Quiz 2 material

Question 1

Informed consent

Answer 1

Agreement to a procedure or action based on understanding of fact and possible consequences of such actions

Question 2

What does true informed consent imply?

Answer 2

• Consents is given by someone who has capacity for giving it; competency is established (parent, legal guardian, mature minor)
• Full comprehension of procedure (what, purpose, risks, benefits, complications, what happens in absence of treatment)

Question 3

Right to Refuse

Answer 3

Consent involves the right or refusal; must be cognicent of the implications.

Question 4

Limitations on refusal of therapy

Answer 4

• Preservation of life is patient does not have a terminal disease (comes in from a car accident)
• Protection of minor dependents (parent refusal can be overridden)
• Protection of public health (ebola and refusing quarantine is not acceptable)

Question 5

Constraints on Informed Consent

Answer 5

• Coercion
• Manipulation
• Offers and rewards
• Influence
• Medical paternalism

Question 6

Consent is Research/Clinical Trials

Answer 6

• Codified in federal law
• Specific requirements mandated
• Risks, risks v benefits, subject selection, data collection/monitoring, privacy and confidentiality, purpose of research, expected duration, ability to opt out

Question 7

Vulnerable populations in research

Answer 7

• Federally protected
• Pregnany women and their fetuses
• Neonates
• Prisoners
• Children and adults who cannot provide informed consent

Question 8

Respect for Persons

Answer 8

Acknowledging patient’s right to autonomy in making decisions and choices about participation; protecting those with diminished autonomy

Question 9

Beneficence

Answer 9

Obligation to do no harm, maximizing possible benefits while minimizing possible harms assoiciated with research.

Question 10

Justice

Answer 10

What is considered fair, due or owed to persons; for example, genetic mutations, or variations should not preclude individuals from equal access to employment or health care insurance

Question 11

What is the Patient Self Determination Act (PSDA)?

Answer 11

It requires health care institutions receiving Medicare/Medicaid funding to ask patients whether they have an advanced directive.

No coercion, just a question.

Designed to facilitate conversation.

Offer help and information about creating one.

Enacted in 1991.

Question 12

What are Advanced Directives?

Answer 12

• Living will: snapshot of your opinions on different scenarios
• Durable power attorney of health care (DPA) - strictly related to medical decisions
• Power of attorney - general ability to take care of financials

Question 13

How does Health Literacy Relate to Informed Consent?

Answer 13

Make sure the patient/families actually understand what they are signing and what it entails.

Teach-back; can you tell me what you understand.

Low health literacy affects nearly half of the US population.

Question 14

Informational Privacy

Answer 14

Communication of protected information to others

Question 15

Physical privacy

Answer 15

Regards personal space

Question 16

Decisional privacy

Answer 16

Regarding personal choices

Question 17

Proprietary privacy

Answer 17

Regards bodily tissues

Question 18

Communication

Answer 18

Process of imparting or exchanging information in meaningful, clearly understood ways between communicators.

Consists of mindfulness and effective listening.

Question 19

Confidentiality

Answer 19

Principle requiring one to protect and secure personal information of others and see what it is only shared with those who have a need and right to know.

Question 20

What protects health information?

Answer 20

HIPAA

Question 21

Required disclosure

Answer 21

• Third party payers or other health care providers
• Law enforcement
• Threats to public health/safety
• Suspected abuse
• Specifict threats to harm self or others
• Subpoenas for legal proceedings

Question 22

Considerations in sharing PHI

Answer 22

• Is there a right or need to know?
• What outcomes might occur if information is not shared? Is shared?
• Is it based on fact, assumption or opinion?
• Is there a safety concern involved?
• Does it create potential for bias?

Question 23

Paradigms: Right Vs. Right Dilemmas

Answer 23

• Truth vs. loyalty
• Invidual vs community
• Short term vs. long term goals
• Justice vs mercy

Question 24

Mandatory Reporting

Answer 24

• Child abuse or neglect
• Suspected elder abuse
• Certain disease

Question 25

Nurse-Nurse Relationship

Answer 25

• Horizontal violence and workplace bullying
• Walking wounded
  
  • Nurses who feel put down; bullied
  • Can create a hostile work environment
• Behavioral characteristics seen in nurses dealing with unresolved stress

Question 26

Professional Boundaries in Nursing

Answer 26

• Disclosure of personal information
• Health related disclosure
• Mandatory reporting to state board of nursing

Question 27

Nurses and Social Media

Answer 27

The risk for crossing professional boundaries increases as lines and moral spaces become blurred.

Can cause line crossing and an invasion of moral space and possibly a violation of privacy.