Andersons Caring for Older Adults Holistically 6th Edition by Tamara R. Dahlkemper – Test Bank

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Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   Which situation could cause an ethical/legal issue?

1) Allowing a resident to refuse care
2) Deciding whether to pass pills first or do a dressing change
3) Deciding whether to include the resident in planning care
4) Reporting a nursing assistant for not answering a resident’s call light

 

 

____     2.   Which situation could be a legal dilemma for nurses caring for older adults?

1) The resident requests not to be bathed.
2) The nurse passes the medications to all of the residents on time.
3) The resident signs out of the nursing facility and does not tell the staff where he or she is going.
4) The nurse gives the resident only half of the ordered dose of a medication because of side effects that the resident is experiencing.

 

 

____     3.   Which best describes ethics?

1) Legal aspects of health
2) Consequence evaluation
3) Values and moral concepts
4) Right and wrong behaviors

 

 

____     4.   Which is true about ethical decision making?

1) It is governed by the law.
2) It is beyond the legal scope of the practical nurse.
3) It is the use of personal values and beliefs to solve problems.
4) It is unnecessary if there are comprehensive physician orders.

 

 

____     5.   What is the Patient Care Partnership designed to do?

1) Protect the nurse from unfounded lawsuits.
2) Identify the individual’s ability to make decisions.
3) Support the choices of an individual who is able to read and write.
4) Protect the individual’s right to make informed choices relating to his or her health care.

 

 

____     6.   Which is true regarding laws governing health care and health-care delivery?

1) They are consistent with values systems.
2) They are fair and benefit most of the population.
3) They are man-made and capable of being changed.
4) They are developed with the rights of residents as the central theme.

 

 

____     7.   A licensed practical nurse (LPN) finds a resident unresponsive, calls for help, and instructs the staff to call 911 and bring emergency supplies while she sets up oxygen for the resident. What is this nurse guilty of doing?

1) The LPN should have called 911.
2) The LPN did not document the event.
3) The LPN functioned within the scope of practice.
4) The LPN should have requested a physician’s order for the oxygen.

 

 

____     8.   A non-intravenous (IV) certified LPN starts an IV infusion in a resident during an emergency situation. What is this nurse guilty of doing?

1) Doing someone else’s job
2) Adhering to the Nurse Practice Act
3) Being negligent because of not being IV-certified
4) Skipping resident consent for the IV insertion

 

 

____     9.   If a non-IV certified LPN starts an IV infusion what should the judge determine if this situation is reviewed in court?

1) Was the physician in attendance?
2) Who was responsible for the resident’s care?
3) Did the resident give permission for the IV?
4) Would another LPN do the same thing?

 

 

____   10.   What does the failure to notify the physician or nursing supervisor when a resident’s heart rate decreases to less than 48 describe?

1) Libel
2) Omission
3) Negligence
4) Unprofessional behavior

 

 

____   11.   An 84-year-old patient experiencing severe cancer pain is restless and refuses pain medication. Which is an ethical approach to this problem?

1) Discuss with the patient feelings about the pain and the medication.
2) Call the family to ensure that the resident’s choice is in the living will.
3) Withhold the medication, because all residents have the right to refuse care.
4) Give the medication, because the resident’s decision may be related to delirium.

 

 

____   12.   What is a positive result of a restraint-free environment?

1) Use of more medications
2) Fewer incidents of resident falls
3) Increased nursing assistant staffing
4) Development of more creative care strategies

 

 

____   13.   What may an LPN be required to do when providing ethical nursing care?

1) Examine personal beliefs and values.
2) Practice outside of the facility’s policies and procedures.
3) Practice outside of the legal scope of practical nursing practice.
4) Compromise the rights of residents as outlined in the Patient Care Partnership.

 

 

____   14.   What does NOT legally define the practice of the LPN?

1) Facility procedure outlines
2) The State Nurse Practice Act
3) Facility nursing care policies
4) Experience in providing nursing care

 

 

____   15.   Which is an example of omission?

1) Forgetting to unclamp a catheter
2) Changing a resident’s diet to increase fiber
3) Refusing to sign off on a medication that was not given
4) Adjusting a dosage schedule of an antibiotic that the pharmacy delivered late

 

 

____   16.   Why are other nurses often used as expert witnesses in lawsuits involving nurses?

1) They can review the usual job description of nurses.
2) They can learn about the Nurse Practice Act standards.
3) They can establish the definition of safe and prudent care.
4) They can validate the credentials of the nurse being charged.

 

 

____   17.   What is the most important factor in successfully initiating a restraint-free environment?

1) Discussing safer methods of restraining residents
2) Educating the residents and families regarding restraint-free principles
3) Providing in-service training of nursing staff about restraint policies and procedures
4) Reviewing the Patient Care Partnership with the whole staff so that they understand the right of the resident to choose to be unrestrained

 

 

____   18.   What does informed consent mean?

1) The resident has the right to refuse treatment.
2) The resident must sign a release statement before all treatments.
3) The care personnel are exempt from any lawsuit if something goes wrong during a procedure.
4) The resident has the right to know all of the information regarding procedures before consenting to treatment.

 

 

____   19.   What is the role of the LPN when elder abuse is suspected?

1) Review the care of other residents.
2) Document and investigate the incident.
3) Report the incident to the local, county, or state authorities.
4) Discuss suspicions at the next interdisciplinary team meeting.

