Professional Development (Exam Two) Flashcards
Define ethics.
System of beliefs and behaviors that goes beyond the law
T/F: Ethical decision-making is a skill that can be learned.
True
List the four categories of ethics.
- Metaethics
- Normative ethics
- Applied ethics
- Descriptive ethics
What category of ethics is used mostly by nurses and other health-care providers?
Applied ethics
Which category of ethics is deemed as a bottom-up approach to ethics?
Descriptive ethics
Define morals.
Fundamental standards of right and wrong that an individual learns and internalizes
When are morals usually developed?
In the early stages of childhood
As nurses become more ___________ they must accept their ethical accountability.
Autonomous
Values are derived most commonly from what?
- Societal norms
- Religion
- Family orientation
What concept serves as the framework for making decisions and taking action in daily life?
Values
T/F: Peoples values tend to change as their life situations change, as they grow older, and as they encounter situations that cause value conflicts.
True
List the two important aspects of laws.
- Enforceable
- Equal
As a society increases in size and becomes more complex, there becomes an increased need for what?
- More laws
- Stronger ethical system
_________ is the right to self-determination, independence, and freedom.
Autonomy
Autonomy refers to what?
The client’s right to make health-care decisions for him/herself even if the physician does not agree with those decisions
It is important to know what two factors in order to maintain autonomy?
- State laws
- Patients right and wishes
The principal of justice underlies the first statement of what document?
American Nurses Association (ANA) Code of Ethics
Define fidelity as it relates to healthcare.
Must be faithful in the promises made as a professional
____________ is one of the oldest requirements for health-care providers.
Beneficence
What principal views the primary goal of health care as doing good for clients under their care?
Beneficence
The ethical principal that requires health-care providers do no harm to their clients, either intentionally or unintentionally is known as ______________.
Nonmaleficence
Besides do no harm, the ethical principal of nonmaleficence also requires health-care providers to do what?
Protect from harm those who cannot protect themselves from harm
List examples of individuals who cannot protect themselves as defined by nonmaleficence.
- Children
- Elderly
- Mentally incompetent
- Unconscious
- Extremely weak and debilitated
Define veracity.
Truthfulness or right-to-know
Describe the primary limitation of veracity.
Occurs when telling the patient the truth would seriously harm the patient’s ability to recover or would produce greater illness
What is the standard of best interest?
Type of decision made about a patient’s health care when the patient is unable to make an informed decision
The standard of best interest is used on what basis?
Health-care providers and the family decides what is best for the patient
What should the health care team consider under the principal of standard best interest?
Patients expressed wishes either written or verbal
An individual who is legally designated to make health-care decisions for a patient if they are unable to is known as what?
Durable power of attorney
What two ethical systems make up bioethics?
- Normative ethics
- Applied ethics
Which ethical systems are nurses most likely to encounter?
- Normative ethics
- Applied ethics
Utilitarianism is also known as what?
Teleology or situation ethics
Utilitarianism is subdivided into what two categories?
- Rule
- Act
Describe rule utilitarianism.
- Decision-making is guided based upon past experiences
- Do not believe in system of rules
Describe act utilitarianism.
The rightness or wrongness of an act is based upon the situation
What two underlying principals is utilitarianism associated with?
- Greatest good for the greatest number
- End justifies the means
What is the most publicized form of act utilitarianism?
Situation ethics
The discipline of philosophy that attempts to apply ethical theory to real-life situations is __________ ethics.
Applied
What ethical system applies to basic human behavior?
Normative ethics
What population rarely fare well under a utilitarian system?
Minorities
An individual involved in ___________ believes in ethical absoluteness of principals regardless of the consequences of the decision.
Deontology
The American Nurses Association (ANA) last revised the Nursing Code of Ethics in what year?
2015
What is the similarity between laws and ethics?
A. They are both enforceable by police authority
B. They are both needed when a group of people live together
C. They are both focused on how a society should function
D. They are both concerned with the basic survival of a group
B. They are both needed when a group of people live together
___________ are meaningful ideals that are derived from societal norms, religion, and family orientation and serve as the framework for making decisions and taking action in daily life.
Values
Gerard, an RN, is caring for Mr. Sweeney, a 75-year-old cancer patient in an infusion center. Mr. Sweeney tells Gerard that he will not continue his chemotherapy after this treatment; he wants to travel during the time that remains. Gerard tells his client that he (Gerard) will get in trouble if Mr. Sweeney discontinues treatment. Which ethical principal is Gerard violating? (SATA) A. Autonomy B. Justice C. Fidelity D. Beneficence E. Nonmaleficence F. Veracity
A, F
Place the steps of the ethical decision-making process in the order they should be done.
- State the dilemma
- Collect, analyze, and interpret the data
- Analyze the advantages and disadvantages of each course of action
- Consider the choices of action
- Accept the consequences of the decision
- Make the decision and act on it
2, 1, 4, 3, 6, 5
A nurse displays ___________ by standing and speaking up for the patient.
Advocacy
What is deontology?
