CH 6 & 7 Taylor

A nurse is arrested for possession of illegal drugs. What kind of law is involved with this type of activity?

Criminal

A nurse is caring for a woman 28 years of age who has delivered a baby by Cesarean section. She describes her pain as a 9. The nurse medicates her for pain. This is an example of which of the following ethical frameworks?

Beneficence: doing or promoting good.

Two children need a kidney transplant. One is the child of a famous sports figure, whereas the other child comes from a low-income family. What ethically relevant consideration is important tot he nurse as an advocate for these clients?

Cost-effectiveness and allocation

A nurse has had, on several occasions, the opportunity to share personal prescriptions with family members when they were in need of pain medication or antibiotics. Which set of rules should govern this moral decision?

Ethics

Which of the following aspects of nursing would be most likely defined by legislation at a state level?

The differences in the scope of practice between registered nurses and licensed practical nurses.

A nurse in a woman's health clinic values abstinence as the best method of birth control. However, she offers compassionate care to unmarried pregnant adolescents. What is the nurse demonstrating?

nonjudgmental "value neutral" care

A client, unsure of the need for surgery, asks the nurse, "What should I do?" What answer by the nurse is based on advocacy?

Tell me more about what makes you think you don't want surgery.

A nurse using the principle-based approach to client care seeks to avoid causing harm to clients in all situations. What is this principle known as?

Nonmaleficence

Which of the following nursing actions would be considered a violation of HIPPA regulations?

A nurse ambulates a client through the hospital hallway in a hospital gown that is open in the back. A nurse uses a client's chart as a sample teaching case without changing the client's name. A nurse reports the condition of a client to the client's employer.

A nurse is caring for a client who is practicing Jehovah's Witness. The physician orders two units of packed cells based on his low hemoglobin and hematocrit levels . The nurse states to the surgeon that it is unethical to go against the patient's beliefs even though his blood counts are very low. What is the best description of the nurse's intentions?

Acting in the patient's best interest

A group of nurses working in a long term care facility fails to keep the narcotic medications in a secure location. The nurses also fail to count the medications before and after each shift, as indicated by the institution's policies and procedures. These failures may result in what type of disciplinary action?

Action against the nurse's licenses

Which of the following is the most frequent reason for revocation or suspension of a nurse's license?

Alcohol or drug abuse

While at lunch, a nurse heard other nurses at a nearby table talking about a client they did not like. When they asked him what he thought, he politely refused to join in the conversation. What value was the nurse demonstrating?

Basic respect for human dignity

The nurse reports a nursing colleague on the unit who is lethargic and verbally responding in a slow manner. What is this an example of?

Whistle-blowing

A nurse fails to administer a medication that prevents seizures, and the client has a seizure. The nurse is in violation of the Nurse Practice Act. What type of law is the nurse in violation of ?

Civil

What type of law regulates the practice of nursing?

Civil Law

A lawsuit has been brought against a nurse for malpractice. The client fell and suffered a skull fracture, resulting in a longer hospital stay and need for rehabilitation. What does the description of the client injuries represent as proof of malpractice?

Damages

What is the function of the American Nurses Association's Code of Ethics for Nurses?

Delineates nurses' conduct and responsibilities

A nurse explains the informed consent form to a client who is scheduled for heart bypass surgery. Which of the following are elements of this consent form?

Disclosure, Comprehension and Competence

A client who is scheduled to have surgery for a hernia the next day is anxious about the whole procedure. The nurse assures the client that surgery for hernias is very common and that the prognosis is very good. What skills of the nurse are reflected here?

Interpersonal Skills

A male client age 56 years is experiencing withdrawal from alcohol and is placing himself at risk for falls by repeatedly attempting to scale his bedrails. Benzodiazepines have failed to alleviate his agitation and the nurse is considering obtaining an order for physical restraints to ensure his safety. The nurse should recognize that this measure may constitute what?

Paternalism: involves a violation of the client's autonomy in order to maximize good or minimize harm, a situation that requires careful consideration in light of ethical principles

A client is suing a nurse for malpractice. What is the term for the person bringing suit?

Plaintiff

A baccalaureate-prepared nurse is applying for a nurse practitioner position. The nurse is:

Practicing beyond his scope according to licensure

A nursing instructor is teaching a class about ethical principles to a group of nursing students. The instructor determines that the teaching was successful when the students give which of the following as an example of nonmaleficence?

Protecting clients from a chemically impaired practicioner

A home care nurse is caring for a quadriplegic client who needs regular position changes and back massages. A gentleman identifying himself as a family friend inquires if he can be of any help to the family. What should be the nurse's response?

The nurse should ask the gentleman to talk to the family directly

A group of nurse researchers has proposed a study to examine the efficacy of a new wound care product. Which of the following aspects of the methodology demonstrates that the nurses are attempting to maintain the ethical principle of non-maleficence?

