NCLEX - Legal & Ethical, Nursing Jurisprudence: Legal and Ethical Considerations NCLEX Practice Quiz, Legal and Ethical Issues in Nursing, NCLEX Questions-Ethical and Legal Issues, NCLEX STYLE REVIEW QUESTIONS FOR NURSE PROCESS, LEGAL, PROFESSIONALIS...

Family friend call about patient concerned about patient and you tell them. Is this a violation of HIPAA?

YES.

Nurse allows a staff member to draw blood for lab. Is this a violation of HIPAA?

NO.

Patient doing cocaine & using cocaine during her pregnancy. She asks you not to tell anyone b/c her husband is unaware of it. (select all that applies)

A) yes. she has the right for confidentiality

B) share the info w/ the doctor only

C) yes. record on patient's record.

D) mother would be separated from the mom

A) yes. she has the right for confidentiality

B) share the info w/ the doctor only

Failure to raise a side rail up is considered which malpractice?

breach of duty

A attorney charged a nurse with manslaughter because she poisoned her patient with a lethal medication. What type of law is this?

criminal law

Who's responsible of wrong medication by physician order?

both the nurse and doctor

The RN employed in a medical center in a large metropolitan area was asked to resign after consistently failing to report changes in client status to the health care provider. The RN subsequently applied for a staff nurse position in another hospital. Which action is best for the nurse manager to take when the new employer asks for a reference?

A) consult an attorney

B) inform the potential employer that the nurse resigned

C) inform the new employer about occurrences

D) ignore the request for reference

C) inform the new employer about occurrences

The nurse reviews informed consent with a group of nursing students. Which conditions must the informed consent meet to be valid?

(select all that applies)

A) there is adequate disclosure

B) the nurse explains the procedure to the client

C) the informed consent is given voluntarily

D) the client has the opportunity to rescind.

E) the client has sufficient comprehensions.

F) the client is under the influence of morphine

A) there is adequate disclosure

C) the informed consent is given voluntarily

E) the client has sufficient comprehensions.

The nurse notices a patient dx w/ major depression crying in the day room. The nurse puts her hand over the patient's shoulder and states, "Let's talk about it." Which of the following ethical principles describes the nurse's action?

A) Autonomy

B) Veracity

C) Nonmaleficence

D) Beneficence

D) Beneficence

On the morning before surgery, the client signs an operative consent form. Soon afterward, the client tells the nurse that the client does not want the surgery. Which action does the nurse take first?

A) notifies the health care provider of the client's decision.

B) informs the client the decision has delayed the operating room schedule.

C) encourages the client to discuss reasons for canceling the surgery

D) asks the client's family to encourage the client to have the surgery

C) encourages the client to discuss reasons for canceling the surgery

A nurse approaches the nurse manager to ask for a raise. After some discussion about why the nurse feels a raise is warranted, the nurse manager suggests they discuss the raise further over dinner. The nurse refuses, and the nurse manager replies, "No dinner, no raise." Which action does the nurse take first?

A) immediately document the incident

B) immediately report the incident to the supervisor

C) immediately inform the nurse manager that the nurse does not want to go out to dinner.

D) immediately contact the nurse's family

C) immediately inform the nurse manager that the nurse does not want to go out to dinner.

The student nurse discusses causes of malpractice suits with the instructor. The instructor intervenes if the student include which occurrence as an example of malpractice?

A) failure to warn a potential employer of an RN's incompetence.

B) failure to staff a unit adequately

C) failure to ensure that nurses are practicing in a competent manner

D) failure to document within 30 minutes after a change in the client condition

D) failure to document within 30 minutes after a change in the client condition

The nurse understands that risk management, within the context of managed care, focuses on which principle?

A) educate clients about managing risk factors that would predispose to certain health conditions.

B) teach employees how to take risks safely in their personal and professional lives.

C) propose risk taking activities for the institution that will enhance its public image

D) prevent and minimize institutional and treatment factors that could lead to legal liability.

D) prevent and minimize institutional and treatment factors that could lead to legal liability.

The nursing instructor discusses perioperative care. Which statement best describes informed consent?

A) informed consent is required for every invasive procedure done in the hospital.

B) informed consent is obtained before major invasive (surgical) procedures.

C) informed consent is implied when the client signs the admission papers.

D) informed consent is not necessary for surgical or invasive hospital procedures.

B) informed consent is obtained before major invasive (surgical) procedures.

When witnessing the client's signature during informed consent, it is most important for the nurse to make which assessment?

A) does the client understand the procedure?

B) does the client have any questions?

C) does the client give consent voluntarily?

D) is the client about to write the name?

C) does the client give consent voluntarily?

The nurse reporting suspected child abuse is legally operating under which cope?

A) good samaritan

B) duty to disclose

C) discretionary powers

D) expert witness

B) duty to disclose

The parents of an adult child have just been informed that the client will die shortly. The parents do not wont the nurse to discuss the situation with the client. The nurse states, "I will be truthful." The nurse's action is based on which ethical concept?

