PrepU | Chapter 3: Laws and Ethics

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? Justice Autonomy Fidelity Nonmaleficence

Nonmaleficence

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? Values clarification Standards of care Code of ethics Definition of nursing

Code of ethics

An older adult client has expressed to the nurse a desire to specify and document the care they want to receive and do not want to receive if they become incapacitated. The nurse should encourage the client to explore what option? A do-not-resuscitate (DNR) order Assignment of a surrogate decision-maker A will A living will

A living will

A client who experienced a cesarean birth rates pain as a 9 on a 10-point scale. The nurse medicates the client for pain. This is an example of the nurse practicing which ethical principle? Beneficence Justice Fidelity Nonmaleficence

Beneficence

The nurse is concerned about a potential malpractice or negligence lawsuit regarding a client who was cared for on the unit. What specific elements must be established to prove that malpractice or negligence has occurred in this client? Select all that apply. Damages Duty Breach of duty Misrepresentation Causation Breach of confidentiality

Duty Breach of duty Causation Damages

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? Autonomy Nonmaleficence Justice Fidelity

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? Nonmaleficence Fidelity Justice Autonomy

Fidelity

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

Invasion of privacy

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: The Bill of Rights for Registered Nurses. Standards of Clinical Nursing Practice. The Code of Ethics for Nurses. Patient's Bill of Rights.

Patient's Bill of Rights.

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

Plaintiff

The nurse is leading a discussion with a group of adolescents about what to do "if a friend shows you a gun at school in a backpack." The nurse is encouraging the adolescents to explore consequences of their actions for decisions made. What value transmission is the nurse demonstrating? Responsible choice Rewarding and punishing Laissez-faire approach Modeling behavior

Responsible choice

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. The nurses have given multiple opportunities for potential participants to ask questions, and have been following the informed consent process systematically. The nurses have completed a literature review that suggests the new treatment may result in decreased wound healing time. The nurses have organized the study in such a way that the foreseeable risks and benefits are distributed as fairly as possible.

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

Which is not true regarding nurse practice acts? They define the boundaries of the functions of a nurse. They vary among states. They describe what medications nurses can prescribe. They were established to describe legitimate nursing functions.

They describe what medications nurses can prescribe.

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

To protect the safety of the public

What is the term for the beliefs held by the individual about what matters? Values Ethics Morals Bioethics

Values

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? damages duty causation breach of duty

breach of duty

A nurse observes another nurse place an unused dose of an opioid in the nurse's pocket. If caught, the nurse could be charged with which type of crime? tort negligence misdemeanor felony

felony

Which is an example of nonmaleficence? performing dressing changes to promote wound healing providing emotional support to clients who are anxious protecting clients from a health care provider under the influence of an opioid administering pain medications to a client in pain

protecting clients from a health care provider under the influence of an opioid

What is the legal source of rules of conduct for nurses? Constitution of the United States nurse practice acts agency policies and protocols American Nurses Association

nurse practice acts

A group of nurses working in a long-term care facility fails to keep the opioid medications in a secure location. The nurses also fail to count the medications before and after each shift, as indicated by the institution's policies and procedures. These failures may result in disciplinary action against the: facility's state license. pharmacist's license. state regulating body. nurses' licenses.

nurses' licenses.

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: educating the client about the right to autonomy. respecting the desire to have the uncle make choices on the client's behalf. revisiting the decision when the uncle is not present at the bedside. holding a family meeting and encouraging the client to speak on the client's own behalf.

respecting the desire to have the uncle make choices on the client's behalf.

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

stays with a client during 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 an infant. The registered nurse is eager to help. The nurse recalls being covered under the Good Samaritan law. This law states: that the nurse is required to assist this couple because of knowledge and abilities. that the nurse is not allowed to help this couple and should instead call 911. that the nurse's license is protected if the nurse acts in a reasonable manner given the circumstances. that the nurse's license is at risk and the nurse would face criminal prosecution if an error was made.

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

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 health care provider. The health care provider advises the nurse to prepare an incident report. What is the purpose of an incident report? to provide information to local, state, and federal agencies to evaluate the immediate care provided by the nurse to the client to provide a method of deciding the nurse's fault in the incident to evaluate quality care and potential risks for injury to the client

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

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? Justice Beneficence Autonomy Confidentiality

Autonomy

Which clinical events constitute areas of potential liability for the nurses involved? Select all that apply. An older adult 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. An anemic client experiences a febrile reaction to a transfusion of packed red blood cells. A client with no known cardiac history suffers an unwitnessed cardiac arrest and dies. A confused client experiences a fall because her bed rails were left in a lowered position.

