Deck 2: Legal Issues

Question 1

A terminally ill patient tells the nurse that he wants his family to remember him in a positive way, celebrating the life they shared and not mourning his passing. The nurse realizes the patient is demonstrating which of the following constructs of mindful listening?

A) Consciousness
B) Commitment
C) Connection
D) Communication

Answer 1

Consciousness

Question 2

The nurse caring for a terminally ill patient has received a court order to withhold all food and fluids from the patient because of the threat of aspiration pneumonia even though the patient is awake, alert, and asking for a drink of water. Which of the following should the nurse do?

A) Refuse to uphold the court order and contact the physician because the decision is unethical
B) Provide water to the patient
C) Ask the nurse manager to assign the care of the patient to another nurse
D) Uphold the court order

Answer 2

Uphold the court order

Question 3

Because of a court order, it has been determined that a terminally ill patient is to receive food, fluids, and comfort measures until the patient independently ceases to breathe. The nurse, fearful that the patient will aspirate and develop pneumonia, should do which of the following?

A) Provide food, fluids, and comfort measures while following aspiration precautions
B) Provide solid food only
C) Provide fluids only
D) Withhold both food and fluids and provide comfort measures

Answer 3

Provide food, fluids, and comfort measures while following aspiration precautions

Question 4

A terminally ill patient tells the nurse that he wants to be the one who makes the decisions about his healthcare going forward and asks the nurse to tell him "everything" about his health and status. The nurse, supporting the ethical principle of veracity, will also support which of the following ethical principles?

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

Question 5

The parents of a terminally ill patient diagnosed as having no electroencephalogram activity do not want to stop life-sustaining treatment even though the patient's wife tells the physician that the patient did not want to live "on machines." The ethical committee structure that would best support this patient's needs would be:

A) Social justice
B) Autonomy
C) Patient benefit
D) Double effect

Question 6

A patient tells the nurse that he does not want to have surgery to remove a tumor from his small bowel but doesn't want to tell his physician. The nurse encourages the patient to talk with the surgeon in an honest way and volunteers to be in the room when the patient tells the physician. The advocacy model this nurse is implementing would be:

A) Rights protection
B) Values-based decision
C) Respect for persons
D) Therapeutic jurisprudence

Question 7

An 80 year old patient, told that he "probably has" prostate cancer and given two options of treatment, asks the physician "what would you do?" The nurse realizes that this situation indicates which of the following ethical principles?

A) Justice
B) Paternalism
C) Fidelity
D) Autonomy

Question 8

Which of the following patient care situations would support the concept of double effect?

A) Leaving a terminally ill patient lying flat in bed so as to not cause more pain
B) Inserting a central line into a terminally ill patient to provide nutrition and medications
C) Moving a terminally ill patient from the bed to a chair in order to change the bed linens
D) Providing a terminally ill patient who is NPO with ice chips

Question 9

The nurse is determining if the application of a particular action would be considered a law or an ethical principle. Which of the following should the nurse consult to determine if the action is a law?

A) The state nurses' association
B) The organization's ethics committee
C) The American Nurses' Association
D) The state board of nursing

Question 10

A patient with a Do Not Resuscitate order is demonstrating signs of fluid volume deficit. Although the nurse believes the patient needs intravenous fluids the physician believes that the provision of fluids would be considered resuscitation. Which of the following ethical committee structures would be helpful in determining the best outcome for the patient?

A) Autonomy model
B) Social justice model
C) Patient benefit model
D) Veracity model

Question 11

The nurse plans and provides quality care to all patients assigned during the shift. This nurse is implementing which of the following ethical principles of care?

A) Respect for others
B) Autonomy
C) Paternalism
D) Fidelity

Question 12

A dying patient is unable to take fluids by mouth and tells the nurse that "it's okay" since he's not thirsty anyway and is ready to die. The nurse ensures the patient has a functioning intravenous line and administers fluids around the clock. Which of the following ethical theories is this nurse implementing?

A) Rule deontology
B) Act deontology
C) Rule utilitarianism
D) Act utilitarianism

Question 13

A terminally ill patient is admitted to the hospital with multiple organ system failure. In implementing the respectful death model, the nurse would do which of the following first?

A) Mindfully listen to the patient talk about his healthcare problems
B) Inform the family that the patient needs end-of-life care
C) Help the family realize that the patient is going to die
D) Establish a therapeutic relationship with the patient and family

Question 14

A patient tells the nurse that he "doesn't care" who his doctor is, as long as the doctor is competent and will prescribe the best treatment for his problem. The nurse realizes this patient is describing:

A) What the patient considers ethics.
B) What the patient values as competence.
C) What the patient believes to be a law.
D) What the patient believes the legal system to be.

Question 15

A patient believes that his physician "broke the law" and has consulted with an attorney. Which of the following activities will be studied when determining if the law was broken?

A) What the physician did or did not do.
B) Why the physician did or did not do it.
C) How the physician's actions benefited all of society.
D) The motivation for the physician's actions.

Question 16

The nurse providing care to a dying patient knows the patient prefers to wear his own pajamas even though this makes it difficult to maintain his intravenous lines and drainage tubes. By ensuring that the patient wears his own pajamas, the nurse is implementing which of the following ethical theories?

A) Rule deontology
B) Rule utilitarianism
C) Act deontology
D) Situation ethics

Question 17

The nurse caring for a terminally ill patient receiving chemotherapy discusses the patient's needs and wants and learns that he does not want any more chemotherapy and just wants to be kept comfortable until he passes away. The nurse is working within which of the following advocacy models?

A) Respect for persons
B) Rights protection
C) Values-based decision
D) Patient-advocate

Question 18

A terminally ill patient, with significant ascites, would be more comfortable after a paracentesis to remove the fluid, even though the procedure is painful and could cause abdominal organ damage. This procedure would be considered as which of the following?

A) Best interest standard
B) Therapeutic jurisprudence
C) Double effect
D) Competent care

Question 19

A patient, nearing the end of life, tells the nurse that the one thing that he will "miss the most" is the taste of ice cream. By providing this patient with ice cream during his dying days, the nurse is implementing which of the following ethical theories?

A) Act deontology
B) Rule utilitarianism
C) Act utilitarianism
D) Rule deontology

Question 20

While planning care for a terminally ill patient, the nurse realizes that, in order to support the ethical concept of nonmaleficence, the patient may experience discomfort with one intervention though the outcome will be "good" for him. The nurse is applying which of the following concepts?

A) Best interest
B) Beneficence
C) Double effect
D) Justice