaves the room, the client gets out of bed and falls. In which order should the nurse proceed? 1. Assist the client back into bed. 2. Assess the client for injury. 3. Document the incident. 4. Notify the physician. 5. Complete an incident report. 1. Assess the client for injury. 2. Assist the client back into bed. 3. Notify the physician. 4. Document the incident. 5. Complete an incident report. Following a fall, the nurse should assess the client before moving the client. If the client can be moved, safely return the client to bed and make sure the client is secure per safety procedures. The nurse should then notify the physician. The nurse should document the incident and interventions or treatments provided. Finally, an incident report should be completed. [Show Less]
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ethics nclex questions and answers latest 2023
Which would the nurse not list as a purpose of the nursing code of ethics when discussing it with a group of new employees? Providing solutions for specif... [Show More] ic ethical situations When trying to make a responsible ethical decision, what should the nurse understand as the basis for ethical reasoning? Ethical principles and codes A nurse working in the Emergency Department is asked to care for an openly gay client with AIDS. The nurse tells her supervisor that caring for the client is against her religious beliefs, and asks if she must take the assignment. Does this nurse have a moral obligation to care for the client? Yes, unless the risk exceeds the responsibility A fully alert and competent 89-year-old client is in end-stage liver disease. The client says, "I'm ready to die," and refuses to take food or fluids. The family urges the client to allow the nurse to insert a feeding tube. What is the nurse's moral responsibility? The nurse should honor the client's decision. Which act would the nurse consider passive euthanasia? Removing a "no code" client from a ventilator A client with cancer has decided against further treatment. Which nursing action would be most helpful? Making sure the client has accurate information and understands the consequences of the decision A client asks you not to tell his wife that he has cancer. He does not want to burden her with this information. What would be the most appropriate response by the nurse? "What benefits do you see from doing this?" The nurse notes that a client has a slight red rash after taking a dose of an antibiotic. What action by the nurse would demonstrate the moral principle of nonmaleficence? Noting the reaction and getting a new medication ordered A mentally competent client with end-stage liver disease continues to consume alcohol after being informed of the consequences of this action. What action best illustrates the nurse's role as a client advocate? Accepting the client's choice and not intervening Which of the following terms are moral principles? Select all that apply. Autonomy Beneficence Fidelity A client with a low postoperative hemoglobin and hematocrit levels refuses a potentially life saving blood transfusion. When questioning the client about the refusal, the client states, "I know about the risks of AIDS and hepatitis and do not want a blood transfusion." The physician enters the room and begins to coerce the client to accept the blood transfusion. The nurse's best response would be: "The client understands the risks associated with blood transfusions. Perhaps you can speak with him about his concerns." A 43 year-old client with end stage ovarian cancer is admitted to the hospital with a bowel obstruction. The client in a tremendous amount of pain, states, "please give me enough morphine to kill me." The nurse's best response would be: "I am trying to understand what you are saying. Describe the pain, where is it? How intense is the pain? What do you normally do for this type of pain?" A famous actress has had plastic surgery. The media contacts the nurse on the unit and asks for information about the surgery. The nurse knows: Nurses are obligated to respect client's privacy and confidentiality. The nurse did not follow hospital procedure and hung a unit of blood on the wrong client. The client had an anaphylactic reaction and the team is called in for emergency treatment. During the resuscitation, the nurse does not reveal that the wrong blood was given. Which moral principles were violated? Select all that apply. Veracity Beneficence [Show Less]
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NCLEX Ethical Questions correctly answered 2023
1. The patient for whom you are caring needs a liver transplant to survive. This patient has been out of work for several months and doesn't have health in... [Show More] surance or enough cash. Even though several ethical principles are at work in this case, list the principles from highest to lowest priority. 1. Accountability: You as the nurse are accountable for the well-being of this patient. 2. Respect for autonomy: This patient's autonomy will be violated if he does not receive the liver transplant. 3. Ethics of care: The caring thing that a nurse could provide this patient is resources for a liver transplant. 4. Justice: The greatest question in this situation is how to determine the just distribution of resources. 4, 2, 3, 1 2. Fill in the Blank. The point of the ethical practice is an agreement to reassure the public that in all ways the health care team not only works to heal patients but agrees to do this in the least painful and harmful way possible. This principle is commonly called the principle of ________? Nonmalificence 3. A child's immunization may cause discomfort during administration, but the benefits of protection from disease, both for the individual and society, outweigh the temporary discomforts. Which principle is involved in this situation? 1. Fidelity 2. Beneficence 3. Nonmaleficence 4. Respect for autonomy 2. Beneficence 4. When designing a plan for pain management for a postoperative patient, the nurse assesses that the patient's priority is to be as free of pain as possible. The nurse and patient work together to identify a plan to manage the pain. The nurse continually reviews the plan with the patient to ensure that the patient's priority is met. Which principle is used to encourage the nurse to monitor the patient's response to the pain? 1. Fidelity 2. Beneficence 3. Nonmaleficence 4. Respect for autonomy 1. Fidelity 5. A patient is admitted to a medical unit. The patient is fearful of hospitals. The nurse carefully assesses the patient to determine the exact fears and then establishes interventions designed to reduce these fears. In this setting how is the nurse practicing patient advocacy? 1. Seeking out the nursing supervisor to talk with the patient 2. Documenting patient fears in the medical record in a timely manner 3. Working to change the hospital environment 4. Assessing the patient's point of view and preparing to articulate it 4. Assessing the patient's point of view and preparing to articulate it 6. The application of utilitarianism does not always resolve an ethical dilemma. Which of the following statements best explains why? 1. Utilitarianism refers to usefulness and therefore eliminates the need to talk about spiritual values. 2. In a diverse community it can be difficult to find agreement on a definition of usefulness, the focus of utilitarianism. 3. Even when agreement about a definition of usefulness exists in a community, laws prohibit an application of utilitarianism .4. Difficult ethical decisions cannot be resolved by talking about the usefulness of a procedure. 2. In a diverse community it can be difficult to find agreement on a definition of usefulness, the focus of utilitarianism. 7. The ethics of care suggests that ethical dilemmas can best be solved by attention to relationships. How does this differ from other ethical practices? (Select all that apply.) 1. Ethics of care pays attention to the environment in which caring occurs. 2. Ethics of care pays attention to the stories of the people involved in the ethical issue. 3. Ethics of care is used only in nursing practice. 4. Ethics of care focuses only on the code of ethics for nurses 5. Ethics of care focuses only on understanding relationships. 1. Ethics of care pays attention to the environment in which caring occurs. 2. Ethics of care pays attention to the stories of the people involved in the ethical issue. 5. Ethics of care focuses only on understanding relationships. 8. In most ethical dilemmas in health care, the solution to the dilemma requires negotiation among members of the health care team. Why is the nurse's point of view valuable? 1. Nurses understand the principle of autonomy to guide respect for a patient's self-worth. 2. Nurses have a scope of practice that encourages their presence during ethical discussions. 3. Nurses develop a relationship with the patient that is unique among all professional health care providers. 4. The nurse's code of ethics recommends that a nurse be present at any ethical discussion about patient care. 3. Nurses develop a relationship with the patient that is unique among all professional health care providers. [Show Less]
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Chapter 3: Nursing Practice and the Law, NCLEX - Legal & Ethical, Nursing
