davis edge nursing ethics, legal issues, informatics

Which is a description of nurses being able to apply standards of ethical conduct to professional practice and participate in ethical decision making? 1. Ethical agency 2. Moral judgement 3. Whistleblowing 4. Ethical distress

ANS: 1 Rationales Option 1: Ethical agency is the application of ethical principles to professional practice. Option 2: Moral judgement is a person's own standard of right and wrong. Option 3: Whistleblowing is a type of ethical distress signal in which a nurse observes an immoral or unethical behavior. Option 4: Ethical distress is a situation in which a nurse observes or even participates in a violation of ethics.

hat are applications that allow for communication among several caregivers considered to be? 1. Integrated 2. Interfaced 3. Encrypted 4. Interactive

ANS: 1 Rationales Option 1: Integrated applications provide a platform for caregivers to communicate pertinent client information and access each other's documentation. Option 2: Interfaced applications allow for direct input of data such as vital signs, lab results, and diagnostic testing right at the bedside. Option 3: Encrypted information is a manner of protecting private information. Option 4: Interactive applications are those that allow the client to interact with the program.

Which must a nurse remember when accessing articles on the Internet related to nursing practice? 1. The article may not be reliable. 2. The article will be factual if it is on the Internet. 3. The article usually has an anonymous author. 4. If an article has been up-voted many times, it is probably a good resource.

ANS: 1 Rationales Option 1: Not all information found on the Internet is peer reviewed or reliable. Nurses should learn how to perform a reliable literature search. Option 2: Not all articles on the Internet are factual; nurses should only use trusted sources. Option 3: Most literature available on the Internet has an author cited. Option 4: Popularity of an article is not directly linked to accuracy and reliability.

What is an appropriate nursing intervention for moral distress? 1. Self-manage emotions; discuss with mentor if you are having difficulty 2. Decreased anxiety level 3. Assess nature of the action and likelihood of immediate harm 4. Self-determination; to choose and act on that choice

ANS: 1 Rationales Option 1: An intervention of self-management and working with a mentor is appropriate for a client who is experiencing moral distress. Option 2: Decreased anxiety level is an outcome or goal but not an intervention. Option 3: When working with immediate harm and nature of actions, this is involving a whistleblower intervention. Option 4: Self-determination is autonomy that is only a small component of working with a client in moral distress.

A client has called the nurse to the room several times over the course of the past hour because he or she keeps getting up and wandering and is having difficulty getting back into bed. On the last visit to the client, the nurse gives the client a sedative to cause drowsiness. What can this treatment be considered? 1. False imprisonment 2. Assault 3. Battery 4. Quasi-intentional tort

ANS: 1 Rationales Option 1: Any attempts to restrain a client, either physically or medically, without his or her permission or justification is considered false imprisonment. Option 2: Assault occurs when a nurse intentionally places a client in immediate fear of personal violence, such as threatening to slap the client or withhold food. Option 3: Battery occurs when there is offensive or harmful physical contact made toward a client without consent or unauthorized touching of a person's body by another person. Option 4: A quasi-intentional tort results in defamation of character and involves actions that injure a person's reputation.

How can a nurse recognize a client is struggling with an ethical issue? 1. The client experiences conflict in some form. 2. There is incongruent behavior between the client and the family. 3. Vitals signs are abnormal and the client appears to be in distress. 4. The physician and the client do not agree on the method of treatment.

ANS: 1 Rationales Option 1: Conflict in decisions that need to be made about care, needs and interests, and duties and obligations are the foundation of ethical distress and confusion. Option 2: Incongruent behavior could be related to a variety of issues not related to health care and ethics. Option 3: Stress may be an effect of indecisiveness, fear, or disease and not particular to ethical issues. Option 4: The client has a right to choose his or her care, and disagreements between the physician and the client do not particularly create an ethical issue.