A) beneficence

B) autonomy

C) veracity

D) nonmaleficence

C) veracity

The healthcare provider asks the nurse to assist in obtaining informed consent for a procedure from the client. Which action does the nurse take to obtain informed consent form the client who is declared mentally incompetent?

A) contact the client's next of kin to obtain consent.

B) consult with the client's psychiatrist to determine if the client is able to sign the form.

C) contact the client's legal guardian or health care surrogate.

D) have the client's health care provider obtain informed consent from the client.

C) contact the client's legal guardian or health care surrogate.

When an older nurse complains to a younger nurse that nurses just aren't ethical anymore, which reply reflects the best understanding of moral development?

A) "behaving ethically develops gradually from childhood; maybe my generation doesn't value this enough to develop"

B) "I don't agree that nurses were more ethical in the past It's a new age and the ethics are new!"

C) "Ethics is genetically determined... it's like having blue or brown eyes. Maybe were evolving out of the ethical sense your generation had."

D) "I agree! It's impossible to be ethical when working in a practice setting like this!"

A) "behaving ethically develops gradually from childhood; maybe my generation doesn't value this enough to develop"

A home health nurse who performs a careful assessment of the home of a frail elderly patient to prevent harm to the patient is acting in accordance with which of the principles of bioethics?

A) autonomy

B) beneficence

C) justice

D) fidelity

E) nonmaleficence

E) nonmaleficence

A professional nurse committed to the principle of autonomy would be careful to?

A) provide the info. and support a patient needed to make decisions to advance one's own interest.

B) treat each patient fairly, trying to give everyone his or her due.

C) keep any promises made to a patient or another professional caregiver

D) keep any promises made to a patient or another professional caregiver

D) avoid causing harm to a patient.

A) provide the info. and support a patient needed to make decisions to advance one's own interest.

Janie wants to call an ethics consult to clarify treatment goals for a patient no longer able to speak for himself. She believes his dying is being prolonged painfully. She is troubled when the patient's doctor tells her that she'll be fired if she raises questions about his care or calls the consult. This is a good example of:

A) ethical uncertainty

B) ethical distress

C) ethical dilemma

D) ethical residue

B) ethical distress

A student nurse begins a clinical rotation in a long term care facility and quickly realizes that certain residents have unmet needs. The student wants to advocate for these residents. Which statements reflect a correct understanding of advocacy? Select all that applies.

A) advocacy is the protection and support of another's rights.

B) patient advocacy is primarily done by nurse.

C) patients with special advocacy needs include the very young and the elderly, those who are seriously ill, and those with disabilities.

D) Nurse advocates make good health care decisions for patients and residents.

E) nurse advocates do whatever patients and residents want.

F) effective advocacy may entail becoming politically active.

A) advocacy is the protection and support of another's rights.

C) patients with special advocacy needs include the very young and the elderly, those who are seriously ill, and those with disabilities.

F) effective advocacy may entail becoming politically active.

A state attorney decides to charge a nurse with manslaughter for allegedly administering lethal medication. This is an example of what type of law?

A) public law

B) private law

C) civil law

D) criminal law

D) criminal law

Newly hired nurses in a busy suburban hospital are required to read the state Nurse Practice Act as part of their training. Which topics are covered by this act? Select all that applies.

A) violations that may result in disciplinary action.

B) clinical procedures.

C) medication administraiton

D) scope of practice

E) delegation policies

F) medicare reimbursement

A) violations that may result in disciplinary action.

D) scope of practice

If review of this patient's record revealed that she had never consented to the eye surgery, of which intentional tort might the surgeon have been guilty?

A) assault

B) battery

C) invasion of privacy

D) false imprisonment

B) battery

What must be est. to prove that malpractice or negligence has occurred in this case?

A) the surgeon who performed the procedure called the nurse's action pure negligence, saying that the patient could have been saved.

B) the fact that this patient should not have died, she was a vibrant grandmother of 10 who had walked three quarters of a mile the morning of her surgery and had sung in her church choir the day before.

C) the nurse intended to harm the patient and was willfully negligent.

D) then nurse had a duty to monitor the patient's vital signs, failed to do so, the patient died, and it was Jean's failure to do her duty that caused the patient's death.

D) then nurse had a duty to monitor the patient's vital signs, failed to do so, the patient died, and it was Jean's failure to do her duty that caused the patient's death.

When the attorney representing the pt's family calls Jean and asks to talk with her about the case so that he can better understand her actions, how should Jean respond?

A) "I'm sorry, but I can't talk with you. You'll have to contact my attorney."

B) Answer the attorney's questions honestly and make sure that he understand her side of the story.

C) appeal to the attorney's sense of compassion and try to enlist his sympathy by telling him how busy it was that morning.

D) "Why are you doing this to me? This could ruin me!"

A) "I'm sorry, but I can't talk with you. You'll have to contact my attorney."

A nurse ans. a patient's call light and finds the patient on the floor by the bathroom door. After calling for assistance and examining the patient for injury, the nurse helps the patient back to the bed and then fills out an incident report. Which statements accurately describe aspects of this procedure? select all that applies.

A) an incident report is used as disciplinary action against staff members.

B) an incident report is used as a means of identifying risks.

C) an incident report is used for quality control

D) the facility manager completes the incident report.

