Unit 8: Ch. 11 Ethical and Legal Considerations Flashcards
On which ethical theory do nurses implement their care when they act on the basis of the needs of one specific patient rather than the potential consequences to other patients?
a. Deontology
b. Autonomy
c. Utilitarianism
d. Nonmaleficence
Answer: a
The ethical theory of deontology focuses on the act rather than on the consequences. Autonomy is an ethical concept that values an individual’s right to make personal decisions. Utilitarianism is an ethical theory that focuses on the consequences of an action and the good of many rather than of an individual. The ethical principle of nonmaleficence asserts an obligation to “do no harm.”
Which nursing intervention is the best example of patient advocacy?
a. Collecting blood samples according to the physician’s order each morning
b. Assessing the vital signs of a patient who is receiving a blood transfusion
c. Seeking an additional analgesic medication order for a patient who is experiencing severe pain
d. Accompanying an ambulating patient who is walking for the first time after undergoing surgery
Answer: c
Advocacy requires a nurse to work on behalf of others who may be unable to speak for themselves. When a patient is in pain and the physician or primary care provider is not present, a nurse must advocate for the patient’s needs by initiating contact with the person responsible for addressing an immediate need. In this case, an order for additional pain medication is needed, which requires collaboration with the patient’s physician. Collecting blood samples, assessing vital signs, and assisting a patient with ambulation are primary responsibilities of the nurse that do not require advocacy to meet the patient’s need.
What action should nurses who demonstrate accountability take if they forget to administer a patient’s medication at the ordered time?
a. Document the medication as refused by the patient.
b. Administer the medication as soon as the error is discovered.
c. Record the medication as given after making sure the patient is okay.
d. Follow the administration and documentation procedures for medication errors.
Answer: d
Agency procedures must be followed after every medication error. Care must be taken to adhere to medication administration recommendations and documentation requirements to legally record the incident and provide patient safety. Documenting that the patient refused or already took the medication when that is not factual is illegal and unethical regardless of the patient’s condition. Administering the medication as soon as the error is discovered may not be recommended depending on the medication’s potency and frequency of administration.
Nursing students are held to which standards by the Code of Ethics for Nurses? (Select all that apply.)
a. Clinical skills performance equal to that of an experienced nurse
b. Demonstration of respect for all individuals with whom the student interacts
c. Avoidance of behavior that shows disregard for the effect of those actions on others
d. Accepting responsibility for resolving conflicts in a professional manner
e. Incorporating families in patient care regardless of patient preference
Answers: b, c, d
Nursing students are expected to demonstrate respect, avoid hurting others by their actions, and take responsibility for resolving conflicts in a professional manner, much the same as professional nurses. Student nurses are not required to perform clinical skills at the level of expertise exhibited by an experienced nurse. Involving a patient’s family in care without the patient’s approval indicates a lack of respect for patient autonomy.
If a student nurse overhears a peer speaking disrespectfully about a patient, nurse, faculty member, or classmate, what is the most ethical first action for the student nurse to take?
a. Discuss the peer’s actions during group clinical conference
b. Ignore the initial occurrence and observe if it happens again
c. Report the actions of the classmate to the clinical instructor
d. Speak to the peer privately to prevent further occurrences
Answer: d
Alerting the peer who has acted disrespectfully in a private setting is the most professional way to approach this situation. It is never appropriate for a professional to belittle or reprimand a peer in front of others which may be perceived as a form of bullying. Ignoring disrespectful behavior may only perpetuate its occurrence. Seeking help from a clinical instructor would be appropriate if the peer does not respond to the initial intervention from the fellow student.
What nursing intervention is best when a patient is struggling with the decision to abort an abnormally developing fetus discovered during genetic testing in the first trimester of pregnancy?
a. Recommend additional testing
b. Refer the patient to an abortion clinic
c. Listen to the patient’s concerns
d. Discuss regional adoption agencies
Answer: c
Listening is the best option for the nurse when patients are considering ethical care decisions. Patients often need someone to listen to their verbalized concerns to sort out feelings about the situation and make decisions that are best for them. The patient’s primary care provider is responsible for recommending further testing or making requested patient referrals.
Making prejudicial, untrue statements about another person during conversation may expose a nurse to being charged with what offense?
a. Libel
b. Assault
c. Slander
d. Malpractice
Answer: c
Conversation that includes prejudicial and false statements about another person is an example of oral defamation of character or slander. Libel is the written form of defamation of character. Assault is a threat of bodily harm accompanied by a sense of imminent danger. Malpractice is professional negligence caused by unsafe practice.
What legal consequences may a nurse experience if the nurse is convicted of a crime? (Select all that apply.)
a. Loss of nursing licensure
b. Employment affirmation
c. Monetary penalty
d. Unit transfer
e. Imprisonment
Answers: a, c, e
Nurses who are convicted of a crime may have their nursing licenses revoked, be required to pay fines or pay restitution to patients or their families for damages, and be incarcerated for various periods, depending on the severity of the crime. Nurses who commit crimes are most often placed on probation pending the outcome of court proceedings or dismissed from their employment, not affirmed or transferred to work on another unit.
What is the best way for a nurse to avoid crossing professional practice boundaries with patients?
a. Spend extensive time with a patient without visitors
b. Focus on the needs of patients and their families
c. Intervene in problematic patient relationships
d. Relay personal stories when unsolicited
Answer: b
The best way to avoid crossing professional practice boundaries is to focus on the patient’s needs and those of the patient’s family. Nurses should consistently avoid unsolicited self-disclosure of personal information, intervening in patient relationships, and spending excessive amounts of time with one patient. In addition to keeping patients’ secrets, gaining personally from a relationship with a patient and engaging in sexual overtures or sexual behavior with a patient are considered violations of professional boundaries.
What action should a nurse take if a patient who needs to sign an informed consent form for nonemergency surgery appears to be under the influence of drugs or alcohol?
a. Contact the physician to see what should be done.
b. Ask the patient’s spouse to sign the informed consent form.
c. Request permission to bypass the need for a signed consent form.
d. Wait to have the informed consent form signed when the patient is alert and oriented.
Answer: d
When a normally competent patient is assessed to be under the influence of alcohol or drugs, it is the nurse’s responsibility to delay a nonemergency procedure until legal informed consent can be obtained from the patient. Only in the case of an emergency is it possible to obtain informed consent from a spouse or designated power of attorney for a temporarily impaired adult. It is not necessary to contact the physician for guidance on what should be done because there is an established legal procedure to follow. The nurse should contact the surgeon who is scheduled to perform the surgery and the operating room staff regarding the need to delay due to the patient’s status.
