Craven Ch. 7: Values, Ethics, and Legal Issues
Which example most accurately depicts the ethical principle of autonomy?
Describing a surgery to a client before the consent is signed
A client is brought to the emergency department by an adult child, who states, "I am unable to care for my parent anymore. Although I would like to, financially and physically I can't do it anymore." What ethical problem is the adult child experiencing?
Distress
Upon entering the hospital system, the nurse discusses the rights and responsibilities that the client is entitled to in the institution. The information the nurse discusses is commonly referred to as:
Patient's Bill of Rights.
A client is suing a nurse for malpractice. What is the term for the person bringing suit?
Plaintiff
The principle of autonomy by a client is applied in which situation?
The client has decided to stop chemotherapy treatments.
A nurse practices the ethical principle of autonomy when providing nursing care for clients. Which nursing actions best describe the use of this value? Select all that apply.
A nurse reads The Patient Care Partnership to a visually impaired client. A nurse asks the surgeon to further explain details of a surgery to a client before obtaining informed consent.
Which nursing student would most likely be held liable for negligence?
A nursing student administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home.
Which word is best described as protection and support of another's rights?
Advocacy
A client informs the nurse about leaving the health care facility because the client is not satisfied with the treatment. The nurse knows that the client's treatment is incomplete and further testing and evaluations are scheduled. Which action by the nurse would be most appropriate to prevent false imprisonment?
Ask the client to sign a release without medical approval.
A client refuses to have pain medication administered by injection. The nurse states, "If you don't let me give you the shot, I will get help to hold you down and give it." What tort may the nurse be committing?
Assault
Which are torts rather than crimes? Select all that apply.
Assault Defamation of character Negligence
Nurses complete incident reports as dictated by the agency protocol. What is the primary reason nurses fill out an incident report?
To improve quality of care
Professional regulations and laws that govern nursing practice are in place for which reason?
To protect the safety of the public
A nurse is caring for a client who has undergone coronary angioplasty. The cardiac monitor is showing abnormal electrocardiogram waves, indicating atrial fibrillation. The nurse does not recognize the importance of the sign; as a result, the client's condition deteriorates and the client has to be taken up for an emergency procedure. Which describes the nurse's legal liability?
Tort
A nurse arrives on the medical unit wearing large, dangling earrings. This is an example of which type of conduct?
Unprofessional
What is the term for the beliefs held by the individual about what matters?
Values
Ethical distress is:
knowing the correct action but being unable to perform it due to constraints.
What is the legal source of rules of conduct for nurses?
nurse practice acts
A nurse is caring for a client who is a celebrity in the area. A person claiming to be a family member inquires about the medical details of the client. The nurse reveals the information but later comes to find out that the person was not a family member. The nurse has violated:
confidentiality.
A nurse shows client advocacy by:
offering a hospice consultation to a client who is terminally ill.
A client with a diagnosis of colorectal cancer has been presented with the treatment options, but wishes to defer any decisions to an uncle, who acts in the role of a family patriarch within the client's culture. The client's right to self-determination is best protected by:
respecting the desire to have the uncle make choices on the client's behalf.
Which of the following illustrates the activity of acting in values clarification?
respecting the human dignity of all clients
A nurse is overheard in the hospital cafeteria making false, derogatory comments about a client. The nurse is guilty of:
slander
A nurse, while off-duty, tells the physiotherapist that a client who was admitted to the nursing unit contracted AIDS at the age of 18. The client discovers that the nurse has revealed the information to the physiotherapist, and learns that the nurse wrongfully attributed the disease to the client's contact with sex workers. With what legal action could the nurse be charged?
slander
What would be an example of the nurse practicing fidelity? The nurse:
stays with a client during death as promised.
A client who is cognitively impaired is scheduled to undergo surgery. The nurse demonstrates understanding of the principle of autonomy and checks the client's health record to ensure that consent has been obtained from which person?
surrogate decision-maker
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. The registered nurse is eager to help. The nurse recalls being covered under the Good Samaritan law. This law states:
that the nurse's license is protected if the nurse acts in a reasonable manner given the circumstances.
A nurse is concerned about the practice of routinely ordering an extensive series of laboratory tests for clients who are admitted to the hospital from a long-term care facility. An appropriate entity for addressing this ethical dilemma would be:
the institutional ethics committee.
