Chapter 08: Upholding Legal and Ethical Principles My Nursing Test Banks

Chapter 08: Upholding Legal and Ethical Principles

Test Bank

MULTIPLE CHOICE

1. The nurse who fails to remove a patient from an unsafe situation has violated which bioethical principle?

a.

Justice

b.

Fidelity

c.

Veracity

d.

Beneficence

ANS: D

The nurse who fails to remove a patient from an unsafe situation violates the bioethical principle of beneficence, which means to prevent harm, or promote good. Justice refers to fairness, and fidelity is the principle of faithfulness. Veracity refers to truth-telling.

DIF: Cognitive Level: Application REF: Page 122

OBJ: Apply the seven universal biomedical ethical principles discussed in this chapter to the clinical setting. TOP: Nursing Ethics

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

2. The nurse who respects the patients right to refuse treatment is following which bioethical principle?

a.

Justice

b.

Beneficence

c.

Autonomy

d.

Fidelity

ANS: C

Autonomy refers to the patients right to refuse treatment and to make ones own decisions regarding health care. Justice, beneficence, and fidelity refer to fairness, doing no harm, and truth-telling.

DIF: Cognitive Level: Application REF: Page 124

OBJ: Apply the seven universal biomedical ethical principles discussed in this chapter to the clinical setting. TOP: Nursing Ethics

MSC: NCLEX: Psychosocial Integrity

3. The student understands the bioethical decision-making theory of utilitarianism when she makes which statement?

a.

Utilitarianism is concerned only with duty.

b.

Utilitarianism is also called Kantian ethics.

c.

Utilitarianism judges actions based on possible consequences.

d.

Utilitarianism judges actions based on intent.

ANS: C

Utilitarianism uses potential consequences to judge whether actions produce the greatest good. Kantian ethics judge actions based on intent and possible consequences. Deontology is a duty-oriented theory.

DIF: Cognitive Level: Application REF: Page 126

OBJ: Apply an ethical framework or model for ethical decision-making.

TOP: Nursing Ethics

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

4. Which statement made by the nursing student indicates an accurate understanding of culturally competent care?

a.

It means having knowledge of the health-related beliefs and practices of all cultures.

b.

It is the ability to care only for individuals from ones own culture.

c.

It means working within the cultural context of individuals, families, and communities.

d.

It means avoiding discussing the patients practices or beliefs because they may not agree with your own.

ANS: C

Working within the cultural context of individuals, families, and communities is the definition of culturally competent nursing care. Knowing the health-related beliefs and practices of all cultures is unrealistic. The ability to care only for those from ones own culture or avoiding discussing the patients beliefs is not within the definition of culturally competent care.

DIF: Cognitive Level: Application REF: Page 123

OBJ: Explain the role of culture in biomedical ethics. TOP: Nursing Ethics

MSC: NCLEX: Psychosocial Integrity

5. The student understands the ANA Code of Ethics for Nurses when she identifies which statement as incorrect? The Code of Ethics for Nurses:

a.

provides a framework for ethical decision-making.

b.

is non-negotiable.

c.

is applicable to most practice settings.

d.

helps with professional self-regulation.

ANS: C

The ANA Code of Ethics is applicable to all practice settings. The Code is also provides a framework for ethical decision-making, is non-negotiable, and helps with professional self-regulation.

DIF: Cognitive Level: Application REF: Page 127

OBJ: Explain the role of the Code of Ethics for Nurses to the practice of nursing.

TOP: Nursing Ethics

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

6. Which statement is correct about the bioethical decision-making theory of deontology?

a.

It is concerned only with consequences.

b.

It judges actions based on motive or intent.

c.

It emphasizes treating others as a means to an end.

d.

It cannot be applied to research.

ANS: B

Deontology judges actions based on motive or intent and is especially applicable to the field of research. Deontology is not solely concerned with consequences and does not emphasize treating others as a means to an end.

DIF: Cognitive Level: Application REF: Page 126

OBJ: Apply an ethical framework or model for ethical decision-making.

TOP: Nursing Ethics

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

7. The RN student has been studying ethics in health care. Based on what she has learned, how would she explain the bioethical principle of autonomy?

a.

It states that the physician knows what is best for the patient.

b.

It does not apply to informed consent.

c.

It refers to patient self-determination.

d.

It states that every patient has a right to health care.

ANS: C

Self-determination, or the right to make ones own health care decisions, and informed consent are grounded in the principle of autonomy. The belief that a physician knows what is best for the patient is known as paternalism, and the belief that every patient has a right to health care, as well as informed consent, is the principle of justice.

DIF: Cognitive Level: Evaluation REF: Page 122

OBJ: Define the seven universal biomedical ethical principles discussed in this chapter.

TOP: Nursing Ethics

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

8. The nursing student knows that ethics is a part of which branch?

a.

Sociology

b.

Law

c.

Philosophy

d.

Medicine

ANS: C

Ethics is a branch of philosophy. Nursing, law, and medicine each have a Code of Ethics based on general ethical principles.

DIF: Cognitive Level: Knowledge REF: Page 121 OBJ: Define the term ethics.

TOP: Nursing Ethics

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

9. For the RN to practice ethical decision-making, it is most important for him or her to:

a.

base decision-making on whether an action is right or wrong.

b.

base decision-making on possible consequences.

c.

accurately assess a situation.

d.

seek the assistance of an ethics committee.

ANS: C

As with all nursing functions, the first step is assessment. Basing a decision on whether an action is right or wrong is an ethical decision-making framework based on deontology. Basing a decision on the possible consequences reflects the theory of utilitarianism. Seeking the assistance of an ethics committee would occur after assessment if the ethical dilemma cannot be resolved among the patient, family, and caregivers.

DIF: Cognitive Level: Application REF: Pages 127-128

OBJ: Discuss the eight-step ethical decision-making process discussed in this chapter as it applies to the clinical setting. TOP: Nursing Ethics

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

10. The RN understands administrative law when she says, Administrative law governs:

a.

federal treaties.

b.

the operations of government.

c.

the conduct of judges.

d.

the United States Supreme Court.

ANS: B

Administrative law controls the operations of government, such as the National Labor Relations Board. Administrative law does not govern federal treaties, the conduct of judges, or the United States Supreme Court.

DIF: Cognitive Level: Application REF: Page 114

OBJ: State the three most common sources of law. TOP: Law

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

11. The nurse working in family practice is assessing an elderly female patient and notices bruises on the patients arm and back. Which action is the most appropriate for the nurse to take?

a.

Ignore the bruises because her daughter tells you that her mother is clumsy.

b.

Do nothing because you cannot prove anything.

c.

Report the suspected abuse to the appropriate authorities.

d.

Confront and accuse the daughter of elder abuse.

ANS: C

Nurses are mandatory reporters, and suspected abuse or neglect cannot be ignored. Suspicion of abuse or neglect is sufficient to report suspected abuse to authorities. It is not your burden to prove.

DIF: Cognitive Level: Application REF: Page 121

OBJ: Apply mandatory reporting requirements to the clinical setting.

TOP: Law MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

12. The nurse threatens to place a verbally abusive patient in restraints. The patient could press charges against the nurse for which of the following?

a.

Battery

b.

Assault

c.

Malpractice

d.

Negligence

ANS: B

Assault is the threat to do harm. Battery is the actual touching of another. Malpractice and negligence are the basis for civil lawsuits.

DIF: Cognitive Level: Application REF: Page 116

OBJ: Compare and contrast negligence and intentional torts. TOP: Law

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

13. Steps the RN can take to reduce the risk of malpractice include all of the following except:

a.

administer drugs carefully.

b.

document accurately.

c.

do not delegate any tasks.

d.

think before you speak.

ANS: C

To reduce the risk of malpractice the nurse should administer drugs carefully, document accurately, and think before speaking. Avoiding the delegation of tasks is not realistic.

DIF: Cognitive Level: Application REF: Page 118

OBJ: Apply the legal principles of safe practice to the clinical setting.

TOP: Law MSC: NCLEX: Safe, Effective Care Environment: Management of Care

14. A nurse educator is preparing a presentation on professional negligence. The nurse determines that all of the following actions would be considered professional negligence except:

a.

administering the wrong medication.

b.

failure to obtain informed consent.

c.

taking a picture of a patient without his or her consent.

d.

refusing to permit the patient to walk without assistance.

ANS: D

Refusing to permit the patient to walk without assistance is an appropriate nursing intervention. Administering the wrong medication is an act of commission; failure to obtain informed consent is negligence. Taking a picture of a patient without his or her consent is considered invasion of privacy.

DIF: Cognitive Level: Application REF: Page 117

OBJ: Compare and contrast negligence and intentional torts. TOP: Law

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

15. A nurse manager is preparing a presentation on negligence to present at the next staff meeting. She would not consider which as a form of negligence?

a.

Malfeasance

b.

Nonmalfeasance

c.

Misfeasance

d.

Nonfeasance

ANS: B

Nonmalfeasance is the bioethical principle of doing no harm and would not be considered a form of negligence. Malfeasance, misfeasance, and nonfeasance are all forms of negligence.

DIF: Cognitive Level: Application REF: Page 122

OBJ: Compare and contrast negligence and intentional torts. TOP: Law

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

16. An RN administers an ordered dose of medication over the patients refusal. On review, the manager interprets this action to be:

a.

assault.

b.

battery.

c.

negligence.

d.

malpractice.

ANS: B

Battery is the actual touching of another, including administering a medication over the patients refusal. Assault is the threat to do so. Negligence is the failure to act as an ordinary and reasonably prudent person would act in the same or similar circumstances. Malpractice is a specialized kind of negligence and is defined as the violation of a professional duty.

DIF: Cognitive Level: Analysis REF: Page 116

OBJ: Compare and contrast negligence and intentional torts. TOP: Law

MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

17. The nurse accidentally administers the wrong dose of a medication. Her first action would be to:

a.

notify the physician.

b.

fill out an incident report.

c.

assess the patient.

d.

tell her supervisor.

ANS: C

Assessing the patient is the highest priority. The physician must be notified after the patient is assessed. Filling out an incident report and telling the supervisor are not priorities.

DIF: Cognitive Level: Application REF: Page 118

OBJ: Apply the legal principles of safe practice to the clinical setting.

TOP: Law MSC: NCLEX: Safe, Effective Care Environment: Safety and Infection Control

18. The four elements that must be present for a person to recover damages as the result of alleged malpractice are duty, breach of duty, actual injury, and:

a.

insurance.

b.

battery.

c.

intent.

d.

causation.

ANS: D

The fourth element that must be present for a person to recover damages as the result of alleged malpractice is causation; in other words, the injury was foreseeable and the conduct was the cause of the injury. Battery is an intentional tort for which an action can be brought. Intent or insurance does not need to be present for a personal to recover damages as the result of alleged malpractice.

DIF: Cognitive Level: Knowledge REF: Page 118

OBJ: State the four elements that must be present for a person to recover damages.

TOP: Law MSC: NCLEX: Safe, Effective Care Environment: Management of Care

19. Which of the following is not considered a major law that governs our society?

a.

Criminal law

b.

Common law

c.

Statutory law

d.

Administrative law

ANS: A

Major laws that govern our society include common, statutory, and administrative. Criminal law is a subcategory of the major laws.

DIF: Cognitive Level: Knowledge REF: Page 114

OBJ: Identify the three major types of law and explain how they apply to nursing.

TOP: Sources of Law

20. A nurse is working the night shift on a respiratory floor. She is walking toward a patients room when she sees a nursing assistant performing patient care with the curtain and door open. The nurse knows that the nursing assistant is violating which legal principle?

a.