The nurses are taking every reasonable measure to ensure that no participants experience impaired wound healing as a result of the study intervention.

A client refuses to have a pain medication administered by injection. A nurse says, "If you don't let me give you the shot, I will get help to hold you down and give it." With what crime might the nurse be charged?

Assault

A nurse has been named as a defendant in a lawsuit. With whom should the nurse discuss the case?

Attorney

A nurse provides client care within a philosophy of ethical decision making and professional expectations. What is the nurse using as a framework for practice?

Code of Ethics

A lawyer quotes a precedent for punishment of a crime committed by the defendant in a trial. What is court-made law known as?

Common law

Which of the following accreditations is a legal requirement for a school of nursing to exist?

State Board of Nursing Accredidation

A nurse is providing client care in a hospital setting. Who has full legal responsibility and accountability for the nurse's actions?

The nurse

A client nearing the end of life requests that he be given no food or fluids. The physician order the insertion of a naso-gastric tube to feed the client. What situation does this create for the nurse providing care?

An ethical dilemma about inconsistent courses of action

A nurse has taken a telephone order from a physician for an emergency medication. The dose of the medication is abnormally high. What should the nurse do next?

Question the order for the medication

A nurse has a duty of nonmaleficence. Which one of the following would be considered a contradiction to that duty?

Refuse to administer pain medication as ordered.

An on-duty nurse discovers that her colleague is pilfering medicines. According to the Nurse Practice Act what should the nurse do?

Report the incident to the supervisor

A woman 83 years who has suffered a cerebrovascular accident and is unable to swallow refuses the insertion of a feeding tube. This is an example of what ethical principle?

Autonomy

When the nurse inserts an ordered urinary catheter in the client's urethra after the client has refused the procedure, and then the client suffers an injury, the client may sure the nurse for which type of tort?

Battery

A client with a diagnosis of colorectal cancer has been presented with her treatment options, but wishes to defer any decisions to her uncle, who acts in the role of a family patriarch within the client's culture. By which of the following is the client's right to self determination best protected?

Respecting the client's desire to have the uncle make choices on her behalf.

Which of the following is the nurse's best legal safeguard?

Competent practice

A nurse is caring for a client who is a celebrity in the area. A person claiming he is a family member inquires about the medical details of the client. The nurse reveals the information but later comes to find out that the person was not a family member. The nurse has violated which of the following?

Confidentiality

A student nurse is working in the library on her plan of care for a clinical assignment. The client's name is written at the top of her plan. What ethical responsibility is the student violating?

Confidentiality

Which of the following statements accurately describes an aspect of the credentialing process used in nursing practice?

Credentialing refers to the way in which professional competence is ensured and maintained. Certification grants recognition in a specified practice area to people who meet certain criteria. Once earned, a license to practice is a property right and may not be revoked without due process.

When a nurse refuses to compromise a client's right to privacy, even when the nurse is threatened, the nurse is expressing an ethical framework termed what?

Deontologic: Emphasizes roles or responsibilities that one is morally obligated to fulfill.

A nurse states to the client that she will keep her free of pain. However, her family wishes to try a treatment to prolong her life that may necessitate withholding pain medication. This factor will cause an ethical dilemma for the nurse in relation to which ethical principle?

Fidelity: being faithful to on'es commitments and promises.

An ethical conflict exists around a female client's expressed desire to have a neighbor make her treatment decisions. This neighbor is an individual who the client's children characterize as a predator. Place in the correct order the steps that the nurse should follow in resolving this ethical conflict.

Gather relevant data about the situation, Clearly identify the ethical problem, Identify the different options, Apply ethical principles to the situation, Make and evaluate a decision.

A dying client tells the nurse that he doesn't want to see his family because he doesn't want to cause them more sadness. Which action by the nurse is most appropriate?

Help the patient clarify his values

Two nurses are discussing a client's condition in an elevator full of visitors. With what crime might the nurses be charged?

Invasion of privacy

A nurse working in a long term care facility has an elderly male client who is very confused. What ethical dilemma is posed when using restraints in a long term care setting?

It threatens autonomy.

Which of the following modes of value transmission is most likely to lead to confusion and conflict?

Laissez-Faire: leave children to explore values on their own and to develop a personal value system. This approach often involves little or no guidance and can lead to confusion and conflict.

A nurse moves from Ohio to Missouri. Where can a copy of the Nurse Practice Act in Missouri be obtained?

Missouri State Board of Nursing

A mother always thanks clerks at the grocery store. Her daughter age 6 years echos her thank you. The child is demonstrating what mode of value transmission?

Modeling

A nurse does not assist with ambulation for a postoperative client on the first day after surgery. The client falls and fractures a hip. What charge might be brought against the nurse?

