Module 5 EAQ's

The nurse forgets to administer prescribed medication to a patient who has undergone surgery. The nurse finds that the patient is in severe pain, rectifies the mistake, and reports the mistake to the supervising nurse. Which ethical practice is exemplified by this action?

Accountability

State Board of Nursing

Administrative body(to establish regulatory laws) given authority from the state legislatures to outline how requirements of statutory laws will be met. Decides nursing liscensing.

Which best represents the dominant values in American society on individual autonomy and self-determination?

Advance directive

Which ethical principles are included in the professional nursing code of ethics?

Advocacy Responsibility Accountability

Advance Directives

Consists of living will, Durable power of attorney, and health care proxy

A terminally ill patient does not want to be resuscitated if complications arise. Which document would record the patient's wishes regarding the treatment?

Living will

Advocacy

Promoting the interests of others

A nurse is conducting an assessment of a 65-year-old male patient admitted to the medical-surgical unit. The patient tells the nurse that his urine smells of ammonia. Which of the following may be causing this smell?

Renal failure Urinary tract infection

When teaching nursing students about malpractice, what should be taught as essential criteria that establish nursing malpractice?

The nurse owed a duty to a patient The nurse did not follow an ordered intervention for a patient. The nurse's failure to carry out the duty caused an injury to the patient.

The nurse educator has been treated disrespectfully by peers and students and is experiencing insomnia, severe stress, and depression. Which strategies should the nurse educator use to cope with incivility in the academic setting?

Use the terms 'please' and 'thank you' while interacting. Refrain from talking about people who are not present. Treat peers respectfully on a consistent basis.

civility

acting politely and respectfully

Code of Ethics

statement of the ethical values, obligations, duties, and professional ideals of nurses. Written by the ANA.

Justice

to act fairly and equitably

Veracity

truthfulness

Intentional Torts

wrongs committed by individuals who deliberately seek to injure someone ex: assault, battery, false imprisonment

The nurse is teaching a patient how to perform a testicular self-examination. Which statement by the nurse is correct?

"The testes are normally round and feel smooth and rubbery."

An occupational nurse is speaking to a patient who has started a new job after working for a company for six months. The patient is worried about losing health insurance. What advice should the nurse give to the patient?

"You should apply for your new health plan as soon as possible."

A nurse works in an emergency room. An 8-year-old girl is brought to the hospital with severe abdominal pain. The nurse has to get consent before medical treatment can begin. The parents of the child are divorced and the mother has custody. The patient is accompanied by her mother, father, and sister, who is 19 years old. What information should be provided to the patient's guardian before she gives her consent?

A complete explanation of the procedure or treatment Names and qualifications of the people performing the treatment A description of possible adverse effects or side effects of the treatment

Which patients would require a physical restraint?

A patient who persistently displaces a urinary catheter An aggressive patient who has an intravenous line

A public health nurse is conducting a health camp in a remote rural area. She has assessed the skin turgor of all patients as part of a total health checkup. How do certain conditions affect skin turgor?

Age is indirectly proportional to skin turgor. Body fluid levels regulate skin turgor. Dehydration decreases skin turgor.

The nurse is caring for a patient with a chronic illness. The nurse finds that the patient is depressed in the hospital environment and frequently demands to go home. The primary health care provider feels that the patient is not well enough to be discharged. What is the best nursing intervention in this situation?

Ask the patient to sign an against-medical-advice (AMA) form

A nurse attends to a trauma patient who has been transferred from the ICU. The nurse finds out that an ICU nurse provided a detailed explanation on the patient's condition to the family without consent from the patient. The ICU nurse also gave the patient a steroid shot even though the patient refused the medication. Which torts would the ICU nurse be guilty of?

Battery Invasion of privacy

You are floated to work on a nursing unit where you are given an assignment that is beyond your capability. What is the best nursing action to take first?

Call the nursing supervisor to discuss the situation

Healthcare institutions establish ethics committees to process ethical dilemmas. What are the purposes of ethics committees?

Case consultation Policy recommendation Education

An older patient says, "I am unable to hear properly when somebody talks near my left ear." The nurse finds that the patient has otosclerosis in the ear. Which type of hearing loss does the nurse anticipate in this patient?

Conductive hearing loss

A code of ethics is a set of guiding principles that all members of a profession are held accountable for. Under which ethical principle is the patient's personal health information protected? Choose the best answer.

Confidentiality

You are participating in a clinical care coordination conference for a patient with terminal cancer. You talk with your colleagues about using the nursing code of ethics for professional registered nurses to guide care decisions. A nonnursing colleague asks about this code. Which of the following statements best describes this code?

Defines the principles of right and wrong to provide patient care

The nurse is caring for a patient in a coma. The nurse is reading the living will of the patient. Which information does the nurse obtain from this document?

Desire for organ donation Consent for performing an autopsy Designation of a spokesperson

A nurse finds that a patient's breath has a sweet and fruity odor. Which of the following might be the cause?

Diabetic acidosis

You are the night shift nurse and are caring for a newly admitted patient who appears to be confused. The family asks to see the patient's medical record. What is the first nursing action to take?

Discuss the issues that concern the family with them

Utilitarianism

Doesn't matter what you do to get the right outcome as long as it's the right outcome.

