Exam 4 Review

A nurse is caring for a 7-year old with appendicitis and multiple bruises. The nurse suspects the child is being abused. What should the nurse do? -SATA 1. Document all the physical findings 2. Question the mother 3. Notify the physician 4. Report the case to authorities 5. Discuss it with another nurse

1,3,4

The patient with severe metabolic abnormalities needs a PICC line inserted. The nurse tells the patient that informed consent is required. The patient asks why consent is needed. The best response for the patient would include the following: -SATA 1. To be fully informed, you need to be aware of the risk and benefits of the procedure 2. We need consent unless it is an emergency 3. You need to understand how dangerous the procedure is 4. The joint commission requires is 5. The consent ensures that you have made an informed decision based on the indications for the procedure and alternatives you have.

1,5

A client is referred to a surgeon by the healthcare provider. After meeting the surgeon, the client decides to consult with a different surgeon about treatment options. The nurse supports the clients action, utilizing which ethical principle? 1. Beneficence 2. Veracity 3. Autonomy 4. Privacy

3

A client with cancer has decided to discontinue further treatment. Although the nurse would like the client to continue treatment, the nurse recognizes the client is competent and supports the client's decision using which ethical princicple? 1. Justice 2. Fidelity 3. Autonomy 4. Confidentiality

3

The nurse hears a client calling out for help, hurries down the hallway to the client's room, and finds the client lying on the floor. The nurse performs an assessment, assists the client back to bed, notifies the health care provider of the incident, and completes an incident report. Which statement should the nurse document on the incident report? 1. The client fell out of bed. 2. The client climbed over the side rails. 3. The client was found lying on the floor. 4. The client became restless and tried to get out of bed.

3

The nurse who works on the nightshift enters the medication room and finds a coworker with a tourniquet wrapped around her arm. The coworker is about to insert a needle attached to a syringe containing clear liquid, in the antecubital area. Which is the most appropriate action by the nurse? 1. Call security 2.Call the police 3. Call the nursing supervisor 4. Lock the coworker in the medication room until help is obtained.

3

A nurse and teacher are discussing legal issues related to the practice of their professions. The teacher asks what the functions are of the Nurse Practice Act (NPA) in that state. The nurse would include which thoughts in a response? SATA 1. Accredit schools of nursing 2. Enforce ethical standards of behavior 3. Protect the public 4. Define the scope of nursing practice 5. Determine liability insurance rates

3,4

The nurse working in an acute care environment would utilize which strategies to reduce the risk of malpractice litigation? SATA 1. Discuss any errors with the client and family in detail 2. Keep incident reports on file 3. Maintain expertise in practice 4. Offer opinions to client's when the situation warrants 5. Report unsafe staffing levels to the supervisor

3,5

A hospitalized client tells the nurse that a living wil is being prepared and that the lawyer will be bringing the will to the hospital today for witness signatures. The client asks the nurse for assistance obtaining a witness to the will. What is the most appropriate response to the client? 1. I will sign as a witness to your signature 2. You will need to find a witness of your own. 3. Whoever is available at the time will sign as a witness for you 4. I will call the nursing supervisor to seek assistance regarding your request.

4

A patient wished to have DNR to prevent heroic measures in the event of a cardiac or respiratory arrest. Which of the following principles is the nurse upholding by supporting the decision? 1. Justice 2. Beneficence 3. Nonmaleficence 4. Autonomy

4

A nurse is caring for a client who is about to undergo an elective surgical procedure. The nurse should take which of the following actions regarding informed consent. SATA A. Make sure the surgeon obtained the clients consent B. Witness the client's signature on the consent form C. Explain the risks and benefits of the procedure D. Describe the consequences of choosing to not have the surgery E. Tell the client about the alternatives to having the surgery

A, B

A nurse threatens to place a NG tube in a client who is refusing to eat. What is this an example of?

Assault

A nurse is caring for a client who decides not to have surgery despite significant blockages of the coronary arteries. The nurse understands that this client's choice is an example of which of the following ethical principles? A. Beneficence B. Autonomy C. Justice D. Nonmaleficence

B

A nurse is caring for a competent adult who tells the nurse, "I am leaving the hospital this morning whether the doctor discharges me or not." The nurse believes that this is not in the client's best interest and prepares to administer a PRN sedative medication the client has not requested along with the scheduled morning medication. Which of the following types of tort is the nurse about to commit? A. Assault B. False imprisonment C. Negligence D. Breach of confidentiality

B

A nurse uses restraints on a competent client to prevent them leaving the health care facility What is this an example of?

False imprisonment

A physician allows students to watch a procedure without asking the patient first. What is this an example of?

