Ch 6 (test 1)
Even after a lengthy discussion concerning the ramifications, a patient wants to leave the hospital against medical advice (AMA). What would the nurse do in the role of patient advocate? A) Encourage the patient to wait until morning to leave the hospital B) Ask family members to help talk the patient out of the decision C)Call the security guard to escort the patient off hospital property D) Make sure the patient has appropriate follow-up appointments
Ans: D Feedback: As advocate for this patient, you have made sure he is informed of the ramifications of leaving AMA; however, it is a patient's right to refuse treatment. The other options fail to recognize the patient's right to make autonomous choices.
Which leadership role is associated with advocacy? A) Create a climate where advocacy and its associated risk-taking are valued B) Give subordinates and patients adequate information to make informed decisions C) Ensure that rights and values of patients supersede those of the health-care providers D) Seek appropriate consultation when advocacy results in intrapersonal or interpersonal conflict
Ans: A Feedback: A leadership role associated with advocacy is to create a climate where advocacy and its associated risk-taking are valued. Management functions include the following: give subordinates and patients adequate information to make informed decisions; ensure that rights and values of patients supersede those of the health-care providers; and seek appropriate consultation when advocacy results in intrapersonal or interpersonal conflict.
Which management function is associated with advocacy? A) Awareness of current legislative efforts affecting nursing practice and organizational and unit management B) Role modeling proactive involvement in health-care policy through both formal and informal interactions with the media and legislative representatives C) Participation in professional nursing organizations and other groups that seek to advance the profession of nursing D) Assertively advocating on behalf of patients and subordinates when an intermediary is necessary
Ans: A Feedback: A management function associated with advocacy is awareness of current legislative efforts affecting nursing practice and organizational and unit management. Leadership roles include the following: role models' proactive involvement in health-care policy through both formal and informal interactions with the media and legislative representatives; participates in professional nursing organizations and other groups that seek to advance the profession of nursing; assertively advocate on behalf of patients and subordinates when an intermediary is necessary.
How is the action of advocacy described? A) Informing others of their rights and making certain they have sufficient information to make decisions B) Learning about the need for a decision and then making a good decision for other people C)Supporting an individual's right to make a decision even when they do not have accurate information D) Protecting the rights of patients in accordance with the law
Ans: A Feedback: The advocate informs others of their rights and makes certain they have sufficient information to make decisions. The remaining options are incorrect when describing the action associated with advocacy.
Whose rights do the legislative controls of nursing practice primarily protect? A) Patients B) Subordinates C) Managers D) Administrators
Ans: A Feedback: The legislative controls of nursing practice primarily protect the rights of patients. Protection of those identified by the other options while important is the primary focus of the nursing practice legislative bodies.
Which nursing intervention demonstrates attention to the nursing values central to patient advocacy? Select all that apply. A) Assuring the patient that their wishes will be respected regarding the care they receive B) Identifying the patient's religious dietary practices when discussing a prescribed diet C) Answering the patient's questions regarding the alternatives to a proposed procedure D) Suggesting to a patient that a social services consult would help with discharge needs
Ans: A, B, C, D Feedback: The nursing values central to advocacy emphasize caring, autonomy, respect, and empowerment. While appropriate, comforting a patient is not an act of advocacy in this situation.
Which intervention demonstrates that the nurse-manager is to advocate for patients in common areas of concern? Select all that apply. A)Staffing a unit with sufficient care providers B) Orienting staff to safely use a new patient lift C) Providing an in-service on culturally meeting end-of-life needs D) Arranging for patient consultations with members of the financial office
Ans: A, B, C, D Feedback: Common areas for managers to advocate for patients include distribution of resources; use of technology; end-of-life decisions; and health-care reimbursement. While aesthetics is an important consideration, it is not a common area for managers to act as advocators
Which are common areas requiring nurse-patient advocacy? Select all that apply. A) Securing patient consents B)Preventing medication errors C)Facilitating access to health-care services D) Respect for patient dignity and cultural values
Ans: A, B, C, D Feedback: Common areas requiring nurse-patient advocacy include inadequate patient consents; medical errors; access to health care; and respect for patient dignity and cultural values. While hospitalization is expensive, education on this subject is not considered a nursing advocacy role.
Managerial advocacy has resulted in which profession of nursing characteristics? Select all that apply. A) Ethical code B) Legal recognition C)Nurse Practice Acts D)Professional licensing
Ans: A, B, C, D Feedback: Managers must be advocates for the nursing profession. It was nurses who pushed for accountability through state nurse practice acts and state licensing. Nurse-leaders collaborated on defining the profession, achieving legal recognition of the profession and establishing a culture for professional nursing which has continued to the present time. Advocating for professional nursing is a leadership role. Professional issues are always ethical issues. When nurses find a discrepancy between their perceived role and society's expectations, they have a responsibility to advocate for the profession. This includes speaking out on consumer issues, continuing and expanding attempts to influence legislation, and increasing membership on governmental health policy-making boards and councils. Only then will nurses be able to influence the tremendous problems facing society today.
