Question 1

During a jury trial, the presence of a nurse-patient relationship is questioned. What kind of question is this and who would determine it?

Accepted Answer

A)  Law to be determined by the jury 
B)  Fact to be determined by the jury 
C)  Fact to be determined by the judge 
D)  Law to be determined by the judge 
A)  Law to be determined by the jury 
B)  Fact to be determined by the jury 
C)  Fact to be determined by the judge 
D)  Law to be determined by the judge B

Question 2

A group of nurses are discussing state legislation regulations regarding health maintenance organizations (HMOs) and delivery of patient care. Which statement would the nurses identify as being accurate?

Accepted Answer

A)  States have allowed patients who receive substandard care to successfully bring suit against HMOs. 
B)  States have mandated how many HMOs will operate within the state. 
C)  States have mandated that all citizens be covered by HMOs if that is the desire of the citizen. 
D)  States have set the premiums that enrollees pay for HMO coverage. 
A)  States have allowed patients who receive substandard care to successfully bring suit against HMOs. 
B)  States have mandated how many HMOs will operate within the state. 
C)  States have mandated that all citizens be covered by HMOs if that is the desire of the citizen. 
D)  States have set the premiums that enrollees pay for HMO coverage. A

Question 3

The patient self-reports that she is a female escort and the nurse documents this as her occupation in the medical record. The nurse has been sued for defamation after charting that the patient is a prostitute. What is the nurse's best defense in this case?

Accepted Answer

A)  Define the contributing factors. 
B)  Provide hearsay evidence. 
C)  Prove that the statement is true. 
D)  No defense exists for defamation. 
A)  Define the contributing factors. 
B)  Provide hearsay evidence. 
C)  Prove that the statement is true. 
D)  No defense exists for defamation. C

Question 4

A nurse works in a state where Physician Orders for Life-Sustaining Treatment (POLST) is enforced. How would the nurse explain POLST to a patient?

Accepted Answer

A)  This process represents informed consent to be assumed for all medical procedures and treatments. 
B)  POLST is a scoring tool used to determine cardiac risk. 
C)  POLST provides communication relative to seriously ill patients' wishes concerning specified medical treatments. 
D)  It takes the place of a living will in emergency situations. 
A)  This process represents informed consent to be assumed for all medical procedures and treatments. 
B)  POLST is a scoring tool used to determine cardiac risk. 
C)  POLST provides communication relative to seriously ill patients' wishes concerning specified medical treatments. 
D)  It takes the place of a living will in emergency situations.

Question 5

A group of nursing students are discussing legal considerations related to standards of care. Which scenarios would the nursing students identify as reflecting the "two schools of thought" doctrine?

Accepted Answer

A)  The nurse manager insists that standards are uniform and all nurses must act in the same manner. 
B)  The hospital policy and procedures manual lists both local and national nursing care quality standards. 
C)  The nurse expert witness in a case describes two methods of providing the intervention in question. 
D)  An honest error in judgment prevented a nurse from providing quality care. 
E)  Nurses on one unit vary in their choice of ways to deliver quality care. 
A)  The nurse manager insists that standards are uniform and all nurses must act in the same manner. 
B)  The hospital policy and procedures manual lists both local and national nursing care quality standards. 
C)  The nurse expert witness in a case describes two methods of providing the intervention in question. 
D)  An honest error in judgment prevented a nurse from providing quality care. 
E)  Nurses on one unit vary in their choice of ways to deliver quality care.

Question 6

The nurse working in an emergency room is taking care of a patient who is unresponsive with a confirmed terminal medical diagnosis of metastatic cancer. There is no documentation relative to advance directives and the patient has been placed on life support. Family members arrive shortly afterward asking the nurse to remove the patient from life support. What actions should the nurse take?

Accepted Answer

A)  Comply with the family's request. 
B)  Limit visitation between the patient and the family until a decision has been made. 
C)  Ask the family members if they can provide legal documentation of advance directives. 
D)  Contact the nursing supervisor providing information relative to the patient's status. 
E)  Inform the emergency room physician of the family's request and concern. 
A)  Comply with the family's request. 
B)  Limit visitation between the patient and the family until a decision has been made. 
C)  Ask the family members if they can provide legal documentation of advance directives. 
D)  Contact the nursing supervisor providing information relative to the patient's status. 
E)  Inform the emergency room physician of the family's request and concern.

Question 7

A nurse is working in a long-term care facility where the notation of "allow natural death" is noted on a patient's chart. What should the nurse include in the plan of care for this patient?

Accepted Answer

A)  Playing music to help increase patient comfort. 
B)  Administer pain medication as needed to provide patient comfort. 
C)  Administering Epinephrine via parenteral route during code. 
D)  Chest compressions will be started if the patient stops breathing. 
E)  Maintain oxygen support via mask. 
A)  Playing music to help increase patient comfort. 
B)  Administer pain medication as needed to provide patient comfort. 
C)  Administering Epinephrine via parenteral route during code. 
D)  Chest compressions will be started if the patient stops breathing. 
E)  Maintain oxygen support via mask.

