NSG 203 Ch. 6

A client is unhappy with the health care provided to him. He approaches the nurse and informs her that he is leaving the facility. The client has not been discharged by the physician. The nurse finds that the client has dressed and is ready to go. What would the nurse's action be in this situation? a) The nurse should call the nursing supervisor and inform her about the situation. b) The nurse should let the client go because she cannot do anything. c) The nurse should get the client restrained and call the physician. d) The nurse should warn the client that he cannot come to the hospital again.

a) The nurse should call the nursing supervisor and inform her about the situation.

Upon entering the hospital system, the nurse discusses the client's rights and responsibilities that he is entitled to in the institution. The information the nurse discusses is commonly referred to as: a) The Bill of Rights for Registered Nurses. b) The Code of Ethics for Nurses. c) Patient's Bill of Rights d) Standards of Clinical Nursing Practice.

c) Patient's Bill of Rights

Select all answer choices that apply. Which clinical events constitute areas of potential liability for the nurses involved? Select all that apply. a) An elderly client develops skin breakdown on his coccyx because he was turned infrequently. b) An anemic client experiences a febrile reaction to a transfusion of packed red blood cells. c) A confused client experiences a fall because her bed rails were left in a lowered position. d) A client with no known cardiac history suffers an unwitnessed cardiac arrest and dies. e) A client experiences a seizure after a missed dose of his scheduled anticonvulsant medication.

a) An elderly client develops skin breakdown on his coccyx because he was turned infrequently. c) A confused client experiences a fall because her bed rails were left in a lowered position. e) A client experiences a seizure after a missed dose of his scheduled anticonvulsant medication.

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? a) Code of Ethics b) Values Clarification c) Standards of Care d) Definition of Nursing

a) Code of Ethics

A client rings the call bell to request pain medication. Upon performing the pain assessment, the nurse informs the client that she will return with the pain medication. The nurse's promise to return with the pain medication is an example of which principle of bioethics? a) Fidelity b) Nonmaleficence c) Justice d) Autonomy

a) Fidelity

A client who is mentally incapacitated is scheduled to undergo surgery. The nurse demonstrates understanding of the principle of autonomy and checks the client's medical record to ensure that consent has been obtained from which person? a) Surrogate decision-maker b) Operating surgeon c) Client d) Attending nurse

a) Surrogate decision-maker

A nurse is aware that the principle of autonomy is being applied in which situation? a) The client has decided to stop chemotherapy treatments. b) The family is discussing care with the physician. c) A hospice consult is ordered by the nurse. d) An order for an antibiotic is being written in the chart.

a) The client has decided to stop chemotherapy treatments.

A group of nurse researchers has proposed a study to examine the efficacy of a new wound care product. Which aspect of the methodology demonstrates that the nurses are attempting to maintain the ethical principle of nonmaleficence? a) The nurses are taking every reasonable measure to ensure that no participants experience impaired wound healing as a result of the study intervention. b) The nurses have organized the study in such a way that the foreseeable risks and benefits are distributed as fairly as possible. c) The nurses have completed a literature review that suggests the new treatment may result in decreased wound healing time. d) The nurses have given multiple opportunities for potential participants to ask questions, and have been following the informed consent process systematically.

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

What is the term for the beliefs held by the individual about what matters? a) Values b) Morals c) Ethics d) Bioethics

a) Values

A nursing student is studying the principle of autonomy. Which example most accurately depicts this principle? a) describing surgery to a client before the consent is signed b) transporting a client to a scheduled physical therapy appointment c) changing a dressing on a wound as needed d) administering a morning dose of insulin before breakfast

a) describing surgery to a client before the consent is signed

Select all answer choices that apply. Which examples of nursing situations have a significant ethical component? Select all that apply. a) helping a client make end-of-life decisions b) deciding which continuing education offerings should be chosen c) deciding when to stop cardiopulmonary resuscitation (CPR) on a client in cardiac arrest d) addressing a suspected breach in confidentiality e) deciding how to reassign staff in light of budget cuts

a) helping a client make end-of-life decisions c) deciding when to stop cardiopulmonary resuscitation (CPR) on a client in cardiac arrest d) addressing a suspected breach in confidentiality e) deciding how to reassign staff in light of budget cuts

Which of the following illustrates the activity of acting in values clarification? a) respecting the human dignity of all clients b) considering consequences of actions c) disregarding several alternatives when choosing d) seeking public affirmation for actions

a) respecting the human dignity of all clients

What would be an example of the nurse practicing fidelity? The nurse: a) stays with the client during his death as promised. b) withholds information as requested. c) provides continuity of care. d) regulates visitors.

a) stays with the client during his death as promised.

