Question 1

A group of nurses in an organization are discussing methods that can be used to improve patient outcomes. Which option would the nurses identify as providing best practice to advance patient outcomes?

Accepted Answer

A)  Develop a monthly newsletter focusing on patient outcome information. 
B)  Perform chart checks on a routine basis. 
C)  Develop an ad hoc committee to review patient outcomes. 
D)  Have nurses participate as members in the hospital ethics committee.

Question 2

A 4-year-old child developed a seizure disorder that may be related to a medication error that occurred 3 years ago. What is true of the statute of limitations in this case?

Accepted Answer

A)  Depending upon the state, the statute of limitations might not begin to be calculated until the child reaches the age of majority. 
B)  Since the incident occurred over 2 years ago, the statute of limitations has expired. 
C)  There is no statute of limitations on medication errors that occur in children prior to the age of 2. 
D)  The statute of limitations in this case won't begin to be calculated until the child reaches the age of 13.

Question 3

A nurse is taking care of an incompetent patient who is admitted to a medical-surgical unit for treatment. Which notation on the medical record would the nurse identify as indicating the best form of substituted judgement?

Accepted Answer

A)  Court order is present. 
B)  Durable power of attorney for health care (DPAH
C) . 
C)  Physician directive. 
D)  Common law power of attorney.

Question 4

A nurse has requested reasonable accommodation from the nurse manager based on needing more flexibility in her work schedule. The nurse's attendance record indicates several call ins during the prior month. The nurse is asking to be able to start shift work approximately two hours start of the shift. The nurse has previously asked for consideration based on a medical diagnosis of anxiety. How should the nurse manager respond?

Accepted Answer

A)  Obtain medical documentation of the confirmed diagnosis and submit to Human Resources. 
B)  Ask the nurse for additional information relative to nurse's concern. 
C)  Compromise and allow the nurse to being shift work 30 minutes later. 
D)  Consider this to be a reasonable accommodation. 
E)  Transfer the nurse to a different unit.

Question 5

The nurse is preparing an educational class to improve communication by members of the healthcare team who interact with patients who have health literacy issues concerning obtaining informed consent. What method would be most effective for the nurse to use so as to help enhance communication?

Accepted Answer

A)  Refer the participants to an online website for review of available resources. 
B)  Update all patient information forms within the hospital to stated health literacy standards. 
C)  Encourage the use of drawings to deliver information. 
D)  Use shared decision making as the framework for communication.

Question 6

A nurse is working with a pregnant patient who has been referred to the clinic for genetic testing based on a family history of genetic illnesses. The patient states, "why should have the test done because I am not going to terminate the pregnancy." How should the nurse respond to this patient comment?

Accepted Answer

A)  Whether or not to have the test is ultimately your decision, but having adequate knowledge to make that decision is important. 
B)  Provide information about the reliability of genetic testing. 
C)  Obtain an obstetrical history from the patient. 
D)  Inquire about patient's insurance status to determine if the patient has to pay out of pocket for testing.

Question 7

A nurse walking down the medical unit hears a patient gasp and goes into the room to find that the patient is not breathing and unresponsive. The patient is not assigned to this nurse and there is no indication in the room regarding the patient's code status. What priority action should the nurse perform?

Accepted Answer

A)  Look at the patient's armband to determine patient's age. 
B)  Reposition the patient in the bed and insert the backboard. 
C)  Ring the call bell and seek clarification on code status. 
D)  Activate a code by pressing the emergency button.

Question 8

A nurse executive has requested that additional budgetary funds be allocated to support staff seeking a baccalaureate degree in nursing or specialty certification. Which information should this nurse executive provide during discussions of this funding?

Accepted Answer

A)  "Education at the BSN level, when coupled with specialty certification, has been shown to reduce adverse patient outcomes." 
B)  "Research shows decreased morbidity and mortality of patients when nurses' educational status is beyond minimum licensure attainment." 
C)  "Practical experience alone is the basis for improved patient outcomes." 
D)  Higher failure-to-rescue rates 
E)  "If our nursing staff is educated at a higher level and are certified we will see fewer lawsuits for negligence and malpractice."

Question 9

A nurse has been assigned to take care of a patient who doesn't speak English. Which person would the nurse select to be the best choice as an interpreter for a non-English-speaking patient?

Accepted Answer

A)  The patient's daughter who is bilingual 
B)  The patient's neighbor who is bilingual 
C)  A hospital housekeeper who is bilingual 
D)  A hospital-provided interpreter

Question 10

A group of nurses are reviewing the concept of quasi-intentional torts as applied to a long-term care facility. Which scenario would the nurses identify as being indicative of this legal consequence?

