Week 2 Review 164

What is the term for the beliefs held by the individual about what matters?

Values

A nurse who has worked on a unit for 8 years is conflicted about asking to meet with the charge nurse about staffing ratios. Which question(s) reflect the professional value of altruism in this decision? Select all that apply.

"Am I able to provide safe and efficient care to my clients?" "Am I willing to take this risk to help protect my fellow nurses?" "Will less experienced nurses on the unit learn from my actions?"

A nurse confides in a nurse friend, "I never report minor incidents. The charge nurse always wants a variance report filled out and they take so much time." Which responses by the friend are indicated? Select all that apply.

"Having documentation might keep you out of trouble someday." "Reporting helps us fix problems that result in danger to clients."

Which statement by the nurse is an example of deception?

"This injection of procaine will feel like a little pinch."

Which statement(s) by a nurse to a charge nurse indicates that the nurse requires further training? Select all that apply.

"When I sign the consent form as a witness, I am saying that the person knows all the risks and benefits of the procedure." "I must make sure I give the client all necessary information about the procedure before I have the client sign the consent form." "When a client is having surgery, it is my responsibility to get the consent."

Which word is best described as protection and support of another's rights?

Advocacy

A nurse demonstrates the professional value known as altruism when caring for clients in a long-term care facility. What nursing action demonstrates this behavior?

A nurse researches the culture of a Muslim client when planning care.

A nurse has completed 4 hours of an 8-hour shift on a medical-surgical unit when the nursing supervisor calls. The nursing supervisor directs the nurse to give a report to the other two nurses on the medical-surgical unit and immediately report to the telemetry unit to assist with staff needs on that unit. The nurse informs the supervisor that the nurse has been busy with client assignments and feels this will overwhelm the nurses on the medical-surgical unit. The supervisor informs the nurse that the need is greater on the telemetry unit. This is an example of which type of ethical problem?

Allocation of scarce nursing resources

Which scenario is an example of the laissez-faire approach to value transmission?

Allowing a child to decide not to have an intravenous line inserted

Which are professional values that the nurse should incorporate into practice? Select all that apply

Altruism Autonomy Human dignity Social Justice

A client admitted to a mental health unit has exhibited physical behaviors that put the client and others at risk. The nurse applies four-point restraints on the client without obtaining a physician's order or the client's consent. The nurse is at risk of being accused of which action?

Battery

A nurse working in a coronary care unit resuscitates a client who had expressed wishes not to be resuscitated. Which tort has the nurse committed?

Battery

The nurse is providing care to a client who had orthopedic surgery. The nurse has medicated the client for pain. However, the client reports that the pain is unrelieved. The nurse takes no further action regarding assessment and intervention for the client's pain. The nurse does not notify the surgeon regarding the client's pain. The nurse's failure to take further action represents which element of liability in this case?

Breach of duty

The nurse is preparing to administer a prescribed medication and notes the dosage is well above the suggested therapeutic range. Which action should the nurse take?

Call the provider to clarify the medication prescription

A client has been in the emergency department for 3 hours for treatment of a migraine headache. Care has been delayed due to a multiple fatality car accident. The client gets up to go to the bathroom unattended, faints, and suffers a subdural hematoma. The family threatens to sue for malpractice. Which element of malpractice will be the most difficult for the attorney to prove?

Causation

Identify the activities a nurse uses in the process of valuing. Select all that apply.

Choosing Acting Prizing

A family has recently immigrated. All members are quickly learning the language and the children are all in public school. Both parents are working and adapting to the new culture. What is this family demonstrating?

Cultural assimilation

A staff nurse meets with the charge nurse and is reporting that all the new nurses are leaving messes on the unit. The staff nurse states, "These youngsters think they can waltz in here and get our jobs." What is this nurse demonstrating?

Cultural conflict

A nurse explains the informed consent form to a client who is scheduled for heart bypass surgery. Which items are elements of this consent form? Select all that apply.

Disclosure Comprehension Competence

The nurse is providing care to a client whose condition has progressively declined. The nurse assesses and makes appropriate interventions as well as notifies the health care provider. Despite the nurse's efforts, the client expires. What element of liability has the nurse demonstrated?

