Chapter 11-Legal and Ethical-Final Exam Adaptive Quiz
The nurse is explaining organ donation to a licensed driver who wants to donate his organs after death. Which information would the nurse provide? Select all that apply. -"Provide your consent in written form." -"Inform your family that this is your desire." -"Carry a separate organ donation card in your wallet." -"Submit your living will at the time of consent." -"Sign the organ donation form on the back of your license."
-"Provide your consent in written form." -"Inform your family that this is your desire." -"Sign the organ donation form on the back of your license." If a licensed driver wants to donate organs for transplantation, then the nurse takes his consent in written form and tells the person to inform his family about the decision. If relevant in that state, the nurse also informs the licensed driver to sign the organ donation form on the back of the license. It is not required for a licensed driver to carry a separate organ donation card in his or her wallet, as the license itself will include an organ donation notation. It is not necessary to submit a living will at the time of signing the consent. A living will is mainly relevant for patients who are receiving end-of-life care.
The nurse is required to obtain consent before medical treatment can begin on an 8-year-old girl. The parents of the child are divorced and the mother has custody. The patient is accompanied by her mother, father, and sister, who is 19 years old. Which information would be provided to the patient's guardian before she gives her consent? Select all that apply. -A complete explanation of the procedure or treatment -Names and qualifications of the people performing the treatment -The exact number of days required for complete cure and treatment -A description of possible adverse effects or side effects of the treatment -An explanation that once the guardian signs the consent, treatment must be given
-A complete explanation of the procedure or treatment -Names and qualifications of the people performing the treatment -A description of possible adverse effects or side effects of the treatment The patient should give consent only after receiving information about the procedure or treatment. The information should also include the names of the people who will be treating the patient and the possible side effects of the treatment or procedure. It is not practical for the nurse to anticipate the exact number of days required for a cure, and such information is not included in the consent. The nurse should also inform the guardian that she can refuse the treatment even if she initially signed consent.
The nurse notes that an advance directive is on a patient's medical record. Which statement represents the correct description of an advance directive guideline the nurse will follow? -A living will allows an appointed person to make health care decisions when the patient is in an incapacitated state. -A living will is invoked only when the patient has a terminal condition or is in a persistent vegetative state. -The patient cannot make changes in the advance directive once admitted to the hospital. -A durable power of attorney for health care is invoked only when the patient has a terminal condition or is in a persistent vegetative state.
-A living will is invoked only when the patient has a terminal condition or is in a persistent vegetative state. A durable power of attorney for health care is active when the patient is incapacitated or cognitively impaired. A living will does not assign another individual to make decisions for the patient. A cognitively intact patient may change an advance directive at any time.
Which ethical principles are included in the professional nursing code of ethics? Select all that apply. -Advocacy -Responsibility -Accountability -Fidelity -Justice
-Advocacy -Responsibility -Accountability The professional nursing code of ethics includes advocacy, responsibility, and accountability. Advocacy means to support a patient's cause. Responsibility refers to being answerable for the patient's health condition. Accountability refers to the ability to answer for one's actions. Fidelity and justice are components of ethics; these are not part of the professional nursing code of ethics.
Which attributes are included in the nursing code of ethics? Select all that apply. -Fidelity -Advocacy -Responsibility -Accountability -Confidentiality
-Advocacy -Responsibility -Accountability -Confidentiality Advocacy, responsibility, accountability, and confidentiality are guiding principles in a code of ethics. Advocacy refers to the act of providing support to a particular cause. Responsibility refers to a willingness to respect one's professional obligations, and following through on the promises. Accountability refers to the ability to answer for one's actions. Confidentiality refers to the act of protection of the patient's personal health information. Fidelity is a term related to health ethics. It refers to the agreement to keep promises. It is not part of the nursing code of ethics but a standard followed in nursing practice.
