PVR1- Chapters 6 & 7 (Study Guide)

The instructor is accountable for making an unsafe patient care assignment.

The instructor tells an SP/VN, "You have functioned at a substandard level of clinical performance recently. Now you have a chance to redeem yourself. I'm assigning you to a complex nursing situation. I expect you to function without asking for assistance." What is the most accurate assessment of the instructor's action?

Peer reporting. Accountability. Patient advocacy.

The introduction of the nursing process and critical thinking into nursing practice has resulted in increased ethical and legal responsibilities for nurses in the area of:

Breached confidentiality.

The nurse discusses the patient's condition on the phone with the patient's brother. On learning this, the patient is upset, saying he has not spoken with his brother for years and does not want his brother to know anything about his condition. The nurse has:

Values

The nurse states "I like being apart of the health care team caring for the traditional two-parent family during the postpartum period as they bond with their newborn." This statement reveals the nurse's:

Beneficent Paternalism

The patient asks the nurse what he should do about continuing cancer treatment. The nurse responds, "You should stop before you get so weak you can't enjoy a few good weeks with your family." This is an example of:

Personal responsibility for one's nursing actions.

The patient asks the nurse, "I overheard the instructor talking to a student about accountability. What does the word 'accountability' really mean? The best response by the nurse would be:

Durable medical power of attorney.

The patient tells the nurse, "I want to make sure that my daughter can make health care decisions for me in the event I'm unable to make decisions for myself. What do I need to do?" The nurse should advise the patient that he or she needs to execute a/an:

Libel

The student nurse caring for a patient with a large decubitus ulcer photographs the ulcer without obtaining permission from the patient. The patient developed the ulcer while being cared for at home by her physician husband. The student plans to give the patient's history and use the photograph in a paper she is writing. The instructor explains to the student that this action is unacceptable and could result in a court action for:

Informed consent.

The term used to describe a competent patient's agreement to have a surgical procedure after the physician explains the procedure, the desired outcome, possible complications, and possible alternative treatment is:

Nurse Practice Act of the State

To function within the scope of the law, the nurse must know that the legal duties and functions of the nurse in a given state are determined by the:

Treat all patients with equal dignity and respect

To provide justice to patients on the unit, the nurse must:

The Nurse Practice Act.

An example of statutory law is?

Living Will.

A legal document that describes the kind of medical or life-sustaining treatments the person would want if seriously or terminally ill is known as a:

the rights of the individual

A major change in medical ethics that affected nursing occurred when the Western Secular Belief System shifted emphasis from duties to __________________.

The nurse should contact the state board of nursing of the state in which she wishes to work to determine whether they have multistate licensure with state X.

A new LPN/LVN passes the NCLEX-PN examination and obtains licensure in state X. The LPN/LVN wishes to work in a state other than state X but is unsure of how to proceed. Which statement provides sound advice in this situation?

Slander

A nurse damages a patient's reputation by verbalizing private information about the patient to a third party. This is an example of:

Libel

A nurse damages a physician's reputation through false written communication without the physician's permission. This is an example of:

Unethical and illegal behavior.

A nurse injects himself or herself with a narcotic prescribed for a patient. This is an example of:

The nurse, without consent, touched the patient in a way that caused harm.

A nurse is found liable for battery. What does this mean?

Assault

A nurse who angrily tells a patient, "If you don't go to sleep, I'm going to give you an injection," can be accused of:

Sending the student off duty and turning the patient's care over to staff.

A nursing student is assigned to care for a patient who requires several technical procedures. The student was busy and did not prepare in advance for the assignment. In preconference, the student is unable to describe the care to be given. The instructor would be justified in:

Explain that the request will be made to the RN, who will follow agency policy.

A patient tells the LPN/LVN, "I want you to bring my medical record so I can read it. I know HIPAA gives me the right to see it." The LPN/LVN should:

Care that an ordinary, prudent LPN/LVN with the same education and experience would perform in similar circumstances.

A resident asks an LPN/LVN, "What is meant by the practical/vocational nurse's standard of care in a long-term care agency?" The LPN/LVN should respond, "The practical/vocational nurse who provides care for residents in a long-term care agency must implement care that is consistent with:

Maintaining good relationships with patients and families.

A risk management strategy a nurse can use to prevent being named in malpractice lawsuits is:

Ethics refer to expected behavior of nurses, but laws require mandatory observance by nurses.

A student nurse asks, "What's the difference between laws and ethics?" Which response best explains the difference between laws and ethics?

Sending the student home and turning the patient's care over to staff.

A student nurse is assigned to care for a patient with complex nursing care needs. The student was busy and did not prepare in advance for the assignment. In preconference, the student is unable to describe the care to be given and admits not knowing how to execute one of the treatments. The instructor would be ethically justified in:

ethics

A system of standards or moral principles that direct actions as being right or wrong is called _____________.

Document the patient's expression of feeling and wishes

A way of practicing fidelity to a patient would be to:

Discontinuing a ventilator without a physician's order.

An example of a criminal action committed by a nurse is:

A patient who refuses to be suctioned and is suctioned anyway after refusal.

An example of battery is?

Intentional and unintentional torts.

