HESI: advocacy/ ethical/ and legal issues

A client is presented with the treatment option of electroconvulsive therapy (ECT). After discussion with staff members, the client requests that a family member be called to help make the decision about this treatment. What ethical principle does the nurse consider when supporting the client's request? 1 Justice 2 Veracity 3 Autonomy 4 Beneficence

3

A nurse needs to obtain consent for the medical treatment of a child whose parent is a minor. What appropriate step should the nurse take to obtain consent? 1 The nurse should ask the minor to give consent. 2 The nurse should wait for the consent of the court. 3 The nurse should ask any adult siblings of the minor to give consent. 4 The nurse should ask a legal guardian of the minor to give consent.

1

A client with rheumatoid arthritis does not want the prescribed cortisone and informs the nurse. Later, when the nurse attempts to administer cortisone, the client asks what the medication is and the nurse gives an evasive answer. The client takes the medication and later discovers that it was cortisone. The client states an intent to sue. What factors in this situation must be considered in a legal action? Select all that apply. 1 Clients have a right to refuse treatment. 2 Nurses are required to answer clients truthfully. 3 The healthcare provider should have been notified. 4 The client had insufficient knowledge to make such a decision. 5 Legally prescribed medications are administered despite a client's objections.

1,2,3

Which statement accurately demonstrates an act of nursing negligence? 1 A nurse enters false information in the client's electronic health record to prolong treatment. 2 A nurse threatens to initiate intravenous therapy by force because the client refuses to give consent. 3 A nurse instructs the nursing assistive personnel to administer medication through an intravenous line. 4 A nurse informs the client's family about a surgical procedure despite the client's instructions against doing so.

3

When intimate partner violence (IPV) is suspected, the nurse plays an important role as an advocate for the victim. The advocate role includes what important components? Select all that apply. 1 Planning for future safety 2 Normalizing victimization 3 Validating the experiences 4 Promoting access to community services 5 Providing housing for the victim

1, 3, 4

A registered nurse is educating a nursing student about the utilitarian system of ethics. What information should the nurse provide? Select all that apply. 1 "The value of something is decided by its usefulness." 2 "The main emphasis is on the outcome or consequence of the action." 3 "The system examines a situation for the presence of essential right or wrong." 4 "The greatest good for the greatest number of people determines the right actions 5 "The actions can be determined whether right or wrong based on their 'right-making characteristics.'"

1,2,4

A student nurse is listing different scenarios that comply with basic healthcare ethics. Which scenarios mentioned by the student nurse relate to the healthcare ethic of fidelity? Select all that apply. 1 "A nurse monitors a client after providing nonpharmacological measures to relieve anxiety due to hospitalization." 2 "A nurse notes that the pain relief measures provided to that client have been ineffective. The nurse formulates a different plan of care." 3 "A nurse ensures that the client understands the risks and benefits of an experimental treatment before signing the appropriate consent form." 4 "A nurse carefully evaluates the advantages and disadvantages of the client's plan of care to ensure that the risks do not outweigh the benefits." 5 "A nurse is caring for a client who refuses to be touched by people of certain skin color. The nurse continues providing care since other colleagues refuse to attend to the client."

1,2,5

The spouse of a client who is dying tells the primary nurse that the client is asking the nurses to leave the pain medication on the bedside table and fears they are being saved for a suicide attempt. The nurse knows that the staff members have mixed feelings about the client's terminal status and prolonged pain. What is the most ethically appropriate intervention by the nurse? 1 Reporting the information about the medication to the nurse manager 2 Reminding the nurses that they should not leave the medication at the bedside 3 Asking the nurse manager to address the medication problem and the staff's feelings 4 Suggesting a nursing conference to discuss the medication problem and the staff's feelings

4

A nonviolent client on the psychiatric unit suddenly refuses to take the prescribed antipsychotic medication. What should the nurse do? 1 Honor the client's decision and document the behavior and all interventions. 2 Use an authoritarian approach to induce the client to take the prescribed medication. 3 Call the primary healthcare provider and request that the client be discharged against medical advice. 4 Start proceedings to have the client declared incompetent and seek a court order permitting medication.

1

A nurse in charge in the surgical intensive care unit notes that a number of clients do not seem to be responding to morphine that was administered for pain. Later in the evening the nurse finds a staff nurse dozing in the nurses' lounge. When awakened, the staff nurse appears uncoordinated and drugged, with slurred speech. What should the nurse in charge do? 1 Ask the nurse manager to be present before confronting the staff nurse. 2 Ask other staff members whether they have noticed anything unusual lately. 3 Tell the staff nurse that everyone now knows who has been stealing the morphine. 4 Arrange to secretly observe the staff nurse the next time the staff nurse administers morphine.

