Nokea
A client who has been diagnosed with terminal cancer states wanting no further treatment and also informs the physician of not wanting any resuscitative action taken if the client experiences a cardiac or respiratory arrest. What type of order does the nurse anticipate the physician will write?
- A. A do-not-resuscitate order
- B. Intubation and mechanical ventilation only if respiratory arrest occurs
- C. Emergency medications only
- D. Do everything except resuscitate
Correct Answer: A
Rationale: DNR orders are written when clients wish to have no resuscitative action taken if they experience cardiac or respiratory arrest. Intubation, mechanical ventilation, emergency medications, and do everything but resuscitate are measures that are against the client's wishes.
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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.
The nurse understands that laws and ethics are made in order to maintain order and harmony within society. What is the difference between laws and ethics?
- A. Laws are written rules for conduct and actions, and ethics are moral principles and values that guide our behavior.
- B. Laws are written to protect society from unsavory people, and ethics are rules for appropriate behavior.
- C. Laws are written to ensure appropriate behavior and ethics are to conduct actions.
- D. Ethics determine how a client is to be treated, and laws are forms of punishment.
Correct Answer: A
Rationale: Laws are written rules for conduct and actions and ensure the protection of rights, and ethics are moral principles and values that guide the behavior of honorable people. Ethical standards dictate the rightness or wrongness of human behavior. The other answers do not address this as clearly.
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.