A nurse has been assigned to the ICU by her supervisor because there is an emergency there. However, the nurse is not aware of the setup and workings of the ICU. What would be the appropriate action by the nurse?
to report to the nurse-in-charge for duty and tell her the tasks she can help with
Action has been taken against a nurse's license based on a claim that the nurse acted outside of nursing's scope of practice. The nurse's attorney determines that the nurse needs more education about the purpose of the board of nursing when the nurse makes which statement?
"The rules made by the board of nursing don't reflect my practice."
A nurse knows that the expression "Do not cause harm" refers to which ethical principle?
Nonmaleficence
Which is the best definition of ethics?
The formal, systematic study of moral beliefs
A nurse observes another nurse place an unused dose of narcotics in their pocket. If caught, the nurse could be charged with which type of crime?
felony
A nurse who obtains a license to practice nursing through self-misrepresentation is guilty of what tort?
Fraud
Which is a characteristic of the care-based approach to bioethics?
The promotion of the dignity and respect of clients as people
Which aspect of nursing would most likely be defined by legislation at the state level?
Differences in scope of practice between registered nurses and licensed practical nurses
A nurse exits the room of a confused client without raising the side rails on the bed. The failure to raise the side rails would constitute which element of liability related to malpractice?
breach of duty
Which word is most closely associated with the term "ethics"?
conduct
A client is discussing informed consent prior to a scheduled procedure. Informed consent includes what rights? Select all that apply.
confidentiality right of refusal to participate right to withdraw from treatment at any time
A group of nursing students is reviewing legally sensitive issues surrounding death and dying. The students demonstrate understanding of active euthanasia when they identify which action as an example?
deliberately injecting an excessive insulin dose
A nursing instructor is describing values and how they can reflect a person's age and stage of development. The sense of self that underlies value formation is normally completed by:
early adulthood.
The nurse finds that there have been several opportunities to share personal prescriptions with family members when they were in need of pain medication or antibiotics. Which area of rules should govern the nurse's moral decision?
ethics
A nurse completing admission paperwork asks the client about having an advanced directive. The client states, "I do not know, what is an advanced directive?" What is the nurse's best response?
"It is a written document that identifies a person's preferences regarding which medical interventions to use in the event of a terminal condition."
Which phrase best describes a value?
"The rules made by the board of nursing don't reflect my practice." a belief about the worth of something to guide behavior
A nurse is caring for a client with a complete spinal cord injury that has caused paraplegia. The client is very distraught and asks the nurse, "Are they sure, even with therapy, I will never walk again?" Which statement made by the nurse demonstrates veracity?
"You have a complete injury, which results in a total loss of movement and sensation below the level of injury."
Which best defines value clarification?
A process by which people come to understand their own values and value systems
A school nurse interviewing parents of a child who is doing poorly in school determines that the parents practice a laissez-faire method of discipline. What are examples of this form of value transmission? Select all that apply.
A teenage boy explores religions of friends in hopes of developing his own faith. A teenage girl tries alcohol at a party with her friends.
Which ethical principle is related to the idea of self-determination?
Autonomy
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?
Certification
An illegal immigrant with no health insurance sustained life-threatening injuries in an automobile accident. Which action in this case demonstrates the ethical principle of justice?
Airlifting the client to a local trauma center for emergency surgery
Which is the most frequent reason for revocation or suspension of a nurse's license?
Alcohol or drug use
During a nursing shift, which events warrant completion of an incident report? Select all that apply.
An intravenous antibiotic was administered 2 hours late because the IV site infiltrated. A visitor slipped and fell in the hallway, but was not injured. A client falls while being transferred from the bed to the chair.
The 40-year-old client is admitted for repair of a femoral fracture. The client discloses a history of an addiction to painkillers and asks that the nurse assist in adhering to the recovery from this addiction by not administering any narcotics. As the nurse reviews postoperative prescriptions for the client, the nurse notes that the health care provider has prescribed codeine 30 mg p.o. q6 hours for pain. How does the nurse best approach this situation?
Ask the health care provider to remove this prescription from the client's chart.
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?
Asking the LPN/LVN to teach a new diabetic client how to administer insulin
While walking down the hall, a nurse manager overhears a staff member telling a client, "If you don't stay in this chair and stop wandering, I'm going to tie you to it." The nurse manager pulls the staff member aside and discusses what was said. The nurse manager intervenes because the staff member's statement is which type of tort?
