Nokea
The nurse is to administer a potassium supplement to the client. The nurse does not check the potassium level prior to administering the medication and later finds that the potassium level was at a critical high. What principle has this nurse violated?
- A. Beneficence
- B. Nonmaleficence
- C. Autonomy
- D. Fidelity
Correct Answer: B
Rationale: Nonmaleficence is the duty to do no harm to the client. For instance, if a nurse fails to check a prescription for an unusually high dose of insulin and administers it, the nurse has violated the principle of nonmaleficence. 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.
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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 is concerned about the potential to be sued for a possible act of malpractice. What essential element(s) of malpractice must be present for this to occur? Select all that apply.
- A. Harm to an individual
- B. Duty of a professional toward an individual
- C. Breach of duty by the professional
- D. Poor rapport built with the client
- E. Cause of harm is the breach of duty
Correct Answer: A,B,C,E
Rationale: The essential elements of malpractice must include harm to the individual, duty of a professional toward an individual, breach of duty by the professional, and cause of harm is the breach of duty. Not building a rapport can contribute to a possible malpractice suit but is not an essential element.
The nurse has a client who is confused and disrupting the unit by screaming obscenities and making a lot of noise. The client has been medicated as prescribed but is not responding to the sedation. The other clients on the unit are reporting agitation. The nurse makes the decision to move the client to a location further down the hall where there are fewer clients. What theory of ethics is the nurse demonstrating?
- A. Utilitarianism
- B. Deontology
- C. The idea of rights
- D. Obligation of duty
Correct Answer: A
Rationale: Utilitarianism is an outcome-oriented approach for decision making. There are two important principles: 'the greatest good for the greatest number' and 'the end justifies the means.' Deontology argues that consequences are not the only important consideration in ethical dilemmas. The idea of rights and the obligation of duty are not theories.
A client who has end-stage chronic obstructive pulmonary disease (COPD) asks the nurse, 'Am I going to be getting better? Is there a cure?' What is the best response by the nurse that demonstrates the professional value, veracity?
- A. Everything will be fine.'
- B. Did someone tell you that there is a cure for this?'
- C. You don't need to worry about that; just get better.'
- D. Although there is no cure for this disease, we will keep you as comfortable as possible.'
Correct Answer: D
Rationale: The professional value of veracity is the duty to tell the truth. The nurse must provide factual information so the client may exercise autonomy. 'Everything will be fine,' 'Did someone tell you that there is a cure for this?', and 'You don't need to worry about that; just get better' are nontherapeutic responses that do not answer the client's question.
Which of the following is an example of statutory law?
- A. Permission for care
- B. Consent for minor client
- C. Nurse practice act
- D. Inferring consent
Correct Answer: C
Rationale: Statutory law is a law that any local, state, or federal legislative body enacts. An example of statutory law is the nurse practice act in each state. Clients sign a general permission for care and treatment on hospitalization. The parent or guardian should provide consent if the client is a minor to protect healthcare workers from being charged with battery. In an emergency, healthcare providers can infer consent.