Module 14 Practice Quizzes

Malpractice

A client has a prescription for amoxicillin 500 mg P.O. every 8 hours. The nurse administers the medication via the intravenous route. Based on the nurse's action, the client develops complications and has an increased length of stay. The client files a lawsuit against the facility and the nurse. Which legal action has the nurse's attorney identified that meets the criteria for the client's lawsuit?

The charge nurse is providing support for the staff nurse in new responsibilities.

A charge nurse on a medical-surgical unit is asked by the nurse manager to serve as a mentor to another staff nurse who is less experienced. Which of these would best describe this role?

"I had a duty and it was my responsibility to get clarification before administering the medication, which I did not."

A client admitted with Hodgkin lymphoma has a handwritten prescription for vinblastine 3.7 mg intravenously (IV) weekly. The nurse interprets the prescription as vincristine 3.7 mg and administers the wrong medication. The client becomes neurovascularly compromised and has a fatal reaction to the medication. The client's family begins a lawsuit against the facility and the nurse's license is suspended by the board of nursing. In preparation for the lawsuit, the nurse meets with the nurse attorney to review the events. Which appropriate statement given by the nurse indicates he has an understanding of the lawsuit?

Autonomy

A client aged 83 years who has suffered a cerebrovascular accident and is unable to swallow refuses the insertion of a feeding tube. The nurse communicates the client's wish to the family and healthcare team. This is an example of what ethical principle?

"Take it with you. It is recognized universally in the United States."

A client being discharged from the hospital asks the nurse, "When I go visit my family out of state, should I take my living will with me, or do I need a new one for that state?" What is the most appropriate response made by the nurse?

Autonomy

A client diagnosed with cancer has met with the oncologist and is now weighing whether to undergo chemotherapy or radiation for treatment. This client is demonstrating which ethical principle in making this decision?

1. Trustworthiness 2. Humility 3. Compassion

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

Care-based ethics

Which theory of ethics prioritizes the nurse's relationship with clients and the nurse's character in the practice of ethical nursing?

Bathing a combative client

The registered nurse on a busy telemetry floor is delegating tasks to an unlicensed assistive personnel member. Which task is appropriate for the unlicensed personnel member to complete?

Ask the client to sign a release without medical approval.

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?

Let the client go after signing a document stating he is going against medical advice.

A client informs the nurse that he wants to discontinue his treatment and go home. Later, the nurse finds the client dressed to leave. Which action should the nurse take in this situation?

Distress

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 can't do it anymore." What ethical problem is the adult child experiencing?

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

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?

Autocratic leadership

A client is received into the emergency department after getting shot in the chest. The client is hemorrhaging profusely and is in hypovolemic shock. The nurse calls a code blue. What type of leadership style will be most effective during the management of the code?

Allow the client to verbalize feelings, and provide information to help the client assess options.

A client is scheduled to have an elective surgical procedure performed but cannot decide whether to go forward with the procedure or cancel it. The client asks the nurse to help make the decision because the client lacks knowledge about the procedure. Which action by the nurse is the best way for this nurse to advocate for the client?

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

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?

Fidelity

A client rings the call bell to request pain medication. On performing the pain assessment, the nurse informs the client that the nurse will return with the pain medication. After a few moments, the nurse returns with the pain medication. The nurse's returning with the pain medication is an example of which principle of bioethics?

Document the client's claims and the events surrounding the alleged incident.

A client states that his recent fall was caused by the fact that his scheduled antihypertensive medications were mistakenly administered by two different nurses, an event that is disputed by both of the nurses identified by the client. Which measure should the nurses prioritize when anticipating that legal action may follow?

institutional policy.

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

advance directive.

A legal document that states a client's health-related wishes — such as a preference for pain management if the client becomes terminally ill — and also allows the client's daughter to direct his care, is a(an):

"I cannot give you that information due to client confidentiality."

A medical-surgical client is in the radiology department. The client's cousin arrives on the medical-surgical unit and asks to speak with the nurse caring for his cousin. The visitor asks the nurse to provide a brief outline of the client's illness. Which response, if given by the nurse, would demonstrate application of legal safeguard in her practice?