Which are discrete entities that are described objectively without interpretation? 1. Data 2. Knowledge 3. Wisdom 4. Information

ANS: 1 Rationales Option 1: Data are raw, unprocessed numbers, symbols, or words that have no meaning by themselves. Option 2: Knowledge is formed when data are grouped to provide meaningful information. Option 3: Wisdom develops as a result of clinical experience, theoretical knowledge, critical thinking, or intuition. Option 4: Information is groups of data processed into a meaningful, structured form.

Fair access to care and allocation of resources are examples of what type of justice? 1. Distributive 2. Procedural 3. Compensatory 4. General

ANS: 1 Rationales Option 1: Distributive justice requires fair distribution of both benefits and burdens and includes allocation of health-care resources and available care for all. Option 2: Procedural justice is important in processes that require ranking or ordering such as visiting hours, sick leave, holiday schedules, and other institutional policies. Option 3: Malpractice is an example of compensatory justice, which focuses on making amends for wrongs that have been done to individuals or groups. Option 4: General justice is an overall term for the obligation to be fair and implies equal treatment of all clients.

A nurse discharges a client without answering any questions or teaching him or her how to treat a wound care at home. What type of malpractice claim could be brought against this nurse? 1. Failure to implement a plan of care 2. Failure to assess and diagnose 3. Failure to plan 4. Failure to evaluate

ANS: 1 Rationales Option 1: Not answering questions, failing to educate clients, and failing to provide care in a reasonable and timely manner are considered failure to implement a plan of care, which is considered a form of malpractice. Option 2: Failure to complete an assessment as well as analyze the data to make correct nursing diagnoses can lead to inappropriate action(s) or improper delegation. Option 3: ANA standards require the nurse to complete a care plan that is individualized for the client; therefore, failure to do so is considered malpractice. Option 4: Failing to observe for changes in treatment and interventions is in direct violation of the ADA nursing standards and can be considered malpractice.

Nurse practice acts are an example of what type of law? 1. Statutory 2. Administrative 3. Common 4. Constitutional

ANS: 1 Rationales Option 1: Nurse practice acts (NPAs) passed by the legislative body of each state are regulations that govern the profession of nursing. Option 2: Administrative law refers to the laws that govern the activities of administrative agencies. Option 3: Common law, also called case law, is based on common customs and traditions and comes from legal principles used by judges. Option 4: Constitutional law is a system of basic and foundational laws and principles that sets the nature, functions, and limits of a government.

A nurse has been caring for a client and appears to make excessive visits to the client's room. The nurse states he or she has the best understanding of the client's needs while behaving as if no one else can care for the client. When asked about this behavior, the nurse becomes defensive. What could possibly be the issue in this scenario? 1. Potential boundary issues 2. Possible substance abuse issues 3. Infraction of statutory law 4. Unclear scope of practice

ANS: 1 Rationales Option 1: Nurses exhibiting secretive behaviors or excessive visits to a client's room could be demonstrating behavior that is consistent with boundary issues. Option 2: Substance abuse issues can be seen in the behaviors of nurses who have excessive absences or take long breaks. Option 3: Infractions regarding the scope of practice can be considered statutory law issues. Option 4: The scope of practice is clearly defined and is not the issue in this scenario.

What is one major drawback of applying the Golden Rule way of thinking when addressing a client's wishes? 1. It is presumptuous in that nursing actions may not really be what the client wants. 2. It removes all grounds for client autonomy. 3. It removes the family from decision making. 4. It blurs the role of nurse, advocate, and ethical decision making.

ANS: 1 Rationales Option 1: Presuming the client would want to be treated the same way the nurse does can have significant clinical and ethical implications, as it causes health-care professionals and families to make decisions for the client that are, in reality, not what the client would want. Option 2: Client autonomy may be removed if the client has not already stated wishes and are unable to determine for himself or herself, but this is not the major problem. Option 3: Applying the Golden Rule way of thinking does not mean removing the family from any decision making. Option 4: Blurring the lines between nurse and advocate is difficult because both are ethical duties of the nurse.

