Mngment

What ethical principle is implemented, or supported, when the nurse encourages a client to be involved in planning and implementing his or her own care? -Justice -Veracity -Fidelity -Autonomy

Autonomy

According to the ANA code of ethics, which action is unethical for a nurse?

Refusing to care for a client who is diagnosed as HIV positive

Of the following errors in judgement, which one would be the most serious for the nurse defendant in a legal case? -Being discourteous on the witness stand -Hiding information from the nurse's attorney -Discussing the case with the plaintiff, the party who initiated the lawsuit -Tampering with the chart

Tampering with the chart

A nurse manager is reviewing the Good Samaritan Laws with a group of newly licensed nurses. Which of the following statements by the nurse manager is appropriate?

"If you render aid in an accident, do not leave the scene until another competent person can take over"

The nurse is caring for a patient who has chosen to discontinue hemodialysis. The patient's family, however, is not supportive of the decision. The nurse who uses the theory of principles-based reasoning would make which statement regarding the current situation? -"The patient understands the decision and the advanced stage of the disease. If the patient quits the treatment, the patient will die." -"This patient's health is so deteriorated that the treatment is not saving the patient's life. It is prolonging the ultimate outcome, which is death" -"this patient is of sound mind and is capable of making independent decisions regarding health care. It really is the patient's decision to make" -"I need to try and help the family understand the patient's decision so they can work through this situation together."

"This patient is of sound mind and is capable of making independent decisions regarding health care. It is really the patient's decision to make."

A student administers a medication to the wrong client while the instructor is with another student. Which statement by the instructor is most appropriate in this situation? -"You have set a bad example for the other student" -"You have placed the nursing student program in danger" -"You are expected to practice like a licensed nurse" -"You may be sued by the hospital for the extra care cost to the client"

"You are expected to practice like a licensed nurse"

A nurse reports an incident of suspected child abuse. One of the parents of the child becomes upset and demands to know the reason for the nurse's action. Which of the following responses by the nurse is appropriate?

"as a nurse, I am required by law to report suspected child abuse."

Order of actions when a patient's husband has died, does not know about it, and the family wants to keep this information from her.

1. Gather all information relevant to the case 2. Examine and determine one's own values on the issue 3. Verbalize the problem 4. Consider possible courses of action 5. Negotiate the outcome 6. Evaluate the action

The supervisor of a cardiovascular unit, responsible for checking staffing patterns, assigned a particular staff nurse to work on the unit because that nurse had many years of experience on that unity. That evening, this staff nurse made a treatment error and a client was injured. Who is liable?

The staff nurse nurse and the hospital

The nurse notes that an advance directive is in the client's medical record. Which of the following statements represents the best description of guidelines a nurse would follow in this case? -A living will allow an appointed person to make health care decisions when the client is in an incapacitated stated -A durable power of attorney must be a family member of the patient -A living will is invoked only when the client has a terminal condition and is in a persistent vegetative state -The client cannot make changes in the advance directive once the client is admitted into the hospital

A living will is invoked only when the client has a terminal condition and is in a persistent vegetative state

What is the purpose of the American Nurses Association (ANA) Code of Ethics?

Their purpose is to provide a standard of ethical care and guidelines of the ethical obligations of nurses

What is the best definition of "malpractice?" -An intentional professional act of negligence -A criminal act committed against society -Doing something a reasonable person/nurse would not do -A professional act or failure to act that leads to injury of a client

A professional act or failure to act that leads to injury of a client

What is the Nurse Licensure Compact? -An agreement between compact states to recognize licensure from member states -An agreement between the state board of nursing and the national council regarding foreign nurses -An instrastate agreement for the nurse to practice in any area within the state -An agreement between all states to recognize the license of all graduate nurses

An agreement between compact states to recognize licensure from member states

A client who fell and broke his hip while being assisted to the bathroom by a nurse states that he plans to sue the nurse. In a legal proceeding, the nurse should be aware that the standard that be will be used to determine if the nurse was negligent is which of the following?

Another staff nurse provides testimony about how a responsible, prudent nurse would have handled the situation

A nurse is working in a long-term care facility and is administering medications to assigned clients. A client refuses to take the prescribed medication, and the nurse threatens the client and tells the client that if the medication is not take orally, then restraints will be applied and the medication will be given by injection. This statement by the nurse constitutes which legal tort?

