1. The primary purpose for regulating nursing practice is to protect:
a. The public
b. Practicing nurses
c. The employing agency
d. Professional standards
2. A client with coronary artery disease has a sudden episode of cyanosis and a change in respirations. The nurse starts oxygen administration immediately. In this situation:
a. Oxygen had not been ordered and therefore should not be administered
b. The nurse’s observations were sufficient to begin the administration of oxygen
c. The symptoms were too vague for the nurse to determine a need for oxygen
d. The physician should have been called for an order before oxygen was begun
3. A 15 year old is taken to the emergency department of the local hospital after stepping on a nail. The puncture wound is cleansed and a sterile dressing applied. The nurse asks if the client has been immunized against tetanus. The reply is affirmative. Penicillin is administered, and the client is sent home with instructions to return if there is any change in the wound area. A few days later, the client is admitted to the hospital with a diagnosis of tetanus. Legally the :
a. Nurse’s judgment was adequate in view of the client’s symptoms
b. Assessment by the nurse was incomplete and the treatment was inadequate
c. Nurse should routinely administer immunization against tetanus after such an injury
d. Possibility of tetanus could not have been foreseen, because the client had immunized
4. An example of an intentional tort would be:
a. Negligence
b. Malpractice
c. Breach of duty
d. False imprisonment
5. The spouse of a comatose client who has severe internal bleeding refuses to allow transfusions of whole blood because they are Johovah’s Witnesses. The nurse involved in this situation should:
a. Phone the physician for a special administrative order to give the blood under these circumstances
b. Have the spouse sign a treatment refusal form and notify the physician so that a court order can be obtained
c. Gently is necessary to the spouse why the transfusion is necessary
d. Institute the blood transfusion anyway, because the physician ordered it and the client’s survival depends on volume replacement
6. The best definition of a tort is:
a. The application of force to the person of another by a reasonable individual
b. An illegality committed by one person against the property or person of another
c. Doing something that a reasonable person under ordinary circumstances would not to do
d. An illegality committed against the public and punishable by the law through the court
Mr. Steven is a 70-year-old man with end-stage COPD, admitted last month with pneumonia. His course was complicated by respiratory failure needing mechanical ventilation, and multiple efforts to wean him have been unsuccessful. Awake and alert, he now communicates through written notes that he wants the ventilator taken off. Will you honor his request?
a. If the patient’s decision making capacity is intact, his request should be honored.
b. His request should not be honored.
c. The surrogate decision maker should make the final decision.
d. A court order is necessary because the outcome of taking him off the respirator is death certain
Mrs. Hanes is a 62-year-old woman with metastatic breast cancer. She was admitted with dehydration and weakness. Her cancer treatments have failed, as she now has a recurrence. The oncologists are contemplating some new palliative chemotherapy. The nutrition team is concerned about her cachexia and recommends total parenteral nutrition (TPN). Should the patient be started on TPN?
a. The patient should NOT be started on TPN.
b. The patient should be started on TPN.
c. The patient decides whether or not to be started on TPN after being fully informed about all the treatment choices and probable outcomes.
d. The treatment with TPN is “futile” in this patient and will serve no purpose.
A 65-year-old man comes to his physicians with complaints of abdominal pain that is persistent but not extreme. Workup reveals that he has metastatic cancer of the pancreas. The man has just retired from a busy professional career, and he and his wife of 40 years are about to leave on a round-the-world cruise that they've been planning for over a year. Should you tell him his diagnosis?
a. Withhold telling the man his diagnosis for fear of psychological harm.
b. The man should be told his diagnosis, prognosis, and treatment options before his planned trip.
c. It is best to wait until he returns from his trip before telling him the diagnosis.
d. Tell the wife the diagnosis, and let her decide when to inform the patient and her husband of 40 years.
The newly RN begins work on a hospital unit where RN are allowed to start intravenous fluids. The physician orders intravenous fluids to be started on one of this nurse's assigned clients. Which of the following actions would be most necessary on the part of this newly hired and newly licensed nurse before starting an intravenous on the client?
a. Check the hospital policy and check on any certification required.
b. Ask another nurse to do a supervised check on administering IVs.
c. Ask one of your nursing-school instructors to refresh your skills.
d. Take a continuing-education IV course to make sure you have the skills. |
2. When working as a RN, you determine that your client scheduled for surgery does not understand the physician's earlier explanation of the surgery. The client is asking many questions about the risks and seems worried. Which of the following actions would be best on your part?
a. Quickly explain the surgery procedures and the risks to the client.
b. Cancel the surgery.
c. Ask your supervising RN to explain the surgery procedure and its risks
d. Notify the physician.
3. Fidelity is:
a. Duty to do good: a nurse ought to prevent or remove harm and promote or do good
b. Neglience, malpractice, standards of practice
c. Client's right to self determination
d. Duty to maintain committments of professional obligation and responsiblity
4. Safeguarding the clients rights and supporting their interests: a. Duty to do no harm to a client b. Duty to be fair to all people regardless of age, sex, race and sexual orientation c. Advocacy d. Duty to maintain committments of professional obligation and responsibility |
5. Justice is:
a. Duty to do no harm to a client
b. Duty to be fair to all people regardless of age, sex, race and sexual orientation
c. Assault, battery, false imprisonment, invasion of privacy and defamation
d. Outcome oriented approach for decision making:"greatest good for the greatest number"
6. When the licensed practical/vocational nurse is checking the physician's orders against the medication record prior to setting up medications, the nurse discovers a medication error made on the previous shift. The nurse reports this error to the supervising nurse. Which of the following persons will need to fill out an incident report?
a. Licensed practical/vocational nurse who discovered the error
b. Licensed nurse who committed the medication error the previous shift
c. Supervising nurse who is in charge of the nursing care unit
d. Primary nurse assigned to this client the previous day
7. You are the nurse working with an elderly, competent client who refuses a vitamin B injection ordered by the physician. The family insists that this injection be given, and you give it while the client is objecting. Even though the client improves, the client contacts a lawyer. From your knowledge of nursing and the law, you realize that you:
a. Did the right thing because the client improved
b. Should have had the family put their request in writing
c. Have commited an assault against the client.
d. Have committed an act of battery against the client.
