CH 16: Ethical & Legal Issues Flashcards
A nurse posts a photo of a patient on social media without consent. This violates which law?
A. The Good Samaritan Law
B. HIPAA
C. The Nurse Practice Act
D. The Patient Self-Determination Act
B. HIPAA
Rationale: HIPAA protects patient privacy and prohibits unauthorized disclosure of personal health information.
A nurse is caring for a competent adult patient who refuses a life-saving blood transfusion due to religious beliefs. What is the nurse’s best action?
A. Administer the transfusion because it is necessary to save the patient’s life.
B. Respect the patient’s autonomy and document the refusal.
C. Contact the ethics committee to overrule the patient’s decision.
D. Obtain a court order to administer the transfusion.
B. Respect the patient’s autonomy and document the refusal.
Rationale: The ethical principle of autonomy states that competent individuals have the right to make their own healthcare decisions, even if it results in harm or death. The nurse must document the refusal and ensure the patient understands the consequences.
A nurse is reviewing ethical principles with a group of nursing students. Which of the following are considered fundamental ethical principles in nursing? (SATA)
A. Beneficence
B. Nonmaleficence
C. Justice
D. Fidelity
E. Persuasion
A. Beneficence
B. Nonmaleficence
C. Justice
D. Fidelity
Rationale: Beneficence, nonmaleficence, justice, and fidelity are all fundamental ethical principles in nursing. Persuasion is not an ethical principle.
A nurse fails to implement fall precautions for a patient at risk for falls, and the patient sustains a fracture. Which legal term applies to this situation?
A. Assault
B. Malpractice
C. Battery
D. False imprisonment
B. Malpractice
Rationale: Malpractice occurs when a nurse fails to meet the standard of care, leading to harm. Failing to implement fall precautions for a high-risk patient constitutes malpractice.
A nurse caring for a terminally ill patient overhears the family arguing about the patient’s end-of-life wishes. What is the nurse’s best intervention?
A. Call the physician to make a decision.
B. Ask the patient directly about their preferences.
C. Refer the family to the ethics committee.
D. Follow the family’s decision.
C. Refer the family to the ethics committee.
Rationale: The ethics committee assists with ethical dilemmas, including end-of-life decision-making.
A patient with a terminal illness has a Physician Order for Life-Sustaining Treatment (POLST) form. What does this document indicate?
A. A legally binding decision about life-sustaining treatments across all healthcare settings.
B. A general expression of a patient’s end-of-life preferences.
C. A replacement for a Do Not Resuscitate (DNR) order.
D. A document created only after a patient loses decision-making capacity.
A. A legally binding decision about life-sustaining treatments across all healthcare settings.
Rationale: A POLST is a medical order that outlines specific treatment preferences and is legally binding across various healthcare settings.
Which of the following are required for informed consent? (SATA)
A. Patient must be competent.
B. Patient must be informed of risks and benefits.
C. Consent must be given voluntarily.
D. The nurse must provide all information about the procedure.
E. A family member must co-sign the form.
A. Patient must be competent.
B. Patient must be informed of risks and benefits.
C. Consent must be given voluntarily.
Rationale: Informed consent requires competency, full disclosure of risks and benefits, and voluntary agreement. The provider, not the nurse, explains the procedure.
A nurse restrains a competent patient who wants to leave the hospital against medical advice (AMA). What legal violation has occurred?
A. Assault
B. False imprisonment
C. Malpractice
D. Negligence
B. False imprisonment
Rationale: False imprisonment occurs when a competent patient is restrained or prevented from leaving a facility against their will.
A nurse is discussing advanced directives with a patient. Which statement by the patient indicates correct understanding?
A. “A living will allows my healthcare provider to make decisions for me.”
B. “A durable power of attorney (DPA) allows me to designate someone to make healthcare decisions on my behalf.”
C. “A Do Not Resuscitate (DNR) order means I won’t receive any medical treatment.”
D. “I can’t change my advanced directive once I complete it.”
B. “A durable power of attorney (DPA) allows me to designate someone to make healthcare decisions on my behalf.”
Rationale: A DPA authorizes a designated person to make healthcare decisions if the patient becomes incapacitated.
Which legal issues could result in a nurse facing disciplinary action from the state board of nursing? (SATA)
A. Practicing outside the scope of practice
B. Administering medications without an order
C. Reporting suspected abuse
D. Documenting incorrect patient data
E. Providing care without a valid nursing license
A. Practicing outside the scope of practice
B. Administering medications without an order
D. Documenting incorrect patient data
E. Providing care without a valid nursing license
Rationale: Practicing outside the scope, giving medications without an order, falsifying documentation, and practicing without a license are all violations.
A nurse is assisting in an emergency outside of work. What protection does the Good Samaritan Law provide?
A. Immunity from all liability
B. Protection if care is given in good faith and not grossly negligent
C. Protection only if the patient is conscious
D. Full legal coverage regardless of negligence
B. Protection if care is given in good faith and not grossly negligent
Rationale: The Good Samaritan Law protects individuals providing emergency aid unless gross negligence occurs.
A nurse documents an incident report after a patient falls in the hospital. What is the correct approach to documentation?
A. Place a copy of the report in the patient’s chart.
B. Include details of the incident report in the nurse’s notes.
C. Avoid mentioning the incident report in the patient’s chart.
D. Submit the report only if the patient was injured.
C. Avoid mentioning the incident report in the patient’s chart.
Rationale: Incident reports are used for internal quality improvement and should not be referenced in the patient’s medical record.
A nurse is responsible for ensuring that care is provided according to hospital policies and procedures. What is the primary role of risk management?
A. Prevent legal and ethical violations.
B. Discipline nurses for mistakes.
C. Report all incidents to legal authorities.
D. Replace the state board of nursing in regulatory matters.
A. Prevent legal and ethical violations.
Rationale: Risk management focuses on preventing errors and improving patient safety.
A nurse is reviewing the role of an Institutional Review Board (IRB) in healthcare research. What is the primary function of an IRB?
A. To approve all medical treatments for experimental procedures.
B. To protect the rights and welfare of research participants.
C. To provide funding for new research projects.
D. To develop hospital-wide ethical guidelines for patient care.
B. To protect the rights and welfare of research participants.
Rationale: Institutional Review Boards (IRBs) are responsible for reviewing and approving research studies to ensure they meet ethical standards and protect the rights and safety of participants.
A nurse is accused of falsifying a patient’s medical record. Which type of law has been violated?
A. Criminal law
B. Civil law
C. Constitutional law
D. Statutory law
B. Civil law
Rationale: Falsifying documentation is considered a civil law violation, specifically under tort law, as it can lead to liability for negligence or malpractice.
A nurse is educating a group of patients about the Patient Self-Determination Act (PSDA). Which statement indicates a correct understanding of the PSDA?
A. “This law requires patients to follow medical advice to avoid legal consequences.”
B. “The PSDA ensures patients understand their right to accept or refuse medical treatment.”
C. “The PSDA applies only to terminally ill patients.”
D. “This law allows nurses to make healthcare decisions for patients who are unable to do so.”
B. “The PSDA ensures patients understand their right to accept or refuse medical treatment.”
Correct Answer: B. “The PSDA ensures patients understand their right to accept or refuse medical treatment.”
A nurse is caring for a patient who has been declared brain dead. The patient has not indicated their organ donation preferences. What is the nurse’s best action?
A. Approach the family to discuss organ donation.
B. Consult the hospital’s ethics committee before proceeding.
C. Notify the Organ Procurement Organization (OPO).
D. Document that the patient is ineligible for organ donation.
C. Notify the Organ Procurement Organization (OPO).
Rationale: Federal law requires hospitals to refer all potential organ donors to the OPO, which will determine eligibility and approach the family if appropriate.
What is the key difference between negligence and malpractice?
A. Negligence applies only to physicians, while malpractice applies to nurses.
B. Malpractice involves professional misconduct or breach of duty, while negligence does not require professional status.
C. Negligence results in criminal charges, whereas malpractice does not.
D. Malpractice applies only in hospital settings, while negligence applies everywhere.
B. Malpractice involves professional misconduct or breach of duty, while negligence does not require professional status.
Rationale: Negligence refers to a failure to act with reasonable care, while malpractice is a form of negligence specific to professionals who fail to meet the expected standard of practice.
A nurse is caring for a patient who is about to undergo a surgical procedure. The patient states, “I don’t understand what I’m signing.” What is the nurse’s best action?
A. Explain the procedure to the patient.
B. Ask the patient to sign the consent form and clarify later.
C. Notify the healthcare provider to provide further explanation.
D. Document that the patient refused the procedure.
C. Notify the healthcare provider to provide further explanation.
Rationale: The healthcare provider is responsible for obtaining informed consent, including ensuring the patient understands the procedure. The nurse should notify the provider rather than explain the procedure themselves.
The Nurse Practice Act (NPA) is designed to do which of the following?
A. Define legal nursing practices and outline disciplinary actions.
B. Allow nurses to practice independently without physician oversight.
C. Provide protection for nurses from all legal claims.
D. Establish federal guidelines for nursing care across all states.
A. Define legal nursing practices and outline disciplinary actions.
Rationale: The Nurse Practice Act is state-specific legislation that defines the scope of nursing practice, establishes licensing requirements, and outlines disciplinary actions for violations.
T/F
Institutional review boards (IRBs) set guidelines and approve all research studies that occur in the organization; protect the rights & welfare of the client.
true
An act of charity, mercy, and kindness with a strong connotation of doing good to others
the professional is obligated to favor the interest of the client
beneficence
do no harm
nonmaleficence
The quality of being just, impartial, or fair.
justice
Independence in one’s thoughts or actions.
autonomy
Faithfulness to a person, cause, or belief
Keeping your word
Returning when you say you will
fidelity
truthfulness or accuracy
veracity
is a wrongful act or an infringement of a right that may lead to civil legal liability
tort
You are the nursing supervisor and there is a patient that will be going to the operating room for a kidney transplantation. It is the ultimate responsibility of the _________ to check and ensure that the organ donor and recipient are correct.
A.Surgeon
B.Anesthesiologist
C.Registered nurse and surgeon
D.Surgeon and anesthesiologist
C.Registered nurse and surgeon
Issues that are commonly addressed by ethics committees are:
A.End-of-life issues, organ donation, futility-of-care issues
B.End-of-life issues, organ donation, change in the durable power of attorney
C.Organ donation, futility-of-care issues, pediatric patient issues
D.Organ donation, do not resuscitate order, Jehovah’s Witness issues
A.End-of-life issues, organ donation, futility-of-care issues
What is the document that permits an individual to give a surrogate or proxy the authority to make decisions for that person in the event that they become incompetent?
A.Living will
B.Durable power of attorney for health care decisions
C.Advance directive
D.Informed consent
B.Durable power of attorney for health care decisions
Care providers have the duty to do good to others; to maintain a balance between benefits and harm; to provide all patients, including terminally ill, with caring attention; and to treat every patient with respect and courtesy. What is the requirement that care providers contribute to the health and welfare of the patient and not merely attempt to avoid harm to the patient or client?
A.Beneficence
B.Nonmaleficence
C.Personal liability
D.Corporate liability
A.Beneficence
Which of the following sets educational standards, examination requirements, and licensing requirements and regulates the nursing profession in each particular state?
A.The National League for Nursing
B.Nurse practice acts
C.State board of nursing
D.The National Council of State Boards of Nursing
B.Nurse practice acts
Hospitals are legally and ethically obligated to uphold patient rights, which include the right to:
A.Review records; family can also review records
B.Participate in treatment decisions and to provide consent to treatment
C.Be informed of hospital bylaws and hospital attorneys’ names and telephone numbers
D.Expect reasonable care after hospitalization
B.Participate in treatment decisions and to provide consent to treatment
The difference between bioethics and ethics is:
A.Bioethics is specific to health care; ethics deals with the principles of right and wrong
B.Bioethics is specific to health care; ethics deals with the g, good and bad
C.Bioethics is specific to health care; ethics deals with the principles of right and wrong and good and bad with no issues of beliefs and values
D.Bioethics is specific to health care; ethics is the science that deals with the principles of right and wrong and good and bad, and governs our relationships with others. It is based on personal beliefs and values
D.Bioethics is specific to health care; ethics is the science that deals with the principles of right and wrong and good and bad, and governs our relationships with others. It is based on personal beliefs and values