E) an incident report makes facts available in case litigation occurs.

F) filling of an incident report should be documented in the patient record.

B) an incident report is used as a means of identifying risks.

C) an incident report is used for quality control

E) an incident report makes facts available in case litigation occurs.

A nursing student asks the charge nurse about legal liability when performing clinical practice. Which statement regarding liability is true?

A) students are not responsible for their acts of negligence resulting in patient's injury.

B) student nurses are held to the same standard of care that would be used to evaluate the actions of a registered nurse.

C) hospitals are exempt from liability for student negligence if the student nurse is properly supervised by an instructor.

D) most nursing programs carry group professional liability making student personal professional liability insurance unnecessary.

B) student nurses are held to the same standard of care that would be used to evaluate the actions of a registered nurse.

The best explanation of what Title VI of the Civil Rights Act mandates is the freedom to:

A. Pick any physician and insurance company despite one's income

B. Receive free medical benefits as needed within the county of residence

C. Have equal access to all health care regardless of race and religion

D. Have basic care with a sliding scale payment plan from all health care facilities

Answer: C. Have equal access to all health care regardless of race and religion

Which statement would best explain the role of the nurse when planning care for a culturally diverse population? The nurse will plan care to:

A. Include care that is culturally congruent with the staff from predetermined criteria

B. Focus only on the needs of the client, ignoring the nurse's beliefs and practices

C. Blend the values of the nurse that are for the good of the client and minimize the client's individual values and beliefs during care

D. Provide care while aware of one's own bias, focusing on the client's individual needs rather than the staff's practices

Answer: D. Provide care while aware of one's own bias, focusing on the client's individual needs rather than the staff's practices

Without understanding one's own beliefs and values, a bias or preconceived belief by the nurse could create an unexpected conflict or an area of neglect in the plan of care for a client (who might be expecting something totally different from the care). During assessment values, beliefs, practices should be identified by the nurse and used as a guide to identify the choices by the nurse to meet specific needs/outcomes of that client. Therefore identification of values, beliefs, and practices allows for planning meaningful and beneficial care specific for this client.

Which factor is least significant during assessment when gathering information about cultural practices?

A. Language, timing

B. Touch, eye contact

C. Biocultural needs

D. Pain perception, management expectations

Answer: C. Biocultural needs

Cultural practices do not influence biocultural needs because they are inborn risks that are related to a biological need and not a learned cultural belief or practice.

Transcultural nursing implies:

A. Using a comparative study of cultures to understand similarities and differences across human groups to provide specific individualized care that is culturally appropriate

B. Working in another culture to practice nursing within their limitations

C. Combining all cultural beliefs into a practice that is a non-threatening approach to minimize cultural barriers for all clients' equality of care

D. Ignoring all cultural differences to provide the best generalized care to all clients

Answer: A. Using a comparative study of cultures to understand similarities and differences across human groups to provide specific individualized care that is culturally appropriate

Transcultural care means that by understanding and learning about specific cultural practices the nurse can integrate these practices into the plan of care for a specific individual client who has the same beliefs or practices to meet the client's needs in a holistic manner of care.

What should the nurse do when planning nursing care for a client with a different cultural background? The nurse should:

A. Allow the family to provide care during the hospital stay so no rituals or customs are broken

B. Identify how these cultural variables affect the health problem

C. Speak slowly and show pictures to make sure the client always understands

D. Explain how the client must adapt to hospital routines to be effectively cared for while in the hospital

Answer: B. Identify how these cultural variables affect the health problem

Without assessment and identification of the cultural needs, the nurse cannot begin to understand how these might influence the health problem or health care management.

Which activity would not be expected by the nurse to meet the cultural needs of the client?

A. Promote and support attitudes, behaviors, knowledge, and skills to respectfully meet client's cultural needs despite the nurse's own beliefs and practices

B. Ensure that the interpreter understands not only the language of the client but feelings and attitudes behind cultural practices to make sure an ethical balance can be achieved

C. Develop structure and process for meeting cultural needs on a regular basis and means to avoid overlooking these needs with clients

D. Expect the family to keep an interpreter present at all times to assist in meeting the communication needs all day and night while hospitalized

Answer: D. Expect the family to keep an interpreter present at all times to assist in meeting the communication needs all day and night while hospitalized

It is not the family's responsibility to assist in the communication process. Many families will leave someone to help at times, but it is the hospital's legal obligation to find an interpreter for continued understanding by the client to make sure the client is fully informed and comprehends in his or her primary language.

Ethical principles for professional nursing practice in a clinical setting are guided by the principles of conduct that are written as the:

A. American Nurses Association's (ANA's) Code of Ethics

B. Nurse Practice Act (NPA) written by state legislation

C. Standards of care from experts in the practice field

D. Good Samaritan laws for civil guidelines

Answer: A. American Nurses Association's (ANA's) Code of Ethics

This set of ethical principles provides the professional guidelines established by the ANA to maintain the highest standards for ideal conduct in practice. As a profession, the ANA wanted to establish rules and then incorporate guidelines for accountability and responsibility of each nurse within the practice setting.