After assessing a client who has just been weaned from the ventilator, the nurse determines the client is not yet able to ambulate and does not follow the physician's order. What protects the nurse from being terminated or disciplined for not following orders? 1. Safe harbor laws 2. Good Samaritan laws 3. Professional liability 4. Nurse practice acts

ANS: 1 Rationales Option 1: Safe harbor laws protect nurses from being suspended, terminated, disciplined, or discriminated against for refusing to do (or not do) something they believe would be harmful to a client. Option 2: Good Samaritan laws protect those who provide emergency care to individuals in need of medical services. Option 3: Professional liability insurance covers the nurse if sued for malpractice. Option 4: Nurse practice acts (NPAs) are statutory laws within each state that define the practice of nursing, including regulations and scope of practice.

A 49-year-old uninsured and unemployed client arrives at the emergency department of the local private hospital closest to home complaining of chest pain radiating between the shoulder blades, tightness in the neck, and nausea. The triage nurse calls the on-call provider, who instructs the nurse to send the client to the county hospital several blocks away. What federal law protects this client against refusal of care at the private hospital? 1. EMTALA 2. PSDA 3. HITECH 4. DPOA

ANS: 1 Rationales Option 1: The Emergency Medical Treatment and Active Labor Act (EMTALA) mandates health-care facilities provide emergency medical treatment to clients seeking emergency health care regardless of their ability to pay, legal status, or citizenship status. Option 2: The Patient Self-Determination Act (PSDA) identifies a client's right to make informed decisions regarding his or her health care. Option 3: Under the HITECH Act, health-care agencies are required to notify clients of any breach of information without unreasonable delay and by no longer than 60 days. Option 4: Durable power of attorney (DPOA) identifies a surrogate decision maker who is able to make decisions regarding health in the event the client is unable to do so.

The provider prescribed Demerol 50 mg at 1400 as an initial dose for a post-operative client to be monitored for reactions and titrate accordingly every 3 to 4 hours prn for pain. The nurse documented the following: 1500Demerol 150 mg given intramuscularly. 1530R: 10 breaths/min; BP 98/62; skin pale.1600 Called provider. Prescription for naloxone (Narcan) 1 mg IV STAT1605 Narcan given as prescribed. R: 14 breaths/min, BP 112/68What important step could be called into question when reporting this incident? 1. The 30-minute delay in contacting the provider 2. The difference in what was given and what was prescribed 3. The delay in administering the initial dosage 4. The 30-minute delay in assessing the client for side effects

ANS: 1 Rationales Option 1: The standard of care would require that the provider be notified immediately, and a 30-minute delay could be detrimental to this client. Option 2: While the nurse should be prepared to address this issue, it is not the issue with this client after the initial dose was administered and the issue has been reported. Option 3: Delaying of initial administration could be due to pharmacy delays or other assessment issues taking place. Option 4: 30 minutes is not particularly a delay but an appropriate time frame to monitor for side effects.

Which civil laws deal with wrongs done by one person to another without a contract involved? 1. Tort laws 2. Criminal laws 3. Assault 4. Misdemeanor

ANS: 1 Rationales Option 1: Tort laws are a wrong done by one person to another without a contract being involved. Option 2: Criminal laws involve breaking the law and committing a crime. Option 3: Assault is a criminal law. Option 4: A misdemeanor is a lesser criminal offense.

What is the mission of the Client Care Partnership? 1. It encourages health-care providers to be more aware of the need to treat clients in an ethical manner and to protect their rights. 2. A client's values, preferences, need for information, and other factors that promote autonomy must be considered in the plan of care. 3. It states that ethical behavior in care, treatment, services, and business practices should be maintained at all times. 4. It addresses the nurse's responsibilities to clients and directs nurses to contribute to the establishment and maintenance of an ethical environment.