8. When documenting an assigned client's record during and at the end of the shift, the nurse must keep in mind which of the following facts?
a. In order to get the care done for all assigned clients, the charting must be as brief as possible.
b. The proper format, such as SOAP or PIE, as chosen by the hospital, must be adhered to.
c. The chart is a legal document and may be all a nurse has to support care that was given if called to court.
d. Clients need to be assessed and the care documented at least once every hour during the shift
9. Nonmaleficence is:
a. Duty to do no harm to a client
b. Duty to be fair to all people regardless of age, sex, race and sexual orientation
c. Rights are freedoms or actions to which individuals have a just moral or legal claim
d. Outcome oriented approach for decision making:"greatest good for the greatest number"
10. You are a student nurse working as a part-time or temporary nursing assistant in a nursing home. The nurse on duty asks you to insert NGT in a patient. You have recently passed an examination on putting in NGT. Which of the following actions is best on your part?
a. Go ahead and insert the nasogastric tube. |
b. Ask the nurse to supervise you while you insert the tube. |
c. Call your school instructor for help with your decision. |
d. Tell the nurse that you cannot legally insert this tube. |
11. Ulitilitarian: a. Outcome oriented approach for decision making:"greatest good for the greatest number" b. Duty to maintain committments of professional obligation and responsiblity |
c. Assault, battery, false imprisonment, invasion of privacy and defamation
d. Values
12. Deontologic or teleologic:
a. Assessment, diagnosis, outcome,planning, implementation and evaluation
b. Assault, battery, false imprisonment, invasion of privacy and defamation
c. Outcome oriented approach for decision making:"greatest good for the greatest number
d. Rights are freedoms or actions to which individuals have a just moral or legal claim
13. Veracity:
a. Advocacy
b. Outcome oriented approach for decision making:"greatest good for the greatest number"
c. Duty to do no harm to a client
d. To tell the truth
14. Safeguarding the clients rights and supporting their interests
a. Values
b. Advocacy
c. Duty to be fair to all people regardless of age, sex, race and sexual orientation
d. To tell the truth
15. Autonomy:
a. To tell the truth
b. Rights are freedoms or actions to which individuals have a just moral or legal claim
c. Duty to be fair to all people regardless of age, sex, race and sexual orientation
d. Client's right to self determination
16. According to the nursing code of ethics, when working as a nurse and a conflict comes up between your client's needs and what the family and/or the physician wants, and/or the hospital policies, your first loyalty is to the:
a. Hospital.
b. Client.
c. Family.
d. Physician
17. Consent may be implied, verbal or written; but to be lawful it must be:
a. Voluntary and freely given, with the understanding that it can be withdrawn at any time; consent obtained through threat or coercion would not meet this condition
b. Specific: only the act to which the patient has consented can be carried out
c. Given by a competent person. With some exceptions this means an adult (a person 18 years or over); who is able to understand the nature and effect of the proposed care, and make a choice in relation to that care
d. All of the above
18. Which of the following strategies can most help you as a nurse to enhance your ethical practice and client advocacy?
a. Reading a book on religions of the world
b. Examining and clarifying your own values
c. Talking with peers about their beliefs and values
d. Buying a nursing book on ethical decisions
19. The most relevant ethical principle to consent is:
a. The Mental Health Act
b. The Guardian and Administration Act
c. Respect for autonomy
d. All of the above
20. Researchers have a duty to avoid, prevent or minimize risk to study participants. This is based on the principle of:
a. Human rights
b. Non-maleficence
c. Beneficence
d. Justice
21. Which of the following is correct if a participant wishes to withdraw from a study?
a. Participation is voluntary and they can withdraw at any time
b. They must continue to participate as they have signed the consent form
c. Withdrawal from the study has to occur through the ethics committee
d. They may be able to withdraw if they negotiate with the research team
22. Researchers can ensure confidentiality by:
a. Using identification numbers or pseudonyms for participants
b. Not discussing participants in any data gathering with others
c. Keeping any identifying information separate from the data
d. All of the above
23. One of the requirements for informed consent is that the participant/s have been:
a. Told they have been selected because they meet the criteria for inclusion
b. Told they need to read the ethics proposal
c. Informed of the risks and benefits of the study
d. Informed the study has approval from administration
24. The principle underpinning voluntary and informed consent is:
a. Beneficence
b. Autonomy
c. Non-maleficence
d. Respect
25. You are invited to be a participant in a research study and have been given an information sheet about the study. Which of the following statements best includes the information you would expect to see included in this sheet?
a. A brief summary of the literature review, focus of the research and how the research will affect you
b. What the research is about, benefits and risks of the research and how your privacy will be respected
c. A brief summary of the literature review, how findings will be disseminated and a place to sign your consent
d. What the research is about, benefits of the study and how your privacy will be respected
26. If you collected data from a patient who had not been asked to give consent, which of the following principles would you have broken?
a. Autonomy and human rights
b. Beneficence and autonomy
c. Human rights and maleficence
d. Beneficence and dignity
27. An elderly woman told her daughters that if she ever ended up with dementia she wouldn't want to live like that. Years later she developed senile dementia and her daughters had her move into a nursing home. Although she did not recognize family or friends, she enjoyed the company of others and the nursing home's cat. When she stopped eating, her daughters were asked whether she should receive a feeding tube.
a. The daughters may approve the insertion of a feeding tube with the proviso that future triggers could lead to its removal or nonuse.
b. The daughters should consider their mother’s previously stated wishes as an advance directive and must not place a feeding tube.
c. The daughters cannot decide for their mother because of lack of both a power of attorney for health care and an advance directive.
d. Before placing a feeding tube, the daughters should obtain a court order.
a. What should the doctor do and say to the patient in response to this?2
a. The doctor should educate the patient about the near futility of CPR under these circumstances.
b. The doctor might want to ask the patient to explore this further with the chaplain.
c. The patient's expression of a preference should be explored to understand its origins.
d. All the above.
29. An elderly man with end-stage emphysema presents to the emergency room awake and alert and complaining of shortness of breath. An evaluation reveals that he has pneumonia. His condition deteriorates in the emergency room and he has impending respiratory failure, though he remains awake and alert. A copy of a signed and witnessed living will is in his chart stipulates that he wants no "invasive" medical procedures that would "serve only to prolong my death." No surrogate decision maker is available. Should mechanical ventilation be instituted?
a. The presence of a living will or other advance directive obviates the responsibility to involve a competent patient in medical decision making.
b. If the patient has remained awake and alert, his living will is irrelevant to medical decision making.
c. The potential risks and benefits of mechanical ventilation need not be presented to the patient because of the presence of a valid living will.
d. Even if the patient refuses mechanical ventilation therapy, his wishes need not be honored because he is in the emergency room.
