Med Ethics Final 1
Enlist the help of the hospital ethics committee to resolve the situation
A daughter insists on keeping her mother on life-support following a brain hemorrhage that left her in an irreversible coma. The mother made an advance directive requesting a DNR in this type of situation. What would be the best action of the mother's care providers? a. Explain the situation to the daughter and proceed with terminal weaning b. Arrange a meeting with other members of the family and explain the situation c. Allow the daughter's wishes to override the mother's advance directive d. Enlist the help of the hospital ethics committee to resolve the situation
Bioethics
A discipline related to ethics concerning biological research as applied to medicine is ________.
To help avoid legal entanglements that may threaten a successful living
A health care practitioner completes a course in law and ethics. Which of the following is one of the most important reasons medical professionals should be familiar with this field of study? a. To learn the inner working of the health care system b. To help avoid legal entanglements that may threaten a successful living c. To be able to explain the process of informed consent to patients d. To promote patient and employee safety in the workplace
Duty of Care
A health care practitioner has established a doctor-patient relationship with a patient who seeks treatment for lung cancer. Since the actions or omissions within the scope of this health care practitioner's job could cause harm to the patient with lung cancer, the patient is owed a __________.
Discovery deposition
A health care practitioner is asked to give testimony in an attorney's conference room in a pretrial proceeding. What is the term for this method of obtaining testimony? A. Discovery deposition B. Deposition in lieu of trial C. Expert witness testimony D. Appeal
Battery
A health care professional restrains a patient against his will and administers an injection to calm him. This professional may be found guilty of which of the following torts in a court of law? A. Assault B. Battery C. Defamation of character D. Fraud
A hospital
A health care provider is explaining to staff members about the accreditation process. Which of the following may be accredited? A. A physician B. A pharmacist C. A Hospital D. A pharmaceutical company
Reasonable person standard
A health care worker is responsible for his or her actions or failure to act. Which of the following best describes this responsibility to prevent negligence from occurring? A. Standard of care B. Duty of care C. Reasonable person standard D. Performance standard
Teleological
A healthcare practitioner explores the possible consequences of a decision regarding patient care to decide if it is right or wrong. This practitioner is following consequence-oriented theory or _______ theory.
Act-utilitarianism
A hospital administrator makes a decision to shut down a wing due to budget cuts even though some people will lose their jobs. The decision is based on results that will produce the greatest balance of good over evil, everyone considered. What type of framework is the administrator employing to make this value decision? A. Duty-oriented theory B. Deontological theory C. Rule-utilitarianism D. Act-utilitarianism
Case Law
A judge decides a malpractice case in favor of the plaintiff. This judgment then becomes a legal precedent. What type of law is established through this type of legal precedent? A. Constitutional law B. Case law C. Administrative law D. Statutory law
Precedent
A legal case that serves as a model for future cases is said to have established a _______.
consumers in charge of healthcare coverage & care
A major goal of the Patient Protection and Affordable Care Act's Patient's Bill of Rights as outlined in the legislation is to put American __________________________________________________.
HIPAA
A nurse discusses a patient's condition with relatives who are not designated as caregivers for the patient. This nurse is in violation of the _______.
Accessory
A nurse finds out that another nurse is stealing the possessions of residents of a long-term nursing facility, but does not say anything to anyone about the crimes. What is the term for the nurse who does not act on knowledge of these crimes? A. Defendant B. Proxy C. Accessory D. Tortfeasor
Critical thinking
A nurse is caring for a hospitalized patient who is hard of hearing and having trouble answering assessment questions. The nurse is practically shouting at the patient and disturbing the other patient in the room. The nurse evaluates the situation and considers other options for the assessment. The nurse then finds a quiet, private room to perform the assessment and includes a trusted family member. What characteristic of a successful professional health care practitioner has this nurse displayed? a. Compassion b. Critical thinking c. Etiquette d. Courtesy
HIPAA
A nurse is caring for a patient and discusses his condition with another nurse outside his door in a loud voice. This nurse has violated the _______.