Civil law is concerned with

Autonomy

Encouraging a patient to be involved I planning and carrying out his or her own care is a nursing action that supports the ethical principle of:

"Accountability is assuming personal responsibility for one's nursing actions."

How should an LPN/LVN explain the term accountability to a student nurse?

The nurse accidently administers an excessively large dose of prescribed medications and the patient becomes comatose. The nurse notes the patients poor capillary return distal to a cast, becomes busy and does not report it, and the patient later loses limb function.

In the following list, identify the instances of possible malpractice.

The State Board of Nursing, when notified, will charge the nurse with fraud and deceit. The agency will terminate the employment of the individual.

Individual A has worked as an LPN/LVN for a year. The agency where she works discovers that the registration document she presented at the time she was hired was altered to remove the name of the rightful registrant and show her name instead. What are the possible outcomes of this situation?

Autonomy

Leaving an unconscious patient exposed during treatment or procedure is a violation of the ethical principle of:

To the level of an LPN/LVN

Legally, student practical/vocational nurses are held to the level of performance:

Duty Breach of Duty Damages Proximate Cause

Nurse A is assigned to care for a patient with diabetes who is being regulated on new types of insulin. The patient performs most of her own care and rarely uses the call bell to summon the nurses. The nurse knows this and leaves the patient unobserved most of the shift. Just before change of shift report, the aide reports that she cannot rouse the patient. The patient enters a vegetative state as the result of brain damage related to a severe hypoglycemia. Which, if any, of the four elements are needed to be proved?

False Imprisonment

Patient A, who has Alzheimer's disease, wanders and is often noisy and intrusive. The patient has a prn order for haloperidol (Haldol) IM for assaultive behavior. At report, the LPN/LVN charge nurse explains that staffing is poor and she is unable to provide the supervision the patient needs. She directs the medication nurse to administer the patient's prn haloperidol q4h during the shift. This action constitutes

"I cannot accept the assignment. Complex nursing situations are beyond my abilities."

The instructor tells a student nurse, "You have functioned at a substandard level of clinical performance recently. Now you have a chance to redeem yourself. I'm assigning you to a complex nursing situation. I expect you to function without asking for assistance." The most appropriate response from the student nurse would be:

Never; LPN/LVNs cannot administer packed cells.

The Nurse Practice Act of state X expressly states that blood products may be administered only by physicians, registered nurses, and physician assistants. Under what conditions can an LPN/LVN administer a unit of packed red cells?

Right & Wrong Moral & Immoral Good & Bad Ought & Ought Not Rights & Duties

The nurse is asked to explain the meaning of ethics to a patient. The nurse should currently state, "Ethics is a system of standards that refer ideas and actions in terms of being:

Considerate and respectful care from all care providers.

The nurse providing care for patients or residents must act on the knowledge that a basic right of a patient or resident is to receive:

Never participate in any action that will deliberately harm the patient. Question how to do the least amount of harm when doing something that is expected to result in good. Make sure the patient has agreed to the procedure verbally or in writing. Become aware of side effects of commonly administered medications

What actions should be taken by the nurse to increase the possibility of doing no harm while caring for a patient?

Justice

What ethical principle underlies the statement in the National Federation of Licensed Practical Nurses (NFLPN) Code for Licensed/Vocational Nurses, "The practical nurse provides health care to all patients regardless of race, creed, cultural background, disease, or lifestyle."?

The nurse must go directly to the physician and, if necessary, refuse to carry out the order.

What is the nurse's responsibility regarding an improper medical order that, if carried out, may harm a patient?

Nonmaleficence

When a student nurse prepares diligently for a clinical assignment, the ethical principle being observed is:

Autonomy and Fidelity

When a treatment team decides to go to court to obtain permission to provide chemotherapy for a child whose parent refuse to give consent for the treatment based on religious grounds, the ethical principles that are in conflict are:

Record all interventions performed and patient instruction given.

When documenting patient behavior, the LPN/LVN should:

Provides emotional support when the patient cries. Places the bed in a low position before leaving the room. Places medication the patient brought from home at the nurses' station.

Which nursing actions are examples of use of the ethical principle of beneficence?

The LPN/LVN does not perform duties according to the standard of care.

Which of the following is an example of breach of duty?

A patient is informed that he or she has the right to revoke consent at any time.

Which of the following is true regarding informed consent?

Going off duty without giving report rather than care for patients on an unfamiliar unit.

Which situation can be identified as abandonment of patients by the nurse?

They allow patients a voice about medical interventions after they are incapable of acting.

Which statement is true regarding durable medical power of attorney and living wills?

"I wish I knew for sure that I had all the facts about the treatment." "My son told me emphatically what he thought would be best for the family."

Which statement would the nurse evaluate as suggesting that the patient's decision has not been autonomous?

A living will does not let the person select someone to make decisions for them. Living wills are recognized as legal documents in 47 states in the U.S., the district of Columbia, and Guam. A living will is a legal document that describes the kind of medical or life-sustaining treatments the person would want if seriously or terminally ill.

Which statements are accurate with regard to a living will?

Be aware that each agency may interpret HIPAA provisions somewhat differently.

With regard to HIPAA implementation, the LPN/LVN who is newly employed at a health care agency should: