Leadership

The nurse treats the lacerations and prepares to interview Angela to gather additional subjective data about her injuries and medical history. Which action by the nurse is appropriate?

Moving Angela to a private room for the interview

Justice

: the equitable distribution of potential benefits and tasks; determining the order in which clients should be cared for

A nursing student who has been assigned to care for a client on a medical unit arrives at the unit and asks the nurse in charge for the client's medical record so that she may review it. Which action should the charge nurse take?

Asking the client for permission for the student to review the medical record

Duty

At the time of injury, the defendant had a duty to the plaintiff.

Technical and scientific changes have resulted in a multiplicity and complexity of functions placed on nurses, and sometimes job descriptions have not been rewritten. The role of the LPN/LVN is constantly:

changing.

Values

Beliefs and attitudes that may influence behavior and the process of decision-making

A health care provider writes a prescription for furosemide (Lasix), 80 mg/day by mouth, for a hospitalized client with a diagnosis of heart failure. When the nurse brings the medication to the client, the client states that he normally takes only 40 mg of the medication each day. Which action on the part of the nurse would be most appropriate?

Calling the health care provider who wrote the prescription

The health care organization that thrives would have a working environments where which practices are the norm?

Nurses are involved in decision making.

The LPN/LVN is correct when identifying that his or her license permits primarily which action?

Rendering safe nursing care to the public

Madeleine expresses concern about her condition and tells that nurse that even though her daughters would be upset, she does "not want anything done if my heart stops." Which response by the nurse is appropriate?

Reporting Madeleine's request to her health care provider

A male health care provider who has been making sexual comments to a female nurse for some time asks the nurse to help him collect equipment with which to perform a procedure on a client. While in the supply closet, he places his hands on the nurse and tells her that he would like to take her to dinner. Which action should the nurse take first to best deal with the unwanted sexual advances?

Telling the health care provider that his behavior is making her uncomfortable and that he needs to stop it immediately

A concise, one-page, comprehensive, well-organized, neat, accurate summary of educational and work experience that provides prospective employers with their first impression, is called a(n):

resumé.

Good Samaritan Laws

encourage health care professionals to assist in emergency situations without fear of being sued for the care provided —vary from state to state

Battery

intentional touching of another's body without that person's consent

Ethics

is the branch of philosophy that concerns the distinction made between right and wrong on the basis of a body of knowledge, not just on the basis of opinions.

Autonomy

respect for an individual's right to self-determination

Fidelity

the duty to do what one has promised

Invasion of Privacy

violations includes breaches of confidentiality, intrusion on private client or family matters, and sharing of client information with unauthorized persons. Refer to Lesson 23 for information on the Health Insurance Portability and Accountability Act (HIPAA).

Do Not Resuscitate (DNR)

written by a health care provider when a client has indicated a desire to be allowed to die if he or she stops breathing or his or her heart stops beating.

A contract can be written or oral, includes a set of promises between two people, and states the obligations both must fulfill. This contract establishes a relationship between the two people that is:

legal.

A setting in which a new graduate has a very good salary, the opportunity to refuse to take an assignment, and more flexibility in one's personal schedule but with an uncertainty of work availability is a(n):

temporary agency.

Beneficence

the duty to do good to others and to maintain a balance between benefit and harm (paternalism being an undesirable outcome of beneficence in which the health-care provider decides what is best for the client and attempts to encourage the client to act against his or her own choices)

Nonmaleficence

the obligation to do or cause no harm to another

Veracity

the obligation to tell the truth

One of Madeleine's daughters comes in for a visit and talks to Madeleine about her wishes. She is willing to call an attorney for assistance but asks the nurse, "What's the difference between a durable power of attorney for health care and a living will? I'm so confused!" Which of these responses by the nurse is correct? Select all that apply.

-"The client specifies who will hold the client's durable power of attorney, and that person does not have to be a family member." -"The living will is a legal document that tells the health care providers and family members what your wishes are about life-sustaining treatments if you can no longer make decisions." -"The durable power of attorney for health care is a legal document in which you name someone else to make decisions about your health care if you are no longer able to make these decisions."

Match the licensing body with its function

*Licensing law-Nurse Practice Act *Approves schools of nursing State Board of Nursing *Gives a voice to one's profession Professional Organizations *Can provdie educational and professional advancement Professional Certifications

After Madeleine talks to her health care provider, a do-not-resuscitate (DNR) order is written. However, Madeleine's daughter expresses concern: "My mother isn't near death, is she? Does this mean you're going to stop giving her medical care?" Which of these responses by the nurse are correct? Select all that apply.