 

 

____   20.   Who are the abusers in most cases of elder abuse?

1) Privately paid caregivers
2) Long-term care facility employees
3) Anyone who cares for an older adult
4) Family members who are living with the older adult

 

 

____   21.   What is a major barrier to reporting of elder abuse?

1) Reporting involves too much paperwork.
2) It is not a felony to abuse a competent adult.
3) Elders are reluctant to report incidents of abuse.
4) Families of elderly abuse victims seldom believe that they are abusing the elder.

 

 

____   22.   The wife of a married couple in a facility requests to be moved into a different room. How should the nurse respond to this request?

1) “Don’t you think your husband will miss you?”
2) “This must have been a difficult decision for you to make.”
3) “We will have to get your husband’s permission for you to move.”
4) “This is against the facility policy, which encourages couples to be in the same room.”

 

 

____   23.   What statement best describes a resident’s rights for sexual expression?

1) The right to use touch to express sexual feelings.
2) The right to have access to opportunities for sexual expression.
3) The right to engage in sexual relationships with other residents.
4) The right to express sexual feelings in socially appropriate ways.

 

 

____   24.   Which statement is NOT true about physical restraints?

1) They may include bed rails.
2) They restrict access to one’s body.
3) They can be removed by the resident.
4) They include anything attached to the individual that cannot be removed easily.

 

 

____   25.   A certified nursing assistant (CNA) uses soft restraints to protect a resident from falling out of bed even though there was no order for their usage. On rounds several hours later, the resident is found not breathing, tangled, with her restraints around her neck. What is the responsibility of the LPN?

1) Guilty of omission
2) Guilty of negligence
3) Not at fault because of being unaware of the restraints being used
4) Not concerned because the resident has a do not resuscitate (DNR) order

 

 

____   26.   A primary care provider orders short-term restraints for an elderly patient. Which is NOT a responsibility of the nurse regarding these restraints?

1) Remove the restraints periodically.
2) Assist with range-of-motion exercises.
3) Observe and care for the skin periodically.
4) Delay following the physician’s instructions and contact the interdisciplinary team (IDT).

 

 

____   27.   Which law was specifically designed to protect and regulate patient privacy?

1) Patient Care Partnership
2) Patient Self-Determination Act
3) Omnibus Budget Reconciliation Act (OBRA)
4) Health Insurance Portability and Accountability Act (HIPAA)

 

 

____   28.   What has research been unable to prove regarding the use of restraints?

1) Care based on the patient’s individual needs
2) A reduction in the person’s functional capacity
3) Injuries to the patient who tries to get free from the restraints
4) Problems with many body systems often resulting from immobility

 

 

____   29.   The nurse lives in Erie, Pennsylvania, but sees home care patients in New York, Pennsylvania, and Ohio. Which state licensure requirements should the nurse follow?

1) Ohio
2) New York
3) Pennsylvania
4) All of the states

 

 

____   30.   The nurse is concerned about an unsafe situation with a resident. With whom should the nurse discuss this situation first?

1) The CNAs
2) The physician
3) The charge nurse
4) The administrator

 

 

____   31.   While making afternoon rounds the charge nurse sees a resident sitting in a geriatric chair with a tray. What should the nurse do?

1) Do nothing.
2) Remove the tray.
3) Assist with ambulation.
4) Transfer to another chair.

 

 

____   32.   A resident of a nursing facility demonstrates occasional delirium. From whom should the nurse obtain consent for an invasive procedure?

1) The resident
2) The physician
3) Family attorney
4) Medical power of attorney

 

 

____   33.   What is the primary objective of an advance directive?

1) Reduce the cost of care.
2) Restrict the utilization of resources.
3) Follow the resident’s wishes for care.
4) Calm the family’s fears and concerns.

 

 

____   34.   What is the most extreme expression of ageism?

1) Negligence
2) Malpractice
3) Elder abuse
4) False imprisonment

 

 

____   35.   During morning care an older male resident begins to masturbate. What should the CNA do?

1) Ignore the action and complete the bath.
2) Ask the resident to stop until the bath is over.
3) Leave the resident to complete the action in private.
4) Stand and wait for the resident to complete the action.

 

 

____   36.   The nurse overhears several CNAs discussing a resident’s health problems in the lunch room. What should the nurse do?

1) Do nothing.
2) Participate in the discussion.
3) Listen to what they have to say.
4) Remind them that the information is confidential.

 

 

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

 

____   37.   What information should the nurse expect to find within the Patient Care Partnership? Select all that apply.

1) Billing and collection policies
2) Access to health care and coverage
3) Acceptable nurse-resident staffing ratios
4) Intolerance of racial and ethnic disparities
5) Partnership with health-care decisions and delivery

 

 

____   38.   Which actions should the nurse take when enforcing the Patient Self-Determination Act of 1990 with a newly admitted resident of a nursing facility? Select all that apply.

1) Ask if the resident has a living will.
2) Ask if the resident has advance directives.
3) Ask if the executor of the will has been identified.
4) Ask if the resident has a durable power of attorney.
5) Ask if the resident will sign the consent to treatment form.

 

 

____   39.   The Director of Nursing is concerned that one staff nurse is at risk for liability issues when providing resident care. What did the director observe to make this decision? Select all that apply.

1) The nurse changed a medication dosage.
2) The nurse worked 32 hours over the last 2 days.
3) The nurse documented the status of a resident’s pressure ulcer.
4) The nurse did not have supplies to change a wound-vac draining system.
5) The nurse did not obtain consent before sending a resident for a surgical procedure.

 

 

____   40.   The nurse is identifying tasks to delegate to CNAs. What should the nurse use as a guide when making these decisions? Select all that apply.