ANS: 1 Rationales Option 1: When clients are admitted to hospitals or extended care facilities, they are entitled to specific rights in terms of their treatment, which vary from culture to culture, so awareness of client needs is important. Option 2: The Joint Commission standards state that a client's values as well as factors that facilitate autonomy are important aspects of ethical care. Option 3: The Joint Commission standards contain sections on organizational ethics and individual rights, including requiring ethical behavior in care, treatment, services, and business practices. Option 4: Standard 7 of the ANA Standards of Care speaks to the nursing responsibilities to clients and focus on maintaining an ethical environment.

What would be an appropriate nursing diagnosis for a client who is uncertain about which course of action to take in his or her treatment? 1. Decisional Conflict 2. Moral Distress 3. Values Clarification 4. Value/Belief/Action Congruence

ANS: 1 Rationales Option 1: With Decisional Conflict, the client may verbalize distress and uncertainty, may delay decision making, and may be unable to make a definitive decision. Option 2: Moral Distress is used when the client has made a moral decision but is unable to carry out the chosen action. Option 3: Values Clarification refers to the process of becoming conscious of and naming one's values, which enables sound decision making. Option 4: Value/Belief/Action Congruence is a class of diagnoses in the NANDA-I classification list.

. When using the MORAL model for ethical decision making, what principles will help the nurse to function effectively as an advocate? Select All That Apply. 1. Know and document facts. 2. Know the argument. 3. Avoid getting into a power struggle. 4. Be aware of client vulnerability. 5. Assess the group's willingness.

ANS: 1, 2, 3, 4 Rationales Option 1: By having a complete understanding of the data, the nurse can best serve in an advocacy position for clients. Option 2: Understanding the components of the argument, being unbiased, and understanding the opposition of the client will best suit the client's needs. Option 3: Decide how far is appropriate and enlist those with more power to help facilitate the change. Option 4: Avoid confrontation and be sure the client is aware of possible risks. Option 5: Assessing a group's willingness is not particular to the model for ethical decision making.

Which are examples of protected health information? Select all that apply. 1. Client's diagnosis 2. Treatment for depression 3. Account turned over to collections 4. Appointments 5. Employer records of treatment

ANS: 1, 2, 3, 4 Rationales Option 1: Individual information regarding treatment and demographic information are considered protected. Option 2: Past as well as current medical treatment is considered protected information. Option 3: Payment history and transactions, including accounts placed in collections, are considered protected information. Option 4: Appointments are considered protected information, as are any other dates such as discharge and admission dates. Option 5: Employer documents are not protected under HIPPA when used for the purpose of employment.

What are steps to help avoid malpractice? Select all that apply. 1. Don't blame or criticize other health-care providers. 2. Recognize "problem" clients. 3. Recognize significant assessment cues. 4. Know and follow standards of care. 5. Be sure medical equipment has been properly inspected.

ANS: 1, 2, 3, 4 Rationales Option 1: It is never wise to blame or criticize other health-care professionals in the presence of clients, as it demeans the whole system and is unprofessional. Option 2: Clients who have unresolved issues and are angry may more often feel mistreated, which can lead to a lawsuit. Option 3: It is important to report all changes in client status, as well as any concerns expressed by the client, to the provider. Option 4: Adhering to local, state, and professional agency policies will help eliminate the risk for malpractice. Option 5: Ensuring equipment has been inspected and working properly is a smart nursing activity, but it is not one particular to avoiding malpractice.

hen creating a password for computer usage, what are some important factors that should be kept in mind? Select all that apply. 1. Use combinations of letters, numbers, and symbols. 2. Don't use words or numbers that are easy to guess. 3. Change passwords frequently. 4. Never share passwords with others. 5. Use the same password for multiple accounts so it is not forgotten.

ANS: 1, 2, 3, 4 Rationales Option 1: Using a combination of letters, numbers, and symbols makes for a complex password that is difficult to recreate or guess. Option 2: Using common words like pet names, birthdates, and so forth are easy for hackers to guess. Option 3: Passwords should be changed frequently to prevent invasion of privacy. Option 4: Passwords should never be shared with others to avoid the possibility of others accessing private information. Option 5: It is not recommended to use the same password for multiple accounts, as this can increase the risk for invasion.