30. Jose is a 62-year-old man who just had a needle biopsy of the pancreas showing adenocarcinoma. You run into his brother in the hall, and he begs you not to tell Jose because the knowledge would kill him even faster. A family conference to discuss the prognosis is already scheduled for later that afternoon. What is the best way for the doctor to handle the situation?
a. The doctor should honor the request of the family member who is protecting his beloved brother from the bad news.
b. The doctor should tell Jose's brother that withholding information is not permitted under any circumstance.
c. Jose should withhold informing the patient about the pancreatic cancer because of the grave diagnosis.
d. The doctor should ask Jose how he wants to handle the information in front of the rest of the family, and allow for some family discussion time for this matter.
31. An 80-year-old Asian woman is hospitalized with weight loss, generalized weakness, and a pulmonary mass. Work-up reveals that she has pulmonary tuberculosis. Her family approaches the physician and asks that the patient not be told, stating that in her upbringing in mainland China
Should you respect the family's concerns?
a. The doctor should explore the patient's belief system then decide accordingly whether or not to inform the patient.
b. The doctor should respect and follow the family’s request.
c. The physician has a duty to inform the patient and the Department of Public Health about the diagnosis.
d. It would be justifiable in this case to withhold the diagnosis of tuberculosis based on cultural beliefs.
a. The medical student should follow the protocol for breaking bad news because it covers everything.
b. The medical student should tell Sara about the advanced HIV and the need for blood tests and not be concerned about provoking a reaction.
c. The medical student should get another perspective perhaps from someone in clinic who has known Sara before breaking the bad news.
d. None of the above.
What should you do as the team physician?
a. I should wait to hear from the family physician.
b. I should honor the mother’s request in this situation.
c. I should arrange promptly a care conference with both the mother and the family's naturopathic physician to discuss the chemotherapy.
d. If chemotherapy offers a clear and compelling survival benefit as the only hope this child has, and the mother refuses treatment, I am professionally obligated to seek a court order to appoint a guardian for the child.
34. Your 36-year-old patient has just tested positive for HIV. He asks that you not inform his wife of the results and claims he is not ready to tell her yet.
What would you say to your patient?
a. Encourage the patient to share the information with his wife on his own, giving him a bit more time if necessary.
b. Tell the patient that his wife is at serious risk for being infected with HIV, and that you have a duty to ensure that she knows of the risk.
c. Tell the patient that public health law requires reporting both the patient and any known sexual partners to local health officers.
d. All the above.
a. This is a case of elder abuse and the doctor is required to always report incidents of abuse to the authorities.
b. The doctor is not permitted under HIPAA (Health Insurance Portability and Accountability Act) to report the abuse.
c. The laws supporting reporting elder abuse allow the doctor to break confidentiality and report suspected abuse.
d. The patient should not be reported. Instead, she should obtain support and access to other services in order to maintain her primary caregiver.
What are you required to do legally?
a. The doctor should inform the wife about her husband’s poor prognosis.
b. The doctor is should not divulge the prognosis to the wife, but he should ask the nurse to let the wife know about her husband’s condition.
c. The wife is certainly affected by her husband's health and prognosis and every effort should be made to encourage an open dialogue between them.
d. The doctor should not encourage the patient to talk to his wife about his condition.
37. Which of the following is NOT an underlying goal of ethics committees?
a. To promote the rights of patients;
b. To promote shared decision making between patients (or their surrogates if decisionally incapacitated) and their clinicians;
c. To promote fair policies and procedures that maximize the likelihood of achieving good, patient-centered outcomes; and
d. To improve the public perception of health care professionals and health care institutions.
How should the physician handle this?
a. The physician should do what the parents request to take the child home.
b. The physician should call the parent’s religious leader and have him come to the hospital before providing standard medical therapy.
c. The physician has no duty to provide treatment to the child when the parents refuse treatment.
d. When efforts to obtain parental permission to treat the patient fail, the physician is justified in seeking legal help or may be legally authorized to proceed with the procedure and treatment of the child.
39. Mr. H is a 24-year-old man who resides in a skilled nursing facility, where he is undergoing rehabilitation from a cervical spine injury. The injury left him quadriplegic. He has normal cognitive function and no problems with respiration. He is admitted to your service for treatment of pneumonia. The resident suggests antibiotics, chest physiotherapy, and hydration. One day while signing out Mr. H to the cross covering intern, the intern says "he should be a DNR, based on medical futility." How would you respond to the intern?
a. The patient should be a DNR because in this case CPR offers no chance of meaningful benefit to the patient and the probability of success is <1%.
b. The patient should NOT be a DNR based on medical futility.
c. The patient should be a DNR because even if the CPR is successful, his quality of life is below the minimum acceptable based on his quadriplegia and his pneumonia.
d. The patient should be a DNR because his quality of life is without value.
40. Mrs. W is an 81-year-old woman with recurrent colon cancer with liver metastases admitted to the hospital for chemotherapy. Because of her poor prognosis, you approach her about a DNR order, but she requests to be "a full code." Can you write a DNR order anyway?
a. No, because the patient requested “a full code.”
b. Yes, because Mrs. W is elderly, has a diagnosis of recurrent metastatic cancer, and the chance of a successful DNR is 0%.
c. No, because the CPR for Mrs. W and in her condition could not be called "futile."
d. Yes, because hospital policy allows doctors to write a DNR in this situation.
41. Mrs. W is an 81-year-old woman with recurrent colon cancer with liver metastases admitted to the hospital for chemotherapy. Mrs. W still wants to be a "full code." Your intern suggests that you sign her out as a "slow code." Should you do this?
a. Yes, because slow codes are ethically justifiable.
b. Yes, because the "slow code" allows the appearance of respecting the patient's desire for CPR.
c. No, because the slow code is not actually complying with the request for a “full code” and is ethically unjustifiable.
d. No, because slow codes are illegal.
a. Call the local medicine man before proceeding with treatment of the leg fracture.
b. The emergency room medical doctor is under no obligation to communicate with a medicine man about the patient’s leg fracture.
c. Tell the patient that he will not call his medicine man.
d. Because the patient came to the emergency room, the doctor is allowed to begin treatment then call the medicine man.