1) Age of the CNAs
2) Skill level of the CNAs
3) Experience of the CNAs
4) Certification of the CNAs
5) Shift the CNAs are working

 

 

____   41.   What are the characteristics of a prudent, responsible nurse? Select all that apply.

1) Attends seminars
2) Thinks through actions
3) Applies for re-licensure
4) Reads nursing magazines
5) Carefully considers options

 

 

____   42.   What can be used in place of restraints to monitor residents who have a tendency to wander? Select all that apply.

1) Sitters hired to stay with the resident
2) Alarm doors
3) Bed alarm pads
4) Room door locks
5) Wristband alarms

 

 

____   43.   A resident is having a health-care proxy created. What should be included in this document? Select all that apply.

1) Use of feeding tubes
2) Types of medications
3) Plans for resuscitation
4) Location of will in the home
5) Desire for mechanical ventilation

 

 

____   44.   Which parts of Medicare are associated with monthly premiums? Select all that apply.

1) A
2) B
3) C
4) D
5) E

 

 

____   45.   What should the nurse explain to a resident of a nursing facility about Medicaid? Select all that apply.

1) It includes acute care.
2) It includes long-term care.
3) It has a monthly premium.
4) It has substantial co-payments.
5) It is the largest payer for skilled care.

 

 

____   46.   How did the Affordable Care Act (ACA) impact Medicare? Select all that apply.

1) Increased co-payments
2) Added deductibles for office visits
3) Included more preventive services
4) Reduced the cost of prescription drugs
5) Limited the number of skilled care days

 

Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  1

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 1. Compare and contrast the terms legal and ethical.

Chapter page reference: 92

Heading: The Law

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Ethics; Legal

Difficulty: Easy

  Feedback
1 Refusal of care often goes against what we know as right or best for a resident, which would define it as ethical in nature. However, according to the law the resident has the right to refuse care.
2 This is a nursing decision.
3 The nursing process is individualized for each person and provides a planned framework for providing care.
4 This could lead to a resident safety issue.

 

 

PTS:   1                    CON:  Ethics | Legal

 

  1. ANS:  4

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 2. Define the term liability and discuss the impact it can have on your career.

Chapter page reference: 95

Heading: Acts of Negligence, Malpractice, and Omission

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Ethics; Legal

Difficulty: Easy

  Feedback
1 The resident has the right to refuse care.
2 This is a nursing responsibility and no ethical issue is present.
3 This could be an ethical issue because the facility needs to be concerned with the safety of all residents.
4 It is ethical to support a resident’s right to be free from side effects. Legally, however, the physician has ordered the medication to be given.

 

 

PTS:   1                    CON:  Ethics | Legal

 

  1. ANS:  3

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 1. Compare and contrast the terms legal and ethical.

Chapter page reference: 90

Heading: Ethics

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Ethics; Legal

Difficulty: Easy

  Feedback
1 Legal aspects of health do not describe ethics.
2 Consequence evaluation does not describe ethics.
3 Ethics in nursing is the study of values and moral concepts as they relate to providing nursing care.
4 Right and wrong behaviors are defined by the laws governing nursing practice.

 

 

PTS:   1                    CON:  Ethics | Legal

 

  1. ANS:  3

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 1. Compare and contrast the terms legal and ethical.

Chapter page reference: 91

Heading: Ethics

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Ethics; Legal

Difficulty: Easy

  Feedback
1 Ethics are not governed by the law.
2 Ethics are not beyond the scope of the practical nurse.
3 Values and beliefs are used to influence ethical decision making.
4 Ethics are necessary, regardless of the presence of comprehensive physician orders.

 

 

PTS:   1                    CON:  Ethics | Legal

 

  1. ANS:  4

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 1. Compare and contrast the terms legal and ethical.

Chapter page reference: 91

Heading: Patient Care Partnership

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Ethics; Legal

Difficulty: Easy

  Feedback
1 The Patient Care Partnership was not designed to protect the nurse from lawsuits.
2 The Patient Care Partnership was not designed to identify an individual’s ability to make decisions.
3 The Patient Care Partnership was not designed to support the choices of a literate individual; it was designed to protect all individuals in health-care facilities.
4 The Patient Care Partnership supports informed choices for individual health.

 

 

PTS:   1                    CON:  Ethics | Legal

 

  1. ANS:  3

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 1. Compare and contrast the terms legal and ethical.

Chapter page reference: 91

Heading: The Law

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Legal

Difficulty: Easy

  Feedback
1 Laws are not necessarily consistent with a person’s value system.
2 Laws are not always fair and beneficial to most of the population.
3 The legal system is based on rules and regulations that guide society in a formal and binding manner. These regulations are human-made rules capable of being changed by the legislative and judiciary systems of the United States.
4 Laws are not necessarily developed with the rights of residents as a central theme.

 

 

PTS:   1                    CON:  Legal

 

  1. ANS:  3

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 2. Define the term liability and discuss the impact it can have on your career.

Chapter page reference: 94

Heading: Acts of Negligence, Malpractice, and Omission

Integrated Processes: Nursing Process: Evaluation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Analysis [Analyzing]

Concept: Legal

Difficulty: Moderate

  Feedback
1 The LPN delegated the calling of 911 to a staff member, which was within the scope of practice.
2 It is unknown if the LPN did not document the event.
3 The LPN functioned within the scope of practice, most likely followed facility guidelines, and delegated direction appropriately.
4 It is unknown if the resident was provided with oxygen. The LPN was setting it up.

 

 

PTS:   1                    CON:  Legal

 

  1. ANS:  3

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 2. Define the term liability and discuss the impact it can have on your career.