-"It means that if her heart stops, she has chosen to let nature take its course rather than let us take measures to keep her alive." -"A do-not-resuscitate order does not indicate that her death is coming soon. It just helps us follow her wishes in the event that her heart does stop."

Which clients are considered legally capable of giving informed consent? Select all that apply.

-A 17-year-old who is seeking treatment for a substance abuse problem -A married 17-year-old who requires treatment for a suspected respiratory infection -A 17-year-old soldier in the U.S. Army who requires sutures for a laceration sustained while home on leave

The nurse is reviewing Angela's laboratory results and discovers that her pregnancy test result is positive. The nurse asks Angela, "When was your last menstrual period?" Angela answers, "I'm not sure. Am I pregnant?" The nurse tells Angela that the pregnancy test result was positive, and Angela starts sobbing: "That's all I need right now!" Who else should the nurse notify? Select all that apply.

-Angela's health care provider -The nurse on the oncoming shift, during report -The radiology technician who comes in to perform a chest x-ray

The nurse goes to check on Margaret and finds her crying. Margaret says, "I don't know what to do. My health care provider has just told me that I have hepatitis, and I may have given it to my family, but I don't want them to know that I have this disease! Please don't tell them—it's none of their business." Which actions by the nurse are ethically correct? Select all that apply.

-Consulting the hospital's ethics committee -Documenting what the client has said in the medical record -Telling her, "Margaret, I won't tell your family, but let's discuss what could happen if you don't tell them."

Components of A Complete Prescription

-Date and time when the prescription was written -Medication name -Medication dosage -Route of administration -Frequency of administration -Prescribing health care provider's signature

Examples of Nurse Practice Act Statutes

-Educational requirements for the nurse -Scope of nursing practice -Licensure requirements for the protection of the public -Grounds for disciplinary action Rights of the nurse licensee if a disciplinary action is taken

According to HIPAA, in which situations could a client's PHI be used or disclosed? Select all that apply.

-For treatment purposes -For health care payment purposes -To administer health care benefits -For learning purposes for medical and nursing students if the client

In which situation is the nurse functioning as an advocate? Select all that apply

-Including the client in the formulation of a nursing care plan -Ensuring that the client has been informed of the treatment plan -Sharing the client's viewpoint regarding treatment during an interdisciplinary health care conference

Which statements regarding advance directives are accurate? Select all that apply.

-On admission to a health care agency, the client must be asked about the existence of an advance directive. -The nurse is responsible for integrating the client's wishes as noted in the advance directive into the plan of care. -An advance directive is a document that supplies directions concerning the provision of care when a client is unable to

The nurse prepares to transcribe the health care providers medication prescriptions. Which of the prescriptions noted in this medication record should the nurse question? Select all that apply.

-Ramipril (Altace) 1 tablet/day by mouth -Metoprolol (Toprol) 50 mg/day -Metformin and sitagliptin (Janumet) 50 to 1000 mg twice daily

The health care industry is changing constantly as a result of rapidly developing technology. For nurses to stay current with the nursing trends and issues, he/she must: (SELECT ALL THAT APPLY)

-Read articles on nursing journals that can improve the quality of patient care -Attends seminars and conferences to meet required continuing education as well as keeping up with current research. -Network with other nurses in other facilities and other states.

Margaret's health care provider calls back to prescribe an x-ray and some blood chemistry studies. Which of these actions on the part of the nurse while taking a verbal telephone prescription is correct? Select all that apply.

-Reading back the prescriptions to the health care provider before the health care provider hangs up the phone -Writing the prescription in the client's medical record and reading back what was written to the health care provider. -Recognizing that the verbal prescription must be signed by the health care provider as soon as possible, usually within 24 hours

A nurse employed in a medical unit arrives at work and is told that she will be floated to work in the delivery room for the day because several nurses who work there have called in sick with the flu. The nurse is reluctant to float because she has never worked in the delivery room. Which action should the nurse take? Select all that apply.

-Reporting to the delivery room -Informing the supervisor of her lack of experience in caring for clients in the delivery room

A nurse is describing the situations that constitute invasion of client privacy to a group of staff members. In which situations is a nurse violating the client's privacy? Select all that apply.