Should you honor the family's request?
a. The request must be honored because the family members insisted to do “everything possible”.
b. The request should be honored because of absence of a court order to withhold treatment.
c. The request should NOT be honored because it is unreasonable.
d. The request need NOT be honored if the doctor and the members of the health care team agree that the interventions in question requested by the family would be futile.
What would you NOT do in this situation?
a. Recommend induction of labor at term because it is an intervention with demonstrated efficacy and carries low risk to the mother.
b. Inform the mother that the fetus may sustain serious damage.
c. Make effort to persuade the mother to change her mind.
d. To benefit the fetus, disregard the maternal refusal for therapy and induce labor.
45. An 18-month-old child presents to the clinic with a runny nose. Since she is otherwise well, the immunizations due at 18 months are administered. After she and her mother leave the clinic, you realize that the patient was in the clinic the week before and had also received immunizations then.
Should you tell the parents about your mistake?
a. No because the error is a trivial one.
b. No because no harm is done.
c. No because the mother will never find out.
d. Yes because an open and honest approach to errors is most appropriate.
What is your duty here?
a. Inform the parents about the mistake and say you are sorry.
b. Do not inform the parents.
c. Do not say sorry.
d. Let the liability insurance company handle everything, because a malpractice lawsuit may follow.
a. No. The parents must consent first.
b. The Baby-sitter’s permission would be sufficient without the parent’s consent.
c. Because the parents can not be reached, the doctor should first obtain a court order before treating the infant.
d. The doctor should proceed with x-rays and treatment of the child’s fractured forearm without the consent.
Is the team's judgment appropriate in this case?
a. The team's judgment is appropriate in this case.
b. If the patient consents to the heart valve replacement, it should be done because it is not “futile”.
c. If the patient can pay for the heart valve replacement, it should be done.
d. Replacing the heart valve is “futile”.
49. On a busy night in the ER a member of the hospital board comes in with her sick child and asks that you see him right away. The child has a sore throat and red eye and he appears subdued, but alert. You have a full waiting room. What should you do?
a. The ER doctor should see the sick child right away.
b. The ER doctor should call the Chief of Staff and ask what to do.
c. The ER doctor should call the Hospital Administrator and ask what to do.
d. As with the other people waiting in the ER, the sick child should be subject to triage criteria based on medical need.
50. Ethics is a branch of philosophy, and can be described as moral philosophy. However, in health care, not only may the term ethics be used, but also terms such as bioethics, medical ethics, nursing ethics and psychiatric ethics. That is, ethics may be further specified by a health discipline and an area of practice.
Describing ethics in these ways may represent a number of things. For example, the terms may be used to show that:
Describing ethics in these ways may represent a number of things. For example, the terms may be used to show that:
a. health disciplines have different approaches to moral issues in their practice because of the particular values or focus of the health discipline
b. the discipline’s scope of practice involves particular ethical issues
c. An area of practice (such as psychiatry or mental health), entails particular ethical issues
d. All of the above
7. A client is placed on a stretcher and restrained with straps while being transported to the x-ray department. A strap breaks, and the client falls to the floor, sustaining a fractured arm. Later the client states, “the strap was worn just at the very spot where it snapped: The nurse is:
a. Exempt from any lawsuit because of the doctrine of respondeat supervisor
b. Totally and singly responsible for the obvious negligence because of failure to report defective equipment
c. Liable, along with the employer, the misapplication of equipment or use of defective equipment that harms the client
d. Completely exonerated, because only the hospital, as principal employer is primarily responsible for the quality and maintenance of equipment
8. A 2 year old child is admitted with a diagnosis of pneumonia & on antibiotics, fluid & oxygen. The child’s temperature rises until it reaches 39C. The nurse calls the physician at the mother’s request, but the physician sees no need to change treatment, even thought the child ha history of convulsions during previous periods of a high fever. Although concerned, the nurse takes no further action. Later the child has a convulsion that results in neurologic impairment. Legally:
a. The physician’s decision takes precedence over the nurse’s concern
b. The nurse’s failure to further question the physician placed the child at risk
c. The physician is totally responsible for the client’s health history and treatment regimen
d. High temperatures are common in children, and the situation presented little cause for undue concern
9. When teaching about child abuse, the nurse tells a parent group that the best legal definition of assault is:
a. Threats to do bodily harm to another person
b. The application of force to another person with out a lawful justification
c. A legal wrong committed against the property of another
d. A legal wrong committed against the public & punishable by law through the state & courts.
10. When obtaining consent for surgery, the nurse should initially:
a. Explain the risks involved in the surgery
b. Explain that obtaining the signature is routine for any surgery
c. Evaluate whether the client’s knowledge level is sufficient to give consent
d. Witness the signature because this is what the nurse’s signature documents
11. A client who has been told she needs a hysterectomy for cervical cancer is upset about being unable to have children. The nurse should:
a. Evaluate her willingness to persue adoption
b. Encourage her to focus on her own recovery
c. Emphasize that she does have two children already
d. Ensure that all treatment options have been explored
12. The family of an older adult who is aphasic complains that the nurse failed to obtain a signed consent before inserting an indwelling catheter to measure hourly output. This is an example of:
a. A treatment that does not need a separate consent form
b. A catheter inserted for the client’s benefit, so consent is unnecessary
c. Treatment without consent of the client, which is an invasion of rights
d. Inability to obtain consent for treatment because the client was aphasic
13. Integrity is:
a. Building trust through loyalty and fairness
b. Honor sensitivity the values, right and needs of others and self
c. Practice up-to-date scientific skills to ensure the best outcome for clients
d. All of the above
14. The ICN Code of Ethics for Nurses (2005) affirms that nurses have four fundamental responsibilities:
Promoting health
Preventing illness
Alleviating suffering
All of the above
Accountability toward the profession of nursing, in that:
a. Our nurses will be provided a program of study and practice that adequately supplies the nursing knowledge, attitudes, and skills
b. Demonstrate an adequate base of nursing knowledge
c. The patients' health care needs are adequately met in a caring, humane manner
d. A+B
Organs may be removed from the bodies of deceased persons for the purpose of transplantation except:
a. Any consent required by law is obtained
b. There is no reason to believe that the deceased person will not be harmed.