An older adult 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

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 opioids. 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? Inform the next nurse that the client does not wish to receive opioids. Leave the prescription in the chart. Offer the medication to the client; if the client really doesn't want it, the client will tell the nurse. Ask the health care provider to remove this prescription from the client's chart.

Ask the health care provider to remove this prescription from the client's chart.

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 Battery Negligence Defamation

Assault

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 Battery Invasion of privacy False imprisonment

Assault

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? Fraud Battery Assault Defamation of character

Battery

Which ethical principle refers to the obligation to do good? Beneficence Veracity Nonmaleficence Fidelity

Beneficence

Which theory of ethics prioritizes the nurse's relationship with clients and the nurse's character in the practice of ethical nursing? Care-based ethics Deontology Utilitarianism Principle-based ethics

Care-based ethics

A client who has suffered a cerebrovascular accident is unable to swallow and refuses the insertion of a feeding tube. In order to promote the client's autonomy, the nurse should perform which action? Inform the client of their rights under the law Communicate the client's wish to the family and health care team Assess the client's understanding of the risks and benefits of tube feeding Promptly arrange for a swallowing assessment

Communicate the client's wish to the family and health care team

Which is the nurse's best legal safeguard? Competent practice Client education Written or implied contracts Collective bargaining

Competent practice

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 Social justice Altruism Human dignity

Integrity

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? The nurse encourages the parents to tell the family so that they can provide support. The nurse can keep details of the diagnosis from the family, but not the fact that the infant is dying. It is wrong to lie to people. It is the parents' decision who to inform about the family's medical decision.

It is the parents' 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: defamation of character. invasion of privacy. professional negligence. false imprisonment.

invasion of privacy.

A nurse witnesses a 50-year-old woman go into cardiac arrest while traveling in a train and attempts to resuscitate her. In spite of the nurse's efforts, 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 is not applicable to nurses and health professionals. The Good Samaritan law will protect the nurse from any lawsuit filed by family members. The Good Samaritan law will likely protect the nurse because she acted in the woman's best interests. The Good Samaritan law will protect the nurse if she was negligent in her action.

The Good Samaritan law will likely protect the nurse because she acted in the woman's best interests.

Which is the best definition of ethics? The adherence to formal personal values The adherence to informal personal values The informal, systematic study of moral beliefs The formal, systematic study of moral beliefs

The formal, systematic study of moral beliefs

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

respecting the human dignity of all clients

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 attending nurse client operating surgeon

surrogate decision-maker

The nurse reports a nursing colleague on the unit who is lethargic and verbally responds in a slow manner. This is an example of: delegating nursing care. collective bargaining. whistle-blowing. ensuring adequate staffing.

whistle-blowing

What governing body has the authority to revoke or suspend a nurse's license? The State Board of Nurse Examiners The employing health care institution The National League for Nursing The Supreme Court

The State Board of Nurse Examiners

The nurse administered acetaminophen 15 mg/kg to a 2-year-old child with a sore throat. After charting the medication, the nurse realized that the client has a documented allergy to the medication. The client breaks out in a rash 15 minutes later, the throat swells, and the client must be intubated. Which best describes the nurse's actions? The nurse is guilty of malpractice. This was an honest mistake and the nurse is not at fault. The nurse is guilty of negligence but not malpractice. The nurse committed a crime and is going to jail.

The nurse is guilty of malpractice.

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." "The board of nursing is established by state legislation." "The board of nursing exists to protect the safety of the public." "Board of nursing rules keep unlicensed people from practicing nursing."

"The rules made by the board of nursing don't reflect my practice."

What best describes the utilitarian theory of ethics? All actions are either right or wrong, regardless of consequences. The consequences of an action determine if it is right or wrong. If an action is useful, it is ethically correct. There is no way to determine whether an action is ethical or not.

The consequences of an action determine if it is right or wrong.

A nurse is providing client care in a hospital setting. Who has full legal responsibility and accountability for the nurse's actions? The health care provider The nurse The hospital The head nurse

The nurse

A nurse from the postanesthesia care unit (PACU) transports a client in the elevator with a nurse from the intensive care unit (ICU). There are staff members and visitors in the elevator as well. Which response from the ICU nurse is appropriate when the PACU nurse begins the report? "I will look at the EHR when I get to the nurse's station." "Before you begin we need to ensure a family member is present." "Wait and give me a report in the room at the bedside." "You can just put the report on the foot of the bed and I will look at it when I get to the room."

"Wait and give me a report in the room at the bedside."

The client experienced cardiac arrest, was resuscitated, and has now been on a ventilator for several days. The client had a written advance directive, which the spouse brought from home. The primary care provider (PCP) is encouraging the spouse to consent for placement of a percutaneous endoscopic gastrostomy (PEG) tube, which is contrary to the client's advance directive. After the PCP leaves, the spouse states, "I wish I knew what my spouse wanted." What is the best reply by the nurse? "Your spouse did tell you in the advance directive." "You will now have to make the decision." "The PCP only wants what is best for your spouse." "Your spouse will live with the PEG tube but die without it."