Negligence

A home care nurse visits a client who is confined to bed and is cared for by her daughter. The daughter is known to suffer from chemical dependence. The home is cluttered and unclean. During the assessment the nurse notes that the client is wet with urine and has dried feces on her buttocks, and demonstrates signs of dehydration. After caring for the client, the nurse contacts the physician and reports the incident to Adult Protective Services. This is an example of which ethical framework?

Nonmaleficence

A home health nurse who performs a careful safety assessment of the home of a frail elderly patient to prevent harm tot he patient is acting in accord with which of the following, a principle of bioethics?

Nonmaleficence

What is the legal source of rules of conduct for nurses?

Nurse Practice Acts

The nurse is accused of malpractice by a client. List the order in which the steps of the litigation process will occur:

The basis for the claim is determined to be appropriate and timely with all elements of liability present. All parties named as defendants, as well as insurance companies and attorneys, work toward a fair settlement. The case is presented to a malpractice arbitration panel. The panel's decision is either accepted or rejected, in which case a complaint is filed in trial court. The defendants contest allegations. Pretrial discovery activities occur: review of medical records and depositions of plaintiff, defendants, and witnesses. Trial takes place: both sides present their evident and arguments.

The client was diagnosed with diabetes three years ago, but has failed to integrate regular blood glucose monitoring or dietary modifications into his lifestyle. He has been admitted to the hospital for treatment of acute renal failure secondary to diabetic nephropathy, an event that has prompted the client to reassess his values. Which of the following actions most clearly demonstrates that this client is engaging in the step of prizing within his valuing process?

The client expresses pride that he now has the knowledge and skills to take control of his diabetes management.

The nursing student asks the nurse for an example of a "never event". Which example provided by the nurse best answers the nursing student's question?

The client scheduled for a cholecystectomy has a total abdominal hysterectomy. A "Never Event" is an extremely rare medical error that should never occur. (Wrong surgery)

A client is admitted with symptoms of psychosis. The nurse hurries to the client's room when she hears the client calling for help. She finds the client lying on the ground. The nurse assists the client back to the bed and performs a thorough assessment. The nurse informs the physician and completes the incident report. Which of the following statements should the nurse document in the report?

The client was found lying on the floor.

The children of a female client 78 years of age with a recent diagnosis of early-stage Alzheimer's disease are attempting to convince their mother to move into an assisted living facility, a move to which the client is vehemently opposed. Both the client and her children have expressed to the nurse how they are entrenched in their position. Which of the following statements expresses a utilitarian approach to this dilemma?

The decision should be made in light of consequences.

A nurse is concerned about the practice of routinely ordering a battery of laboratory tests fr clients who are admitted to the hospital from a long term care facility. An appropriate source in handling this ethical dilemma would be which of the following?

The institutional ethics committee

Which of the following are examples of a nurse demonstrating the professional value of altruism?

The nurse arranges for an interpreter for a client whose primary language is Spanish. The nurse calls the physician of a client whose pain medication is not strong enough.

A client who has undergone resection of the intestine in on a liquid diet with a nasogastric tube in place. He refuses the food tray with regular food that comes to his room and insists that a physician be called. The nurse insists that it is the right food and makes the client take it. The client develops complications and has to be re-operated upon. How is negligence determined in this situation?

The nurse did not realize the importance of the tube

A client gets out of bed following hip surgery, falls, and re-injures her hip. The nurse caring for her knows that is is her duty to make sure an incident report is filed. Which of the following statements accurately describes the correct procedure for filing an incident report?

The report should contain all variables related to the incident.

During a clinical placement on a subacute, geriatric medicine unit, a student nurse fed a stroke client some beef broth, despite the fact that the client's diet was restricted to thickened fluids. As a result, the client aspirated and developed pneumonia. Which of the following statements underlies the student's potential liability in this situation?

The same standards of care that apply to a registered nurse apply to the student.

According to HIPPA regulations, which of the following is a client right regarding the client's medical record?

To see the health record. To copy the health record. To restrict certain disclosures of the health record.

A nurse in a physicians office has noted on several occasions that one of the physicians frequently obtains controlled drug prescription forms for prescription writing. One day the nurse enters the physicians office an see him take a pill out of a bottle. The doctor mentions that he suffers from migraines and that his wife's pain medication alleviates the pain. What type of nurse-physician ethical situation is illustrated in this scenario?

Unprofessional, incompetent, unethical or illegal physician practice.

A middle-aged man is having increasing difficulty breathing. He never exercises, east fast food regularly, and smokes two packs of cigarettes a day. He tells the nurse practitioner that he wants to change the way he lives. What is one means of helping him change behaviors?

Values clarification

Which of the following best describes voluntary standards?

Voluntary standards are guidelines for peer review, guided by the public's expectation of nursing.