Question 8

A nurse is caring for a patient who wants to enact a living will after being admitted for a 23-hour observation post outpatient surgery for a benign tumor removal. It has been over 4 hours since the procedure which was done under local anesthesia. There is no significant medical history noted. Which action should the nurse take in order to assist the patient?

Accepted Answer

A)  Sign the document for this competent patient. 
B)  Do not serve as a witness to this document. 
C)  Refuse to sign the document as the patient has received pain medication 15 minutes ago. 
D)  Contact the physician immediately. 
E)  Tell the patient that due to the effects of anesthesia, the patient should refrain from making any legal/ethical decisions. 
A)  Sign the document for this competent patient. 
B)  Do not serve as a witness to this document. 
C)  Refuse to sign the document as the patient has received pain medication 15 minutes ago. 
D)  Contact the physician immediately. 
E)  Tell the patient that due to the effects of anesthesia, the patient should refrain from making any legal/ethical decisions.

Question 9

A group of nurses are reviewing the purpose of the Americans with Disabilities Act. Which legal concept would the nurses indicate as supportive of the purpose of the act?

Accepted Answer

A)  Autonomy 
B)  Fairness 
C)  Right to work 
D)  Equality 
A)  Autonomy 
B)  Fairness 
C)  Right to work 
D)  Equality

Question 10

A group of nurses are discussing types of legal contracts in the clinical setting. Which nursing scenario indicates an implied contract has been initiated?

Accepted Answer

A)  A nurse has made an oral agreement with the nurse manager to work an extra shift. 
B)  Signature of the nurse entered on the electronic medical record chart indicates a legal contract between the nurse and the patient. 
C)  A new nurse signs paperwork with Human Resources to start employment process. 
D)  Nurses write their names down on a document to indicate that they have attended a continuing education conference. 
E)  Nurses on the unit are focused on providing quality of care to all patients. 
A)  A nurse has made an oral agreement with the nurse manager to work an extra shift. 
B)  Signature of the nurse entered on the electronic medical record chart indicates a legal contract between the nurse and the patient. 
C)  A new nurse signs paperwork with Human Resources to start employment process. 
D)  Nurses write their names down on a document to indicate that they have attended a continuing education conference. 
E)  Nurses on the unit are focused on providing quality of care to all patients.

Question 11

A group of nurses are reviewing patient coverage relative to the Social Security Act of 1953. Which person would the nurse identify as being covered by this law?

Accepted Answer

A)  A 16-year-old whose father died in a motor vehicle accident 
B)  A 30-year-old woman who has become blind secondary to diabetic retinopathy 
C)  A 70-year-old man who is retired from a job he held for 30 years 
D)  A 34-year-old person who files for unemployment after losing her job 
E)  A 45-year-old woman who suffered a myocardial infarction 
A)  A 16-year-old whose father died in a motor vehicle accident 
B)  A 30-year-old woman who has become blind secondary to diabetic retinopathy 
C)  A 70-year-old man who is retired from a job he held for 30 years 
D)  A 34-year-old person who files for unemployment after losing her job 
E)  A 45-year-old woman who suffered a myocardial infarction

Question 12

A group of nurses are discussing concepts related to products liability. In which situations would the nurses identify that the manufacturer of a drug designated as unavoidably unsafe be held liable for injuries to a patient receiving the drug?

Accepted Answer

A)  The information printed in the drug information sheet accompanying the medication was wrong. 
B)  The physician prescribed the medication after being told that problems with the drug had been corrected. 
C)  The physician did not educate the patient about the risks of the medication. 
D)  The nurse did not educate the patient about the risks of the drug. 
E)  The nurse was not warned of risks by the pharmacist. 
A)  The information printed in the drug information sheet accompanying the medication was wrong. 
B)  The physician prescribed the medication after being told that problems with the drug had been corrected. 
C)  The physician did not educate the patient about the risks of the medication. 
D)  The nurse did not educate the patient about the risks of the drug. 
E)  The nurse was not warned of risks by the pharmacist.

Question 13

A group of nurses are reviewing the decision of legal action in which a patient brought suit against a hospital for injuries sustained in a fall. The case went to trial and the jury found for the hospital. Which legal precedent would the nurses select if the patient were to take this same suit and evidence to another trial court in hopes of a different decision?

Accepted Answer

A)  Stare decisis 
B)  Res judicata 
C)  Doctrine of precedent 
D)  None needed as this is an example of a landmark decision. 
A)  Stare decisis 
B)  Res judicata 
C)  Doctrine of precedent 
D)  None needed as this is an example of a landmark decision.

Question 14

A nurse is reviewing the policy and procedure for application of restraints in a long-term care facility. Which statement would the nurse identify as being correct?