A nurse is driving on a back country road when a man flags the nurse down and yells that his wife is having a baby. As a registered nurse she is eager to help. The nurse recalls that she is covered under the Good Samaritan Law. This law states: a) that the nurse's license is protected if she acts in a reasonable manner given the circumstances. b) that the nurse is required to assist this couple because of her medical knowledge. c) that the nurse's license is at risk and she would face criminal prosecution if an error was made. d) that the nurse is not allowed to help this couple and should instead call 911.

a) that the nurse's license is protected if she acts in a reasonable manner given the circumstances.

Which of the following is a characteristic of the care-based approach to bioethics? a) the promotion of the dignity and respect of clients as people b) The rightness or wrongness of an action is independent of its consequences. c) the need to emphasize the relevance of clinical experience d) the need for an orientation toward service

a) the promotion of the dignity and respect of clients as people

A client informs the nurse that he wants to discontinue his treatment and go home. Later, the nurse finds the client dressed to leave. Which action should the nurse take in this situation? a) Restrain the client until his medical treatment is over. b) Call the physician and get his discharge paper signed. c) Let the client go after signing a document stating he is going against medical advice. d) Warn the client that he may not be able to access health care again.

c) Let the client go after signing a document stating he is going against medical advice.

The client is a 40-year-old man admitted s/p repair of a femoral fracture. He discloses that he has a history of an addiction to painkillers and asks that the nurse assist him in adhering to his recovery from this addiction by not administering any narcotics. As the nurse reviews postoperative orders for the client, the nurse notes that his physician has ordered Codeine 30 mg p.o. q6 hours for pain. How does the nurse best approach this situation? a) Leave the order in the chart. b) Asks the physician to remove this order from the client's chart. c) Offer the medication to the client; if he really doesn't want it, he will tell the nurse. d) Inform the next nurse that the client does not wish to receive narcotics.

b) Asks the physician to remove this order from the client's chart.

Select all answer choices that apply. A nurse is being sued for malpractice in a court of law. What elements must be established to prove that malpractice or negligence has occurred? Select all that apply. a) Intent to harm b) Causation c) Fraud d) Duty e) Breach of duty f) Punitive damages

b) Causation d) Duty e) Breach of duty

Which word is best described by the following: the protection and support of another's rights? a) Paternalism b) Advocacy c) Ethics d) Autonomy

b) Advocacy

A client states that his recent fall was caused by the fact that his scheduled antihypertensive medications were mistakenly administered by two different nurses, an event that is disputed by both of the nurses identified by the client. Which measure should the nurses prioritize when anticipating that legal action may follow? a) Consult with the hospital's legal department as soon as possible. b) Document the client's claims and the events surrounding the alleged incident. c) Consult with practice advisors from the state board of nursing. d) Enlist support from nursing and non-nursing colleagues from the unit.

b) Document the client's claims and the events surrounding the alleged incident.

Two nurses are discussing a client's condition in an elevator full of visitors. With what crime might the nurses be charged? a) Defamation of character b) Invasion of privacy c) Intentional negligence d) Unintentional negligence

b) Invasion of privacy

A nurse knows the ethical term "Do not cause harm" is an example of: a) Beneficence b) Nonmaleficence c) Justice d) Fidelity

b) Nonmaleficence

What is the legal source of rules of conduct for nurses? a) American Nurses Association b) Nurse Practice Acts c) Constitution of the United States d) Agency policies and protocols

b) Nurse Practice Acts Explanation: Nurse Practice Acts are examples of statutory law, enacted by a legislative body in keeping with both the federal constitution and the applicable state constitution. They are the primary source of rules of conduct for nurses. Standards of practice, which differ from rules of conduct, are made by agency policies and protocols and by the American Nurses Association

A nurse witnesses a traffic accident in which a child is badly hurt. The nurse dresses the open wounds sustained by the child. The family tries to give monetary compensation, which the nurse refuses. Later, in the hospital, the child develops complications due to infection in the wound. The family holds the nurse responsible for the complications and wants to file a lawsuit. Which of the following statements is true regarding the Good Samaritan law? a) The Good Samaritan law does not provide absolute exemption from prosecution. b) The Good Samaritan law will provide legal immunity to the nurse. c) The Good Samaritan law will not protect the nurse, as she did not accept the compensation. d) The Good Samaritan law is not applicable to health care workers.

b) The Good Samaritan law will provide legal immunity to the nurse.