Rule-utilitarianism
A nurse manager determines the work shifts for the staff based on predetermined healthcare facility guidelines. This is an example of what type of decision making? A. Rule-utilitarianism B. Act-utilitarianism C. Duty oriented D. Deontological
Nuisance
A nurse refuses to allow elderly residents of a nursing home visits from family and friends as punishment for filing a petition against her with the administrators of the facility. Of which of the following torts might this nurse be convicted? A. Conversion B. False imprisonment C. Invasion of privacy D. Nuisance
Whistleblower
A nurse reports false claims made by her employer to the federal government under the Federal False Claims Act. Under this act, the nurse is considered a _______________ or qui tam relator.
Breach
A nursing assistant overheard a physician talking about a patient's narcotic addiction with an unauthorized individual. This physician has committed a _________ of confidence.
When the treatment ends and the bill is paid
A patient has an implied contract with a physician to receive treatment for breast cancer. When is the patient/physician contract usually terminated? A. When the treatment begins B. When the treatment has therapeutic effects C. When the treatment ends D. When the treatment ends and the bill is paid
Autonomy
A patient undergoing surgery signs an informed consent for the procedure. Which of the following principles of health care ethics does informed consent protect? A. Autonomy B. Role Fidelity C. Confidentiality D. Nonmaleficence
Waiver
A patient who files an insurance claim gives consent for patient information to be given to a third party. In this case, a _______ has been signed by the patient allowing the release of information.
Licensure
A pediatrician completes all the state requirements for mandatory credentialing allowing him to practice in a community health clinic. Which of the following has this physician achieved? A. Certification B. Licensure C. Permit D. Accreditation
Fetal tissue research
A physician debates the issues related to bioethics with other members of an ethics committee. Which of the following would be considered a topic related to bioethics? a. False imprisonment of patients b. Safety in the workplace c. Fetal tissue research d. Whistle-blowing
State medical board
A physician has finished her education and obtained a license to practice as an internist. Under what jurisdiction does the continuation of licensure fall? A. Federal medical board B. Drug Enforcement Administration C. State medical board D. Joint Accreditation Commission
The physician has unlimited personal liability.
A physician is practicing in a sole proprietorship. Which of the following is a disadvantage of this type of practice? A. The physician takes all the profits. B. The physician has unlimited personal liability. C. The physician cannot get malpractice insurance. D. The physician provides reception, billing, and all patient care tasks.
Ethics committee
A physician is treating a hospitalized, terminally ill child and believes further treatment would be futile and would significantly prolong the child's suffering. To help with their difficult decision, the child's parents and/or the child's physician may request a consultation with the hospital's __________.
Virtue Ethics
A physician running a busy practice makes decisions for his employees on a regular basis. The physician would describe himself as "moral man with common sense, a sense of justice, and courage who makes the right decisions in life by focusing on these moral traits." What theory of decision making is being employed by this physician? A. Deontological B. Utilitarian C. Virtue ethics D. Consequence-oriented theory
People skills
A physician tactfully explains to a nurse why it is important not to carry on a loud conversation outside a patient's hospital room. What professional skill is the physician displaying in this situation? a. Technical skills b. Critical thinking skills c. Common sense skills d. People skills
Serving as a guide for personal ethical conduct
A physician volunteering time in a free inner-city health care clinic relies on moral values in her practice. Which of the following best describes the role of moral values in society? a. Protecting the public from harm b. Elevating the standard of competence c. Serving as a guide for personal ethical conduct d. Enabling one to get along with others
Death or imprisonment in a state or federal prison for more than one year
A physician who is caught illegally prescribing narcotic drugs is found guilty of a felony in court. Which of the following is the usual punishment for a felony? A. Death or imprisonment in a state or federal prison for more than one year B. Death or imprisonment in a state or federal prison for more than five years C. Imprisonment in a state or federal prison for ten years or more D. Fine or imprisonment in a facility other than a prison for less than one year
Duty
A physician who is treating a patient who has pancreatic cancer provides competent care for his patient, thereby preventing a charge of negligence. Which of the following four Ds of negligence refers to this responsibility to properly care for a patient? A. Duty B. Dereliction C. Direct cause D. Damages
Agent
A physician who owns a physician's office employs a physician's assistant, an RN, and a receptionist. These employees act as _________ of the employer.