1. A nurse was called before the State Board of Nursing. The nurse had been in practice for over six years, had her license suspended because an audit of h... [Show More] er continuing education credits showed that she had not met the mandatory course requirements. The Board of Nursing has the ability to do this based on: A. Case law B. Administrative law C. Civil law D. Statutory law B. Administrative law 2. A nurse graduated from an associate degree nursing program two years ago. The nurse is brought before the State Board of Nursing for offering to give physicals for $25.00 to children who needed them for or summer camp. What charge can the State Board of Nursing apply to the nurse? A. Misdemeanor B. Felony C. Tort D. Larceny B. Felony 3. A registered nurse returning from vacation is a passenger on a flight from Los Angeles to New York. The flight attendant requests the help of a nurse or physician if one is on board. The nurse approaches the flight attendant and asks if she can assist. What statement in the Good Samaritan Act protects the nurse as a licensed healthcare provider? A. The provider may administer care any time. B The provider is covered if he/she administers the same level of care as a paramedic. C. The provider is covered if he/she administers the level of care that any other prudent individual with the same education would provide D. The provider may perform care outside the scope of his/her scope of practice if he/she knows how to perform the required procedure C. The provider is covered if he/she administers the level of care that any other prudent individual with the same education would provide 4. A patient was brought to the emergency department by two police officers. The patient was combative and verbally abusive. After waiting for over an hour, the patient tells the nurse he is leaving. The nurse removes Larry's clothes from the room, leaving him only in his underwear. The nurse may be charged with: A. Cruel and unusual punishment B. Slander and libel C. False imprisonment D. Assault and battery C. False imprisonment 5. A nurse and his girlfriend witness a motor vehicle accident. The calls 911 and pulls over to the side of the road. The nurse assesses the victim and determines that he is unconscious. His girlfriend says, "This guy can't give you permission to help him; maybe you should just leave him alone." The nurse explains that he has implied consent. When is implied consent assumed? A. At the time a person sees a physician or nurse by appointment in the office or clinic setting B. When a person arrives in the operating suite for a surgical procedure. C. On the person's admission to the hospital unit. D. If the person is treated at the scene of an accident D. If the person is treated at the scene of an accident 6. Three nursing students are in the elevator and overhear another staff nurse, discussing a neighbor who was hospitalized last night for liver failure. The nurse told his colleague that a mutual friend told him that the neighbor was "known for liking his brandy." A family member was in the elevator and also overheard the conversation. What charges may be brought against the nurse by the patient and/or family: A. Slander B. Libel C. Malpractice D. Breach of confidentiality A. Slander 7. A nurse is caring for a patient who was admitted with a subarachnoid hemorrhage. The healthcare provider orders state that neurological assessments need to be preformed every 30 minutes. The nurse forgets to perform the assessments on two different occasions. An action that can lead to a malpractice suit would be: A. Assessing the patient more than once per shift. B. Explaining the patient's current condition to the family. C. Holding the next dose of sedation in order to perform a neurological assessment. D. Altering the time the assessments were performed D. Altering the time the assessments were performed 8. A nurse is caring for a patient who suffered a stroke. The patient's daughter brings a DNR and the power of attorney documents to the hospital. What is the purpose of the DNR? A. Document the terminal nature of the client's condition B. Allow an alternative to the universal standing order to provide cardiopulmonary resuscitation to all clients C. Provide an opportunity for the client, family, and caregivers to discuss the nature of the client's condition and the best possible course of action if the client has a cardiac arrest D. Provide legal protection for nurses who believe a client should not be resuscitated B. Allow an alternative to the universal standing order to provide cardiopulmonary resuscitation to all clients 9. A nurse is caring for a patient who has diabetes and gangrene of the lower left extremity. The nurse accompanies the surgeon when he explains that he will perform a below-the-knee amputation that will remove the infection. He states that the patient will receive antibiotics, and go home in a few days. After the surgeon leaves, the nurse brings in the consent forms and asks the patient explain what the surgeon said. The patient states, "Oh, he is going to remove the infection and give me antibiotics and then I can go home. I feel so much better now because my other doctor told me they were going to cut off my leg!" What should the nurse do next? A. Ask the patient to sign the consent form B. Draw a picture of a below-the-knee amputation for the patient C. Tell the patient that she did not hear what her doctor told her D. Call the surgeon and explain the situation to him D. Call the surgeon and explain the situation to him 10. A nurse on a busy medical-surgical unit reports for a scheduled shift after working a double shift yesterday. At the end of this day, two nurses call in, and the nurse manager tells the nurse that he needs to stay and cover the next shift. The nurse may refuse to accept an assignment if: A. He is being asked to care for too many difficult clients B. He believes his assignment is unsafe C. He is being asked to work overtime D. He believes there are not enough nurses to work with him C. He is being asked to work overtime 11. A health-care provider orders an injection for a pediatric patient. The patient's legal guardian refuses to allow the nurse to administer the medication. The nurse proceeds to administer the injection. Which action has the nurse committed? A. Assault B. Battery C. Invasion of privacy D. False imprisonment B. Battery 12. After administering an incorrect dosage of a medication the nurse realizes that too little medication was given to the client. The nurse then administers a second dose in order to give the correct dosage. What should the nurse do? Select all that apply: A. Report the error B. Explain what happened to the patient C. Document that the correct medication was administered D. Chart both times the medication was administered C. Document that the correct medication was administered 13. A high school graduate who wants to be a nurse is looking online at different programs in the state. The graduate knows that in order to practice nursing it is necessary to pass the NCLEX-RN. What is the basic qualification required for licensure? A. The individual must complete a minimum of 12 months of study from a program. B. The individual must graduate from a school located within their state of residence C. The individual must provide documentation of citizenship D. The individual must graduate from an approved nursing program D. The individual must graduate from an approved nursing program 14. A nurse is caring for a patient who has colon cancer. The interprofessional team met to discuss some changes in the patient's plan of care. The nurse discusses the changes with the patient's daughter before discussing anything with the patient. Which did the nurse violate? a. The Patient Care Partnership b. The Fifth Amendment c. The American Disabilities Act d. Health Insurance Portability and Accountability Act d. Health Insurance Portability and Accountability Act 15. A nurse is looking at the healthcare provider orders for a patient. The healthcare provider ordered a medication to be administered intravenously via a bolus. The nurse knows that this medication should not be given through this route and calls the healthcare provider for clarification. The healthcare provider tells the nurse to give the medication. What action should the nurse take next? A. Hold the medication and notify a supervisor B. Hold the medication and call another healthcare provider in the same facility C. Administer the medication as ordered D. Administer the medication and document the healthcare provider's response A. Hold the medication and notify a supervisor 1. A nurse was caring for a patient who reported syncopal episodes. The nurse placed the call bell in reach, and instructed the patient not to get out of bed without assistance. The patient forgot to call the nurse and got out of bed to go to the bathroom. The patient fell and broke a hip. The patient is now suing for negligence. What needs to be considered to constitute a negligence claim? Select all that apply A. Duty B. Breach of duty C. Spontaneous duty D. Harm A.- Duty B.- Breach of duty D. -Harm 2. A nurse is caring for an elderly patient. The patient falls and injures herself. Which of the following actions should the nurse take to decrease his/her liability? Select all that apply. A. Document the incident carefully on the designated form provided by the institution. B. Chart the facts surrounding the client's fall, condition, and follow-up care. C. It is not necessary to document anything about the fall. D. Report the incident to the next shift during report. A.- Document the incident carefully on the designated form provided by the institution. B. -Chart the facts surrounding the client's fall, condition, and follow-up care. D. -Report the incident to the next shift during report. 3. A nursing student is preparing for the NCLEX. Which of the following activities should the nurse perform several days prior to taking the examination? Select all that apply. A. Pack a bag of items that may be needed during the test. B. Map out the route to the exam site. C. Eat a diet high in fats and carbohydrates. D. Decrease fluids to prevent needing to go to the bathroom during the exam. A.- Pack a bag of items that may be needed during the test. B. -Map out the route to the exam site. 4. What criteria are outlined in the Patient Self-Determination Act? Select all that apply. A. All clients need to be informed in writing of their rights to accept or refuse treatment while they are competent. B. All clients need to provide the name of a healthcare surrogate before receiving care. C. Nurses have an obligation to provide patients with the names of individuals who can act as durable power of attorneys D. Nurses need to recognize the role culture and spiritual beliefs have in a patient's decision-making process A. -All clients need to be informed in writing of their rights to accept or refuse treatment while they are competent. D. -Nurses need to recognize the role culture and spiritual beliefs have in a patient's decision-making process [Show Less]
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Nursing Jurisprudence: Legal and Ethical Considerations NCLEX Practice Quiz latest 2023