Chapter page reference: 94

Heading: Acts of Negligence, Malpractice, and Omission

Integrated Processes: Nursing Process: Evaluation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Analysis [Analyzing]

Concept: Legal

Difficulty: Moderate

  Feedback
1 Doing someone else’s job would not be illegal.
2 Starting an IV when not IV-certified is not adhering to the Nurse Practice Act.
3 If an LPN starts an IV procedure, even in an emergency situation, and is not IV-certified, the law has been broken as outlined in the Nurse Practice Act and the LPN is liable for this behavior even if there is a good outcome from the action.
4 The resident’s signature on the Consent for Treatment form on admission to the facility most likely covered emergency procedures.

 

 

PTS:   1                    CON:  Legal

 

  1. ANS:  4

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 2. Define the term liability and discuss the impact it can have on your career.

Chapter page reference: 94

Heading: Acts of Negligence, Malpractice, and Omission

Integrated Processes: Nursing Process: Evaluation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Analysis [Analyzing]

Concept: Legal

Difficulty: Moderate

  Feedback
1 The judge is not investigating the physician’s actions.
2 The person responsible for the resident’s care is not an issue.
3 The resident most likely signed a Consent to Treatment form on admission, which would cover the insertion of an IV during an emergency situation.
4 In a court of law, a judge must assess this one issue—would another LPN do the same thing under the same circumstances? This is the measure of safe and prudent care. As long as the answer is always yes, the LPN’s actions are safe.

 

 

PTS:   1                    CON:  Legal

 

  1. ANS:  2

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 2. Define the term liability and discuss the impact it can have on your career.

Chapter page reference: 95

Heading: Acts of Negligence, Malpractice, and Omission

Integrated Processes: Nursing Process: Evaluation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Analysis [Analyzing]

Concept: Legal

Difficulty: Moderate

  Feedback
1 Libel does not relate to this situation.
2 Omission is not doing something that is ordered or normally expected as part of nursing care.
3 Negligence is not doing what another professional would do in a similar situation.
4 Unprofessional behavior does not relate to this situation.

 

 

PTS:   1                    CON:  Legal

 

  1. ANS:  1

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 2. Define the term liability and discuss the impact it can have on your career.

Chapter page reference: 91

Heading: Ethics

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Analysis [Analyzing]

Concept: Ethics

Difficulty: Moderate

  Feedback
1 Ethically, before making a decision about the resident’s care, the nurse needs to assess the resident’s reasoning for the choice to refuse medication.
2 Calling the family should not be done before discussing the decision with the resident.
3 The choice to refuse medication could cause the resident more pain. The nurse needs to do something else besides withholding the medication.
4 Giving the medication when the resident clearly refused is unethical and could be breaking the law.

 

 

PTS:   1                    CON:  Ethics

 

  1. ANS:  4

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 3. Define the guiding principles of a restraint-free environment.

Chapter page reference: 96

Heading: Use of Restraints

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Analysis [Analyzing]

Concept: Safety

Difficulty: Moderate

  Feedback
1 Use of more medications would mean that the environment might not be free of chemical restraints.
2 Evidence never did support that falls are prevented by restraints.
3 Needing more staff in restraint-free environments has not been proven.
4 Without the option of restraints, nurses are often more creative in their approaches to patient care.

 

 

PTS:   1                    CON:  Safety

 

  1. ANS:  1

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 1. Compare and contrast the terms legal and ethical.

Chapter page reference: 91

Heading: Ethics

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Application [Applying]

Concept: Ethics

Difficulty: Moderate

  Feedback
1 Ethics and ethical care require that the nurse explore values and beliefs that are self-important.
2 Ethical care is not practicing outside of the facility’s policies and procedures.
3 Ethical care is not practicing outside of the legal scope of practical nursing practice.
4 Ethical care is not compromising the rights of residents.

 

 

PTS:   1                    CON:  Ethics

 

  1. ANS:  4

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 2. Define the term liability and discuss the impact it can have on your career.

Chapter page reference: 92

Heading: The Law

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Legal

Difficulty:  Easy

  Feedback
1 Facility procedure outlines legally define the practice of the LPN.
2 The State Nurse Practice Act legally defines the practice of the LPN.
3 Facility nursing care policies legally define the practice of the LPN.
4 Experience is not a legal justification for practice.

 

 

PTS:   1                    CON:  Legal

 

  1. ANS:  1

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 2. Define the term liability and discuss the impact it can have on your career.

Chapter page reference: 95

Heading: Acts of Negligence, Malpractice, and Omission

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Legal

Difficulty:  Easy

  Feedback
1 Omission is not doing something that is ordered or normally expected as part of nursing care, such as unclamping a catheter.
2 Changing a resident’s diet to increase fiber is not an act of omission.
3 Refusing to sign off on a medication that was not given is not an act of omission.
4 Adjusting a dosage schedule of an antibiotic that the pharmacy delivered late is not an act of omission.

 

 

PTS:   1                    CON:  Legal

 

  1. ANS:  3

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 2. Define the term liability and discuss the impact it can have on your career.

Chapter page reference: 94

Heading: Acts of Negligence, Malpractice, and Omission

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Legal

Difficulty:  Easy

  Feedback
1 Job descriptions are guidelines that assist the expert witness in defining care.
2 The Nurse Practice Act is a guideline that assists the expert witness in defining care.
3 Nurses who are expert witnesses define safe and prudent care.
4 The nurse’s credentials are guidelines that assists the expert witness in defining care.