Contact the physician and obtain necessary orders.

A nurse assesses a client with psychotic symptoms and determines that the client needs vest restraints. However, the client asks the nurse not to put on vest restraints. What would be the best nursing action?

Personal moral

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?

The nurse documents a complete description of the happenings in the client's records.

A nurse enters a client's room and finds that the client is lying on the floor. The nurse makes the client comfortable on the bed and completes an examination. She informs the physician and the nursing supervisor about this incident and also completes an incident report. Which action by the nurse indicates correct knowledge of handling an incident report?

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

A nurse enters the client's room and finds the client lying on the floor experiencing a seizure. After stabilizing the client, the nurse informs the physician. The physician advises the nurse to prepare an incident report. What is the purpose of an incident report?

breach of duty

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?

Directive leadership

A nurse informs the client that he has no choice and must take his bath in the morning. What type of leadership does this exemplify?

Acting in the client's best interest

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

"You have a complete injury, which results in a total loss of movement and sensation below the level of injury."

A nurse is caring for a client with a complete spinal cord injury that has caused paraplegia. The client is very distraught and asks the nurse, "Are they sure, even with therapy, I will never walk again?" Which statement made by the nurse demonstrates veracity?

The nurse has a legal and ethical responsibility to report the suspected abuse.

A nurse is caring for a client with vertigo. During data collection, the nurse finds multiple bruises on the client's arms and back and suspects the client is being abused. When questioned, the client denies any abuse by the daughter she lives with. Despite the client's denial, which rationale would the nurse use for reporting the suspected abuse?

Shared decision making

A nurse is caring for an older adult who has cancer and is experiencing complications requiring a revision of the plan of care. The nurse sits down with the client and the family and discusses their preferences while sharing the nurse's own judgments based on the nurse's expertise. Which type of healthcare decision making does this represent?

personal values.

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

Justice

A nurse is providing care for three clients on a medical unit, two of whom are significantly more acute than the third. The nurse is making a concerted effort to ensure that the less acute client still receives a reasonable amount of time, attention, and care during the course of the shift. Which ethical principle is the nurse attempting to practice?

1. Describe the evaluation process with use of the new system. 2. Discuss potential decrease in medication errors with the new system. 3. Encourage feedback by the nursing staff with use of the new system.

A nurse manager helps staff nurses who are resistant to change with use of a new medication administration system by doing which of the following actions?

Autocratic

A nurse manager informs the staff members during a meeting that unlicensed assistive personnel will no longer be allowed to check patients' blood glucose levels. The nurse manager informs the group this was a new policy on the unit, and discussions will not change the enforcement of this policy. What type of leadership style is the nurse manager demonstrating?

Performance appraisal

A nurse manager is reviewing an employee's contribution to the nursing division annually. This process is

felony

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?

1. A nurse reads The Patient Care Partnership to a visually impaired client. 2. A nurse asks the surgeon to further explain details of a surgery to a client before obtaining informed consent.

A nurse practices the ethical principle of autonomy when providing nursing care for clients. Which nursing actions best describe the use of this value? Select all that apply.

Integrity

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

offering a hospice consultation to a client who is terminally ill.

A nurse shows client advocacy by:

Fidelity

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

Assist in decision making based on the client's best interests.

A nurse volunteers to serve on the hospital ethics committee. Which action should the nurse expect to take as a member of the ethics committee?

The Good Samaritan law will provide legal immunity to the nurse.

A nurse witnesses a traffic accident and dresses the open wounds sustained by a child. Later, in the hospital, the child develops complications from an infection in the wound. The family holds the nurse responsible for the complications and attempts to file a lawsuit. Which statement is true regarding the Good Samaritan law?

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

Which statement by the nurse is an example of deception?

ethical distress.

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:

Slander

A nurse, while off-duty, tells the physiotherapist that a client who was admitted to the nursing unit contracted AIDS due to exposure to sex workers at the age of 18. The client discovers that the nurse has revealed the information to the physiotherapist. With what legal action could the nurse be charged?

1. "I am glad I am a student because nursing faculty will be blamed, not me." 2. "I cannot be held liable because this is only my second time at this facility."

