Deck 5: Legal and Ethical Issues

Question 1

Three gravely ill patients are candidates for the only available bed in the ICU.As the supervisor,you assign the bed to the patient with the best chance of recovery.This decision reflects which of the following ethical principles?

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

Answer 1

Beneficence

Question 2

A colleague asks you to give her your password access so that she can view her partner's healthcare record.This request violates the patient's right to:

A)Privacy.
B)Confidentiality.
C)Undue authorization of treatment.
D)Protection against slander.

Answer 2

Privacy.

Question 3

The principle that requires nurses to uphold a professional code of ethics,to practice within the code of ethics,and to remain competent is which of the following?

A)Veracity
B)Autonomy
C)Fidelity
D)Honesty

Answer 3

Fidelity

Question 4

The parents of a toddler who dies after being brought to the ER launch a lawsuit,claiming that the failure of nurses to pursue concerns related to their son's deteriorating condition contributed to his death.The senior nurse executive is named in the suit:

A)As a global respondent.
B)Under the doctrine of respondeat superior.
C)As a frivolous action.
D)Under the element of causation.

Question 5

As a charge nurse,you counsel your RN staff member that he has satisfied his duty of care by notifying a child's physician of his concerns about deterioration in the child's status at 0330 hours.The physician does not come in.The child dies at 0630 hours.As the charge nurse,you could be held liable for:

A)Professional negligence.
B)Assault.
C)Avoidance.
D)Murder.

Question 6

A nurse on your inpatient psychiatric unit is found to have made sexually explicit remarks toward a patient with a previous history of sexual abuse.The patient sues,claiming malpractice.Which of the following conditions may not apply in this situation?

A)Injury
B)Causation
C)Breach of duty
D)Breach of duty of care owed

Question 7

On your nursing unit,you employ LPNs,RNs,and advanced practice nurses.You will need to be familiar with at least:

A)Two nursing practice acts.
B)Two nursing practice acts in most states.
C)At least one nursing practice act.
D)One nursing practice act and a medical act.

Question 8

In keeping with standards of The Joint Commission (TJC),the nurse manager organizes an orientation for new staff members.As part of the orientation,the nurse manager reviews the employee handbook.Employers may be bound to statements in the employee handbook:

A)Under the doctrine of apparent agency.
B)Under the doctrine of respondeat agency.
C)Based on the employee's or the employer's expectations.
D)Based on the theory that the handbook creates an explicit contract.

Question 9

The manager in the coronary care unit believes that the most important ethical considerations in performance evaluations are that they include the employee's good qualities and that they give positive direction for professional growth.This belief is an example of:

A)Justice.
B)Fidelity.
C)Beneficence.
D)Nonmaleficence.

Question 10

During a staff shortage,you hire an RN from a temporary agency.The RN administers a wrong IV medication that results in cardiac arrest and a difficult recovery for the patient.Liability in this situation:

A)Is limited to the temporary agency.
B)Is restricted to the RN.
C)Could include the RN, the agency, and your institution.
D)May depend on the patient's belief regarding the employment relationship.

Question 11

An individual in a wheelchair is applying for the position of receptionist in an outpatient clinic.The nurse manager understands that the Americans with Disabilities Act of 1990 requires that employers:

A)Make reasonable accommodations for persons who are disabled.
B)Allow modified job expectations for persons recovering from alcoholism.
C)Hire disabled individuals before hiring other qualified, non-disabled persons.
D)Treat, for purposes of employment, homosexuals and bisexuals as disabled.

Question 12

A staff nurse in the area that you manage has excelled in the delivery of patient education.You are considering implementing a new job description that would broaden her opportunity to teach patients and orient new staff members to the value of patient education.The ethical principle that you are most directly reinforcing is:

A)Justice.
B)Fidelity.
C)Paternalism.
D)Respect for others.

Question 13

Which ethical principle is primarily involved in informed consent?

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

Question 14

A staff nurse who was fired for reporting patient abuse to the appropriate state agency files a whistleblower lawsuit against the former employer.Reasons that the court would use in upholding a valid whistleblower suit claiming retaliation include that the nurse:

A)Had previously reported the complaint, in writing, to hospital administration.
B)Had threatened to give full details of the patient abuse to local media sources.
C)Was discharged after three unsuccessful attempts at progressive discipline had failed.
D)Had organized, before filing the complaint, a work stoppage action by fellow employees.