 

 

PTS:   1                    CON:  Legal

 

  1. ANS:  4

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 3. Define the guiding principles of a restraint-free environment.

Chapter page reference: 96

Heading: Use of Restraints

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Application [Applying]

Concept: Legal; Safety

Difficulty:  Moderate

  Feedback
1 Discussing safer methods of restraining residents is a component of initiating change but is less successful if the staff, residents, and families do not understand the underlying philosophy of restraint-free environments.
2 Educating the residents and families regarding restraint-free principles is a component of initiating change but is less successful if the staff, residents, and families do not understand the underlying philosophy of restraint-free environments.
3 Providing in-service training of nursing staff about restraint policies and procedures is a component of initiating change but is less successful if the staff, residents, and families do not understand the underlying philosophy of restraint-free environments.
4 Education is important to support the staff’s understanding of the philosophy behind releasing restraints.

 

 

PTS:   1                    CON:  Legal | Safety

 

  1. ANS:  4

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 4. Outline the role of the licensed practical nurse (LPN) in using advanced directives and informed consent.

Chapter page reference: 96

Heading: Informed Consent

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Legal; Safety

Difficulty:  Easy

  Feedback
1 The resident’s right to refuse treatment is part of the Patient Care Partnership.
2 Signing a release before all treatments may be required by individual facilities.
3 Exempting personnel from lawsuits if something goes wrong during a procedure is not a part of informed consent.
4 Informed consent implies that the resident has all of the information necessary to make informed decisions regarding his or her care.

 

 

PTS:   1                    CON:  Legal | Safety

 

  1. ANS:  3

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 4. Outline the role of the licensed practical nurse (LPN) in using advanced directives and informed consent.

Chapter page reference: 98

Heading: Elder Abuse

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity

Cognitive level: Comprehension [Understanding]

Concept: Violence; Legal; Safety

Difficulty:  Easy

  Feedback
1 Reviewing the care of other residents may be required by the facility.
2 Documenting and investigating the incident may be required by the facility.
3 Elder abuse must be reported whenever it is suspected.
4 Discussing suspicions at the next interdisciplinary team meeting may be required by the facility.

 

 

PTS:   1                    CON:  Violence | Legal | Safety

 

  1. ANS:  3

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 4. Outline the role of the licensed practical nurse (LPN) in using advanced directives and informed consent.

Chapter page reference: 98

Heading: Elder Abuse

Integrated Processes: Nursing Process: Assessment

Client Need: Psychosocial Integrity

Cognitive level: Comprehension [Understanding]

Concept: Violence; Legal; Safety

Difficulty:  Easy

  Feedback
1 Privately paid caregivers are not the abusers in most cases of elder abuse.
2 Long-term care facility employees are not the abusers in most cases of elder abuse.
3 Anyone who cares for an older adult is the abuser in most cases of elder abuse.
4 Family members who are living with the older adult are not the abusers in most cases of elder abuse.

 

 

PTS:   1                    CON:  Violence | Legal | Safety

 

  1. ANS:  3

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 4. Outline the role of the licensed practical nurse (LPN) in using advanced directives and informed consent.

Chapter page reference: 98

Heading: Elder Abuse

Integrated Processes: Nursing Process: Assessment

Client Need: Psychosocial Integrity

Cognitive level: Comprehension [Understanding]

Concept: Violence; Legal; Safety

Difficulty:  Easy

  Feedback
1 This is not a reason why elder abuse is not reported.
2 It is a felony to abuse a competent adult.
3 Individuals are often unwilling or unable to report their abuse to the authorities or family members.
4 Families of elderly abuse victims are aware that their actions are inappropriate.

 

 

PTS:   1                    CON:  Violence | Legal | Safety

 

  1. ANS:  2

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 5. Express an understanding of the ethical responsibility of working with older adults in meeting their sexual needs.

Chapter page reference: 100

Heading: Providing for Intimacy Needs

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity

Cognitive level: Application [Applying]

Concept: Sexuality

Difficulty:  Moderate

  Feedback
1 Asking if the husband will miss the wife is a prejudiced response.
2 Recognizing that this was a difficult decision for the resident to make is the only one that acknowledges the resident’s right to choose what she believes would be best for her care.
3 Asking the husband for permission is a prejudiced response.
4 Saying that this is against facility policy does not acknowledge that situations could arise that would make it difficult for them to room together.

 

 

PTS:   1                    CON:  Sexuality

 

  1. ANS:  4

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 5. Express an understanding of the ethical responsibility of working with older adults in meeting their sexual needs.

Chapter page reference: 100

Heading: Providing for Intimacy Needs

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity

Cognitive level: Application [Applying]

Concept: Sexuality

Difficulty:  Moderate

  Feedback
1 The right to use touch to express sexual feelings may be appropriate statements if the rights of all residents and employees are considered.
2 The right to have access to opportunities for sexual expression may be appropriate statements if the rights of all residents and employees are considered.
3 The right to engage in sexual relationships with other residents may be appropriate statements if the rights of all residents and employees are considered.
4 Sexuality and sexual expression are appropriate if they do not infringe on the rights of others.

 

 

PTS:   1                    CON:  Sexuality

 

  1. ANS:  3

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 3. Define the guiding principles of a restraint-free environment.

Chapter page reference: 95

Heading: Use of Restraints

Integrated Processes: Nursing Process: Assessment

Client Need: Psychosocial Integrity

Cognitive level: Knowledge [Remembering]

Concept: Legal; Safety

Difficulty:  Easy

  Feedback
1 Physical restraints include leg restraints, hand mitts, bed rails, or soft ties.
2 They restrict free movement and restrict access to one’s body.
3 By definition, physical restraints cannot be removed easily by the resident.
4 They include anything attached to the body that cannot be easily removed by the person.