Assault

A new nurse witnesses an experienced nurse documenting an assessment of a patient-controlled analgesia (PCA) pump incorrectly on the computerized flow sheet. Which of the following should the new nurse do? -Notify the charge nurse that the nurse has a staff development need -Bring to the nurse's attention that she is charting incorrectly and offer to demonstrate correct charting on the flow sheet -Question his or her own level of proficiency and seek out her mentor for verification of correct procedure -Leave a note for the unit manager that the nurse may have a learning need in regard to computerized charting

Bring to the nurse's attention that she is charting incorrectly and offer to demonstrate correct charting on the flow sheet

A nurse is reviewing a client's health care record and discovers that the client's do-not-resuscitate (DNR) order has expired. The client's condition is not stable. Which of the following actions should the nurse take? -Anticipate that CPR will be instituted if the client goes into cardiopulmonary arrest -Assume that the client does not want to be resuscitated, and take no action if she experiences cardiac arrest -Write a note on the front of the provider order sheet asking that the DNR order be reordered -Call the provider to determine whether the order should be immediately reinstated

Call the provider to determine whether the order should be immediately reinstated

A the nurse is caring for a client who is scheduled for surgery. The nurse's role in regard to informed consent is which of the following?

Determining the client's level of understand about the procedure

During a malpractice suit, how can the standard of what the wise and prudent nurse would do best be established? -Conferring with a lawyer regarding malpractice parameters -Form the testimony of a qualified nurse -By consulting the standards of a joint commission -By consulting with nursing faculty regarding standards of care

Form the testimony of a qualified nurse

A newborn has several congenital anomalies incompatible with living beyond a month. He cannot retain formula and his temperature drops when he is removed from the warmer. Two nurses who alternate caring for the baby argue whether or not to attempt bottle feedings and whether he should be removed from the warmer to be held. What is the origin of the conflict described?

Ethical values

A patient with terminal cancer has signed an advanced directive indicating that no parenteral nutrition or hydrations be implemented. For several days the patient has refused food and fluids, pushing the caregiver's hands away when attempts are made to feed the patient or offer any kinds of fluids. The family is considering placing a gastrostomy tube because they feel the patient is "starving to death.: The nurse should: -Talk to the physician so the family's wishes can be acted upon -Help the family come to terms with the situation -Honor the family's wishes and have them sign a consent form -Take the case to the hospital's ethics committee -Honor the patient's refusal of parenteral nutrition and hydration

Help the family come to terms with the situation Honor the patient's refusal of parenteral nutrition and hydration

Which of the following most clearly represents a situation of assault?

In the emergency room, a client intoxicated and verbally abused; the nurse tells him she will put him in restraints if he does not quit talking

What is your responsibility, as a nurse to maintain patient autonomy in a competent client during end-of-life care

In those cases, the nurse's primary responsibility is to provide care and support to the patient and to respect the patient's autonomy while continuing to support the family as they struggle to adjust to the impending reality of the patient's death.

In a suit, what element is necessary to prove a tort has been committed? -Intent -Injury -Malpractice -Assault

Injury

All of the following are considered unintentional torts, except: -Professional negligence -Malpractice -Libel -Negligence

Libel

A newly licensed nurse is seeking advice from her mentor about the need to purchase professional liability insurance. Which fo the following statements is most accurate?

Personal liability coverage is not mandatory, but you should consider purchasing your own coverage

The nurse is giving care to a six-year-old with a broken arm. the nurse notices multiple bruises. He tells the nurse that his father got mad because he was bad and hit him and broke his arm so he would remember to be good. What is the best nursing action? -Ignore what the child said as little boys often lie -Do nothing because you cannot prove he was abused -Chart that the client is a victim of abuse -Report to the authorities that you suspect child abuse

Report to authorities that you suspect child abuse

A nurse who commits an infarction of the nurse practice is always subject to discipline by what group?

State board of nursing

The ethical principle of autonomy is not applicable in which client situation?

The client is unaware of who he is and where he is

A nursing is caring for a client who refuses to take her prescribed oral medication. The nurse states, "If you don't take this pill, I'm going to give you the medication by injection." Which of the following types of torts has this nurse committed? -Assault -Battery -Slander -Negligence

Assault Causing a person to fear that he/she will be touched without their consent is assualt

A nurse is caring for an older adult client who has a terminal illness and is ventilator-dependent. The client is alert and oriented and he wants to discontinue the use of the ventilator. The nurse should be aware that the continued treatment against the client's wishes is a violation of which of the following ethical principles?