Which are examples of protected health information? Select all that apply. 1. Client's diagnosis 2. Treatment for depression 3. Account turned over to collections 4. Appointments 5. Employer records of treatment

ANS: 1, 2, 3, 4, Rationales Option 1: Individual information regarding treatment and demographic information are considered protected. Option 2: Past as well as current medical treatment is considered protected information. Option 3: Payment history and transactions, including accounts placed in collections, are considered protected information. Option 4: Appointments are considered protected information, as are any other dates such as discharge and admission dates. Option 5: Employer documents are not protected under HIPPA when used for the purpose of employment.

Which are forms of electronic communication? Select all that apply. 1. Email 2. Telephone 3. Text message 4. Telehealth 5. Interoffice memo

ANS: 1, 3, 4 Rationales Option 1: Electronic mail (email) is a form of electronic communication. Option 2: Telephones may be electronic, but this is not electronic communication. Option 3: Text messaging is electronic communication. Option 4: Telehealth is the transmission of information to provide care remotely. Option 5: An interoffice memo by itself may not be an electronic communication.

Which are client privacy and security safeguards in an electronic medical record system? Select all that apply. 1. Passwords and PIN numbers 2. Having the client sign a release of information 3. Encrypting 4. Workstation privacy filters 5. Not being able to share protected health information

ANS: 1, 3, 4 Rationales Option 1: Use of passwords and PIN numbers will prevent access for those who should not be viewing client information. Option 2: A client signing a release of information is not a security safeguard. Option 3: Encrypting utilizes a special code to view protected information. Option 4: Privacy filters set up at workstations block the view of a computer screen. Option 5: Protected health information can be shared with other members of the health-care team.

Which questions are examples of bioethics considerations? Select all that apply. 1. Should a client be allowed to die? 2. Should a nurse practice outside of scope? 3. Should a nurse question an order? 4. Should a nurse sign with "RN" behind her name? 5. Should a client be told about a medical error?

ANS: 1, 3, 5 Rationales Option 1: End-of-life decisions apply principles of bioethics. Option 2: A nurse practicing outside of scope is more an issue of a legal nature. Option 3: Questioning a physician's order applies principles of bioethics. Option 4: It is a legal responsibility to sign with "RN" after the signature. Option 5: Informing a client and the family about a medical error is an application of bioethics.

Which are elements of the Good Samaritan law? Select all that apply. 1. Care was provided in an emergency situation. 2. A person was harmed as a result of care provided. 3. Care was voluntary and payment was not provided. 4. A health-care provider is required to provide care in an emergency situation. 5. Care is provided in a reasonably competent manner.

ANS: 1, 3, 5 Rationales Option 1: Good Samaritan laws apply to care given in emergencies. Option 2: Good Samaritan laws do not apply to a person harmed as a result of the care provided. Option 3: If payment is given for care provided, Good Samaritan laws are nullified. Option 4: Good Samaritan laws do not require that a health-care provider respond to an emergency. Option 5: Good Samaritan laws state that emergency care should be provided in a reasonably competent manner.

Which are examples of beliefs? Select all that apply. 1. Elderly people cannot provide a good medical history. 2. A family should be told if a medical error occurs. 3. A nurse should not be allowed to work while impaired. 4. A person should not accept blood or blood products from another person. 5. Arriving 15 minutes before shift will give the appearance of dedication.

ANS: 1, 4, 5 Rationales Option 1: Beliefs are not necessarily facts. These are particular to an individual and personal. Option 2: There is an ethical and legal basis for this statement, so it goes further than a belief. Option 3: Nurses working while impaired presents ethical and safety concerns, and therefore is more than a belief. Option 4: The rightness of accepting certain medical treatment is based on beliefs, which may be based on faith. Option 5: There is no legal or ethical basis to arrive early for work, and the appearance of this practice is a belief.