A nursing student administers an overdose of a narcotic to a client and the client arrests. When discussing the incident with nursing faculty, which statements made by the student indicate the need for further teaching? Select all that apply.

Laissez-faire

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?

a failure to model one's own values.

A parent teaches a child not to drink and drive; however, the parent does drink and drive. This action results in:

to protect the safety of the public

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?

The nurse will be legally held to the same standards of care as when staffing levels are normal.

After reporting to work for a night shift, the nurse learns that the unit will be understaffed because two RNs called out sick. As a result, each nurse on the unit will need to provide care for an additional four acute clients, in addition to her regular client assignment. Which statement is true for this nurse when working in understaffed circumstances?

"Dispose of the disconnected IV set."

In a nursing unit, the RN delegates nursing tasks to the nursing assistant. Keeping in mind the delegation guidelines, which of the following statements denotes the right direction for the nursing assistant?

invasion of privacy

An HIV-positive client discovers that his name is published in a research report on HIV care prepared by his nurse. He is hurt and files a lawsuit against her. Which offense has the nurse committed?

battery

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?

Begin CPR.

An oncology nurse is caring for a client suffering from metabolic encephalopathy and end-stage kidney disease. The client has no known family and no advance directives. Upon entering the room, the nurse observes the client is pale and has no spontaneous respiration. What is the priority action the nurse should take?

reporting the abuse to the appropriate authorities

During the admission assessment of a 40-year-old female client 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?

Health care institution

During the orientation to the hospital, the staff development educator discusses unit and institutional-based policies. What is the source of the practice rules that result in unit and institutional-based policies?

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

Ethical distress is:

Leadership is the process of guiding, educating, motivating, and directing others.

How might one define leadership?

1. The nurse obtains informed consent from a client to perform a procedure. 2. The nurse educates the client about The Patient Care Partnership. 3. The nurse documents all client care in a timely manner.

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 are examples of legal safeguards for the nurse? Select all that apply.

statutory laws

Nurse practice acts are examples of which type of laws?

Witnesses to a signature do not need to read the will.

Nurses are occasionally asked to witness a testator's (person who makes the will) signing of his or her will. Which guideline is true regarding a nurse's role is witnessing a testator's signature?

to improve quality of care

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

Certification

Nurses practicing in a critical care unit must acquire specialized skills and knowledge to provide care to the critically ill client. These nurses can validate this specialty competence through what process?

They give priority to the good of the individual client rather than to the good of society in general.

Nurses who value client advocacy follow what guideline?

The interdisciplinary health care team collectively developing plans of care for clients

The case manager works in a facility that supports a participative leadership style. Which of the following should the nurse recognize as an example of democratic leadership style?

a living will

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?

Restrain all four extremities

The health care provider prescribes orders for a client with newly diagnosed uncontrolled seizure activity. When reviewing the prescriptions, the nurse correctly identifies that which prescription, if followed, puts him at risk for negligence charges?

Initiating intravenous therapy

The nurse and unlicensed assistive personnel (UAP) are working together to admit a pediatric client to a nursing unit. Which task would be inappropriate to delegate to the UAP?

International Council of Nurses

The nurse beginning practice would like to access the standards for ethical practice. Which organization should the nurse research for these standards?

1. "If I make a mistake, I will not tell anyone." 2. "I will have the supervisor fill out the incident report when I make an error."

The nurse educator is presenting an in-service on nursing and malpractice. Which statements made by the nursing staff would indicate to the educator that further teaching is required? Select all that apply.

1. With the client's permission, the nurse explained the client's diagnosis to the client's spouse. 2. The nurse removed the client from the emergency department waiting room into a private area to collect assessment data.

The nurse educator provides an educational session to the nursing staff on protection of a client's privacy. Which circumstances, identified by the staff, would indicate to the educator that the teaching was effective? Select all that apply.

The stability of the patient's condition, potential for harm, and complexity of the activity

The registered nurse (RN) wants to delegate measuring a client's urinary output to an unlicensed assistive personnel (UAP). Which factors should the nurse consider before delegating the task?

Limiting visitors due to client complaining of pain

The nurse is managing the care for a postoperative client. How does the nurse demonstrate advocacy?