c. The human body and its parts are the subject of commercial transactions
d. Donated organs should be made available to patients on the basis of medical need
All the following are ethical principles for organ transplantation except:
a. Fidelity
b. Autonomy
c. Beneficence
d. Justice
Improve working conditions, Particularly Staffing include all except:
a. Reduce work loads
b. Significant changes in job responsibilities
c. Implement ergonomically sound, safe, work place for nurses of all ages
d. Provide professional development
a. Disclosing information about the patient's case to other interested parties
b. Encourages the physician to take precautions with the information to ensure that only authorized access occurs
c. Exchanging information about your patients with other physicians
d. All of the above
a. When pressed for time
b. Teaching conferences that contain identifiable patients should be removed at the conclusion of the session
c. Creating a trusting environment with family members
d. A+B
21. In general, the deceptive use of placebos isn’t ethically justifiable except in specific exceptions:
a. The alternatives are effective and/or risky
b. The patient hasn’t a strong need for some prescription
c. The condition is known to have a low placebo response rate
d. The placebo effect is powerful, in many cases providing measurable improvement in symptoms in 20-30% of patients
22. A client is voluntarily admitted to the psychiatric unit. Later the client develops severe pain in the right lower quadrant and is diagnosed as having acute appendicitis. When preparing the client for an appendectomy:
a. Have two nurses witness the operative consent as the client signs it
b. Have the surgeon and the psychiatrist sign for the surgery, because it is an emergency procedure
c. Phone the client’s next of kin to come in to sign the consent form because the client is on the psychiatric unit
d. Ask the client to sign the preoperative consent form after being informed of the procedure and required care
23. In relation to obtaining an informed consent from a 17 year old adolescent, the nurse should remember that the adolescent:
a. Does not have the legal capacity to give consent
b. Is not able to make an acceptable or intelligent choice
c. Is able to give voluntary consent when parents are not available
d. Will most likely be unable to choose between alternatives when asked to consent
24. A client with rheumatoid arthritis does not want cortisone even if it is prescribed and informs the nurse of this. Later the nurse attempts to administer cortisone that has been ordered by the physician. When the client asks what the medication is, the nurse gives an evasive answer. The client takes the medication and later finds that it was cortisone. The client states intent to sue. The decision in this suit would take into consideration the fact that:
a. The nurse should have notified the physician
b. The nurse is required to answer the client truthfully
c. The client has insufficient knowledge to make such a decision
d. The physician’s order takes precedence over a client’s preference
25. A client using fentanyle transdermal patches for pain management in late- stage cancer has died. The hospice nurse who is caring for this client should:
a. Remove and dispose of the patch
b. Tell the family to remove and dispose of the patch
c. Leave the patch in place for the mortician to remove
d. Have the family return to the patch to the pharmacy for accounting
26. At 11:00 PM , the count of hydrocodone “Vicodin”is incorrect. After several minutes of searching the medication cart and medication administration records, no explanation can be found. The charge nurse should next notify the :
a. Nursing unit manager
b. Hospital administrator
c. Quality control manager
d. Physician ordering the medication
An example of an intentional tort is:
a. Leaving a surgical instrument in a client during surgery
b. Divulging private information about the client to the media
c. Causing a burn when applying a warm soak to a client’s extremity
d. Failing to monitor the client’s blood pressure when administering an antihypertensive
27. Twenty four hours after a cesarean delivery, a client elects to sign herself and her baby out of the hospital because of difficulty at home with her 2 years old son. Staff members have been unable to contract her physician. The client arrives at the nursery dressed and ready to leave and asks that her infant be given to her to dress and take home. Appropriate nursing actions would be:
a. Explain to the client that her infant must remain in the hospital until signed out by the physician
b. Give the baby to the client to take home, making sure that she receives information regarding care of a 2 day old infant
c. Allow the client time the baby before she leaves, but emphasize that the baby is a minor and legally must remain until orders are received
d. Tell the client that under the circumstances, hospital policy prevents the staff from releasing the infant into her care, but she will be informed when the infant is discharged
28. Nurses are protected from legal action when they:
a. Offer health teaching regarding family planning
b. Offer first aid at the scene of a collision between an automobile and a bus
c. Report incidents of suspected child abuse to the appropriate authorities
d. Administer CPR measures to an unconscious child pulled from a swimming pool
29. A terminally ill client is visited frequently by her spouse, a 16 years old daughter, and a 20 year old son. In view of the client’s extreme weakness and dyspnea, client care plan should include:
a. Allowing self activity whenever possible
b. Encouraging family members to feed and assist the client
c. Limiting family visiting hours to the evening before the client sleeps
d. Planning all necessary care t one time with long rest periods in between
30. The nursing process can be defined as the:
a. Implementation of client by the nurse
b. Steps the nurse employs to meet client needs
c. Activities a nurse employs to identify a client’s problem
d. Process the nurse uses to determine nursing goals for the client
31. The primary purpose for regulating nursing practice is to protect:
a. The public
b. Practicing nurses
c. The employing agency
d. Professional standards
32. When teaching staff about legal terminology used in child abuse, the nurse emphasizes that the term battery means:
a. Legal wrong committed by one person against the property of another
b. Maligning the character of an individual while threatening to do bodily harm
c. The application of force to the person of another person without lawful justification
d. Doing something that a reasonable person with the same education or preparation would not do
34. Which of the following principles applies to utilitarian action guiding theory?
a. The rightness or wrongness of an action depends on the consequences the action produces
b. An action is right or wrong independent of the consequences is produces
c. An action is right or wrong depending on the process used to arrive at the room
d. The rightness or wrongness of an action is not dependent on the process used to arrive at the action
35. When a nurse provides the information & support that patients & their families need to make the decision that is right for them, he\she is practicing which of the following principles of bioethics?
