Nokea
A client has designated a family member as a person to make healthcare decisions for the client if the client is not able to do so. What type of advance directive is this considered?
- A. Power of attorney
- B. Do-not-resuscitate order (DNR)
- C. Living will
- D. Durable power of attorney (DPOA) for healthcare
Correct Answer: D
Rationale: A client may designate another person to be the DPOA for healthcare or healthcare proxy. This person has the authority to make healthcare decisions for the client if the client is no longer competent or able to make these decisions. A general power of attorney does not give that designated person the ability to make healthcare decision. In a DNR order, the client wishes to have no resuscitative action taken in the event of a cardiac or respiratory arrest. A living will is a document that states a client's wishes regarding healthcare if the client is terminally ill.
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The nurse is caring for a client who has been intubated and on a mechanical ventilator and has been restrained with soft wrist restraints. The client no longer requires the restraints, so the nurse removes them. What type of ethical decision making does the nurse display?
- A. Fidelity
- B. Autonomy
- C. Beneficence
- D. Nonmaleficence
Correct Answer: C
Rationale: Beneficence is the duty to do good for the clients assigned to the nurse's care. The nurse has a duty to remove wrist restraints whenever possible (removing a harm) and to help the client regain independence (promoting and doing good). Fidelity is the duty to maintain commitments of professional obligations and responsibilities. Autonomy refers to a client's right to self-determination or the freedom to make choices without opposition. Nonmaleficence is the duty to do no harm to the client.
Which of the following is a true statement with regard to laws?
- A. They deal with right and wrong.
- B. They are written rules for conduct and actions.
- C. They consider beliefs about morals and values.
- D. They do not have a formal enforcement system.
Correct Answer: B
Rationale: Laws are written rules for conduct and actions. Ethical standards dictate the rightness or wrongness of human behavior. Ethics are moral principles and values. Laws do have a formal enforcement system.
The nurse is caring for an alert and oriented client in the hospital. The client is unhappy with the care the hospital is giving and states they are leaving the hospital. The nurse brings the client a sedative and tells the client that it is for blood pressure to prevent the client from leaving the facility. What type of intentional tort is this nurse guilty of?
- A. Assault
- B. Battery
- C. False imprisonment
- D. Invasion of privacy
Correct Answer: C
Rationale: False imprisonment occurs when healthcare workers physically or chemically restrain an individual from leaving a healthcare institution. A nurse cannot detain a competent client who wishes to leave a hospital or long-term care facility before being discharged by the physician. The client may sign an against medical advice form that releases the hospital from liability. Assault is an act that involves a threat or attempt to do bodily harm. Battery is actual physical contact with another person without that person's consent. Invasion of privacy means the failure of the right to expect that the clients and their property will be left alone.
An LPN is at a community softball game observing the game when a person sitting nearby clutches the chest and falls to the ground. The nurse begins cardiopulmonary resuscitation (CPR), and in the process, one of the person's ribs cracks. The client is taken by rescue squad to the hospital and survives a heart attack. What may protect the nurse from this outcome?
- A. The state board of nursing
- B. Statute of limitations
- C. Good Samaritan law
- D. Assumption of risk
Correct Answer: C
Rationale: Many states have enacted Good Samaritan laws, which provide legal immunity for rescuers who provide first aid to accident victims in an emergency. The law defines an emergency as one occurring outside a hospital, not in an emergency department. Statute of limitations is the designated time in which a person can file a lawsuit. Assumption of risk is if a client is forewarned of a potential safety hazard and chooses to ignore the warning; the court may hold the client responsible. The state board of nursing would not be involved unless the nurse was reported for negligent or care outside of the scope of practice.
The nurse is assigned to care for a client who is admitted to the medical unit with an infection after having an abortion. The nurse is uncomfortable caring for this client because the religious beliefs of the nurse are very firm on the issue of abortion. What first step can the nurse make in order to solve the ethical dilemma?
- A. Evaluate the decision in terms of effects and results.
- B. Make the decision and follow through on it.
- C. List all possible options for solving the dilemma.
- D. Obtain as much information as possible to understand the situation.
Correct Answer: D
Rationale: The first step in the ethical dilemma decision-making process is to obtain as much information as possible to understand the situation. Evaluating the decision in terms of effects and results is the fifth step in the process. Making the decision and following through is the fourth step of the process, and listing all possible options is the second step in the process.