Module 9

Question 1

A nurse working in a critical care unit has experienced personal tragedy, extreme shortage of staff in the work environment, and health issues. The nurse has overcome much of these hardships and is now mentoring other nurses in similar situations. What behavior is this nurse demonstrating?

Answer 1

moral resilience

Question 2

A nurse has completed 4 hours of an 8-hour shift on a medical-surgical unit when the nursing supervisor calls. The nursing supervisor directs the nurse to give a report to the other two nurses on the medical-surgical unit and immediately report to the telemetry unit to assist with staff needs on that unit. The nurse informs the supervisor that the nurse has been busy with client assignments and feels this will overwhelm the nurses on the medical-surgical unit. The supervisor informs the nurse that the need is greater on the telemetry unit. This is an example of which type of ethical problem?

Answer 2

allocation of scarce nursing resources

Question 3

Which example most accurately depicts the ethical principle of autonomy?

Answer 3

Describing a surgery to a client before the consent is signed

Question 4

A client diagnosed with cancer has met with the oncologist and is now weighing whether to undergo chemotherapy or radiation for treatment. This client is demonstrating which ethical principle in making this decision?

Answer 4

Autonomy

Question 5

A nurse is providing care to an older adult client who was just diagnosed with cancer. The client together with the immediate family discuss their preferences with the health care providers involved. The health care providers offer their clinical recommendations about possible treatments. Ultimately, the group arrives at a decision. The nurse interprets this decision-making process as reflecting which type?

Answer 5

shared

Question 6

A nurse learns to adopt behavior modeled by a charge nurse. What ethical principle or behavior is the nurse most likely to learn through this process?

Answer 6

ethical conduct

Question 7

Which example best describes feminist ethics?

Answer 7

An approach critiquing existing patterns of oppression and domination in society

Question 8

Which word is best described as protection and support of another’s rights?

Answer 8

advocacy

Question 9

A nurse is caring for an older adult who has cancer and is experiencing complications requiring a revision of the plan of care. The nurse sits down with the client and the family and discusses their preferences while sharing the nurse’s own judgments based on the nurse’s expertise. Which type of healthcare decision making does this represent?

Answer 9

Shared decision making

Question 10

A nurse reports to the charge nurse that a client medication due at 9 am was omitted. Which principle is the nurse demonstrating?

Answer 10

integrity

Question 11

A parent teaches a child not to drink and drive; however, the parent does drink and drive. This action results in:

Answer 11

a failure to model one’s own values.

Question 12

A client tells the nurse that the client does not want to have a painful procedure. By respecting and supporting the client’s right to make decisions, the nurse is demonstrating:

Answer 12

advocacy

Question 13

________ is the principle and moral practice of concern for happiness of other human beings, resulting in a quality of life both material and spiritual

Answer 13

altruism

Question 14

______ is concerned with moral rightness and fairness

Answer 14

justice

Question 15

_______ is keeping or one’s personal information secret or private.

Answer 15

confidentiality

Question 16

Which traits are examples of virtues that can exemplify character and conduct as a professional nurse? Select all that apply.

Answer 16

Trustworthiness
Humility
Compassion

Question 17

A nurse is providing care for three clients on a medical unit, two of whom are significantly more acute than the third. The nurse is making a concerted effort to ensure that the less acute client still receives a reasonable amount of time, attention, and care during the course of the shift. Which ethical principle is the nurse attempting to practice?

Answer 17

Justice
Explanation:
The ethical principle of justice includes an effort to fairly distribute benefits and to minimize discrimination, even when circumstances make this difficult to achieve. This is demonstrated by the nurse’s efforts to fairly distribute the nurse’s time and care.

Question 18

_______ is the ethical principle of promoting good.

Answer 18

Beneficence

Question 19

______ states that one should not do harm to clients.

Answer 19

nonmaleficence

Question 20

_______ is faithfulness to a person, cause, or belief, demonstrated by continuing loyalty and support.

Answer 20

Fidelity

Question 21

A nurse’s friend states, “I admire you so much. I would love to be a nurse, but I don’t think I have the courage.” Which response will the nurse make?

Answer 21

“You can work on being more courageous as you learn to be a nurse.”

Question 22

What would be an example of the nurse practicing fidelity? The nurse:

Answer 22

stays with a client during death as promised.
Explanation:
Fidelity requires the nurse to keep promises made and to be faithful to one’s commitments. Regulating visitors is a demonstration of the value of privacy. Withholding client’s information as requested is an example of maintaining confidentiality. Providing continuity of care is an example of integrity and professionalism.

Question 23

Which is a characteristic of the care-based approach to bioethics?

Answer 23

The promotion of the dignity and respect of clients as people

Question 24

A nurse obtains an order for a bed alarm for a confused client. This is an example of which ethical principle?

Answer 24

Paternalism
Explanation:
Making a decision for a client who is confused to prevent an injury is an example of paternalism

Question 25

A nurse believes that abortion is an acceptable option if a pregnancy results from a situation of rape. What is the best description of this belief?

