Deck 2: Legal and Ethical Issues

Question 1

When the nurse is dealing with a specific and actual legal problem involving a child or adolescent, which of the following actions is most important for the nurse to take?

A) Consult with legal counsel who is familiar with the laws in the state where the problem occurred.
B) Select an attorney who appears to be sympathetic to pediatric clients, who has had success in similar cases, and who is willing to work with the nurse.
C) Contact the nursing school where he or she graduated to see if it has free legal counsel.
D) Wait to see if the problem will resolve itself without further action on the part of the nurse.

Answer 1

Consult with legal counsel who is familiar with the laws in the state where the problem occurred.

Question 2

Nurse Practice Acts, Mandatory Reporting Laws, and Good Samaritan Acts are examples of laws affecting nurses. Which of the following is the source for such laws and acts?

A) constitutional law
B) federal law and regulations
C) state laws and regulations
D) case law

Answer 2

state laws and regulations

Question 3

Which of the following factors is not necessary to review when obtaining informed consent?

A) risks of the procedure
B) benefits of the procedure
C) alternatives to the procedure
D) cost of the procedure

Answer 3

cost of the procedure

Question 4

In the majority of cases, pediatric clients are asked to give their consent or permission before receiving a procedure or treatment. This process is referred to as which of the following terms?

A) inclusion
B) assent
C) consideration
D) co-permission

Question 5

The major benefit of getting assent from a child is which of the following?

A) having the assurance of not being sued
B) enhancing the self-esteem of the child
C) lessening the controlling nature of caregivers
D) obtaining the child's cooperation and lessening the trauma

Question 6

If a health care facility or health care provider treats a client without proper consent, and legal action follows, the facility or provider would most likely be:

A) charged with failure to render optimum care to the client
B) charged with assault and held liable for any damages
C) fined severely for not following state regulations
D) denied Medicare- and Medicaid-approved status

Question 7

A family is involved in an automobile accident. The father, who is unconscious, and his 14-year-old son, who has suffered life-threatening injuries, are transported by ambulance to the hospital. The hospital staff attempt to contact the mother; however, they learn from the housekeeper that the mother is out of the country and not reachable by phone. Which of the following actions would be most reasonable and prudent on the part of the hospital staff?

A) Obtain informed consent from the child, if possible, and with or without it, provide life-saving procedures.
B) Get a court order from a judge in case the family later has objections to some of the care, such as the use of blood products.
C) Have the housekeeper give informed consent.
D) Locate another relative and get informed consent.

Question 8

A nurse is working in the emergency room when a child is brought in with injuries and a history that suggests sexual abuse. The child is not cooperative. Which of the following reasons presents the best rationale for waiting until the child is cooperative, instead of restraining and forcing the child to submit to the examination?

A) The hospital staff would likely be charged with abuse.
B) One of the parents may object to restraint if both have not signed informed consent, especially if they are divorced.
C) Forcing participation may damage the child's ability to give testimony in a criminal case.
D) Forced examination may not provide accurate results.

Question 9

Although the age varies among states, the majority of states define a minor as being a person under the age of:

A) 16
B) 17
C) 18
D) 21

Question 10

Most states permit a child under age 18 to consent to certain types of care without parental or guardian notification or consent. The types of care that most often do not require the consent or notification of the parents or guardian include:

A) minor surgery
B) liposuction
C) contraception
D) psychiatric care

Question 11

Which of the following acts offers protection from liability when care is rendered voluntarily, such as at the scene of an accident?

A) Nurse Practice Act
B) Health Insurance Portability and Accountability Act (HIPAA)
C) Good Samaritan Act
D) Voluntary Assisting Act

Question 12

Emancipation is a legal recognition that a minor meets which of the following criteria?

A) has been freed from the caregivers' rules and now makes his or her own rules
B) lives independently, is self-supporting, and makes his or her own decisions
C) is no longer required to go to school and can get a job
D) is no longer required to attend public school and is working on the general equivalency diploma (GED)

Question 13

Which of the following terms refers to the age determined by state law when an individual is said to have all the legal rights and responsibilities of an adult?

