Deck 11: Practice Issues Related to Patient Self-Determination

Question 1

As the nurse is completing the pre-operative checklist, Mrs. Jones asks whether she will be awake during her surgery. What is the next step for this nurse?  

A)Answer Mrs. Jones's question to reassure her prior to her surgery. 
B)Put a note on the chart for this to be reviewed with Mrs. Jones by the Anesthetist in the Operating Room. 
C)Contact the surgeon, as Mrs. Jones does not have a clear understanding and therefore has not given informed consent. 
D)Document Mrs. Jones's questions in the chart and note that the nurse provided the answers.

Answer 1

Contact the surgeon, as Mrs. Jones does not have a clear understanding and therefore has not given informed consent. 

Question 2

What is the definition of competence?  

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 2

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

Question 3

Which of the following actions are part of the nurse's role and responsibilities in informed consent?  

A)verifying that the patient is aware of options and the implications of each option  
B)providing recommendations about care to the patient  
C)explaining the procedure to the patient when the doctor cannot do so  
D)signing as a witness attesting that the patient is unable to give consent

Answer 3

verifying that the patient is aware of options and the implications of each option  

Question 4

What is the purpose of a patient completing a living will?  

A)prolonging life or improving quality of life  
B)identifying a proxy or substitute decision-maker  
C)a medical determination relating only to the issue at hand  
D)evaluating health care decisions and reducing choices

Question 5

When a nurse discusses the results of a patient's diagnostic test with family members who were not authorized to have medical information disclosed to them, what principle is the nurse breaching?  

A)autonomy  
B)non-maleficence  
C)competence  
D)confidentiality

Question 6

What should be considered when  determining  whether the information provided for consent was adequate?  

A)a subjective standard of what a person may want or need to know  
B)what the ethics board for that institution has put into policy  
C)a physician's standard of what she has determined the patient should know  
D)the standard that determines the potential serious outcomes of the treatment or procedure

Question 7

Which source document acknowledges the importance of living wills by clearly identifying, promoting, and respecting informed decision making?  

A)Substitute Decision Maker Proxy  
B)Code of Ethics  
C)Lifestyle Choices Policy  
D)Advance Directives Act

Question 8

A nurse is injured with a percutaneous exposure of blood while on duty. The nurse wishes to have the patient tested for HIV; however, the patient refuses. Which of the following statements best summarizes testing issues related to HIV?  

A)The nurse's right to have the testing completed supersedes any patient's objections. 
B)It is illegal to perform testing without the patient's consent. 
C)It is mandatory for all patients to be tested for HIV, and therefore the nurse would have results available. 
D)The nurse needs to advise the patient of the potential risks of refusing to have the testing completed.

Question 9

Which of the following elements must be included in an informed consent?  

A)description of common practices of the healthcare institute  
B)needs and expectations of the patient  
C)description of the health concern  
D)verification of understanding

Question 10

A nurse is caring for a patient with cancer who describes using meditation, guided imagery, and mega intravenous doses of vitamin C as part of her treatment. Which of the following nursing actions would take into consideration the patient's ability for self-determination?  

A)Honour the patient's right to use therapies other than conventional medicine to address their health care needs. 
B)Tell the patient that she  should stop these therapies because the research does not support them. 
C)Inform the patient that she has  a right to do what she  wants, but that it is unwise to mix different modalities of therapy. 
D)Encourage the patient to share the alternative therapies with other patients to see if they might help them as well.

Question 11

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

A)paternalism  
B)advanced directives  
C)informed consent  
D)competence

Question 12

A patient is refusing to participate in his plan of care. The nurse is aware that the patient's refusal will negatively affect his health outcome. According to the Canadian Nurses Association Code of Ethics, what must the nurse take into consideration?  

A)that the patient's unhealthy life practices require further allocation of resources  
B)that the nurse has the right to refuse to continue care  
C)that the quality of nursing care must NOT be affected  
D)that the plan of care should NOT be revised

Question 13

What does a nurse's advocacy role regarding a patient's advance directives (AD) include?  

A)making sure that the patient is not resuscitated in a cardiac arrest situation  
B)telling patients about changes in their condition so they can modify their AD  
C)informing health team members about healthcare decisions when the patient cannot do so  
D)informing health team members of the content of a patient's AD

Question 14

A nurse encourages a patient to take narcotics for severe cancer pain. The patient is concerned about the possible side effects. The nurse gives the patient the narcotic and tells the patient; "It's for your own good and it's important to get your pain under control." What is the nurse's behaviour an example of?  

A)paternalism  
B)justice  
C)autonomy  
D)competence

Question 15

Which of the following elements must be present when evaluating a patient's decision-making capacity?  

A)the ability to determine a positive outcome  
B)the ability to communicate understanding  
C)the ability to behave in an ethical manner  
D)the ability to understand medical terminology

Question 16

A patient asks the surgeon what will be gained by having the procedure and the surgeon does not respond. Which patient right is being violated?  

A)autonomy  
B)justice  
C)advance directives  
D)informed consent