Which characteristic associated with being a patient increases the need for advocacy? Select all that apply. A) Loss of physical freedom as a result of extended hospitalizations B) Decreased independence due to physical or psychosocial limitations C) Physical or psychosocial limitations negatively impacted autonomy D) Illness tends to make an individual more vulnerable to unethical activities
Ans: A, B, C, D Feedback: Patient advocacy is necessary because disease almost always results in decreased independence, loss of freedom, and interference with the ability to make choices autonomously. In addition, aging, as well as physical, mental, or social disability may make individuals more vulnerable and in need of advocacy. It is not true that cognitive function is impaired as a result of chronic and/or acute illness.
Which strategy demonstrates an understanding of the management's role as advocate for their subordinates? Select all that apply. A) Staff representatives on all unit committees B) Monthly "brown bag lunches" with the staff C) Requests revising criteria for granting a "leave of absence" D) Working with primary care providers to expand standing nursing orders
Ans: A, B, C, D Feedback: The following are suggestions for creating an environment that promotes subordinate advocacy: Invite collaborative decision making; get to know staff personally; "go to bat" for staff when needed; and promote nurse autonomy. Rather than anticipating educational needs, the manager advocates by asking for and then respecting their suggestions by planning accordingly.
How can nurses act as advocates? Select all that apply. A) Helping others make informed decisions B) Directly intervening on behalf of others C) Providing consent to treat for the cognitively impaired patients D)Making health-care decisions for those who are not able to do so
Ans: A, C, D Feedback: Nurses may act as advocates by either helping others make informed decisions, by acting as intermediary in the environment, or by directly intervening on behalf of others. Advocates do not make decisions or provide consent but rather educate patients so they can be informed.
Patients were often denied basic human rights until when? A) 1940s B) 1950s C) 1960s D) 1970s
Ans: C Feedback: Until the 1960s patients had few rights; in fact, patients before then often were denied basic human rights. Conditions improved by the 1970s.
Which statement regarding the responsibility of a manager in advocacy is accurate? A) Advocacy is a management function and not a leadership role B) Managers advocate only as needed to meet organizational goals C) Managers should advocate for patients as well as subordinates D) Professional advocacy is not a primary concern for most managers
Ans: C Feedback: Advocacy is helping others to grow and self-actualize. The manager must be an advocate for patients, subordinates, and the nursing profession. The remaining statements are not accurate descriptions of the manager's role as advocate.
Who plays a primary role in ensuring that workers have reasonable, working schedules? A) Unions B) Top administrators C) Managers D) Federal government
Ans: C Feedback: In workplace advocacy, the manager works to see that the work environment is both safe and conducive to professional and personal growth for subordinates. The other options play a role in such situations but the manager has the primary responsibility.
The Patient's Bill of Rights established by which body has the most legal authority? A) A health-care organization B)A professional medical organization C) A regulation professional nursing organization D) A specific state
Ans: D Feedback: A bill of rights that has become law or state regulation has the most legal authority because it provides the patient with legal recourse. A bill of rights issued by health-care organization and professional associations is not legally binding but may influence federal or state funding and certainly should be considered professionally binding.
6. Which situation is a reality for whistle-blowers? A) Retaliation against them is illegal B) Fellow workers are supportive of them C) Federal and State law protects them D) They are often afraid to speak out
Ans: D Feedback: Although whistle-blower protection has been advocated for at the federal level and has been passed in some states, many employees are reluctant to report unsafe conditions for fear of retaliation. Nurses should check with their state association to assess the status of whistle-blower protection in their state. Retaliation and resentment still exist against these individuals in many situations.
What statement is true concerning nurses as a political body? A) They are very committed to both their profession and the political process B) Many are active members of the American Nurses Association (ANA) C) Their primary focus is to speak out on consumer health-related issues D) They have not yet recognized the full potential of political activity
Ans: D Feedback: As a whole, the nursing profession has not yet recognized the full potential of collective political activity. Nurses must exert their collective influence and make their concerns known to policy makers before they can have a major impact on political and legislative outcomes. The remaining options are not true of nurses in general.
Which standard of the American Nurses Association (ANA) Scope and Standards for Nurse Administrators suggests that nurse administrators should advocate for subordinates as well as patients? A) II B) III C)IV D) V
Ans: D Feedback: Standard V of the ANA Scope and Standards for Nurse Administrators suggests that nurse administrators should advocate for subordinates as well as patients. This issue is not addressed in the other options.
