Deck 2: Healthcare Policy, Legal Issues, and Ethics in Healthcare Delivery

Question 1

The patient is angry about the nursing care delivered on the past two shifts and demands to see his medical record. What should the nurse consider prior to granting this request?

A) The patient always has the right to view his medical record.
B) In some cases, the patient does not have the right to view his medical record.
C) The patient does not have the right to view his medical record.
D) The patient must have permission from the physician prior to viewing the medical record.

Answer 1

In some cases, the patient does not have the right to view his medical record.

Question 2

On admission, the patient states, "My son can make healthcare decisions for me if it is necessary." What does this statement imply?

A) The patient has a living will.
B) The son has durable power of attorney.
C) This patient has violated the Patient Self-Determination Act.
D) The patient wishes a do-not-resuscitate status.

Answer 2

The son has durable power of attorney.

Question 3

Which strategy could the nurse use to avoid disparity in healthcare delivery?

A) Recognize the cultural issue related to patient care.
B) Request more health plan options.
C) Care for more patients even if quality suffers.
D) Campaign for fixed nurse-patient ratios.

Answer 3

Recognize the cultural issue related to patient care.

Question 4

The risk manager is reviewing these events that occurred over the weekend. Which scenario should the risk manager be most concerned would represent malpractice?
0)25 mg orally.

A) The nurse did not obtain an apical pulse on a patient prior to administering Digoxin
B) The nurse did not raise the bed when changing the linens for a patient who was up in the chair.
C) A nurse did not obtain consent before drawing blood.
D) The nurse continued to assess the diabetic patient's blood sugar before each meal.

Question 5

The nursing assistant left a side rail down upon exiting the room of a patient who had just returned from the recovery room postoperatively. What does this scenario most closely illustrate?

A) Personal injury
B) Criminal intent
C) Malpractice
D) Negligence

Question 6

Which situation illustrates the ethical concept of autonomy?

A) The patient is instructed on the technique of insulin administration.
B) The patient is asked to choose from which arm to have blood drawn.
C) The patient's information can be used for research purposes.
D) The patient is informed of privacy rights.

Question 7

Which scenario is an example of informed consent?

A) The nurse omits diabetic education for a patient who has had diabetes for 10 years.
B) The nurse applies restraints to a patient who is trying to remove the nasogastric tube.
C) The patient understands the surgical procedure that will occur in the morning.
D) The patient asks the nurse for pain medication.

Question 8

Which option best illustrates a positive outcome from managed care?

A) Reshaped current policy
B) Consumer involvement in the healthcare political process
C) Increase in quality care with reduced cost
D) Managed care is now the method used for reimbursement.

Question 9

Which option represents a situation exemplifying the need for nurses to become involved in healthcare policy development?

A) The nurse omitted documentation of a surgical dressing change.
B) The nurse must have a nursing license and be certified as APRN to prescribe medications.
C) The nurse administered oral medications to the patient in the home.
D) The nurse discussed do-not-resuscitate decisions with the patient and the family.

Question 10

The nurse closely follows hospital policy for recording patient charges. After attending a conference break out session on reimbursement, the nurse realizes that the hospital policy is in violation of Medicare rules. Is this nurse guilty of fraud?

A) Yes, but since the nurse was following hospital policy no charges can be filed.
B) Yes, this is a clear example of fraud.
C) No, but the hospital is clearly guilty of fraud.
D) No, fraud requires intention to do wrong.

Question 11

Which statements correctly apply to the process of developing public policy? Select all that apply.

A) The two types of public policy are regulatory and allocative.
B) Since public policy supports the general population, decisions regarding policy are typically straightforward and easy to make.
C) Often, in order to pass a policy, deals have to be made.
D) Public policy may benefit some at the expense of others.
E) By law, political influence is separate from policy development.

Question 12

What is different about today's healthcare environment that makes it crucial that nurses are involved in the development of healthcare policy? Select all that apply.

A) The focus of this new environment is on one-to-one nursing care.
B) There has been a shift from curing patients to prevention of illness.
C) Care must be cost-effective.
D) There is a need to reinvent nursing's professional culture.
E) High quality care will again be provided primarily in acute care settings.

Question 13

Which action, taken by the nurse, best illustrates the ethical concept of justice?

A) The nurse witnesses consent prior to a surgical procedure for a patient.
B) The nurse advises the patient to take slow, deep breaths to try to relax before a urinary catheter is inserted.
C) The nurse provides discharge teaching to a postoperative patient and spends time with a patient who is depressed.
D) The nurse works with a physician to solve a patient problem.

Question 14

What was the American Nurses Association's stance on the healthcare reform plan supported by the Obama administration? Select all that apply.

A) This law is a significant victory for patients.
B) The debate over healthcare reform is finally over.
C) There is need to help nurses understand the significance of this law.
D) Access to primary care will be more difficult for most Americans.
E) There will be greater protection against being denied health insurance.