The best explanation of what Title VI of the Civil Rights Act mandates is the freedom to: A. Pick any physician and insurance company despite one's inco... [Show More] me B. Receive free medical benefits as needed within the county of residence C. Have equal access to all health care regardless of race and religion D. Have basic care with a sliding scale payment plan from all health care facilities Answer: C. Have equal access to all health care regardless of race and religion Which statement would best explain the role of the nurse when planning care for a culturally diverse population? The nurse will plan care to: A. Include care that is culturally congruent with the staff from predetermined criteria B. Focus only on the needs of the client, ignoring the nurse's beliefs and practices C. Blend the values of the nurse that are for the good of the client and minimize the client's individual values and beliefs during care D. Provide care while aware of one's own bias, focusing on the client's individual needs rather than the staff's practices Answer: D. Provide care while aware of one's own bias, focusing on the client's individual needs rather than the staff's practices Without understanding one's own beliefs and values, a bias or preconceived belief by the nurse could create an unexpected conflict or an area of neglect in the plan of care for a client (who might be expecting something totally different from the care). During assessment values, beliefs, practices should be identified by the nurse and used as a guide to identify the choices by the nurse to meet specific needs/outcomes of that client. Therefore identification of values, beliefs, and practices allows for planning meaningful and beneficial care specific for this client. Which factor is least significant during assessment when gathering information about cultural practices? A. Language, timing B. Touch, eye contact C. Biocultural needs D. Pain perception, management expectations Answer: C. Biocultural needs Cultural practices do not influence biocultural needs because they are inborn risks that are related to a biological need and not a learned cultural belief or practice. Transcultural nursing implies: A. Using a comparative study of cultures to understand similarities and differences across human groups to provide specific individualized care that is culturally appropriate B. Working in another culture to practice nursing within their limitations C. Combining all cultural beliefs into a practice that is a non-threatening approach to minimize cultural barriers for all clients' equality of care D. Ignoring all cultural differences to provide the best generalized care to all clients Answer: A. Using a comparative study of cultures to understand similarities and differences across human groups to provide specific individualized care that is culturally appropriate Transcultural care means that by understanding and learning about specific cultural practices the nurse can integrate these practices into the plan of care for a specific individual client who has the same beliefs or practices to meet the client's needs in a holistic manner of care. What should the nurse do when planning nursing care for a client with a different cultural background? The nurse should: A. Allow the family to provide care during the hospital stay so no rituals or customs are broken B. Identify how these cultural variables affect the health problem C. Speak slowly and show pictures to make sure the client always understands D. Explain how the client must adapt to hospital routines to be effectively cared for while in the hospital Answer: B. Identify how these cultural variables affect the health problem Without assessment and identification of the cultural needs, the nurse cannot begin to understand how these might influence the health problem or health care management. Which activity would not be expected by the nurse to meet the cultural needs of the client? A. Promote and support attitudes, behaviors, knowledge, and skills to respectfully meet client's cultural needs despite the nurse's own beliefs and practices B. Ensure that the interpreter understands not only the language of the client but feelings and attitudes behind cultural practices to make sure an ethical balance can be achieved C. Develop structure and process for meeting cultural needs on a regular basis and means to avoid overlooking these needs with clients D. Expect the family to keep an interpreter present at all times to assist in meeting the communication needs all day and night while hospitalized Answer: D. Expect the family to keep an interpreter present at all times to assist in meeting the communication needs all day and night while hospitalized It is not the family's responsibility to assist in the communication process. Many families will leave someone to help at times, but it is the hospital's legal obligation to find an interpreter for continued understanding by the client to make sure the client is fully informed and comprehends in his or her primary language. Ethical principles for professional nursing practice in a clinical setting are guided by the principles of conduct that are written as the: A. American Nurses Association's (ANA's) Code of Ethics B. Nurse Practice Act (NPA) written by state legislation C. Standards of care from experts in the practice field D. Good Samaritan laws for civil guidelines Answer: A. American Nurses Association's (ANA's) Code of Ethics This set of ethical principles provides the professional guidelines established by the ANA to maintain the highest standards for ideal conduct in practice. As a profession, the ANA wanted to establish rules and then incorporate guidelines for accountability and responsibility of each nurse within the practice setting. A bioethical issue should be described as: A. The physician's making all decisions of client management without getting input from the client B. A research project that included treating all the white men and not treating all the black men to compare the outcomes of a specific drug therapy. C. The withholding of food and treatment at the request of the client in a written advance directive given before a client acquired permanent brain damage from an accident. D. After the client gives permission, the physician's disclosing all information to the family for their support in the management of the client. Answer: B. A research project that included treating all the white men and not treating all the black men to compare the outcomes of a specific drug therapy. The ethical issue was the inequality of treatment based strictly upon racial differences. Secondly, the drug was deliberately withheld even after results showed that the drug was working to cure the disease process in the white men for many years. So after many years, the black men were still not treated despite the outcome of the research process that showed the drug to be effective in controlling the disease early in the beginning of the research project. Therefore harm was done. Nonmaleficence, veracity, and justice were not followed. When the nurse described the client as "that nasty old man in 354," the nurse is exhibiting which ethical dilemma? A. Gender bias and ageism B. HIPAA violation C. Beneficence D. Code of ethics violation Answer: A. Gender bias and ageism Stereotyping an "old man" as "nasty"is a gender bias and an ageism issue. The nurse is verbalizing a negative descriptor about the client. The distribution of nurses to areas of "most need" in the time of a nursing shortage is an example of: A. Utilitarianism theory B. Deontological theory C. Justice D. Beneficence Answer: C. Justice Justice is defined as the fairness of distribution of resources. However, guidelines for a hierarchy of needs have been established, such as with organ transplantation. Nurses are moved to areas of greatest need when shortages occur on the floors. No floor is left without staff, and another floor that had five staff will give up two to go help the floor that had no staff. Nurses are bound by a variety of laws. Which description of a type of law is correct? A. Statutory law is created by elected legislature, such as the state legislature that defines the Nurse Practice Act (NPA). B. Regulatory law includes prevention of harm for the public and punishment for those laws that are broken. C. Common law protects the rights of the individual within society for fair and equal treatment. D. Criminal law creates boards that pass rules and regulations to control society. Answer: A. Statutory law is created by elected legislature, such as the state legislature that defines the Nurse Practice Act (NPA). Statutory law is created by legislature. It creates statues such as the NPA, which defines the role of the nurse and expectations of the performance of one's duties and explains what is contraindicated as guidelines for breach of those regulations. Besides the Joint Commission on Accreditation of Healthcare Organizations (JACHO), which governing agency regulates hospitals to allow continued safe services to be provided, funding to be received from the government and penalties if guidelines are not followed? A. Board of Nursing Examiners (BNE) B. Nurse Practice Act (NPA) C. American Nurses Association (ANA) D. Americans With Disabilities Act (ADA) Answer: D. Americans With Disabilities Act (ADA) If the hospital fails to follow ADA guidelines for meeting special needs, the facility loses funding and status for receiving low-income loans or reimbursement of expenses. ADA protects the civil rights of disabled people. It applies to both the hospital clients and hospital staff. Privacy issues for persons who are positive for human immunodeficiency virus (HIV) have been one issue in relationship to getting information when hospital staff have been exposed to unclean sticks. The ADA allows the infected client the right to choose whether or not to disclose that information. When a client is confused, left alone with the side rails down, and the bed in a high position, the client falls and breaks a hip. What law has been broken? A. Assault B. Battery C. Negligence D. Civil tort Answer: C. Negligence Knowing what to do to prevent injury is a