Which statements by the student nurse regarding the ethical rules of deontology indicate the need for further teaching? Select all that apply. -Are the basis for most professional codes of ethics -Are specific to ethics as they relate to nursing practice -Are applicable to all people, at all times, and in every situation -Emphasize right and wrong behaviors with respect to the consequences -Emphasize meeting the needs of a patient maintaining autonomy
-Are specific to ethics as they relate to nursing practice -Emphasize right and wrong behaviors with respect to the consequences -Emphasize meeting the needs of a patient maintaining autonomy Deontology is the foundation of most professional codes of ethics, including the Code of Ethics for Nurses. Deontology is an ethical theory that stresses the rightness or wrongness of individual behaviors, duties, and obligations without concern for the consequences of specific actions. Meeting the needs of patients while maintaining their right to privacy, confidentiality, autonomy, and dignity is consistent with the tenets of deontology. Deontology is an ethical theory that focuses on the motives of an individual toward moral responsibilities and not on the actions nor as to how they relate to specific practices. The theory of utilitarianism justifies the rightness or wrongness of an individual's behavior solely depending upon the consequences.
The nurse finds that the patient who is scheduled for surgery has consumed alcohol before visiting the primary health care provider. Which nursing intervention is applicable in this situation? -Ask the patient's spouse to sign the consent form. -Ask the primary health care provider to sign the consent form. -Perform the surgery after the patient is alert and able to provide consent. -Obtain the patient's signature on the consent form after the surgery.
-Ask the patient's spouse to sign the consent form. A patient who has consumed alcohol has low levels of consciousness and improper cognition, and therefore may not be able to give consent for treatment. The nurse can obtain the consent from the legal guardian or spouse if the patient is not stable enough to provide the consent. Asking the primary health care provider to sign the consent form is not the correct practice and is in violation of ethical rules and practices. Urgent surgery should not be delayed until the patient is alert enough to consent, as waiting may escalate the condition further. Obtaining consent of the patient after surgery is a violation of legal guidelines and is not appropriate practice.
The nurse immediately starts performing cardiopulmonary resuscitation on the patient who collapsed. Which ethical concept does this nursing action reflect? -Advocacy -Autonomy -Beneficence -Accountability
-Autonomy Autonomy is the freedom to make decisions independent of the primary health care provider. In this case, the nurse performs cardiopulmonary resuscitation to save the life of the patient in an emergency situation such as heart attack. This indicates that the nurse is applying the ethical concept of autonomy to save the life of the patient. Advocacy is an essential nursing aspect that requires the nurse to promote the interests and rights of the patient. In this scenario, the nurse is not conveying any concerns of the patient. So, this nursing action does not indicate advocacy. Beneficence is caring for the patient irrespective of personal feelings regarding the patient. Performing cardiopulmonary resuscitation does not reflect beneficence. Accountability is being answerable for any right or wrong action. For example, the nurse is expected to report any mistakes. Performing interventions to save the life of the patient does not indicate accountability. Test-Taking Tip: To help you recall the meaning of autonomy, remember that "auto" means self (as in an autologous transfusion or graft, where the patient's own blood or tissue is used). Autonomy means that the nurse can make decisions on his/her own, independent of the primary health care provider.
The nurse monitors the patient's response to a pain management regimen and revises the plan to reduce the pain. Which principle is the nurse showing? -Fidelity -Advocacy -Responsibility -Accountability
-Fidelity Fidelity refers to the agreement to keep promises. The nurse assesses the patient's needs and performs interventions to fulfill them. If the interventions are not found to be effective, the nurse still follows through on the actions and modifies the care plan to reduce the pain. Advocacy, responsibility, and accountability are principles of the codes of ethics. Advocacy is when the nurse speaks up for patient rights. Responsibility refers to a willingness to respect one's professional obligations and follow through on promises. Accountability is when the nurse agrees to be answerable for one's actions.
A nurse attends to a patient who was hit by a car that failed to stop at a stop sign. The patient was rushed to the emergency department and then to surgery. After surgery, the patient was transferred to the medical-surgical unit. The health care provider informs the nurse that patient confidentiality should be strictly maintained. Which interpretation is correct? Select all that apply. -Respecting that the patient has the right to keep personal information from being disclosed -Avoiding discussing the patient's medical reports in public areas with other health care professionals -Having the right to not disclose the information about a procedure to the patient if required -Protecting any private information about the patient, once it has been disclosed in health care settings -Removing information revealing the patient's medical condition from message boards in the patient's room where daily nursing care information is posted
-Avoiding discussing the patient's medical reports in public areas with other health care professionals -Protecting any private information about the patient, once it has been disclosed in health care settings -Removing information revealing the patient's medical condition from message boards in the patient's room where daily nursing care information is posted Confidentiality means that nurses and all health care providers need to avoid discussing patients in public hallways and provide reasonable levels of privacy in communicating with and about patients in any manner. Confidentiality protects private patient information once it has been disclosed in health care settings. Message boards used in patient's hospital rooms to post daily nursing care information can no longer contain information revealing the patient's medical condition. Privacy is the right of patients to keep personal information from being disclosed. It is the right of any patient to get every possible detail before he undergoes any particular procedure.
The nurse forcefully transfers the patient who is extremely irritable and agitated to an isolated room to avoid disturbing other patients and then sedates the patient by giving a morphine injection. Which torts has the nurse performed? Select all that apply. -Assault -Battery -False imprisonment -Invasion of privacy -Defamation of character
-Battery -False imprisonment Battery is referred to as intentional touching without the patient's consent. The nurse gives a morphine injection without requesting consent. This is indicative of battery. Because the nurse also transfers the patient to an isolated room, this indicates the false imprisonment tort. The tort of false imprisonment refers to the unjustified restraint of a person without legal warrant. Assault is an action that places an apprehensive patient within harmful or offensive contact without consent. Threatening the patient to give the injection is an example of assault. Invasion of privacy refers to the unwanted intrusion into the personal matters of the patient. Defamation of character is the publication of false statements about a person that could damage a person's reputation.
A nurse attends to a trauma patient who has been transferred from the ICU. The nurse learns that the ICU nurse provided a detailed explanation on the patient's condition to the family without consent from the patient and also gave the patient a steroid shot even though the patient refused the medication. Which torts would the ICU nurse be guilty of? Select all that apply. -Malpractice -Battery -Invasion of privacy -Negligence -Defamation of character
-Battery -Invasion of privacy Battery is any intentional touching without consent. If the health care provider has given a steroid injection to a patient even after the patient has rejected an invasive procedure, it is considered battery. When the health care provider informs the patient's family of the patient's present medical condition without consent, the patient's privacy has been invaded. Malpractice occurs when health care delivered falls below a standard of care expected. Negligence is conduct that falls below a standard of care. Defamation of character is the publication of false statements that damage a person's reputation.
A nurse has failed to obtain informed consent before performing a procedure on a patient. Which type of torts result from this nursing action? Select all that apply. -Assault -Battery -Negligence -False imprisonment -Libel
-Battery -Negligence Battery is referred to as any intentional touching without consent. As the nurse has failed to obtain informed consent, doing any intervention on the patient would be considered as battery. Negligence is performing an action that falls below a standard of care. Failure to obtain informed consent is an act of negligence. Assault refers to an action that places a person in apprehension within harmful or offensive contact without consent. False imprisonment is the unjustified restraint of a person without a legal warrant. Failure to obtain informed consent would not result in assault or false imprisonment. Libel is the written defamation of character.
When caring for a patient, which actions would the nurse perform to maintain the standards of fidelity? Select all that apply. -Be punctual. -Monitor the patient's response to a given medication. -Revise the care plan to provide pain relief to the patient. -Encourage discussion about errors with other nurses. -Weigh the risks and benefits of a procedure for a patient.
-Be punctual. -Monitor the patient's response to a given medication. -Revise the care plan to provide pain relief to the patient. Fidelity means to keep promises made to the patient while providing care. The nurse practices the standards of fidelity by being punctual, by monitoring a patient's response to a given medication, and by revising the care plan to provide pain relief to the patient. Encouraging discussion about errors with other nurses is an example of practicing justice, not fidelity. Weighing the risks and benefits of a procedure for a patient is an example of practicing nonmaleficence, not fidelity.