Assault
Which ethical principle refers to the obligation to do good?
Beneficence
A client has been in the emergency department for 3 hours for treatment of a migraine headache. Care has been delayed due to a multiple fatality car accident. The client gets up to go to the bathroom unattended, faints, and suffers a subdural hematoma. The family threatens to sue for malpractice. Which element of malpractice will be the most difficult for the attorney to prove?
Causation
What type of law regulates the practice of nursing?
Civil law
A nurse provides client care within a philosophy of ethical decision-making and professional expectations. What is the nurse using as a framework for practice?
Code of ethics
A lawyer quotes a precedent for punishment of a crime committed by the defendant in a trial. What is court-made law known as?
Common law
Which is the nurse's best legal safeguard?
Competent practice
A nurse assesses a client with psychotic symptoms and determines that the client needs vest restraints. However, the client asks the nurse not to put on vest restraints. What would be the best nursing action?
Contact the physician and obtain necessary orders.
A nurse is most likely to experience ethical distress in which client situation?
Continuing intravenous fluids for a client who wants to die
A nurse is arrested for possession of illegal drugs. What kind of law is involved with this type of activity?
Criminal
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?
Damages
A client is to undergo surgery for removal of the gallbladder. Which action related to the client's informed consent falls within the nurse's scope of practice? Select all that apply.
Ensuring the signed form is on the chart Acting as a witness to the client's signature on the form Answering questions about elements of the consent
Which statement best conveys the concept of ethical agency?
Ethical practice requires a skill set that must be conscientiously learned and nurtured.
Using the nursing process to make ethical decisions involves following several steps. Which step is the nurse implementing when reflecting on the decision-making process and the role it will play in making future decisions?
Evaluating
A nurse on the oncology unit is caring for a client on hospice care. The client is weak and is resting. The client's adult child comes storming onto the unit and demands that the nurse do everything that the nurse can do to treat the mother. This is an example of what type of values conflict?
Family conflict
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?
Fidelity
Which nursing action demonstrates the principle of fidelity?
Filing an incident report after making a medication error
A nurse has applied soft wrist restraints to a client following endotracheal intubation. Documentation of which information is essential when using restraints on a client? Select all that apply.
Findings from patient assessment, performed every 2 hours Foley catheter draining clear yellow urine 0.9 normal saline infusing intravenously at 100 mL/hr
During the orientation to the hospital, the staff development educator discusses unit and institutional-based policies. What is the source of the practice rules that result in unit and institutional-based policies?
Health care institution
In the delivery of care, the nurse acts in accordance with nursing standards and the code of ethics and reports a medication error that the nurse has made. The nurse is most clearly demonstrating which professional value?
Integrity
The nurse beginning practice would like to access the standards for ethical practice. Which organization should the nurse research for these standards?
International Council of Nurses
An HIV-positive client discovers that the client's name is published in a research report on HIV care prepared by the client's nurse. The client is hurt and files a lawsuit against the nurse. Which offense has the nurse committed?
Invasion of privacy
Two nurses are discussing a client's condition in an elevator full of visitors. With what tort might the nurses be charged?
Invasion of privacy
When talking with family over dinner, the nurse shares about a client with infertility at the hospital, identifying the person by name. Which tort has the nurse committed?
Invasion of privacy
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?
Is the program accredited?
What is the primary ethical dilemma posed when using restraints on an older adult client in a long-term care setting who is confused?
It threatens autonomy.
A nurse is providing care for three clients on a medical unit, two of whom are significantly more acute than the third. The nurse is making a concerted effort to ensure that the less acute client still receives a reasonable amount of time, attention, and care during the course of the shift. Which ethical principle is the nurse attempting to practice?
Justice
A nurse is called to a deposition for a malpractice charge that has resulted in the death of a client. As the chart is reviewed, the prosecuting attorney questions the nurse about several defaming comments written in the medical record about the client. What charges can be filed against the nurse due to these comments?
Libel
A nurse suspects that a client is a prostitute. The nurse documents this suspicion in the medical record and includes it in report to the oncoming shift. The nurse also mentions the suspicion to the nurse's sister saying, "I had a client named Susan in room 126 today who I think is a prostitute." Which violations has this nurse committed? Select all that apply.
Libel HIPAA Slander
Which action most clearly demonstrates a nurse's commitment to social justice?