Based on whether the act itself is right or wrong regardless of the consequence
Describe a slow-code order.
Order by a health care provider for the nursing staff indicating that nurses should not resuscitate the patient but merely go through the motions to make the family feel better
What is the federal statue that protects private patient information from being disclosed?
HIPAA
What evolving issue has posed a problem in relation to private patient information and Health Insurance Portability and Accountability Act (HIPAA)?
Social media
Describe an induced abortion.
Intentionally caused by the mother or another person
Describe an elective abortion.
An induced abortion that is performed when the mother no longer wants to continue the pregnancy
Describe a therapeutic abortion.
Abortion recommended by a physician/psychiatrist due to damage of the mothers health or mental state
What historical court case deemed elective abortion legal in the United States? What year did this take place?
- Roe vs. Wade
- 1973
The principal that all people have a right to determine what they can do with their bodies is known as what?
Right to self-determination
What act made it illegal for insurance companies to exclude individuals from health and life insurance policies based on genetic screenings?
Affordable Care Act (ACA)
Cells derived from fetal tissue were used transplanted into people with what type of chronic or severe diseases?
- Alzheimers
- Parkinsons
- Amyotrophic lateral sclerosis (ALS)
- Spinal cord injuries
At what age must in vitro fetuses be destroyed?
6 weeks
Where do adult stem cells originate from what?
Bone marrow
Adult stem cells from bone marrow can grow into what different types of cells?
- Nerve
- Liver
- Heart
- Cartilage
The best fetal tissue comes from fetuses aborted during what trimester?
Second
If employed by a facility where elective abortions take place, the nurse should be aware of what?
- Where aborted fetuses are taken
- How aborted fetuses are disposed of
What is the most widely accepted criteria for determining death in a patient who wishes to donate their organs?
Neurological criteria
What is the most important role of nurses in the organ donation process?
Recognize and refer potential donors to local organ procurement organization
Not accepting an anatomical donation from a suitable donor is a violation of what law?
Uniform Anatomical Gift Act
The United Network for Organ Sharing (UNOS) was created by which act?
National Organ Transplant Act
What is the primary function of the United Network for Organ Sharing (UNOS)?
- Created a database of all people waiting for an organ
- Lists potential recipients using a prioritized computer algorithm
Who is responsible for obtaining permission or consent for organ donation?
Professionals who work exclusively for organ procurement organizations
By legal definition, a child younger than 18 years of age __________ give informed consent to organ procurement.
Cannot
List the criteria necessary for a nurse to refer a patient to a local organ procurement organization.
- Severe neurological insult or injury
- Glasgow Coma Scale Score >4
- Intubated with a heartbeat
- Scheduled brain death evaluation
- Before terminal extubation
What is the best method for a nurse to acknowledge a clients autonomy?
Grant the patients wishes through their living will
__________ __________ requires that all citizens have equal access to all types of health care, regardless of their income levels, race, gender, religious beliefs, or diagnosis.
Distributive justice
What document is the best means to guarantee that a patients medical care wishes will be honored?
Advance directive
This legislative act requires all hospitals, nursing facilities, etc., ask patients about advance directives and provide information regarding living wills?
Omnibus Budget Reconciliation Act
Passive euthanasia encompasses what practices?
- DNR orders
- Living wills
- Withdrawal of life support
T/F: The nurse must know the laws about living wills.
True
What special drug form of medical marijuana helps control hard-to-treat seizures?
Epidiolex
List the two FDA approved man-made cannabinoid medications used to treat nausea and vomiting from chemotherapy.
- Dronabinol
- Nabilone
Marijuana is a Schedule ____ drug.
Schedule I
Which conditions are commonly treated with medical marijuana?
- Alzheimers
- Cancer
- Crohn’s disease
- Epilepsy
- Multiple sclerosis
- Muscle spasms
- Nausea
- Wasting syndrome
- Seizures
List the side effects of medical marijuana.
- Bloodshot eyes
- Depression
- Dizziness
- Tachycardia
- Hallucinations
- Hypotension
Nurses regularly face ethical dilemmas on the job. What steps should nurses take to ensure that they are acting as ethically as possible? (SATA)
A. Know the Code of Ethics for nurses
B. Strictly follow the facility’s policy and procedures manual
C. Identify and articulate their own personal ethics and their source
D. Make the best interests of the client the priority
E. Defer to a more experienced colleague
A, C, D
Describe civil law.
Violation of one individuals rights by another individual
What type of law governs the profession of nursing?
Statutory
What act establishes the state board of nursing, the scope of practice for nurses, and individual licensure procedures?
The Nurse Practice Act (NPA)
What statue protects workers with disabilities against discrimination?
American with Disability Act (ADA)
What is the most common violation by nurses of the criminal law?
Failure to renew nursing license
List the four elements required for a patient to file a claim of negligence.
- Professional relationship
- Breach of duty
- Causality
- Damages
What branch of civil law are nurses most commonly involved?
Tort law
The patient does not have to prove that an injury has occurred nor is the opinion of an expert witness required with what type of tort?
