VNSG 1304: Ch. 3 Prep U Questions

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 Explanation: The UAP is engaging in battery, which is an assault that is carried out and includes willful, angry, and violent or negligent touching of another person's body or clothes or anything attached to (or held by) that other person. Assault is a threat or an attempt to make bodily contact with another person without that person's consent. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property. Defamation of character is an intentional tort in which one party makes derogatory remarks about another that harms the other party's reputation.

The nurse fails to contact the physician regarding a client who had an open-reduction internal fixation of the tibia and has experienced increasing leg pain (unrelieved by pain medication) for the past 4 hours. Which element of liability has been violated?

Breach of Duty Explanation: Failure to contact the physician and report the client's condition does not meet the expected standard of care and is a breach of duty. Duty refers to an obligation to use due care and is defined by the standard of care appropriate for the nurse-client relationship. Causation shows that the failure to meet the standard of care actually caused injury. Damages are the actual harm or injury to the client.

A nurse fails to administer a medication that prevents seizures, and the client has a seizure. The nurse is in violation of the Nurse Practice Act. What type of law is the nurse in violation of?

Civil Explanation: Malpractice cases are generally civil litigation cases that involve nurses.

The nurse suspects another staff member may have a substance use disorder. What changes would the nurse observe that would indicate possible substance use? Select all that apply.

Clients frequently reporting ineffective pain relief following administration of opioids Confusion about clients' plans of care A decrease in personal hygiene and appearance

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?

Document the client's claims and the events surrounding the alleged incident. Explanation: It is imperative for nurses to carefully and accurately document assessment findings and the nursing care that they provide, a fact that is especially salient when legal action is anticipated. This thorough and accurate assessment should precede consultation with the legal department, the state board of nursing, and colleagues.

When assessing if a procedural risk to a client is justified, the ethical principle underlying the dilemma is known as:

Non-maleficence Explanation: Nonmaleficence is the principle of creating no harm. It refers to preventing or minimizing harm to an individual. The other options do not represent the situation presented in the question.

Which of the following illustrates the activity of acting in values clarification?

Respecting the human dignity of all clients When one values something, one chooses freely from alternatives after careful consideration of the consequences of each alternative. Acting incorporates the choice one makes for behavior and follows that choice consistently (e.g., respecting human dignity for all clients).

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. Explanation: Ethics is a formal inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil as they relate to human conduct and human flourishing. "Morals" usually refers to personal or communal standards of right and wrong.

The new nurse is being oriented to the unit and is assigned an experienced nurse to work with during the orientation. What are positive modeling experiences for the new nurse? Select all that apply.

The nurse organizes the day by obtaining reports, completing assessments, charting the assessments, and administering 0900 medications starting at 0830. The nurse contacts the primary care provider to clarify a new prescription for a medication dose. Explanation: Through modeling, one learns high and low values by observing others. Modeling can lead to acceptable and unacceptable behaviors. Positive modeling experiences are the nurse organizing the day and clarifying a prescription. Negative modeling experiences are not responding to the call regarding unrelieved pain, interrupting the conversation with the hospice nurse, and doing all the charting at the end of the shift.

Nurses are working in an emergency department (ED). Which nurses are acting in a moralizing manner? Select all that apply.

The client frequently visits the ED for various reports of pain. The nurse tells another nurse, "She is drug seeking." The client is found to be at fault in a motor vehicle accident in which others are injured. The nurse delays treatment for this client. Explanation: Moralizing provides little opportunity to weigh other values. Examples are the nurse who states the client is drug seeking and the nurse who delays treatment. The nurse who is answering the parent's questions is keeping an open mind to other possibilities, as is the nurse who obtains a thorough history. The nurse is not being judgmental and is providing reassurance to the client who had been at home sick for several days by stating "We're going to take care of you now."

Which is the nurse's best legal safeguard?

Competent Practice Explanation: Competent practice is the nurse's most important and best legal safeguard. Each nurse is responsible for making sure their educational background and clinical experience are adequate to fulfill the nursing responsibilities laid out in the job description. Collective bargaining, written or implied contracts, and/or client education do not provide the best legal safeguard.

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 Daily living is expressed in many traditions and customs; understanding these differences is cultural value orientation.

Which nursing action demonstrates the principle of fidelity?

Filing an incident report after making a medication error Explanation: Fidelity means being faithful to work-related commitments and obligations. The ethical principle is best demonstrated by the nurse following the employer's policies by completing the incident report following a medication error. Administering vaccines is an example of beneficence; treating an uninsured client in the emergency room is an example of justice; witnessing a client signature on an informed consent is autonomy.

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 Explanation: Invasion of privacy involves a breach of keeping client information confidential. Slander is oral defamation of character. Assault is a threat or attempt to make bodily contact with another person without that person's consent.

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. Explanation: The nurse should call the nursing supervisor and inform her about the situation. The client should be made to sign the document stating that he is responsible for his own actions. The nurse cannot keep the client restrained because that would be false imprisonment. Likewise, the nurse cannot overlook the incident because there is a responsibility for client care. Additionally, the nurse cannot warn the client that he will not be allowed to come back to the hospital because it is the client's right to access health care whenever required.