Duty

A client is to undergo surgery for removal of the gallbladder. Which action related to the client's informed consent falls within the nurse's scope of practice? Select all that apply.

Ensuring the signed form is on the chart Acting as a witness to the client's signature on the form Answering questions about elements of the consent

A nurse who is caring for a new mother realizes that the woman is not prepared to go home with her newborn after a hospital stay of only 24 hours. However, hospital policy dictates that the mother be discharged. This nurse may be faced with which moral problem?

Ethical distress

A female client is brought to the emergency room with matted hair, bruising, and malnutrition. The nurse suspects physical abuse and neglect. The nurse states, "This happens to many women." Which type of ethical approach is the nurse exhibiting?

Feminist

A nurse who obtains a license to practice nursing through self-misrepresentation is guilty of what tort?

Fraud

A nurse reports to the charge nurse that a client medication due at 9 am was omitted. Which principle is the nurse demonstrating?

Integrity

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

Integrity

Two nurses are discussing a client's condition in an elevator full of visitors. With what tort might the nurses be charged?

Invasion of privacy

When talking with family over dinner, the nurse shares about a client with infertility at the hospital, identifying the person by name. Which tort has the nurse committed?

Invasion of privacy

What is the primary ethical dilemma posed when using restraints on an older adult client in a long-term care setting who is confused?

It threatens autonomy.

Which nursing action demonstrates the principle of fidelity?

Justice

A charge nurse is always careful to listen carefully to clients and to be respectful of their privacy and care needs. The nurse says, "I want the staff on this unit to see me interacting with clients in the manner I would like for them to interact with clients." The nurse is using which technique to guide value development of the staff?

Modeling

A parent always thanks clerks at the grocery store. The parent's child, age 6 years, echoes the thank you. The child is demonstrating what mode of value transmission?

Modeling

The nurse has identified an ethical dilemma that has the potential to interfere with a client receiving optimal care. The nurse discussed this issue with the charge nurse on the unit. What action should the nurse choose next?

Monitor for resolution of the problem

A nurse works in a nursing care facility that has a policy of regularly using restraints on clients that the nurse believes is unethical. However, the nurse feels obligated to follow the policy because of a fear of being fired. This is an example of which type of ethical situation?

Moral distress

A home care nurse visits a client who is confined to bed and is cared for by an adult child with substance use disorder. The home is cluttered and unclean, and the nurse notes that the client is wet with urine, has dried feces on the buttocks, and shows signs of dehydration. After caring for the client, the nurse contacts the health care provider and reports the incident to Adult Protective Services. What ethical principle is the nurse practicing?

Nonmaleficence

A nurse who is infected with human immunodeficiency virus (HIV) accidentally gets a cut while debriding a wound, exposing the client to possible HIV infection. Failure of the nurse to report this incident violates which ethical principles? Select all that apply.

Nonmaleficence Veracity Fidelity

A nurse obtains an order for a bed alarm for a confused client. This is an example of which ethical principle?

Paternalism

An on-duty nurse discovers that a colleague is pilfering medicines. According to the Nurse Practice Acts, what should the nurse do?

Report the incident to the supervisor.

The nurse is leading a discussion with a group of adolescents about what to do "if a friend shows you a gun at school in a backpack." The nurse is encouraging the adolescents to explore consequences of their actions for decisions made. What value transmission is the nurse demonstrating?

Responsible choice

Parents giving money to a child for receiving an exemplary report from school is an example of which type of value transmission?

Rewarding

A nurse is having lunch in the break room and overhears the other nurses talking about a difficult client in an inappropriate way. The nurses attempt to engage her in the conversation. Which response by the nurse would best represent behavior that supports the value of human dignity in nursing practice?

Saying that this discussion is inappropriate and disrespectful to the client and that the nurse does not want to be a part of it

A client has recently immigrated and is exhibiting symptoms of culture shock. The client reports feeling unaccepted in the new culture. The client states, "I can't do anything right here." What is the priority nursing diagnosis?