a. Autonomy
b. Nonmaleficence
c. Justice
d. Fidelity
36. Nurses who value patient advocacy follow which of the following guidelines?
a. They value their loyalty to an employing institution or to a colleague over their commitment to their patients
b. They give priority to the good of the individual patient rather than to the good of society in general
c. They choose the claims of the patient's well- being over the claims of the patient's autonomy
d. They make decisions for patients who are uninformed concerning their rights & opportunities
37. Which of the following actions best describe the use of the professional value of autonomy?
a. A nurse stays later than her shift to continue caring for a patient in critical condition
b. A nurse researches a new procedure that would benefits a new procedure that would benefit her patient
c. A nurse keeps her promises to call a patient's doctor regarding pain relief
d. A nurse reads the Patients Bill of Rights to a visually impaired patient
38. Which of the following actions best describe the use of the professional value of altruism?
a. A nurse demonstrate an understanding of the culture of his patient
b. A nurse is accountable for the care provided to a mentally challenged patient
c. A nurse lobbies for universal access to healthcare
d. A nurse protects the privacy of a patient with AIDS
39. Which of the following actions best describe the use of the professional value of human dignity?
- A nurse plans nursing care together with her patient
- A nurse plans individualized nursing care for her patients
- A nurse provides information to a patient about his illness
- A nurse provides privacy for an elderly patient
40. Which of the following actions best describe the use of the professional value of autonomy?
a. A nurse collaborates with other healthcare team members to ensure the best possible treatment for his patients
b. A nurse respects the right of Muslim to call a religious man for talking to him
c. A nurse becomes a mentor to a student nurse working on her floor
d. A nurse reports an error made by an incompetent coworker
41. Which of the following actions best describe the use of the professional value of Nonmaleficence?
a. Binding rules of conduct enforced by authority.
b. The ability to perceive the feelings of the person, and the ability to communicate to him/her.
c. The duty not to inflict as well as to prevent and remove harm
d. Enduring beliefs or attitudes about the worth of a person, object, idea or action
42. Which of the following statements accurately represent the Basic principles of ethics?
a. The term ethics generally refers to personal or communal standards of right or wrong
b. The ability to be ethical begins in childhood and develops gradually
c. An action that is legal or customary is ethically right
d. Most nurses are born with a natural ability to behave in an ethically professional way
43. Which of the following are key principles of the Childress principle- based approach to bioethics:
a. Autonomy
b. Human dignity
c. Altruism
d. Justice
44. A personal belief about worth that acts as standard to guide one's behavior
a. Ethics
b. Value
c. Morals
d. Advocacy
45. The protection & support of another's right is
a. Ethical dilemma
b. Autonomy
c. Advocacy
d. Ethics
46. Personal or communal standard of right & wrong
a. Morals
b. Right of Patients
c. Code of ethics
d. Value
47. Ethical dilemma is
a. Ethical problem in which the person knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right actions
b. A commitment to developing one's ability to act ethically
c. A process of discovering allowing the person to discover what choices to make when alternatives are presented & to identify whether these choices are rationally made or the result of previous conditioning
d. Two or more clear moral principles apply, but they support mutually inconsistent courses of actions
48. Which of the following is the primary reason for filling out an incident report?
a. To document everyday occurrences
b. To document the need for disciplinary action
c. To improve quality of care
d. To initiate litigation
49. Which of the following actions would be recommended for a nurse who is named as a defendant?
a. Discuss the case with the plaintiff to ensure understanding of each other's positions
b. If a mistake was done on a chart, change it to read appropriately
c. Be prepared to tell your side to he press, if necessary
d. Do not volunteer any information on the witness stand
50. A nurse forgets to replace an IV bag that is empty, this called:
a. Malpractice
b. Negligence
c. False imprisonment
d. None of the above
51. Which of the following are elements that must be established to prove that malpractice or negligence has occurred?
a. Duty
b. Intent to harm
c. Punitive damage
d. False imprisonment
52. Which of the following are elements that must be established to prove that malpractice or negligence has occurred?
a. Intent to harm
b. Punitive damage
c. False imprisonment
d. Breach of duty
53. Which of the following are legal safeguards for the nurse?
a. Informed consent
b. Incompetent practice
c. Inadequate staffing
d. Executing physician orders without questioning them
54. Which of the following are legal safeguards for the nurse?
a. Incompetent practice
b. Inadequate staffing
c. Patient education
d. Executing physician orders without questioning them
55. Which of the following is the best professional response to a patient who tells you that she believes that "White nurses are smarter than of color" & then asks if you agree:
a. "You are right! (The patient\customer is always right!)
b. "What I think doesn't matter, what's important is what you believe"
c. "I don’t believe being smart is related to race or ethnicity
d. "I can't give you my opinion"
56. The American Association of College of Nursing
a. Altruism
b. Autonomy
c. Integrity
d. Social justice
57. A professional nurse with a commitment to social justice is most a patient to:
a. Provide honest information to patients & the public
b. Promote universal access to healthcare
c. Plan care in partnership with patients
d. Document care accurately & honestly
58. A home health nurse who performs a careful safety assessment of the home of a frail elderly patient to prevent harm to the patients is achieving in according with which of the principles of bioethics?
a. Autonomy
b. Beneficence
c. Justice
d. Nonmaleficence
59. A professional nurse committed to the principle of autonomy would be careful to:
a. Provide the information & support a patient needed to make decisions to advance her own interest
b. Teach each patient fairly, try to give everyone his\her due
c. Keep any promises made to a patient or another professional caregiver
d. Avoid causing harm to a patient
60. Nurse advocates often are conflicted about respecting a patient's right to be self determining, which at the same time wanting to do everything in their power to promote the patient's best interest. Which are the best general guidelines for situations like these?
a. "Patients rules! It's my life!"
b. Nurse rules! " It may be your life, but in this instance, you don't know enough to make the right choice"
c. When in conflict, weight the benefits & risks of following each options & then choose wisely
d. Institutional rules! " Do the best with low cost"
61. If you harm a patient by administering a medication "wrong drug, wrong dose" ordered by a physician, which of the following is true?
a. You aren't responsible, since you were merely following the doctor's order
b. Only you are responsible, since you actually administering the medication
c. Only the physician is responsible, since he\she actually ordered the drug
d. Both you and the physician are responsible for your respective action
62. A fellow student ask you about your legal liability when you do your clinical practice. Which of the following are true?