A bioethical issue should be described as:

A. The physician's making all decisions of client management without getting input from the client

B. A research project that included treating all the white men and not treating all the black men to compare the outcomes of a specific drug therapy.

C. The withholding of food and treatment at the request of the client in a written advance directive given before a client acquired permanent brain damage from an accident.

D. After the client gives permission, the physician's disclosing all information to the family for their support in the management of the client.

Answer: B. A research project that included treating all the white men and not treating all the black men to compare the outcomes of a specific drug therapy.

The ethical issue was the inequality of treatment based strictly upon racial differences. Secondly, the drug was deliberately withheld even after results showed that the drug was working to cure the disease process in the white men for many years. So after many years, the black men were still not treated despite the outcome of the research process that showed the drug to be effective in controlling the disease early in the beginning of the research project. Therefore harm was done. Nonmaleficence, veracity, and justice were not followed.

When the nurse described the client as "that nasty old man in 354," the nurse is exhibiting which ethical dilemma?

A. Gender bias and ageism

B. HIPAA violation

C. Beneficence

D. Code of ethics violation

Answer: A. Gender bias and ageism

Stereotyping an "old man" as "nasty"is a gender bias and an ageism issue. The nurse is verbalizing a negative descriptor about the client.

The distribution of nurses to areas of "most need" in the time of a nursing shortage is an example of:

A. Utilitarianism theory

B. Deontological theory

C. Justice

D. Beneficence

Answer: C. Justice

Justice is defined as the fairness of distribution of resources. However, guidelines for a hierarchy of needs have been established, such as with organ transplantation. Nurses are moved to areas of greatest need when shortages occur on the floors. No floor is left without staff, and another floor that had five staff will give up two to go help the floor that had no staff.

Nurses are bound by a variety of laws. Which description of a type of law is correct?

A. Statutory law is created by elected legislature, such as the state legislature that defines the Nurse Practice Act (NPA).

B. Regulatory law includes prevention of harm for the public and punishment for those laws that are broken.

C. Common law protects the rights of the individual within society for fair and equal treatment.

D. Criminal law creates boards that pass rules and regulations to control society.

Answer: A. Statutory law is created by elected legislature, such as the state legislature that defines the Nurse Practice Act (NPA).

Statutory law is created by legislature. It creates statues such as the NPA, which defines the role of the nurse and expectations of the performance of one's duties and explains what is contraindicated as guidelines for breach of those regulations.

Besides the Joint Commission on Accreditation of Healthcare Organizations (JACHO), which governing agency regulates hospitals to allow continued safe services to be provided, funding to be received from the government and penalties if guidelines are not followed?

A. Board of Nursing Examiners (BNE)

B. Nurse Practice Act (NPA)

C. American Nurses Association (ANA)

D. Americans With Disabilities Act (ADA)

Answer: D. Americans With Disabilities Act (ADA)

If the hospital fails to follow ADA guidelines for meeting special needs, the facility loses funding and status for receiving low-income loans or reimbursement of expenses. ADA protects the civil rights of disabled people. It applies to both the hospital clients and hospital staff. Privacy issues for persons who are positive for human immunodeficiency virus (HIV) have been one issue in relationship to getting information when hospital staff have been exposed to unclean sticks. The ADA allows the infected client the right to choose whether or not to disclose that information.

When a client is confused, left alone with the side rails down, and the bed in a high position, the client falls and breaks a hip. What law has been broken?

A. Assault

B. Battery

C. Negligence

D. Civil tort

Answer: C. Negligence

Knowing what to do to prevent injury is a part of the standards of care for nurses to follow. Safety guidelines dictate raising the side rails, staying with the client, lowering the bed, and observing the client until the environment is safe. As a nurse, these activities are known as basic safety measures that prevent injuries, and to not perform them is not acting in a safe manner. Negligence is conduct that falls below the standard of care that protects others against unreasonable risk of harm.

When signing a form as a witness, your signature shows that the client:

A. Is fully informed and is aware of all consequences.

B. Was awake and fully alert and not medicated with narcotics.

C. Was free to sign without pressure

D. Has signed that form and the witness saw it being done

Answer: D. Has signed that form and the witness saw it being done

Your signature as a witness only states that the person signing the form was the person who was listed in the procedure.

Which criterion is needed for someone to give consent to a procedure?

A. An appointed guardianship

B. Unemancipated minor

C. Minimum of 21 years or older

D. An advocate for a child

Answer: A. An appointed guardianship

A guardian has been appointed by a court and has full legal rights to choose management of care.

Which statement is correct?

A. Consent for medical treatment can be given by a minor with a sexually transmitted disease (STD).

B. A second trimester abortion can be given without state involvement.

C. Student nurses cannot be sued for malpractice while in a nursing clinical class.

D. Nurses who get sick and leave during a shift are not abandoning clients if they call their supervisor and leave a message about their emergency illness.

Answer: A. Consent for medical treatment can be given by a minor with a sexually transmitted disease (STD).

Anyone, at any age, can be treated without parental permission for an STD infection. The client is "advised" to contact sexual partners but is not "required" to give names. Permission from parents is not needed, based upon current privacy laws.

Most litigation in the hospital comes from the:

A. Nurse abandoning the clients when going to lunch

B. Nurse following an order that is incomplete or incorrect

C. Nurse documenting blame on the physician when a mistake is made

D. Supervisor watching a new employee check his or her skills level

Answer: B. Nurse following an order that is incomplete or incorrect

The nurse is responsible for clarifying all orders that are illegible, unreasonable, unsafe, or incorrect. The failure of the nurse to question the physician about an order creates an area of liability on the nurse's part because this is perceived as a medical action and not the role of the nurse to write orders. Some RNs do have prescriptive privileges based upon advanced degrees and certification. Therefore the nurse who cannot correct the order must document that the physician was called and clarification or a new order was given to correct the unclear or illegible one that was currently on the chart. Phone calls, follow-up, and lack of follow-up by the physician should also be documented if there is a problem with getting the information in a timely manner. The nurse must show the sequence of events of a situation in a clear manner if there is any conflict or question about any orders or procedures that were not appropriate. Assessments and documentation of the client's status should also be included if there is a potential risk for harm present. Contact of the staff's chain of command should also be specifically stated for the proof of the responsibilities being followed according to hospital policy.

The nurse places an aquathermia pad on a client with a muscle sprain. The nurse informs the client the pad should be removed in 30 minutes. Why will the nurse return in 30 minutes to remove the pad?

A. Reflex vasoconstriction occurs.

B. Reflex vasodilation occurs.

C. Systemic response occurs.

D. Local response occurs.

Answer: A. Reflex vasoconstriction occurs.

If heat is applied for 1 hour or more, blood flow is reduced by reflex vasoconstriction. Vasoconstriction is the opposite of the desired effect of heat application

A client has recently been told he has terminal cancer. As the nurse enters the room, he yells, "My eggs are cold, and I'm tired of having my sleep interrupted by noisy nurses!" The nurse may interpret the client's behavior as:

A. An expression of the anger stage of dying

B. An expression of disenfranchised grief

C. The result of maturational loss

D. The result of previous losses

Answer: A. An expression of the anger stage of dying

In the anger stage of Kubler-Ross's stages of dying, the individual resists the loss and may strike out at everyone and everything, in this case, the nurse.

When helping a person through grief work, the nurse knows:

A. Coping mechanisms that were effective in the past are often disregarded in response to the pain of a loss

B. A person's perception of a loss has little to do with the grieving process.

C. The sequencing of stages of grief may occur in order, they may be skipped, or they may recur.

D. Most clients want to be left alone.

Answer: C. The sequencing of stages of grief may occur in order, they may be skipped, or they may recur.

Grief is manifested in a variety of ways that are unique to an individual and based on personal experiences, cultural expectations, and spiritual beliefs. The sequencing of stages or behaviors of grief may occur in order, they may be skipped, or they may recur. The amount of time to resolve grief also varies among individuals.

A client is hospitalized in the end stage of terminal cancer. His family members are sitting at his bedside. What can the nurse do to best aid the family at this time?

A. Limit the time visitors may stay so they do not become overwhelmed by the situation.

B. Avoid telling family members about the client's actual condition so they will not lose hope.

C. Discourage spiritual practices because this will have little connection to the client at this time.

D. Find simple and appropriate care activities for the family to perform

Answer: D. Find simple and appropriate care activities for the family to perform.

It is helpful for the nurse to find simple care activities for the family to perform, such as feeding the client, washing the client's face, combing hair, and filling out the client's menu. This helps the family demonstrate their caring for the client and enables the client to feel their closeness and concern. a. Older adults often become particularly lonely at night and may feel more secure if a family member stays at the bedside during the night. The nurse should allow visitors to remain with dying clients at any time if the client wants them. It is up to the family to determine if they are feeling overwhelmed, not the nurse.

When caring for a terminally ill client, it is important for the nurse maintain the client's dignity. This can be facilitated by:

A. Spending time to let clients share their life experiences

B. Decreasing emphasis on attending to the client's appearance because it only increases their fatigue

C. Making decisions for clients so they do not have to make them

D. Placing the client in a private room to provide privacy at all times

Answer: A. Spending time to let clients share their life experiences

A. Spending time to let clients share their life experiences enables the nurse to know clients better. Knowing clients then facilitates choice of therapies that promote client decision making and autonomy, thus promoting a client's self-esteem and dignity.

What are the stages of dying according to Elizabeth Kubler-Ross?

A. Numbing; yearning and searching; disorganization and despair; and reorganization.

B. Accepting the reality of loss, working through the pain of grief, adjusting to the environment without the deceased, and emotionally relocating the deceased and moving on with life.

C. Anticipatory grief, perceived loss, actual loss, and renewal.

D. Denial, anger, bargaining, depression, and acceptance.

Answer: D. Denial, anger, bargaining, depression, and acceptance.

Bereavement may be defined as:

A. The emotional response to loss.

B. The outward, social expression of loss.

C. Postponing the awareness of the reality of the loss.

D. The inner feeling and outward reactions of the survivor

Answer: D. The inner feeling and outward reactions of the survivor.