Right to privacy

b.

False imprisonment

c.

Failure to rescue

d.

Informed consent

ANS: A

The nursing assistant is violating the patients right to privacy by keeping the curtain and door open. The legal principles of false imprisonment, failure to rescue, and informed consent are not occurring in this situation.

DIF: Cognitive Level: Application REF: Page 115

OBJ: Identify the three major types of law and explain how they apply to nursing.

TOP: Legal Principles

21. A nurse is working with a patient who is well known to the public. Shortly before lunch, a news reporter walks into the nursing unit and begins questioning the nurse. The nurse knows that if she gives out patient information without the patients consent, she would be failing to comply with which law?

a.

Informed consent

b.

Health Insurance Portability and Accountability Act (HIPAA) of 1996

c.

Hospital policy

d.

Common law

ANS: B

The nurse would be violating HIPAA of 1996. This law was enacted to protect the privacy of patients, including medical records and personal health information.

DIF: Cognitive Level: Application REF: Page 115

OBJ: Identify the three major types of law and explain how they apply to nursing.

TOP: Patients Rights

22. The nurse manager shows an understanding of preventable medical errors when she makes which statement?

a.

There are only a few deaths related to medical errors per year.

b.

Medical errors are made only by nurses who are not focused.

c.

About 20,000 patients die each year from preventable medical errors in the United States.

d.

Each year between 44,000 and 98,000 patients die from preventable medical errors.

ANS: D

The Institute of Medicine estimates that each year in the United States, between 44,000 and 98,000 patients die from preventable medical errors.

DIF: Cognitive Level: Application REF: Page 117

OBJ: Define professional negligence and malpractice. TOP: Negligence and Malpractice

23. The nurse on a busy surgical floor is preparing her patient for surgery. The patient refuses to sign the surgical consent form because he has not spoken to the surgeon regarding the procedure. When the nurse speaks to the surgeon on the phone, he tells her that he is too busy to come to the floor. If the nurse were to insist that the patient sign the consent anyway, she would be violating which of the patients rights?

a.

Right to refuse treatment

b.

Confidentiality

c.

Right to informed consent

d.

Right to privacy

ANS: C

In order for the consent to be valid, the patient must fully know what he is consenting to. He has the right to know the potential risks, benefits, and any other treatments that may be available.

DIF: Cognitive Level: Application REF: Page 115

OBJ: Identify the three major types of law and explain how they apply to nursing.

TOP: Legal Principles

24. A nurse is working in the surgical recovery unit and is caring for a patient who is still under anesthesia. She notes that the patients oxygen level is 82% on room air. What would the nurse be guilty of if she were to withhold oxygen from this patient?

a.

Commission of an act

b.

Nothing, because the patient will naturally recover from the anesthesia

c.

Professional negligence

d.

Assault and battery

ANS: C

The nurse would be guilty of professional negligence through the omission of an act, giving oxygen, to a patient who was in need.

DIF: Cognitive Level: Application REF: Page 117

OBJ: Define professional negligence and malpractice. TOP: Negligence and Malpractice

25. The nurse has an adequate understanding of a tort when she makes which statement?

a.

A tort is a legal wrong committed against another person or their property.

b.

A tort refers to the nurses duty to practice within the boundaries of the nurses role.

c.

A tort is a principle concerned with being fair or just.

d.

A tort refers to truth telling and not intentionally misleading patients.

ANS: A

A tort is a legal wrong that is committed against either a person or the persons property. Fidelity is a term that defines the nurses duty to practice within the boundaries of the nurses role, as determined by state rules and regulations. Justice is a principle concerned with being fair or just. Veracity refers to truth-telling and not intentionally misleading patients.

DIF: Cognitive Level: Application REF: Page 117

OBJ: Define professional negligence and malpractice. TOP: Negligence and Malpractice

26. A nurse is caring for an elderly patient with terminal cancer. The patient has just told his family that he wants to end treatment and be kept comfortable for the remainder of his life. His family is very upset and does not agree with his decision. Both the patient and his family have confided their wishes to the nurse privately, and the family has asked the nurse to intervene. How would you classify the ethical dilemma that the nurse is experiencing?

a.

