week 1---book ch 22 & 23

Question 1

the nurse is caring for a patient who needs a liver transplant to survive. This patient has been out of work for several months, does not have health insurance, and cannot afford the procedure. Which of the following statements speaks to the ethical elements of this case?

Answer 1

The health care team should select a plan that considers the principle of justice as it pertains to the distribution of health care resources.

Question 2

When designing a plan for pain management for a patient following surgery, the nurse assesses that the patient’s priority is to be as free of pain as possible. The nurse and patient work together to identify a plan to manage the pain. The nurse continually reviews the plan with the patient to ensure that the patient’s priority is met. If the nurse’s actions are driven by respect for autonomy, what aspect of this scenario best demonstrates that?

Answer 2

Asking the patient to establish the goal for pain control

Question 3

The application of deontology does not always resolve an ethical problem. Which of the following statements best explains one of the limitations of deontology?

Answer 3

In a diverse community it can be difficult to find agreement on which principles or rules are most important.

Question 4

The ethics of care suggests that ethical dilemmas can best be solved by attention to relationships. How does this differ from other approaches to ethical problems? (Select all that apply.)

Answer 4

**Ethics of care pays attention to the context in which caring occurs
**Ethics of care requires understanding the relationships between involved parties.
***Ethics of care considers the decision maker’s relationships with other involved parties.

Question 5

The following are steps in the process to help resolve an ethical problem. What is the best order of these steps to achieve resolution?

Answer 5

1.Recognize that the problem requires ethics.
2.Gather all relevant information regarding the clinical, social, & spiritual aspects of the problem.
3.Take time to clarify values and identify the ethical elements, such as principles and key relationships involved.
4.Articulate a statement of the problem or dilemma that you are trying to resolve
5.List all the possible actions that could be taken to resolve the problem.
6.Develop and implement a plan to address the problem.

Question 6

What is the best response for the nurse to give if a patient asks the nurse to send a photo of an x-ray to him via a messaging tool in a social media site?

Answer 6

No, because health information of any kind should not be shared on social media

Question 7

Resolution of an ethical problem involves discussion with the patient, the patient’s family, and participants from appropriate health care disciplines. Which statement best describes the role of the nurse in the resolution of ethical problems?

Answer 7

To articulate the nurse’s unique point of view, including knowledge based on clinical and psychosocial observations

Question 8

Which statements reflect the difficulty that can occur for agreement on a common definition of the word quality when it comes to quality of life? (Select all that apply.)

Answer 8

*Community values influence definitions of quality, & they’re subject to change over time.
**Individual experiences influence perceptions of quality in different ways, making consensus difficult.
**Statistical analysis is difficult to apply when the outcome cannot be quantified.

Question 9

Which statements properly apply an ethical principle to justify access to health care? (Select all that apply.)

Answer 9

*Access to health care reflects the commitment of society to principles of beneficence & justice.
**If low income compromises access to care, respect for autonomy is compromised.
**Poor access to affordable health care causes harm that is ethically troubling because nonmaleficence is a basic principle of health care ethics

Question 10

You see an open medical record on the computer and close it so that no one else can read the record without proper access.

Answer 10

Confidentiality

Question 11

You administer a once-a-day cardiac medication at the wrong time, but nobody sees it. However, you contact the provider and your head nurse and follow agency procedure

Answer 11

Accountability

Question 12

A patient at the end of life wants to go home to die, but the family wants every care possible. The nurse contacts the primary care provider about the patient’s request.

Answer 12

Advocacy

Question 13

You tell your patient that you will return in 30 minutes to give him his next pain medication.

Answer 13

Responsibility

Question 14

3 examples of autonomy

Answer 14

informed consent
explaining procedures
clarification

Question 15

just culture

Answer 15

*justice
promotion of open discussion w/o fear of recrimination whenever mistakes occur or nearly occur

Question 16

4 code of ethics principles

Answer 16

1.advocacy
2. responsibility
3.Accountability
4. confidentiality

Question 17

deotonology

Answer 17

judges “rightness”–defines actions as right/wrong based on their adherence to rules & principles

Question 18

utalitarianism

Answer 18

focuses on outcomes–value is determined by its usefulness
**consequentialism

Question 19

casuistry

Answer 19

case-based reasoning
**comparison

Question 20

ethical dilemma

Answer 20

2 opposing courses of action can both be justified by ethical principles-“competing”

Question 21

moral distress

Answer 21

the need to take a specific actionn while believing the action to be wrong

Question 22

futile

Answer 22

interventions unlikely to produce benefit

Question 23

7 Steps to Solving an Ethical Problem

Answer 23

1. ask if its an ethical problem
   2.gather relevant info
   3 ID ethical element & your values
2. Name the problem
   5.Consider courses of action
   6.Create Action
3. Evaluate