A senior nurse is discussing ethical dilemmas with colleagues. Which statements are true about ethical dilemmas? Select all that apply. -Nurses should consider personal views while processing ethical dilemmas. -Resolving ethical dilemmas includes discussions without any contradictions. -Ethical dilemmas should be processed carefully to reduce distress and controversy. -An ethical dilemma cannot be resolved solely through scientific data. -Resolving ethical dilemmas is similar to the nursing process.
-Ethical dilemmas should be processed carefully to reduce distress and controversy. -An ethical dilemma cannot be resolved solely through scientific data. -Resolving ethical dilemmas is similar to the nursing process. Ethical dilemmas can cause distress and controversy; to reduce that, they should be processed carefully and deliberately. An ethical dilemma cannot be resolved solely through scientific data; it requires negotiations of differences of opinions. Resolving ethical dilemmas is similar to the nursing process; it follows a methodical approach to come to a conclusion. The nurse should try to put personal views aside when working through an ethical dilemma. Resolving ethical dilemmas includes discussions and negotiation of differences of opinion.
Which information would the nurse include in the explanation to help the students understand the difference between nonmaleficence and beneficence? Select all that apply. -Beneficence means that all the interventions should be done while considering the best interest of the patient. -Beneficence refers to including patients in decisions about all aspects of care as a way of acknowledging and protecting a patient's independence. -Nonmaleficence means the health care professional should weigh the risks and benefits of the intervention before delivering it. -Nonmaleficence ensures that a nurse is loyal and does not abandon the patient even when the treatment procedure is very complicated. -Nonmaleficence holds that a health care professional must strive to avoid harm to the patient due to any interventions delivered.
-Beneficence means that all the interventions should be done while considering the best interest of the patient. -Nonmaleficence means the health care professional should weigh the risks and benefits of the intervention before delivering it. -Nonmaleficence holds that a health care professional must strive to avoid harm to the patient due to any interventions delivered. The principle of beneficence is fundamental to the practice of nursing and medicine. The agreement to act with beneficence implies that the best interests of the patient remain more important than self-interest. Nonmaleficence is the avoidance of harm or hurt. According to this concept, the health care professional tries to balance the risks and benefits of care while striving at the same time to do the least harm possible. Autonomy refers to the commitment to include patients in decisions about all aspects of care as a way of acknowledging and protecting a patient's independence. Under the concept of fidelity, a health care professional should not abandon patients even when care becomes controversial or complex.
The nurse is reading the living will of the patient. Which information does the nurse obtain from this document? Select all that apply. -Desire for organ donation -Consent for performing an autopsy -Designation of a spokesperson -Do-not-resuscitate order -Designation of legal power of attorney
-Desire for organ donation -Consent for performing an autopsy -Designation of a spokesperson A living will is an advance directive that specifies the details of treatment a patient wants to receive when he or she is not in a position to make decisions. The patient can include his or her desire for organ donation in the living will, so that the caregiver or the nurse would arrange for the same after the death of the patient. The patient may also include consent for performing an autopsy if necessary. The patient may specify a member of the family in the living will as the spokesperson to make decisions on behalf of the patient when he or she is unable to do so. A do-not-resuscitate order is not a part of living will as it is not an advance directive. It specifies the patient's or the family's decision to limit the treatment during end-of-life situations. A living will includes durable power of attorney for health care. It does not specify the legal power of attorney.
Which patient information, if not charted, can lead to malpractice lawsuits? Select all that apply. -Drug allergies -Number of patient siblings -Discontinued medications -History of cancer -Illegible writing
-Drug allergies -Discontinued medications -History of cancer -Illegible writing Documentation errors such as failing to record drug allergies, information on discontinued medications, or a history of cancer can result in serious treatment errors and negative outcomes. This results in malpractice lawsuits. Recording information with incomprehensible writing also leads to errors and consequent lawsuits. Failing to record the number of siblings of the patient does not reflect the health status of the patient; it does not affect the treatment delivered.