Situational low self-esteem related to culture shock and feelings of fear and incompetence

A client on a surgical unit asks for the nurse's opinion of the surgeon. The nurse says that the surgeon is rude and that the surgeon's clients always end up with infections. The nurse is at risk of being accused of which?

Slander

While at a coworker's house, a nurse discusses with the coworker a client whom the nurse suspects of physically abusing the client's child. The next day, the client is moved to another nursing unit after a surgical procedure and comes under the care of the coworker, who is also a nurse. The coworker confronts the client about the alleged physical abuse. The client is shocked and angered by the accusation and denies it categorically. What would be the charge if the client were to file a suit?

The first nurse could be charged with slander.

A client is being prepared for an elective surgical procedure and the consent form has not been signed. Who should the nurse have obtain consent for the procedure?

The health care provider performing the surgical procedure

Which is a characteristic of the care-based approach to bioethics?

The promotion of the dignity and respect of clients as people

A client gets out of bed following hip surgery, falls, and re-injures the hip. The nurse caring for the client knows that it is the nurse's duty to make sure an incident report is filed. Which statement accurately describes the correct procedure for filing an incident report?

The report should contain all the variables related to the incident.

Nurses complete incident reports as dictated by the agency protocol. What is the primary reason nurses fill out an incident report?

To improve quality of care

A client tells the nurse that the client does not want to have a painful procedure. By respecting and supporting the client's right to make decisions, the nurse is demonstrating:

advocacy.

A nurse is arrested for possession of illegal drugs. What kind of law is involved with this type of activity?

criminal

Despite the presence of a large number of older adult residents from Asian cultures, a long-term care facility has not integrated the medical concept of hot and cold into meal planning. The nurses at the facility should recognize this as an example of

cultural blindness.

When a home-bound client expresses the client's past-oriented ancestral heritage and family rituals, the nurse recognizes that the client is expressing:

ethnic identity.

Ethical distress is:

knowing the correct action but being unable to perform it due to constraints

A client is brought to the emergency department by an adult child, who states, "I am unable to care for my parent anymore. Although I would like to, financially and physically I cannot do it anymore." What ethical problem is the adult child experiencing?

moral distress

A nurse working in a critical care unit has experienced personal tragedy, extreme shortage of staff in the work environment, and health issues. The nurse has overcome much of these hardships and is now mentoring other nurses in similar situations. What behavior is this nurse demonstrating?

moral resilience

A nurse is concerned about the practice of routinely ordering an extensive series of laboratory tests for clients who are admitted to the hospital from a long-term care facility. An appropriate entity for addressing this ethical dilemma would be:

the institutional ethics committee

A nurse is preparing a client for discharge from the cardiac unit and observes cigarettes in the client's belongings. The nurse asks the client to consider the client's health and that of the client's spouse. This is an example of:

values clarification.

A client who is scheduled for hernioplasty needs clarification regarding the procedure. The nurse calls the physician at the client's insistence. The physician, who is in a bad mood, is overheard telling the client that the nurse does not know anything. Which legal tort has the physician committed?

Slander

When analyzing an ethical dilemma according to the ethical framework, what is most important for the nurse to take into consideration?

Standards of conduct

A newly hired young nurse overheard the charge nurse talking with an older nurse on the unit. The charge nurse said, "All these young nurses think they can come in late and leave early." What cultural factor can the new nurse assess from this conversation?

Stereotyping

Professional regulations and laws that govern nursing practice are in place for which reason?

To protect the safety of the public

A nurse is caring for a client who has undergone coronary angioplasty. The cardiac monitor is showing abnormal electrocardiogram waves, indicating atrial fibrillation. The nurse does not recognize the importance of the sign; as a result, the client's condition deteriorates and the client has to be taken up for an emergency procedure. Which describes the nurse's legal liability?

Tort

What type of law regulates the practice of nursing?

Civil law

The unit where a nurse works is undergoing structural changes along with changes in client load and managerial style. The nurse feels disorganized and stressed and is having difficulty sleeping. The nurse wonders if these feelings are related to the changes at work. What next step should the nurse choose in the 4A plan to address this issue?

Committing to self-care

A lawyer quotes a precedent for punishment of a crime committed by the defendant in a trial. What is court-made law known as?