A) young adult
B) postteen
C) age of majority
D) legal adult

Question 14

In some states a minor can become emancipated without going through the courts by:

A) getting notarized signed permission by the caregivers
B) being thrown out of the parental home
C) making more money than the caregivers or having a full-time job
D) joining the military, marrying, or becoming a parent

Question 15

You are working in an adolescent residential treatment center. When admitting an adolescent to your unit, you need to get parental consent for care. You discover that the adolescent's parents are divorced. One parent and a stepparent are caring for the adolescent. You would have the consent forms signed by:

A) the parent or parents who were granted legal custody by the divorce decree
B) either parent, as both parents are still the biological parents and have the right to sign forms
C) the parent and stepparent the adolescent is living with at this time
D) a court-appointed attorney-at-law who acts in the adolescent's best interest

Question 16

The parents of a critically ill child are refusing medical treatment for the child. Which of the following terms identifies a legal rule that allows the state to make legal decisions in the best interest of the child?

A) parenti loci
B) parens patrie
C) in lieu parental
D) bon parentus

Question 17

A child is being considered as a donor for a kidney transplant. Which of the following areas must be evaluated before any genetic testing is ordered on a child?

A) the urgency of the need for the donated organ
B) the possibility the mother has withheld the fact that the children have different fathers
C) the parents' religious beliefs and the doctrine of the church regarding organ donation
D) the best interests of the child who would undergo the testing

Question 18

Research facilities receiving federal funds for research involving children as research subjects must require and make certain that all research protocols:

A) are tested first on animals
B) are tested in another country prior to being tested in this country
C) are reviewed by an institutional review board
D) provide for financial compensation for the child and the parents

Question 19

When a nurse breaches the duty of confidentiality, he or she can be disciplined by both the employer and the state board of nursing. In addition to this discipline, he or she can:

A) immediately lose his or her nursing license
B) be held responsible for any damages that result
C) be fined by the federal government
D) be sentenced for up to 1 year in jail

Question 20

If a nurse fails to report suspected child abuse and a child later receives additional injuries at the hands of the suspected abuser, the nurse may face legal consequences in states with child abuse reporting laws. Which of the following consequences may be the harshest faced by the nurse?

A) to be held liable for civil damages to compensate the child and to be fined and imprisoned
B) to have the nursing license suspended for up to a year
C) to be assigned at least 1 year of community service
D) to be put on probation and have to meet periodically with the assigned probation officer

Question 21

You are working in a health care practitioner's office. A child is treated in the office for a stab wound to the arm. In your state, you would most likely be required to:

A) keep this confidential unless the child gives permission to report, according to confidentiality laws
B) report this information to law enforcement, based on mandatory injury reporting laws
C) ask the parents to provide the circumstances surrounding the incident and chart it
D) remind the health care practitioner that the incident should be reported

Question 22

Based on case law (Safer v. Estate of Pack, 1996), the duty to warn persons of possible harm may extend to which of the following conditions?

A) risk of sexually transmitted diseases
B) risk of infectious diseases
C) genetically inherited disease risk
D) risk of physical harm

Question 23

In the case of Tarosoff v. The Regents of the University of California (1976), the court said that health care providers have a duty to breach confidentiality when:

A) a mentally ill person has a history of violence
B) a client, with a psychiatric diagnosis that carries any risk of harm to others, returns to his or her family
C) a client tells the health care provider that he or she is going to harm anyone who mistreats him or her
D) a client makes a specific threat to an identifiable person

Question 24

You are the nurse working with an adolescent who has just been diagnosed with a sexually transmitted disease. In your state the provider of care has an obligation to report sexually transmitted diseases to the local health department. Your best action is which of the following?

A) Explain to the adolescent that the law requires reporting of this information, which will be handled in a sensitive and appropriate manner.
B) Report the information, and let the local health department deal with the adolescent, as they are trained in sensitive matters.
C) Ask the parents of the adolescent to notify the local health department.
D) Ask the hospital social worker to notify the local health department.

Question 25

For a nurse to be charged with malpractice in a malpractice lawsuit, four legal elements must be present. Three of these are the duty the nurse owes to the client, a breach of that duty, and the breach of duty being the cause of damage. The fourth element that must be present is:

A) The nurse caused more than 50% of the damage.
B) The hospital policies did not support the nurse's actions.
C) There was actual damage to the client.
D) Damage in this case was permanent and irreversible.