part of the standards of care for nurses to follow. Safety guidelines dictate raising the side rails, staying with the client, lowering the bed, and observing the client until the environment is safe. As a nurse, these activities are known as basic safety measures that prevent injuries, and to not perform them is not acting in a safe manner. Negligence is conduct that falls below the standard of care that protects others against unreasonable risk of harm. When signing a form as a witness, your signature shows that the client: A. Is fully informed and is aware of all consequences. B. Was awake and fully alert and not medicated with narcotics. C. Was free to sign without pressure D. Has signed that form and the witness saw it being done Answer: D. Has signed that form and the witness saw it being done Your signature as a witness only states that the person signing the form was the person who was listed in the procedure. Which criterion is needed for someone to give consent to a procedure? A. An appointed guardianship B. Unemancipated minor C. Minimum of 21 years or older D. An advocate for a child Answer: A. An appointed guardianship A guardian has been appointed by a court and has full legal rights to choose management of care. Which statement is correct? A. Consent for medical treatment can be given by a minor with a sexually transmitted disease (STD). B. A second trimester abortion can be given without state involvement. C. Student nurses cannot be sued for malpractice while in a nursing clinical class. D. Nurses who get sick and leave during a shift are not abandoning clients if they call their supervisor and leave a message about their emergency illness. Answer: A. Consent for medical treatment can be given by a minor with a sexually transmitted disease (STD). Anyone, at any age, can be treated without parental permission for an STD infection. The client is "advised" to contact sexual partners but is not "required" to give names. Permission from parents is not needed, based upon current privacy laws. Most litigation in the hospital comes from the: A. Nurse abandoning the clients when going to lunch B. Nurse following an order that is incomplete or incorrect C. Nurse documenting blame on the physician when a mistake is made D. Supervisor watching a new employee check his or her skills level Answer: B. Nurse following an order that is incomplete or incorrect The nurse is responsible for clarifying all orders that are illegible, unreasonable, unsafe, or incorrect. The failure of the nurse to question the physician about an order creates an area of liability on the nurse's part because this is perceived as a medical action and not the role of the nurse to write orders. Some RNs do have prescriptive privileges based upon advanced degrees and certification. Therefore the nurse who cannot correct the order must document that the physician was called and clarification or a new order was given to correct the unclear or illegible one that was currently on the chart. Phone calls, follow-up, and lack of follow-up by the physician should also be documented if there is a problem with getting the information in a timely manner. The nurse must show the sequence of events of a situation in a clear manner if there is any conflict or question about any orders or procedures that were not appropriate. Assessments and documentation of the client's status should also be included if there is a potential risk for harm present. Contact of the staff's chain of command should also be specifically stated for the proof of the responsibilities being followed according to hospital policy. The nurse places an aquathermia pad on a client with a muscle sprain. The nurse informs the client the pad should be removed in 30 minutes. Why will the nurse return in 30 minutes to remove the pad? A. Reflex vasoconstriction occurs. B. Reflex vasodilation occurs. C. Systemic response occurs. D. Local response occurs. Answer: A. Reflex vasoconstriction occurs. If heat is applied for 1 hour or more, blood flow is reduced by reflex vasoconstriction. Vasoconstriction is the opposite of the desired effect of heat application A client has recently been told he has terminal cancer. As the nurse enters the room, he yells, "My eggs are cold, and I'm tired of having my sleep interrupted by noisy nurses!" The nurse may interpret the client's behavior as: A. An expression of the anger stage of dying B. An expression of disenfranchised grief C. The result of maturational loss D. The result of previous losses Answer: A. An expression of the anger stage of dying In the anger stage of Kubler-Ross's stages of dying, the individual resists the loss and may strike out at everyone and everything, in this case, the nurse. When helping a person through grief work, the nurse knows: A. Coping mechanisms that were effective in the past are often disregarded in response to the pain of a loss B. A person's perception of a loss has little to do with the grieving process. C. The sequencing of stages of grief may occur in order, they may be skipped, or they may recur. D. Most clients want to be left alone. Answer: C. The sequencing of stages of grief may occur in order, they may be skipped, or they may recur. Grief is manifested in a variety of ways that are unique to an individual and based on personal experiences, cultural expectations, and spiritual beliefs. The sequencing of stages or behaviors of grief may occur in order, they may be skipped, or they may recur. The amount of time to resolve grief also varies among individuals. A client is hospitalized in the end stage of terminal cancer. His family members are sitting at his bedside. What can the nurse do to best aid the family at this time? A. Limit the time visitors may stay so they do not become overwhelmed by the situation. B. Avoid telling family members about the client's actual condition so they will not lose hope. C. Discourage spiritual practices because this will have little connection to the client at this time. D. Find simple and appropriate care activities for the family to perform Answer: D. Find simple and appropriate care activities for the family to perform. It is helpful for the nurse to find simple care activities for the family to perform, such as feeding the client, washing the client's face, combing hair, and filling out the client's menu. This helps the family demonstrate their caring for the client and enables the client to feel their closeness and concern. a. Older adults often become particularly lonely at night and may feel more secure if a family member stays at the bedside during the night. The nurse should allow visitors to remain with dying clients at any time if the client wants them. It is up to the family to determine if they are feeling overwhelmed, not the nurse. [Show Less]
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NCLEX Legal/Ethical Questions and answers 2023
Which of the following are examples of medical battery? Select all that apply. 1. A child is placed in a papoose restraint for suturing of a facial lacera... [Show More] tion with the parent present 2. Application of soft wrist restraints to the arms of a confused, adult client with a NG tube 3. The nurse administers 2mg of morphine PRN to a difficult, alert client but tells the client it is saline 4. The nurse inserts a needed urinary catheter even though a competent client refuses it 5. The nurse threatens to put a client in restraints if the client does not stay in bed 3,4 Battery is the intentional touching of a person that is legally defined as unacceptable or occurs without the person's consent. Many routine actions that are permissible when proper consent is obtained would otherwise be considered medical battery. Furthermore, actions can be considered battery even if no physical injury results. Any health care provider (HCP) who performs a medical or surgical procedure without receiving the required informed consent from a competent client (or parent/legal guardian in the case of a child) is committing battery and could be legally charged (Option 3). A competent client has the right to refuse any treatment, even if it is for the client's benefit. The nurse should help the client understand the need (eg, informed refusal), but the client's decision should be upheld. Proceeding to administer treatment to a competent client who has refused that treatment is medical battery (Option 4). (Option 1) The temporary restraint for this minor child is needed for a therapeutic intervention, and it is implied that the parent consents to its use. (Option 2) Using a restraint to prevent a client from inadvertently removing essential medical interventions is an acceptable medical precaution. A prescription from the HCP is required, and the nurse is responsible for performing appropriate, timely assessments related to the restraint. This is not an example of battery as there is a medical reason for the restraint and a prescription/order was obtained. (Option 5) This is an example of assault. Assault is a deliberate threat with the power to carry out the threat. Educational objective: Battery is touching that is legally defined as unacceptable or occurs without consent. Examples include performing a procedure despite a competent client's refusal or without obtaining proper consent from a competent client (or parent/legal guardian when the client is a child). Assault is the threat of battery. While reviewing prenatal records with a client and her partner, the nurse notes documentation in the medical record indicating that the client is a G2P0. However, the client denies a previous pregnancy. Which action by the nurse is appropriate? 