Nokea
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.
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The nurse is assigned to a group of clients on the medical floor. A client at the hospital has a neighbor visit who asks the nurse what is wrong with the client. The nurse checks the client's electronic medical record (EMR) and proceeds to inform the visitor about the client's diagnosis. What federal guideline has the nurse violated?
- A. HIPAA
- B. Nurse Practice Act
- C. Hospital policy
- D. Agency standards of practice
Correct Answer: A
Rationale: The client has the right to request restrictions and confidential communications concerning protected health information, which is an overview of the major client protections provided by HIPAA. The nurse may also have violated the hospital's policy and/or an agency's standards of practice, depending on their verbiage, and the Nurse Practice Act, but the federal guideline violated is HIPAA.
The nurse is preparing a client for a colonoscopy at the hospital. Who does the nurse understand is responsible for obtaining the informed consent from this client?
- A. The nurse
- B. The primary provider
- C. The nurse manager
- D. The health care provider's office nurse
Correct Answer: B
Rationale: The primary provider obtains the informed consent and must inform the client of the description of the procedure, potential benefits, material risk involved, acceptable alternatives available, expected outcome, and consequences if the procedure is not done.
The LPN has the responsibility to take the vital signs for a client who had a surgical procedure earlier that day. The blood pressure results were 78/42 mm Hg from a previous 132/74 mm Hg. The LPN documented the results without reporting them to the RN in charge. The client developed shock and died 3 hours later. What type of unintentional tort may the nurse be sued for?
- A. Defamation
- B. Battery
- C. Assault
- D. Malpractice
Correct Answer: D
Rationale: The law defines malpractice as professional negligence. It refers to harm that result from a licensed person's actions or lack of action. A jury must determine if the responsible person's conduct deviated from the standard expected of others with similar education and experience. All other answers are intentional torts.
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 LPN administered a medication to a client reporting pain. When checking the armband and the medication administration record, there were no allergies listed. The client then tells the nurse of having informed the admitting nurse of being allergic to that medication. What documentation on the incident form would be the best option?
- A. Medication is administered to client by mouth; reports having an allergy to the medication that causes hives.'
- B. The admitting nurse failed to document that the client has an allergy to the medication.'
- C. The client reports being allergic to the medication, but I really don't think so. I didn't see any hives.'
- D. I should have asked the RN if the client is allergic to any medication.'
Correct Answer: A
Rationale: Healthcare workers complete incident reports when they make or discover errors or when an event occurs that results in harm. The first option is concise and to the point without any accusation. The LPN's documentation should not accuse the admitting nurse of failure to document. The LPN's documentation should not judge the client's statement nor place blame on the client. The LPN's documentation also should not place the blame on oneself.