Liable
A physician who owns a physician's office is legally responsible for her employees. What is the term for this responsibility? A. Liable B. Duty of care C. Confidentiality D. Privileged communication
Duty of Care
A physician working in an emergency room is obligated to treat all the patients who come through the door. This is an example of which of the following concepts? A. Standard of care B. Duty of care C. Reasonable person standard D. Performance standard
Falsifying records
A physician's license can be revoked for conviction of a felony, unprofessional conduct, or personal or professional incapacity. Which of the following is considered unprofessional conduct? A. Conviction of rape B. Conviction of tax evasion C. Falsifying records D. Having dementia related to Alzheimer's disease
Technical skills
A radiologist is proficient at reading films and documenting the results. What type of skill is displayed by this ability? a. People skills b. Technical skills c. Critical thinking skills d. Abstract skills
Ethical implications of biological research
A university maintains a bioethics department employing health care professionals. What is the focus of this discipline? a. Ethical implications of medical practices b. Ethical implications of biological research c. Ethical implications of workplace etiquette d. Ethical implications of dealing with death and dying
Release of tortfeasor
A victim in a medical malpractice lawsuit receives compensation for all medical expenses from the defendant. Which of the following would almost always be an absolute defense in this case? A. Res judicata B. Release of tortfeasor C. Statute of limitations D. Assumption of risk
It will transfer to the new state
An LPN who is living in Pennsylvania is seeking a new job located in New Jersey. What will usually occur with this nurse's license? A. It will be revoked. B. It will transfer to the new state. C. It will become inactive. D. It will be reissued following new testing.
Reasonable person
An RN fails to regularly turn and change the position of a diabetic patient who is on bed rest and consequently the patient develops necrotic heels. The nurse is responsible for her actions under the _____________ standard.
Coinsurance
An insurance company agrees to pay 80% of the cost of treatment for a patient. What is the term for this managed care practice? A. Copayment B. Deductible C. Formulary D. Coinsurance
standard of care.
An orthopedic surgeon operates at the level of performance expected of a health care practitioner carrying out his or her professional duties in this specialty. This level of performance is known as the ____________.
A health care practitioner makes competent decisions related to patient care.
Autonomy is considered one of the seven universal principles of health care ethics. Which of the following is an example of autonomy? A. A physician performs health care screenings for impoverished patients. B. A UAP performs duties according to policies to keep patients safe. C. A health care practitioner makes competent decisions related to patient care. D. An x-ray technician follows HIPPA regulations when displaying x-rays
Breach of Contract
Civil law includes a general category of law known as torts. Which of the following is not an example of a tort? A. Breach of contract B. Assault C. Battery D. Defamation of character
Failing to recognize and act on common symptoms
Each state's medical practice acts define unprofessional conduct for medical professionals. Which of the following is an example of this misconduct? A. Failing to recognize and act on common symptoms B. Refusing to treat a patient whose condition is not related to the physician's specialty C. Having a minor disagreement with a patient D. Providing poor customer service to patients
The day the alleged act was committed
Establishing when the statute of limitations begins varies with state law, but one of the most common dates for marking the beginning of the statutory period is which of the following? A. The day the alleged act was committed B. One week after the alleged act was committed C. One month after the injury from the alleged act was discovered D. The day the physician-patient relationship began
Civil
Following an extended hospitalization, a patient with HIV/AIDS sues a doctor for HIPAA violations leading to defamation of character. This is an example of what type of law? A. Criminal B. Civil C. Administrative D. Common
Charting
For legal purposes, the health care professional should know that if it isn't in writing and explained completely and accurately, it wasn't done. To which of the following "4 Cs of medical malpractice prevention" does this statement refer? A. Caring B. Communication C. Competence D. Charting
An employee who accidentally prescribed the wrong medication for a patient
For which of the following employees would an employer be responsible under the doctrine of respondeat superior? A. An employee who assaulted a patient B. An employee who knowingly defamed the character of a patient C. An employee who accidentally prescribed the wrong medication for a patient D. An employee who steals narcotic drugs from the medication cabinet
Falsifying a medical diploma
Fraud may, in some states, be considered unprofessional conduct, or it may be separately specified as grounds for revoking a physician's license. Which of the following is an example of fraud? A. Falsifying a medical diploma B. Physically abusing a patient C. Being sexually intimate with a patient D. Committing a felony
1. Identify & clarify the problem 2. Gather information 3. Evaluate the evidence 4. Consider alternatives & implications 5. Choose & implement the best alternative
Give the 5 steps to solve an ethical problem.