1

A nurse is teaching a client about false imprisonment. What information should the nurse provide? Select all that apply. 1 "False imprisonment is an example of an intentional tort." 2 "False imprisonment refers to any intentional touching without consent." 3 "False imprisonment involves restraining a person unjustly without any legal warrant." 4 "A falsely imprisoned client should be aware of his or her confinement." 5 "An unconscious client in restraints is considered to be falsely imprisoned."

1,3,4

Which initiatives for leaders and managers are set forth in the Institute of Medicine's core relevance report "The Future of Nursing?" Select all that apply. 1 Created state coalitions focused on nursing 2 Reinforced the disparities that occur within healthcare 3 Supported the concept of shared governance in nursing 4 Focused on outcomes, accreditation processes, and nurse's roles 5 Provided a framework for considering how nurses could determine staffing requirements

1,5

Which right of delegation refers to the giving of clear, concise descriptions of a task to the delegatee? 1 Right task 2 Right person 3 Right supervision 4 Right communication

4

The family of a client infected with human immunodeficiency virus (HIV) wants to see the results of the client's blood tests, unaware that the client is infected. A nurse obliges the family's request without waiting for the client's consent. What legal charge may be brought against the nurse? 1 Slander 2 Negligence 3 Invasion of privacy 4 Defamation of character

3

In what instances can a minor give consent for himself or herself for medical treatment? Select all that apply. 1 The minor can give consent for his or her siblings. 2 The minor can give consent for any venereal disease. 3 The minor can give consent if he or she is lawfully married. 4 The minor can give consent for a drug or substance abuse. 5 The minor can give consent for an abortion.

2,3,4

A client tells the nurse, "I am so worried about the results of the biopsy they took today." The nurse overhears the nursing assistant reply, "Don't worry. I'm sure everything will come out all right." What does the nurse conclude about the nursing assistant's answer? 1 It shows empathy. 2 It uses distraction. 3 It gives false reassurance. 4 It makes a value judgment.

3

A client who has a hemoglobin of 6 gm/dL (60 mmol/L) is refusing blood because of religious reasons. What is the most appropriate action by the nurse? 1 Call the chaplain to convince the client to receive the blood transfusion. 2 Discuss the case with coworkers. 3 Notify the primary healthcare provider of the client's refusal of blood products. 4 Explain to the client that they will die without the blood transfusion.

3

A nurse who lacks confidence in her performance in a new position is worried about an upcoming review with the nursing director. What type of power does the nursing director hold in this scenario? 1 Expert power 2 Position power 3 Coercive power 4 Referent power

3

A nurse's coworker approaches the nurse to inquire about the test results of a friend who is being cared for by the nurse. How should the nurse respond? 1 Answer the questions softly so other people will not hear 2 Decline to discuss the friend's medical condition. 3 Give the coworker the name of the client's primary healthcare provider, so the coworker can contact the provider instead. 4 To provide reassurance, tell the coworker of the friend's test results that are within normal limits.

2

The leader is devising a strategy to connect individuals, groups, and organizations to attune them toward a common goal. Which political strategy is the leader pursuing? 1 Negotiating 2 Building coalitions 3 Adopting an empowering attitude 4 Fostering collegiality and collaboration

2

Two 14-year-old girls are best friends and always eat lunch together at school. One of the girls eats rapidly and then immediately leaves to go to the girls' restroom. After a week or so the other girl begins to suspect that her friend is using self-induced vomiting to keep her weight down. Because the friend is not sure what to do, she speaks with a relative who is a nurse. What should the nurse encourage her to do? 1 Confront her friend with her suspicions. 2 Talk to the school nurse about her concerns. 3 Inform the girl's mother about her daughter's behavior. 4 Watch a while longer before doing anything that might ruin the friendship

2

A nurse is evaluating different situations that constitute acts of assault and battery. Which situations would the nurse consider to be instances of battery? Select all that apply. 1 A nurse threatens to restrain a client who refuses to consent to having a bath. 2 A nurse force feeds a client who refuses to eat by opening his mouth. 3 A nurse pats an aggressive client to calm him or her down without waiting for the client's consent. 4 A nurse administers an intramuscular injection to a client before obtaining consent for the injection. 5 A nurse locks a client in a private room to prevent him or her from going to the cafeteria without obtaining consent.