A client who had a "Do Not Resuscitate" order passed away. After verifying there is no pulse or respirations, the nurse should next:

A. Have family members say goodbye to the deceased.

B. Call the transplant team to retrieve vital organs.

C. Remove all tubes and equipment (unless organ donation is to take place), clean the body, and position appropriately.

D. Call the funeral director to come and get the body.

Answer: C. Remove all tubes and equipment (unless organ donation is to take place), clean the body, and position appropriately.

The body of the deceased should be prepared before the family comes into view and say their goodbyes. This includes removing all equipment, tubes, supplies, and dirty linens according to protocol, bathing the client, applying clean sheets, and removing trash from the room.

A client's family member says to the nurse, "The doctor said he will provide palliative care. What does that mean?" The nurse's best response is:

A. "Palliative care is given to those who have less than 6 months to live."

B. "Palliative care aims to relieve or reduce the symptoms of a disease."

C. "The goal of palliative care is to affect a cure of a serious illness or disease."

D. "Palliative care means the client and family take a more passive role and the doctor focuses on the physiological needs of the client. The location of death will most likely occur in the hospital setting."

Answer: B. "Palliative care aims to relieve or reduce the symptoms of a disease."

The goal of palliative care is the prevention, relief, reduction, or soothing of symptoms of disease or disorders without effecting a cure.

Which of the following is not included in evaluating the degree of heritage consistency in a client?

A. Gender

B. Culture

C. Ethnicity

D. Religion

Answer: A. Gender

When providing care to clients with varied cultural backgrounds, it is imperative for the nurse to recognize that:

A. Cultural considerations must be put aside if basic needs are in jeopardy.

B. Generalizations about the behavior of a particular group may be inaccurate.

C. Current health standards should determine the acceptability of cultural practices.

D. Similar reactions to stress will occur when individuals have the same cultural background.

Answer: B. Generalizations about the behavior of a particular group may be inaccurate.

To respect a client's personal space and territoriality, the nurse:

A. Avoids the use of touch

B. Explains nursing care and procedures

C. Keeps the curtains pulled around the clients bed

D. Stands 8 feet away from the bed, if possible.

Answer: B. Explains nursing care and procedures

To be effective in meeting various ethnic needs, the nurse should:

A. Treat all clients alike.

B. Be aware of client's cultural differences.

C. Act as if he or she is comfortable with the client's behavior.

D. Avoid asking questions about the client's cultural background.

Answer: B. Be aware of client's cultural differences.

The most important factor in providing nursing care to clients in a specific ethnic group is:

A. Communication

B. Time orientation

C. Biological variation

D. Environmental control

Answer: A. Communication

A health care issue often becomes an ethical dilemma because:

A. A client's legal rights coexist with a health professional's obligation.

B. Decisions must be made quickly, often under stressful conditions.

C. Decisions must be made based on value systems.

D. The choices involved do not appear to be clearly right or wrong.

Answer: D. The choices involved do not appear to be clearly right or wrong.

A document that lists the medical treatment a person chooses to refuse if unable to make decisions is the:

A. Durable power of attorney

B. Informed consent

C. Living will

D. Advance directives

Answer: D. Advance directives

Which statement about an institutional ethics committee is correct?

A. The ethics committee is an additional resource for clients and healthcare professionals.

B. The ethics committee relieves health care professionals from dealing with ethical issues.

C. The ethics committee would be the first option in addressing an ethical dilemma.

D. The ethics committee replaces decision making by the client and health care providers.

Answer: A. The ethics committee is an additional resource for clients and healthcare professionals.

The nurse is working with parents of a seriously ill newborn. Surgery has been proposed for the infant, but the chances of success are unclear. In helping the parents resolve this ethical conflict, the nurse knows that the first step is:

A. Exploring reasonable courses of action

B. Collecting all available information about the situation

C. Clarifying values related to the cause of the dilemma.

D. Identifying people who can solve the difficulty.

Answer: B. Collecting all available information about the situation.

Miss Mary, an 88-year old woman, believes that life should not be prolonged when hope is gone. She has decided that she does not want extraordinary measures taken when her life is at its end. Because she feels this way, she has talked with her daughter about her desires, completing a living will and left directions with her physician. This is an example of:

A. Affirming a value

B. Choosing a value

C. Prizing a value

D. Reflecting a value

Answer: C. Prizing a value.

The scope of Nursing practice is legally defined by:

A. State nurses practice acts

B. Professional nursing organizations

C. Hospital policy and procedure manuals

D. Physicians in the employing institutions

Answer: A. State nurses practice acts.

A student nurse who is employed as a nursing assistant may perform any functions that:

A. Have been learned about in school

B. Are expected of a nurse at that level

C. Are identified in the positions job description

D. Require technical rather than professional skill.

Answer: C. Are identified in the positions job description.

A confused client who fell out of bed because side rails were not used is an example of which type of liability?