Health care institutions establish ethics committees to process ethical dilemmas. Ethics committees include which functions? Select all that apply. -Education -Patient teaching -Patient care -Case consultation -Policy recommendation
-Education -Case consultation -Policy recommendation Ethics committees are usually multidisciplinary. They have several purposes such as education, case consultation, and policy recommendation. Any person involved in an ethical dilemma can request access to an ethics committee. Patient teaching and patient care are the responsibility of all members of the health care team.
Which activities of the nurse indicate malpractice? Select all that apply. -Interacting with patients on social media -Engaging in sexual activity with the patient -Allowing patient participation in developing the care plan -Sharing the patient's health information publicly -Administering a drug despite a documented patient allergy
-Engaging in sexual activity with the patient -Sharing the patient's health information publicly -Administering a drug despite a documented patient allergy The nurse must limit unprofessional practices while caring for a patient to avoid malpractice. The nurse avoids excessive personal involvement and sexual activity with the patient. The nurse keeps the patient's health information confidential in accordance with the law. The nurse must check the patient's medical history to avoid administering drugs that cause allergic reactions. The nurse is permitted to interact with patients on social media provided the interaction does not violate ethical standards regarding nurse-patient professional boundaries. The Patient's Bill of Rights adopted by the American Hospital Association (AHA) states that patients should expect to be included in planning their nursing care.
A senior nurse is teaching a group of nursing students about health care ethics. Which examples would the nurse illustrate to show respect for a patient's autonomy? Select all that apply. -Ensuring that the patient understands the risks of a medical procedure. -Keeping promises by following through on any interventions. -Including the patient when deciding on care. -Asking the patient to read and sign an informed consent before surgery. -Receiving permission from the patient before performing a physical examination.
-Ensuring that the patient understands the risks of a medical procedure. -Including the patient when deciding on care. -Asking the patient to read and sign an informed consent before surgery. -Receiving permission from the patient before performing a physical examination. Autonomy is the patient's right to make his or her own decisions. The nurse shows respect for a patient's autonomy by ensuring that the patient understands the risks of a medical procedure. Nurses promote autonomy when they include patients in the process of developing care plans with realistic goals and interventions and by asking the patient to read and sign an informed consent before surgery When a nurse seeks and receives permission from a patient before performing a physical examination, he or she is showing respect for the patient's autonomy. When the nurse keeps promises by following through on interventions, he or she is acting on the principle of fidelity, not respect for a patient's autonomy.
A nurse is learning about negligence in unintentional torts. Which actions, if not performed, would the nurse consider as common acts of negligence? Select all that apply. -Following orders -Performing malpractice -Documenting monitoring activities -Following policies and guidelines -Explaining the risks of a surgery to a patient
-Following orders -Documenting monitoring activities -Following policies and guidelines Failure to follow orders is an act of negligence since it is the duty of the nurse to follow all given orders. Documentation of monitoring is one of the best practices to prevent legal issues and is important to communicate with other health care team members. Policies and guidelines are created in accordance with laws and regulations, so they should be followed. Malpractice is professional negligence and should be avoided. Explaining the risks of a medical procedure to a patient is not a nurse's responsibility.
Which information would the nurse include in her explanation to help nursing students understand the difference between nonmaleficence and beneficence? Select all that apply. -For beneficence, all interventions should consider the patient's best interest. -With beneficence, maximum priority is given to the patient by allowing the patient to make his or her own health care decisions. -For nonmaleficence, the health care provider should weigh the risks and benefits of the intervention before delivering it. -With nonmaleficence, a nurse should be loyal and not abandon the patient even when the treatment procedure is complicated. -For nonmaleficence, a nurse should keep promises by following through on his or her actions and interventions.
