Fundamentals of Nursing Chapter 3: Laws and Ethics

A nurse observes another nurse place an unused dose of narcotics in their pocket. If caught, the nurse could be charged with which type of crime?

felony

Which nursing action demonstrates the principle of fidelity?

filing an incident report after making a medication error

Recent staffing shortages on a hospital unit have resulted in unlicensed care providers being assigned to duties that are beyond their scope of practice. This has resulted in a number of near misses involving client safety. How should a nurse best respond to this trend in care?

Make the appropriate hospital authorities aware of this practice

A competent adult client is scheduled for surgery. Who signs the informed consent form to allow the surgery?

The client

The nursing student demonstrates the need for further instruction with which statement concerning moral values?

"Moral values give individuals some sense of what is right and wrong."

The client being admitted to the oncology unit conveys his wishes regarding resuscitation in the event of cardiopulmonary arrest. The nurse advises the client that it would be in his best interest to obtain which document?

A living will

Which nursing student would most likely be held liable for negligence?

A nursing student administers medication to a resident, while working as an unlicensed assistive personnel (UAP) at a local nursing home.

A client informs the nurse that he is leaving the health care facility because he is not satisfied with the treatment. The nurse knows that the client's treatment is incomplete and further testing and evaluations are scheduled. Which action by the nurse would be most appropriate to prevent false imprisonment?

Ask the client to sign a release without medical approval.

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

When the nurse inserts an ordered urinary catheter into the client's urethra after the client has refused the procedure, and then the client suffers an injury, the client may sue the nurse for which type of tort?

Battery

A nurse exits the room of a confused client without raising the side rails on the bed. The failure to raise the side rails would constitute which element of liability related to malpractice?

Breach of duty

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. What does the description of the client and his injuries represent as proof of malpractice?

Damages

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

Dignity

The nurse finds that there have been several opportunities to share personal prescriptions with family members when they were in need of pain medication or antibiotics. Which area of rules should govern the nurse's moral decision?

Ethics

A dying client tells the nurse that he doesn't want to see his family because he doesn't want to cause them more sadness. Which action by the nurse is most appropriate

Help the client clarify his values.

The nursing supervisor is preparing to delegate some aspects of the nursing care plan interventions to other healthcare providers on the unit. Which are requirements of supervisory nursing? Select all that apply.

In-depth knowledge of the job descriptions and capabilities of each person on the team. Registered nurses cannot delegate the practice-pervasive functions of assessment. Registered nurses must assure the care was delivered accurately and appropriately.

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

Integrity

A home health nurse performs a careful safety assessment of the home of a frail older adult client to prevent harm to the client. The nurse is acting in accord with which principle of bioethics?

Nonmaleficence

What is the legal source of rules of conduct for nurses?

Nurse Practice Acts

A nurse is caring for a client following endotracheal intubation. Before applying soft wrist restraints to prevent the client from pulling out the endotracheal tube, what is the most appropriate action of the nurse?

Obtain a medical order.

During the admission assessment of a female client age 40 years with a suspected mandibular fracture, the client discloses to the nurse that her injury came as a result of her husband hitting her. Which action should the nurse prioritize when responding to this disclosure?

Reporting the abuse to the appropriate authorities

A client on a surgical unit asks for the nurse's opinion of the surgeon. The nurse replies, "He is rude. His clients always end up with infections." The nurse is at risk of being accused of which of the following?

Slander/defamation

Which accreditation is a legal requirement for a school of nursing to exist?

State Board of Nursing accreditation

A client is in a persistent vegetative state. The client has no immediate family and is a ward of the state. Under these circumstances, who will speak on this client's behalf?

Surrogate decision maker

A client who is mentally incapacitated is scheduled to undergo surgery. The nurse demonstrates understanding of the principle of autonomy and checks the client's health record to ensure that consent has been obtained from which person?

Surrogate decision-maker

A registered nurse has had her license suspended after being convicted of being impaired at work. What governing body has the authority to revoke or suspend a nurse's license?

The State Board of Nurse Examiners

Which aspect of nursing would be most likely defined by legislation at a state level?

