NCLEX: Ethical and Legal Issues PRACTICE QUESTIONS

NCLEX: Ethical and Legal Issues PRACTICE QUESTIONS

Leave the first rating Students also studied Terms in this set (13) Science MedicineNursing Save Legal/Ethics practice questions (ncl...21 terms kristie_g_hamilton Preview Ch.3 Law and Ethics NCLEX style qu...20 terms karlamtz101Preview ADRN 110 Exam 1 Teacher 81 terms leila22152Preview NCLEX 13 terms Kat The nurse hears a client calling out for help, hurries down the hallway to the client's room, and finds the client lying on the floor. The nurse performs an assessment, assists the client back to bed, notifies the primary health care provider, and completes an occurrence report. Which statement should the nurse document on the occurrence report?

• The client fell out of bed.
• The client climbed over the side rails.
• The client was found lying on the floor.
• The client became restless and tried to get out of bed.

3 The occurrence report should contain a factual description of the occurrence, any injuries experienced by those involved, and the outcome of the situation. The correct option is the only one that describes the facts as observed by the nurse. Options 1, 2, and 4 are interpretations of the situation and are not factual information as observed by the nurse.Test-Taking Strategy: Focus on the subject, documentation of events, and note the data in the question to select the correct option. Remember to focus on factual information when documenting, and avoid including interpretations. This will direct you to the correct option.A client is brought to the emergency department by emergency medical services (EMS) after being hit by a car. The name of the client is unknown, and the client has sustained a severe head injury and multiple fractures and is unconscious. An emergency craniotomy is required. Regarding informed consent for the surgical procedure, which is the best action?

• Obtain a court order for the surgical procedure.
• Ask the EMS team to sign the informed consent.
• Transport the victim to the operating room for surgery.
• Call the police to identify the client and locate the

family.3 In general, there are two situations in which informed consent of an adult client is not needed. One is when an emergency is present and delaying treatment for the purpose of obtaining informed consent would result in injury or death to the client. The second is when the client waives the right to give informed consent. Option 1 will delay emergency treatment, and option 2 is inappropriate.Although option 4 may be pursued, it is not the best action because it delays necessary emergency treatment.Test-Taking Strategy: Note the strategic word, best. Also note that an emergency is present. Recalling that a delay in treatment for the purpose of obtaining informed consent could result in injury or death will direct you to the correct option.

The nurse has just assisted a client back to bed after a fall. The nurse and primary health care provider have assessed the client and have determined that the client is not injured. After completing the occurrence report, the nurse should implement which action next?

• Reassess the client.
• Conduct a staff meeting to describe the fall.
• Contact the nursing supervisor to update information

regarding the fall.

• Document in the nurse's notes that an occurrence

report was completed.1 After a client's fall, the nurse must frequently reassess the client, because potential complications do not always appear immediately after the fall. The client's fall should be treated as private information and shared on a "need to know" basis. Communication regarding the event should involve only the individuals participating in the client's care. An occurrence report is a problem-solving document; however, its completion is not documented in the nurse's notes. If the nursing supervisor has been made aware of the occurrence, the supervisor will contact the nurse if status update is necessary.

Test-Taking Strategy: Note the strategic word, next. Using the steps of the

nursing process will direct you to the correct option. Remember that assessment is the first step. Additionally, use Maslow's Hierarchy of Needs theory, recalling that physiological needs are the priority. The correct option is the only option that addresses a potential physiological need of the client.The nurse arrives at work and is told to report (float) to the intensive care unit (ICU) for the day because the ICU is understaffed and needs additional nurses to care for the clients. The nurse has never worked in the ICU. The nurse should take which best action?

• Refuse to float to the ICU based on lack of unit

orientation.

• Clarify the ICU client assignment with the team leader

to ensure that it is a safe assignment.

• Ask the nursing supervisor to review the hospital policy

on floating.

• Submit a written protest to nursing administration, and

then call the hospital lawyer.2 Floating is an acceptable practice used by hospitals to solve understaffing problems. Legally, the nurse cannot refuse to float unless a union contract guarantees that nurses can work only in a specified area or the nurse can prove the lack of knowledge for the performance of assigned tasks. When encountering this situation, the nurse should set priorities and identify potential areas of harm to the client. That is why clarifying the client assignment with the team leader to ensure that it is a safe one is the best option. The nursing supervisor is called if the nurse is expected to perform tasks that he or she cannot safely perform.Submitting a written protest and calling the hospital lawyer is a premature action.

Test-Taking Strategy: Note the strategic word, best. Eliminate option 1 first

because of the word refuse. Next, eliminate options 3 and 4 because they are premature actions.The nurse who works on the night shift enters the medication room and finds a coworker with a tourniquet wrapped around the upper arm. The coworker is about to insert a needle, attached to a syringe containing a clear liquid, into the antecubital area. Which is the most appropriate action by the nurse?

• Call security.
• Call the police.
• Call the nursing supervisor.
• Lock the coworker in the medication room until help is

obtained.3 Nurse practice acts require reporting impaired nurses. The board of nursing has jurisdiction over the practice of nursing and may develop plans for treatment and supervision of the impaired nurse. This occurrence needs to be reported to the nursing supervisor, who will then report to the board of nursing and other authorities, such as the police, as required. The nurse may call security if a disturbance occurs, but no information in the question supports this need, and so this is not the appropriate action. Option 4 is an inappropriate and unsafe action.Test-Taking Strategy: Note the strategic words, most appropriate. Eliminate option

• first, because this is an inappropriate and unsafe action. Recall the lines of

organizational structure to assist in directing you to the correct option.