Accepted Answer

A)  Chemical restraints are preferable to physical restraints. 
B)  Use of restraints increases the need to monitor the resident. 
C)  Restraints should be used for all residents at risk for falls. 
D)  They are expressly forbidden by federal laws. 
E)  The least restrictive restraint possible should be used. 
A)  Chemical restraints are preferable to physical restraints. 
B)  Use of restraints increases the need to monitor the resident. 
C)  Restraints should be used for all residents at risk for falls. 
D)  They are expressly forbidden by federal laws. 
E)  The least restrictive restraint possible should be used.

Question 15

A nurse has been hired by a clinical facility and signed a contract. Which option indicates consideration with regard to the legal elements of the contract as it relates to the nurse?

Accepted Answer

A)  The nurse agrees to work for specific wages. 
B)  The nurse agrees to work at an immunization clinic from October through December. 
C)  The assertion that the nurse is legally able to enter into a contract is implied. 
D)  A description of the type of work expected by the facility wishing to employ the nurse is provided. 
A)  The nurse agrees to work for specific wages. 
B)  The nurse agrees to work at an immunization clinic from October through December. 
C)  The assertion that the nurse is legally able to enter into a contract is implied. 
D)  A description of the type of work expected by the facility wishing to employ the nurse is provided.

Question 16

A group of nurses are discussing the use of restraints for patients in acute care settings. Which options reflect a general criterion that a nurse can use for restraining a patient?

Accepted Answer

A)  The patient's threat to harm another patient 
B)  The patient's refusal to take psychotropic medications as prescribed 
C)  The patient's inability to care for himself or herself 
D)  The patient's verbally abusive but nonthreatening behavior toward others 
E)  The patient's immediate ability to harm self 
A)  The patient's threat to harm another patient 
B)  The patient's refusal to take psychotropic medications as prescribed 
C)  The patient's inability to care for himself or herself 
D)  The patient's verbally abusive but nonthreatening behavior toward others 
E)  The patient's immediate ability to harm self

Question 17

Which statement, made by a staff nurse, would the nurse manager evaluate as evidence of good understanding of the concept of patient self-determination as it applies to consent?

Accepted Answer

A)  "States' rights with regard to patient self-determination are applied equally across the country." 
B)  "The competency of the patient does not affect medical consent." 
C)  "The primary focus should be on what the patient wants relative to medical treatment and care." 
D)  "Self-determination principles apply to death and dying issues and have little impact on consent." 
A)  "States' rights with regard to patient self-determination are applied equally across the country." 
B)  "The competency of the patient does not affect medical consent." 
C)  "The primary focus should be on what the patient wants relative to medical treatment and care." 
D)  "Self-determination principles apply to death and dying issues and have little impact on consent."

Question 18

A nurse is considering that financial exploitation has occurred when interviewing a patient and his caregiver. Which observation by the nurse would indicate that financial exploitation has occurred?

Accepted Answer

A)  The caregiver encourages the elder person who wishes to continue to work in the family business. 
B)  The caregiver has the patient sign power of attorney papers by saying they are required by the government. 
C)  The caregiver allows the patient to pay for incidentals necessary for care. 
D)  The caregiver takes the patient's Social Security check to the bank for deposit. 
A)  The caregiver encourages the elder person who wishes to continue to work in the family business. 
B)  The caregiver has the patient sign power of attorney papers by saying they are required by the government. 
C)  The caregiver allows the patient to pay for incidentals necessary for care. 
D)  The caregiver takes the patient's Social Security check to the bank for deposit.

Question 19

A group of nurses are discussing the emerging concern of Physician Assisted Suicide (PAS). Based on American Nurses Association (ANA), what priority action should a nurse take if a physician asks for assistance in ending one's life?

Accepted Answer

A)  Refer the physician for psychiatric treatment. 
B)  Involve the physician in a discussion relative to expressed feelings. 
C)  Assume that the physician is making a joke and quietly ignore the comment. 
D)  Ask the physician how long he/she has felt this way. 
A)  Refer the physician for psychiatric treatment. 
B)  Involve the physician in a discussion relative to expressed feelings. 
C)  Assume that the physician is making a joke and quietly ignore the comment. 
D)  Ask the physician how long he/she has felt this way.

Question 20

A group of nursing students are discussing potential impact for malpractice/negligence litigation in their professional career. Which statement made by the nursing students indicates understanding of the importance of maintaining professional liability insurance?

Accepted Answer

A)  Professional liability insurance should be provided to nurses by the facility as part of their work agreement. 
B)  Nurses who work in specialty areas are more likely to require professional liability insurance regardless of performance practice. 
C)  Securing liability insurance does not increase the potential for poor nursing judgment. 
D)  Liability insurance increases the likelihood for settlement of claims despite nursing performance. 
A)  Professional liability insurance should be provided to nurses by the facility as part of their work agreement. 
B)  Nurses who work in specialty areas are more likely to require professional liability insurance regardless of performance practice. 
C)  Securing liability insurance does not increase the potential for poor nursing judgment. 
D)  Liability insurance increases the likelihood for settlement of claims despite nursing performance.

Exam 1: Ethical Issues in Nursing