Patient rights
What are the Patient's Bill of Rights three key goals?
A. The right to decide, the right to deny, and the right to confidentiality
B. Confidence in health care system, strong relationship with providers, key role of patients play in staying healthy
C. Visitation rights, deciding length of stay, protection from legal action in facility
D. Choosing the practitioners for care, ability to leave when desired to, the right to transfer to another facility
Answer B, pg 141
Patient's Bill of Rights three key goals
1. To help patients feel more confident in the US health care system
2. To stress the importance of a strong relationship between patients and their health care providers
3. To stress the key role patients play in staying healthy by laying out rights and responsibilities for all patients and health care providers
Patient care is not the only area where a nurse can display advocacy. What are other areas a nurse can be an advocate. (Select all that apply)
A. Workplace
B. Professional
C. Subordinate
D. Whistleblowing
Answer: A, B, C, D
All of these areas have situations where nurses can display advocacy.
True or False
Answer: False
Discipline involves training or molding the mind or character to bring about desired behavior.
What is nonmaleficence?
A. Requires that clinicians not make decisions resulting in patient harm, either through acts of commission or omission.
B. Based on the principle of respect for others, and the idea that people should make their own independent decisions.
C. Involves ethical and legal principles usually defined as a form of "fairness".
D. In healthcare, this often relates to "informed consent"
Answer A - Nonmaleficence is defined as taking actions in an effort to avoid hard (pg 88, Leadership Roles and Management Functions in Nursing)
Who has influenced the protection of patient rights by linking reimbursement with patient right provisions?
A. Humana
B. Anthem
C. The Patient
D. The Government
Answer: D
The government has in its role as the single largest insurer of health care
You are reviewing a client's chart and discover that the client's DNR prescription has expired. The client's condition is not stable. What action should you take?
A. Assume the client does not want to be resuscitated, and take no action if she experiences cardiac arrest
B. Write a note on the front of the provider prescription sheet asking the DNR be re-prescribed
C. Anticipate that CPR will be instituted if the client goes into cardiopulmonary arrest
D. Call the provider to determine whether the prescription should be immediately reinstated
Answer: D - You should immediately call the provider to determine whether the prescription should be reinstated. This is the action to take to be sure that the client's wishes are carried out
Four elements must be present to make a discipline as fair and growth-producing as possible: forewarning, immediate consequences, consistency, and impartiality. This is known as what?
A: McGregor’s rule
B: Wolter's law
C: Huston’s theory
D: Taylor’s theory of application
Answer is A: pg 678
McGregor’s hot stove rule
*all employees must be forewarned that if they touch the hot stove(break a rule), they will be burned(punished or disciplined). They must know the rule beforehand and be aware of punishment
*If the person touches the stove(breaks a rule), there will be immediate consequences (getting burned). All discipline should be administered immediately after rules are broken
* If the person touches the stove again, he or she will again be burned. Therefore there is consistency; each time the rule is broken, there are immediate and consistent consequences
*If any other person touches the hot stove, he or she will get burned. Discipline must be impartial, and everyone must be treated in the same manner when the rule is broken
When caring for a terminally ill patient, a family member says, “I need your help to hasten my mother’s death so that she is no longer suffering.” What should the nurse do based on the position of the American Nurses Association in relation to assisted suicide?
A: Not participate in active euthanasia
B Participate based on personal values and beliefs
C: Participate when the patient is experiencing severe pain
D: Not participate unless two practitioners are consulted and the patient has had counseling
Answer A - Nursing actions must comply with the law and the law states that euthanasia is legally wrong. Euthanasia can lead to criminal charges of homicide or civil lawsuits for providing an unacceptable standard of care.
When the nurse attempts to administer a medication to a patient, the patient refuses to take the medication because it causes diarrhea. The nurse provides teaching about the medication, but the patient continues to adamantly refuse the medication. What should the nurse do first?
A: Document the patient’s refusal to take the medication
B: Notify the practitioner of the patient’s refusal to take the medication
C: Discuss with a family member the need for the patient to take the medication
D: Explain again to the patient the consequences of refusing to take the medication
Answer A - Withholding the medication and documenting the patient’s refusal are the appropriate interventions. Patient’s have a right to refuse care.
A nurse believes that a pediatric patient has been a victim of abuse based on verbal statements and scarring noted on the patient’s abdomen and legs. Which of the following is the best action for the nurse to take?
A. Do nothing but document the patient’s condition.
B. Contact the patient’s family.
C. Contact the patient’s teacher.
D. Contact the Child Abuse Hotline.
Answer D - Nurses are mandatory reporters for suspected child abuse. Although documenting the patient’s condition is important, it is insufficient to meet the mandatory reporting requirement.
Physicians and nurses that have problems with substance abuse such as alcohol or narcotics are more likely to admit to their colleagues that they are using.
