Question 1

A nurse is caring for a patient with cancer, who describes using an herbal preparation and guided imagery as part of her treatment. Considerations related to patient self-determination would direct the nurse to:

Accepted Answer

Patient self-determination involves respecting the patient's right to make decisions about their healthcare, which includes using alternative therapies that may not be supported by conventional medicine. The nurse should still monitor the patient for any adverse effects and encourage open communication with the healthcare team. However, the nurse should not discourage the patient from using the therapies they believe are beneficial.

Question 2

Which of the following statements about living wills are true? Select all that apply.

Accepted Answer

A, C, D

Question 3

Competence is:

Accepted Answer

C

Question 4

The law passed in 1991 that requires institutions receiving Medicaid or Medicare funding to provide written information to adult patients regarding their right to make health care decisions is the:

Accepted Answer

The law described in the prompt is commonly known as the Patient Self-Determination Act of 1991. This law requires healthcare institutions that receive Medicare or Medicaid funding to provide written information to adult patients about their right to make healthcare decisions, including the right to accept or refuse treatment and the right to execute advance directives. Option A (Uniform Health Care Information Act) is a model law developed by the National Conference of Commissioners on Uniform State Laws in 1993 to regulate the collection, use, and disclosure of health information. Option C (Patient Bill of Rights) is a general term used to describe various documents that outline patients' rights in different healthcare settings. Option D (Civil Rights Act) is a federal law that prohibits discrimination on the basis of race, color, national origin, sex, and religion.

Question 5

What is the legal protection of a patient's right to personal autonomy?

Accepted Answer

Informed consent provides legal protection of a patient's right to personal autonomy by ensuring that patients have the right to make informed decisions about their own medical care. This includes the right to be informed about the risks and benefits of treatment, alternative options, and to refuse treatment if they choose to do so. This protection is only applicable if the patient is deemed competent to make his or her own decisions. Advanced directives and competence are also important factors, but are not directly related to legal protection of a patient's right to personal autonomy. Paternalism is the opposite of personal autonomy and refers to making decisions for the patient without their input or consent.

Question 6

In dealing with a patient's lifestyle choices, nurses need to remember the instructions in the American Nurses Association Code of Ethics, which would include:

Accepted Answer

The best choice is E, as all of the listed choices are included in the American Nurses Association Code of Ethics and are important when dealing with a patient's lifestyle choices. It is important for nurses to respect the patient's human dignity, avoid value judgments, and practice compassion when discussing lifestyle choices and providing care.

Question 7

Factors that may threaten autonomy in health care settings may include which of the following? Select all that apply.

Accepted Answer

A persistent paternalistic attitude can lead to a belief that the patient should rely solely on the health care provider's decisions, undermining the patient's autonomy. Making assumptions about a patient's values and thought processes can also limit their ability to exercise autonomy. Similarly, not appreciating the patient's knowledge level regarding their health can be an obstacle to autonomy. However, a focus on caring rather than technology and patients and families feeling confident enough to share their choices with health care providers can support autonomy.

Question 8

If a patient is not given the opportunity to ask questions about a procedure prior to the start of the procedure, which patient right is being violated?

Accepted Answer

Informed consent is the process where the healthcare provider must give the patient all information about a procedure including benefits, risks, alternatives, and allow them to ask questions before consenting to the procedure. By not giving the opportunity to ask questions, the patient's right to fully understand and consent to the procedure may be violated.

Question 9

Instructions that indicate health care interventions to initiate or withhold, or that designate someone who will act as a surrogate in making such decisions in the event that we lose decision-making capacity is termed:

Accepted Answer

Advanced directives are instructions given by a competent individual that direct health care interventions to initiate or withhold or designate someone to act as their surrogate in decision making in the event they lose decision-making capacity. Informed consent refers to a process of obtaining consent from individuals before subjecting them to medical procedures or treatments, while autonomy refers to an individual's right to self-rule and decision-making. Paternalism, on the other hand, refers to the practice of making decisions for others in their best interest without their consent.

Question 10

The nurse's role and responsibilities in informed consent include all the following except:

Accepted Answer

The nurse's role in informed consent primarily involves verifying patient awareness, advocating for the patient's autonomy, and witnessing the consent process. It does not typically include explaining the procedure, which is the responsibility of the healthcare provider performing the procedure.

Question 11

A nurse who discusses a patient's condition and treatment with family members who were not authorized to have medical information disclosed to them is breaching:

Accepted Answer

The nurse breaching confidentiality by disclosing medical information to family members who were not authorized to have it. Confidentiality is an essential ethical principle in healthcare that protects patients' privacy by preventing unauthorized disclosure of their medical information.

Question 12

A nurse's advocacy role regarding a patient's advance directives (AD) include which of the following? Select all that apply.

Accepted Answer

The nurse's role in advocating for a patient's advance directives (AD) include ensuring that care is consistent with the patient's wishes and AD (A), alerting physicians to changes in the patient's decision-making capacity (C), informing health team members of the content of a patient's AD (D), and intervening appropriately when a patient's wishes are not being followed (E). While it is important for patients to be informed of changes in their conditions and modify their AD accordingly, this responsibility falls on the patient or their designated decision maker, not the nurse (B).

Question 13

The information that needs to be included in an informed consent document include which of the following?

Accepted Answer

All of the options should be included in an informed consent document. This provides the patient with a complete understanding of their situation and all available options, allowing them to make an educated decision about their care.

Question 14

Having the freedom to make choices about issues that affect our own lives and to make decisions about personal goals is called:

Accepted Answer

Autonomy refers to the ability to make choices and decisions about our own lives and personal goals, without interference from others. Paternalism involves someone else making decisions for us, while informed consent and competence are related but more specific concepts that do not fully capture the idea of personal choice and agency.

Question 15

Which of the following elements must be present when evaluating a patient's decision-making capacity? Select all that apply.

Accepted Answer

The answer of Which of the following elements must be...

Quiz 11: Practice Issues Related to Patient Self Determination