PVC exam

A new graduate nurse asks the nurse mentor what is a good guideline to help nurses effectively avoid liability. How does the nurse mentor appropriately respond?

"Practice within the scope of the Nurse Practice Act"

1. What is the scope of practice for an LPN?

It is what the LPN is allowed to do. The state board of nursing is the group that determines the scope of practice. Also, each hospital can limit what the nurses are allowed to do.

1. Can a client refuse their treatment at any time, and why?

Yes, they can at any time because it is their body and they have complete control over it, even if they have already signed consent

Autonomy means all of the following except:

Having patients do whatever they want

Upon a client's entering the hospital system, the nurse discusses the rights and responsibilties that the client is entitled to in the institution. The information the nurse discusses is commonly referred to as

A patient's bill of rights

An employee health nurse is assisting a stressed, working mother with value clarification. Which of the following best defines value clarification?

A process by which people come to understand their own values and value systems.

What makes something an ethical dilemma and what steps do you take to "fix it"?

An ethical dilemma is when there is no ideal way to fix the issue, but you have to choose what the best option is even if they break moral principles (Knecht, 2017). The best way to fix it is to adhere to the ethical principles of nonmaleficence, beneficence, autonomy, fidelity, and justice.

value

a belief about the worth or importance of something that acts as a standard to guide one's behavior

Nonmaleficence

duty to do no harm

Justice

fairness

Fidelity

faithfulness; loyalty

Integrity

honesty, high moral standards

Utilitarianism

idea that the goal of society should be to bring about the greatest happiness for the greatest number of people

advocate

to recommend; to speak in favor of

Veracity

truthfulness, honesty

For a hospitalized client, the physician prescribes hydromorphone (Dilaudid) I.M. every 4 hours as needed for pain. However, the client refuses to take injections. Which nursing action is most appropriate?

Calling the physician to request pain medication that isn't administered IM

Beneficence

Doing good or causing good to be done; kindly action

which of the following statements by the nurse would be helpful when a nurse is assisting clients clarifying their values?

"Some people might have made a different decision. What led you to make your decision?"

The nurse is serving on the hospital ethics committee which is considering the ethics of a proposal for the nursing staff to search the room of a client diagnosed with substance abuse while he is off the unit and without his knowledge. Which of the following should be considered concerning the relationship of ethical and legal standards of behavior?

Ethical standards are generally higher than those required by law.

In the delivery of care, the nurse acts in accordance with nursing standards and the code of ethics and reports a medication error that she has made. The nurse is most clearly demonstrating which of the following professional values?

Integrity

The guidelines for evaluating registered nurse professional conduct are contained in the:

Standards of Care.

What is the ANA and what function do they serve for nursing?

The ANA is the American Nurses Association, and they protect, promote, and prevent illness and injury. They advocate for the care of individuals, families, communities, and populations

1. As a nurse, who is our first loyalty to always?

The patient

Quality Assurance

The use of quality control techniques associated with a process.

A nurse is discussing principles in healthcare ethics with the nursing students. Which of the following would be an appropriate example of nonmaleficence?

To protect clients from a chemically impaired practitioner.

A nurse immediately tells the truth about a medication error that she made. This nurse is following which ethical principle?

Veracity

A group of nursing students are reviewing current nursing codes of ethics. Such as code is important in the nursing profession because:

Nursing practice involves numerous interactions between laws and individual values.

The nursing staff is divided over withdrawing care from a competent, chronically ill client. The nurse manager should take which step to meet the needs of her staff?

Reinforce to the staff the decision is the client's to make.

Parents refuse to permit withdrawal of life support from the child with no apparent brain function. Although the nurse believes that the child should be allowed to die and organ donations considered, the nurse supports their decision. Which moral principle provides the best basis for the nurse's actions?

Respect for autonomy

A client rings a call bell to request pain medication. Upon performing the pain assessment, the nurse informs the client that she will return with the pain medication. The nurse's promise to return with the pain medication is an example of which principle of bioethics?

Fidelity

After recovering from her hip replacement, an elderly client wants to go home. The family want the client to go to a nursing home. If the nurse is acting as a client advocate, the nurse would perform which of the following actions?

Help the client and family communicate their views to each other.

Explain what Evidenced-based Practice is and how it affects the nurse/client relationship?

It's when the nurse can best integrate current evidence with clinical expertise and patient/family preferences and values for delivery of optimal healthcare. It affects the nurse/client relationship in a positive way because the nurse will get to know the client much better.

Parents of a neonate born with severe congenital anomalies have requested that the staff institute a do-not-resituate (DNR) order. While working with this family, the nurse applies the ethical principle of autonomy by:

Making sure the parents are well informed about that infant's condition and that they've made an informed decision

How do moral and ethical decisions differ from legal decisions?

Moral and ethical decisions differ from legal decisions because they are more personally based. Legal decisions are the law and must be followed, as well as they reflect the morals and values of a society and offer guidance

When an ethical issue arises, one of the most important nursing responsibilities in managing client care situations with which of the following?

Be able to defend the morality of one's own actions

Which of the following represents a breach of the nursing code of ethics regarding the rights of clients in psychiatric care situations?

Nurse discusses with a friend the progress of a local celebrity being cared for at the hospital.

Quality Improvement

Search for new ways to improve patient care, prevent errors, and identify and fix problems

The children of a 78-year-old female patient with a recent diagnosis of early-stage Alzheimer's disease are attempting to convince their mother to move into an assisted living facility, a move to which the patient is vehemently opposed. Both the patient and her children have expressed to the nurse how they are entrenched in their position. Which of the following statements expresses a utilitarian approach to this dilemma?

The decision should be made in light of consequences

A nurse who works on a palliative care unit has participated in several clinical scenarios that have required the application of ethics. Ethics is best described as:

The principles that determine whether an act is right or wrong.

Where can you look to see what you can legally do as an LPN?

They act in the state they are employed in, so the State Board of Nursing would be a good place, or the hospitals policies

What is the State Board of Nursing responsible for?

They are responsible for their own state's licensing for qualified candidates, scope of practice, and they make the standards for safe nursing care for that state

What are the Standards of Nursing Practice?

They are the responsibilities for which nurses are held accountable for, developed by the ANA, and generic nature

Which of the following situations is most clearly a violation of the underlying principles associated with nursing ethics?

When asked about the purpose of a medication, a nurse colleague responds, "Oh, I never look them up. I just give what is prescribed orders."

Accountability

Willingness to take credit and blame for actions.

Shared Governance

a method that aims to distribute decision making among a group of people

Autonomy

control over personal decisions

A client with metastatic brain cancer is admitted to the oncology floor. According to the self determination act of 1991 concerning the execution of an advance directive, the hospital is required to

inform the client or legal guardian of their rights to execute an advance directive.

informed consent

process of presenting clients with information about the benefits, risks, and side effects of specific treatments, thus enabling the client to make voluntary and competent decisions about their care.