-Telling a family member about the client's condition -Taking photographs of the client during the client's birthday party -Accessing a neighbor's medical record to find out about his or her health care status

A nurse is preparing to work as a volunteer at a seafood festival, in charge of the first aid tent. What does the nurse understand about working as a volunteer? Select all that apply.

-That Good Samaritan laws vary by state, and the nurse must be aware of the law in the state in which the nurse is volunteering -That the nurse will be covered by the Good Samaritan law as long as the nurse provides nursing care within acceptable standards

The nurse reviews the documentation written in the client's medical record by the student nurse. Which statements reflect incorrect documentation and require correction? Select all that apply.

-The client is a complainer and has repeatedly stated that the nurses take too long to answer his call bell. -The client's abdominal dressing was changed -The client CO pain and was given his PM

The nurse calls Margaret's health care provider to report the fall, completes an incident report, and documents the occurrence in Margaret's medical record. Which statements should be included in Margaret's medical record? Select all that apply.

-The client's health care provider was notified. -The client was found lying on the floor. -The client had no complaints of discomfort or pain after the fall

Later that evening, a newly hired nurse comes to the emergency department and states to the nurse caring for Angela, "I've been assigned to work here, but I don't have a computer password yet. May I use yours?" How should the nurse respond? Select all that apply.

-The nurse states, "No, I can't give you my password. It's against our hospital policy to share passwords." -The nurse states, "Let's call the information technology department and see what they can do about getting a password for you."

Taking a Prescription over the Phone

-Write down the date and time of the entry. -Repeat the prescription to the health care provider and record the prescription as having been obtained by telephone; next write the health care provider's name and sign the prescription. -If another nurse witnesses the prescription, that person's signature follows the signature of the nurse who takes down the prescription. -The health care provider must countersign the prescription within a certain time frame, set forth in agency policy.

Assault

-considered to have occurred when a person puts another person in fear of harmful or offensive contact -The victim fears and believes that harm will result from the threat.

When a resumé reflects too many job changes, the employer may question it. It is best to remain at the first place of employment for at least:

1 year.

Patient Self-Determination Act

A federal law passed in 1991 that requires hospitals and other health care providers to provide written information to patients regarding their rights under state law to make medical decisions and execute advance directives.

Living Will

A legal document (sample) that lists the medical treatment a client wants or does not want if he or she becomes unable to make decisions and is terminally ill

Health Care Proxy and Durable Power of Attorney for Health Care

A legal document that appoints a person or persons chosen by the client to carry out his or her wishes about health care or to make decisions on the client's behalf if and when he or she is no longer able to do so

A nurse reviewing the medical record of an assigned client notes that a do not resuscitate (DNR) order is part of the record. What does the nurse understand with regard to a DNR order?

Agency and/or state guidelines must be followed with regard to notification of the client or family about consideration of a

A 16-year-old girl arrives at the women's health center and tells the nurse that she thinks she is pregnant. The nurse obtains subjective data from the client and informs her about the laboratory procedures used to test for pregnancy. Which action should the nurse take in obtaining informed consent to treat the client?

Asking the 16-year-old girl to sign the informed consent

A nurse is caring for a client who is scheduled for surgery at 11 a.m. A member of the operating room staff calls the nurse at 9:30 a.m. and informs her that the client must be premedicated and transported to the operating room by 10 a.m. The nurse immediately administers the sedative medications as prescribed. At 10 a.m., as the nurse is getting the client ready for transport, she notes that the client has not signed the informed consent for surgery. Which action should the nurse take?

Contacting the client's surgeon

After the admission assessment, the nurse reviews Margaret's medical record and notes that the health care provider has written prescriptions. Which prescription should the nurse question?

Ibuprofen (Motrin) 400 mg every 4 hours prn

A nurse employed in the emergency department (ED) cares for a male client who has sustained a gunshot wound, but the client dies in the ED. The client, who was having a romantic affair with a married woman, was shot by the woman's husband. The nurse tells a neighbor about the incident and the affair and also reports to the neighbor that the woman's husband was arrested by the police for murder. What offense has the nurse committed by sharing this information with the neighbor?

Invasion of Privacy

A nurse manager is reviewing ethical principles with the nursing staff. Which example does the nurse manager provide to explain the concept of fidelity?

Keeping a promise made to the client

Madeleine expresses concern to the nurse about the need for having one of her daughters act as a spokeswoman in the event of an emergency should additional decisions need to be made. What should the nurse tell Madeleine?