Invasion of privacy

A nurse administers a large dose of medication due to a calculation error. The patient goes into cardiac arrest and dies. What is this an example of?

malpractice-unintentional tort

A nurse fails to implement safety measures for a client at risk for falls. What is this an example of?

negligence-unintentional tort

A nurse forgets to administer a client's diuretic and the client experiences an episode of pulmonary edema. The charge nurse would consider the medication error to constitute negligence because the situation contains which element? 1. Purposeful failure to perform a health care procedure 2. Unintentional failure to perform a health care procedure 3. Act of substituting a different medication for the one ordered 4. Failure to follow a direct order by a physician

2

A client who takes warfarin is given aspiring for a headache while visiting a neighbor, who is a nurse. The client subsequently has a bleeding episode caused by an interaction of these drugs. The legal nurse consultant interprets which elements of malpractice are missing from this case? SATA 1. Breach of duty 2. Duty owed 3. Injury experienced 4. Causation between nurse's action and injury 5. Intent to cause harm or injury

2,5

A client is brought to the emergency department by the EMS after being hit by a car. The name of the client is unknown, and the client has sustained a sever head injury and multiple fractures and is unconscious. An emergency craniotomy is required. Regarding informed consent for the surgical procedure, what is the best action? 1. obtain a court order for the surgical procedure 2. ask the EMS team to sign the informed consent 3. transport the victim to the operating room for surgery 4. call the police to identify the client and locate the familt

3

A nursing instructor delivers a lecture to nursing students regarding the issue of client's rights and asks a nursing student to identify a situation that represents an invasion of client privacy. Which situation, if identified by the student, indicates an understanding of a violation of this client right? 1. Performing a procedure without consent 2. Threatening to give a client a medication 3. Telling a client that he or she cannot leave the hospital. 4. Observing care provided to a client without the client's permission.

4

An 87-year old woman is brought the the ED for treatment of a fractured arm. On assessment, the nurse notes old and new ecchymosis areas on the client's chest and legs an asks the client how the bruises were sustained. The client, although reluctant, tells the nurse in confidence that her son hits her if supper is not prepared on time when he arrives home from work. What is the most appropriate nursing response? 1. Oh really, I will discuss this situation with your son 2. Let's talk about the ways you can manage your time to prevent this from happening. 3. Do you have any friends that can help you out until you resolve these important issues with your son? 4. As a nurse, I am legally bound to report abuse. I will stay with you while you give the report and help find a safe place for you to stay.

4

The nurse arrives at work and is told to report (float) to the intensive care unit (ICU) for the day because the ICU is understaffed and needs additional nurses to care for the clients. The nurse has never worked in the ICU. The nurse should take which action first? 1. Call the hospital lawyer. 2. Refuse to float to the ICU. 3. Call the nursing supervisor. 4. Identify tasks that can be performed safely in the ICU.

4

The nurse must take a verbal order over the phone in an emergency. Which of the following steps should be taken to ensure accuracy of the phone order? 1. Ask another nurse to review the order 2. Ask another nurse to write down the order 3. Do not administer the medication until the physician signs the order 4. Read back the order to the physician

4

A nurse observes an assistive personnel reprimanding a client for not using the urinal properly. The AP tells the client that diapers will be used next time the urinal is not used properly. Which of the following torts in the AP committing? A. Assault B. Battery C. Invasion of privacy D. Breach of confidentiality

A

A nurse restrains a client and administers an injection against their wishes. What is this an example of?

Battery

A nurse in a surgeon's office is providing preoperative teaching for a client who is scheduled for surgery the following week. The client tells the nurse that "I plan to prepare my advanced directives before I come to the hospital." Which of the following statements made by the client would indicate and understanding of advanced directives. A. "I'd rather have my brother make decisions for me, but I know it has to be my wife." B. "I know they won't go ahead with the surgery unless I prepare these forms." C. "I plan to write that I don't want them to keep me on a breathing machine." D. "I will get my regular doctor to approve my plan before I hand it in at the hospital."

C

A nurse is instructing a group of newly licensed nurses about responsibilities organ donation and procurement involve. When the nurse explains that all clients waiting for a kidney have to meet the same qualifications, the newly licensed nurses should understand that this aspect of care delivery is following which ethical principle? A. Beneficence B. Autonomy C. Justice D. Nonmaleficence

C

A nurse offers pain medication to a client who is postop prior to ambulation. The nurse understands that this aspect of care delivery is an example of which of the following ethical principles? A. Nonmaleficence B. Autonomy C. Justice D. Beneficence

D

A nurse questions a medication prescription as too extreme in light of the client's advanced age and unstable status. The nurse understands that this action is an example of which of the following ethical principles? A. Beneficence B. Autonomy C. Justice D. Nonmaleficence

D