Lobbying for an expansion of healthcare resources and benefits to those in poverty
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?
Nonmaleficence
A nurse using the principle-based approach to client care seeks to avoid causing harm to clients in all situations. What is this principle known as?
Nonmaleficence
A nurse is caring for a hospitalized client. Which nursing actions demonstrate a caring and compassionate attitude? Select all that apply.
Notifying the client before leaving for lunch Offering snacks and beverages to visiting family Explaining all nursing procedures clearly Listening to the client tell stories about past experiences
A nurse is caring for a client following endotracheal intubation. Before applying soft wrist restraints to prevent the client from pulling out the endotracheal tube, what is the most appropriate action of the nurse?
Obtain a medical order.
Which is an example of nonmaleficence?
Protecting clients from a chemically impaired practitioner
A client has been diagnosed with a debilitating neuromuscular disease that has left the client tired, confused, and in pain. Which action(s) will the nurse choose to advocate for this client in planning future care? Select all that apply.
Provide education about treatments. Facilitate involvement of people essential to the decision. Explain laboratory and radiology findings.
A nurse has taken a telephone order from a physician for an emergency medication. The dose of the medication is abnormally high. What should the nurse do next?
Question the order for the medication.
A nurse is reviewing the nurse practice act of the state in which the nurse is licensed. The nurse understands that this act was derived from which source of law?
Statutory
Nurse practice acts are examples of which type of laws?
Statutory laws
A nurse witnesses a 50-year-old woman go into cardiac arrest while traveling in a train and resuscitates her. The family is very happy and insists the nurse accept a monetary compensation. Not wanting to hurt the family's feelings, the nurse reluctantly accepts the compensation. Later, in the hospital, the woman dies, and the family members file a suit against the nurse. Which of the following statements about Good Samaritan laws is applicable here?
The Good Samaritan law will not protect the nurse because she has accepted monetary compensation.
A client is being prepared for an elective surgical procedure and the consent form has not been signed. Who should the nurse have obtain consent for the procedure?
The health care provider performing the surgical procedure
A nurse enters a client's room and finds that the client is lying on the floor. The nurse makes the client comfortable on the bed and completes an examination. She informs the physician and the nursing supervisor about this incident and also completes an incident report. Which action by the nurse indicates correct knowledge of handling an incident report?
The nurse documents a complete description of the happenings in the client's records.
Which are areas of potential liability for the nurse? Select all that apply.
The nurse fails to document refusal by the client to ambulate following surgery. The nurse documents that the client's blood pressure has increased from 118/72 to 188/98 mm Hg and decides to retake the blood pressure in an hour.
Which situation violates an element of informed consent?
The nurse says, "You have to sign this before we can do the surgery."
During a clinical placement on a subacute, geriatric medicine unit, a student nurse fed a stroke client some beef broth, despite the fact that the client's diet was restricted to thickened fluids. As a result, the client aspirated and developed pneumonia. Which statement underlies the student's potential liability in this situation?
The same standards of care that apply to a registered nurse apply to the student.
A client is requesting to view all medical record information regarding the care received while hospitalized. What rights does the client have regarding accessing the medical record according to HIPAA regulations? Select all that apply.
To see the health record To copy the health record To restrict certain disclosures of the health record
When providing nursing care to clients, the nurse is required to adhere to ethical values and legal rules to guide practice behavior. Which values would be included? Select all that apply.
Veracity Fidelity Privacy Confidentiality
A nurse is working as part of a group to develop programs that will reduce the health disparities among different groups in the area. Which principle is the nurse applying?
justice
The nurse is caring for a client living in a long-term care facility who has a diagnosis of dementia. While caring for this client, which action(s) taken by the nurse would constitute malpractice? Select all that apply.
leaving bedrails down when the client is sleeping informing the client he or she must use the nurse call bell to receive care holding the client's dinner meal until the client agrees to take medication sharing the client's health status with all inquiring family members
When assessing if a procedural risk to a client is justified, the ethical principle underlying the dilemma is known as:
nonmaleficence
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:
protection of the client's right to self-determination in decision-making.
A nurse is applying for professional liability insurance. The nurse knows that professional liability insurance is important for which reason?
to be familiar with legal mechanisms
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?
to evaluate quality care and potential risks for injury to the client
A public health nurse is involved in planning a community outreach program for a large assisted living community. Due to the aging population within the community, the program will offer hypertension screening and management. This decision is based on which principle?
utilitarianism
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:
values clarification.