 

 

PTS:   1                    CON:  Legal | Safety

 

  1. ANS:  2

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 3. Define the guiding principles of a restraint-free environment.

Chapter page reference: 94

Heading: Acts of Negligence, Malpractice, and Omission

Integrated Processes: Nursing Process: Assessment

Client Need: Psychosocial Integrity

Cognitive level: Analysis [Analyzing]

Concept: Legal; Safety

Difficulty:  Moderate

  Feedback
1 Nothing was omitted in the care of the resident.
2 The LPN was negligent in not assessing the resident more frequently. The CNA was guilty of imprisoning a patient.
3 The LPN should have been aware of everything going on with an assigned resident.
4 A DNR order has nothing to do with this situation.

 

 

PTS:   1                    CON:  Legal | Safety

 

  1. ANS:  4

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 3. Define the guiding principles of a restraint-free environment.

Chapter page reference: 95

Heading: Use of Restraints

Integrated Processes: Nursing Process: Assessment

Client Need: Psychosocial Integrity

Cognitive level: Analysis [Analyzing]

Concept: Legal; Safety

Difficulty:  Moderate

  Feedback
1 While the restraints are on the patient, the nurse must remove the restraints periodically.
2 While the restraints are on the patient, the nurse must assist with range-of-motion exercises.
3 While the restraints are on the patient, the nurse must monitor the patient closely and observe for skin irritations.
4 The nurse cannot refuse to obey the physician’s orders. After placing the restraints on the patient as ordered, the nurse may discuss the situation with the supervisor or IDT if he or she seriously disagrees with the physician’s assessment.

 

 

PTS:   1                    CON:  Legal | Safety

 

  1. ANS:  4

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 6. Explain the HIPAA law and the significance it has for your nursing practice.

Chapter page reference: 100

Heading: Confidentiality

Integrated Processes: Nursing Process: Assessment

Client Need: Psychosocial Integrity

Cognitive level: Knowledge [Remembering]

Concept: Legal

Difficulty:  Easy

  Feedback
1 The Patient Care Partnership summarizes the rights of a patient, but is not specifically aimed at guarding privacy.
2 The Patient Self-Determination Act requires that patients be asked if they have living wills, have given someone durable power of attorney, or have advance directives in place.
3 OBRA monitors many aspects of care, including the use of restraints.
4 HIPAA, enacted in April 2003, includes regulations specifically focused on patient privacy. It is a federal law binding in all states.

 

 

PTS:   1                    CON:  Legal

 

  1. ANS:  1

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 3. Define the guiding principles of a restraint-free environment.

Chapter page reference: 96

Heading: Use of Restraints

Integrated Processes: Nursing Process: Assessment

Client Need: Psychosocial Integrity

Cognitive level: Knowledge [Remembering]

Concept: Legal; Safety

Difficulty:  Easy

  Feedback
1 Restraints tend to depersonalize care and result in a paternalistic or controlling attitude toward the patient.
2 Restraints often reduce functional capacity.
3 Restraints can result in injuries when trying to get free of the restraint.
4 Restraints can cause problems with body systems because of immobility.

 

 

PTS:   1                    CON:  Legal | Safety

 

  1. ANS:  4

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 1. Compare and contrast the terms legal and ethical.

Chapter page reference: 92

Heading: The Law

Integrated Processes: Nursing Process: Planning

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Application [Applying]

Concept: Legal

Difficulty:  Moderate

 

  Feedback
1 The nurse needs to adhere to the licensure requirements for New York and Pennsylvania in addition to Ohio.
2 The nurse needs to adhere to the licensure requirements for Ohio and Pennsylvania in addition to New York.
3 The nurse needs to adhere to the licensure requirements for Ohio and New York in addition to Pennsylvania.
4 Nurse practice acts differ from state to state, so if practicing in more than one state, the nurse needs to know the differences.

 

 

PTS:   1                    CON:  Legal

 

  1. ANS:  3

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 2. Define the term liability and discuss the impact it can have on your career.

Chapter page reference: 93

Heading: The Law

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive level: Application [Applying]

Concept: Legal

Difficulty:  Moderate

  Feedback
1 The CNA is not a member of the chain of command.
2 The physician is not identified as being a member of the chain of command.
3 If any situation is present that could cause a medical or nursing error the nurse needs to work through the chain of command until the problem is solved. This means starting with the charge nurse.
4 If the situation is not resolved, the nurse should see the nurse manager and then finally the administrator. The administrator is not contacted first.

 

 

PTS:   1                    CON:  Legal

 

  1. ANS:  4

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 3. Define the guiding principles of a restraint-free environment.

Chapter page reference: 95

Heading: Use of Restraints

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive level: Application [Applying]

Concept: Legal

Difficulty:  Moderate

  Feedback
1 Anything restricting a person’s movement is considered a restraint.
2 Removing the tray is not sufficient. The geriatric chair is considered a restraint.
3 There is not enough information to determine if the resident is able to be ambulated.
4 The legal system considers the use of restraints, as well as the threat of using restraints, as unlawful imprisonment. Anything that restricts a person’s movement is considered a restraint. These items include wheelchairs with trays and geriatric chairs. The resident should be transferred to another chair.

 

 

PTS:   1                    CON:  Legal

 

  1. ANS:  4

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 4. Outline the role of the licensed practical nurse (LPN) in using advanced directives and informed consent.