The differences in the scope of practice between registered nurses (RNs) and licensed practical nurses (LPNs).

Nursing students in an ethics class have been asked to define "ethics." What would be the best definition of ethics?

The formal, systematic study of moral beliefs.

A client is brought to the emergency department in an unconscious state with a head injury. The client requires surgery to remove a blood clot. What would be the appropriate nursing intervention in keeping with the policy of informed consent prior to a surgical procedure?

The nurse ensures that the client's family signs the consent form.

A physician is called to see a client with angina. During the visit the physician advises the nurse to decrease the client's atenolol to 12.5 mg daily. However, since the physician is late for another visit, the physician requests that the nurse write down the order and sign it. What should be the appropriate nursing action in this situation?

The nurse should ask the physician to come back and write the order.

A client is unhappy with the health care provided to him. He approaches the nurse and informs her that he is leaving the facility. The client has not been discharged by the physician. The nurse finds that the client has dressed and is ready to go. What would the nurse's action be in this situation?

The nurse should call the nursing supervisor and inform her about the situation.

Two nurses meet at their home, where one of the nurses discusses a client who had been physically abused. The next day, the client is shifted to another nursing unit after a surgical procedure and becomes the care of the second nurse who had been part of the original discussion. Nurse No. 2 asks the client about the physical abuse. The client discovers that his original nurse revealed the information and is hurt. What would be the charges if the client files a suit?

The nurses could be charged for slander.

Which is not true regarding Nurse Practice Acts?

They describe what medications nurses can prescribe.

Which ethics theory focuses on ends or consequences of actions?

Utilitarian theory

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

Values

The client is a 2-month-old infant extremely ill from HSV sepsis. Her mother and father have decided to stop additional medical intervention and allow the infant to pass away naturally. The mother does not want her relatives to know that they plan to stop pursuing aggressive medical treatment because it is against their family's religious beliefs to withdraw medical support. What does the nurse tell the client's mother?

Yes, it is her decision who to inform about the family's medical decision.

A nurse is caring for a client who is a practicing Jehovah's Witness. The physician orders two units of packed cells based on his low hemoglobin and hematocrit levels. The nurse states to the surgeon that it is unethical to go against the client's beliefs even though his blood counts are very low. What is the best description of the nurse's intentions?

acting in the client's best interest

A client admitted to the mental health unit has exhibited physical behaviors that put him 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:

battery.

A hospital owned by a Catholic order of nuns will not allow tubal ligations to be performed. This is considered to be:

institutional policy.

While riding in the elevator, a nurse discusses the HIV-positive status of a client with other colleagues. The nurse's action reflects:

invasion of privacy.

The foundation for decisions about resource allocation throughout a society or group is based on the ethical principle of:

justice.

A nurse is of the Catholic faith and votes pro-life. He is considered to have:

personal values.

A nurse is driving on a back country road when a man flags the nurse down and yells that his wife is having a baby. As a registered nurse she is eager to help. The nurse recalls that she is covered under the Good Samaritan Law. This law states:

that the nurse's license is protected if she acts in a reasonable manner given the circumstances.

Following a neonatal death, a maternity nurse has become named in a malpractice suit. When evaluating the nurse's actions, the court will compare the nurse's actions to:

the practice norms of nurses in similar circumstances.

A nurse enters the client's room and finds the client lying on the floor with ongoing seizures. The nurse helps the client to get up, makes him comfortable, and then informs the physician. The physician advises the nurse to prepare an incident report. What is the purpose of an incident report?

to evaluate quality care and potential risks for injury to the client

A student is preparing to graduate from nursing school and understands that professional regulations and laws that govern nursing practice are in place. These regulations and laws are in place for which reason?

to protect the safety of the public

A public health nurse is involved in planning a community outreach program for a large assisted living community. Due to the aging population within the community, the program will offer hypertension screening and management. This decision is based on which principle?

utilitarianism

Socialization into the nursing profession may have the most significant effect on:

values

A parent teaches his or her children not to drink and drive; however, the parent does drink and drive. This action causes

Failure to reflect own values

A nurse states to the client that she will keep her free of pain. However, her family wishes to try a treatment to prolong her life that may necessitate withholding pain medication. This factor will cause an ethical dilemma for the nurse in relation to which ethical principle?

