Deck 10: Ethical and Legal Concepts

Question 1

A patient becomes upset when touched by a staff member who is attempting to obtain the patient's blood pressure. What has the staff member overlooked?

A) Privacy
B) Confidentiality
C) Duty to protect
D) Informed consent

Answer 1

Informed consent

Question 2

The nurses on a medical-surgical floor disagree with the care being provided to a patient by a particular physician. They contact the ethics committee at the hospital. Which action should they expect the committee to take?

A) Assume primary care of the patient.
B) Censure the physician for inappropriate care.
C) Turn the information over to a judge.
D) Make recommendations to resolve conflict.

Answer 2

Make recommendations to resolve conflict.

Question 3

A nurse in the emergency department is working triage. Although a patient with hypomania has been waiting for 2 hours, the nurse sends a suicidal patient to be evaluated immediately. This decision is most likely based upon which ethical principle?

A) Deontology
B) Utilitarianism
C) Ethics of care
D) Virtue ethics

Answer 3

Utilitarianism

Question 4

What concepts create the framework for the American Nurses Association's Code of Ethics for Nurses?

A) Patient care and a commitment to learning
B) Patient rights and a commitment to compassion
C) Patient advocacy and a commitment to society
D) Patient education and a commitment to professionalism

Question 5

Which statement would indicate that a novice nurse understands the concept of autonomy?

A) "All patients should be given their due."
B) "We must always be honest with patients."
C) "Part of our profession is doing good things for others."
D) "After I provide information, I will respect my patient's right to make a decision."

Question 6

The nurse who is operating with the ethics of care in mind believes which statement?

A) "We should always tell the truth."
B) "We are expected to always do the right thing."
C) "We should do whatever provides the best benefit."
D) "We are all interconnected and part of the same global family."

Question 7

A patient is on life support and unresponsive to stimuli. One of her daughters talks to the nurse about withdrawing life support. The other daughter asks the nurse when the patient is likely to wake up and be able to eat. The nurse talks with her charge nurse and manager about this patient situation. This action demonstrates which ethical skills outlined in the PILLAR mnemonic? Select all that apply.

A) The ability to IDENTIFY ethical issues
B) The ability to find needed RESOURCES
C) The ability to ANTICIPATE ethical issues
D) The ability to work within defined professional LIMITATIONS
E) The ability to understand how PERSONAL experiences impact care

Question 8

A nurse fails to check on her suicidal patient every 15 minutes per hospital policy. When she checks on him next, he has jumped off the bed and broken his ankle. Why could she be charged with negligence? Select all that apply.

A) Failure to properly monitor
B) Failure to communicate risk
C) Failure to assess the risk of suicide
D) Failure to maintain proper boundaries
E) Failure to provide sufficient documentation

Question 9

A nurse makes a medication error and, even though it does not cause any adverse reaction, she tells the patient about this error and apologizes. This is an example of which ethical principle?

A) Justice
B) Fidelity
C) Veracity
D) Beneficence

Question 10

A nurse is caring for an older adult with a mental illness who will be going to surgery for placement of a non-emergent pacemaker in the morning. The patient has been deemed incompetent by a court of law. The nurse understands that which individual will need to sign the patient's surgical consent?

A) Spouse
B) Guardian
C) Oldest child
D) Hospital administrator

Question 11

A physician orders a nurse to give a patient a placebo instead of her scheduled opiate medication because he doesn't believe that the patient is really experiencing pain. The nurse refuses to do so but tells the physician he is happy to talk with the patient about her pain and whether they could try decreasing the dosage of her pain medication. This is an example of which element of ethical decision making?

A) Values clarification
B) Stakeholder identification
C) Moral hierarchy exploration
D) Integrity-preserving compromise

Question 12

A patient who was admitted voluntarily to the hospital verbally refuses his medication. The nurse proceeds to give the medication over the patient's objections. What is the legal significance of the nurse's actions?