A registered nurse has had her license suspended after being convicted of being impaired at work. What governing body has the authority to revoke or suspend a nurse's license? a) The Supreme Court b) The State Board of Nurse Examiners c) The employing health care institution d) The National League for Nursing

b) The State Board of Nurse Examiners

A nursing faculty is presenting a lecture on ethics. The correct definition of ethical distress is: a) supporting the rights of a client during hospitalization b) knowing the correct action, but unable to perform due to constraints c) belief about worth as a standard to guide behavior d) being aware of the principles of right and wrong

b) knowing the correct action, but unable to perform due to constraints

Professional regulations and laws that govern nursing practice are primarily in place for which reason? a) to ensure that enough new nurses are always available b) to protect the safety of the public c) to ensure that practicing nurses are of good moral standing d) to limit the number of nurses in practice

b) to protect the safety of the public

Which nursing student would most likely be held liable for negligence? a) A nursing student completes an incident report after administering a medication to a client, who then experienced an adverse reaction to the medication. b) A nursing student performs a dressing change using sterile technique and documents the presence of necrotic tissue in the wound. c) A nursing student administers medication to a resident, while working as an unlicensed assistive personnel (UAP) at a local nursing home. d) A nursing student reports that insulin was not administered to the client by the nurse on the previous shift.

c) A nursing student administers medication to a resident, while working as an unlicensed assistive personnel (UAP) at a local nursing home.

A client refuses to have 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? a) Battery b) Defamation c) Assault d) Negligence

c) Assault Explanation: Assault is a threat or attempt to make bodily contact with another person without that person's consent. Threatening to forcibly administer an injection after the client has refused the injection is assault. Battery is an assault that is carried out and includes willful, angry, and violent or negligent touching of another person's body, clothes, or anything attached to (or held by) that other person.

A nurse volunteers to serve on the hospital ethics committee. Which of the following indicates that the nurse knows what the purpose of an ethics committee is? a) Decide the care for a client who is unable to voice their opinion. b) Present options about the type of care. c) Assist in decision making based on the client's best interests. d) Convince the family to choose a specific course of action.

c) Assist in decision making based on the client's best interests. Explanation: An ethics committee will meet when a client is unable to make an end-of-life decision and the family cannot come to a consensus. The committee members are there to advocate for the best interest of the client. The committee would not convince, decide, or present options about the type of care. This is not the role of an ethics committee

Nurses who value client advocacy follow what guideline? a) They choose the claims of the client's well-being over the claims of the client's autonomy. b) They make decisions for clients who are uninformed concerning their rights and opportunities. c) They give priority to the good of the individual client rather than to the good of society in general. d) They value their loyalty to an employing institution or to a colleague over their commitment to their clients.

c) They give priority to the good of the individual client rather than to the good of society in general.

A client nearing the end of life requests that he be given no food or fluids. The physician orders the insertion of a nasogastric tube to feed the client. What situation does this create for the nurse providing care? a) The nurse must follow the physician's orders. b) an inability to provide care for the client c) an ethical dilemma about inconsistent courses of action d) a barrier to establishing an effective nurse-client relationship

c) an ethical dilemma about inconsistent courses of action

A nurse is administering evening medications and notices that a medication was omitted during the day shift. Which statement demonstrates the principle of accountability? a) telling the client that the medication will be given the following morning b) administering the medication with the other evening medications c) filling out an occurrence report and notifying the health care provider d) documenting in the chart a narrative note about the occurrence

c) filling out an occurrence report and notifying the health care provider

A nurse has a duty of nonmaleficence. Which of the following would be considered a contradiction to that duty? a) providing comfort measures for a terminally ill client b) assisting the client with ADLs c) refusing to administer pain medication as ordered d) providing all information related to procedures

c) refusing to administer pain medication as ordered

Which of the following is the most frequent reason for revocation or suspension of a nurse's license? a) Mental impairment b) Fraud c) Criminal acts d) Alcohol or drug abuse

d) Alcohol or drug abuse

A client age 46 years has been diagnosed with cancer. He has met with the oncologist and is now weighing his options to undergo chemotherapy or radiation as his treatment. This client is utilizing which ethical principle in making his decision? a) Beneficence b) Confidentiality c) Justice d) Autonomy

d) Autonomy

Which ethical principle refers to the obligation to do good? a) Veracity b) Fidelity c) Nonmaleficence d) Beneficence

d) Beneficence

Nurses practicing in a critical care unit must acquire specialized skills and knowledge to provide care to the critically ill client. These nurses can validate this specialty competence through what process? a) Licensure b) Accreditation c) Litigation d) Certification

d) Certification Explanation: Certification validates specialty knowledge, experience, and clinical judgment. A nurse in a critical care unit having specialized skills and knowledge to provide care would be an example of certification. Licensure is a specialized form of credentialing based on laws passed by a state legislature. Licensure endorses entry-level competence. Legal accreditation is granted to educational programs by state agencies endorsing the approval of the program's design and mission to meet the needs of state requirements. Litigation is not a method for validation.