1. Adjust documentation to indicate that the client is a G1P0 2. Ask the client and partner about a previous miscarriage or abortion 3. Confirm the obstetric hx when the client is alone 4. Explain the importance of accurate info to the client and partner 3 When reviewing obstetric history, the GTPAL notation system gives the health care provider information about a client's past pregnancies. This notation may be shortened to gravida (ie, number of previous pregnancies) and para (ie, number of births after 20 weeks). For example, a G2P0 indicates 1 prior pregnancy ending before 20 weeks and 1 current pregnancy. The nurse should be cautious of discussing obstetric history with a client in front of the partner or family and not assume that others have knowledge of the client's past pregnancies. If there is a discrepancy between what the client discloses in the interview and the medical record, the information should be clarified when the client is alone to maintain confidentiality (Option 3). (Option 1) The nurse should not change information in the medical record until the information is clarified appropriately with the client. (Option 2) Although the client's medical record indicates a previous pregnancy, it is not appropriate to ask if the pregnancy was an abortion or a miscarriage in front of the client's partner. (Option 4) Explaining the need for accurate information is not appropriate at this time and does not assist with clarifying the client's obstetric history in a private manner. Educational objective: The nurse should be cautious of discussing a client's obstetric history in front of the client's partner or family to avoid breaching confidentiality. Clarification or further questioning about the client's history should take place when the client is alone. A visiting family member of a hospitalized client reports sudden onset of a headache and numbness in half of the body. The visitor asks the nurse to take a blood pressure reading. What is the most appropriate response by the nurse? 1. Encourage the visitor to lie down to see if symptoms change 2. Initiate protocol to assist the visitor to the emergency depertment 3. Proced to take the visitor's BP 4. Suggest that the visitor call the HCP 2 Providing care establishes a legal caregiver obligation/relationship between the nurse and the visitor. If a relationship is started, the nurse has a duty to continue care until the visitor is stable or other health care personnel can take over. If proper care is not continued, the nurse could be accused of negligence (ie, failure to act in a prudent manner as would a nurse with similar education/experience). This visitor's symptoms are potentially serious as sudden onset of headache and numbness in half of the body may indicate stroke. In the event of a visitor emergency, the nurse should not establish a caregiver relationship but rather implement facility protocol to help the visitor get to the emergency department promptly to receive immediate assessment and further evaluation (Option 2). (Options 1 and 4) Asking the visitor to call the health care provider (HCP) or giving advice to lie down delays the essential assessment and treatment that this visitor with potentially serious symptoms requires. (Option 3) When a nurse provides care (eg, takes blood pressure), a client-caregiver relationship is established. The nurse caring for a visitor is ill-equipped to provide care without any HCP prescriptions in place and risks being negligent. Educational objective: Providing care establishes a legal caregiver obligation/relationship between the nurse and a visitor. In the event of a visitor emergency, the nurse should refrain from actions that establish this relationship and instead implement facility protocol to help get the visitor promptly to the emergency department. The charge nurse supervising a graduate nurse would need to intervene when the nurse violates health information privacy laws with which action? Select all that apply. 1. Accesses the medical record of a client not currently assigned, but previously cared for, to assess client improvement 2. Advise a client's transport technician, "this client has metastatic breast cancer and must be moved very carefully due to fragile bones" 3. Asks a client quietly "when were you diagnosed with diabetes?" during admission assessment in a semiprivate room with the privacy curtain in place between beds 4. Explains the results of a client's diagnostic testing to the unit clerk who is organizing paperwork to be included in the client's medical record 5. Writes a client's last name on a whiteboard hanging in the nurses' station on which scheduled procedures are logged 1,2,4 Nurses need to maintain privacy and confidentiality when caring for clients. Health care workers (HCWs) need to use the minimum necessary standard (reasonable precautions) to protect a client's health information. Confidentiality is violated when information about a client's personal health (eg, diagnosis, test results) is accessed by or given to those without permission or without a "need to know." For example, a transport technician may require pertinent client information (eg, fragility) to transport a client safely but never needs to know the client's exact diagnosis (Option 2). Other violations include when HCWs access medical records of clients not currently assigned or discuss client diagnoses with nonessential personnel (Options 1 and 4). Certain incidental disclosures are allowed if reasonable precautions are taken. Common precautions include: Allowing medical record access to a HCW only when necessary to perform job duties Employing room dividers/curtains in semiprivate spaces (Option 3) Avoiding discussions about clients and their conditions in public areas Listing only last names on whiteboards at nurses' stations (Option 5) Placing communication whiteboards where they are least visible to the public Communicating with lowered voices in semiprivate spaces (eg, nurses' stations, client rooms) Educational objective: Only health care personnel requiring client health information to carry out their job duties should have access to or be advised of this information. Nurses, health care providers, and hospitals should take reasonable precautions at all times to safeguard client information. The nurse prepares to teach an in-service on legal issues related to nursing. Which legal terms are followed by an appropriate example? Select all that apply. 1. Assault: Threatening to admin a benzo if the client does not comply 2. Battery: misinforming a client that a painful injection will not create discomfort 3. False imprisonment: storing a competent client's clothes to prevent the client from leaving prior to a prescribed treatment 4. Informed consent: calling the parent of an emancipated minor for approval prior to providing care 5. Invasion of privacy: posting a medical update on the social media page of a client who is a friend 1,3,5 Assault is an act that threatens the client and causes the client to fear harm, but without the client being touched (Option 1). False imprisonment is the confinement of a client against the client's will or without legal justification (eg, client is not a threat to self or others) (Option 3). Invasion of privacy includes disclosing medical information to others without client consent. Under the Health Insurance Portability and Accountability Act (HIPAA), a client's information regarding medical treatment is private and cannot be released without the client's permission (Option 5). (Option 2) Battery involves making physical contact with the client without permission. This includes harmful acts or acts that the client refuses (eg, performing a procedure). When interacting with the client, it is important to practice veracity, the ethical principle of being truthful. (Option 4) An emancipated minor is an individual under the age of legal responsibility who has been legally freed from parental control through a court order (eg, due to enlistment in the military, marriage, pregnancy). The parent in this situation would not need to be called. Clients have the right to be informed of risks and benefits of procedures prior to care and to give informed consent. Educational objective: Clients have the right to privacy and to give informed consent prior to medical care. Assault is an act that threatens the client, causing the client to fear harm without the client being touched. Battery is physical contact against a client's will or without legal justification. False imprisonment includes restraining a competent client without the client's permission. The clinic nurse is teaching a client about the advance directive form that needs to be completed. Which statement indicates that the client understands the information? 1. I will get this notarized as soon as I can 2. I will give a copy of this to my daughter, who is listed as my health care proxy 3. I'll put this on my refrigerator, so no one will give me cardiopulmonary resuscitation 4. You and my daughter can witness this for me 2 When the advance directive is completed, a copy should be placed in the client's medical record and copies should be given to everyone listed as health care proxies. The client should also keep a copy in a safe place. (Option 1) The advance directive form does not need to be notarized, and so it can be completed in the health care setting if there are 2 witnesses. (Option 3) The advance directive is used to document a client's wishes, but it is not a medical order. It will not prevent from performing CPR on a client when necessary. If this client does not want CPR, a portable "do not resuscitate" (DNR) order should be used to ensure that the DNR order is followed outside the hospital setting. Types of portable orders include a POLST (Portable Orders for Life Sustaining Treatment) form, an out-of-hospital DNR, and a DNR bracelet. (Option 4) Two witnesses are required for completion of the advance directive form. The witnesses cannot be health care providers involved in the care of the client or individuals named as health care proxies in the document. Educational objective: An advance directive is placed in the client's medical record and copies are given to health care proxies. Two witnesses are required for completion of the advance directive, but they should not be the health care proxies listed in the document. The acute care clinic nurse administers a prescribed narcotic for a client with renal colic and then discharges the client without ensuring that the client has a designated driver. The client is subsequently involved in a motor vehicle accident causing injury to self and others. Which ethical principle did the nurse violate? 