Chapter page reference: 97

Heading: Informed Consent and Advance Directives

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive level: Application [Applying]

Concept: Legal

Difficulty:  Moderate

  Feedback
1 The resident has occasional delirium and may not recall or remember information to obtain a legal consent.
2 The physician cannot sign a consent form for a resident’s procedure.
3 The family attorney cannot sign a consent form for a resident unless the attorney is the medical power of attorney.
4 Some older adults have a medical power of attorney entrusted to a family member or friend. If so, that is the person who should understand the procedure and sign the consent form.

 

 

PTS:   1                    CON:  Legal

 

  1. ANS:  3

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 4. Outline the role of the licensed practical nurse (LPN) in using advanced directives and informed consent.

Chapter page reference: 97

Heading: Informed Consent and Advance Directives

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive level: Knowledge [Remembering]

Concept: Legal

Difficulty:  Easy

  Feedback
1 The primary objective of the advance directive is not to reduce the cost of care.
2 The primary objective of the advance directive is not to restrict the utilization of resources.
3 The primary objective of the advance directive is to follow the wishes of the person who wrote it.
4 The primary objective of the advance directive is not to calm the family’s fears and concerns.

 

 

PTS:   1                    CON:  Legal

 

  1. ANS:  3

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 4. Outline the role of the licensed practical nurse (LPN) in using advanced directives and informed consent.

Chapter page reference: 98

Heading: Elder Abuse

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive level: Knowledge [Remembering]

Concept: Legal

Difficulty:  Easy

  Feedback
1 Negligence is not the most extreme expression of ageism.
2 Malpractice is not the most extreme expression of ageism.
3 Elder abuse is the most extreme and destructive form of ageism that can be demonstrated.
4 False imprisonment, something that can occur with the use of restraints, is not the most extreme expression of ageism.

 

 

PTS:   1                    CON:  Legal

 

  1. ANS:  3

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 5. Express an understanding of the ethical responsibility of working with older adults in meeting their sexual needs.

Chapter page reference: 99

Heading: Providing for Intimacy Needs

Integrated Processes: Nursing Process: Implementation

Client Need: Psychosocial Integrity

Cognitive level: Application [Applying]

Concept: Sexuality

Difficulty:  Moderate

  Feedback
1 Ignoring the action and completing the bath does not provide for the resident’s privacy.
2 Asking the resident to stop the action implies that the action is inappropriate, which it is not.
3 Leaving the resident to complete the action in private is appropriate.
4 Standing and waiting for the resident to complete the action is inappropriate and does not provide for the resident’s privacy.

 

 

PTS:   1                    CON:  Sexuality

 

  1. ANS:  4

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 6. Explain the HIPAA law and the significance it has for your nursing practice.

Chapter page reference: 100

Heading: Confidentiality

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Application [Applying]

Concept: Legal

Difficulty:  Moderate

  Feedback
1 Doing nothing promotes violations of the resident’s privacy.
2 Participating in the discussion promotes a violation of the resident’s privacy.
3 Listening to what they have to say promotes a violation of the resident’s privacy.
4 Reminding them that the information is confidential is adhering to the HIPAA law.

 

 

PTS:   1                    CON:  Legal

 

MULTIPLE RESPONSE

 

  1. ANS:  1, 2, 4, 5
  Feedback
1. The Patient Care Partnership document covers billing and collection policies.
2. The Patient Care Partnership document stresses access to health care and coverage.
3. The Patient Care Partnership document does not address staffing ratios.
4. The Patient Care Partnership document is clear in not allowing racial or ethnic disparities.
5. The Patient Care Partnership document defines the right of every person to be a partner in health-care decisions and delivery.

 

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 1. Compare and contrast the terms legal and ethical.

Chapter page reference: 91

Heading: Patient Care Partnership

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Legal

Difficulty: Easy

 

PTS:   1                    CON:  Legal

 

  1. ANS:  1, 2, 4
  Feedback
1. The Patient Self-Determination Act of 1990 requires asking people if they have living wills.
2. The Patient Self-Determination Act of 1990 requires asking people if they have advance directives.
3. The Patient Self-Determination Act of 1990 does not require asking people if they have an executor of their will identified.
4. The Patient Self-Determination Act of 1990 requires asking people if they have a durable power of attorney.
5. The Patient Self-Determination Act of 1990 does not require asking if the resident will sign the consent to treatment form.

 

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 1. Compare and contrast the terms legal and ethical.

Chapter page reference: 93

Heading: The Law

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Application [Applying]

Concept: Legal

Difficulty: Moderate

 

PTS:   1                    CON:  Legal

 

  1. ANS:  1, 2, 4, 5
  Feedback
1. The risk of liability increases when practicing beyond the scope of the Nurse Practice Act.
2. The risk of liability increases when working when physically or emotionally exhausted.
3. The risk of liability is not increased when documenting assessment findings.
4. The risk of liability increases when not having the necessary equipment available to meet resident needs.
5. The risk of liability increases when not following the policies and procedures of the facility.

 

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 2. Define the term liability and discuss the impact it can have on your career.

Chapter page reference: 93

Heading: Legal Liability

Integrated Processes: Nursing Process: Evaluation

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive level: Analysis [Analyzing]

Concept: Legal; Safety

Difficulty: Moderate

 

PTS:   1                    CON:  Legal |Safety

 

  1. ANS:  2, 3, 4
  Feedback
1. Age of the CNAs is not information to consider when delegating.
2. It is important to delegate only those tasks that an individual has the knowledge to perform.
3. It is important to delegate only those tasks that an individual has the knowledge to perform.
4. It is important to delegate only those tasks that an individual has the license or certification to perform.
5. The shift that the CNAs are working is not information to consider when delegating.