Right to life

b.

Informed consent

c.

Right to die

d.

Medical futility

ANS: C

The ethical dilemma that the nurse is experiencing is right to die. Although the patients family may be upset with his decision, it is ultimately the patients right to choose when to end treatment for his terminal cancer.

DIF: Cognitive Level: Analysis REF: Page 125

OBJ: Value the need for registered nurses to demonstrate the ethical duties owed to self and others.

TOP: Ethics Committees

27. A nurse is working the night shift in the ICU. She notices cardiac alarms sounding for one of the patients, and on arriving to the patients room, finds him in full cardiac arrest. It is later determined that the patients assigned nurse was at the front desk sleeping. The nurse realizes the important of reporting this issue but does not want to face backlash from her co-worker. Which describes what the nurse is experiencing?

a.

Decision-making

b.

Ethical dilemma

c.

Preconceived beliefs

d.

Discrimination

ANS: B

This nurse is experiencing an ethical dilemma. She understands the importance of reporting her co-workers lack of patient supervision but is concerned with the backlash that she may experience from her co-worker.

DIF: Cognitive Level: Application REF: Page 123

OBJ: Identify an ethical dilemma in the clinical setting and outline a framework for ethical decision-making. TOP: Ethical Dilemmas

MULTIPLE RESPONSE

1. A new nurse has just been hired to work at a local hospital. Which actions by the nurse show her understanding of the Patients Bill of Rights? (Select all that apply.)

a.

Allowing the patient access to health records

b.

Responding to patient care requests in a timely manner

c.

Explaining to another nurse the patients right to refuse treatment

d.

Maintaining the patients confidentiality

e.

Ensuring that the patient is informed about his or her medical condition

ANS: A, C, D, E

The Patients Bill of Rights states that patients have the right to access to their health records, the right to refuse treatment, the right to confidentiality, and the right to be informed about their medical conditions, among others. The right to timely care is not listed in the Patients Bill of Rights.

DIF: Cognitive Level: Application REF: Page 115

OBJ: Identify the three major types of law and explain how they apply to nursing.

TOP: Patients Rights

2. Which statements by the nursing student describe how ethics help nurses solve dilemmas in health care? (Select all that apply.)

a.

Ethics requires us to analyze our actions or potential actions critically.

b.

Ethics assists us in determining the right course of action to take.

c.

Ethics allows nurses to let others more qualified make decisions for us.

d.

Ethics allows nurses to take a break from the situation by waiting for the ethics committee.

e.

Ethics causes problems in health care rather than helps.

ANS: A, B

Ethics assists nurses in solving dilemmas by requiring them to analyze their actions or potential actions critically and by assisting in determining the right course of action to take.

DIF: Cognitive Level: Application REF: Page 121

OBJ: Value the need for registered nurses to demonstrate the ethical duties owed to self and others.

TOP: Nursing Ethics

3. The RN understands the importance of providing culturally competent nursing care when she does which of the following? (Select all that apply.)

a.

Uses flexibility to accommodate the patient

b.

Becomes knowledgeable about other cultures

c.

Lets go of negative attitudes about other cultures

d.

Believes that her culture is superior

e.

Avoids patients of different cultures

ANS: A, B, C

In order to provide culturally competent nursing care, the nurse must be able to integrate skills, knowledge, and attitudes into care. The nurse must be able to work within the cultural context of the patient, family, or community. Using flexibility in the patients care to accommodate needs, becoming knowledgeable about other cultures, and letting go of negative attitudes are all ways that the nurse can provide culturally competent care.

DIF: Cognitive Level: Application REF: Page 123

OBJ: Recognize your personal attitudes about working with patients from different ethnic and cultural backgrounds. TOP: Ethics and Culture

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