All non-telephone patient conversations
Health care practitioners should know that patient records are often used as evidence in medical malpractice cases, and improper documentation can lose a case. Which of the following does not need to be documented? A. Case withdrawals B. Patient referrals C. Treatment refusals D. All non-telephone patient conversations
To increase the competence and standards of care within the profession
Health care professionals follow a formalized code of ethics governing their practice. What is the purpose of these codes? a. To increase the competence and standards of care within the profession b. To revoke the licenses of unethical practitioners c. To provide a consistent guide for protocol in the office d. To relieve the lawmaking bodies of some of their legal responsibilities
Code of Ethics
Health care professionals have principles and standards that govern behavior that are termed _______.
The right action is based on a determined principle regardless of the outcome.
Immanuel Kant is considered the father of duty-oriented theory. What principle underlies Kant's theory? A. The rights of the majority are considered over the individual. B. There may be exceptions to the golden rule. C. The right action is based on a determined principle regardless of the outcome. D. In some cases it is necessary to use people as a means to an end.
An expected level of performance
In a hospital setting a certain standard of care is expected of health care practitioners. Which of the following best describes this concept? A. Bare minimum care as needed B. A legal responsibility for patients C. An expected level of performance D. An obligation to patients
When a third party requests a medical examination of a person for employment
In which of the following situations may patient confidentiality be waived? A. When a physician does not agree with the decisions of the patient B. When a patient leaves a facility against medical advice C. When a patient refuses to sign a consent for a third party payor D. When a third party requests a medical examination of a person for employment
Assumption of risk
In which of the following types of defenses to professional liability suits is informed consent one of the most important elements? A. Contributory negligence B. Comparative negligence C. Denial D. Assumption of risk
Mediation
Instead of going to court, two disputing parties agree to a neutral third party listening to both sides of the argument and helping resolve the dispute. What is the term for this type of dispute resolution? A. Mediation B. Arbitration C. Med-arb D. Discovery
An explanation and apology
Just over 41 percent of the respondents in the Vincent study said that certain actions after their injuries might have prevented litigation. Which of the following is the highest rated action that might prevent litigation? A. An explanation and apology B. Financial compensation C. An admission of negligence D. Investigation by the hospital
Implied
Law of agency may be expressed or implied. In the medical office, it is most often ________.
Medical Practice Acts
Laws applying specifically to the practice of medicine in a certain state are called _________.
Code of Ethics
Many health care professionals are members of professional organizations. Which of the following do professional organizations create to govern their members? a. Code of Ethics b. Laws c. Etiquette d. Statutes
Quality assurance
Methods used to manage risk are considered a part of which of the following? A. Assumption of risk B. Quality assurance C. Comparative negligence D. Telemedicine
Negligence
Of all the following torts, which is an unintentional tort? A. Assault B. Fraud C. Invasion of privacy D. Negligence
Hammurabi
One of the earliest medical codes of ethics was written by the Babylonians around 2250 b.c.e. Who was the author of this code of ethics? a. Hippocrates b. Percival c. Kevorkian d. Hammurabi
They serve as moral guidelines for members
Organizations for the health occupations have a code of ethics for their members. Which of the following is true regarding these codes? a. They serve as moral guidelines for members b. Their principles are legally binding c. They replace personal value systems d. They are informal guidelines to medical practices
Against Medical Advice
Patients have the right to terminate a physician's services if they wish. Terminating a physician's services extends to the right of hospitalized patients to leave before their physicians have discharged them, or to leave ________________.
