Chapter 5: Legal and Ethical Issues
Several times, family members have asked a nurse to share personal prescriptions when they were in need of pain medication or antibiotics. Which type of rules or standards should govern the nurse's moral decision?
ethics
A nurse in a hospice facility cares for clients with terminal illnesses and witnesses a great deal of pain and emotional distress. Which factor that affects healthcare ethics determines how the nurse must respond when a client asks for help in ending his or her suffering?
legislative and judicial decisions
A nurse administers a dose of the wrong antibiotic to a client who has a severe allergic reaction within an hour. Which term describes the nurse's legal responsibility for the harm that resulted from this action?
liability
After working a lot of overtime, a nurse does not shovel their sidewalk after the most recent snow and someone falls on the snow-covered sidewalk and brings suit against the nurse. What type of tort would be involved?
unintentional tort
Federal and state governments carefully regulate the treatment given in licensed healthcare facilities, particularly long-term care facilities, because of clients':
vulnerability.
A nurse has often had the opportunity to share personal prescriptions with family members when they were in need of pain medication or antibiotics. Which area of rules should govern the nurse's moral decision?
ethics
The nurse moves a confused, disruptive patient to a private room at the end of the hall so that other patients can rest, even though the confused patient becomes more agitated. The nurse's intervention is consistent with what moral theory?
"Consequentialism," by which good consequences for the greatest number are maximized
Telling the truth (veracity) is one of the basic principles of North American culture. Three ethical dilemmas in clinical practice can directly conflict with this principle. Choose the three from the list below.
Revealing a diagnosis to people other than the client with the diagnosis Using placebos Not revealing a diagnosis to a client
Which of the following best describes the utilitarian theory of ethics?
The consequences of an action determine if it is right or wrong.
Which of the following aspects of nursing would be most likely defined by legislation at a state level?
The differences in the scope of practice between registered nurses (RNs) and licensed practical nurses (LPNs).
Which of the following clinical events is addressed by the provisions of the Health Insurance Portability and Accountability Act (HIPAA)?
A patient believes that the healthcare team is withholding information about her diagnosis and wishes to read her medical chart
In the past several years, the number of malpractice suits against nurses has increased. Many reasons contribute to the increase in litigation. Which measures can limit or reduce a nurse's liability?
All of the responses are correct.
Which professional values apply to the nursing profession?
All of the responses are correct.
A nurse exits the room of a confused patient without raising the side rails on the bed. The failure to raise the side rails would be which of the following elements of liability related to malpractice?
Breach of duty
The patient has become confused and attempts to climb out of bed. What interventions can the nurse provide prior to using restraints?
Ask a family member to sit with the patient.
Guidelines assist nurses in ethical decision making. The nurse knows that the following steps are involved in this process. Select all that apply.
Assess the ethical/moral situations of the problem. Collect information. List the alternatives. Decide and evaluate the decision.
An 83-year-old woman who has suffered a cerebrovascular accident and is unable to swallow refuses the insertion of a feeding tube. This is an example of what ethical principle?
Autonomy
The nurse prepares to administer medication to the patient. The patient states, "I would prefer not to take that medication until I speak with my physician." The nurse honors the patient's desire to make decisions, following which common ethical principle?
Autonomy
A registered nurse enters a patient's room and observes the nursing assistant pushing a patient down on the bed. The patient starts crying and informs the nursing assistant that he needs to go to the bathroom. The nursing assistant holds the patient down and tells him he was just in the bathroom. The nurse observing this incident is aware that the nursing assistant's action is an example of which of the following?
Battery
A nurse is caring for a 28-year-old woman who has delivered a baby by Cesarean section. She describes her pain as a nine. The nurse medicates her for pain. This is an example of which of the following ethical frameworks?
Beneficence
A nurse provides patient care within a philosophy of ethical decision making and professional expectations. What is the nurse using as a framework for practice?
Code of Ethics
The differences in the scope of practice between registered nurses (RNs) and licensed practical nurses (LPNs).
Define the issue as clearly as possible. List all possible options for solving the dilemma; do not determine the consequences at this point. Examine pros and cons of each option, foreseeing possible consequences from both a utilitarian and a deontologic approach; consider the effects on the individual. Make the decision and follow through on it. Evaluate the decision in terms of effects and results.
Healthcare providers use a problem-solving approach for ethical dilemmas. Which is the last step of the ethical decision-making model?
Evaluate the decision in terms of effects and results.
An HIV-positive client discovers that his name is published in a research report on HIV care prepared by his nurse. He is hurt and files a lawsuit against her. Which of the following offenses has the nurse committed?
Invasion of privacy
The foundation for decisions about resource allocation throughout a society or group is based on the ethical principle of
Justice
A physician is being sued for malpractice in a case involving a birth accident. What circumstance determines whether the suit is a negligence or malpractice suit?
None of the options is correct.
The nurse is caring for a client who is withdrawing from heavy alcohol use and who is consequently combative and confused, despite the administration of benzodiazepines. The client has a fractured hip that he suffered in a traumatic accident and is trying to get out of bed. What is the most appropriate action for the nurse to take?
Obtain a physician's order to restrain the client.
Nurse Practice Acts are examples of which type of laws?
Statutory law
A client is brought 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 ensures that the client's family signs the consent form.
A nurse is working with a physician and client to complete the informed consent process. Place the steps in the correct order in which they would proceed.
The physician informs the client of the treatment proposed, potential benefits, material risk involved, acceptable alternatives available, expected outcome, and consequences if treatment is not done. The nurse makes certain that the client understands the necessary information. Competent adult signs consent form. The nurse witnesses the signature.
