Question 1

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

Accepted Answer

A

Question 2

A nurse responsible for the care of older adult patients shows the best understanding of the nursing standards of practice when basing nursing care on which of the following?

Accepted Answer

C

Question 3

An older adult patient has been approached to participate in a research study.The nurse best advocates for the patient's right to self-determination by doing which of the following?

Accepted Answer

Evaluating the patient's cognitive ability to understand the risks of the study is crucial for ensuring that the patient can make an informed decision about participation, which is a key aspect of advocating for the patient's right to self-determination.

Question 4

The director of nursing at a long-term care facility is getting ready for the annual inspection.What information guides the director?

Accepted Answer

Nurses are often required to answer questions from inspectors during an inspection to demonstrate compliance with regulations and standards of care. This interaction helps inspectors assess the facility's adherence to required protocols and the quality of care provided.

Question 5

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

Accepted Answer

Reminding the patient to call for assistance before getting out of bed is an implementation of the standard of care for older adult patients as they are at increased risk of falls and injuries. It is important for the nurse to remind the patient to call for assistance before getting out of bed to prevent falls and ensure patient safety. The other options may be considered as showing compassion or respect towards the patient, but they do not directly relate to the implementation of standards of care.

Question 6

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

Accepted Answer

Nurses must follow state-specific reporting requirements for elder abuse, so it's important to know where to find this information.

Question 7

The manager of a long-term care facility is evaluating patients' use of drugs.The resident on which of the following medications would be allowed to continue taking medications to control behavior?

Accepted Answer

Anxiolytics can be used to help patients participate in group activities, which is a positive outcome. The other options involve using medications for convenience or to control behavior without a clear therapeutic benefit for the patient.

Question 8

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 intervention to minimize the patient's risk for injury is guided by which of the following?

Accepted Answer

Nondrug interventions should be prioritized to minimize the risk of injury before considering medication, especially in older adults.

Question 9

To meet current guidelines regarding incontinence in a long-term care facility,what action by the director of nursing is best?

Accepted Answer

The best action to meet current guidelines regarding incontinence in a long-term care facility is to assess residents for the ability to participate in a bladder training program. Bladder training can help improve bladder control and reduce incontinence symptoms. Taking all residents to the toilet every 2 hours and after meals or ensuring all residents wear incontinence briefs are not individualized interventions and may not be appropriate for all residents. Asking physicians and other providers to prescribe medications for bladder control may also not be appropriate for all residents and should be based on individual assessment and evaluation.

Question 10

A graduate nurse learns about the provisions of the Health Insurance Portability and Accountability Act (HIPAA),which include which of the following?

Accepted Answer

HIPAA helps maintain health insurance coverage for individuals when they change or lose their job. It does not require employers to offer insurance or mandate specific benefits, and it does not regulate the amount employers can charge for insurance.

Question 11

An 87-year-old patient is unsure of the purpose of a living will.Which statement by the nurse is the best description?

Accepted Answer

A living will is a legal document that specifies what healthcare treatments an individual wishes to receive or not receive if they become unable to make those decisions themselves. It specifically applies to situations of terminal illness or permanent unconsciousness. It does not designate a family member to make decisions or assure that unwanted treatments are avoided, although those may be addressed in other legal documents. Social Services may be able to assist in creating a living will, but it is not their main purpose.

Question 12

An alert but disoriented older patient lives with family members.The home health nurse,being aware of the role of patient advocate,recognizes the obligation to report possible patient abuse based on which of the following?

Accepted Answer

Bruises in the genital area could be a sign of physical abuse or sexual abuse, and it is the nurse's responsibility to report suspected abuse. Option A does not provide sufficient evidence of abuse, option C suggests a cognitive issue rather than abuse, and option D could be indicative of neglect but not necessarily abuse.

Question 13

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

Accepted Answer

The state board of nursing is responsible for reviewing situations where there is suspicion of a nurse not providing the proper standard of care.

Question 14

What provisions for nursing service are part of the Omnibus Budget Reconciliation Act (OBRA)as it pertains to long-term care facilities? (Select all that apply. )

Accepted Answer

The answer of What provisions for nursing service are part...

Question 15

The adult child of a long-term care facility resident receives a phone call from the director of nursing stating that resident has 30 days to move out of the home.Under what conditions can a facility require a resident to move? (Select all that apply. )

Accepted Answer

A long-term care facility can require a resident to move out if they are not paying for the services received, if the resident's needs exceed what the facility can provide, if the resident's medical condition no longer requires a stay at the facility, or if the facility is going out of business. Frequent disruptive behavior during the night may result in the facility taking steps to address the behavior, but it is not typically a reason for requiring a resident to move out.

Question 16

To best address the patient's right to self-determination,which of the following questions does the nurse ask at the time the patient is admitted to a nursing facility? (Select all that apply. )

Accepted Answer

By asking if the patient understands what a living will and durable power of attorney are (A) and if they have already prepared an advance care directive (B), the nurse is acknowledging the patient's right to make decisions about their own care. By asking if the patient has discussed their end-of-life choices with their family or designated surrogate (D), the nurse is respecting the patient's right to choose who they want to speak for them if they are unable to speak for themselves. By asking if the patient would like help with preparing a living will or durable power of attorney (E), the nurse is offering support for the patient's right to make their own decisions about their care. Asking if the patient is prepared to discuss their end-of-life choices with the nursing staff (C) can be seen as more of a directive from the nurse and may not be the best way to approach the patient's right to self-determination.

Question 17

The nurse manager in a long-term care facility reviews resident care plans at what interval?

Accepted Answer

Care plans in long-term care facilities are typically reviewed quarterly to ensure they meet the residents' current needs.

Question 18

The director of nursing at a certified long-term care facility overhauls the nursing assistant training program to include which features? (Select all that apply. )

Accepted Answer

The overhaul of the nursing assistant training program should include training in infection control measures, instruction on resident rights, and education on safety measures to ensure comprehensive care and compliance with regulations.

Question 19

The nursing student learns about the Patient Self-Determination Act.What is a key provision of this act?

Accepted Answer

The Patient Self-Determination Act requires healthcare facilities to inform patients of their rights under state law to make decisions concerning their medical care, including the right to accept or refuse medical or surgical treatment and the right to prepare advance directives.

Question 20

A patient residing in a long-term care facility has been experiencing restlessness and has often been found by nursing staff wandering in and out of other patients' rooms during the night.The nurse views the patient's PRN antipsychotic medication order as which of the following?

Accepted Answer

The answer of A patient residing in a long-term care...

Quiz 3: Legal and Ethical Issues