Question 24

statuatory law

Answer 24

derived from statutes passed by US Congress & state legislatures

Question 25

civil law example

Answer 25

Nurse Practice Acts
** protects rights of individual

Question 26

example of regulatory law

Answer 26

reporting unethical conduct
*defines expectations of criminal & civil law

Question 27

example of common law

Answer 27

right to privacy

Question 28

HITECH

Answer 28

social media privacy

Question 29

Patient Self Determination Act

Answer 29

requires institutions to provide written info to client about care & advanced directives

Question 30

parens patriae

Answer 30

state/government makes decisions n behalf of those who are unable to make decisions for themselves

Question 31

order of consent in organ donation

Answer 31

1.spouse
2. adult child
3. parent
4. adult sibling
5. grandparent
6. guardian

Question 32

Omnibus Reconciliation Act

Answer 32

addressed use of both physical and chemical restraints—-client must be assessed within 1 hour of applying restraints

Question 33

tort

Answer 33

civil wrongful acts or omissions made against a person/property

Question 34

examples of intentional torts

Answer 34

assault
battery

Question 35

Quasi Intentional torts

Answer 35

a person may not intend to cause harm but does
**defamation of character
**slander (speaking falsely)
**libel (written defamation)

Question 36

example of unintentional tort

Answer 36

Negligence & Mal practice
**person is harmed & inflicting person knew or shouldv’e

Question 37

Minors may consent to treatment if they have

Answer 37

*sexually transmitted infection
**pregnant
**substance abuse treatment
**mental health treatment
**a minor parent for child

Question 38

A nurse is planning care for a patient going to surgery. Who is responsible for informing the patient about the surgery along with possible risks, complications, and benefits?

Answer 38

Surgeon

Question 39

A woman has severe life-threatening injuries, is unresponsive, and is hemorrhaging following a car accident. The health care provider ordered two units of packed red blood cells to treat the woman’s anemia. The woman’s husband refuses to allow the nurse to give his wife the blood for religious reasons. What is the nurse’s responsibility?

Answer 39

Gather more information about the wife’s preferences and determine whether the husband is her power of attorney for health care.

Question 40

A nurse sends a text message to the oncoming nurse to report that a patient refuses to take medication as ordered. What should the oncoming nurse do?

Answer 40

Tell the nurse who sent the text that the text is a HIPAA violation.

Inform the nursing supervisor.

Question 41

Which of the following actions, if performed by a registered nurse, could result in both criminal and administrative law sanctions against the nurse?

Answer 41

Reviewing the electronic health record of a family member who is a patient in the same hospital on a different unit

Applying physical restraints without a written order

Question 42

A nurse received bedside report at the change of shift with the night-shift nurse and the patient. The nursing student assigned to 320the patient asks to review the patient’s medical record. The nurse lists patients’ medical diagnoses on the message boards in the patients’ rooms. Later in the day the nurse discusses the plan of care for a patient who is dying with the patient’s family. Which of these actions describes a violation of the Health Insurance Portability and Accountability Act (HIPAA)?

Answer 42

Posting medical information about the patient on a message board in the patient’s room

Question 43

A patient is in skeletal traction and has a plaster cast due to a fractured femur. The patient experiences decreased sensation and a cold feeling in the toes of the affected leg. The nurse observes that the patient’s toes have become pale and cold but forgets to document this because one of the nurse’s other patients experienced cardiac arrest at the same time. Two days later the patient in skeletal traction has an elevated temperature, and he is prepared for surgery to amputate the leg below the knee. Which of the following statements regarding a breach of duty apply to this situation?

Answer 43

Failure to document a change in assessment data

Failure to notify a health care provider about a change in the

Question 44

A man who is homeless enters the emergency department seeking health care. The health care provider indicates that the patient needs to be transferred to the city hospital for care before assessing the patient. This action is most likely a violation of which of the following laws?

Answer 44

Emergency Medical Treatment and Active Labor Act (EMTALA)

Question 45

A home health nurse notices significant bruising on a 2-year-old patient’s head, arms, abdomen, and legs. The patient’s mother describes the patient’s frequent falls. What is the best nursing action for the home health nurse to take?

Answer 45

Contact a child abuse hotline.

Question 46

Which of the following statements indicate that the new nursing graduate understands ways to remain involved professionally?

Answer 46

“I am thinking about joining the health committee at my church.”

“I need to read newspapers, watch news broadcasts, & search the Internet for information related to health.”

“I will join nursing committees at the hospital after I have completed orientation & better understand the issues affecting nursing.”

Question 47

You are floated to work on a nursing unit where you are given an assignment that is beyond your capability. Which is the best nursing action to take first?

Answer 47

Call the nursing supervisor to discuss the situation.