When on the telephone with a patient, do not use his or her name if others may hear.
Since health care procedures and facilities present numerous opportunities for a breach of confidentiality, health care practitioners must make every effort to safeguard each patient's privacy. Which of the following is a recommended guideline for protecting a patient's privacy? A. Do not disclose patient information to a third party, even with signed consent. B. When on the telephone with a patient, do not use his or her name if others may hear. C. Decide confidentiality on the basis of approval of patient views or morals. D. It is appropriate to reveal patient financial information, as it is not confidential
Confidentiality
The Health Information Portability and Accountability Act (HIPAA) mandates privacy and ________ of medical records.
Use a process for taking verbal or telephone orders or critical test results that requires a verification read-back by the person receiving the information.
The Joint Commission addresses accurately identifying patients and improving communication among caregivers by making sure all accredited health care organizations implement which of the following requirements? A. Use two patient identifiers including the patient's hospital room number and another identifier when performing procedures. B. Prior to the start of any surgical or invasive procedure, confirm the correct patient, procedure, and site, using passive communication. C. Use a process for taking verbal or telephone orders or critical test results that requires a verification read-back by the person receiving the information. D. Do not use any standardized abbreviations, acronyms, and symbols throughout the organization.
People skills
The art of listening to others and communicating well is a key component of care provided by a health care professional. Which of the following is a term for this type of skill? a. People skills b. Critical thinking skills c. Technical skills d. Etiquette
Hippocratic Oath
The is a pledge for physicians developed by the Greek physician, known as the father of medicine, circa 400 b.c.e. _________.
Civil
The laws that are most likely to pertain to health care practitioners are criminal and _______ laws.
Step 3
The nurse is planning care for a client and makes a list of all the options from which to choose. This is an example of what step of the decision making process? A. Step 1 B. Step 2 C. Step 3 D. Step 4
Moral values
The physician draws upon the influences of family, culture, and society to determine a basic for ethical conduct in the workplace. Which of the following has the physician developed? a. Laws b. Codes of etiquette c. Moral values d. Protocols
Risk management
The physician who owns a physician's office examines the practices and behaviors of his employees to determine and eliminate problems that may lead to a malpractice lawsuit. What is the term for this practice? A. Credentialing B. Liability insurance C. Occurrence insurance D. Risk management
Communicate clearly and ask for confirmation that you have been understood.
Therapeutic communication is key to avoiding medical malpractice lawsuits. Which of the following is a recommended guideline when communicating with patients? A. Clearly state that it is not within your scope of practice to make appointments. B. If adverse events occur, do not report the event immediately until damage is assessed. C. When adverse events occur, try to avoid or ignore the patients involved. D. Communicate clearly and ask for confirmation that you have been understood.
"four D's of negligence"
There are four elements that must be present in a given situation to prove that a health care professional is guilty of negligence. These elements are sometimes called the ____________.
A physician is engaged solely in research, and not treating patients.
There are situations when physicians do not need a valid license to practice medicine in a specific state. Which of the following is an example of one of these situations? A. A physician is practicing medicine in an underserved area. B. A physician is engaged solely in research, and not treating patients. C. A physician is employed by a state facility. D. A physician is caring for patients who are in a hospice program.
Sharing the workload & expenses
Three physicians form a partnership to practice together under a written agreement. Which of the following is an advantage of a partnership? A. Sharing liability for the acts, conduct, losses, and deficits of the partnership. B. There are financial and tax advantages involved in a partnership. C. Fringe benefits to employees may be more generous than other types of practices. D. Sharing the workload and expenses
Respondeat Superior
Under the doctrine ______________ Latin for "let the master answer," physicians are legally responsible for their own acts and for employees' acts performed in the line of duty.
Respondeat Superior
Under the doctrine of _________________ or "Let the master answer," physicians are liable for the acts of their employees performed "within the course and scope" of employment.
