PREP U Chapter 3: Values, Ethics, Legal Issues
A registered nurse who has an associate degree would like to obtain a baccalaureate degree in nursing. The nurse works full time and has several family obligations and would like to find a program that fits into that lifestyle. What is the nurse's priority question about an educational program? A. What is the NCLEX pass rate? B. Is the program accredited? C. Is it online? D. How much does it cost?
B. Is the program accredited?
A nurse is preparing a client for discharge from the cardiac unit and observes cigarettes in the client's belongings. The nurse asks the client to consider the client's health and that of the client's spouse. This is an example of: A. Values clarification B. Moral distress C. Social justice D. Ethical dilemma
A. Values clarification
Which best defines value clarification? A. A process by which people come to understand their own values and value systems B. A systematic inquiry into principle of right and wrong conduct, of virtue and vice, and of good and evil, as they relate to conduct C. An organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct D. A belief about the worth of something, about what matters, that acts as a standard to guide one's behavior
A / Value clarification is a process by which people come to understand their own values and value systems. A value is a belief about the worth of something, about what matters, that acts as a standard to guide one's behavior. A value system is an organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct. Ethics is a systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil, as they relate to conduct.
Which nursing action demonstrates fidelity? A. Filing an incident report after making a medication error B. Administering a vaccination C. Witnessing a client signature on an informed consent D. Treating an uninsured client in the emergency department
A. Filing an incident report after making a medication error
Which is not true regarding nurse practice acts? A. They describe what medications nurses can prescribe B. They were established to describe legitimate nursing functions C. They vary among states D. They define the boundaries of the functions of a nurse
A. They describe what medications nurses can prescribe
Which action most clearly demonstrates a nurse's commitment to social justice? A. Lobbying for an expansion of healthcare resources and benefits to those in poverty B. Ensuring that a hospital client's diet is culturally acceptable C. Answering a client's questions about care clearly and accurately D. Documenting client care in a timely, honest, thorough manner
A/ Social justice is a professional value that encompasses efforts to promote universal access to health care, such as the expansion of publicly funded programs like Medicare. Culturally competent care is a reflection of human dignity. Answering clients' questions and documenting care accurately are expressions of the value of integrity.
A client who is scheduled for abdominal surgery gives informed consent. While reviewing the client's medical record, the nurse identifies the consent form, interpreting it as most reflective of: A. Protection of the client's right to self-determination in decision-making B. Assurance of the client's ability to refuse treatment if necessary C. Confirmation of the client's mental capacity D. The client's in-depth knowledge about the treatment options available
B. Protection of the client's rights to self-determination in decision-making
A client nearing the end of life requests that the client be given no food or fluids. The health care provider orders the insertion of a nasogastric tube to feed the client. What is the primary concern of the nurse providing care? A. The health care provider's order creates a barrier to establishing an effective nurse-client relationship B. The nurse faces an ethical dilemma about inconsistent courses of action C. The nurse must follow the health care provider's orders D. the nurse is unable to provide care for the client
B. The nurse faces an ethical dilemma about the inconsisten course of action
What type of law regulates the practice of nursing? A. Public law B. Civil law C. Common law D. Criminal law
B/ Civil laws regulate the practice of nursing. A law is a standard or rule of conduct established and enforced by the government, chiefly to protect the rights of the public. Private law, also called civil law, regulates relationships among people and includes laws related to the practice of nursing. Public law is that part of law that governs relationships between individuals and the government and relationships between individuals that are of direct concern to society. Common law is law that is derived from custom and judicial precedent rather than statutes. Criminal law is the body of law that relates to crime. It proscribes conduct perceived as threatening, harmful, or otherwise endangering to the property, health, safety, and moral welfare of people inclusive of one's self.
A home health nurse performs a careful safety assessment of the home of a frail older adult client to prevent harm to the client. The nurse is acting in accord with which principle of bioethics? A. Morals B. Nonmaleficence C. Values D. Advocacy
B/ Nonmaleficence is a principle of bioethics and is defined as the obligation to prevent harm. Advocacy, morals, and values are not principles of bioethics. An effective advocate is a nurse who is willing to act on behalf of a client and can work well with other members of the healthcare team. A moral is a person's standard of behavior or belief concerning what is and is not acceptable to do. A value is one's judgment of what is important in life.
