Deck 3: Legal and Ethical Issues

Question 1

During a state inspection of a skilled nursing facility, a surveyor notes suspicion that a particular nurse may not be providing proper standard of care.The nurse manager informs the nurse to expect:

A)a review of the situation by the state board of nursing.
B)termination of employment from the facility.
C)mandatory remediation related to the suspect care issues.
D)unannounced reevaluation of the nurse's performance within the next 3 months.

Answer 1

a review of the situation by the state board of nursing.

Question 2

An 87-year-old client is unsure of the purpose of a living will.The nurse describes its purpose best when stating:

A)"It's a legal document that Social Services can help you create."
B)"It designates a family member to make decisions if you become incompetent."
C)"It provides a written description of your wishes in the event you become terminally ill."
D)"It assures you won't be subjected to treatments you don't want."

Answer 2

"It provides a written description of your wishes in the event you become terminally ill."

Question 3

A nurse new to geriatric nursing asks the nurse manager to clarify how to handle a client's claim she has been physically abused.The nurse manager responds most appropriately when stating:

A)"I'll show you where you can find this State's reporting requirements."
B)"As a nurse you are considered a 'mandated reporter' of elder abuse."
C)"As long as you are reasonably sure abuse has occurred, report it."
D)"You need to report any such claims directly to me."

Answer 3

"I'll show you where you can find this State's reporting requirements."

Question 4

A nurse caring for older adult clients shows an understanding of the implementation of standards of care when:

A)dialing the telephone when the client wants to call his daughter.
B)requesting the client's favorite dessert on his birthday.
C)closing the client's door when he is praying.
D)reminding the client to call for assistance before getting out of bed.

Question 5

The nurse recognizes that a nursing aide likely to abuse an older client is one who has: ineffective verbal communication skills.

A)little experience working with the older population.
B)poor stress management skills.
C)been a victim of abuse.

Question 6

A nurse responsible for the care of older adult clients shows the best understanding of the nursing standards of practice when basing nursing care upon the:

A)physician's medical orders.
B)stated requests of the individual client.
C)care that a responsible geriatric nurse would provide.
D)implementation of the nursing process.

Question 7

The nurse is caring for an unresponsive 67-year-old client who has terminal cancer with a Do Not Resuscitate order in affect.A family member tells the nurse, "I'll sue you and every other nurse here if you don't do everything possible to keep her alive." The nurse understands that protection from legal prosecution in this situation is provided by:

A)legal immunity granted when acting according to the client's expressed wishes.
B)the legal view that the duty to put into effect the client's wishes falls to the physician.
C)knowledge of and compliance with facility policies and procedures regarding end-of-life care.
D)implementing interventions that preserve the client's right to self determination.

Question 8

An alert but disoriented 84-year-old client lives with family members.The home health nurse, being aware of the role of client advocate, recognizes the obligation to report possible client abuse based on:

A)family member stating, "It's hard being a caregiver."
B)assessment showing increased client disorientation.
C)observation of several areas of tissue bruising on arms.
D)client's report of always being hungry.

Question 9

A 69-year-old client diagnosed with Tourette's syndrome has been experiencing restlessness and has often been found by nursing staff wandering in and out of other clients' rooms during the night.The nurse views the client's PRN antipsychotic medication order as:

A)an appropriate intervention to help assure his safety.
B)an option once all other nondrug interventions prove ineffective.
C)inappropriate unless the physician is notified and approves its use.
D)not an option because it should not be used to manage behaviors of this type.

Question 10

An older adult resident of a long-term care nursing facility frequently attempts to get out of bed and is at risk of sustaining an injury.The nurse's planned interventions to minimize the client's risk for injury is guided by:

A)the client's right to a self-determination.
B)an understanding that nondrug interventions must be ineffective before administering a PRN sedative.
C)the knowledge that application of a vest restraint requires a physician's order.
D)the client's cognitive ability to understand and follow directions.

Question 11

During a client's orientation to a skilled nursing facility, a member asks the nurse to explain what an ombudsman does.The nurse's most appropriate response is:

A)"If your mother has a financial concern, the ombudsman is notified."
B)An ombudsman is a volunteer advocate."
C)"Your mother's care will be managed by an ombudsman."
D)"If you have concerns about your mother's care, an ombudsman will look into the problem."

Question 12

The nurse caring for an older client who resides in an assistant living facility is asked to obtain and witness the client's signature on a living will document.The nurse responds most appropriately when stating:

A)"I will certainly do that since such a document is so valuable to the client's plan of care."
B)"I'll ask the client's family if they agree that the client should sign the document."
C)"First I need to discuss the purpose of this document with the client."
D)"I'm sorry but I cannot ethically do that."

Question 13

In order to best address the client's right to self-determination, at the time of admission to a nursing facility, the nurse asks which of the follow questions? Select all that apply.

A)"Do you understand what a living will and durable power of attorney are?"
B)"If you have already prepared an advance care directive, can you provide it now?"
C)"Are you prepared to discuss your end-of-life choices with the nursing staff during this hospitalization?"
D)"Have you discussed your end-of-life choices with your family or designated surrogate?"
E)"Would you like help with preparing a living will and/or a durable power of attorney?"

Question 14

The nurse is caring for a terminally ill older client who has a living will that excludes pulmonary and cardiac resuscitation.The family expresses a concern that the client may "change her mind." The nurse best reassures the family by stating:

A)"The nursing staff will watch her very closely for any indication she has changed her mind."
B)"We will discuss her wishes with her regularly."
C)"She can change her mind about any provision in the document at anytime."
D)"Your mother was very clear about her wishes when she signed the document."

Question 15

An older adult client has been approached to participate in a research study.The nurse best advocates for the client's right of self-determination by:

A)evaluating the client's cognitive ability to understand the consequence of the study.
B)determining what risks to the client are involved.
C)discussing the importance of the study with the client and his family.
D)encouraging the client to discuss the decision with trusted family or friends.