Question 15

To reduce the incidence of falls in a skilled nursing unit,the nurse manager contacts the risk manager.Risk management is a process that attempts to identify potential hazards and:

A)Compensate for previous injuries.
B)Eliminate these risks before anyone else is harmed.
C)Supersede the need for staff members to file incident reports.
D)Discipline staff members who have been involved in previous incident reports.

Question 16

Mr.M.complains to you that one of your staff asked him details about his sexual relationships and financial affairs.He says that these questions were probing and unnecessary to his care,but he felt that if he refused to answer,the nurse would be angry with him and would not provide him with good care.Mr.M.'s statements reflect concern with:

A)Privacy.
B)Confidentiality.
C)Veracity.
D)Informed consent.

Question 17

To satisfy duty of care to a patient,a nurse manager is legally responsible for all of the following except:

A)Notifying staff of changes to policies related to medication administration.
B)Scheduling and staffing to ensure safe care.
C)Delegating in accordance with practice acts.
D)Supervising the practice of the physician.

Question 18

You volunteer at a free community clinic.A 13-year-old girl claims to have been diagnosed with SLE and presents with chlamydia.The team leader at the clinic advises that:

A)The state-defined age of legal consent is 18; therefore, no treatment can be delivered.
B)The teen is underage and should be referred to the family general practitioner.
C)Care can be provided as long as consent is voluntary and information about treatment and options is provided.
D)Treatment is provided as long as telephone consent is obtained from a parent or legal guardian.

Question 19

A patient refuses a simple procedure that you believe is in the patient's best interest.The two ethical principles that are directly in conflict in such a situation are:

A)Fidelity and justice.
B)Veracity and fidelity.
C)Autonomy and beneficence.
D)Paternalism and respect for others.

Question 20

One means of ensuring that nurses floated to other patient care areas in healthcare organizations are qualified to work in those areas is:

A)Employing additional staff to assist with orientation processes.
B)Cross-educating staff members to other areas of the institution.
C)Transferring patients to units where the staffing pattern is optimal.
D)Orienting staff members to all patient care areas as part of their general orientation to the institution.

Question 21

While walking past a patient's room,you overhear one of the RN staff telling a patient that the patient has no right to refuse chemotherapy treatment because the family and the doctor think the treatment is the best option for the patient.This patient is 40 years of age and alert.When you meet later to discuss what you heard with the RN,it is important to:

A)Discuss how statute law enforces the right of the doctor, but not of families, to ensure that patients comply with recommended treatment plans.
B)Discuss that statute law provides for patient autonomy and refusal of treatment.
C)Remind the nurse to provide clearer explanations to aid in the patient's comprehension of the treatment and compliance.
D)Acknowledge the nurse's role in ensuring that she does not fail in her duty of care for the patient.

Question 22

In a telehealth organization,a nurse who is licensed in New York and Pennsylvania provides teaching to a patient who resides in Pennsylvania.The patient charges that the teaching failed to provide significant information about a potential side effect,which led to delay in seeking treatment and untoward harm.Under which state nurse practice act and standards would this situation be considered?

A)New York
B)Pennsylvania
C)Neither New York nor Pennsylvania
D)Both New York and Pennsylvania

Question 23

One of your staff nurses asks for your advice because a patient refuses to sign a consent for surgery.The patient says that he won't sign because he doesn't understand the nature of the surgery.You advise that (select all that apply):

A)Consent must not be coerced.
B)The patient has a right to choose not to consent.
C)The patient must sign the consent because the doctor wants him to sign.
D)Witnessing a consent is related only to the voluntary nature of the signature.

Question 24

With regard to nursing practice,nurse managers are held responsible for (select all that apply):

A)Practicing within legal guidelines established under state law and nurse practice acts.
B)Ensuring that nursing staff under their supervision are currently licensed to practice.
C)Referring all errors in nursing judgment to state discipline boards.
D)Ensuring that physicians are properly licensed to provide care on patient care units.

Question 25

A member of a patient's family calls the nurse manager of the palliative care unit to express concern that a member of the family,who died on the weekend,had requested analgesics from the RNs on duty.An RN came with the analgesic nearly 45 minutes later,just after the patient had died.The manager is aware that the unit was especially busy that weekend because many patients were seriously ill,staff had called in ill,and the staffing manager was unable to completely replace staff who were absent.The manager is deeply troubled that the family member had to die in pain because it violates what she knows should have been done.This manager is experiencing:

A)Compromised agency.
B)Moral distress.
C)Moral sensitivity.
D)Moral dilemma.