A patient gets out of bed following hip surgery and falls and re-injures her hip. The nurse caring for her knows that it is her duty to make sure an incident report is filed. Which of the following statements accurately describes the correct procedure for filing an incident report?
The report should contain all the variables related to the incident.
A nurse chooses a quiet, private area to conduct an end-of-shift report to the oncoming nurse. Following this procedure is necessary because of what ethical problem in nursing?
The right of confidentiality is essential to protect each client's private information.
A client wants to sue a nurse for an incident that happened several years ago. Upon consulting with a lawyer, the nurse learns that there is no likelihood that the suit will continue. What is the most likely reason?
The statute of limitations has expired.
A client is confused about advance directives and asks the nurse to explain them. What information will the nurse include in client teaching about advance directives? Select all that apply.
They provide information about client wishes for health care situations. They may contain a living will.
Which of the following actions is not consistent with a nurse attempting to maintain a client's privacy?
Using the client's first name and last initial in written reports or research papers.
When the nurse voices preference for the funding of services that assist many clients in his community over services that assist a small group of in the community is noted as a(an)
Utilitarian framework
When an ethical decision is made based on the reasoning of the "greatest good for the greatest number," what theory is the nurse following?
Utilitarian theory
A client has just been told she has cancer. The client tells the nurse that she is not sure if she wants her family to know. The nurse encourages the client to consider sharing this information with her family members so they can support her through future treatment-related decisions. What ethical principle is the nurse demonstrating?
Veracity
When a nurse answers questions posed by a cancer client in a thorough and accurate manner, the nurse is demonstrating the ethical principle of
Veracity
Which of the following phrases best describes a value?
a belief about the worth of something to guide behavior
The nurse understands that the sharing of personal prescriptions, especially narcotic pain medication, violates a number of local, state, and federal regulations. Specifically referring to nursing licensure, which area of law would be violated?
administrative law
A client has been a resident of a long-term care facility for several years. The client's condition has deteriorated to the point that the client is now unable to eat. The physician has recommended surgical implantation of a feeding tube. The client's family has a legal document outlining the client's wishes in regard to measures such as this. What is this document?
advance directive
A patient tells the nurse that he does not want to have a painful procedure. By respecting and supporting the patient's right to make decisions, what is the nurse demonstrating?
advocacy
A patient nearing the end of life requests that he be given no food or fluids. The physician orders the insertion of a nasogastric tube to feed the patient. What situation does this create for the nurse providing care?
an ethical dilemma about inconsistent courses of action
A nurse who has been working a lot of overtime didn't shovel the sidewalk after a recent snow. A person walking down the street fell on the snow-covered sidewalk and brought suit against the nurse for negligence. Negligence is categorized as:
an unintentional tort.
A client at a long-term care facility has a history of dementia and frequently uses the call light without reason. On a very hectic night, the client calls the nurse for the third time in an hour and responds to the nurse's arrival with the question, "What do you want?" In frustration, the nurse instructs the client that further imporper use of her call light will necessitate restraint of the client's hands. What crime has just been committed?
assault
a client who lives in long-term care has a history of dementia and frequently uses the call light without reason. After summoning a nurse for the third time in an hour, the nurse tells the client that continuing to needlessly use the call light will result in the client's hands being restrained. The nurse's actions are subject to prosecution for which charge?
assault
A nurse warns a client that he may fall off his bed during a seizure attack if he does not put on the side rails of the bed. Before leaving the client's room, the nurse puts on the side rails, but after the nurse has left, the client lowers them again. Later, the client has a fall from the bed during seizures and holds the nurse responsible for it. Which of the following legal provisions protects the nurse in this case?
assumption of risk
A client with a history of drug and alcohol abuse entered a rehab program. The second night after admission the client became violent and began throwing furniture while halucinating. Which information should the nurse document when physical force is used to subdue a client endangering the safety of others?
behavior that resulted in use of force
In the past several years, the number of malpractice suits against nurses has increased. Many reasons contribute to the increase in litigation. What is a nurse's best deterrent to being sued for malpractice?
closely complying with standards of care
A nurse was subpoenaed to testify in a malpractice suit brought against a friend who is an LPN who works on the same unit. The jury will determine if there was malpractice by
comparing the actions of the nurse with the standard expected of the nurse's peers.
A nurse has been subpoenaed to testify in a malpractice suit brought against an LV/PN coworker. The jury will determine if there was malpractice by:
comparing the actions of the nurse with those of the nurse's peers.
Several days this week, a nurse takes time after work to read to a visually impaired client who has no family close by. This behavior demonstrates that ethical values:
concern the treatment of others.
A physician's methods and outcomes are frequently the topic of conversation among the nursing staff. Often, staff will second-guess the physician's diagnoses and treatments. What tort is being committed each time staff members criticize the physician's perceived abilities in public
defamation
A physician's methods and outcomes are frequently the topic of conversation among the nursing staff. They often second-guess the physician's diagnoses and treatments. Which tort is being committed when staff members criticize the physician's abilities in public?
defamation
Which written medical instruction explicitly states that no action should be taken to revive a client if he or she experiences cardiac arrest?
do-not-resuscitate order
A nurse provided nursing care ten years ago to a client who was diagnosed with prostate cancer. Last week the nurse received notification that suit was being brought by the client's family against the hospital, the oncologist, and nurses who provided care. The suit claimed the diagnosis was not completed quickly enough to prevent the client's death (nine years later). Which measure to limit professional liability could offer the physician and nurses some peace of mind?
statute of limitations