A) The nurse cannot be held liable.
B) The nurse could be charged with battery.
C) The nurse could be charged with negligence.
D) The nurse could be charged with malpractice.

Question 13

The novice nurse is applying the ANA Code of Ethics to the care of individuals with mental illness. Which reflects its appropriate use? Select all that apply.

A) As a framework to help nurses solve ethical dilemmas.
B) As an affirmation of nursing's nonnegotiable ethical standards.
C) As an answer to specific ethical challenges which nurses face in clinical practice.
D) As a reference for how the nursing profession sees itself in terms of its obligation to society.
E) As a brief description of the ethical obligations and duties of all persons who enter the nursing profession.

Question 14

The nurse is caring for the patient complaining of acute pain. The physician tells the nurse that the patient is not really in pain and orders a placebo instead. The nurse disagrees with this idea and tells the physician he will not administer a placebo, even though he does not know whether the patient is experiencing pain or not. He suggests to the physician that they have an honest discussion with the patient rather than administering a placebo. This is an example of which element of ethical decision- making?

A) Utilitarianism
B) Virtue ethics
C) Paternalism
D) Rule-based ethics

Question 15

Which statement by the nurse reflects the application of deontology to the care of patients admitted to the mental health unit? Select all that apply.

A) "I need to report this error because it is the right thing to do."
B) "I think patients have a right to refuse certain psychotropic medications."
C) "All patients need flu shots so that we can all be healthy during flu season."
D) "All patients should be treated equally whether they have insurance or not."
E) "The doctor needs to obtain informed consent so the patient can make a good decision."

Question 16

The psychiatric nurse faces a patient care ethical dilemma and uses the ANA's Code of Ethics for Nurses as a reference. What will the ANA's Code of Ethics provide to the nurse's situation?

A) The answer to the ethical dilemma
B) A framework for addressing the ethical dilemma
C) A choice for various decisions regarding the ethical dilemma
D) The evaluation of the decision made regarding the ethical dilemma

Question 17

The novice nurse is reviewing the ANA's Code of Ethics for Nurses and its influence on providing patient care. What concept is correct regarding ethical and legal standards?

A) Ethical standards outweigh legal standards.
B) Legal standards outweigh ethical standards.
C) Ethical and legal standards are separate, yet similar.
D) Ethical and legal standards are intertwined, yet distinct.

Question 18

The nurse is participating in a team meeting to determine the disposition of a patient with severe mental illness. The nurse speaks up to ensure that the placement is appropriate to the patient's needs and interests. Which ethical principle is the nurse demonstrating?

A) Justice
B) Veracity
C) Fidelity
D) Beneficence

Question 19

A nurse is a member of an ethics committee. The committee has been asked to help make a decision regarding end-of-life care for an unresponsive patient who has no advanced directives or next of kin. The nurse asks the committee to meet with the patient's friends to learn more about his life. This action corresponds with which guideline from the DILEMMA mnemonic?

A) Moral hierarchy
B) Make decisions
C) Describe the conflict
D) Learn background information

Question 20

The nurse is caring for the patient with a history of addiction. The nurse notes that although the patient is in severe pain, the patient's requests for pain medication have been ignored. Which ethical principle is the nurse exercising when advocating for appropriate pain relief?

A) Justice
B) Autonomy
C) Beneficence
D) Nonmaleficence

Question 21

The nurse is working with a patient who has revealed to the nurse that she hits her toddler with a wooden paddle when she is angry. When the child visits, the nurse sees bruises and welts on the child's legs. The patient asks the nurse not to tell anyone because she is ashamed and afraid the child will be taken away from her. What is the most appropriate response by the nurse?

A) "I won't tell anyone. HIPAA protects this information."
B) "I will not report this if you sign a contract stating that you won't hit the child again."
C) "I will have to report this because it is my legal obligation to do so as a nurse."
D) "I will refer you to social services so they can discuss it with you."