Autonomy

Advance directives such as the health are proxy and living will support what ethical principle? -Autonomy -Veracity -Beneficence -Advocacy

Autonomy The right self-determination (make one's own decision) without interference

The nurse is concerned about being sued for negligence when providing care. which nursing actions may be grounds for negligence? -Client states not understanding activity restrictions and their wound eviscerates -Client falls getting out of bed because the call light was not placed within reach -Client's morning medication were administered in the early afternoon -Client documentation did not include appearance of infiltrated IV site -Client name band was not checked prior to providing all medication

Client states not understanding activity restrictions and their wound eviscerates Client falls getting out of bed because the call light was not placed within reach Client's morning medication were administered in the early afternoon Client's name band was not checked prior to providing all medication

The nurse is working with parents of a seriously ill newborn diagnosed with a diaphragmatic hernia. Surgery has been proposed for the infant, but the chances of success are unclear, as the infant has been placed on ECMO for respiratory support. In helping the parents resolve this ethical conflict, the nurse knows that the first step is: -Clarifying values related to the cause of the dilemma -Exploring reasonable courses of action -Identifying people who can solve the difficulty -Collecting all available information about the situation

Collecting all available information about the situation

A patient comes to the clinic and is found to have an STD. The patient states to the nurse, "Promise you won't tell anyone about my condition." The nurse, according to the Health Insurance Portability and Accountability Act (HIPAA) of 1996, must do which of the following? -Not disclose any information to anyone -Respect the patient's privacy and confidentiality -Honor the patient's wishes -Communicate only necessary information

Communicate only necessary information

What is the best legal safeguard for a nurse? -Following management policies -Competent practice -A valid license -A legal contract

Competent practice

A hospice nurse has been working closely with a patient who, on several occasions, has asked about guidance and support in ending life. The nurse recognizes that in making ethical and moral decisions: -Passive euthanasia is an easy decision to arrive at -Assisted suicide is illegal in all states -Active euthanasia is supported in the Code for Nurses -Euthanasia has legal implications along with moral and ethical ones

Euthanasia has legal implications along with moral and ethical ones

To respect a client's personal space and autonomy, the nurse: -Avoids the use of touch -Explains nursing care and procedures -Stands 6 feet away from the bed, whenever possible -Keeps the curtains pulled around the client's bed for privacy

Explains nursing care and procedures

Ethical decision making does not always have the patient's well-being at the center of it it

False

The nurse practice acts are an example of civil law True or False

False

The nurse puts wrist restraints on the client's bilateral wrists without the client's permission and without the physician's order. The nurse may be guilty of assault

False

The nurse puts a restraint jacket on a client without the client's permission and without a physician's order. The nurse may be guilty of assault

False Battery is physical in nature; assault is a threat

A nurse is caring for a client who refuses treatment and asks to be discharged from the hospital against medical advice. The nurse notifies the client's provider, who tells the nurse to restrain the client, if necessary, to keep her from leaving the hospital. The nurse understands that restraining this client would be considered which type of civil action by the nurse?

False imprisonment

A nurse who tells the client, "If you don't stop getting out of that chair, I'm going to put some restraints on you." What may this nurse be accused of? -Assault -False imprisonment -Malpractice -Defamation

False imprisonment

Confidentiality will be maintained by a nurse who believes in and values the ethical principle of: -Veracity -Justice -Fidelity -Autonomy

Fidelity

A nurse is reviewing a provider's prescriptions for four clients. Which of the following prescriptions is outside of the legal scope of practice for the nurse?

Insert a tunneled central venous catheter for a client

The health care team of the iCU needs to decide whether to move a critically ill client out of the ICU so that a new client may be admitted. The team is faced with what principle of an ethical dilemma?

Justice

The nurse is very busy caring for a large caseload. A client mentions that because he is slow, people just do things for him rather than allowing him to do as much as he is able. To solve the dilemma of needing to conserve time versus supporting the client's involvement in his care, what principle may help the nurse? -Autonomy -Fidelity -Justice -Veracity

Justice The duty to treat all patients fairly, without regard to race, sex, age, SES, medical diagnosis, or religious beliefs

Pick on of the ANA Code of Ethics Provisions and discuss how you will use it in your clinical practice to provide ethically sound care

Justice is fairness. Nurses must be fair when they distribute care, for example, among the patients in the group of patients that they are taking care of. Care must be fairly, justly, and equitably distributed among a group of patients. Beneficence is doing good and the right thing for the patient. Nonmaleficence is doing no harm, as stated in the historical Hippocratic Oath. Harm can be intentional or unintentional. Accountability is accepting responsibility for one's own actions. Nurses are accountable for their nursing care and other actions. They must accept all of the professional and personal consequences that can occur as the result of their actions. Fidelity is keeping one's promises. The nurse must be faithful and true to their professional promises and responsibilities by providing high quality, safe care in a competent manner. Autonomy and patient self-determination are upheld when the nurse accepts the client as a unique person who has the innate right to have their own opinions, perspectives, values and beliefs. Nurses encourage patients to make their own decision without any judgments or coercion from the nurse. The patient has the right to reject or accept all treatments. Veracity is being completely truthful with patients; nurses must not withhold the whole truth from clients even when it may lead to patient distress.

What is a significant action a nurse can take to prevent being named in a malpractice suit? -Maintain updated professional knowledge and skills -Check with a nursing supervisor before undertaking care -Carry professional liability insurance -Refuse to care for suit-prone clients

Maintain updated professional knowledge and skills

A nurse accidentally administers the wrong medication to a client, which resulted in a severe allergic reaction and prolongs the client's hospitalization. The client could rightfully sue the nurse for which of the following?