Exercise his or her best professional judgment in all cases
Under the provisions of the physician-patient contract, both parties have certain rights and responsibilities. Which of the following is a responsibility of the physician? A. Treat every patient who seeks medical care B. Restore the patient to his or her original state of health C. Possess the highest skills possible within the profession D. Exercise his or her best professional judgment in all cases
Litigous
We live in a society where patients, relatives, and others are inclined to sue health care practitioners, health care facilities, manufacturers of medical equipment and products, and others when medical outcomes are not acceptable. The term for this inclination is __________.
To increase the competence and standard of care within the profession
What is the purpose of formalized codes of ethics in the health care professions? a. To increase the competence and standard of care within the profession b. To revoke the licenses of unethical practitioners c. To provide a consistent guide for protocol in the office d. To relieve the lawmaking bodies of some of their legal responsibilities
Consider alternatives & implications
What step of the critical thinking process does the speech therapist use after she determines that evidence supports the fact that a problem exists in her speech therapy program? a. Consider alternatives and implications b. Evaluate the evidence c. Gather information d. Choose and implement the best alternative
It must be communicated.
When entering into a contract, certain conditions must pertain to the offer. Which of the following accurately describes one of these conditions? A. It can only relate to the future. B. It must be communicated. C. It must be made under duress, but not as a joke. D. It must be clearly understood by at least one of the parties.
Listen carefully to the patient's complaints and remarks and see that the comments reach the treating physician.
When showing people they care, what would be the best advice for a nurse caring for patients who have complaints about dissatisfaction with their treating physicians? A. Listen to the patients and verbally agree with them if indeed the physician is incompetent. B. Ask the patients to describe the physician's behavior and tell them how patient care will be improved under the new health care team. C. Listen carefully to the patient's complaints and remarks and see that the comments reach the treating physician. D. Do not allow the patients to speak about their physicians, rather steer the conversation to the present treatment.
The solution that provides happiness over pain for those involved
When using the utilitarianism method of problem solving, which of the following do proponents of this method indicate should be the solution of choice? A. The option with the earliest solution to the problem B. The option that reflects the decider's highest principles C. The solution that provides happiness over pain for those involved D. The solution that has the best long-term results
"These things happen, and you may never know what went wrong."
Which of the following - according to Micalizzi's Suggestions for Things NOT to Say After Medical Complications - should not be said to the patient or family following an adverse event? A. "Practices and systems have been changed to prevent a similar event." B. "These things happen, and you may never know what went wrong." C. "Your medical bills have been dismissed." D. "There will be an immediate unbiased investigation with complete disclosure."
Answer the questions asked, no more and no less.
Which of the following are recommended guidelines for a health care practitioner who is summoned to appear in court? A. Bring required documents to court and present them before being asked for them. B. When testifying, use medical terms whenever possible. C. Use humor appropriately to defuse tension in the courtroom. D. Answer the questions asked, no more and no less.
A patient suffers an infection caused by the use of unsterilized instruments.
Which of the following examples of negligence would fall under the doctrine of res ipsa loquitur? A. A patient claims that a physician assaulted her during her hospital stay. B. A patient claims that an obstetrician did not do enough to save her baby. C. A patient claims that his reputation was ruined due to lack of confidentiality. D. A patient suffers an infection caused by the use of unsterilized instruments.
The act serves the interest of the employer.
Which of the following is a test to determine whether an employee was acting with the scope of employment when a negligent act is committed? A. The act does not affect the employer's business. B. The act does not harm the patient. C. The act serves the interest of the employer. D. The act is not considered fraud.
A nurse is changing a patient's IV line, but does not wash her hands prior to procedure.
Which of the following is an example of misfeasance? A. A pharmacist steals two of the narcotic pain pills ordered for a patient. B. A physician fails to help an injured person at the scene of an accident. C. A nurse is changing a patient's IV line, but does not wash her hands prior to procedure. D. A medical assistant dispenses medications to patients, which is beyond her scope of practice.
Physician-Hospital Organizations (PHOs)
_________________ are organizations that include physicians, hospitals, surgery centers, nursing homes, laboratories, and other medical service providers that contract with one or more HMOs, insurance plans, or directly with employers to provide health care services.
Ethical
_______decision making requires a person to tap into their values, morals, and sense of fair play to make and implement a decision that does not harm others.