Madeleine may appoint a person to carry out her wishes or to make decisions on her behalf if and when she is no longer able to do so.

The professional organization that specifically supports and meets the needs of the LVN/LPN is the:

National Fedreation of Licensed Practical Nurses (NFLPN)

A licensing law that defines the title and the regulations governing the practice of nursing.

Nurse Practice Act

Values Clarification

Process of analyzing one's own values to understand more completely regarding what is truly important

A nurse is gathering subjective data from a client being admitted to the hospital. The client tells the nurse that she has already prepared an advance directive. On the basis of this information, which action should the nurse take?

Requesting a copy of the advance directive and placing it in the client's medical record

malpractice

lawsuit and it is shown that neither the accepted standard of care outlined by the state nurse practice act nor the policies of the employing institution were followed, the nurse's legal liability is clear

The emergency department nurse completes the interview with Angela, and, with Angela's permission, calls a social worker to speak to her. While the social worker is talking with Angela, Angela's husband arrives at the emergency department and requests information about Angela's physical status. Which action should the nurse take initially?

Telling Angela's husband that this information cannot be shared with him

The emergency department nurse is sitting in the conference room attached to the nurses' station, using the computer to update Angela's medical record. The nurse hears the two unit secretaries, who are in the nurses' station, talking about Angela. One secretary says to the other, "Gosh, that girl has been here so many times for injuries. I wouldn't stand for that abuse. I hope she'll finally do something about that big bully." Which action on the part of the nurse is appropriate?

Telling the secretaries that Angela's information is confidential and should not be discussed

Proximate cause

The breach of the duty was the legal cause of injury to the client.

Breach of duty

The defendant failed to fulfill his or her duty of care to the plaintiff.

The nurse asks Madeleine whether she has discussed her health care decisions with her daughters. Madeleine tells the nurse that she plans to do so when they visit and that she would like to have a living will completed. Madeleine asks the nurse about the procedure for preparing a living will and wonders whether it can be done while she is in the hospital. How should the nurse respond?

The living will must be legally prepared.

After eating lunch, Margaret gets out of bed and walks to the bathroom. On her way back from the bathroom she becomes lightheaded and grabs at the overbed table, which rolls into the wall, causing Margaret to fall to the floor. The nurse rushes into the room on hearing the noise and finds Margaret lying on the floor. The nurse takes Margaret's vital signs and assesses Margaret for injuries. After determining that Margaret has sustained no further injuries, the nurse assists Margaret back into bed. Which statement indicates negligence on the part of the nurse with regard to Margaret's fall?

The nurse did not instruct Margaret in how to use the call bell.

Damage or injury

The plaintiff sustained injury, damage, or both and may be compensated under the law

The graduate may practice in another state if he or she has passed the NCLEX-PN® examination in his or her own state and meets the other state's educational requirements. This licensure from one state to another is called:

This licensure from one state to another is called endorsement.

False Imprisonment

is considered to have occurred when a client is not allowed to leave a health care facility when there is no legal justification to detain the client or when restraining devices are used without an appropriate clinical need.

Defamation

is the making of false statements that result in damage to an individual's reputation.

Nurse Practice Acts

act is a series of statutes enacted by a state legislature to regulate the practice of nursing in that state

negligence

any conduct that falls below the standard of care. This may include acts of commission as well as acts of omission.

Fraud

any deliberate deception intended to produce unlawful gain.

When expressing interest in a job, the first letter submitted should be customized, brief, neatly typed, correctly spelled, simple, and direct. The purpose is to introduce oneself and state qualifications, interest, and availability. This is called a letter of:

application.

When a nurse encounters a problem, it is best to follow the chain of command. Problems can best be resolved by:

communication.

advocate

is a person who speaks up for or acts on the behalf of the client, protects the client's right to make his or her own decisions, respects the client's decisions, and upholds the principle of fidelity

advance directives

is a written document that provides directions for the provision of care when a client is unable to make his or her own treatment choices; the two basic types of advance directives are the living will and the durable power of attorney.

A setting in which the new graduate gives total care to one patient; is totally independent; provides care in the home, hospital, or other facility; is paid directly by the patient; and is legally responsible for his or her own actions is:

private duty nursing

The primary purpose of state's requiring nurses to be licensed to practice nursing is to:

provide legal guidelines to protect the public.

ethical reasoning

to make a choice between two alternatives that are equally unsatisfactory.