Accepted Answer

A)  The resident is restrained to a chair in the day room to prevent wandering. 
B)  The nursing assistant slaps a resident's hand when the resident pinches another resident. 
C)  The local newspaper publishes pictures of residents enjoying a holiday presentation by children. 
D)  The nursing home provides a list of names and clothing sizes to a local group who wishes to purchase birthday gifts for residents. 
E)  A resident wanders away from the facility and is found 2 miles away.

Question 11

The nurse is reviewing the Patient Determination Act of 1990. What principles should the nurse understand as being the basis for this act?

Accepted Answer

A)  State law is not changed relative to the enforcement of this act. 
B)  Economic costs should not play a role in healthcare decisions. 
C)  Educated patients will be better able to participate in the process leading to improved decision-making outcomes. 
D)  Providing written material to patients is sufficient to encourage self-determination. 
E)  Creation of new rights available to patients.

Question 12

A group of nurses are discussing subject involvement in a clinical research trial. Which action would the nurses indicate as being required in order to be compliant with an Institutional Review Board (IRB)?

Accepted Answer

A)  Informed consent is implied once the subject agrees to participate in a research study. 
B)  The nurse tells a subject involved in a clinical research trial that they cannot terminate the agreement. 
C)  Provide a listing of all subjects' names who are involved in the research study and circulate to hospital departments. 
D)  Contact information provided to subjects in case any problems arise.

Question 13

An individual is brought into the emergency room by law enforcement for observation and treatment and placed under arrest. Which nursing action would be appropriate related to the concept of informed consent?

Accepted Answer

A)  The nurse obtains information related to patient allergies. 
B)  The nurse draws a blood sample to determine an alcohol level. 
C)  The nurse asks law enforcement officers to restrain the patient. 
D)  The nurse refuses to care for the patient.

Question 14

A nurse is taking care of a terminally ill patient who is seeking to use new experimental medication. Which legal law would the nurse determine to be applicable to this patient request?

Accepted Answer

A)  Natural Death Act 
B)  Right to Try Law 
C)  Advance directives 
D)  Common-law concept

Question 15

A group of nurses are discussing fall prevention on the medical unit. Which option reflects the nurse's duty to prevent patient falls?

Accepted Answer

A)  To assess the patient for risk for falls. 
B)  Perform continuous observation of patients. 
C)  Make sure that side rails on all beds are raised at all times. 
D)  Provide minimal assistance.

Question 16

A group of nursing students are discussing legal/ethical concepts related to standards of care. In given situations, the nature and degree of reasonable care expected of people providing care may differ. Which factor would the nursing students identify that would cause a difference in the delivery of care?

Accepted Answer

A)  The individual's understanding of the law 
B)  The individual's sense of ethical responsibility 
C)  The individual's sense of societal obligations 
D)  The individual's status as a professional

Question 17

A nurse working in the acute care setting is preparing to use equipment while performing morning assessment of patients. Which option reflects the nurse's duty regarding use of equipment?

Accepted Answer

A)  Nurses have no responsibility for use or maintenance of equipment. 
B)  The nurse is required to select the proper equipment and to use it correctly. 
C)  Nurses should modify equipment so that it meets the particular patient's requirements. 
D)  Nurses are responsible for cleaning and repairing equipment so that it can be used readily.

Question 18

A group of nurses are discussing Title 1 provisions of the American Disabilities Act. Which scenario would the nurses identify as representing undue hardship for the hospital?

Accepted Answer

A)  Paying for monthly cell phone use for all hospital employees so as to enhance communication network 
B)  Short staffing occurring in the hospital due to outbreak of influenza 
C)  Providing voluntary physical examinations for all employees as part of the employee health program 
D)  Hiring individuals of the same religion in a faith-based facility

Question 19

The news reports that a nurse "contracted over the telephone" to distribute narcotics. Would that action taken by a nurse considered to be a contract?

Accepted Answer

A)  Yes, the contract agreement can be verbal or written. 
B)  No, contracts must fulfill a lawful purpose. 
C)  Yes, if something of value, like money, is offered as compensation. 
D)  Yes, if both parties understand the agreement.

Question 20

A group of nurses are discussing the concept of substituted judgment. Which option would the nurse identify as best describing this type of legal decision?

Accepted Answer

A)  Family members should be included in this decision. 
B)  The assistance of ethics committees is critical in providing this type of decision. 
C)  Use of subjective information to arrive at a judgment. 
D)  Family members express their beliefs for the incompetent patient in order to determine care based on prior interactions when the patient was competent. 
E)  The use of substitute judgment denies any right of appeal.

Exam 1: Ethical Issues in Nursing