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P&P Chapter 22 - 23
Terms in this set (37)
Four patients in labor all request epidural analgesia to manage their pain at the same time.
Which ethical principle is compromised when only one nurse anesthetist is on call?
The patient tells the nurse that she is afraid to speak up regarding her desire to end care for
fear of upsetting her husband and children. Which principle in the nursing code of ethics
ensures that the nurse will promote the patient's cause?
The patient's son requests to view the documentation in his mother's medical record. What is
the nurse's best response to this request?
"You will need your mothers permission."
When people work together to solve ethical dilemmas, individuals must examine their own
values. This step is crucial to ensure that
Different perspectives are respected.
Ethical dilemmas are common occurrences when caring for patients. The nurse understands
that dilemmas are a result of
Presence of conflicting values.
The nurse questions a physician's order to administer a placebo to the patient. The nurse's
action is based on which ethical principle?
The nurse finds it difficult to care for a patient whose advance directive states that no
extraordinary resuscitation measures should be taken. Which step may help the nurse to find
resolution in this assignment?
Scrutinize her own personal values.
The nurse values autonomy above all other principles. Which patient assignment will the
nurse find most difficult to accept?
Family elder who is making the decisions for a 30-year-old female member
Which philosophy of health care ethics would be particularly useful when making ethical
decisions about vulnerable populations?
A nurse argues that we need to reform our health care system because we have a large number
of people who are uninsured and end up needing expensive emergent care when low-cost
measures could have prevented their illnesses. What ethical framework is she using to make
The nurse has become aware of missing narcotics in the patient care area. Which ethical
principle obligates the nurse to report the missing medications?
A young woman who is pregnant with a fetus exposed to multiple teratogens consents to have
her fetus undergo serial PUBS (percutaneous umbilical blood sampling) to examine how
exposure affects the fetus over time. Although these tests will not improve the fetus' outcomes
and will expose it to some risks, the information gathered may help infants in the future.
Which ethical principle is at greatest risk?
Which issue has increased the attention paid to quality of life concerns in recent history?
National movement regarding disabled persons
Which patient is most likely to have difficulty with the ethical concept of autonomy?
78-year-old patient with rheumatoid arthritis
The nurse is caring for a severely ill patient with AIDS who now requires ventilator support.
Which intervention is considered futile?
Administering the influenza vaccine
During a severe respiratory epidemic, the local health care organizations decide to give health
care providers priority access to ventilators over other members of the community who also
need that resource. Which philosophy would give the strongest support for this decision?
Determinations regarding quality of life are
Value judgments that can vary from person to person.
A newly hired experienced nurse is preparing to change a patient's abdominal dressing and
hasn't done it before at this hospital. Which action by the nurse is best?
Check the policy and procedure manual for the agency's method.
A new nurse notes that the health care unit keeps a listing of patient names in a closed book
behind the front desk of the nursing station so patients can be located easily. What action is
most appropriate for the nurse to take?
Use the book as needed while keeping it away from individuals not involved in
A 17-year-old patient, dying of heart failure, wants to have his organs removed for
transplantation after his death. What action by the nurse is correct?
Instruct the patient to talk with his parents about his desire to donate his organs.
An obstetrical nurse comes across an automobile accident. The patient seems to have a
crushed upper airway, and while waiting for emergency medical services to arrive, the nurse
makes a cut in the trachea and inserts a straw from her purse to provide an airway. The patient
survives and has a permanent problem with his vocal cords, making it difficult to talk. Which
statement is true regarding the nurse's performance?
The nurse took actions beyond those that are standard and appropriate.
A nurse performs cardiopulmonary resuscitation (CPR) on a 92-year-old with brittle bones
and breaks a rib during the procedure, which then punctures a lung. The patient recovers
completely without any residual problems and sues the nurse for pain and suffering, and for
malpractice. What key point will the prosecution attempt to prove?
The CPR procedure was done incorrectly.
A recent immigrant who does not speak English is alert and requires hospitalization. What is
the initial action that the nurse must take to enable informed consent to be obtained?
Request an official interpreter to explain the terms of consent.
A pediatric oncology nurse floats to an orthopedic trauma unit. What actions should the nurse
manager of the orthopedic unit take to enable safe care to be given by this nurse?