Fidelity

A child on a pediatric unit hits one of the other children and subsequently has video game privileges revoked for the rest of the day. The next day the same child plays with the other children without any problems in order to avoid losing video game privileges again. According to Kohlberg, the child is demonstrating what stage of development?

First-level preconventional stage

While teaching about advance care planning, which fact is important for the nurse to share with a client who has been diagnosed with a terminal illness?

A durable power of attorney for health care appoints an agent the person trusts to make decisions.

The client is a 40-year-old man admitted for repair of a femoral fracture. He discloses that he has a history of an addiction to painkillers and asks that the nurse assist him in adhering to his recovery from this addiction by not administering any narcotics. As the nurse reviews postoperative orders for the client, the nurse notes that his physician has ordered Codeine 30 mg p.o. q6 hours for pain. How does the nurse best approach this situation?

Asks the physician to remove this order from the client's chart.

A nurse caring for an older adult client following a total abdominal hysterectomy documents administration of morphine 4 mg intravenously for pain of 8 on 1-10 scale, bed in the lowest position, bed alarm on, side rails up times two, and call light in reach. After the nurse leaves the room, the client gets out of bed and falls. In which order should the nurse proceed?

Assess the client for injury. Assist the client back into bed. Notify the physician. Document the incident. Complete an incident report.

Which is the nurse's best legal safeguard?

Competent practice

When examining values, a nurse notes that one country uses physician-assisted suicide and another country considers physician-assisted suicide as illegal and punishable with imprisonment. How are these two views on physician-assisted suicide affected?

Culturally

The nurse is concerned about a potential malpractice or negligence lawsuit regarding a client that was cared for on the unit. What specific elements must be established to prove that malpractice or negligence has occurred in this client? (Select all that apply.)

Duty Breach of duty Causation Damages

The nursing student talks with her family about an AIDS client from the clinical experience yesterday. Which tort has the student committed?

Invasion of privacy

The student nurse tells her family about a client with AIDS that she cared for in clinical yesterday. Which tort has the student committed?

Invasion of privacy

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

Invasion of privacy

Upon entering the hospital system, the nurse discusses the rights and responsibilities that the client is entitled to in the institution. The information the nurse discusses is commonly referred to as:

Patient's Bill of Rights

A nurse believes that abortion is an acceptable option if a pregnancy results from a situation of rape. What is the best description of this belief?

Personal morality

When individuals or groups use utilitarianism to make ethical decisions, what do they consider?

Rightness or wrongness depends on consequences.

Nurse Practice Acts are examples of which type of laws?

Statutory laws

While delivering patient care, the home healthcare nurse has the ability to see the whole picture and how various parts are related to the client's diagnosis and problems in the home environment. What skills does the nurse possess that allow her to see the connection of various parts of the situation

System skills

A nurse witnesses a 50-year-old woman go into cardiac arrest while traveling in a train and attempts to resuscitate her. In spite of the nurse's efforts, the woman dies, and the family members file a suit against the nurse. Which of the following statements about Good Samaritan Laws is applicable here?

The Good Samaritan Law will likely protect the nurse because she acted in the woman's best interests.

A nurse has become aware of a conflict between a client's children, one of whom want to withhold the client's recent cancer diagnosis from her in the belief that the client would "give up hope" if she became aware of her condition. Which response to this situation most clearly represents a deontological perspective?

The morality of the withholding information from a client is the primary concern

A nurse is completing required tasks prior to the end of a busy shift on a sub-acute geriatric unit. These tasks include the completion of documentation for each of the clients for whom the nurse provided care. What characteristics should be included in the nurse's documentation? (Select all that apply.)

The nurse should ensure that handwritten documentation is legible Documentation should performed in the knowledge that it forms a legal record

A nurse has been assigned to the ICU by a supervisor because of a number of sick calls. However, the nurse is not highly experienced in providing intensive nursing care. What would be the most appropriate action by the nurse?