A nurse fails to alert a physician after a client's condition worsens. This is an example of which aspect of malpractice? a) Damages b) Breach of duty c) Causation d) Duty

d) Duty Explanation: Duty refers to an obligation to use due care. An example of duty would be alerting responsible health care professionals to changes in a client's condition. Breach of duty is the failure to meet the standard of care. An example of causation would be failure to use appropriate safety measures when providing client care. An example of damages would be the injury that would occur from one of the above aspects and the pain, suffering, and lengthened hospital stay that would result from that injury

In the delivery of care, the nurse acts in accordance with nursing standards and the code of ethics and reports a medication error that she has made. The nurse is most clearly demonstrating which professional value? a) Altruism b) Social justice c) Human dignity d) Integrity

d) Integrity

A client is suing a nurse for malpractice. What is the term for the person bringing suit? a) Litigator b) Witness c) Defendant d) Plaintiff

d) Plaintiff

A client is brought to the emergency department in an unconscious state with a head injury. The client requires surgery to remove a blood clot. What would be the appropriate nursing intervention in keeping with the policy of informed consent prior to a surgical procedure? a) The nurse informs the family about the living will. b) The nurse ensures that the client signs the consent form. c) The nurse informs the family about advance directives. d) The nurse ensures that the client's family signs the consent form.

d) The nurse ensures that the client's family signs the consent form.

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 be? a) The nurse should invite the gentleman to learn the caring techniques. b) The nurse should state that the family does not need any help. c) The nurse should refer the gentleman to the local social worker. d) The nurse should ask the gentleman to talk to the family directly.

d) The nurse should ask the gentleman to talk to the family directly.

A physician is called to see a client with angina. During the visit the physician advises the nurse to decrease the atenolol to 12.5 mg. However, since the physician is late for another visit, she requests that the nurse write down the order for her. What should be the appropriate nursing action in this situation? a) The nurse should inform the client of the change in medication. b) The nurse should write the order and implement it. c) The nurse should remind the physician later to write the work order. d) The nurse should ask the physician to come back and write the order.

d) The nurse should ask the physician to come back and write the order.

After reporting to work for a night shift, the nurse learns that the unit will be understaffed because two RNs called out sick. As a result, each nurse on the unit will need to provide care for an additional four acute clients, in addition to her regular client assignment. Which statement is true for this nurse when working in understaffed circumstances? a) Understaffing constitutes an extenuating circumstance that creates a temporarily lower expectation for care for the nurse. b) The nurse is legally obliged to refuse to provide care when understaffing creates the potential for unsafe conditions. c) The nurse must document that float staff, nurses on overtime, and part-time staff were contacted in an effort to fill the gaps in care. d) The nurse will be legally held to the same standards of care as when staffing levels are normal.

d) The nurse will be legally held to the same standards of care as when staffing levels are normal.

The client is a 2-month-old infant extremely ill from HSV sepsis. Her mother and father have decided to stop additional medical intervention and allow the infant to pass away naturally. The mother does not want her relatives to know that they plan to stop pursuing aggressive medical treatment because it is against their family's religious beliefs to withdraw medical support. What does the nurse tell the client's mother? a) No, it is wrong to lie to people. b) Yes, but the nurse encourages her to tell her family so that they can provide support. c) No, the nurse can keep details of her diagnosis from the family, but not the fact that she is dying. d) Yes, it is her decision who to inform about the family's medical decision.

d) Yes, it is her decision who to inform about the family's medical decision.

While riding in the elevator, a nurse discusses the HIV-positive status of a client with other colleagues. The nurse's action reflects: a) false imprisonment. b) professional negligence. c) defamation of character. d) invasion of privacy.

d) invasion of privacy.

A nurse enters the client's room and finds the client lying on the floor with ongoing seizures. The nurse helps the client to get up, makes him comfortable, and then informs the physician. The physician advises the nurse to prepare an incident report. What is the purpose of an incident report? a) to provide a method of deciding the nurse's fault in the incident b) to evaluate the immediate care provided by the nurse to the client c) to provide information to local, state, and federal agencies d) to evaluate quality care and potential risks for injury to the client

d) to evaluate quality care and potential risks for injury to the client