Deck 6: Legal and Ethical Issues

Question 1

A staff nurse is facing a dilemma between meeting clinical ethical standards and meeting organizational goals. The nurse manager understands that the best way to assist staff members in resolving ethical dilemmas effectively is to focus on:

A) doing the right thing and taking the right action.
B) meeting clinical standards before organizational goals.
C) meeting organizational goals before clinical standards.
D) referring indecisive staff members for additional training.

Answer 1

doing the right thing and taking the right action.

Question 2

On admission, the patient was found to have a blood glucose level of 218. The RN knows that except in emergency situations, it is hospital policy to obtain physician's orders before administering any medication. Because the on-call physician did not return the page, the nurse administered insulin according to the common sliding scale. Four hours later, the patient was found nonresponsive in her bed and later died. According to the autopsy, the patient died from heart failure. Her postmortem blood glucose level was 22. The nurse's actions are an example of:

A) breach of contract.
B) common negligence.
C) intentional malpractice.
D) medical oversight.

Answer 2

common negligence.

Question 3

The major responsibility for upholding patient care standards belongs to the:

A) chief executive officer of the facility.
B) nurse manager.
C) on-call physician.
D) staff nurse providing patient care.

Answer 3

nurse manager.

Question 4

The court has found that a registered nurse (RN) harmed a patient by violating his rights. The nurse is ordered to pay the patient a large sum of money. The court has determined that the nurse has committed a:

A) civil act.
B) criminal act.
C) critical wrong.
D) quality breach.

Question 5

On admission, the patient was found to have a blood glucose level of 218. The RN knows that except in emergency situations, it is hospital policy to obtain physician's orders before administering any medication. Because the on-call physician did not return the page, the nurse administered insulin according to the common sliding scale. Four hours later, the patient was found nonresponsive in her bed and later died. According to the autopsy, the patient died from heart failure. Her postmortem blood glucose level was 22. Being aware of the hospital policy for medication administration, the patient's blood glucose level presented the nurse with a(n):

A) assessment option.
B) clinical choice.
C) ethical dilemma.
D) moral decision.

Question 6

A nurse manager is evaluating the efficiency of a process on the nursing unit. The manager believes that the unit could be more efficient if one aspect of this process were delegated to unlicensed personnel. To establish whether the delegation of this duty would be legal, he should check with the:

A) ANA.
B) current federal defense attorney.
C) state nurse practice act.
D) policy and procedure manual of the unit.

Question 7

Which ethical principle is violated when there are insufficient community resources to meet the needs of low-income families?

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

Question 8

The nurse on a medical unit is caring for a 19-year-old with complications from a congenital heart defect. The client's mother is consistently at the bedside asking questions and attempting to direct the treatment plan. Which of the following shows how the nurse should communicate with the mother?

A) Discuss personal information that the client shared with the nurse in confidence.
B) Provide the mother with any information required for continuity of care.
C) Explain that client confidentiality prevents the nurse from disclosing information.
D) Ask the client if he gives permission for the nurse to share information with the mother.

Question 9

"To do good for others" is an example of which ethical principle?

A) Nonmaleficence
B) Fidelity
C) Beneficence
D) Confidentiality

Question 10

Which ethical principle is violated when the RN tells the hospital accountant that the patient is HIV-positive? (Select all that apply.)

A) Beneficence
B) Veracity
C) Confidentiality
D) Autonomy
E) Fidelity

Question 11

Nurse managers are able to respond better to ethical dilemmas when they have access to the organization's:

A) mission and vision.
B) patient safety plan.
C) medical staff bylaws.
D) ethics committee.

Question 12

A staff nurse came in to work the 7 PM to 7 AM shift. She had met her friends for "happy hour" earlier in the evening. Her breath smells of alcohol. If this nurse is allowed to provide care for patients, she may be at risk for:

A) maleficence.
B) melange.
C) nonmaleficence.
D) nonmelange.