A nurse has a duty of nonmaleficence. Which action would be considered a contradiction to that duty?
Refusing to administer pain medication as prescribed
A client being discharged from the hospital asks the nurse, "When I go visit my family out of state, should I take my living will with me, or do I need a new one for that state?" Which is the most appropriate response by the nurse?
"Take it with you. It is recognized universally in the United States."
A client diagnosed with cancer has met with the oncologist and is now weighing whether to undergo chemotherapy or radiation for treatment. This client is demonstrating which ethical principle in making this decision?
Autonomy
A nurse is providing care to a client with end-stage cancer. After weighing the alternatives, the client decides not to participate in a clinical trial offered and is requesting no further treatment. The nurse advocates for the client's decision based on the understanding that the client has the right to self-determination, interpreting the client's decision as reflecting which ethical principle?
Autonomy
A nurse who provides the information and support that clients and their families need to make the decision that is right for them is practicing what principle of bioethics?
Autonomy
A nurse fails to communicate a change in the client's condition to the physician. Which element related to proving malpractice has been met?
Breach of duty
A client states that the client's recent fall was caused by his scheduled antihypertensive medications being 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?
Document the client's claims and the events surrounding the alleged incident.
The nurse is providing care to a client whose condition has progressively declined. The nurse assesses and makes appropriate interventions as well as notifies the health care provider. Despite the nurse's efforts, the client expires. What element of liability has the nurse demonstrated?
Duty
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?
Duty Ask the client to explain the risks and benefits in his own words.
In some cases, the act of providing nursing care in unexpected situations is covered by the Good Samaritan laws. Which nursing action would most likely be covered by these laws?
Emergency care for a choking victim in a restaurant
A client informs the nurse that the client wants to discontinue treatment and go home. Later, the nurse finds the client dressed to leave. Which action should the nurse take in this situation?
Let the client go after signing a document stating that the client is going against medical advice.
A nurse does not assist with ambulation a postoperative client on the first day after surgery. The client falls and fractures a hip. What charge might be brought against the nurse?
Negligence
A nurse is caring for a client with hypertension whose blood pressure has increased from 154/78 mmHg to 196/98 mmHg with a heart rate of 110 beats per minute during the past hour. The nurse goes to lunch without reporting the change to the health care provider, and the client experiences a cardiac arrest. What tort has the nurse likely committed?
Negligence
What governing body has the authority to revoke or suspend a nurse's license?
The State Board of Nurse Examiners
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?
The first nurse could be charged with slander.
A nurse is providing client care in a hospital setting. Who has full legal responsibility and accountability for the nurse's actions?
The nurse
Legal safeguards are in place in the nursing practice to protect the nurse from exposure to legal risks as well as to protect the client from harm. What is an example(s) of legal safeguards for the nurse? Select all that apply.
The nurse confirms informed consent was give by the client to perform a procedure. The nurse educates the client about what to expect during the hospital stay. The nurse documents all client care in a timely manner.
A family brings the client 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?
The nurse confirms that the client's family has signed the consent form.
A nurse gives the 400 IU of a vitamin supplement that was in the client's medications instead of the 200 IU that was prescribed. The dosage was given when the unit was busy admitting three clients and another client was in crisis. Which action(s) by the nurse demonstrate the professional value of integrity? Select all that apply.
The nurse documents the dose given. The nurse completes a variance or incident report.
A client nearing the end of life requests that the client be given no food or fluids. The physician orders the insertion of a nasogastric tube to feed the client. What is the primary concern of the nurse providing care?
The nurse faces an ethical dilemma about inconsistent courses of action.
After reporting to work for a night shift, the nurse learns that the unit is understaffed because two RNs called out sick. As a result, each nurse on the unit must provide care for four acute clients in addition to the nurse's regular clients. Which statement is true for this nurse when working in understaffed circumstances?
The nurse is legally held to the same standards of care as when staffing levels are normal.
A physician is called to see a client with angina. During the visit the physician advises the nurse to decrease the dosage of atenolol to 12.5 mg. However, because the physician is late for another visit, the physician requests that the nurse write down the order for the physician. What should be the appropriate nursing action in this situation?
The nurse should ask the physician to come back and write the order.