Which expectations are covered by the American Hospital Association Patient Care Partnership? Select all that apply. 1. High-quality care 2. No unexpected costs 3. Explanation of a diagnosis 4. Involvement in care 5. A clean and safe environment

ANS: 1, 4, 5 Rationales Option 1: High-quality care is an expectation of clients that is provided in the Patient Care Partnership. Option 2: The Patient Care Partnership does not stipulate no unexpected costs. Option 3: The Patient Care Partnership does not cover explanation of diagnoses. Option 4: Involvement in care is addressed in the Patient Care Partnership. Option 5: A clean and safe environment is an expectation that is addressed in the Patient Care Partnership.

According to the Health Information Portability and Accountability Act Privacy Rule, protected health information can only be shared for which purposes? Select all that apply. 1. Treatment 2. To ensure everyone on a nursing unit is aware of the client 3. Reassurance to family 4. Payment 5. Operations 6. Understanding past treatments

ANS: 1, 4, 5 Rationales Option 1: Treatment is a valid reason for disclosure of protected health information to other members of the treatment team. Option 2: Only those involved in the care of the client should have access to client information. Option 3: Protected health information cannot be shared with the family unless the client provides specific permission. Option 4: Protected health information can be shared with third-party payers to facilitate payment. Option 5: Information can be shared to support operations such as education or data collection. Option 6: Understanding of past treatments is not a reason to disclose protected health information.

Which consequentialist theory requires a risk-benefit analysis? 1. Deontology 2. Utilitarianism 3. Whistleblowing 4. Conflict of universal principles

ANS: 2 Option 1: Deontology involves applying principles of right and wrong to a decision. Option 2: Utilitarianism asserts that the value of an action is determined by its usefulness. Option 3: Whistleblowing can be an ethical action, but it is not a consequentialist theory. Option 4: Conflict of universal principles involves deciding between two actions.

Which nursing value describes the right to self-determination and to choose and act on that choice? 1. Altruism 2. Autonomy 3. Human dignity 4. Integrity

ANS: 2 Rationales Option 1: Altruism refers to client advocacy and concern for the welfare of clients, other nurses, and other health-care providers. Option 2: Autonomy refers to the right to self-determination—to choose and act on that choice. Option 3: Human dignity refers to respect for the inherent worth and uniqueness of individuals and populations. Option 4: Integrity refers to honesty and acting within a certain code of ethics.

A client is being discharged after being admitted for myocardial infarction. The physician wants the client to be monitored for vital signs while he or she is engaging in rehabilitation protocol. What type of informatics system could be suggested for reliable interface with client data? 1. Smart wearable body sensors 2. Real-time health monitor system 3. Personal fitness tracker 4. Telehealth monitoring

ANS: 2 Rationales Option 1: Body sensors are a great way to access physiological data to monitor health and illness in clients, but they may not be best suited for a client with cardiac dysfunction and disease. Option 2: Real-time health monitoring systems have been proven to be beneficial in cardiac rehabilitation with benefits that include access to physiological data and a warning system. Option 3: Personal fitness trackers have been proven to be highly accurate in heart rate monitoring but do not provide enough benefits for those with cardiac abnormalities. Option 4: Telehealth has grown and can be very effective in treating illness, but it does not monitor a client's health progressively.

Which describes the entry of orders directly into an electronic health record by a provider? 1. Decision support algorithms 2. Computerized physician order entry 3. Online order requisitions 4. Client web portal

ANS: 2 Rationales Option 1: Decision support algorithms are used to guide care decisions. Option 2: Computerized physician order entry is the entry of orders directly into a medical record by the provider. Option 3: Ab order requisition is a communication tool to facilitate an order. Option 4: A client web portal is a storage area for all client information.