A hospitalized client tells the nurse that an instructional directive is being prepared and that the lawyer will be bringing the document to the hospital today for witness signatures. The client asks the nurse for assistance in obtaining a witness to the will. Which is the most appropriate response to the client?

• "I will sign as a witness to your signature."
• "You will need to find a witness on your own."
• "Whoever is available at the time will sign as a witness

for you."

• "I will call the nursing supervisor to seek assistance

regarding your request." 4 Instructional directives (living wills) are required to be in writing and signed by the client. The client's signature must be witnessed by specified individuals or notarized. Laws and guidelines regarding instructional directives vary from state to state, and it is the responsibility of the nurse to know the laws.Many states prohibit any employee, including the nurse of a facility where the client is receiving care, from being a witness. Option 2 is nontherapeutic and not a helpful response. The nurse should seek the assistance of the nursing supervisor.Test-Taking Strategy: Note the strategic words, most appropriate. Options 1 and 3 are comparable or alike and should be eliminated first. Option 2 is eliminated because it is a nontherapeutic response.The nurse has made an error in documentation of the dose administered of an opioid pain medication in the client's record. The nurse draws 1 mg from the vial and another registered nurse (RN) witnesses wasting of the remaining 1 mg. When scanning the medication, the nurse entered into the medication administration record (MAR) that 2 mg of hydromorphone was administered instead of the actual dose administered, which was 1 mg. The nurse should take which action(s) to correct the error in the MAR? Select all that apply.

• Complete and file an occurrence report.
• Right-click on the entry and modify it to reflect the

correct information.

• Document the correct information and end with the

nurse's signature and title.

• Obtain a cosignature from the RN who witnessed the

waste of the remaining 1 mg.

• Document in a nurse's note in the client's record

detailing the corrected information.

2, 3, 4, 5

Electronic health records (EHR) will have a time date stamp that indicates an amendment has been entered. If the nurse makes an error in the MAR, the nurse should follow agency policies to correct the error. In the MAR, the nurse can click on the entry (usually right-click) and modify it to reflect the corrected information. Since this is an opioid medication, the nurse should obtain a cosignature from the RN who witnessed the wasting of the excess medication, to validate that 1 mg, rather than 2 mg, was given. A nurse's note should be used to detail the event and the corrections made, and the nurse's name and title will be stamped on the entry in the EHR. An occurrence report is not necessary in this situation.Test-Taking Strategy: Focus on the subject, correcting a documentation error, and use principles related to documentation. Recalling the purpose of an occurrence report will assist in eliminating option 1. From the remaining options, focusing on the subject of the question and using knowledge regarding the principles related to documentation will direct you to the correct options.

Which identifies accurate nursing documentation notation(s)? Select all that apply.

• The client slept through the night.
• Abdominal wound dressing is dry and intact without

drainage.

• The client seemed angry when awakened for vital sign

measurement.

• The client appears to become anxious when it is time

for respiratory treatments.

• The client's left lower medial leg wound is 3 cm in

length without redness, drainage, or edema.

1, 2, 5

Factual documentation contains descriptive, objective information about what the nurse sees, hears, feels, or smells. The use of inferences without supporting factual data is not acceptable, because it can be misunderstood. The use of vague terms, such as seemed or appears, is not acceptable because these words suggest that the nurse is stating an opinion.

Test-Taking Strategy: Focus on the subject, accurate documentation notations.

Eliminate options 3 and 4 because they are comparable or alike and include vague terms (seemed, appears).A nursing instructor delivers a lecture to nursing students regarding the issue of clients' rights and asks a nursing student to identify a situation that represents an example of invasion of client privacy. Which situation, if identified by the student, indicates an understanding of a violation of this client right?

• Performing a procedure without consent
• Threatening to give a client a medication
• Telling the client that he or she cannot leave the

hospital

• Observing care provided to the client without the

client's permission 4 Invasion of privacy occurs with unreasonable intrusion into an individual's private affairs. Performing a procedure without consent is an example of battery. Threatening to give a client a medication constitutes assault. Telling the client that the client cannot leave the hospital constitutes false imprisonment.Test-Taking Strategy: Focus on the subject, invasion of privacy. Noting the words without the client's permission will direct you to this option.Nursing staff members are sitting in the lounge taking their morning break. An assistive personnel (AP) tells the group that she thinks that the unit secretary has acquired immunodeficiency syndrome (AIDS) and proceeds to tell the nursing staff that the secretary probably contracted the disease from her husband, who is supposedly a drug addict. The registered nurse should inform the AP that making this accusation has violated which legal tort?

• Libel
• Slander
• Assault
• Negligence

2 Defamation is a false communication or a careless disregard for the truth that causes damage to someone's reputation, either in writing (libel) or verbally (slander). An assault occurs when a person puts another person in fear of a harmful or offensive contact. Negligence involves the actions of professionals that fall below the standard of care for a specific professional group.Test-Taking Strategy: Note the subject, the legal tort that was violated. Focus on the data in the question and eliminate options 3 and 4 first because their definitions are unrelated to the data. Recalling that slander constitutes verbal defamation will direct you to the correct option from the remaining options.