Deck 2: Standards of Practice and Ethical Considerations

Question 1

The nurse understands that the nursing profession has standards of care that promote the covenant between patient and nurse. Which of the following is an example of this covenant?

A)The nurse adheres to strict guidelines regarding medication administration and procedures.
B)The nurse develops a care plan with mutually developed goals and interventions with the patient.
C)The nurse attends continuing education courses to maintain competency in skills.
D)The nurse considers each patient's cultural practices without bias or judgment.

Answer 1

The nurse develops a care plan with mutually developed goals and interventions with the patient.

Question 2

The nurse is assessing an adolescent patient in the emergency department with a suspected intentional overdose. After given treatment, the patient refuses to give her parent's contact information and states, "It is none of their business." What is the nurse's best response?

A)"Now that you are safe, let me help you develop a plan to prevent a recurrence."
B)"I'm sorry, but I'm obligated to tell them. Let me help you develop a plan for their possible responses."
C)"Although most of your health care is confidential, we are obligated to notify them."
D)"I think you should tell them, but we will honor your confidentiality and not disclose the reason for your visit."

Answer 2

"I'm sorry, but I'm obligated to tell them. Let me help you develop a plan for their possible responses."

Question 3

Which of the following behaviors serves as an example of the nurse directly upholding the American Nurses Association's (ANA's) Code of Ethics for Nurses?

A)The nursing union develops a safe patient-to-nurse ratio.
B)The nurse joins a professional specialty organization.
C)The nurse maintains sterile technique during procedures.
D)The nurse develops a plan of care for a community-wide illness.

Answer 3

The nursing union develops a safe patient-to-nurse ratio.

Question 4

Identify one or more choices that best complete the statement or answer the question.
Which of the following are examples of a nurse adhering to the pediatric standards of practice? Select all that apply.

A)The nurse educates the parents on how to administer insulin to their 9-year-old child.
B)The nurse asks the 3-year-old child to describe their level of pain with a Faces or Oucher scale.
C)The nurse refuses to divulge medical information to the parents of a pregnant adolescent.
D)The nurse provides extra free supplies to the family of an underinsured ill child.
E)The nurse uses evidence-based practice to maintain competency of new practices.

Question 5

Identify one or more choices that best complete the statement or answer the question.
The nurse is providing care to a toddler recently diagnosed with asthma. The parents have become verbally aggressive with staff and have challenged many of the unit rules. Which of the following may have contributed to the family's challenging behavior? Select all that apply.

A)The parents are both working professionals in leadership roles and fear loss of control.
B)The family has researched asthma on the Internet and does not agree with the treatment protocol.
C)The staff members have maintained therapeutic communication with the patient and family.
D)The nurse has developed a mutual set of goals and interventions with the family.
E)The staff members have provided a medically trained translator to promote understanding in care.

Question 6

The nurse is preparing an 8-year-old patient for a cancer protocol that has a significant amount of risk. The parents have provided informed consent for this trial, but the patient has refused to partake in this research. What is the most appropriate course of action for this situation?

A)Treatment is carried forth, despite the patient's dissent.
B)Treatment must be delayed until the parents and patient agree.
C)Treatment is delayed for review by the ethics committee.
D)Treatment is canceled until the patient assents.

Question 7

Which of the following behaviors serves as an example of the nurse directly upholding the ANA Code of Ethics for Nurses?

A)The nursing union develops a safe patient-to-nurse ratio.
B)The nurse joins a professional specialty organization.
C)The nurse maintains sterile technique during procedures.
D)The nurse develops a plan of care for a community-wide illness.

Question 8

The nurse is providing care to an adolescent patient with cystic fibrosis in the acute care setting. The patient tells the nurse, "You are my favorite because you always listen to me, not like the other nurse who hates me." Which response by the nurse is most appropriate?

A)"I will report the other nurse immediately, and you won't have to see her again."
B)"If you have any concerns, I can ask the charge nurse to talk to you, but we all work as a team."
C)"That's nice of you to say. I will try hard to keep you happy while here as my patient."
D)"I understand. She has been reported by the other staff members for playing favorites."

Question 9

The nurse is preparing a 13-year-old patient for a full physical examination by the primary care provider (PCP). The patient asks that her mother leave the room because of the sensitive nature of the examination. What is the best course of action to be taken by the nurse to protect the interested parties?

A)Ask the mother to leave the room, and allow the patient to discuss her concerns privately with the PCP.
B)Allow the mother to stay in the room, and explain that she has the right to witness any care provided by the PCP.
C)Act as a chaperone and remain with the patient and mother in the room during the full examination.
D)Reassure the mother that the nurse will remain as a chaperone while she leaves the room.

Question 10

The nurse is providing care to the mechanically ventilated 4-year-old patient who is believed to be the victim of abuse from the parents. The parents refuse to permit removal of the ventilator. The nurse believes this is because the parents are afraid that they will be charged with murder if the child dies. What is the recourse for the health-care team in this ethical dilemma?

A)Provide the treatment even in the face of undue burden of resources.
B)Provide the parents with their financial burden of this care.
C)Provide information to the courts for legal involvement.
D)Provide support to the parents even if the team would choose differently.