Answer 25

personal moral

Question 26

Which theory of ethics prioritizes the nurse’s relationship with clients and the nurse’s character in the practice of ethical nursing?

Answer 26

Care-based ethics
Explanation:
Central to the care-based approach to ethics is the nurse’s relationships with clients and the nurse’s “being,” or character and identity.

Question 27

______ is the study of the nature of duty and obligation

Answer 27

Deontology

Question 28

_____ is the doctrine that actions are right if they are useful or for the benefit of a majority.

Answer 28

Utilitarianism

Question 29

______ ethics prioritizes goals and principles that exist beyond the particularities of the nurse-client relationship.

Answer 29

Principle-based

Question 30

A nurse volunteers to serve on the hospital ethics committee. Which action should the nurse expect to take as a member of the ethics committee?

Answer 30

Assist in decision making based on the client’s best interests.

Question 31

A nurse is administering evening medications and notices that a medication was omitted during the day shift. Which statement demonstrates the principle of accountability?

Answer 31

Filling out an occurrence report and notifying the healthcare provider

Question 32

A nurse who is caring for a new mother realizes that the woman is not prepared to go home with her newborn after a hospital stay of only 24 hours. However, hospital policy dictates that the mother be discharged. This nurse may be faced with which moral problem?

Answer 32

Ethical distress
Explanation:
Ethical distress occurs when the nurse knows the right thing to do but either personal or institutional factors make it difficult to follow the correct course of action

Question 33

Describe an ethical dilemma

Answer 33

Ethical dilemmas arise when attempted adherence to basic ethical principles results in two conflicting courses of action.

Question 34

Which best exemplifies malpractice?

Answer 34

The nurse administers amoxicillin to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest.

Question 35

The nurse is providing care to a client who had orthopedic surgery. The nurse has medicated the client for pain. However, the client reports that the pain is unrelieved. The nurse takes no further action regarding assessment and intervention for the client’s pain. The nurse does not notify the surgeon regarding the client’s pain. The nurse’s failure to take further action represents which element of liability in this case?

Answer 35

Breach of duty
Explanation:
Breach of duty is the failure to assess, intervene, or notify the health care provider regarding the client’s condition. It does not meet the expected standard of care.

Question 36

____ refers to an obligation to use due care and is defined by the standard of care appropriate for the nurse–client relationship.

Answer 36

Duty

Question 37

_____ is when the failure to meet the standard of care caused injury.

Answer 37

Causation

Question 38

A nurse and the facility have been named as defendants in a malpractice lawsuit. In addition to the nurse’s attorney, whom else would be appropriate for the nurse to talk with about the case?

Answer 38

The agency’s risk manager

Question 39

The nurse is providing care to a client whose condition has progressively declined. The nurse assesses and makes appropriate interventions as well as notifies the health care provider. Despite the nurse’s efforts, the client expires. What element of liability has the nurse demonstrated?

Answer 39

Duty
Explanation:
Duty refers to an obligation to use due care. The nurse assessed the client and made appropriate interventions and notifications. Breach of duty is the failure to meet the standard of care. An example of breach of duty would be not performing assessments, appropriate interventions, and notifications of the health care provider. Causation is when the breach of duty caused the injury. An example of causation would be failure to perform assessment and appropriate interventions when providing client care, and this caused injury to the client. Damages are the harm or injury that occurred to the client. In this situation, it would be the death of the client.

Question 40

A nurse is being sued for malpractice in a court of law. What elements must be established to prove that malpractice or negligence has occurred? Select all that apply.

Answer 40

Duty
 Breach of duty
 Causation
  Explanation:
The elements that must be established to prove that malpractice or negligence have occurred include duty, breach of duty, and causation. Intent to harm would be intentional torts.

Question 41

______ is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property.

Answer 41

Fraud

Question 42

_____ ______ are monetary compensation awarded in a legal case to the injured party.

Answer 42

Punitive damages

Question 43

A nurse from the postanesthesia care unit (PACU) transports a client in the elevator with a nurse from the intensive care unit (ICU). There are staff members and visitors in the elevator as well. Which response from the ICU nurse is appropriate when the PACU nurse begins the report?

Answer 43

“Wait and give me a report in the room at the bedside.”

Question 44

Which nursing student would most likely be held liable for negligence?

Answer 44

The nursing student who administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home is performing a task outside the scope of the job responsibilities of a UAP. The other options demonstrate legally defensible actions by the nursing student.

Question 45

Nurses complete incident reports as dictated by the agency protocol. What is the primary reason nurses fill out an incident report?

Answer 45

To improve quality of care

Question 46

When the nurse informs a client’s employer of the client’s autoimmune deficiency disease, the nurse is committing the tort of:

Answer 46

invasion of privacy.

Question 47

Professional regulations and laws that govern nursing practice are in place for which reason?

Answer 47

To protect the safety of the public
Explanation:
Governing bodies, professional regulations, and laws are in place to protect the public by ensuring that nurses are accountable for safe, competent, and ethical nursing practice.