Question 13

The definition of veracity is:

A) being loyal and faithful to commitments and accountable for responsibilities.
B) the norm of telling the truth and not intentionally deceiving or misleading clients.
C) a prohibition of disclosure of information.
D) a right of limited physical or informational inaccessibility.

Question 14

One mechanism that ensures autonomy in the nursing profession is the:

A) American Nurses Association (ANA).
B) Department of Health Professionals.
C) Nursing Code of Ethics.
D) Professional Regulatory Board.

Question 15

The most common source of legal liability for nurse managers is a(n):

A) medical malpractice suit.
B) organizational nursing issue.
C) tort.
D) vicarious liability.

Question 16

A new RN is observed breaking sterile technique by the perioperative nurse. This is an example of a violation of which ethical principle?

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

Question 17

A patient who is not fully informed about his or her health status is an example of a violation of which ethical principle?

A) Autonomy
B) Justice
C) Utilitarianism
D) Confidentiality

Question 18

On admission, the patient was found to have a blood glucose level of 218. The RN knows that except in emergency situations, it is hospital policy to obtain physician's orders before administering any medication. Because the on-call physician did not return the page, the nurse administered insulin according to the common sliding scale. Four hours later, the patient was found nonresponsive in her bed and later died. According to the autopsy, the patient died from heart failure. Her postmortem blood glucose level was 22. Because of the nurse's actions, the admitting hospital may be found to be:

A) a judicial risk.
B) an ostensible authority.
C) indemnified.
D) vicariously liable.

Question 19

The nursing manager has assumed responsibility for ensuring that tasks within her department are delegated legally and are performed appropriately. In so doing, she has accepted which of the following nursing roles?

A) Ethical
B) Ombudsman
C) Paralegal
D) Supervisor

Question 20

An elderly client becomes confused after surgery. He is in a room farthest away from the nurse's station. The client has been trying to get out of bed several times during the shift. The nurse documents this very well. The client falls out of bed and breaks his hip. Who can possibly be held negligent? (Select all that apply.)

A) Client's wife
B) Nurse manager
C) Pharmacist
D) Staff RN

Question 21

Which of the following patient-related events may be considered as examples of common negligence allegations in a nursing malpractice suit? (Select all that apply.)

A) Staffing levels in the medical unit
B) Patient fall with injury
C) Heparin error
D) Failure to utilize rapid response team with change in vital signs
E) Failure to ensure telemetry monitor is on the correct patient

Question 22

The nurse manager in a large emergency department utilizes agency nursing for staffing. Which of the following should the nurse manager do to help the facility avoid corporate liability? (Select all that apply.)

A) Assume that the agency has reviewed the license status of the individual.
B) Ensure that those who report to them remain competent and qualified and have current licensure.
C) Report incorrect mixes of staff for effectively meeting the health care needs of clients.
D) Assign the staff members to the role of mentor and educator.

Question 23

A Middle Eastern man has just been diagnosed with terminal cancer. The family has asked the medical and nursing staff to keep this information from the patient because in their culture they are fearful of delivering bad news as it may cause the patient to give up hope. Which ethical principles and dilemmas might be faced by nursing staff? (Select all that apply.)

A) Justice
B) Autonomy
C) Veracity
D) Confidentiality

Question 24

Which of the following are examples of intentional torts that may occur in the health care field? (Select all that apply.)

A) Slip and fall in the hospital cafeteria
B) Patient restrained by the neck utilizing the nurse's arm
C) Ovary removal against the patient's signed consent
D) Restraining a patient without a physician's order
E) Hospital-acquired pressure ulcer

Question 25

Professional safeguards that protect the nurse from being wrongfully accused of malpractice include which of the following? (Select all that apply.)

A) Code of Ethics
B) Statute of Limitations
C) Affidavit of Merit
D) Standard of Proof
E) Sources of Law

Question 26

To establish legal liability on the grounds of malpractice, the injured party must prove which of the following? (Select all that apply.)

A) A duty of care was owed to the injured party.
B) An agreement was made to assume another party's liability.
C) There was a breach of duty.
D) Causation was present.
E) Actual harm or damages were suffered by the plaintiff.