Question 22

A patient tells the nurse, "My therapist touched my face and asked me to come to his house for a romantic evening." The nurse recognizes that the therapist has engaged in which unethical behavior?

A) Invasion of privacy
B) Inappropriate self-disclosure
C) Failure to maintain boundaries
D) False imprisonment

Question 23

A patient has been court-ordered to take his antipsychotic medications due to concerns that he will be a danger to himself. The nurse recognizes such action may be justified in which situations? Select all that apply.

A) To alleviate suffering
B) In an emergency situation
C) When in the patient's best interest
D) To foster the therapeutic relationship
E) To care a patient who cannot care for himself

Question 24

A patient holds a knife to his throat and tells a family member that voices in his head are telling him to kill himself. The patient may be admitted to the psychiatric unit under which type of admission?

A) Commitment
B) Temporary admission
C) Observational admission
D) Emergency involuntary admission

Question 25

The patient with a history of schizophrenia presents in the emergency department with delusions, hallucinations, and unsafe behavior. The nurse learns the patient has completed an advance directive agreeing to hospitalization should decompensation occur. How would the current admission be categorized?

A) Voluntary admission
B) Involuntary commitment
C) Temporary involuntary admission
D) Emergency involuntary admission

Question 26

Which patient situation does the mental health nurse recognize may support the need for involuntary commitment?

A) History of incarceration
B) Self-medication with marijuana
C) Threats made against family members
D) Presence of auditory hallucinations

Question 27

A patient tells his nurse during the initial assessment that he is angry with his girlfriend and plans to kill her with a gun as soon as he is released from the hospital. The nurse confirms that he does have a gun and ammunition. Which statement best describes the nurse's legal and ethical obligation?

A) The nurse may not break confidentiality because of HIPAA.
B) The nurse cannot disclose the information because it is considered privileged.
C) The nurse has a duty to warn the girlfriend and law enforcement of the patient's plans.
D) The nurse may not discuss the assessment with anyone except those caring for the patient.

Question 28

The nurse is subpoenaed to provide information about a patient's injuries sustained in a criminal case. The hospital's attorney tells her she must comply. Which statement best describes how the nurse should respond?

A) Plead the Fifth Amendment in this case.
B) Refuse to give any information about the patient.
C) Disclose any information she knows about the patient.
D) Answer questions with the minimum information needed.

Question 29

The relative of a woman with severe mental illness requests that the woman be involuntarily committed because of her history of numerous hospitalizations and because she is refusing to get dressed. Based on which factor does the nurse recognize that the woman likely does not qualify for involuntary commitment?

A) The woman has used up her hospital coverage.
B) The woman has not voluntarily requested hospitalization.
C) There is no evidence that woman is a danger to self or others.
D) It is less than two weeks since the woman's most recent hospital discharge.

Question 30

The patient admitted to the mental health unit is concerned that health information given to the nurse remains confidential. What is the nurse's best response?

A) "We can keep the information just between the two of us if you prefer."
B) "I will share the information with staff members only with your approval."
C) "You can choose whether your physician needs this information for your care."
D) "If the information is important to your care, I will need to share it with the staff."

Question 31

The nurse notes cigarette burns on the back of an adolescent patient while providing routine care. After initial hesitation, the patient tells the nurse that her mother burns her when she is "bad." The patient then begs the nurse not to tell anyone. What is the appropriate statement by the nurse?

A) "Don't worry, I won't break your confidence."
B) "I have to tell or I'll get in big trouble myself."
C) "I'm sorry, but it is my responsibility to report that your mother is burning you with a cigarette."
D) "OK, but can I get your permission to tell your doctor this is happening?"

Question 32

A patient who is agitated and aggressive has threatened two staff members. After other less invasive interventions fail, the nurse calls the physician and obtains an order to physically restrain the patient. Which statement regarding restraint use is correct?

A) The patient must be assessed every 6 hours.
B) The order must be written as "PRN confusion."
C) The doctor must assess the patient every other day.
D) The patient must be educated about the use of restraints.