-For beneficence, all interventions should consider the patient's best interest. -For nonmaleficence, the health care provider should weigh the risks and benefits of the intervention before delivering it. The principle of beneficence is fundamental to the practice of nursing and medicine. The agreement to act with beneficence implies that the best interests of the patient remain more important than self-interest. Nonmaleficence is the avoidance of harm or hurt. According to this concept, the health care professional tries to balance the risks and benefits of care while striving to do the least harm possible. Autonomy refers to the commitment to include patients in decisions about all aspects of care as a way of acknowledging and protecting a patient's independence. According to the concept of fidelity, a health care professional should show unwillingness to abandon patients even when care becomes controversial or complex. In addition, the nurse should follow through on her actions and interventions.
To resolve ethical dilemmas, it is important to distinguish ethical problems from other problems. Which characteristics illustrate an ethical problem? Select all that apply. -It cannot be solved solely through literature review. -It cannot be easily reasoned with logic. -The answer to the problem has profound relevance for patient care. -The problem can be solved by critical thinking. -The problem involves the hospital management.
-It cannot be solved solely through literature review. -It cannot be easily reasoned with logic. -The answer to the problem has profound relevance for patient care. When solving any ethical dilemma, the first step is to distinguish the ethical problems from other problems. Ethical problems cannot be resolved through literature review only and may be difficult to be reasoned with logic. The answer to an ethical problem will have a significant influence on patient care. Ethical problems are usually not solved by critical thinking and do not involve only hospital management. They may involve all members of the health care team.
Which options describe an informed consent form? Select all that apply. -May be signed by an emancipated minor -Protects the health care facility but not the health care provider -Signifies that the patient understands all aspects of the procedure -Signifies that the patient and family have been told about the procedure -Must be signed by the patient or responsible party at the health care facility, and that consent may not be obtained by phone or fax
-May be signed by an emancipated minor -Signifies that the patient understands all aspects of the procedure An emancipated minor may sign a consent form. The consent form signifies that the patient understands all aspects of the procedure. The document protects the surgeon and the health care facility in that it indicates that the patient knows and understands all aspects of the procedure. Only in the cases of underage children or unconscious or mentally incompetent people must a family member be aware of the procedure. The consent may be obtained by fax or phone with appropriate witnesses.
Which descriptions are true regarding informed consent? Select all that apply. -Must be signed while the patient is free from mind-altering medications -Can be witnessed by a nurse or nursing student -May be withdrawn at any time -Must be signed by patients age 16 and older -Must be obtained by the health care provider and not the nurse
-Must be signed while the patient is free from mind-altering medications -May be withdrawn at any time -Must be obtained by the health care provider and not the nurse An informed consent must be signed while the patient is free from mind-altering medications and after it has been determined that the patient has received all of the necessary information to make an informed decision. An informed consent may be withdrawn at any time before the procedure. In most situations, the informed consent is obtained by the health care provider and not the nurse because the nurse does not perform surgery or direct medical procedures. Signed consent must also be witnessed by a nurse, but never by a nursing student because of the legal nature of the document. An informed consent must be signed by patients age 18 and older. A parent or guardian's signature is required for minors.
A nurse is explaining the Americans with Disabilities Act (ADA) to a patient with human immunodeficiency virus (HIV). Which information would the nurse include? Select all that apply. -People with HIV who are asymptomatic also come under the "disabled people" category. -People with HIV have the right to decide whether to disclose their infection. -Health care workers have the choice to not treat HIV-positive patients. -Health care professionals who are HIV positive can also choose to decide whether to disclose their infection. -The motive of this act is to provide equal opportunities for people with disabilities.
-People with HIV who are asymptomatic also come under the "disabled people" category. -People with HIV have the right to decide whether to disclose their infection. -Health care professionals who are HIV positive can also choose to decide whether to disclose their infection. -The motive of this act is to provide equal opportunities for people with disabilities. According to the ADA, asymptomatic HIV is considered a disability. This act gives the HIV-infected individuals the opportunity to decide whether to disclose their disability. The health care provider may choose not to disclose the fact that he or she has HIV. This act aims at removing any discrimination and providing equal opportunities for people with disabilities. Health care workers cannot discriminate against HIV-positive patients.
