Ethical and Legal

What would be an example of the nurse practicing fidelity? The nurse: A. stays with a client during death as promised. B. regulates visitors. C. withholds information as requested. D. provides continuity of care.

Answer: A

Which process evaluates and recognizes educational programs as having met certain standards? A. Accreditation B. Certification C. Credentialing D. Licensure

Answer: A

Moral injury

An emotional, spiritual, or psychological wound the affects an individual as results from exposure to a potentially cruel or unjust environment's ethical and moral dilemmas.

Examples of a intentional tort:

- Assault and battery - Defamation of character - Invasion of privacy - False imprisonment - Fraud

Who develops standards of care that impact nursing practice?

- Board of Nursing - Professional Organizations - American Nurses Associations - Speciality Nursing Organizations - Joint Commission and CMS

Legal safeguards for all nurses

- Competent practice - Informed consent or refusal - Contracts - Patient education - Executing physician orders - Delegating nursing care - Documentation - Appropriate use of social media - Adequate staffing - Whistle-blowing - Professional liability insurance - Risk management programs - Incident, variance, or occurence reports - Patients' rights - Good Samaritan Laws - Student liability

When it comes to ethical conduct, nurses should:

- Cultivate the virtues of nursing - Understand ethical theories that dictate and justify professional conduct - Be familiar with Code of Ethics for nurses and standards for professional conduct

Elements of informed consent

- Disclosure - Comprehension - Competence - Voluntariness

What are reasons that the State Board of Nursing may revoke or suspend a nurse's license?

- Drug or alcohol abuse - Fraud - Deceptive practices - Criminal acts - Gross negligence - Physical or mental impairment

Proof of malpractice involves four elements:

- Duty - Breach of duty - Causation - Damages

Most frequent allegations against nurses:

- Failure to ensure patient safety. - Improper treatment or performance of treatment - Failure to monitor and report - Medication errors and reactions - Failure to follow facility procedure - Documentation - Equipment use - Adverse incidents - Patients with HIV

Examples of an unintentional tort:

- Negligence - Malpractice

Living wills and Durable Power of Attorney may stipulate care such as:

- No emergency medications - Do not perform CPR - No mechanical ventilation - No feeding tubes or IV fluids

What are the professional and legal regulation of nursing practice?

- Nurse practice acts - Standards of care - Credentialing

Example of an ethical dilemma

-Removing life sustaining therapy - Discharging patients with needed therapy, but no means to pay for it

Living Will

A document that indicates what medical intervention an individual wants if he or she becomes incapable of expressing those wishes.

Durable power of attorney

A legal document that designates another person to make health decisions when the client is no longer able to make decisions.

Informed consent

A signed consent is required for all routine treatment, hazardous, treatment programs, and to participate in research.

Do Not Resuscitate (DNR)

A type of advance directive that instructs medical professionals not to perform CPR if a person's heartbeat or breathing stops.

Do Not Intubate (DNI)

A type of advance directive that tells medical professionals not to place a breathing tube in a person.

Crime

A violation punishable by the state

Advanced Directives

A written statement of a person's wishes regarding medical treatment, often including a living will, made to ensure those wishes are carried out should the person be unable to communicate them to a doctor.

Integrity

Acting according to the Code of Ethics and Standards of Practice

Which statement by the nurse is an example of deception? A. "I will administer your pain medication as soon as it is due." B. "This injection of procaine will feel like a little pinch." C. "I am going to teach you how to give yourself insulin." D. "It is important to get out of bed to prevent pneumonia."

Answer: A

A nurse is providing care to an older adult client who was just diagnosed with cancer. The client together with the immediate family discuss their preferences with the health care providers involved. The health care providers offer their clinical recommendations about possible treatments. Ultimately, the group arrives at a decision. The nurse interprets this decision-making process as reflecting which type? A. Client sovereignty B. Shared C. Paternalistic D. Clinical

Answer: B

A nursing student asks the charge nurse about legal liability when performing clinical practice. Which statement regarding liability is true? A. Students are not responsible for their acts of negligence resulting in patient injury. B. Student nurses are held to the same standard of care that would be used to evaluate the actions of a registered nurse. C. Hospitals are exempt from liability for student negligence if the student is properly supervised by an instructor. D. Most nursing programs carry group professional liability making student personal professional liability insurance unnecessary.