"Your spouse did tell you in the advance directive."

A nurse is sitting with friends in a coffee shop while working on a plan of care for a client. The client's name is written at the top of the plan. Which ethical responsibility is the nurse violating? Accountability Trust Informed consent Confidentiality

Confidentiality

A nurse has become aware of a conflict between a client's children, one of whom wants to withhold the client's recent cancer diagnosis from her in the belief that the client would "give up hope" if she became aware of her condition. Which response to this situation most clearly represents a deontological perspective? The wishes of the majority of the client's children should be respected. The morality of the withholding information from a client is the primary concern. Precedents from similar cases in the past should guide the nurse's decision-making. The advantages and disadvantages of withholding this information should be weighed carefully.

The morality of the withholding information from a client is the primary concern.

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 Duty Damages Causation

Breach of duty

A famous actor with bipolar disorder has been admitted in the mental health unit for treatment. A well known news outlet has offered the nurse several thousand dollars to provide information or a picture of the client. The nurse knows that it is their professional duty and legal responsibility to uphold privacy and confidentiality. For each of the behaviors exhibited by the nurse, click to specify whether the behavior upholds the principle of privacy or confidentiality. Confidentiality or Privacy obtaining the client's permission before allowing a student nurse to assist with care logging off the electronic health record after documenting assessment information keeping the door closed while conducting physical assessment sharing client information only to the caregivers directly assigned to client care asking the client to sign a medical release form before providing information to the health insurance company

Confidentiality Privacy Privacy Confidentiality Confidentiality

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? Notify the family. Obtain a medical order. Get written consent. Sedate the client.

Obtain a medical order.

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? Consult with practice advisors from the state board of nursing. Document the client's claims and the events surrounding the alleged incident. Consult with the hospital's legal department as soon as possible. Enlist support from nursing and non-nursing colleagues from the unit.

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

A nurse is providing care to an older adult client. The client has been alert and independent with ambulation but now is exhibiting some confusion along with being unsteady when getting out of bed and walking. The nurse fails to report and document this change in status. No safety measures are taken and the client falls while getting out of bed to use the bathroom and fractures a hip. The client is experiencing significant pain from the fractured hip and requires surgery to repair the fracture. The nurse is sued for malpractice. Which action reflects the element of causation in this case? Lack of safety measures implemented with status change Failure to document and report the change Fractured hip, pain, and need for surgery Responsibility to report changes in status

Lack of safety measures implemented with status change

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. The second nurse could be charged with libel. No charges are valid because both nurses are involved in the client's care. No charges are valid because the revelation took place during off-duty hours and off-site.

The first nurse could be charged with slander.

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 informs the family about advance directives. The nurse confirms that the client's family has signed the consent form. The nurse confirms that the client has signed the consent form. The nurse informs the family about the living will.

The nurse confirms that the client's family has signed the consent form.

The new nurse is being oriented to the unit and is assigned an experienced nurse to work with during the orientation. What are positive modeling experiences for the new nurse? Select all that apply. The nurse organizes the day by obtaining reports, completing assessments, charting the assessments, and administering 0900 medications starting at 0830. The nurse contacts the primary care provider to clarify a new prescription for a medication dose. The nurse does not respond to the call light of the client who frequently requests medications for unrelieved pain. The nurse enters the room to administer medications and interrupts the hospice intake nurse providing information to a terminally ill client and family. The experienced nurse tells the new nurse, "I do all my charting at the end of the shift. Point-of-care charting takes too much time away from my clients."

The nurse organizes the day by obtaining reports, completing assessments, charting the assessments, and administering 0900 medications starting at 0830. The nurse contacts the primary care provider to clarify a new prescription for a medication dose.

A health care provider is called to see a client with angina. During the visit the health care provider advises the nurse to decrease the client's atenolol to 12.5 mg daily. However, since the health care provider is late for another visit, the health care provider requests that the nurse write down the order and sign it. What should be the appropriate nursing action in this situation? The nurse should implement the order and monitor the client closely. The nurse should discuss the order with a pharmacist. The nurse should ask the health care provider to come back and write the order. The nurse should inform the client of the change in medication.

The nurse should ask the health care provider to come back and write the order.

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 health care provider. 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 warn the client that the client cannot come to the hospital again. The nurse should call and inform the nursing supervisor of the situation. The nurse should have the client restrained and call the health care provider. The nurse should let the client go because the nurse cannot do anything

The nurse should call and inform the nursing supervisor of the situation.