Question 48

While riding in the elevator, a nurse discusses the HIV-positive status of a client with other colleagues. The nurse’s action reflects:

Answer 48

invasion of privacy

Question 49

A nurse, while off-duty, tells the physiotherapist that a client who was admitted to the nursing unit contracted AIDS due to exposure to sex workers at the age of 18. The client discovers that the nurse has revealed the information to the physiotherapist. With what legal action could the nurse be charged?

Answer 49

Slander
Explanation:
The nurse can be charged with slander, which is a verbal attack on a person’s character.

Question 50

____ pertains to damaging written statements read by others.

Answer 50

Libel

Question 51

A physician is called to see a client with angina. During the visit the physician advises the nurse to decrease the dosage of atenolol to 12.5 mg. However, because the physician is late for another visit, the physician requests that the nurse write down the order for the physician. What should be the appropriate nursing action in this situation?

Answer 51

The nurse should ask the physician to come back and write the order.

Question 52

Which action constitutes battery?

Answer 52

An older adult client refuses an intramuscular injection, but the nurse administers it

Question 53

A nurse is overheard in the hospital cafeteria making false, derogatory comments about a client. The nurse is guilty of:

Answer 53

slander

Question 54

A client states that the client’s recent fall was caused by his scheduled antihypertensive medications being mistakenly administered by two different nurses, an event that is disputed by both of the nurses identified by the client. Which measure should the nurses prioritize when anticipating that legal action may follow?

Answer 54

Document the client’s claims and the events surrounding the alleged incident.
Explanation:
It is imperative for nurses to carefully and accurately document assessment findings and the nursing care that they provide, especially when legal action is anticipated. This thorough and accurate assessment should precede consultation with the legal department, the state board of nursing, and colleagues.

Question 55

Legal safeguards are in place in the nursing practice to protect the nurse from exposure to legal risks as well as to protect the client from harm. What is an example(s) of legal safeguards for the nurse? Select all that apply.

Answer 55

The nurse confirms informed consent was give by the client to perform a procedure.
The nurse educates the client about what to expect during the hospital stay.
The nurse documents all client care in a timely manner.

Question 56

Which statement about laws governing the distribution of controlled substances is true?

Answer 56

Nurses are responsible for adhering to specific documentation about controlled substances.

Question 57

Nurses practicing in a critical care unit must acquire specialized skills and knowledge to provide care to the critically ill client. These nurses can validate this specialty competence through what process?

Answer 57

certification

Question 58

While a client admitted to the medical-surgical unit is in the radiology department, a visitor claiming to be the client’s cousin arrives on the medical-surgical unit and asks the nurse to provide a brief outline of the client’s illness. Which response by the nurse would be most appropriate, both legally and professionally?

Answer 58

“I cannot give you that information due to client confidentiality.”

Question 59

Which process evaluates and recognizes educational programs as having met certain standards?

Answer 59

accreditation

Question 60

A student nurse is assisting an older adult client to ambulate following hip replacement surgery when the client falls and reinjures the hip. Who is potentially responsible for the injury to this client?

Answer 60

The student nurse, the nurse instructor, and the hospital

Question 61

A client was admitted to a postoperative nursing unit after undergoing abdominal surgery. During this time, the nurse failed to recognize the significance of abdominal swelling, which significantly increased during the next 6 hours. Later, the client had to undergo emergency surgery. The lack of action on the nurse’s part is liable for action. Which legal term describes the case?

Answer 61

Tort
A tort is a litigation in which one person asserts that a physical, emotional, or financial injury was a consequence of another person’s actions or failure to act. The lack of action on the nurse’s part indicates unintentional tort.

Question 62

A nurse is caring for a client following endotracheal intubation. Before applying soft wrist restraints to prevent the client from pulling out the endotracheal tube, what is the most appropriate action of the nurse?

Answer 62

Obtain a medical order

Question 63

Which is true of the Occupational Safety and Health Act?

Answer 63

It helps to reduce workforce injuries and illness in the workplace

Question 64

A client being discharged from the hospital asks the nurse, “When I go visit my family out of state, should I take my living will with me, or do I need a new one for that state?” Which is the most appropriate response by the nurse?

Answer 64

“Take it with you. It is recognized universally in the United States.”

Question 65

Which is an example of an unintentional tort?

Answer 65

A nurse gives the client a medication, and the client has an adverse reaction to it.
Explanation:
An unintentional tort occurs when the nurse does not intend harm, but harm occurs (e.g., the nurse administers a medication and the client has an adverse reaction to it).

Question 66

After reporting to work for a night shift, the nurse learns that the unit is understaffed because two RNs called out sick. As a result, each nurse on the unit must provide care for four acute clients in addition to the nurse’s regular clients. Which statement is true for this nurse when working in understaffed circumstances?`

Answer 66

The nurse is legally held to the same standards of care as when staffing levels are normal.
Explanation:
The claim of being overworked does not constitute a legal defense, and both the potential for liability and standards of care remain unchanged despite an increased client assignment. Although it is prudent to make all realistic attempts to fill the gaps in staffing, documenting these efforts does not change the nurse’s legal position. A nurse has the right to refuse an unsafe client assignment but the nurse is not legally obliged to withhold care.