Which documents are included under advance directives?

Durable power of attorney Living will Health care proxy

A nursing student has learned about advance directives for healthcare. Which documents should the student classify as advance directives?

Durable powers of attorney for health care Healthcare proxies Living wills

A patient is preoccupied with the feeling that she suffers from breast cancer. She asks the nurse to insist that the healthcare provider perform a mastectomy. Following several tests, the nurse finds that the patient has no symptoms of, or risk factors for, breast cancer. What nursing interventions are ethical for this patient? Multiple selection question

Educate the patient on self-examination and mammography. Convince the patient about her health status and promote acceptance. Educate the patient about the risk factors of breast cancer.

A nurse is learning about negligence in unintentional torts. Which actions would the nurse consider as common acts of negligence?

Failure to document monitoring Failure to follow policies and guidelines Failure to follow orders

HIPPA

Federal law to protect the privacy of health care information

A nurse notes that the health care unit keeps a listing of the patient names at the front desk in easy view for health care providers to more efficiently locate the patient. The nurse talks with the nursing manager because this action is a violation of which act?

Health Insurance Portability and Accountability Act (HIPAA)

A nurse is reviewing the history of a patient to assess the risk factors for osteoporosis. What factors may indicate increased risk of osteoporosis?

History of cigarette smoking History of sedentary lifestyle History of menopause before 45 years of age

The nurse finds that an elderly patient has a sudden onset of confusion. What could be the possible causes that the nurse should review in the patient history?

Infections Drug history Heart failure

A nurse is assessing a patient who has multiple myeloma and is in need of a bone marrow transplant. This patient does not have health insurance and cannot pay out-of-pocket for the procedure. Which ethical principle should be discussed regarding the patient's condition? Multiple choice question

Justice

A female patient has just been diagnosed with hepatitis B. What is the most appropriate nursing action to avoid invasion of privacy?

Obtain permission from the patient to inform the patient's husband about the disease

Unintentional Torts

Omissions or acts by individuals that cause unintentional harm. ex: Negligence(failure to do) and malpractice (fails to meet standards of care)

The patient is assessed for range of joint movement. He or she is unable to move the right arm above the shoulder. How should the nurse document this finding?

Patient's abduction of right arm was limited to 100 degrees.

A patient is diagnosed with breast cancer. The healthcare provider educates the patient about the treatment options. The healthcare provider recommends and highly favors chemotherapy; however the patient chooses to undergo surgery. What is the most appropriate intervention?

Prepare the patient for surgery

What is the most common cause of nipple discharge in a nonpregnant patient?

Presence of a tumor

The nurse is caring for a patient in the terminal stage of cancer. The patient tells the nurse, "I can't bear the pain anymore; I want to commit suicide." Which intervention provided by the nurse satisfies the American Nurses Association (ANA) code of ethics?

Providing end-of-life care to the patient to alleviate pain

A nurse is learning about the legal implications in nursing practice. Which statements are true about the various sources of law?

Regulatory law reflects decisions made by administrative bodies when they pass rules. Criminal laws protect society by providing punishment for crimes. Civil laws protect the rights of individuals in the society.

Which activities of the nurse indicate malpractice?

Sharing the patient's health information publicly Administering a drug despite a documented patient allergy Engaging in sexual activity with the patient

A nurse is assessing a patient's heart and lungs. Which positions are usually recommended for this?

Sitting position Lateral recumbent position

Good Samaritan Act

State laws protection for physicians and health care professionals who provide emergency care at the scene

A nurse is planning care for a patient going to surgery. Who is responsible for informing the patient about the surgery along with possible risks, complications, and benefits?

Surgeon

A patient reports a painless, solid mass on the anterior aspect of the testis to the nurse. What would the nurse most likely suspect?

Testicular cancer

The nurse inspects a patient's nails and finds that the nails have concave curves. What could the nurse infer from this observation?

The patient has anemia

A nurse attends to a patient who sustained injuries when crossing the street. The patient was hit by a car, which failed to stop at a stop sign. The patient was rushed to the emergency department and then to surgery to repair injuries. After surgery, the patient was transferred to the medical-surgical unit for postsurgical management. The healthcare provider informs the nurse that the patient has a durable power of attorney for health care (DPAHC). What should the nurse interpret this as?

The patient has designated a person who makes healthcare decisions for him when he is not able to make decisions. The patient has designated a person who is solely responsible for making healthcare decisions for him according to his wishes.

Resolution of an ethical dilemma involves discussion with the patient, the patient's family, and participants from all healthcare disciplines. Which of the following describes the role of the nurse in the resolution of ethical dilemmas?

To articulate his or her unique point of view, including knowledge based on clinical and psychosocial observations

The nurse is caring for a patient who underwent surgery for cardiac valve replacement. The primary health care provider refers the patient to a dentist. What is the priority reason for suggesting dental care for this patient?

To prevent infective endocarditis

Accountability

accept responsibility

Responsibility

being dependable and reliable

Nonmalefisence

do no harm

beneficence

doing good

Deontology

doing the right thing because it you need to.

Autonomy

freedom to make decisions supported by knowledge

Fidelity

keeping promises or agreements

Confidentiality

limits sharing of private information

Informed Consent

permission granted by a patient after discussing a procedure