HESI EXIT FAMILY NURSE PRACTITIONER FINAL EXAMS QUESTIONS AND ANSWERS
Test Bank
Multiple Choice
1. An APRN is about to examine a patient in the
... [Show More] emergency department. A colleague states to the APRN “This patient is probably just seeking pain medication.” Regardless of his or her colleague’s comment he or she enter the examination room and treat the patient as if he or she is trustworthy and has good motives. Which of the ten essential elements of dignity is the APRN utilizing?
a. Inclusion
b. Benefit of the doubt
c. Acceptance of identity
d. Recognition
ANS: B
Treating others as if they are trustworthy, starting with the premise that they have good motives and are acting with integrity are all key points of benefit of the doubt. Benefit of the doubt is one of the ten essential elements of dignity.
2. An APRN approaches his or her patients as neither inferior nor superior and gives others the freedom to express their authentic selves without being judged. Which of the ten essential elements of dignity is the APRN utilizing?
a. Safety
b. Accountability
c. Acceptance of identity
d. Benefit of doubt
ANS: C
The acceptance of identity is one of the ten essential elements of dignity. Approaching people as neither inferior nor superior to you, giving others the freedom to express their authentic selves without fear of being negatively judged, interacting without prejudice or bias, accepting how race, religion, gender, class, sexual orientation, age, disability, and so on are at the core of someone’s identities, and assuming they have integrity are all included in the essential elements of acceptance of identity.
3. Communication problems often plague ethical dilemmas, which of the following is often at the forefront of communication problems regarding clinicians?
a. Poor knowledge of the situation
b. Language barriers
c. Poor independence
d. Failure to speak up
ANS: D
All of the answers may contribute to ethical dilemmas but failure of a clinician to speak up about a real or potential ethical problem is commonly identified. Erosion of open and honest communication is typically the first theme encountered in many ethical dilemmas.
4. A 76-year-old patient is admitted to the hospital after suffering a spinal compression fracture. The patient is unable to ambulate adequately on his or her own and requires assistance for basic needs. Your assessment is that the patient will recover their strength within 2 weeks. The billing department at the facility notifies you that the patient may not stay in the hospital for more than 2 days. The patient does not wish to be transferred to a nursing facility and wishes to remain in the hospital for the remaining 12 days to gain strength. Which of the following best defines this scenario?
a. Interprofessional conflict
b. Communication problems
c. Legal issues
d. Multiple commitments
ANS: A
This ethical scenario plays out routinely in medical care as an element of interprofessional conflict. The clinician wishes to respect patient autonomy but must understand and express the best interests of the patient to a multidisciplinary team.
5. An APRN is scheduled to complete his or her shift at 7 p.m. on a particular day. A new patient arrives 5 minutes prior to the time the APRN is expected to leave. He or she is asked by a supervisor to stay beyond their scheduled time to assess the patient and provide care. Which of the following best defines this scenario?
a. Interprofessional conflict
b. Multiple commitments
c. Communication problems
d. Legal issues
ANS: B
APRNs often fail to practice self-care and it is a significant threat to ethical practice. Multiple commitments including obligations to multiple parties involving the patient, employer, and legal system may create a scenario for ethical issues in nursing practice. Societal issues including cost containment pressures in health systems are likely partially responsible for development of this scenario.
6. An APRN works in a primary care clinic. The APRN wishes to treat a patient’s disease with a specific medication that is far superior to other treatments. The APRN has never encountered issues prescribing this therapy as first-line treatment in the past. The APRN is informed by this particular patient’s insurance that they require proof that the APRN has tried a far less effective therapy for 1 month prior to paying for the medication. Which of the following best describes the forces at work in this scenario?
a. Communication problems
b. Legal issues
c. Interprofessional conflict
d. Societal issues
ANS: D
Societal issues including cost containment pressures in health systems are likely responsible for development of this scenario. Interprofessional conflicts would best be involved in this scenario if this is applied in a multidisciplinary team scenario.
7. Which of the following are defined as the four elements of core competency development in ethical decision making for APRNs?
a. Knowledge development, knowledge application, creating an ethical environment, promoting social justice
b. Knowledge development, educating others, creating an ethical environment, promoting social justice
c. Knowledge development, knowledge application, effective communication, promoting social justice
d. Knowledge development, knowledge application, creating an ethical environment, understanding legal barriers
ANS: A
The core competency of ethical decision making for APRNs is best organized into four key elements: knowledge development, knowledge application, creating an ethical environment, and promoting social justice.
8. Which of the following examples best describes the knowledge development element of core competency development for ethical decision making?
a. Analyzing the policymaking process
b. Using self-reflection during patient case reviews
c. Applying ethical decision-making model to a clinical problem
d. Mentoring others to develop ethical practice
ANS: B
The use of knowledge development is a key element of core competency development for ethical decision making. It involves gaining knowledge of ethical theories and developing the ability to distinguish a true ethical dilemma from a situation of moral distress or other clinically problematic situation. Becoming sensitive to ethical dimensions of clinical practice and fidelity conflicts, developing values clarification (self-reflection), and interpreting reactions and emotions of others are all elements of knowledge development and moral sensitivity. [Show Less]