Deck 11: Practice Issues Related to Patient Self Determination

Question 1

A nurse is caring for a patient with cancer, who describes using an herbal preparation and guided imagery as part of her treatment. Considerations related to patient self-determination would direct the nurse to:

A) honor the patient's right to use therapies other than conventional medicine to address her health care needs.
B) tell the patient that she should stop these therapies because they have no research to support them.
C) inform the patient that she has a right to do what she wants, but that it's crazy to mix different traditions.
D) encourage the patient to share the herbal preparation with other patients to see if it might help them as well.

Answer 1

honor the patient's right to use therapies other than conventional medicine to address her health care needs.

Question 2

Which of the following statements about living wills are true? Select all that apply.

A) Living wills are documents giving directions to health care providers related to withholding or withdrawing life support if certain conditions exist.
B) In all states, only persons who are terminally ill or whose death is imminent are allowed to make living wills.
C) Statutes regulating living wills vary from state to state, so nurses must be familiar with their own state laws.
D) Living wills may be vague and can address only the interventions a person does not want.
E) Allows a competent person to designate another as a surrogate or proxy to act on her or his behalf.

Answer 2

Living wills are documents giving directions to health care providers related to withholding or withdrawing life support if certain conditions exist.
Statutes regulating living wills vary from state to state, so nurses must be familiar with their own state laws.
Living wills may be vague and can address only the interventions a person does not want.

Question 3

Competence is:

A) a legal action physicians can impose on patients who are elderly and confused.
B) the ability of a patient to understand medical options and treatment.
C) a legal ruling regarding a person's ability to make meaningful life decisions.
D) the ability of a patient to communicate about current events.

Answer 3

a legal ruling regarding a person's ability to make meaningful life decisions.

Question 4

The law passed in 1991 that requires institutions receiving Medicaid or Medicare funding to provide written information to adult patients regarding their right to make health care decisions is the:

A) Uniform Health Care Information Act.
B) Patient Self-Determination Act.
C) Patient Bill of Rights.
D) Civil Rights Act.

Question 5

What is the legal protection of a patient's right to personal autonomy?

A) Paternalism
B) Advanced directives
C) Informed consent
D) Competence

Question 6

In dealing with a patient's lifestyle choices, nurses need to remember the instructions in the American Nurses Association Code of Ethics, which would include:

A) respect human dignity.
B) avoid value judgments.
C) practice compassion.
D) a and b.
E) all of the above.

Question 7

Factors that may threaten autonomy in health care settings may include which of the following? Select all that apply.

A) Persistent paternalistic attitude that promotes the dependent role of the patient.
B) Assumptions that a patient's values and thought processes are the same as those of the health care providers.
C) A focus on caring rather than technology.
D) Failure to appreciate a difference in knowledge level regarding health matters.
E) Patients and families who feel confident enough to share their choices with health care providers.

Question 8

If a patient is not given the opportunity to ask questions about a procedure prior to the start of the procedure, which patient right is being violated?

A) Autonomy
B) Justice
C) Advance directives
D) Informed consent

Question 9

Instructions that indicate health care interventions to initiate or withhold, or that designate someone who will act as a surrogate in making such decisions in the event that we lose decision-making capacity is termed:

A) informed consent.
B) autonomy.
C) paternalism.
D) advanced directives.

Question 10

The nurse's role and responsibilities in informed consent include all the following except:

A) verifying that the patient is aware of options and implications of each.
B) advocating to ensure that criteria for autonomous decision making is met.
C) explaining the procedure to the patient when the doctor cannot do so.
D) signing as a witness attesting that the patient is giving consent willingly.

Question 11

A nurse who discusses a patient's condition and treatment with family members who were not authorized to have medical information disclosed to them is breaching:

A) autonomy.
B) paternalism.
C) competence.
D) confidentiality.

Question 12

A nurse's advocacy role regarding a patient's advance directives (AD) include which of the following? Select all that apply.

A) Ensuring that care is consistent with the patient's wishes and AD
B) Telling patients about changes in their conditions so they can modify AD
C) Alerting physicians to changes in the patient's decision-making capacity
D) Informing health team members of the content of a patient's AD
E) Intervening appropriately when a patient's wishes are not being followed

Question 13

The information that needs to be included in an informed consent document include which of the following?

A) A description of all treatment options, even those that the health care provider does not favor or cannot provide
B) The benefits, risks, and consequences of the various treatment alternatives including nonintervention
C) The nature of the health concern and prognosis if nothing is done
D) All of the above
E) a and b

Question 14

Having the freedom to make choices about issues that affect our own lives and to make decisions about personal goals is called:

A) paternalism.
B) informed consent.
C) autonomy.
D) competence.

Question 15

Which of the following elements must be present when evaluating a patient's decision-making capacity? Select all that apply.

A) The ability to understand the information provided
B) The ability to communicate understanding
C) The ability to indicate personal choices and decisions
D) The ability to understand medical terminology
E) The ability to demonstrate values guiding the decision