Common law

A client is scheduled for a colonoscopy. The nurse realizes immediately after administering medications to induce conscious sedation that the client has not signed the informed consent. If the nurse has the client sign the informed consent at this point, which element of informed consent would be violated?

Competence

Which is the nurse's best legal safeguard?

Competent practice

A nurse is most likely to experience ethical distress in which client situation?

Continuing intravenous fluids for a client who wants to die

A nurse is caring for a 79-year-old client who is new to a long-term care facility. Previously, the client lived in a rural community in a household consisting of the client and an adult child. The child is no longer able to care for the client. The client appears disoriented and reports being bothered by the "bright lights and constant activity." The nurse appropriately documents what condition in the chart?

Culture shock

A family has immigrated and settled in a neighborhood that primarily speaks their native language. The nurse caring for this family recognizes that which family member will likely require the greatest amount of time to learn the dominant language?

The 45-year-old mother in the family who does not work outside the home

Legal safeguards are in place in the nursing practice to protect the nurse from exposure to legal risks as well as to protect the client from harm. What is an example(s) of legal safeguards for the nurse? Select all that apply.

The nurse confirms informed consent was give by the client to perform a procedure The nurse educates the client about what to expect during the hospital stay The nurse documents all client care in a timely manner

A nurse gives the 400 IU of a vitamin supplement that was in the client's medications instead of the 200 IU that was prescribed. The dosage was given when the unit was busy admitting three clients and another client was in crisis. Which action(s) by the nurse demonstrate the professional value of integrity? Select all that apply.

The nurse documents the dose given. The nurse completes a variance or incident report

Which are areas of potential liability for the nurse? Select all that apply.

The nurse fails to document refusal by the client to ambulate following surgery The nurse documents that the client's blood pressure has increased from 118/72 to 188/98 mm Hg and decides to retake the blood pressure in an hour.

A nurse uses the utilitarian action guiding theory when deciding how to handle the following ethical conflict: A 13-year-old client with anorexia refuses to eat food despite slowly starving to death. The parents insist that the nurse use a feeding tube to feed the client. Which statement is an example of this theory in practice?

The nurse forces food via an eating tube because the end result is good in that it will save the client's life.

A nurse seeks to incorporate the principle of bioethics known as nonmaleficence when caring for clients in a long-term care facility. Which nursing action(s) exemplify this principle? Select all that apply.

The nurse performs regular client assessments for pressure injuries. The nurse follows "medication rights" when administering medicine to clients.

Which traits are examples of virtues that can exemplify character and conduct as a professional nurse? Select all that apply.

Trustworthiness Humility Compassion

Which nursing situation is an example of an ethical dilemma?

Deciding whether to perform cardiac compressions against a client's wishes

A client is seeking care at the local clinic. The nurse is completing a cultural assessment. Which scenario would demonstrate cultural assimilation?

The client's child learned the dominant language as a second language.

A client tells the nurse that a neighbor, who is a young housekeeper from another country, wears the traditional clothing and head covering of the neighbor's native country. The client says of people like the neighbor, "They are in our country and should dress like we do." What is this statement an example of?

Cultural imposition

A family recently immigrated to a new country. The parent reports that the teenager is showing signs of fear, has vague reports of stomach pain, and feels humiliated by peers because of their culture. What is the priority assessment for the nurse?

Culture shock

Upon moving to another country, a college student is very confused by many local customs. He is especially bothered by the custom of men and women eating in separate areas and it makes him angry and resentful of the new culture. What are the feelings experienced by this student?

Culture shock

A nurse has started a new job and is weighing the pros and cons of obtaining professional liability insurance. Why would the nurse choose to obtain professional liability insurance? Select all that apply.

It provides for an attorney to represent the nurse in malpractice cases It covers incidents that occur during employment even after the nurse has left that employment It covers advice and care given outside the employment area It covers issues such as libel and slander.

A parent of a 17-year-old high school student is allowing the child to decide which college the child will attend. When the child requests direction from the parent in making this decision, the parent responds by stating, "You will need to make this decision on your own." What type of value transmission is the parent displaying?

Laissez-faire

Which mode of value transmission is most likely to lead to confusion and conflict?