Answer: B

A nurse and the facility have been named as defendants in a malpractice lawsuit. In addition to the nurse's attorney, whom else would be appropriate for the nurse to talk with about the case? A. A colleague B. The local press C. The agency's risk manager D. The plaintiff's lawyer

Answer: C

A client tells the nurse that the client does not want to have a painful procedure. By respecting and supporting the client's right to make decisions, the nurse is demonstrating: A. confidentiality B. justice C. altruism D. advocacy

Answer: D

A nurse is providing care to two clients who are sharing the same room. The nurse is preparing to give one of the clients a complete bed bath. Which action by the nurse would suggest liability related to invasion of the client's privacy? A. Applying restraints to the client's arms to keep the client in bed B. Documenting a belief that the client was arrested C. Removing the client's clothing with some force D. Keeping the curtain between the two clients in the room open

Answer: D

A state attorney decides to charge a nurse with manslaughter for allegedly administering a lethal medication. This is an example of what type of law? A. Public law B. Private law C. Civil law D. Criminal law

Answer: D

Professional regulations and laws that govern nursing practice are in place for which reason? A. To limit the number of nurses in practice. B. To ensure that enough new nurses are always available. C. To ensure that practicing nurse are of good moral standing. D. To protect the safety of the public.

Answer: D

Which nursing situation is an example of an ethical dilemma? A. Discussing care of a comatose client with the family B. Transferring a client to a step-down unit C. Administering pain medication as ordered D. Deciding whether to perform cardiac compressions against a client's wishes

Answer: D

Which scenario is an example of certification? A. A graduate of a nursing education program who passes the NCLEX-RN B. An education program that meets the standards of the National League for Nursing C. A hospital that meets the standards of the Joint Commission D. A nurse who demonstrates advanced expertise in a content area of nursing through special testing

Answer: D

Competence of informed consent

Assessing whether the patient/guardian understanding.

Nursing students are legally liable if their actions:

Cause harm to the patient

Altruism

Concern for the welfare and well-being of others

Negligence

Conduct that falls below a standard of care of a reasonably prudent person

Ethics

Consideration of standards of conduct, particularly the study of right and wrong behavior

Justice

Duty to be fair

Nonmaleficence

Duty to do no harm

Beneficence

Duty to doing good

Fidelity

Duty to keep promises

Veracity

Duty to tell the truth

Disclosure for informed consent

Explanation of an overviews and the risks/benefits.

Comprehension for informed consent

Having the patient/guardian repeat what will be happening.

Example of moral distress

Holding a coworker accountable for unethical or unsafe behavior

Two types of a tort

Intentional and unintentional

Nurse practice act

Law that describes and defines the legal boundaries of nursing practice in each state

What are two basic types of advance directives?

Living Wills and Durable Powers of Attorney

Values

Personal belief about the worth a person holds an idea, custom, or an object. *May reflect cultural and social influences

Ethical conduct

Practice based on professional standards of ethical conduct as well as professional values

Human dignity

Respect for inherent worth and uniqueness of individuals and populations

Autonomy

Right to self-determination

When it comes to revoking or suspending a nurse's license, who is the executive decision maker?

State Board of Nursing

Malpractice

The failure to use that degree of care that a reasonable nurse would use under the same or similar circumstances

Nurse Advocate

The legal and ethical obligation to safeguard the patients interests.

Social justice

Upholding moral, legal, and humanistic rights

Before giving informed consent, what are nursing considerations?

What is the patient's developmental level? What is the patient's primary language? Is the patient a minor? Is the patient unconscious?

When are advanced directives able to be enforced?

When the patient is, at that time, unable to make decisions.

Ethical dilemma

When two or more clear moral principles apply, but support mutually inconsistent courses of action

Moral distress

When you know the right thing to do, but personal or institutional factors make it difficult to follow the correct course of action

Tort

a wrongful act or an infringement of a right (other than under contract) leading to civil legal liability.