True or false
Answer is False
They are LESS likely to admit they are abusing controlled substances and will deny being chemically impaired
A client complains of pain and asks the nurse for medication. The nurse says, “I will be right back with your medication.” The medication is given within five minutes. This example best represents what moral principle?
A: Justice
B: Beneficence
C: Ethics
D: Fidelity
Answer D - Fidelity means being faithful to an agreement or promise.
Your adult patient is scheduled for an x-ray of the head. He is refusing to go, despite the fact that the x-ray will give vital information related to his chief complaint of a headache. The nurse learns of the patient’s refusal and comes in to the patient’s room saying, “If you do not go for this x-ray, I’ll have to give you a shot to put you out.” Has the nurse committed a legal mistake?
A. No, the nurse is acting in the best interest of the patient who needs the test to treat him.
B. No, the nurse is merely trying to help the patient understand the necessity of cooperating with the ordered treatment regimen.
C. Yes, the nurse may have committed an assault on the patient by verbally threatening him.
D. Yes, the nurse may have committed malpractice by forcing the patient to do something against his will.
Answer C - An assault is any verbal or nonverbal threat that places the recipient in reasonable fear of imminent danger. Stating that the nurse will given the patient an injection to make him comply with a treatment is a verbal threat. If the patient is reasonably afraid of getting the x-ray and the injection to sedate him if he continues to refuse, he may have a reasonable fear of imminent harm or danger. Although the x-ray may be beneficial to the patient, the patient is an adult with apparent sufficient capacity to refuse a treatment. Therefore, an argument related to his “best interest” has no relevance to his refusal.
Which of the following is the best example of a situation where a nurse could demonstrate workforce advocacy?
A. A client wishes to become and organ donor in spite of family opposition
B. A client feels pressured by a health care provider into agreeing to a specific medical procedure.
C. A nurse volunteers time to participate in a fundraiser to provide toys for a hospital’s pediatric unit.
D. Staff on a particular unit feel that the nurse manager is showing favoritism when granting vacation time.
Answer B - Nurses’ strong concern and commitment to patient care and their role as a patient advocates often place them in direct conflict with those who have more control, such as physicians and health care administrators. How a nurse reacts to such conflicts within the workplace and continues to advocate to improve patient care is a necessary focus for the profession - a focus called workforce advocacy.
List the following in correct order of the steps in a termination conference.
1. Explain the employment termination process
2. Ask the employee for input
3. Calmly state the reasons for dismissal
4. End the meeting on a positive note if possible.
A. 1,2,3,4
B. 3,4,2,1
C. 3,1,2,4
D. 3,2,1,4
Answer is C
A nurse is caring for a client who decides not to have surgery despite significant blockages in his coronary arteries. The nurse understands that this client’s choice is an example of which of the following:
A: Fidelity
B: Autonomy
C: Justice
D: Nonmaleficence
Answer B - In this situation, the client is exercising his right to make his own personal decision about surgery, regardless of others’ opinions of what is “best” for him.
You are a nurse working on a very busy med-surg floor and have several patients to care for. One of your patients who is comatose has a visitor that has been staying with her for a few days. You are in the hallway about to care for another patient when the visitor approaches you and ask you for a copy of the patients CT scan report. You don’t have time for this interruption and feel frustrated. What would be the best way to handle this situation?
A. Tell the visitor you don’t have time
B. Tell the visitor it may be a few minutes but you will get it
C. Tell the visitor it will be a little while , and you investigate and to make sure you can release that information to them
D. Stop what you are doing and print the report for the visitor
Answer is C: you always protect the patients confidentiality
A health care provider has written an order for a patient to receive a medication every 6 hours. You note that the patient has stated that she is allergic to this medication (rash, shortness of breath). Which of the following should you do first?
A. Contact the health care provider.
B. Contact the pharmacist.
C. Place a "hold" note on the medication administration record (MAR).
D. Contact the nursing supervisor.
Answer is C:
You must stop any possible administration of the medication that will cause an allergic response in the patient. Placing a hold order on the MAR stops anyone from inadvertently administering the medication. You should then contact the pharmacy and the health care provider. The nursing supervisor should be contacted if the health care provider does not act to rescind the order.
Marginal employees are those who disrupt unit functioning because the quantity and quality of their work consistently meets only minimal standards at best.
True or False
You are a nurse walking by a patient's room whom is screaming telling the current nurse in the room that he doesn’t want the shot, the nurse replies “you’re getting this shot whether you like it or not because your doctor ordered it and I’m just doing my job” You immediately ask the nurse to come with you in the hallway away from the patient to de-escalate the situation. What theory of ethics are you demonstrating by interfering?
A: Teleological
B: Rights based reasoning
C: Deontological
D: All of the above
Answer is C: by making the decision to interfere you are demonstrating the deontological theory which duty based (a duty to do something or to refrain from doing something)