Intentional tort
A willful act that violated another person’s rights or property is know as what?
Intentional tort
List the intentional torts that are most commonly seen in the health care setting.
- Assault
- Battery
- False imprisonment
- Intentional infliction of emotional distress
Define assault.
Threat of touching or attempting to touch another person
Define battery.
Unwanted and harmful contact with another person without their consent
Define false imprisonment.
When a competent patient is confined or restrained with intent to prevent him or her from leaving the hospital
A criminal charged of assault, battery, or false imprisonment is often accompanied by what other charge?
Intentional infliction of emotional distress
What is the most common intentional tort in nursing?
Battery
Client/patient abandonment falls under which ethical principal?
Beneficence
The nurse-patient relationship is continued until what occurs?
Termination through mutual consent of both parties
What has become an increasingly important ethical issue due to the nursing shortage?
Client Abandonment
List examples of quasi-intentional torts.
- Slander
- Libel
Define slander.
Spoken communication that harms a persons reputation
Define libel.
Written communication that harms a persons reputation
Define quasi-intentional torts.
Mixture of unintentional and intentional torts that usually involve situations of communication
T/F: Quasi-intentional torts can have the elements of volition and causation without the element of intent.
True
What is the most common type of quasi-intentional tort?
Defamation of character
What is the primary source of defamation of character?
Medical record documentation
What is the statute of limitations?
The period of time in which any lawsuit against any healthcare worker must be filed
What is the statute of limitations for children?
21 years
What statute of limitations is commonly seen in most states?
2 years
List in order the process of filing a lawsuit.
- Plaintiff files the complaint
- Defendant responds/answers to complaint
- Discovery
- Deposition
- Trial
- Deliberation and decision
List ways in which the nurse can adequately prepare for a deposition.
- Be familiar with patients medical record
- Look the questioning lawyer in the eye
- Avoid using absolute answers
- Clarify all questions
- If unable to remember, say “I do not know/do not recall”
What is comparative negligence?
Awards are based on the determination of the percentage of fault by both parties
___________ is a clear deviation from a standard of care and considered professional negligence.
Malpractice
Describe defense of the fact.
The actions of the nurse followed the standards of care or if the actions were in violation of the standard of care the actions themselves did not directly cause the injury
List limitations of the Good Samaritan Act?
- Does not cover nurses for grossly negligent acts
- Does not cover acts outside the nurse’s level of education
Who is responsible for obtaining informed consent?
Physician performing the procedure
Informed consent information should come from the __________ and be reinforced by the ________.
- Physician
- Nurse
What are the two exceptions to informed consent?
- Emergency situation
- Situations where informing the patient of all information could be medically contraindicated
The act requiring all federally funded institutions to inform clients of their right to prepare advanced directives is known as what?
Patient Self-Determination Act
List the two types of advance directives.
- Living will
- Medical power of attorney
DNR orders are legally ________ from advance directives.
Separate
What is the leading cause of health care related errors leading to injury, death, and lawsuits?
Miscommunication among health care workers
What are the common characteristics of a patient who is lawsuit prone?
- Constant dissatisfaction with the care given
- Constant complaints about all aspects of care
- Negative comments about other nurses
This legislative act requires insurance companies provide coverage that includes mental health issues.
Mental Health Parity Act
What is negligence?
When the care provided falls below the standards of care
The law protecting the privacy of minors allows them seek treatment and prevention of what medical problems without parental consent?
- STD
- Birth control
- Pregnancy
What law requires reporting of the patient and any known sexual partners to local health officers?
Public health law
Define professional relationship as it relates to proving negligence.
A duty was owed to the patient
Define breach of duty as it relates to proving negligence.
- Professional violated a duty
- Failed to conform to the standard of care
Define causality as it relates to proving negligence.
Failure to act resulted in the sustained injury
Define damages as it relates to proving negligence.
Actual injuries resulted from the breach of duty
Which of the following are associated with statutory law? (SATA)
A. Evolves from decisions of previous legal cases
B. Develop over a long period of time
C. Written and enacted by government bodies
D. Include the nurse practice act
E. Use precedents to inform decisions
F. Define criminal laws
G. Classify offenses as misdemeanors or felonies
C, D, F, G
In order for a client to give informed consent, what information must be explained by the health-care provider? (SATA) A. Proposed treatment B. Potential complications C. Outcome hoped for D. Consequences of not having treatment E. Acceptable alternative treatments F. Estimate of the cost of the treatment
A, B, C, D, E
To prevent litigation, which of the following may be employed? (SATA) A. Discovery B. Mediation C. Deposition D. Arbitration E. Summary judgment
B, D
Which of the following applies to criminal law? (SATA)
A. A jury decision requires three-fourths (8 out of 12) agreement.
B. Punishment can range from community service to imprisonment or even death
C. Contract law, tax law, and treaty law are branches or criminal law
D. It deals with the violation of one individuals rights by another individual
F. The case is brought by a prosecuting attorney
B, E