A home care nurse is caring for a quadriplegic client who needs regular position changes and back massages. A visitor identifying as a family friend inquires about helping the family. What should be the nurse's response be?
The nurse should ask the visitor to talk to the family directly.
While riding in the elevator, a nurse discusses the HIV-positive status of a client with other colleagues. The nurse's action reflects:
invasion of privacy.
A nurse who comments to coworkers at lunch that a client with a sexually transmitted infection has been sexually active in the community may be guilty of what tort?
Slander
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?
The Good Samaritan law will provide legal immunity to the nurse.
A client on a surgical unit asks for the nurse's opinion of the surgeon. The nurse says that the surgeon is rude and that the surgeon's clients always end up with infections. The nurse is at risk of being accused of which?
Slander
Which is not true regarding nurse practice acts?
They describe what medications nurses can prescribe.
A charge nurse has implemented staff education on nursing values. The nurse would determine that further education is required when which statement(s) are overheard? Select all that apply.
"I can't believe the client is giving that precious baby up for adoption." "The gonorrhea test was positive. That's what the client gets for sleeping around." "If that was my mother, I sure wouldn't agree to a no-code."
A nursing student is preparing for the first time to insert an indwelling catheter in a client. The client asks the student if he or she has have performed the procedure before. What is the best response by the student?
"I have practiced the skill in the lab and my instructor will be present during the procedure."
Which clinical events constitute areas of potential liability for the nurses involved? Select all that apply.
An elderly client develops skin breakdown on his coccyx because he was turned infrequently. A client experiences a seizure after a missed dose of his scheduled anticonvulsant medication. A confused client experiences a fall because her bed rails were left in a lowered position.
The nurse is providing care to a client who had orthopedic surgery. The nurse has medicated the client for pain. However, the client reports that the pain is unrelieved. The nurse takes no further action regarding assessment and intervention for the client's pain. The nurse does not notify the surgeon regarding the client's pain. The nurse's failure to take further action represents which element of liability in this case?
Breach of duty
A nurse volunteers to serve on the hospital ethics committee. Which action should the nurse expect to take as a member of the ethics committee?
Assist in decision making based on the client's best interests.
An RN enters a client's room and observes the unlicensed assistive personnel (UAP) forcefully pushing a client down on the bed. The client starts crying and informs the UAP of the need to go to the bathroom. What action is the RN witnessing that should be immediately reported to the supervisor?
Battery
An oncology nurse is caring for a client suffering from metabolic encephalopathy and end-stage kidney disease. The client has no known family and no advance directives. Upon entering the room, the nurse observes the client is pale and has no spontaneous respiration. What is the priority action the nurse should take?
Begin CPR.
A client rings the call bell to request pain medication. On performing the pain assessment, the nurse informs the client that the nurse will return with the pain medication. After a few moments, the nurse returns with the pain medication. The nurse's returning with the pain medication is an example of which principle of bioethics?
Fidelity
A nurse is providing care to a client and is preparing the client for breakfast. The nurse assists the client out of bed to the chair and then helps the client open the items on the breakfast tray. The client begins to eat breakfast. The nurse tells the client, "I'll be back in about 10 minutes to check on you. In the meantime, here is your call light in case you need me." About 10 minutes later, the nurse returns to check on the client. The nurse is demonstrating which ethical principle?
Fidelity
A nurse is administering evening medications and notices that a medication was omitted during the day shift. Which statement demonstrates the principle of accountability?
Filling out an occurrence report and notifying the healthcare provider
A client who is scheduled for hernioplasty needs clarification regarding the procedure. The nurse calls the physician at the client's insistence. The physician, who is in a bad mood, is overheard telling the client that the nurse does not know anything. Which legal tort has the physician committed?
Slander
A client is unhappy with the health care provided and informs the nurse that the client 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 should the nurse's action be in this situation?
The nurse should call and inform the nursing supervisor of the situation.
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?
The nurses are taking every reasonable measure to ensure that no participants experience impaired wound healing as a result of the study intervention.
Nurses who value client advocacy follow what guideline?
They give priority to the good of the individual client rather than to the good of society in general.
The client is a 2-month-old infant extremely ill from herpes simplex virus (HSV) sepsis. The parents have decided to stop additional medical intervention and allow the infant to pass away naturally. One parent does not want 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 parent?
Yes, it is his or her decision who to inform about the family's medical decision.