1. Autonomy 2. Nonmaleficence 3. Paternalism 4. Veracity 2 The nurse violated the ethical principle "nonmaleficence" (ie, do no harm). It is rare to see a nurse inflict intentional harm. However, problems do occur due to unintentional harm, which is usually a result of poor clinical judgment. Beneficence is a nurse's duty to promote good and do what is best for the client. (Option 1) Autonomy is allowing the clients to choose the direction of their care. This is accomplished with advanced directives along with informed consent and choices regarding proposed treatments. (Option 3) Paternalism is a type of beneficence whereby clients are treated as children. The nurse claims to know what is best for the client and coerces the client to act as the nurse wishes without considering the client's autonomy. (Option 4) Veracity refers to the duty to tell the truth. This principle should always be applied to client care and documentation. Educational objective: Nonmaleficence is the ethical principle of doing no harm. All nurses must exercise sound clinical judgment to prevent harm, even if it is unintentional, to their clients. A nurse cares for a client on life support who has been declared brain dead. Which intervention is appropriate at this time? 1. Ask the fam members about their plans for the funeral service 2. Call the local organ procurement services representative 3. Discontinue nursing care and provide postmortem care 4. Remove life support as requested by spouse and family 2 Local organ procurement services (OPS) are notified for every client death, per hospital protocol (Option 2). If the client is deemed appropriate as a donor, then OPS collaborate with hospital staff in approaching the client's family about organ donation. Cardiac support (eg, dopamine, epinephrine) and respiratory support (eg, ventilator) continue as organ donation is discussed and/or performed. Life support is withdrawn only if the client is not a candidate for donation due to physiological reasons or the client/family does not consent. (Option 1) Organ donation is discussed before final arrangements and funeral plans are made. In most cases, the family is referred to the hospital chaplain or someone outside the hospital for assistance with final arrangements. (Option 3) Medical and nursing care would continue as organ donation is discussed due to organ and tissue perfusion being necessary for viable donation. (Option 4) Local OPS are contacted before life support is removed so that physiological support is continued in the event that the client is a viable donor. Educational objective: All client deaths are reported to local organ procurement services, per hospital protocol. Life support is continued until a decision for organ donation is reached so that organs and tissues continue to receive perfusion and oxygenation. The nurse caring for a terminally ill client asks if the client has an advance directive. The client states, "I already have a power of attorney." What is the best response by the nurse? 1. A power of attorney (POA) is good to have in place. It sounds like you are on the right attack 2. Great. Your POA can start to make decisions for you when you are no longer able to do so 3. Many people find a lawyer at this stage of life. A lawyer can help you get your affairs in order 4. There are many types of POAs. Let's clarify if your POA can make health care decisions for you 4 A power of attorney (POA) designates a representative to act on a person's behalf in the event that the individual becomes incapacitated. There are different types of POAs, including medical and financial. An advance directive or living will describes the client's health care decisions (eg, do not resuscitate). As part of an advance directive, the client may designate a representative to make health care decisions for the client - a durable POA for health care or POA for health care (Canada). This client's statement requires further clarification regarding what type of POA is in place (Option 4). (Option 1) The nurse should not assume that the client's affairs are in order based on this statement. Further clarification is needed to determine whether the client has made the appropriate arrangements regarding health care decisions. (Option 2) Although it is correct that the POA makes decisions for a client only when the client is no longer able to make them, the nurse first needs to determine what type of POA is in place. (Option 3) Lawyers can help with end-of-life paperwork, but the priority is to clarify whether the client has the appropriate POA in place. Educational objective: An advance directive makes clear a client's health care wishes (eg, do not resuscitate). A power of attorney (POA) designates a representative to act on a person's behalf. It is important to clarify that the client has the type of POA who can make health care decisions (durable POA for health care, POA for health care [Canada]). A male client has terminal metastatic disease. He arrives at the emergency department with respirations of 6/min and an advance directive indicating to withhold resuscitative efforts. What should the nurse's response be? 1. Apply O2 at 2L by nasal cannula 2. Ask the client if he wants to change his mind 3. Ask the spouse what she wants done 4. Determine who has medical POA 1 Advance directives are prepared by a client prior to the need to indicate the client's wishes. A living will gives instructions about future medical care and treatment if the client is unable to communicate. A medical power of attorney is the individual designated to make health care decisions should a client become unable to make an informed decision. It allows more flexibility to deal with unique situations. Because the client has indicated specific desires, these should be honored. This is especially true as the client has a terminal condition (versus, for example, an acute choking episode that could be easily reversed). Oxygen can provide comfort and is not resuscitative when given by nasal cannula. (Option 2) Advance directives are determined ahead of time to guide decision making at the time of the event. The client can indicate a desire to make a change, and the original decision should be honored. This client could be experiencing hypoxia and thus not thinking as clearly as when the advance directives were made. Asking about changes could imply that he should make a change, which is not true. The original decision should be honored; however, the client can indicate a desire to make a change. (Option 3) The client's advance directives take legal precedence over the spouse's wishes. The spouse is consulted when there are no advance directives or durable power of attorney for health care. (Option 4) Advance directives include living wills with written directives on how to handle situations. A medical power of attorney is used in situations not covered by the written directives. This client has indicated his wishes. A durable power of attorney for health care is used only when clients have not expressed wishes or cannot speak for themselves. Educational objective: Advance directives include a living will (specific situations put in writing) or a medical power of attorney (an individual appointed when the clients are unable to speak for themselves). The client's wishes should be honored. [Show Less]
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NCLEX STYLE REVIEW QUESTIONS FOR NURSE PROCESS, LEGAL, PROFESSIONALISM, AND ETHICS 2023
A nurse informs the patient's health care provider that the patient is refusing potentially life saving surgery. In this situation, which ethical principle... [Show More] is the nurse using? Beneficence Nonmaleficence Autonomy Justice Autonomy Using the principle of autonomy allows individuals to have the right to determine their own actions and make their own choices. Calling the health care provider to report the patient's refusal of surgery demonstrates the nurse's use of autonomy to guide practice. Beneficence is frequently described as "the doing of good." Nonmaleficence is the duty to do no harm. A description of justice includes patients with the same diagnosis and health care needs receiving the same care. On a medical unit, several patients are being treated for Hepatitis B infection. One of the patients contracted Hepatitis B through using infected needles associated with heroin use. Another of the patients contracted Hepatitis B through a blood transfusion following a car accident. Several of the employees on the unit treat the patient who used heroin rudely and delay their attention to the patient's requests. The nurse intervenes and reminds the staff to use which ethical principle? Justice Nonmaleficence Beneficence Autonomy Justice Justice describes providing patients with the same diagnosis and health care needs the same care. By delaying attention to the patient's requests and treating the patient rudely, the staff is not using the principle of justice. Nonmaleficence is the duty to do no harm. Beneficence is frequently described as "the doing of good." Autonomy means that individuals have the right to determine their own actions and the freedom to make their own decisions. A nurse is providing patient teaching for a patient undergoing chemotherapy. The nurse is explaining that the chemotherapy will cause some unpleasant side effects, such as nausea and hair loss. In this situation, the nurse is using which ethical principle? Beneficence Nonmaleficence Autonomy Justice Nonmaleficence Nonmaleficence involves the duty to do no harm. Although the patient will experience nausea and hair loss (harm), the treatment will eventually produce good for the patient. Beneficence is frequently defined as the "doing of good." Autonomy means that individuals have the right to determine their own actions and the freedom to make their own decisions. Justice means that the same care is provided to patients with similar diseases and health care needs. A nurse is on duty in the emergency room when the nurse is notified that a school bus has been struck by a train. Immediately the nurse reports to the triage area and begins the task of determining the severity of injuries, so that the most critical patients receive care first. Which ethical theory is the nurse putting into action? Utilitarianism Act deontology Rule deontology Virtue ethics Utilitarianism Utilitarian ethics states that "what makes an action right or wrong is its