Which describes an ethical dilemma? 1. A client refuses treatment for cancer, stating that his or her religious beliefs forbid it. 2. A pregnant woman may miscarry if she takes a strong chemotherapy agent, but if she doesn't, her cancer will progress quickly. 3. A nurse catches a coworker diverting drugs, and the coworker asks him or her not to tell anyone. 4. A charge nurse asks a staff nurse to stay and work late, but the nurse has plans that evening.

ANS: 2 Rationales Option 1: The client's beliefs must be respected. Although the nurse may disagree with the choice, this is not an ethical dilemma. Option 2: Both choices are undesirable. The client must be allowed to make the decision based on ethical principles. Option 3: This is a moral issue—the nurse has a duty to report this matter. Option 4: The nurse should not have an ethical dilemma in making a choice. This could be a workplace issue, but it is not an ethical dilemma.

A nurse taking care of a client who has been involved in a motor vehicle accident while intoxicated is an example of which principle? 1. Morals 2. Ethics 3. Legal 4. Policy

ANS: 2 Rationales Option 1: A moral judgement on the client has nothing to do with the care provided by the nurse. Option 2: Nursing ethics would require the nurse to care for the client regardless of the cause of the injuries. Option 3: Legality is not the principle represented in this scenario. Option 4: Policy is not a principle that relates to not judging an individual when providing care.

Which are the purposes of the Health Insurance Portability and Accountability Act of 1996? Select all that apply. 1. Mandate the informed consent process before procedures. 2. Protect health insurance benefits for workers who change jobs. 3. Establish standards to protect client privacy and confidentiality. 4. Protect coverage for individuals with preexisting conditions. 5. Guarantee payment to health-care facilities by Medicare.

ANS: 2, 3, 4 Rationales Option 1: HIPAA does not address informed consent. Option 2: HIPAA provides for portability of insurance coverage if a person changes jobs. Option 3: The HIPAA Privacy Rule has stipulations for how and when client information is shared. Option 4: HIPAA prevents denial of coverage for those with preexisting conditions. Option 5: HIPAA does not provide a guarantee of payment by Medicare.

How can nurses use computers to ensure they are following best practices? 1. Join a chat room with other nurses. 2. Ask a question on social media. 3. Perform a literature search. 4. Type a keyword into a browser.

ANS: 3 Rationales Option 1: Joining a chat room may be helpful in sharing ideas and networking, but this does not ensure adherence to best practices. Option 2: Asking a question on social media will produce little, if any, valuable information. Option 3: Performing a search of peer-reviewed literature will help determine standards of practice. Option 4: Performing a browser search will yield many numerous results, which could be difficult to narrow down.

A nurse suspects a colleague is taking a client's narcotics. The colleague has been behaving erratically at work and his or her clients complain of uncontrolled pain. The nurse reports this concern to the colleague's supervisor. Which is this an example of? 1. Mandated reporting 2. Bioethics 3. Whistleblowing 4. Morals

ANS: 3 Rationales Option 1: Mandated reporting is a legal requirement to report suspected abuse or neglect. Option 2: Bioethics is ethical principles applied to nursing practice. Option 3: Whistleblowing is done in response to moral outrage and recognizing an unsafe situation. Option 4: Morals is the application of right and wrong.

Which process assists nurses with selecting correct medication and dosing? 1. Telehealth 2. Electronic database 3. Bar coding 4. Computerized order entry

ANS: 3 Rationales Option 1: Telehealth is beneficial for many health-care uses, but it is not associated with medication and dosing. Option 2: An electronic database can help with obtaining client records, but it is not used for medication and dosing. Option 3: Bar coding matches client information and an order with the medication, ensuring the correct medication and dosage. Option 4: Computerized order entry is used by providers to enter orders directly into electronic health records.

Which describes the ethical concept of fidelity? 1. Doing no harm and preventing harm 2. Duty to do or promote good 3. Duty to keep promises 4. Duty to tell the truth

ANS: 3 Rationales Option 1: This is nonmaleficence. Option 2: This is beneficence. Option 3: This is fidelity. Option 4: This is veracity.

