Nokea
It is important to have a full discussion of the patient's and family's wishes for a do not resuscitate order (DNR) when developing an end-of-life treatment plan for which of the following reasons?
- A. It will ensure that proper medications are given.
- B. It will ensure actions are consistent with the patient's and family's wishes.
- C. It will cover all of the legal issues and prevent malpractice
- D. It will support the standing orders for nursing care.
Correct Answer: B
Rationale: It is important to include a full discussion of DNR orders because too broad or narrow interpretation of those orders could result in the application of basic or advanced life support in ways that may be inconsistent with the patient's and family's wishes.
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Which of the following is true in relation to advance directives?
- A. Advance directives document a patient's health care preferences.
- B. An advance directive is exactly the same as a power of attorney.
- C. Advance directives are consistent between provinces and territories.
- D. An advance directive determines who can make decisions for the patient.
Correct Answer: A
Rationale: A personal directive or advance directive (or living will) enables a person, in advance of incapacity or serious illness or injury, to name a personal agent who will enforce the person's health care preferences and to outline values and beliefs that affect treatment and care.
Margaret is caring for an older resident who has requested medical assistance in dying (MAID) and is awaiting the decision of the health care team. Which of the following is required in Canada before MAID would be permitted? (Select all that apply.)
- A. Financial hardship
- B. Unbearable mental or physical suffering
- C. Unable to obtain home care
- D. Grievous and irredeemable medical condition
- E. Drug addiction
- F. Natural death is foreseeable
- G. Unable to obtain home health care services
Correct Answer: B,D,F
Rationale: A grievous and irremediable medical condition is considered one in which decline cannot be reversed, there is unbearable physical or mental suffering, and natural death is reasonably foreseeable.
Nurses often struggle with distinguishing between active euthanasia and palliative sedation. The assertion that some actions have both good and bad effects, the action itself ought to be good, good is intended, and there must be sufficient reasons to engage in the action is known as which of the following?
- A. Moral biomedical ethics
- B. The principle of nonmaleficence
- C. The principle of both and white
- D. The doctrine of double effect
Correct Answer: D
Rationale: The doctrine of double effect is a moral principle that is sometimes evoked to further distinguish between active euthanasia and palliative sedation. This doctrine asserts that an action may have both good and bad effects, the action itself must be good or neutral, the good effect must be intended, and there must be sufficiently grave reasons to permit the bad effect.
Which of the following is one of the primary legal arguments in support of physician assistance with dying?
- A. It is against the law to allow patients to continue to suffer.
- B. It counteracts the moral principles of autonomy and self-determination.
- C. It interferes with the rights of persons under the Canadian Charter of Rights and Freedoms.
- D. It has a negative effect on the nurse-patient relationship.
Correct Answer: C
Rationale: The Supreme Court held that laws preventing physician assistance with dying interfered with the rights of persons under the Canadian Charter of Rights and Freedoms because not having the liberty to freely make decisions as personal as whether or not to end intolerable suffering threatened their security.
Which following moral principle refers to doing no harm?
- A. Nonmaldefence
- B. Existantalism
- C. Paternalism
- D. Legal moralism
Correct Answer: A
Rationale: The moral principle of nonmaldefence refers to avoiding harm or doing no harm.