utility, with useful actions bringing about the greatest good for the greatest number of people." By triaging the patients according to the severity of the injury, the nurse will be able to save the lives of more patients, thus doing the greatest good for the greatest number of people. Act deontologists determine the right thing to do by gathering all the facts and then making a decision. Rule deontologists emphasize that principles guide our actions. Virtue ethics are tendencies to act, feel, and judge that develop through appropriate training but come from natural tendencies. A nurse is working in a neonatal intensive care unit (NICU) where a premature baby (26 weeks gestation) is facing respiratory disorders, numerous infections, and a brain hemorrhage. The parents want every measure to be taken to keep their baby alive, but several members of the health care team are advocating removal of life support. The nurse believes there are several ethical issues involved in this case. What step should the nurse take first when facing an ethical dilemma? Gather as much information as possible about the situation Identify the options available in this situation Act in a fair and equitable manner for all involved Evaluate the actions taken using ethical principles Gather as much information as possible about the situation The nurse should clarify the ethical dilemma by gathering as much information as possible about the situation. This compares with the assessment phase of the nursing process and is the first step in the ethical decision making model. Most ethical dilemmas have multiple options, which should all be considered, but gathering additional data must be the first step. Making a decision and acting in a fair and equitable manner must take place, but gathering additional data is the first step. Evaluating the actions taken is the last step of the ethical decision making model. A nurse reports a medication error and monitors the patient, who suffers no ill effects. Which element is lacking to prove nursing malpractice? Duty of care Breach of duty Injury Standard of care Injury Since there is no injury, then malpractice cannot be proven. Breach of duty, duty of care, and standard of care are not relevant elements in this case. The patient has a central venous line. The registered nurse (RN) delegates changing the sterile dressing over the line to a nursing assistant. The nursing assistant does not understand sterile technique and contaminates the dressing. An infection develops in the patient. The nurse manager discusses the action of the RN. Which statement is correct regarding the nurse's action? The nursing assistant is guilty of malpractice. The nurse is responsible for the acts delegated. The hospital cannot be held responsible for the act of its employees. No harm came to the patient, so a malpractice suit cannot be claimed. The nurse is responsible for the acts delegated. The registered nurse is responsible for delegating appropriately. It is not appropriate to delegate a skill requiring sterile technique and assessment of a central line site to a nursing assistant. It is not within the nursing assistant's scope of practice to perform central line dressing changes. The hospital is responsible for the acts of its employees under the concept of respondeat superior. Harm was caused by this act, since the patient did develop an infection, so a malpractice suit can be claimed. The registered nurse, employed by the risk management department of a hospital is giving an inservice class on social media to nursing employees. Which one of these statements should be included in this class? Posts are private and accessible only to the intended recipient. Once content has been deleted, it is no longer accessible. No harm is done if patient information is disclosed only to the intended recipient. The nurse should not refer to a patient, even by nickname or room number. The nurse should not refer to a patient, even by nickname or room number. The nurse should never refer to a patient on social media, even by nickname or room number. Social media posts are not considered private and are not always accessible only to the intended recipient. Even deleted content is accessible at times on social media. Disclosing any patient information is a harmful act, even if it is disclosed only to the intended recipient. The registered nurse (RN), who is supervising a group of nurses at a health clinic, overhears a nurse telling a patient, "If you do not stop shouting, I am going to give you an injection." The RN immediately intervenes and tells the nurse this action can lead to which accusation? Delegation Breach of confidentiality Assault Respondeat superior Assault Assault is a threat or an attempt to make bodily contact with another person without that person's consent. Breach of confidentiality is revealing health care information to those not involved with the care of the patient. Delegation involves giving someone else authority to act for another. Respondeat superior attributes the acts of the employees to their employer. A recent graduate of a nursing program has accepted a position in a long term care unit. The nurse can use which strategy to reduce the risk of malpractice suits? Carry malpractice insurance Request supervision for all care Not sign his or her name in patient records Maintain good relationships with patients and families Maintain good relationships with patients and families Maintaining good relationships with patients and families does reduce the risk of malpractice suits. Carrying malpractice insurance does not reduce the risk of a malpractice suit. Requesting supervision for all care provided is not feasible in many situations and does not reduce the risk of malpractice suits. Not signing patient records can actually increase the risk of lawsuits, as failure to document is considered a category of negligence that results in malpractice lawsuits. A nurse manager is conducting an employee evaluation for a new employee. Which employee behavior best indicates that the nurse is providing patient-centered care? The nurse shares his or her own personal problems in order to obtain the patient's trust and to show empathy with the family. The nurse avoids raising the patient's anxiety by chatting about pleasant topics before unpleasant procedures. The nurse clarifies patients' reasons for refusing medications without becoming defensive. The nurse avoids upsetting patients by not bringing up health care issues that might upset the patient. The nurse clarifies patients' reasons for refusing medications without becoming defensive. Providing patient-centered care involves clarifying patients' reasons for refusing medications. Refraining from discussing own concerns demonstrates a patient-centered approach. The nurse displays patient-centered care by attempting to talk the patient through anxiety-laden procedures. Avoiding discussing health issues does not display a patient- centered approach. A nurse informs the patient's health care provider that the patient is refusing potentially life saving surgery. In this situation, which ethical principle is the nurse using? Beneficence Nonmaleficence Autonomy Justice Autonomy Using the principle of autonomy allows individuals to have the right to determine their own actions and make their own choices. Calling the health care provider to report the patient's refusal of surgery demonstrates the nurse's use of autonomy to guide practice. Beneficence is frequently described as "the doing of good." Nonmaleficence is the duty to do no harm. A description of justice includes patients with the same diagnosis and health care needs receiving the same care. On a medical unit, several patients are being treated for Hepatitis B infection. One of the patients contracted Hepatitis B through using infected needles associated with heroin use. Another of the patients contracted Hepatitis B through a blood transfusion following a car accident. Several of the employees on the unit treat the patient who used heroin rudely and delay their attention to the patient's requests. The nurse intervenes and reminds the staff to use which ethical principle? Justice Nonmaleficence Beneficence Autonomy Justice Justice describes providing patients with the same diagnosis and health care needs the same care. By delaying attention to the patient's requests and treating the patient rudely, the staff is not using the principle of justice. Nonmaleficence is the duty to do no harm. Beneficence is frequently described as "the doing of good." Autonomy means that individuals have the right to determine their own actions and the freedom to make their own decisions. A nurse is providing patient teaching for a patient undergoing chemotherapy. The nurse is explaining that the chemotherapy will cause some unpleasant side effects, such as nausea and hair loss. In this situation, the nurse is using which ethical principle? Beneficence Nonmaleficence Autonomy Justice Nonmaleficence Nonmaleficence involves the duty to do no harm. Although the patient will experience nausea and hair loss (harm), the treatment will eventually produce good for the patient. Beneficence is frequently defined as the "doing of good." Autonomy means that individuals have the right to determine their own actions and the freedom to make their own decisions. Justice means that the same care is provided to patients with similar diseases and health care needs. A nurse is on duty in the emergency room when the nurse is notified that a school bus has been struck by a train. Immediately the nurse reports to the triage area and begins the task of determining the severity of injuries, so that the most critical patients receive care first. Which ethical theory is the nurse putting into action? Utilitarianism Act deontology Rule deontology Virtue ethics Utilitarianism Utilitarian ethics states that "what makes an action right or wrong is its utility, with useful actions bringing about the greatest good for the greatest number of people." By triaging the patients according to the severity of the injury, the nurse will be able to save the lives of more patients, thus doing the greatest good for the greatest number of people. Act deontologists determine the right thing