Exam 5 (Ch 45 Test Questions) Flashcards
____ 1. A pregnant 15-year-old girl presents to the emergency department (ED) of the local private hospital. She has been transported by her mother and appears to be in active labor. The girl is crying uncontrollably and says she is scared and experiencing painful contractions. Her mother states, “We don’t have any money or insurance, but this hospital is closer than the public hospital, and she needs help now.” What is the first step that the ED staff should take?
1) Arrange for an ambulance to transport her to the nearest public hospital.
2) Explain to the girl and her mother that the hospital only accepts patients who can pay the hospital bill.
3) Examine her to determine if her condition is stable or if she requires immediate medical attention.
4) Inform her mother that she will need to transport her daughter to the nearest public hospital.
3
____ 2. For the patient with no healthcare coverage who is seeking medical care, the emergency department staff members decide whether to provide care or transport to a public facility based on which law, enacted by Congress in 1986 and updated in 2003?
1) Health Care Quality Improvement Act (HCQIA)
2) Patient Self-Determination Act (PSDA)
3) Newborns’ and Mothers’ Health Protection Act (NMHPA)
4) Emergency Medical Treatment and Active Labor Act (EMTALA)
4
____ 3. A patient tells you that chart entries made by the nurse from the previous day indicate he was uncooperative when asked to ambulate. He says this is not true and asks his record be corrected. You understand that, if what he says is accurate, he has the right to have the documentation error corrected based on which of the following regulations?
1) Americans with Disabilities Act (ADA)
2) Patient Self-Determination Act (PSDA)
3) Health Insurance Portability and Accountability Act (HIPAA)
4) Health Care Quality Improvement Act (HCQIA)
3
____ 4. Upon initial assessment of a 75-year-old patient, you identify bruises and scratches on the patient’s arms, legs, and trunk in various stages of healing. You notify your supervisor when you suspect the patient may be a victim of physical abuse. You are complying with which of the following state laws?
1) Good Samaritan Law
2) Mandatory Reporting Law
3) Nurse Practice Act
4) Nursing Standards of Practice
2
____ 5. Nursing codes of ethics support which of the following?
1) Patients can receive emergency treatment regardless of their ability to pay.
2) Nurses will educate patients about advance directives.
3) Nurses with HIV must disclose their condition to their employer.
4) Patients have the right to dignity, privacy, and safety.
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____ 6. The charge nurse in a progressive care unit assigns the care of a patient receiving hemodialysis to a newly hired licensed practical nurse (LPN) without checking to see that the nurse has been determined competent to care for hemodialysis patients. The LPN is in orientation and, does not inform the charge nurse that she does not have experience with this type of patient. The actions of the charge nurse would be considered to be which of the following?
1) Malpractice
2) Incompetence
3) Negligence
4) Abandonment
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____ 7. In which of the following circumstances might the nurse defer obtaining informed consent for care and treatment of a patient?
1) The patient is confused and cannot understand or sign the consent form.
2) The patient is brought to the emergency department in cardiac arrest; no family is present.
3) The surgeon requests that the patient be sent to the surgical suite before you get the consent form signed.
4) An unconscious patient is admitted to your unit; he is alone.
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____ 8. A 4-year-old child is brought to the emergency department by his mother. He has a large bruise in his left chest and multiple contusions on his face. His mother tells you her boyfriend intentionally pushed the child down the stairs in anger. The child appears to be in a great deal of pain. Which of the following four correct items should the nurse to do first?
1) Notify the nursing supervisor of the suspected physical abuse.
2) Complete a physical assessment of the child.
3) Obtain an order for pain medication.
4) Notify Child Protective Services of the suspected abuse.
2
____ 9. You are caring for an alert, oriented 47-year-old patient who is recovering from abdominal surgery. The patient becomes angry and upset and says, “I’m leaving this hospital. Remove my IV and surgical drains or I will do it myself.” In order to keep him from removing his lines and leaving the hospital, you apply bilateral wrist restraints until you can contact the physician for an order for patient restraint. This is an example of which of the following?
1) Assault and battery
2) A felony
3) False imprisonment
4) A quasi-intentional tort
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____ 10. A registered nurse forgot to put the side rails up for a confused patient. The patient fell out of bed and fractured his hip. The patient sues and wins a judgment (award) for $2 million. The nurse has an occurrence policy with double limit coverage of $3 million/$10 million that covered the time period when the incident occurred. The statement that best describes the nurse’s situation is that her insurance policy will:
1) Not cover her.
2) Pay $4 million.
3) Pay $2 million.
4) Pay 75% of the $2 million
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____ 11. A registered nurse administers the wrong medication to a patient. She does not notify anyone of the error and documents that the correct medication was administered. The nurse was reported to the state board of nursing. Which of the following actions can the state board of nursing take against the nurse in this situation?
1) Disciplinary action against the nurse’s license to practice
2) Criminal misdemeanor charges against the nurse
3) Medical malpractice lawsuit against the nurse
4) Employment release from the institution
1
____ 1. Which of the following are examples of invasion of privacy by nurses? Choose all that apply.
1) Searching a patient’s belongings without permission
2) Reviewing the plan for patient care in the lunchroom
3) Discussing healthcare issues for an unconscious patient with his power of attorney
4) Releasing patient health information to local newspaper reporters
1,2,4
____ 2. While you are admitting an adult patient, he asks you whether he should create an advance directive. To provide him adequate information to make an informed decision, you should tell the patient which of the following? Choose all that apply.
1) If he is unable to communicate, his family may make changes to his advance directive.
2) Once he signs an advance directive, no further care will be provided to him.
3) He may change his advance directive by telling his physician or by making changes in writing.
4) An advance directive will ensure he gets as much or as little care as he wishes.
3,4
____ 3. What do negligence and malpractice have in common? Choose all that apply.
1) Negligence and malpractice are unintentional torts.
2) Negligence and malpractice are felonies.
3) Malpractice is the professional form of negligence.
4) Negligence and malpractice involve the intent to do harm to a patient.
1,3
____ 4. You are caring for a patient with renal failure. His morning laboratory results reveal an abnormal potassium level of 6.8. This value is more elevated than on the previous day, when the level was within normal limits. You page the patient’s physician, but he does not return your call right away. You become busy with another patient and forget to notify the physician again and fail to mention the critical laboratory value to the oncoming nurse during shift report. Which of the following does this scenario illustrate? Choose all that apply.
1) Failure to implement a plan of care
2) Failure to evaluate
3) Malpractice
4) Failure to assess and diagnose
1,2,4