Which actions of the nurse indicate a breach of the American Nurses Association's (ANA) principles of social networking? Select all that apply. -Placing identifiable patient information on a public site -Strengthening privacy settings when posting personal information online -Participating in programs for the development of the organization -Declining to socially interact with a patient online -Immediately informing a higher authority when a colleague breaches ethical rules
-Placing identifiable patient information on a public site -Immediately informing a higher authority when a colleague breaches ethical rules According to ANA's principles, the nurse maintains confidentiality of the patient's information. Therefore the nurse does not keep any identifiable information belonging to a patient on public sites. If the nurse notices any content posted by a colleague that violates ethical or legal standards, the nurse first brings the questionable content to the attention of the colleague so that the individual can take appropriate action. If there is a chance of harm to the patient, then the involvement of an external authority is necessary. The nurse uses privacy settings to post personal information as it helps maintain privacy and does not violate ethical conduct. The nurse participates in the programs that help develop the organization. This action aids in improving the quality of nursing care. The nurse can use social networking sites to interact with the patient; however, the nurse observes patient-nurse boundaries during the interaction. Declining to interact with a patient in this way is not an ethical violation.
Which legal sources of standards of care does the nurse use to deliver safe health care? Select all that apply. -Information provided by the head nurse -Policies and procedures of the employing hospital -State Nurse Practice Act -Regulations identified in The Joint Commission's manual -The American Nurses Association standards of nursing practice
-Policies and procedures of the employing hospital -State Nurse Practice Act -Regulations identified in The Joint Commission's manual -The American Nurses Association standards of nursing practice Policies and procedures of employing agencies and standards set by statutes, accrediting agencies, and professional organizations describe the minimum requirements for safe care. Information provided by the head nurse is not a legal source of standards of care.
The nurse is caring for a low-income geriatric patient. Which interventions are important for the patient according to the Patient's Bill of Rights? Select all that apply. -Privacy -One-to-one observation -Participation in the care plan -Assistance in discharge arrangements -Assistance in financial management
-Privacy -Participation in the care plan -Assistance in discharge arrangements -Assistance in financial management The nurse encourages the patient to participate in devising his or her care plan. The nurse maintains privacy while caring for any patient. This ensures the development of a trusting relationship between the nurse and the patient. The patient is elderly and may require support in certain tasks. The nurse provides assistance in making arrangements for when the patient is discharged. The patient has limited financial means and may require financial assistance for the care. The nurse provides information and guidance as needed to help the patient procure financial assistance. Close or one-to-one observation may not be necessary for a patient with a leg injury. It is generally preferred for patients with suicidal tendencies or severe illnesses.
Which laws were introduced to prevent the loss of registered nurses from the workforce? Select all that apply. -Registered Nurse Safe Staffing Act -Americans with Disabilities Act -Nurse and Health Care Worker Protection Act -American Recovery and Reinvestment Act -Good Samaritan Act
-Registered Nurse Safe Staffing Act -Nurse and Health Care Worker Protection Act The Registered Nurse Safe Staffing Act and the Nurse and Health Care Worker Protection Act were introduced to prevent the loss of registered nurses from the workforce. The Registered Nurse Safe Staffing Act enables registered nurses to make staffing decisions related to nurses in hospitals. This helps reduce the workload on nurses. The Nurse and Health Care Worker Protection Act protects nurses and health care workers from injuries that may occur while executing nursing care. This act allows nurses to practice safe patient handling techniques. The Americans with Disabilities Act is enacted to protect individuals from discrimination against physical and mental impairment. The American Recovery and Reinvestment Act governs the security and privacy of health information. The Good Samaritan Act protects health care workers from charges of negligence while providing emergency care.
A patient is preoccupied with the feeling that she suffers from breast cancer. She asks the nurse to insist that the health care provider perform a mastectomy. Following several tests, the nurse finds that the patient has no symptoms of or risk factors for breast cancer. When the health care provider refers the patient to a psychologist, the patient refuses to go. Which nursing interventions are appropriate in this situation? Select all that apply. -Respect the autonomy of the patient. -Ask family members for their opinion. -Schedule psychological counseling irrespective of the patient's wishes. -Respect the patient's decision and do not schedule counseling. -Convince the patient that counseling by the psychologist would be beneficial.