to do by gathering all the facts and then making a decision. Rule deontologists emphasize that principles guide our actions. Virtue ethics are tendencies to act, feel, and judge that develop through appropriate training but come from natural tendencies. A nurse is working in a neonatal intensive care unit (NICU) where a premature baby (26 weeks gestation) is facing respiratory disorders, numerous infections, and a brain hemorrhage. The parents want every measure to be taken to keep their baby alive, but several members of the health care team are advocating removal of life support. The nurse believes there are several ethical issues involved in this case. What step should the nurse take first when facing an ethical dilemma? Gather as much information as possible about the situation Identify the options available in this situation Act in a fair and equitable manner for all involved Evaluate the actions taken using ethical principles Gather as much information as possible about the situation The nurse should clarify the ethical dilemma by gathering as much information as possible about the situation. This compares with the assessment phase of the nursing process and is the first step in the ethical decision making model. Most ethical dilemmas have multiple options, which should all be considered, but gathering additional data must be the first step. Making a decision and acting in a fair and equitable manner must take place, but gathering additional data is the first step. Evaluating the actions taken is the last step of the ethical decision making model. A nurse reports a medication error and monitors the patient, who suffers no ill effects. Which element is lacking to prove nursing malpractice? Duty of care Breach of duty Injury Standard of care Injury Since there is no injury, then malpractice cannot be proven. Breach of duty, duty of care, and standard of care are not relevant elements in this case. The patient has a central venous line. The registered nurse (RN) delegates changing the sterile dressing over the line to a nursing assistant. The nursing assistant does not understand sterile technique and contaminates the dressing. An infection develops in the patient. The nurse manager discusses the action of the RN. Which statement is correct regarding the nurse's action? The nursing assistant is guilty of malpractice. The nurse is responsible for the acts delegated. The hospital cannot be held responsible for the act of its employees. No harm came to the patient, so a malpractice suit cannot be claimed. The nurse is responsible for the acts delegated. The registered nurse is responsible for delegating appropriately. It is not appropriate to delegate a skill requiring sterile technique and assessment of a central line site to a nursing assistant. It is not within the nursing assistant's scope of practice to perform central line dressing changes. The hospital is responsible for the acts of its employees under the concept of respondeat superior. Harm was caused by this act, since the patient did develop an infection, so a malpractice suit can be claimed. The registered nurse, employed by the risk management department of a hospital is giving an inservice class on social media to nursing employees. Which one of these statements should be included in this class? Posts are private and accessible only to the intended recipient. Once content has been deleted, it is no longer accessible. No harm is done if patient information is disclosed only to the intended recipient. The nurse should not refer to a patient, even by nickname or room number. The nurse should not refer to a patient, even by nickname or room number. The nurse should never refer to a patient on social media, even by nickname or room number. Social media posts are not considered private and are not always accessible only to the intended recipient. Even deleted content is accessible at times on social media. Disclosing any patient information is a harmful act, even if it is disclosed only to the intended recipient. The registered nurse (RN), who is supervising a group of nurses at a health clinic, overhears a nurse telling a patient, "If you do not stop shouting, I am going to give you an injection." The RN immediately intervenes and tells the nurse this action can lead to which accusation? Delegation Breach of confidentiality Assault Respondeat superior Assault Assault is a threat or an attempt to make bodily contact with another person without that person's consent. Breach of confidentiality is revealing health care information to those not involved with the care of the patient. Delegation involves giving someone else authority to act for another. Respondeat superior attributes the acts of the employees to their employer. A recent graduate of a nursing program has accepted a position in a long term care unit. The nurse can use which strategy to reduce the risk of malpractice suits? Carry malpractice insurance Request supervision for all care Not sign his or her name in patient records Maintain good relationships with patients and families Maintain good relationships with patients and families Maintaining good relationships with patients and families does reduce the risk of malpractice suits. Carrying malpractice insurance does not reduce the risk of a malpractice suit. Requesting supervision for all care provided is not feasible in many situations and does not reduce the risk of malpractice suits. Not signing patient records can actually increase the risk of lawsuits, as failure to document is considered a category of negligence that results in malpractice lawsuits. A nurse manager is conducting an employee evaluation for a new employee. Which employee behavior best indicates that the nurse is providing patient-centered care? The nurse shares his or her own personal problems in order to obtain the patient's trust and to show empathy with the family. The nurse avoids raising the patient's anxiety by chatting about pleasant topics before unpleasant procedures. The nurse clarifies patients' reasons for refusing medications without becoming defensive. The nurse avoids upsetting patients by not bringing up health care issues that might upset the patient. The nurse clarifies patients' reasons for refusing medications without becoming defensive. Providing patient-centered care involves clarifying patients' reasons for refusing medications. Refraining from discussing own concerns demonstrates a patient-centered approach. The nurse displays patient-centered care by attempting to talk the patient through anxiety-laden procedures. Avoiding discussing health issues does not display a patient- centered approach. [Show Less]
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Ethics in Nursing Questions and correct answers latest 2023
Which element of ethical practice is associated with fair policies and procedures guiding allocation of organs for transplantation? A. Fidelity B. Veraci... [Show More] ty C. Justice D. Beneficence Justice A nurse admits a patient with end-stage cancer who is obviously in pain, yet refuses pain medication because the patient wants to remain aware of family members who are present. The best example of the nurse acting under the ethical precept of autonomy is: A. Call the physician and get orders for around-the-clock pain medication anyway. B. Assess the patient and pain experience thoroughly and discuss the patient's wishes. C. Try to convince the patient that the family doesn't want her to be in pain. D. Tell the family that the patient is refusing treatment. Assess the patient and pain experience thoroughly and discuss the patient's wishes. A patient is asked to participate in a medical research study involving the relationship of genetics to disease. Which document is crucial for the patient to understand because it protects the patient's rights? A. Code of Ethics B. Informed Consent C. Nurse Practice Act D. United States Constitution Informed consent A post-operative patient requests pain medication. The nurse informs the patient that he will give the medication in the next ten minutes, but goes to lunch and does not do so for another hour. The nurse has demonstrated a lack of ethical: A. Fidelity B. Autonomy C. Teleology D. Justice Fidelity A patient's son requests to review the documentation in his mother's medical record. What is the nurse's best response to this request? A. "I will be happy to get that for you." B. "You will have to ask the physician." C. "You will need your mother's permission." D. "You are not allowed to see the medical records." "You will need your mother's permission." Match the ethical term: -Standard of best interest -Values -Morals -Ethical dilemma With the appropriate definition: -A decision made about a clients health care by a surrogate -Give meaning to an individuals life -Standards of right and wrong that an individual internalizes -A choice between two equally difficult choices Standard of best interest: A decision made about a clients health care by a surrogate Values: Give meaning to an individuals life Morals: Standards of right and wrong that an individual internalizes Ethical dilemma: A choice between two equally difficult choices A nurse questions a physician about an ordered medication for a patient in which the dose seems excessive based on the patient's age and health status. This is an example of the nurse following the ethical precept of: A. Autonomy B. Malfeasance C. Veracity D. Nonmaleficence Nonmaleficence Which of the following choices is the best indication of an ethical dilemma? A. A personal injury attorney has filed a lawsuit B. Scientific information alone does not provide the answer C. The law provides guidance on the situation D. A patient is uncertain on which treatment option to undertake Scientific information alone does not provide the answer According to the American Nurses Association (ANA), it is acceptable to withhold food and fluid from a patient when: A. A competent patient or surrogate makes the decision B. A physician writes a DNR order C. A patient has little hope for a disease cure D. The health care team determines there is a poor quality of life A competent patient or surrogate makes the decision [Show Less]
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