2,3,4

A primary nurse completes a nursing assessment of all assigned clients and develops a care plan for each client. Which element of decision-making does the nurse execute in this situation? 1 Authority 2 Autonomy 3 Responsibility 4 Accountability

3

A nurse notes that a famous client has received an incorrect dose of medication due to the malfunction of the intravenous (IV) device, but does not inform the primary healthcare provider. Instead the nurse tells a colleague that the medication could not be given due to the client's inappropriate behavior. The nurse then updates media personnel about the client's health status. What legal charges may be brought up against the nurse? Select all that apply. 1 Libel 2 Assault 3 Slander 4 Malpractice 5 Invasion of privacy

3, 4, 5

Which statements made by a terminally ill client address areas of concern regarding end-of-life nursing care? Select all that apply. 1 "I want my children to carry in my casket." 2 "I've prepaid all my funeral expenses so I won't be a burden." 3 "My living will states that I want no heroic measures to prolong my life." 4 "Pain is a concern of mine, so I've discussed that thoroughly with my doctor." 5 "I've made arrangements that will allow me to spend my final days in my own home."

3,4,5

A client asks the nurse, "Because I'm so comfortable talking with you, can we go out for coffee and a movie after I get discharged?" To maintain the boundaries of a therapeutic relationship, how will the nurse respond? 1 "I'm flattered, but that would be professionally unethical." 2 "You feel connected to me now; that will change once you are discharged." 3 "The attention I've been giving you is directed toward getting you better; it isn't social." 4 "A social life is important, so as your nurse let's talk about how you can form friendships."

4

A nurse is evaluating different situations related to obtaining informed consent. Which situation does the nurse consider to be the most appropriate method of obtaining informed consent? 1 A client consents to a medical procedure after the nurse has explained its risks and benefits in detail. 2 A client provides consent for a surgery after the primary healthcare provider gives the details of the benefits of the surgery. 3 A client consents to a medical procedure after all the details of the procedure have been provided using strictly medical terminology. 4 A client provides consent after the primary healthcare provider has given a detailed explanation of the risks, benefits, and alternatives to the procedure.

4

The client is scheduled for an abdominal hysterectomy with a bilateral oophorectomy. As the nurse prepares to have the client sign the informed consent, the client asks how long she should wait to become pregnant. Which action should the nurse take? 1 Have the client sign the informed consent form. 2 Ask the client if she understands what the surgery entails. 3 Tell the client that she will not be able to get pregnant after the surgery. 4 Call the primary healthcare provider immediately and hold preoperative medications

4

A 13-year-old who recently was suspended from school for consistently bullying other children is brought to the pediatric mental health clinic by his mother. The child is assessed by the psychiatrist and referred to a psychologist for psychologic testing. The day after the tests are completed, the mother returns to the clinic and asks the nurse for results of the tests. Which is the best response by the nurse? 1 Refer the mother to the psychiatrist. 2 Explain to the mother the results of the tests. 3 Suggest that the mother call the psychologist. 4 Teach the mother about the tests that were administered.

1

A registered nurse is educating a nursing student about abortion-related issues. Which statement provided by the nursing student post-teaching needs correction? 1 "If a woman is in her first trimester, she may end her pregnancy according to state regulations." 2 "In the third trimester when the fetus becomes viable, the state's interest is to protect the fetus." 3 "If the fetus is over 28 weeks old, the state requires viability tests before conducting abortions." 4 "In the second trimester, the state enforces regulation regarding the person performing the abortion and the abortion facility."

1

What professional responsibility does the nurse display as a client's advocate? 1 The nurse protects the client's human and legal rights and provides assistance in asserting said rights. 2 The nurse actively collaborates with other healthcare professionals to follow the best treatment plan for a client. 3 The nurse explains concepts and facts about health, describes the reason for routine care activities, and demonstrates procedures. 4 The nurse establishes an environment for collaborative client-centered care to provide safe, quality care with positive client outcomes.

1

A victim of an automobile crash is brought to the hospital. The nurse notes that the client is in need of cardiopulmonary resuscitation (CPR). What factors should the nurse remember before performing CPR? Select all that apply. 1 Cardiopulmonary resuscitation is an emergency treatment that is provided without a client's consent. 2 Cardiopulmonary resuscitation is not performed on adult clients who have already consented to a do not resuscitate order either verbally or in writing. 3 Cardiopulmonary resuscitation is not to be performed by a primary healthcare provider in violation of a do not resuscitate order under any circumstances. 4 Cardiopulmonary resuscitation is performed on appropriate clients unless a do not resuscitate order has been signed and made part of the client's record. 5 Cardiopulmonary resuscitation is generally performed on any client who requires resuscitation in an emergency, but the client's consent is required.

1,2,4