Malpractice

A nurse plans to leave her scheduled shift an hour early without permission or notifying the charge nurse. The clients in the nurse's assignment are stable. Which of the following legal torts applies to this situation?

Negligence

When a client with dementia is admitted for a UTI, is confused, left alone with the side rails down, and the bed in a high position, the client falls and breaks their hip. What law has been broken? -Assault -Negligence -Civil tort -Battery

Negligence

An RN stops at the scene of an accident and finds a man with a deep laceration on his hand, a fractured arm and leg, and abdominal pain. The nurse wraps the man's hand in a soiled cloth and drives him to the nearest hospital. The nurse is:

Negligent and can be sued for malpractice

A hospice nurse is providing care for a dying patient and withholds a dose of narcotic pain medication when the client experiences respiratory depression. What ethical principle is the nurse practicing by withholding the medication?

Nonmaleficence

A nurse is providing care for a surgeon on a medical-surgical unit. A nurse from another unit asks the nurse about the surgeon's medical diagnosis. The nurse responds that he is unable to provide the information requested. The nurse is displaying which of the following ethical principles?

Nonmaleficence

After a care/pedestrian accident, a pedestrian client is brought to the emergency room. The client is alert and oriented but complains of dyspnea. Oxygen saturation levels are from 88%-90%. Oxygen is applied at 2 L per nasal cannula with no improvement. Oxygen per mask is initiated at 40% with little improvement. Radiograph films reveal no obvious injury of fractures. Suddenly the client loses consciousness, has respiratory arrest, and subsequently dies. During the respiratory arrest resuscitation, it is determined that a nurse failed to open the valve to the oxygen tank and the client has not been receiving oxygen. What is the key ethical principle involved in this situation? -Nonmaleficence -Justice -Fidelity -Beneficence

Nonmaleficence Duty to prevent or avoid doing harm whether intentional or unintentional. It is the nurse's obligation to avoid causing harm to the patient

As an advocate for the client, the nurse must make sure that the "safe, effective care" Is given conformity with the: -American Nursing Association (ANA) -Nurse Practice Acts (NPA) -National Council for Licensure Examinations -State Boards of Licensure

Nurse Practice Acts (NPA)

The scope of Nursing Practice, the established educational requirements for nurses, and the distinction between nursing and medical practice is defined by: -Nurse Practice Acts (NPA) -Common Law -Statutory Law -Civil Law

Nurse Practice Acts (NPA)

A nurse overhears two assistive personnel (AP) from the medical-surgical unit discussing a hospitalized client while in the cafeteria. Which of the following is the priority in nursing action?

Quietly tell the APs that this is not appropriate

A nurse is caring for a client who has a mental illness. Which of the following actions by the nurse demonstrates the ethical concept of autonomy?

Supporting the client's wish to refuse prescribed medications

At the time of admission, a client gave history of allergy to penicillin that was duly noted in all critical areas of client's records. While giving medications, a nurse accidentally gave penicillin to this client. The client had a severe reaction but recovered. What is the implication of the nurse's action? -There is no cause for concern because the action did not result in the client's death -The nurse failed to act in a reasonable and prudent fashion, so is liable for malpractice -The nurse who gave the medication can bring a countersuit against the nurse who took the history -The nurse cannot be sued for malpractice because the client did not tell him/her of the allergy

The nurse failed to act in a reasonable and prudent fashion, so is liable for malpractice

A nurse is being sued for assault and battery. What does this mean? -The nurse failed to perform an act expected of a reasonable nurse -The nurse told the client he could not leave until his bill was paid -The nurse threatened to put the client in restraints if he did not stay in bed -The nurse without consent, touched the client in an offensive, insulting, or injurious way

The nurse without consent, touched the client in an offensive, insulting, or injurious way

Violations requiring report to the BRN include all of the following except: -Failure to pay taxes -Non-payment of child support -Traffic violation over $800 -An expunged conviction

Traffic violation over $800 Traffic violations must be over $1000

The greatest good for the greatest number of people, is the definition of which ethical theory? -Right-based -Utilitarianism -Golder-mean ethics -Deontological

Utilitarianism

Which ethical principle is applied when the nurse acts to safeguard the client and the public by reporting poor nursing practice? -Veracity -Autonomy -Justice -Fidelity

Veracity The duty to tell the truth and the right to know

A client is about to undergo an elective surgical procedure. Which of the following is the role of the nurse providing preoperative care regarding informed consent? -Describe the consequences of choosing to do nothing -Obtain the client's consent -Witness the client's signature -Explain the risks and benefits of the procedure

Witness the client's signature