Question 11

The home care nurse is assessing the home environment for the pediatric patient. The nurse notes that the family is unable to perform some of the physical therapy exercises safely. What is the most appropriate initial nursing action?

A)Consult with the physical therapist to arrange more educational sessions.
B)Consult with the health-care provider for admission to a rehabilitation center.
C)Assess the exercises per the worksheet provided by the physical therapist.
D)Assess the family's understanding of a safe of the physical therapy exercises.

Question 12

The nurse is assessing an adolescent patient in the emergency department after she was attacked at a party. The patient refuses to give her parent's contact information and states, "They will kill me when they find out that I went to the party." What is the nurse's best response?

A)"They will understand. Let me call them to at least get the insurance information."
B)"Since you are a minor, we need their consent to legally treat you."
C)"We will treat you, and your parents do not have to know that you are here."
D)"I need to contact the social worker, as we have a duty to report this attack to your family and the authorities."

Question 13

The nurse is providing care to a hospitalized 1-year-old patient. The nurse locks the exits per protocol to prevent the removal of the child from the unit. The grandparents become angry about this, because they want to take the infant outside for "some fresh air." What is the appropriate measure that the staff take to promote patient safety at this time?

A)Explain that the child is not to leave the floor without express permission from the parents.
B)Explain to the grandparents that this is a measure to prevent abduction of the patient.
C)Permit the grandparents to take the child after they sign a waiver for any possible injuries incurred off the unit.
D)Permit the grandparents a limited amount of time off the unit, due to treatment schedules.

Question 14

The nurse is providing care to a hospitalized pediatric patient, and the patient is refusing all pain medication despite signs of obvious distress. The patient tells the nurse, "All you nurses lied, and the shots hurt." What is the most appropriate nursing measure at this time?

A)Provide the medication in a cup of juice.
B)Have the parents administer the medication.
C)Explain not all medications are shots.
D)Admit to the patient that the shots hurt but explain they help.

Question 15

The nurse is providing discharge teaching to the family of a hospitalized 9-year-old patient, recently diagnosed with asthma. The family states that they feel overwhelmed with the treatment plans and cannot perform the necessary nebulizer treatments. Which nursing intervention best reflects the professional performance aspect of pediatric nursing standards?

A)The nurse arranges for a home care respiratory therapy consultation to teach the family proper techniques in the home setting.
B)The nurse contacts the physician to delay the patient's discharge from the hospital until the family is able to perform treatments.
C)The nurse collects comprehensive data pertinent to the patient's situation by reviewing the home situation.
D)The nurse evaluates progress toward the attainment of outcomes by having the family perform return demonstrations.

Question 16

Identify one or more choices that best complete the statement or answer the question.
Which of the following nursing actions is an example of a function of the Code of Ethics for Nurses directly relating to the health-care environment? Select all that apply.

A)The nurse cowrote a policy on nurse:patient ratio for the unit.
B)The nurse includes the extended family in discharge instructions.
C)The nurse joined a local professional organization that shapes community policy.
D)The nurse enrolled in a basic American Sign Language course.
E)The nurse joins the safety and infection control committees.

Question 17

The nurse is providing care to a child in the home care setting. The nurse often provides the mother with advice that varies from how to perform the child's medical care to marital advice. The nurse has stated that this is her favorite patient and has made this child's home the last stop of her shift to use her free time for visits. What is the relationship status between the nurse and family?

A)This is a therapeutic relationship based on family-centered care, with a focus on empathy.
B)This is not a therapeutic relationship, as the nurse has become enmeshed within the family.
C)This is a therapeutic relationship, with the nurse focusing on the well-being of the whole family.
D)This is not a therapeutic relationship, as the nurse has not included the whole family in the care.

Question 18

The nurse recognizes that the American Nurses Association characterizes which fundamental nursing practice within the Pediatric Nursing Standards of Practice and Professional Performance for Nurses?

A)Nursing utilizes evidence-based practice for the rationale of interventions.
B)Nursing complies with the physician orders to maintain scope of practice.
C)Nursing maintains the institutional review boards that monitor care.
D)Nursing facilitates the rules of laws within the health-care continuum.

Question 19

The emergency department nurse is providing care to a 5-year-old child with a repeated exacerbation of otitis media. When it becomes apparent that the parents smoke and refuse to prevent the child's exposure to secondhand smoke, the nurse voices frustration to the family that they are causing the child's otitis media. Which of the provisions of the ANA Code of Ethics for Nurses has the nurse failed to follow?

A)The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.
B)The nurse practices with compassion and respect for dignity, unrestricted by the nature of health problems.
C)The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient
D)The patient's right to self-determination must be upheld, justified only when justified by law.

Question 20

Identify one or more choices that best complete the statement or answer the question.
Which of the following interventions are examples of a family-focused strategy? Select all that apply.

A)Coordinating care with other departments to lessen sleep disruptions
B)Providing storage and prep of meals from home for family members
C)Stipulating unilateral visiting rules for all patients and their families
D)Involving the parents in nursing change of shift reports and care plans
E)Providing dedicated family space with basic needs for rooming in parents