Determine patient acuity and care the nurse can safely provide.
While recovering from a severe illness, a hospitalized patient states that he wants to change
his living will, which he signed nine months ago. Which response by the nurse is most
"Let me check with someone here in the hospital who can assist you."
A nurse notices that his neighbor's preschool children are often playing on the sidewalk and in
the street unsupervised and repeatedly takes them back to their home and talks with the parent
available, but the situation continues. What immediate action by the nurse is mandated by
Contact the appropriate community child protection agency.
A confused patient with a urinary catheter, nasogastric tube, and intravenous line keeps
touching these needed items for care. The nurse has tried to explain to the patient that he
should not touch these lines, but the patient continues. What is the best action by the nurse at
Try other approaches to prevent the patient from touching these care items.
A patient with sepsis as a result of long-term leukemia dies 25 hours after admission to the
hospital. A full code was conducted without success. The patient had a urinary catheter, an
intravenous line, an oxygen cannula, and a nasogastric tube. What question is priority for the
nurse to ask the family before beginning postmortem care?
"Is an autopsy going to be done?"
Conjoined twins are in the neonatal department of the community hospital until transfer to the
closest medical center. A photographer from the local newspaper gets off the elevator on the
neonatal floor and wants to take pictures of the infants. What initial action should the nurse
Tell the cameraman where the hospital's public relations department is located.
A nursing student has been written up several times for being late with providing patient care
and for omitting aspects of patient care and not knowing basic procedures that were taught in
the skills course one term earlier. The nursing student says, "I don't understand what the big
deal is. As my instructor, you are there to protect me and make sure I don't make mistakes."
What is the best response from the nursing instructor?
"You are expected to perform at the level of a professional nurse."
A nurse works full-time on the oncology unit at the hospital and works part-time on weekends
giving immunizations at the local pharmacy. While giving an injection on a weekend, the
nurse caused injury to the patient's arm and is now being sued. How will the hospital's
malpractice insurance provide coverage for this nurse?
The hospital's malpractice insurance covers this nurse only during the time the nurse is working at the hospital.
A nursing student in the final term of nursing school is overheard by a nursing faculty
member telling another student that she got to insert a nasogastric tube in the emergency
department while she was working as a nursing assistant. What advice is best for the nursing
faculty member to give to the nursing student?
"You are not allowed to perform any procedures other than those in your job description even with the nurse's permission."
The nurse calculates the medication dose for an infant on the pediatric unit and determines
that the dose is twice what it should be. The pediatrician is contacted and says to administer
the medication as ordered. What is the next action that the nurse should take? (Select all that
A. Notify the nursing supervisor
B. Check the chain of command policy for such situations.
A nurse gives an incorrect medication to a patient without doing all of the mandatory checks,
but the patient has no ill effects from the medication. What actions should the nurse take after
reassessing the patient? (Select all that apply.)
a. Notify the health care provider of the situation.
e. Continue to monitor the patient for any untoward effects from the medication.
f. Send an occurrence report to risk management after completing it.
The nurse hears a physician say to the charge nurse that he doesn't want that same nurse
caring for his patients because she is stupid and won't follow his orders. The physician also
writes on his patient's medical records that the same nurse, by name, is not to care for any of
his patients because of her incompetence. What component(s) of defamation has the physician
committed? (Select all that apply.)
A patient has just been told that he has approximately six months to live and asks about
advance directives. Which statements by the nurse give the patient correct information?
(Select all that apply.)
a. "You have the right to refuse treatment at any time."
b. "If you want certain procedures or actions taken or not taken, and you might not be
able to tell anyone at the time, you need to complete documents ahead of time that
give your health care provider this information."
d. "You might want to think about choosing someone who will make medical
decisions for you in the event that you are unable to make your desires known."
e. "We will get someone who knows the state's guidelines to assist you in setting up
your living will."
A patient's condition is slowly deteriorating. What actions should the nurse take to provide
the best care possible? (Select all that apply.)
b. Document the patient's status changes in the medical record in a timely manner.
c. Document that the health care provider has been notified of the specific patient
status, including date and time that messages were left.
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