Laissez-faire

A nurse suspects that a client is a prostitute. The nurse documents this suspicion in the medical record and includes it in report to the oncoming shift. The nurse also mentions the suspicion to the nurse's sister saying, "I had a client named Susan in room 126 today who I think is a prostitute." Which violations has this nurse committed? Select all that apply.

Libel , HIPAA, Slander

A nurse is applying a care-based approach to an ethical dilemma. When integrating this approach, which concept should the nurse keep in mind? Select all that apply.

The caring relationship is essential to the approach. Clients are people and are to be respected. Attention is needed to focus on each person's individual situation.

The nurse has an ethical conflict regarding the client's use of marijuana to control symptoms of advanced cancer. Which argument(s) regarding this conflict reflect a utilitarian approach? Select all that apply.

The client experiences significant reduction of cancer symptoms when using marijuana. The client is homebound and will not be driving. There is little opportunity for any other persons to divert or use the marijuana the client obtains.

A client diagnosed with diabetes 3 years ago has failed to integrate regular blood glucose monitoring or dietary modifications into the client's lifestyle. The client has been admitted to the hospital for treatment of acute renal failure secondary to diabetic nephropathy, an event that has prompted the client to reassess personal values. Which action most clearly demonstrates that this client is engaging in the step of prizing within the valuing process?

The client expresses pride over now having the knowledge and skills to take control of diabetes management.

A client is admitted with symptoms of psychosis. The nurse hurries to the client's room on hearing the client calling for help. The nurse finds the client lying on the ground. The nurse assists the client back to the bed and performs a thorough assessment. The nurse informs the physician and completes the incident report. Which statement should the nurse document in the incident report?

The client was found lying on the floor.

Which best exemplifies malpractice?

The nurse administers amoxicillin to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest.

A nurse exemplifies the professional value of altruism. Which behaviors recognized by others demonstrate this concept? Select all that apply.

The nurse arranges for an interpreter for a client who does not speak the dominant language. The nurse notifies the health care provider that a client reports pain medication to be ineffective.

A client nearing the end of life requests that the client be given no food or fluids. The physician orders the insertion of a nasogastric tube to feed the client. What is the primary concern of the nurse providing care?

The nurse faces an ethical dilemma about inconsistent courses of action

Which scenarios are examples of a nurse committing a tort? Select all that apply.

The nurse told the client, "The doctor prescribed this medication, and you must take it. I'll force you to take it." The nurse tells another employee, "Everyone knows the previous nurse does not do the job and charts medications not administered." The nurse administered a sedative medication to a sleeping client because the client's child requested the parent receive it.

A client who immigrated from another country informs the nurse of dietary requests. The nurse responds to the special dietary needs by stating, "You are now living here, and you should try to start eating those foods common to our diet." This inappropriate response is an example of:

cultural imposition.

An immigrant lives with relatives in a community with many households from the country of origin. The client is taken to the emergency department following a fall at work and is admitted to the hospital for observation. The nurse is aware that this client is at risk for:

culture shock.

A nurse working on a critical care unit was informed by a client with multiple sclerosis that the client did not wish to be resuscitated in the event of cardiac arrest. Now the client is no longer able to express wishes, and the family has informed the physician that they want the client to be resuscitated. Aware of the client's wishes, the nurse is involved in a situation that may involve:

ethical distress.

A client age 56 years is experiencing withdrawal from alcohol and is placing themselves at risk for falls by repeatedly attempting to scale the bedrails. Benzodiazepines have failed to alleviate the client's agitation and the nurse is considering obtaining an order for physical restraints to ensure client safety. The nurse should recognize that this measure may constitute:

paternalism.

A lawsuit has been brought against a nurse for malpractice. The client fell and suffered a skull fracture, resulting in a longer hospital stay and need for rehabilitation. Which element of liability does this description of the client's injuries represent in terms of proof of malpractice?

Damages

A nurse pulls the curtains closed before changing the dressing of the surgical wound on the abdomen of a postsurgical client. What value is served?

Dignity

Which situation violates an element of informed consent?

The nurse says, "You have to sign this before we can do the surgery."