Collaborative mindset

The nurse manager in a critical care unit actively listens to the staff and engages the staff to offer decisions regarding problem solving and implementing these decisions. What type of managerial mindset does this manager exhibit?

Enlist volunteers to help develop a community outreach project that will educate teenagers on methods to prevent pregnancy.

The nurse manager is concerned about the large number of teenage mothers being seen in the obstetrics clinic. How can the nurse manager use the transformational leadership style to address the concern?

1. American Nurses Association Standards of Practice 2. Professional standards for certification of individual nurses in general practice 3. Process of certification

The nurse manager is using voluntary standards as a guideline for developing policies on the unit. What voluntary standards are available for the nurse to use? Select all that apply.

Democratic

The nurse manager who asks staff members to give suggestions on how to improve collaboration between nurses and physicians is exhibiting what style of leadership?

The new mother attempts to breastfeed the baby again using the techniques recently acquired and is successful.

The nurse recognizes that a new mother is having difficulty breastfeeding her baby. The nurse provides assistance by demonstrating various positions to hold the baby while feeding. The nurse also educates the mother on ways to ensure proper latching. The new mother attempts to breastfeed the baby again using the new techniques and is successful. Which statement illustrates Lewin's stage of refreezing?

A nurse gives a medication and client has an adverse reaction.

The nursing faculty is lecturing on unintentional and intentional torts. The faculty asks a nursing student to provide an example of an unintentional tort. Which example would indicate the student has a clear understanding of torts?

The client has decided to stop chemotherapy treatments.

The principle of autonomy by a client is applied in which situation?

allowing the nurse's own judgment to guide practice.

To practice ethically, the nurse should avoid:

The nurses decide to share the preceptor. The preceptor will precept one nurse at the beginning of the orientation and precept the other nurse at the end of the orientation.

Two new graduate nurses are requesting the same preceptor for unit orientation. Both new graduates have been very vocal about being unhappy if they do not receive their choice of preceptors. Which illustrates the nurses using a compromise approach to conflict resolution?

Evaluating

Using the nursing process to make ethical decisions involves following several steps. Which step is the nurse implementing when reflecting on the decision-making process and the role it will play in making future decisions?

"I don't need to assess distal pulses on a client after a femoral arteriography."

Which statement made by the nurse providing care to a group of clients indicates that the nurse requires further education regarding negligence?

Peers

What is likely to have the greatest influence on an adolescent's formation of values in this developmental stage?

stays with a client during death as promised.

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

Cultural

When examining values, a nurse notes that one country allows physician-assisted suicide and another outlaws it, making it punishable by imprisonment. Which factors best explain the differences in values between these two countries?

invasion of privacy

When the nurse informs a client's employer of his autoimmune deficiency disease, the nurse is committing the tort of:

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?

Lobbying for an expansion of healthcare resources and benefits to those in poverty

Which action most clearly demonstrates a nurse's commitment to social justice?

Beneficence

Which ethical principle refers to the obligation to do good?

An approach critiquing existing patterns of oppression and domination in society

Which example best describes feminist ethics?

The formal, systematic study of moral beliefs

Which is the best definition of ethics?

1. The nurse includes the client in developing the plan of care. 2. A nurse provides privacy for an older adult client. 3. A nurse plans individualized nursing care for clients. 4. A nurse refuses to discuss a client with a curious friend.

Which nursing actions best describe the use of the professional value of human dignity? Select all that apply.

1. A nurse demonstrates an understanding of the culture of his or her client. 2. A longtime nurse becomes a mentor to a student nurse working on the floor. 3. A nurse respects the right of a Native American/First Nations client to call in a shaman for a consultation.

Which nursing actions describe the use of the professional value of altruism? Select all that apply.

1. Holding the hand of a dying client 2. Providing a back rub to a client on bed rest 3. Involving the parent in the bed bath of a child

Which nursing situations are examples of the care-based approach to ethics? Select all that apply.

A nursing student performs a dressing change using sterile technique and documents the presence of necrotic tissue in the wound.

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

Accreditation

Which process evaluates and recognizes educational programs as having met certain standards?

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

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