Chapter 03 Legal and Ethical Issues

Chapter 03  Legal and Ethical Issues

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A nurse caring for older adult patients shows an understanding of the implementation of standards of care when:
a.
dialing the telephone when the patient wants to call his daughter.
b.
requesting the patient’s favorite dessert on his birthday.
c.
closing the patient’s door when he is praying.
d.
reminding the patient to call for assistance before getting out of bed.

ANS: D
A standard of care is a guideline for nursing practice and establishes an expectation for the nurse to provide safe and appropriate care, such as reminding the patient to call for assistance before getting out of bed. Standards of care may be established on national or regional levels. Dialing the phone for the patient, closing the patient’s door, and requesting a special dessert are not actions that conform to standards of care.

DIF: Applying (Application) REF: N/A OBJ: 3-1
TOP: Nursing Process: Implementation MSC: Safe and Effective Care Environment

2. A nurse new to geriatric nursing asks the nurse manager to clarify how to handle a patient’s claim that she has been physically abused. The nurse manager responds most appropriately when stating:
a.
“I’ll show you where you can find this state’s reporting requirements.”
b.
“As a nurse you are considered a ‘mandated reporter’ of elder abuse.”
c.
“As long as you are reasonably sure abuse has occurred, report it.”
d.
“You need to report any such claims directly to me.”

ANS: A
To be responsive to the legal obligation to report reasonably suspicious acts of abuse and because there is great variation among the states, nurses should determine the specific reporting requirements of their jurisdictions, including where reports and complaints are received and in what form they must be made. The statements that the nurse is a mandatory reporter and that abuse should be reported if suspected are true, but they do not help the nurse learn to handle the complaint. The manager may want to know about claims of abuse and it may be facility policy to report up the chain of command, but the nurse is responsible for filing the formal complaint.

DIF: Applying (Application) REF: N/A OBJ: 3-8
TOP: Nursing Process: Implementation MSC: Safe and Effective Care Environment

3. The nurse recognizes that a nursing aide likely to abuse an older patient is one who has:
a.
ineffective verbal communication skills.
b.
little experience working with the older population.
c.
poor stress management skills.
d.
been a victim of abuse.

ANS: C
It has been shown that the primary abusers of nursing facility residents are nurse aides and orderlies who have never received training in stress management.

DIF: Remembering (Knowledge) REF: Page 32 OBJ: 3-8
TOP: Nursing Process: Assessment MSC: Safe and Effective Care Environment

4. An older adult resident of a long-term care nursing facility frequently attempts to get out of bed and is at risk of sustaining an injury. The nurse’s planned intervention to minimize the patient’s risk for injury is guided by:
a.
the patient’s right to self-determination and to be free to get out of bed.
b.
an understanding that nondrug interventions must be tried before medications.
c.
the knowledge that application of a vest restraint requires a physician’s order.
d.
the patient’s cognitive ability to understand and follow directions.

ANS: B
The drug use guidelines are based on the principles that certain problems can be handled with nondrug interventions and that such forms of treatment must be ruled out before drug therapy is initiated. The patient does have the right to self-determination, but the staff must ensure the patient’s safety. Vest restraints do require an order, but environmental measures must be tried before chemical or physical restraints. The patient’s cognitive abilities do not allow for unjustified physical or chemical restraints.

DIF: Remembering (Knowledge) REF: Page 35-6 OBJ: 3-7
TOP: Nursing Process: Implementation MSC: Safe and Effective Care Environment

5. During the state inspection of a skilled nursing facility, a surveyor notes suspicion that a particular nurse may not be providing the proper standard of care. The nurse manager informs the nurse to expect:
a.
a review of the situation by the state board of nursing.
b.
termination of employment from the facility.
c.
mandatory remediation related to the suspect care issues.
d.
unannounced reevaluation of performance within the next 3 months.

ANS: A
In such cases, the surveyor may forward the record showing the relevant findings to the appropriate state agency or board for review of the nurse’s practice, requesting a determination of whether the nurse may have violated the state’s nurse practice act. Regulations do not specify that the nurse be terminated, have remediation, or have an unannounced reevaluation.

DIF: Understanding (Comprehension) REF: Page 37 OBJ: 3-1
TOP: Communication and Documentation
MSC: Safe and Effective Care Environment