To report to the nurse-in-charge for duty but explain the nurse's practice limitation

A client is received in a postoperative nursing unit after undergoing abdominal surgery. During this time the nurse failed to recognize the significance of abdominal swelling, which significantly increased during the next 6 hours. Later, the client had to undergo emergency surgery. The lack of action on the nurse's part is liable for action. Which legal term describes the case?

Tort

To practice ethically, the nurse should:

avoid allowing her judgment to guide practice.

An RN enters a client's room and observes the unlicensed assistive personnel (UAP) forcefully pushing a client down on the bed. The client starts crying and informs the UAP of the need to go to the bathroom. What action is the RN witnessing that should be immediately reported to the supervisor?

battery.

A postanesthesia nurse is reporting about a client to the intensive care unit nurse in the elevator. There are staff members and visitors in the elevator. The postanasthesia nurse is doing what?

breaching the client's confidentiality

A nurse is caring for a client who is a celebrity in the area. A person claiming to be a family member inquires about the medical details of the client. The nurse reveals the information but later comes to find out that the person was not a family member. The nurse has violated:

confidentiality.

A nursing student's attitude is defined as:

disposition toward situations.

A nursing student states he is able to put himself in his client's shoes. He states he understands the situation of the ill client. This is considered to be an act of:

empathy.

An adolescence is in the process of value formation. What does the nurse determine that will be the greatest influence in the child's formation of values in this developmental stage?

peers.

Which situation is an example of battery that the nurse may experience while performing her duties at the health care facility?

performing a surgical procedure without getting consent

A nursing instructor is teaching a class about ethical principles to a group of nursing students. The instructor determines that the education was successful when the students give what as an example of nonmaleficence?

protecting clients from a chemically impaired practitioner

A nurse has a duty of nonmaleficence. Which of the following would be considered a contradiction to that duty?

refusing to administer pain medication as ordered

The nurse is engaged in dialogue with a client in an effort to identify the client's values. Value systems are often formally embedded and integrated into:

religion.

A client with a diagnosis of colorectal cancer has been presented with her treatment options, but wishes to defer any decisions to her uncle, who acts in the role of a family patriarch within the client's culture. The client's right to self-determination is best protected by:

respecting the client's desire to have the uncle make choices on her behalf.

A nurse is overheard in the hospital cafeteria making false comments about a client. The nurse is guilty of:

slander.

A nurse is contributing to the analysis of an ethical dilemma. When analysing the dilemma according to the ethical framework, what is most important for the nurse to take into consideration?

standards of conduct.

What would be an example of the nurse practicing fidelity? The nurse:

stays with the client during his death as promised.

A nurse is presenting an in-service workshop about malpractice for a group of newly hired graduate nurses. What would the nurse include as necessary to prove malpractice? Select all that apply.

Client was to be provided care. A breach in duty occurred. An injury occurred. The client has suffered damages

Which clinical events constitute areas of potential liability for the nurses involved? Select all that apply.

An elderly client develops skin breakdown on his coccyx because he was turned infrequently. A client experiences a seizure after a missed dose of his scheduled anticonvulsant medication. A confused client experiences a fall because her bed rails were left in a lowered position.

A woman age 83 years who has suffered a cerebrovascular accident and is unable to swallow refuses the insertion of a feeding tube. This is an example of what ethical principle?

Autonomy

Which ethical principle is related to the idea of self-determination?

Autonomy

A nurse is caring for a woman 28 years of age who has delivered a baby by Cesarean section. She describes her pain as a 9. The nurse medicates her for pain. This is an example of which ethical framework?

Beneficence

Which ethical principle refers to the obligation to do good?

Beneficence

A client requests that the nurse allow her 15 minutes two times a day for prayer during her hospitalization. What value does this represent?

Foundation value

The differences between the pro-life and abortion rights movement are an example of:

values inquiry.

The nurse reports a nursing colleague on the unit who is lethargic and verbally responds in a slow manner. This is an example of:

whistle-blowing.