-Respect the autonomy of the patient. -Respect the patient's decision and do not schedule counseling. -Convince the patient that counseling by the psychologist would be beneficial. The nurse has to respect the autonomy of the patient and her decision. Psychological counseling should not be scheduled. The nurse should try to convince the patient that psychological counseling would be beneficial. The family members can be asked for their opinion, but only with the patient's permission. The nurse should not implement any interventions that violate the patient's wishes.
In which situations is the nurse allowed to apply physical restraints? Select all that apply. -The patient is extremely irritated. -The patient has suicidal ideation. -The health care provider has given a written order. -The patient is potentially dangerous to other patients. -The patient's family members have asked to restrain the patient.
-The health care provider has given a written order. -The patient is potentially dangerous to other patients. The nurse can use physical restraints on a patient only if the health care provider has given an order to do so or to ensure the safety of other patients. If the patient is irritated, other measures of restraining the patient like counseling should be used. If the patient has suicidal ideation, the patient should be monitored closely and should be given psychotherapy. The nurse should not restrain the patient if the family members have asked the nurse to do so.
The health care provider informs the nurse that the patient has a durable power of attorney for health care (DPAHC). How would the nurse interpret this? Select all that apply. -The patient can decide which medical procedures he does not want to undergo. -The patient has designated a person who is solely responsible for making financial decisions for him when he is unable. -The patient has expressed in written form that he does not wish to be sustained on life support. -The patient has designated a person who makes health care decisions for him when he is not able to make decisions. -The patient has designated a person who is solely responsible for making health care decisions for him according to his wishes.
-The patient has designated a person who makes health care decisions for him when he is not able to make decisions. -The patient has designated a person who is solely responsible for making health care decisions for him according to his wishes A health care proxy or DPAHC is a legal document that designates a person or persons of one's choosing to make health care decisions when the patient can no longer make decisions on his or her own behalf. This agent also makes health care treatment decisions based on the patient's wishes. A living will is a written document of the patient's wishes in which the patient declares what he or she wants in the event of a terminal illness or condition. It also gives the patient the right to decide which procedures he wishes to be or not to be done on him. The living will also designates a person who is solely responsible for making financial decisions for him when he is unable. Additionally, the living will expresses in written form that the patient does not wish to be sustained on life support.
A nurse is sued for failure to monitor a patient appropriately after a procedure. Which statements are correct about this lawsuit? Select all that apply. -The nurse represents the plaintiff. -The defendant must prove injury, damage, or loss. -The person filing the lawsuit has the burden of proof. -The plaintiff must prove that a breach in the prevailing standard of care caused an injury. -The nurse is a witness.
-The person filing the lawsuit has the burden of proof. -The plaintiff must prove that a breach in the prevailing standard of care caused an injury. The patient as plaintiff must prove that the defendant nurse had a duty and breached the duty, and because of this breach caused the patient injury or damage. The nurse represents the defendant, not the plaintiff. The plaintiff must prove injury, damage, or loss. The nurse cannot be a witness.
At the end of the ethics committee meeting, the members collectively agree that consensus building is the best method for the decision-making process. Which statement identifies the nurse's interpretation of the decision-making process? -Unusual points should be considered respectfully. -The usefulness of an intervention should be of sole consideration. -The participants should focus on how just and beneficial an intervention is. -Disrespect of opinions and agreement of participants should form the basis.
-Unusual points should be considered respectfully. Building consensus is an act of collective agreement on any given issue. The consensus developed may guide the best decision on the issue. During consensus building, even the unusual points should be considered and discussed. Focusing solely on the usefulness of an intervention may lead to ignorance of other important aspects. Focusing on just the benefits and justice of a procedure may sideline the usefulness aspect of the intervention. A consensus involves respect and agreement rather than a particular philosophy or moral system itself.