1. Student nurses are responsible for their own acts of negligence if these results in patient injury
2. Student nurses are held to the same standard of care that would be used to evaluate the action of RN
3. A hospital may also be held liable for the negligence of student nurse enrolled in a hospital controlled program because the student is considered an employee of the hospital
4. Nursing instructor may share a student with responsibility for damages in the event of patient injury if the instructor failed to provide reasonable & prudent clinical supervision
a. (1,3)
b. (2,4)
c. (1,2,3)
d. All of the above
63. When a state attorney decides to change a nurse with manslaughter for allegedly admitting a lethal medication order, this is an example of:
a. Public law
b. Criminal law
c. Private law
d. Civil law
64. Which of the following is the nurse's responsibility in obtaining informed consent:
a. Ask the physician to complete the form
b. Explain all risks, complications & alternative treatment to the client
c. Confirm that the signed consent is in the chart prior to the procedure
d. The nurse has no responsibility with informed consent
65. Safeguard for the nurse & student nurse against litigation include:
a. Ask for help only when absolutely necessary
b. Document briefly at the end of each shift
c. Try to keep up on current trends when time allows
d. Follow accepted procedures
66. Mrs. Rogers is in acute respiratory distress from pneumonia but refuses to stay for treatment. It is the nurse's responsibility to do which of the following?
a. Restrain the patient until a social worker can talk to her about the results of her action
b. Call for a psychological consultation to see if she is mentally stable
c. Notify the physician, discuss the outcomes of the patient's decision and have her sign a release form
d. Call the patients family and have them discharge her
67. The professional nurse:
a. Is expected to provide safe & competent care
b. Has legal right that are the same as any other citizen
c. Has the right to engage in collective bargaining
d. All of the above
68. Which of the following is not an essential element of informed consent?
a. The consent must be given voluntary
b. The consent must be given by an individual with the capacity & competence to understand
c. The client must be given assurances of complete recovery
d. The client must be given enough information to be the ultimate decision maker
69. If a client is injured, nurse must take steps to protect:
a. The client
b. Themselves
c. The employer
d. A+B
70. A declaration by a person about how his\her property is to disposed of after death
a. Will
b. Informed consent
c. Organ donation
d. Euthanasia
71. Opinions, interpretations or conclusions that people accept as true
a. Value
b. Belief
c. Attitude
d. Foreseeability
72. A principle that may morally justify some actions that may produce both good and evil effects
a. Double effect
b. Justice
c. Empathy
d. Fidelity
73. When community health nurses are faced with a client they believe may be unable to make decisions for himself\herself due to an organic brain condition, which of the following would be an inappropriate response?
a. They should not force their own values on the patient
b. They should attempt to discuss their concerns with the client and get his\her input
c. They should contact the family after discussing their concerns with the client
d. They should begin guardianship proceedings for the client
74. If a community health nurses are subpoenaed to testify concerning a client, they should:
a. Ignore the subpoenaed & not show up on the day they are asked to, since patient confidentiality must be protected at any cost
b. Discuss the subpoenaed with the client & determine what the client would like them to do
c. Contact an attorney concerning the subpoena
d. Go to court on the day subpoenaed & raise patient confidentiality as the reason they will not testify
75. Before purchasing malpractice insurance, community health nurses should inquire into all of the following except:
a. The cost of the policy
b. What it specifically does & does not cover
c. What role, if any, the nurse would have went determining if a case were settled or went to trial if he\she were sued under the policy
d. If their employer carrier malpractice insurance for them
76. Community health nurses' ethical perspectives on the situations they confront on a daily basis can come from which of the following sources?
a. Their own religious views
b. The profession's code of ethics
c. Their own values, ideas, & guidelines
d. All of the above
77. The nurse also assesses Mrs. Dalia ethnic background. What is ethnicity?
a. An integrated system of learned behavior patterns
b. An affiliation with a group of people who have a common background
c. An interrelated group of biologically inherited behavior patterns
d. A belief that one's own behavior patterns & beliefs are the best
78. Which of the following could be a sign of abuse in Mrs. Dalia 3 years old daughter?
a. Increased appetite
b. Self-mutilating behavior
c. Extroverted behavior
d. Irritability
79. Which of the following characterized a law?
- It is a flexible guideline
- It stems from current interpretation of right & wrong
- It changes rapidly by judicial mandate
- It imposes specific penalties if breached
80. Dalia age 29 fell when getting out of bed for the first time after her neonate's birth. Although Dalia suffered no injury from the fall, the nurse completed an incident report. Filling an incident report is part of risk management. Which of the following is a goal of risk management?
- To reduce the number & severity of client injuries
- To ensure client confidentiality
- To interpret right & wrong actions in a situation
- To provide proof of blame in a risk situation
81. What is the purpose of an incident report?
- To track patterns of error & injuries
- To record an incident any time after it occurred
- To substitute for medical record documentation
- To record the facts with no additional information
82. To minimize the risk of liability, the nurse should follow which of these guidelines when documenting Dalia's care?
a. Write the facts legibly
b. Erase all errors completely
c. Insert omitted entries, where necessary
d. Print al, entries clearly in black ink
83. Dalia age 30 undergoes an intrauterine transfusion to treat erythroblastosis fetalis. What is the major legal & ethical concern about such fetal therapy?
- The maternal right to refuse treatment
- The maternal effects of the treatment
- The experimental nature of the treatment
- The need for verbal informed consent
84. Layla's neonate has hyperbilirubinemia that does not respond to phototherapy. The physician orders an exchange transfusion, but the parents refuse consent to it because their religious prohibits the use of blood transfusion. The physician seeks a court order for the treatment. What is the court's most likely action?
- It would not order treatment because the parents represent the neonate's best interest
- It would order treatment because the neonate will suffer harm if nothing is done
- It would'ot order treatment because the neonate has a life threatening problem that mayn't be treatable
- It would order to treatment because the parents have no right to make that judgment for their neonate
85. Which of the following terms best describes the emotional attitude that one’s own ethnic group is superior to others?
a. Culture
b. Ehnicity
c. Superiority
d. Ehnocentrism
89. Which of the following terms describes a group of people who share a set of values, beliefs, practices, social relationships, laws, politics, economic & norms of behavior?
a. Race
b. Culture
c. Ethnicity
d. Social group
90. Racism is defined as:
a. An expectation that all people within a same culture group acts alike
b. Classifying individuals according to biological differences
c. Extrinsic distortion of reality
d. A form of oppression or discrimination of people perceived as inferior
88. The nurse employed in a mental health clinic is greeted by a neighbor in a local grocery store. The neighbor says to the nurse, “How is Carol doing? She is my best friend and is seen at your clinic every week.” The most appropriate nursing response is which of the following?
a. “I’m not supposed to discuss this, but because you are my neighbor, I can tell you that she is doing great!”
b. I’m not supposed to discuss this, but because you are my neighbor, I can tell you that she really has some problems!”
c. “If you want to know about Carol, you need to ask her yourself.”
d. “I cannot discuss any client situation with you.”