Question 15

Evaluate the following: The patient is labeled as a "complainer," and has not been informed of the treatment plan. The patient has no insurance, and the nursing staff is discussing the situation in the hallway. Choose the principles that have been violated. Select all that apply.

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

Question 16

Which question, asked of a patient, reflects the observance of the Patient Self-Determination Act of 1990?

A) Have you recently changed physicians?
B) Why did you come to the hospital today?
C) Do you have a durable power of attorney?
D) Would you sign this release of information form?

Question 17

Why does the process of developing public health policy seem familiar to most nurses?

A) It is very similar to the nursing process.
B) It is taught in all nursing schools.
C) It is emphasized on NCLEX-RN.
D) It reflects common sense.

Question 18

A staff nurse in a small, rural hospital is concerned about the future of healthcare in the rural environment. How can this nurse be involved in healthcare policy development? Select all that apply.

A) Join local and national nursing organizations.
B) Contact elected representatives regarding nursing and healthcare.
C) Act as a patient advocate.
D) Use the Internet to keep current on healthcare policy issues.
E) Serve on the Infection Control committee of the local hospital.

Question 19

Which nursing action best illustrates the ethical concept of beneficence?

A) Providing a walker for a patient prior to ambulating in the hall
B) Allowing the patient to choose what time to have a shower
C) Asking the patient about the existence of a living will or durable power of attorney
D) Continually communicating with the patient regarding procedures

Question 20

Which nursing action is the best example of the ethical principle of veracity?

A) Supporting the patient's right to refuse any part of planned nursing care
B) Informing the patient that the pain medication to be given is not the same as what was administered the previous day
C) Maintaining the privacy of the patient's personal medical information
D) Supporting the patient when ambulating and instructing the patient on the use of a walker

Question 21

You are serving on a state committee to develop a state health policy. Which of the following strategies should be done early in the process?

A) Coalition building
B) Select the solution
C) Monitor the outcomes
D) Implement the policy

Question 22

Consumer advocacy is more common today in healthcare policy. What are the common concerns that consumers have? Select all that apply.

A) Increasing costs of care
B) Impersonal care
C) Decreased communication
D) Provider competence
E) Decreasing quality of care

Question 23

What changes in the organization of healthcare delivery services does the Affordable Care Act of 2010 support? Select all that apply.

A) Nurse-managed health centers
B) Accountable Care Organizations
C) Increase number of acute care hospitals
D) Medical homes
E) Focus on state run clinics

Question 24

Healthcare delivery has experienced many changes and problems. Based on an examination of these changes and problems what would you consider a major concern today?

A) Cost is not related to quality.
B) Healthcare is complex.
C) Quality care is improving rapidly.
D) A functional system is more costly.

Question 25

Nursing: Scope and Standards of Practice (ANA, 2010) describes the model of professional nursing practice regulation. What is the base on which this model stands?

A) Nursing practice acts and rules and regulations
B) Scope of practice, standards of practice, code of ethics, specialty certification
C) Healthcare policies and procedures
D) Self-determination

Question 26

Healthcare in the U.S. would best be described by which of the following statements?

A) The U.S. has a national healthcare system.
B) The U.S has universal health coverage insurance.
C) The U.S. has a local, state, and federal system of healthcare.
D) The U.S. focuses on a public system to provide care.

Question 27

The nurse is considering "blowing the whistle" on a potential Medicare fraud situation occurring in a physician's office. The nurse has worked at this office for 12 years and has many friends among the staff and patients. What incentive does this nurse have for assuming the whistleblower role?

A) The nurse is entitled to a percentage of any money recovered.
B) After the nurse exposes the potential fraud, the nurse's responsibility in the case is complete.
C) By law, the nurse can be subject to no negative actions related to whistleblowing.
D) The nurse can "leak" the information to a news source first and still be protected by whistleblowing laws.

Question 28

Identify typical healthcare areas in which the states have input. Select all that apply.

A) Public health and safety
B) Provision of indigent care
C) Purchase care
D) Regulation
E) Resource allocation

Question 29

Identify strategies that will help the nurse prevent malpractice lawsuits. Select all that apply.

A) Effective communication
B) Establishing security rules
C) Effective leadership
D) Caring attitude
E) Following the rules

Question 30

The nurse has been invited to join the healthcare facility's interprofessional ethics committee. What factors should the nurse consider when making a decision about this invitation? Select all that apply.

A) The decisions made by these committees are advisory in nature.
B) Most of the cases discussed by these committees are related to financial considerations.
C) Nurses are generally active members in these committees and talk freely about ethical issues in nursing.
D) It might be best for the nurse to gain experience on a nursing ethics committee before joining an interprofessional committee.
E) The nurse can expect to be well compensated for work done on the committee.