Which represents an Americans with Disabilities Act (ADA) accommodation? 1. A nurse has chronic back pain and is terminated from his or her position. 2. A nursing mother returns to work and is given a lactation area for pumping breast milk. 3. A nurse who has had a stroke is not physically able to perform client care and is given a position in scheduling, with an associated pay cut. 4. A nurse adopts a baby and is given a maternity leave.

ANS: 3 Rationales Option 1: This is not a reasonable accommodation of a disability. Option 2: There are legal protections for nursing mothers, but this is not an ADA accommodation. Option 3: A nurse who has physical limitations and is given a job he or she can perform has had a reasonable accommodation made. Option 4: FMLA is a maternity leave that is applicable when giving birth or adopting a baby.

Which are examples of negligence? Select all that apply. 1. A nurse inadvertently giving a wrong dose of a medication 2. A nurse documenting vital signs in a medical record when they have not been taken 3. A nurse not turning and repositioning a bedridden client, resulting in the development of bedsores 4. A nurse not administering pain medications as needed for a hospice client 5. A client falling after the client has called for assistance in getting up, for which nobody responded after 25 minutes

ANS: 3, 4, 5 Rationales Option 1: A medication error is not an example of negligence. Option 2: This is an example of falsification of records. Option 3: A nurse failing to provide basic care that a reasonable person with similar credentials should provide is negligent. Option 4: Not administering pain medications to a client who is in severe pain is negligent. Option 5: If a client has a need and the nurse does not respond, this is negligence.

Which is a barrier to adoption of an electronic health record? 1. Higher risk for errors 2. Staff unable to learn to use an EHR 3. Cumbersome and time-consuming to use 4. Purchase and installation cost

ANS: 4 Rationales Option 1: An EHR actually reduces errors through automation. Option 2: Most EHR systems are not difficult to learn and implement. Option 3: Once installed, most EHR's are time savers. Option 4: The cost of purchase and installation can make obtaining an EHR difficult for smaller facilities.

Which regulation requires health-care facilities to provide emergency care to clients who seek health care regardless of ability to pay? 1. Health Insurance Portability and Accountability Act 2. Client Self-Determination Act 3. Durable power of attorney for health care 4. Emergency Medical Treatment and Active Labor Act

ANS: 4 Rationales Option 1: HIPAA does not address emergency treatment without regard to payment. Option 2: The Client Self-Determination act recognizes the client's right to make decisions regarding his or her own health care. Option 3: Durable power of attorney for health care addresses clients determining a decision maker if they are no longer able to make decisions. Option 4: EMTALA requires health-care facilities to provide emergency care to clients who present for health care without regard for ability to pay.

A client is placed under involuntary confinement for suicidal ideation. During this time, the nurse applies restraints to insert a urinary catheter. Which situation has occurred? 1. Neglect 2. Fraud 3. Assault 4. False imprisonment

ANS: 4 Rationales Option 1: This situation does not describe neglectful actions. Option 2: No fraudulent activity is taking place. Option 3: Although this is a threat of violence, this is not an assault. Option 4: False imprisonment is the application of restraints without proper legal authorization.

A client is being discharged after being admitted for myocardial infarction. The physician wants the client to be monitored for vital signs while he or she is engaging in rehabilitation protocol. What type of informatics system could be suggested for reliable interface with client data? 1. Smart wearable body sensors 2. Real-time health monitor system 3. Personal fitness tracker 4. Telehealth monitoring

aNS: 2 Rationales Option 1: Body sensors are a great way to access physiological data to monitor health and illness in clients, but they may not be best suited for a client with cardiac dysfunction and disease. Option 2: Real-time health monitoring systems have been proven to be beneficial in cardiac rehabilitation with benefits that include access to physiological data and a warning system. Option 3: Personal fitness trackers have been proven to be highly accurate in heart rate monitoring but do not provide enough benefits for those with cardiac abnormalities. Option 4: Telehealth has grown and can be very effective in treating illness, but it does not monitor a client's health progressively.