89. Ethical dilemmas are defined as:
a. A problem that can be solved through the use of research data
b. Clearly identified needed information
c. Decisions requiring choices between undesirable alternatives
d. Decisions requiring legal consultation
90. Which of the following indicates that the client has given informed consent?
a. Accepts the plan of care
b. Gets a second opinion
c. Is knowledgeable regarding the choices given
d. Participates in an experimental procedures
91. The nurse assesses, explores & determines personal values through the process of:
a. Enrolling in an ethics class
b. Personal meditation
c. Reviewing the ANA Code of Ethics
d. Values clarification
92. Which ethical principles is reflected when a nurse acts in the best interest of a client?
a. Autonomy
b. Beneficence
c. Justice
d. Nonmaleficence
93. Accountability and responsibility in nursing practice is enhanced by utilization of
a. Assessment or appraisal tools
b. Code of Ethics of nurse'sc. Records for care plan
d. The nursing process
a. Assessment or appraisal tools
b. Code of Ethics of nurse'sc. Records for care plan
d. The nursing process
94. When a nurse starts working In a hospital but without a written contract, which of the following is expected of her?
a. She's not bound to perform according to the standards of nursing practice
b. Provides nursing care within the acceptable standards of nursing practice c. She's not obligated to provide professional service
d. The employer does not hold the nurse responsible for her action
95. A patient, G8P5, refused to be injected with the 3rd dose of Depoprovera. Thebnurse insisted inspite of the patients refusal and forcibly injected the contraceptive. She can be sued for which of the following?
a. Misrepresentation
b. Assault and Battery c. Malpractice
d. Negligence
96. A patient has been in the ICU for 2 weeks. The relatives have consented to a "Do not resuscitate order," When the patient develops a cardiac arrest, the nurse will carry out which of the following actions?
a. Only medication will be given
b. All ordinary measure will be stopped
c. Basic and advance life support will not be given
d. Mechanical ventilation and NGT will be stopped
97. When a patient falls from bed, which of the following is your immediate action?
a. Report to the head nurse and calls someone to help
b. Determine any injury or harm
c. Refer to the resident on duty
d. Put back patient to bed
98. The three essential elements of informed consent are:a. She's not bound to perform according to the standards of nursing practice
b. Provides nursing care within the acceptable standards of nursing practice c. She's not obligated to provide professional service
d. The employer does not hold the nurse responsible for her action
95. A patient, G8P5, refused to be injected with the 3rd dose of Depoprovera. Thebnurse insisted inspite of the patients refusal and forcibly injected the contraceptive. She can be sued for which of the following?
a. Misrepresentation
b. Assault and Battery c. Malpractice
d. Negligence
96. A patient has been in the ICU for 2 weeks. The relatives have consented to a "Do not resuscitate order," When the patient develops a cardiac arrest, the nurse will carry out which of the following actions?
a. Only medication will be given
b. All ordinary measure will be stopped
c. Basic and advance life support will not be given
d. Mechanical ventilation and NGT will be stopped
97. When a patient falls from bed, which of the following is your immediate action?
a. Report to the head nurse and calls someone to help
b. Determine any injury or harm
c. Refer to the resident on duty
d. Put back patient to bed
a. accountability, beneficence, and paternalism
b. financial risk, rule of utility, and protection of privacy.
c. confidentiality, truthfulness, and advocacy.
d. information, comprehension, and freedom from coercion
99. Ensuring that there is an informed consent on the part of the patient before a surgery is done, illustrates the bioethical principle of:
a. Beneficence
b. Autonomy
c. Truth telling/veracity
d. Non-maleficence
100. When a nurse is providing care to her/his patient, s/he must remember that she is duty bound not to do doing any action that will cause the patient harm. This is the meaning of the bioethical principle:
a. Non-maleficence
b. Beneficence
c. Justice
d. Solidarity
101. When the doctor orders “do not resuscitate”, this means that
a. The nurse need not give due care to the patient since s/he is terminally ill
b. The patient need not be given food and water after all s/he is dying
c. The nurses and the attending physician should not do any heroic or extraordinary measures for the patient
d. The patient need not be given ordinary care so that her/his dying process is hastened
True\ False
T \ F Consequentialism maintains that the majority of an action depends on the nonmoral consequences that the action brings about.
T \ F Utilitarianism is a system of ethical decision making based on moral rules and unchanging principles
T \ F CPR be administered when the patient with intact decision making capacity
T \ F If the patient understands her condition and possesses intact decision making capacity, her request should be honored
T \ F Subculture develops when members of a group do not accept all the values of their dominant culture.
T \ F Act Utilitarianism states that the right utilitarian act is the one that produces the greatest ratio of good to evil for all concerned.
T \ F CODE OF ETHICS is a written list of a profession’s values and standards of conduct
T \ F Informed decisions by competent patients always supersede any written directive
T \ F If the directive is constructed according to the outlines provided by pertinent state legislation, they can’t be considered legally binding
T \ F Rule utilitarianism teaches us that certain actions almost always have a great utilitarian value and thus general rules are formulated to help us see that we follow these rules of action.
T \ F In the absence of a written document. The health team has the right to take the decision
T \ F A moral person is characterized by responding to another person in need by providing care and maintaining a level of responsibility in all relationships
T \ F Passive euthanasia: direct action is taken to end a person’s life, usually in the form of a lethal dose of medication.
T \ F According to the deontologist Principle, it would be permissible to end an innocent life
T \ F Any time a person wants to intentionally end his/her life, it is considered suicide. Suicide, in itself isn’t legal
T \ F The goal of awarding damage is to punish defendants, & to assist the injured parties.
T \ F Carelessness, deviation from the standard of care that reasonable person would use in a set of circumstances is considered negligence
T \ F Suit-prone patients tend to be immature overly dependent, hostile, and uncooperative, often failing to follow a designated plan care
T \ F Both negligence and malpractice fall into the classification of tort law
T \ F The nurse acts always in a manner that promotes and control the interests and well-being of clients
T \ F The nurse educator will recommend for graduation only those students who have adequately demonstrated nursing behaviors that meet the educational objectives of the program of study in nursing provided by the college,
T \ F To be responsible is to accept judgments, acts and omissions (refusals or failures to act) as one's own burden where appropriate, and in whole or in part.
T \ F As for a human owning his body is concerned, Islam permits a human in certain situations to utilize his body
T \ F In this time of acute nursing shortages, hospitals need young, bright and compassionate men and women for all manner of nursing positions