Which aspect of nursing would most likely be defined by legislation at the state level? A. The process that nurses must follow when handling and administering medications B. Differences in scope of practice between registered nurses and licensed practical nurses C. Criteria that clients must meet to qualify for medicare or medicaid D. Criteria that a nurse must consider when delegating tasks to unlicensed assistive personnel
B/ The scope of practice defines the parameters within which nurses provide care and is established by state legislation, most commonly in the form of a nurse practice act. The criteria and due process for delegation in the clinical setting is addressed by a state board of nursing. Qualification criteria for programs such as Medicare and Medicaid are established by federal legislation, whereas the process for safe and appropriate medication administration is defined and monitored by a state board of nursing.
A nurse is providing care for a client with cancer. The client's spouse requests that the client not be told that the client is terminal. The nurse complies with this request. The nurse's action is a breach of which ethical principle? A. Justice B. Nonmaleficence C. Fidelity D. Beneficence
C. Fidelity
A nurse is applying for professional liability insurance. The nurse knows that professional liability insurance is important for which reason? A. To upgrade professional knowledge B. To obtain sound compensation C. To be familiar with legal mechanisms D. To obtain free medication for family
C/ The number of lawsuits involving nurses is increasing. It is to every nurse's advantage to obtain liability insurance and to become familiar with legal mechanisms, such as Good Samaritan laws and statutes of limitations that may prevent or relieve culpability and provide a sound legal defense. Professional liability insurance does not focus on enhancing the nurse's professional knowledge, does not offer free medication for family, or obtain sound compensation to a nurse.
An RN is working on a medical-surgical unit with a licensed practical/vocational nurse (LPN/LVN). Which action by the RN is considered negligent if injury results from this action? A. Obtaining the vital signs on a newly admitted client B. Delegating oral medication administration to the LPN/ LVN C. Calling the health care provider about abnormal lab results D. Asking the LPN/LVN to teach a new diabetic client how to administer insulin
D. Asking the LPN/LVN to teach a new diabetic client how to administer insuliin
While at a coworker's house, a nurse discusses with the coworker a client whom the nurse suspects of physically abusing the client's child. The next day, the client is moved to another nursing unit after a surgical procedure and comes under the care of the coworker, who is also a nurse. The coworker confronts the client about the alleged physical abuse. The client is shocked and angered by the accusation and denies it categorically. What would be the charge if the client were to file a suit? A. The second nurse could be charge with libel B. No charges are valid because the revelation took place during off-duty hours and off-site C. No charges are valid because both nurses are involved in the client's care D. The first nurse could be charged with slander
D. The first nurse could be charged with slander
Which word is most closely associated with the term "ethics"? A. Modeling B. Law C. Reward D. Conduct
D/ Ethics is the systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil, as they relate to conduct. Law and ethics are not synonymous.
A lawsuit has been brought against a nurse for malpractice. The client fell and suffered a skull fracture, resulting in a longer hospital stay and need for rehabilitation. Which element of liability does this description of the client's injuries represent in terms of proof of malpractice? A. Breach of Duty B. Causation C. Duty D. Damages
D/ Liability involves four elements: duty (an obligation to use care and follow standards), breach of duty (the failure to follow standards of care), causation (the failure to follow standards of care resulted in the injury), and damages (the actual harm or injury resulting to the client).
A client's morning blood work indicates a significant decline in his hemoglobin and hematocrit, prompting the primary care provider to order a blood transfusion. As a component of the informed consent process, the potential risks and benefits have been explained to the client. How should the client's comprehension of this information be determined? A. Supplement the spoken teaching with written materials B. Provide an opportunity for the client to ask any questions about the procedure C. Ask the client if he understands the risks and benefits of transfusion D. Ask the client to explain the risks and benefits in his own words
D/ When determining a client's comprehension of information, it is insufficient to simply ask if he understands. Rather, the client should be asked to paraphrase or repeat the information that was provided. Supplementing education with written materials may enhance the client's comprehension, but this does not determine whether or not the teaching was understood. Encouraging the client to ask questions is an important aspect of education, but the absence of questions should not be construed as comprehension.