Question 26

When a claim of malpractice is made, the nurse being accused is referred to in legal terms as the:

A) defendant
B) plaintiff
C) accused
D) client

Question 27

The special relationship that is created when the nurse takes an assignment of a client and agrees to provide care to that client is called in legal terms a(n):

A) obligation
B) special arrangement
C) duty
D) case

Question 28

You are the nurse working at a local hospital. When you accept an assignment of clients at the beginning of your shift, under the laws of negligence, you are considered to have a legal duty to:

A) provide care for each of these clients
B) ensure the satisfaction of clients and their families
C) act in a manner that won't create legal difficulties for the hospital
D) perform in an ethical and moral manner

Question 29

When the word causation is used in a lawsuit involving a client who received the wrong medication from a nurse and later died, it means that the plaintiff's lawyer must prove that:

A) the nurse breached the standard of care
B) the injury (death) of the client was the result of receiving the wrong medication
C) the nurse intentionally tried to hurt the client
D) other health care providers were not at fault and only the nurse was at fault

Question 30

When a medication error is made, malpractice has occurred only if:

A) an expert witness can convince a jury that it is malpractice
B) the medication is a prescription drug and not over the counter
C) there are damages such as pain and suffering
D) the client receiving the medication was a child

Question 31

In a malpractice case involving a nurse and a client, the most important document in court is usually which of the following documents?

A) the medication administration record
B) the nursing care plan
C) incident reports
D) the chart

Question 32

At 9:00 AM you taught a client about the importance of voiding into a collection hat in the bathroom toilet. At 11:00 AM you find the client removed the hat and voided directly into the toilet. Which of the following statements would be best in charting this failure to follow your directions?

A) Uncooperative. Taught to void into collection hat and did not do so.
B) Voided directly into toilet. Did not use collection hat that was provided.
C) Exhibiting controlling behaviors. Refused to void in collection hat and voided into toilet; therefore, urine could not be measured.
D) Did not apparently understand instructions to void in collection hat. Voided into toilet.

Question 33

The nurse is caring for a small child who puts his arm through the side rail just as the nurse is lowering the side rail. The child gets a big bruise. The housekeeper asks the nurse what happened. The nurse should:

A) tell the housekeeper, since the housekeeper is part of the health care team
B) restrict information to general statements such as, "It was an accident."
C) suggest the housekeeper ask the head nurse
D) avoid discussing the accident with the housekeeper

Question 34

A person employed by the hospital to make certain the facility conforms to state and federal laws is usually called a:

A) risk manager
B) policy manager
C) legal nurse consultant
D) compliance officer

Question 35

The nurse assigned to the pediatric unit of a hospital is caring for a child who cries for his mother when she is not with him. The mother works during the day. Which of the following actions on the part of the nurse most indicates the nurse is letting her own values get in the way of caring for this family?

A) encouraging the mother to discuss her feelings about leaving her son
B) being angry with the mother because she does not stay with the child
C) assessing the family for socioeconomic needs as well as other needs
D) offering to set up a meeting with social services and child protective services

Question 36

A specific type of ethical theory stresses rightness or wrongness of actions, regardless of consequences, as well as a duty to others. This ethical theory is often regarded as the key theory for use in health care ethical decision making. Which of the following is it?

A) deontologic
B) teleologic
C) virtue
D) care

Question 37

The use of moral reasoning to resolve problems raised by the health care field and life sciences is called:

A) scientific ethics
B) health care ethics
C) bioethics
D) cyroethics

Question 38

Nonmaleficence is an ethical principle that essentially means:

A) Don't use bad language.
B) Don't use bad judgment.
C) Tell the truth at all times.
D) Do no harm to the clients.

Question 39

Which of the following is the best example of the ethical principle of fidelity?

A) being a good friend to the client by sharing secrets
B) keeping a promise to return to the client's room at a given time
C) doing whatever the client or the client's physician asks of you
D) saving the client time and money by not wasting supplies

Question 40

The five-step process for resolving ethical issues involves collecting information about the situation, stating the dilemma, listing all possible courses of action, and which of the following pairs of steps?

A) setting goals and working toward the goals
B) analyzing the advantages and disadvantages of each course of action and making the decision
C) implementing a variety of courses of action and evaluating which course of action is the best
D) surveying others on their opinions and making a choice of action based on the best rationale provided

Question 41

The ethical principle of autonomy is applied in which of the following situations? Select all that apply.

A) allowing the child to select food items from the menu
B) permitting the child to wash in the evening rather than in the morning because this is the child's typical routine
C) playing with a child whose family has gone home for the evening
D) calling the physician for pain medication for a child who has recently had surgery

Question 42

A pregnant client informs the nurse that she has previously had an abortion. The client asks that her parents not be made aware of her past history. Which of the following ethical principles will be implemented by the health care team when maintaining the client's desired confidentiality? Select all that apply.

A) autonomy
B) justice
C) fidelity
D) nonmaleficence