1. Which of the following statements by the nurse would be most helpful to assist patients in clarifying their values?
A. That was not a good decision. Why do you think it would work?
B. The most important thing is to follow the plan of care. Did you follow all your doctor's orders?
C. Some people might have a different decision. What led you to make your decision?
D. If you had asked me, I would have given you my opinion about what to do. Now, how do you feel about your choice? CORRECT ANSWER: C. Some people might have a different decision. What led you to make your decision? RATIONALE: This is the most effective communication technique because it allows the client to analyze their values that can affect their decision making.
2. A child who has been in a car accident has been shown to have no brain function. The parents refuse to allow life support to be withdrawn. Although the nurse believes the child should be allowed to die, the nurse supports their decision. What moral principle provides the best basis for the nurse's action?
A. respect for autonomy
B. non-maleficence
C. beneficence
D. justice CORRECT ANSWER: A. respect for autonomy RATIONALE: Autonomy is respecting an individual's right to make decision. The nurse supports the client's decision even when it conflicts with his/her own preferences or choices.
3. The nurse is caring for a patient admitted to the emergency room after a MVA. The nurse must obtain informed consent before treatment unless the patient:
A. mentally ill and there are relatives present with the patient
B. refuses to give informed consent
C. is in emergency situation
D. asks the nurse to give substituted consent CORRECT ANSWER: C. is in emergency situation RATIONALE: Informed consent need to be obtained before any treatment can be given to clients but if informed consent cannot be obtained because of the client's condition and immediate treatment is necessary to save life, the emergency rule can be applied.
4. A patient became seriously ill after a nurse gave him the wrong medication. After his recovery, he files a lawsuit. Who is likely to be held liable?
A. No one because it was an accident
B. The hospital
C. The nurse
D. The nurse and the hospital CORRECT ANSWER: D. The nurse and the hospital RATIONALE: Both the nurse and the hospital can be sued for damages if a mistake the nurse makes injures the client. The nurse is always responsible for her own actions. The hospital, as the employer, will be liable for the negligent behavior of its nurses under its employ.
5. A nurse needs assistance transferring a confused, elderly patient to bed. The nurse leaves the patient to find someone to assist her with the transfer. While the nurse is gone, the patient falls and hurt herself. The nurse is at fault because she hasn't:
A. properly educated the patient about safety measures
B. restrained the patient
C. documented that she left the patient
D. arranged for continual care of the patient CORRECT ANSWER: D. arranged or continual care of the patient RATIONALE: The nurse's responsibility is to take care of the client and if in case the nurse needs to leave the client, the nurse needs to always arrange for somebody to care for the client especially if the client is confused.
6. In the above scenario, what ethical principle did the nurse not observe?
A. respect for autonomy
B. beneficence
C. non-maleficence
D. fidelity CORRECT ANSWER: C. non-maleficence RATIONALE: The nurse's duty is to prevent or avoid harm whether intentional or unintentional.
7. The nursing staff is sitting in the break room and talking about a patient who was admitted and diagnosed with sexually transmitted disease. What ethical principle is being violated by the nursing staff?
A. Respect for autonomy
B. Beneficence
C. Fidelity
D. Confidentiality CORRECT ANSWER: D. Confidentiality RATIONALE: Information relating to the condition and treatment of clients requires confidentiality and protection against invasion of privacy.
8. A nursing instructor provides a lecture to the nursing students regarding the issue of privacy. Which of the following if identified by the student indicates an understanding of a violation of this patient's rights?
A. Performing a procedure without consent
B. Telling the patient that he/she cannot leave the hospital
C. Threatening to give the patient a medication
D. Observing care provided to a patient without the patient's permission CORRECT ANSWER: D. Observing care provided to a patient without the patient's permission RATIONALE: A client has the right to refuse to participate in clinical teaching. Nurses need to obtain consent before any teaching conference is done.
9. An 80-year old lady was brought to the ER for a fractured arm. On physical assessment, the nurse notes old and new ecchymotic areas on the patient's legs and chest. The nurse reports to the social welfare worker in the hospital despite the patient's refusal. What ethical principle is involved in this situation?
A. Confidentiality
B. Beneficence
C. Veracity
D. Justice
CORRECT ANSWER: A. Confidentiality RATIONALE: Confidentiality is the social contract guaranteeing another's privacy. Clients should be assured that information is kept confidential, unless it places the nurse under a legal obligation. The nurse must report situations related to child or elderly abuse, gunshot wounds and certain infectious diseases.
10. In the above situation, what ethical principle justifies the nurse's action?
A. Beneficence
B. Justice
C. Non-maleficence
D. Fidelity CORRECT ANSWER: A. Beneficence RATIONALE: Beneficence is the principle of attempting to do things that benefit others.
11. A new registered nurse is employed in a busy tertiary hospital. She was asked to float to the ICU for the day because the ICU was understaffed. The nurse has never worked in the ICU and refused the assignment. What ethical principle is involved here?
A. Respect for person
B. Beneficence
C. Non-maleficence
D. Justice CORRECT ANSWER: C. Non-maleficence RATIONALE: The nurse's duty is to prevent or avoid harm whether intentional or unintentional. The nurse should not assume responsibility beyond the level of their experience or education.
12. The following are elements of informed consent: 1) Disclosure 2) Understanding 3) Voluntariness 4) Consent
A. 1,2,3
B. 2,3,4
C. 1,3,4
D. 1,2,3,4 CORRECT ANSWER: D. 1,2,3,4 RATIONALE: Informed consent means the operation has been fully explained to the client, including complications. It has to be explained in terms that the patient understands. Written or verbal consent can be given by alert, coherent or otherwise competent adults. Consents should be signed and witnessed.
13. If a patient is no longer legally capable of making health care decisions, a legal document such as an advance directive may be utilized by the patient. Which of the following are considered to be advance directives?
A. consent
B. living wills
C. Do not resuscitate
D. B and C CORRECT ANSWER: D. B and C RATIONALE: Legal, written or oral statements made by a person who is mentally competent about treatment preferences are known as advanced directives. These include living wills and durable power of attorney
14. Confidential information can be disclosed under which circumstances?
A. when a patient is a danger to him/herself
B. presence of a communicable disease
C. in cases of suspected abuse
D. all of the above CORRECT ANSWER: D. all of the above RATIONALE: Confidentiality is the social contract guaranteeing another's privacy. Clients should be assured that information is kept confidential, unless it places the nurse under a legal obligation. The nurse must report situations related to child or elderly abuse, gunshot wounds and certain infectious diseases.
15. When nurses accurately, promptly and legibly document their care given to patients, what ethical principle is the nurse observing?
A. Fidelity
B. Veracity
C. Justice
D. Confidentiality CORRECT ANSWER: B. Veracity RATIONALE: Veracity is the duty to tell the truth. Documentation should be factual, objective, accurate and complete.