 

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 2. Define the term liability and discuss the impact it can have on your career.

Chapter page reference: 93

Heading: Legal Liability

Integrated Processes: Nursing Process: Planning

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive level: Application [Applying]

Concept: Legal; Safety

Difficulty: Moderate

 

PTS:   1                    CON:  Legal |Safety

 

  1. ANS:  1, 2, 4, 5
  Feedback
1. A prudent, responsible nurse is a professional who renews nursing knowledge by attending seminars and workshops.
2. A prudent, responsible nurse is someone who is wise about his or her actions.
3. Applying for re-licensure is not a characteristic of a prudent, responsible nurse.
4. A prudent, responsible nurse is a professional who renews nursing knowledge by reading.
5. A prudent, responsible nurse is someone who is careful about his or her actions.

 

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 2. Define the term liability and discuss the impact it can have on your career.

Chapter page reference: 94

Heading: Acts of Negligence, Malpractice, and Omission

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive level: Comprehension [Understanding]

Concept: Legal; Safety

Difficulty: Easy

 

PTS:   1                    CON:  Legal |Safety

 

  1. ANS:  2, 3, 5
  Feedback
1. Hiring sitters is not identified as a method to monitor residents who have a tendency to wander.
2. There are numerous devices available to assist with the problem of resident wandering, including alarmed doors.
3. There are numerous devices available to assist with the problem of resident wandering, including bed alarm pads.
4. Locking the resident’s room door is a form of imprisonment and inappropriate for the resident who has a tendency to wander.
5. There are numerous devices available to assist with the problem of resident wandering, including wristband alarms.

 

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 3. Define the guiding principles of a restraint-free environment.

Chapter page reference: 96

Heading: Use of Restraints

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Safety and Infection Control

Cognitive level: Comprehension [Understanding]

Concept: Legal; Safety

Difficulty: Easy

 

PTS:   1                    CON:  Legal |Safety

 

  1. ANS:  1, 2, 3, 5
  Feedback
1. A health-care proxy is a written document prepared by a competent person giving permission for someone to make health decisions on his or her behalf under certain conditions. This document should include clear instructions about the patient’s wishes regarding feeding tubes.
2. A health-care proxy is a written document prepared by a competent person giving permission for someone to make health decisions on his or her behalf under certain conditions. This document should include clear instructions about the patient’s wishes regarding medications.
3. A health-care proxy is a written document prepared by a competent person giving permission for someone to make health decisions on his or her behalf under certain conditions. This document should include clear instructions about the patient’s wishes regarding resuscitation.
4. A health-care proxy is a written document prepared by a competent person giving permission for someone to make health decisions on his or her behalf under certain conditions. It does not identify the location of the resident’s will in the home.
5 A health-care proxy is a written document prepared by a competent person giving permission for someone to make health decisions on his or her behalf under certain conditions. This document should include clear instructions about the patient’s wishes regarding mechanical ventilation.

 

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 4. Outline the role of the licensed practical nurse (LPN) in using advanced directives and informed consent.

Chapter page reference: 97

Heading: Informed Consent and Advance Directives

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Comprehension [Understanding]

Concept: Legal

Difficulty:  Easy

 

PTS:   1                    CON:  Legal

 

  1. ANS:  2, 3, 4
  Feedback
1. There are no premiums for Part A and coverage is automatic for anyone age 65 or older who is eligible for Social Security retirement benefits.
2. Seniors may choose to join Part B and must pay monthly premiums to be enrolled.
3. Part C offers seniors a choice. If they wish, they can join a private health maintenance organization (HMO) or other managed care plan (called a Medicare Advantage plan) that replaces the other three parts. Many seniors have chosen to do this because they feel the Advantage plans offer better coverage at lower premiums.
4. Those who wish to enroll in Part D must pay monthly premiums.
5 Medicare does not have a Part E.

 

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 7. Compare and contrast Medicare and Medicaid.

Chapter page reference: 101

Heading: Financial Considerations

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Economics

Difficulty:  Easy

 

PTS:   1                    CON:  Economics

 

  1. ANS:  1, 2, 5
  Feedback
1. Medicaid includes acute care.
2. Medicaid includes long-term care.
3. Medicaid does not have a monthly premium.
4. Medicaid does not have substantial co-payments.
5 Medicaid is the largest payer for skilled care.

 

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 7. Compare and contrast Medicare and Medicaid.

Chapter page reference: 101

Heading: Financial Considerations

Integrated Processes: Nursing Process: Implementation

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Application [Applying]

Concept: Economics

Difficulty:  Moderate

 

PTS:   1                    CON:  Economics

 

  1. ANS:  3, 4
  Feedback
1. Co-payments were not increased because of the ACA.
2. Deductibles for office visits were not added because of the ACA.
3. More preventive services were added with the ACA.
4. The cost of prescription drugs was reduced with the ACA.
5 The number of skilled care days was not limited because of the ACA.

 

Chapter number and title: Chapter 5: Legal, Ethical, and Financial Considerations Regarding Older Adults

Chapter/learning objective: 7. Compare and contrast Medicare and Medicaid.

Chapter page reference: 101

Heading: Financial Considerations

Integrated Processes: Nursing Process: Assessment

Client Need: Safe and Effective Care Environment: Coordinated Care

Cognitive level: Knowledge [Remembering]

Concept: Economics

Difficulty: Easy

 

PTS:   1                    CON:  Economics

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