A. Felony

B. Assault

C. Battery

D. Negligence

Answer: D. Negligence

The nurse puts a restraint jacket on a client without the client's permission and without the physicians order. The nurse may be guilty of:

A. Assault

B. Battery

C. Invasion of privacy

D. Neglect

Answer: B. Battery

In a situation in which there is insufficient staff to implement competent care, a nurse should:

A. Organize a strike

B. Inform the clients of the situation

C. Refuse the assignment

D. Accept the assignment but make a protest in writing to the administration.

Answer: A. Organize a strike

Which statement about loss is accurate?

A. Loss is only experienced when there is an actual absence of something valued.

B. The more the individual has invested in what is lost, the less the feeling of loss.

C. Loss may be maturational, situational, or both.

D. The degree of stress experienced is unrelated to the type of loss.

Answer: C. Loss may be maturational, situational, or both.

Trying questionable and experimental forms of therapy is a behavior that is characterized of which stage of dying?

A. Anger

B. Depression

C. Bargaining

D. Acceptance

Answer: C. Bargaining

All of the following are crucial needs of the dying client except:

A. Control of pain

B. Preservation of dignity and self-worth

C. Love and belonging

D. Freedom from decision making

Answer: D. Freedom from decision making

Cultural awareness is an in-depth self-examination of one's:

A. Background, recognizing biases and prejudices.

B. Social, cultural, and biophysical factors

C. Engagement in cross-cultural interactions

D. Motivation and commitment to caring.

Answer: A. Background, recognizing biases and prejudices.

Cultural awareness is an in-depth examination of one's own background, recognizing biases and prejudices and assumptions about other people.

Cultural competence is the process of:

A. Learning about vast cultures

B. Acquiring specific knowledge, skills, and attitudes

C. Influencing treatment and care of clients

D. Motivation and commitment to caring.

Answer: B. Acquiring specific knowledge, skills, and attitudes

Cultural competence is the process of acquiring specific knowledge, skills, and attitudes that ensure delivery of culturally congruent care.

Ethnocentrism is the root of:

A. Biases and prejudices

B. Meanings by which people make sense of their experiences.

C. Cultural beliefs

D. Individualism and self-reliance in achieving and maintaining health.

Answer: A. Biases and prejudices

When action is taken on one's prejudices:

A. Discrimination occurs

B. Sufficient comparative knowledge of diverse groups is obtained.

C. Delivery of culturally congruent care is ensured.

D. People think/know you are a ******* for being prejudiced.

Answer: A. Discrimination occurs

The dominant value orientation in North American society is:

A. Use of rituals symbolizing the supernatural.

B. Group reliance and interdependence

C. Healing emphasizing naturalistic modalities

D. Individualism and self-reliance in achieving and maintaining health.

Answer: D. Individualism and self-reliance in achieving and maintaining health.

Disparities in health outcomes between the rich and the poor illustrates: a (an)

A. Illness attributed to natural, impersonal, and biological forces.

B. Creation of own interpretation and descriptions of biological and psychological malfunctions.

C. Influence of socioeconomic factors in morbidity and mortality.

D. Combination of naturalistic, religious, and supernatural modalities.

Answer: C. Influence of socioeconomic factors in morbidity and mortality.

Disparities in health outcomes between the rich and the poor illustrate the influence of socioeconomic factors in morbidity and mortality. Social factors such as poverty and lack of universal medical insurance compromise the health status of the poor and unemployed.

Culture strongly influences pain expression and need for pain medication. However, cultural pain:

A. May be suffered by a client whose valued way of life is disregarded by practitioners.

B. Is more intense, thus necessitating more medication.

C. Is not expressed verbally or physically

D. Is expressed only to others of like culture.

Answer: A. May be suffered by a client whose valued way of life is disregarded by practitioners.

Nurses need not assume that pain relief is equally valued across groups. Cultural pain may be suffered by a client whose valued way of life is disregarded by practitioners.

The dominant values in American society on individual autonomy and self-determination:

A. Rarely have an effect on other cultures

B. Do have an effect on health care

C. May hinder ability to get into a hospice program

D. May be in direct conflict with diverse groups.

Answer: D. May be in direct conflict with diverse groups.

The dominant value in American society of individual autonomy and self-determination may be in direct conflict with diverse groups. Advance directives, informed consent, and consent for hospice are examples of mandates that may violate client's values.

In the United States, access to health care usually depends on a client's ability to pay for health care, either through insurance or by paying cash. The client the nurse is caring for needs a liver transplant to survive. This client has been out of work for several months and does not have insurance or enough cash. A discussion about the ethics of this situation would involve predominantly the principle of:

A. Accountability, because you as the nurse are accountable for the well being of this client.

B. Respect of autonomy, because this client's autonomy will be violated if he does not receive the liver transplant.

C. Ethics of care, because the caring thing that a nurse could provide this patient is resources for a liver transplant.

D. Justice, because the first and greatest question in this situation is how to determine the just distribution of resources.

Answer: D. Justice, because the first and greatest question in this situation is how to determine the just distribution of resources

Justice refers to fairness. Health care providers agree to strive for justice in health care. The term often is used during discussions about resources. Decisions about who should receive available organs are always difficult.

The code of ethics for nurses is composed and published by:

A. The national league for Nursing

B. The American Nurses Association

C. The Medical American Association

D. The National Institutes of Health, Nursing division.

Answer: B. The American Nurses Association

The ANA has established widely accepted codes that professional nurses attempt to follow.

Nurses agree to be advocates for their patients. Practice of advocacy calls for the nurse to:

A. Seek out the nursing supervisor in conflicting situations

B. Work to understand the law as it applies to the client's clinical condition.

C. Assess the client's point of view and prepare to articulate this point of view.

D. Document all clinical changes in the medical record in a timely manner.

Answer: C. Assess the client's point of view and prepare to articulate this point of view.

Nurses strengthen their ability to advocate for a client when nurses are able to identify personal values and then accurately identify the values of the client and articulate the client's point of view.

Successful ethical discussion depends on people who have a clear sense of personal values. When many people share the same values it may be possible to identify a philosophy of utilitarianism, with proposes that:

A. The value of people is determined solely by leaders in the Unitarian church.

B. The decision to perform a liver transplant depends on a measure of the moral life that the client has led so far.

C. The best way to determine the solution to an ethical dilemma is to refer the case to the attending physician.

D. The value of something is determined by its usefulness to society.

Answer: D. The value of something is determined by its usefulness to society.

A utilitarian system of ethics proposes that the value of something is determined by its usefulness.

The philosophy sometimes called the code of ethics of care suggests that ethical dilemmas can best be solved by attention to:

A. Relationships

B. Ethical principles

C. Clients

D. Code of ethics for nurses.

Answer: A. Relationships.

The ethic of care explores the notion of care as a central activity of human behavior. Those who write about the ethics of care advocate a more female biased theory that is based on understanding relationships, especially personal narratives.

In most ethical dilemmas, the solution to the dilemma requires negotiation among members of the health care team. The nurse's point of view is valuable because:

A. Nurses have a legal license that encourages their presence during ethical discussions.

B. The principle of autonomy guides all participants to respect their own self-worth.

C. Nurses develop a relationship to the client that is unique among all professional health care providers.

D. The nurse's code of ethics recommends that a nurse be present at any ethical discussion about client care.

Answer: C. Nurses develop a relationship to the client that is unique among all professional health care providers

When ethical dilemmas arise, the nurses point of view unique and critical. The nurse usually interacts with clients over longer time intervals than do other disciples.

Ethical dilemmas often arise over a conflict of opinion. Once the nurse has determined that the dilemma is ethical, a critical first step in negotiating the difference of opinion would be to:

A. Consult a professional ethicist to ensure that the steps of the process occur in full.

B. Gather all relevant information regarding the clinical, social, and spiritual aspects of the dilemma.

C. List the ethical principles that inform the dilemma so that negotiations agree on the language of the discussion.

D. Ensure that the attending physician has written an order for an ethics consultation to support the ethics process.

Answer: B. Gather all relevant information regarding the clinical, social, and spiritual aspects of the dilemma

Each step in the processing of an ethical dilemma resembles steps in critical thinking. The nurse begins by gathering information and moves through assessment, identification of the problem, planning, implementation, and evaluation.

The nurse practice acts are an example of:

A. Statutory law

B. Common law

C. Civil law

D. Criminal law

Answer: A. Statutory law

The scope of Nursing Practice, the established educational requirements for nurses, and the distinction between nursing and medical practice is defined by:

A. Statutory law

B. Common law

C. Civil law

D. Nurse practice acts

Answer: D. Nurse practice acts

The client's right to refuse treatment is an example of:

A. Statutory law

B. Common law

C. Civil laws

D. Nurse practice acts

Answer: B. Common law.

. Even though the nurse may obtain the client's signature on a form, obtaining informed consent is the responsibility of the:

A. Client

B. Physician

C. Student nurse

D. Supervising nurse.

Answer: B. Physician

The nurse is obligated to follow a physician's order unless:

A. The order is a verbal order

B. The physician's order is illegible

C. The order has not been transcribed

D. The order is an error, violates hospital policy, or would be detrimental to the client.

Answer: D. The order is an error, violates hospital policy, or would be detrimental to the client.

The nursing theorist who developed transcultural nursing theory is

A. Dorothea Orem

B. Madeleine Leininger

C. Betty Newman

D. Sr. Callista Roy

Answer: B. Madeleine Leininger

Madeleine Leininger developed the theory on transcultural theory based on her observations on the behavior of selected people within a culture.

Licensure

Legal process by which an authorized authority (usually a state) grants a qualified person permission to preform designated skills and service in a defined jurisdiction.

Nurse Practice Act

is the single most important piece of legislation for nurses.

Due Process

1. A clear statement of the allegations. 2.A notice of the time and place of the hearing, disciplinary conference, or other proceeding. 3. A right to legal counsel or to consult with legal counsel. 4. A presention of one's on witnesses and evidence. 5. A cross-examination of the state's witnesses and challenge of state's evidence. 6. A full hearing before the board. 7. A written record. 8. A judicial review of the board's decision.

Articulation with Medical Practice Acts

Each state has a nurse practice act and a medical practice act.

Scope of Practice Issues

The actions or duties of a given profession. It refers to the legally permissable boundaries of practice and is defined by statue, rule, or a combination.