Question 1

As the nurse is completing the pre-operative checklist, Mrs. Jones asks whether she will be awake during her surgery. What is the next step for this nurse?

Accepted Answer

Contacting the surgeon is crucial because Mrs. Jones's question indicates a lack of understanding about her surgery, which suggests she may not have given fully informed consent. Informed consent is a fundamental ethical and legal requirement before any surgery.

Question 2

What is the definition of competence?

Accepted Answer

C

Question 3

Which of the following actions are part of the nurse's role and responsibilities in informed consent?

Accepted Answer

The nurse's role in informed consent includes verifying that the patient understands their options and the implications, ensuring the patient has all necessary information to make an informed decision.

Question 4

What is the purpose of a patient completing a living will?

Accepted Answer

The purpose of a patient completing a living will is to identify a proxy or substitute decision-maker who can make medical decisions on their behalf if they are unable to communicate or make decisions for themselves due to illness or injury. It allows patients to have control over their medical treatment and ensures that their wishes are respected even if they cannot express them at the time. A living will does not relate only to the issue at hand, nor does it evaluate healthcare decisions or reduce choices.

Question 5

When a nurse discusses the results of a patient's diagnostic test with family members who were not authorized to have medical information disclosed to them, what principle is the nurse breaching?

Accepted Answer

The nurse is breaching the principle of confidentiality by disclosing medical information to family members who were not authorized to know the results of the test.

Question 6

What should be considered when  determining  whether the information provided for consent was adequate?

Accepted Answer

Adequate information for consent should be determined by considering what a reasonable person would want or need to know in order to make an informed decision about their healthcare. This is a subjective standard that takes into account the patient's individual circumstances and concerns. It is not based on the policies of an ethics board or a physician's personal opinions. While the potential serious outcomes of a treatment or procedure are important to discuss, they should not be the only factor considered in determining the adequacy of informed consent.

Question 7

Which source document acknowledges the importance of living wills by clearly identifying, promoting, and respecting informed decision making?

Accepted Answer

The answer of Which source document acknowledges the importance of...

Question 8

A nurse is injured with a percutaneous exposure of blood while on duty. The nurse wishes to have the patient tested for HIV; however, the patient refuses. Which of the following statements best summarizes testing issues related to HIV?

Accepted Answer

It is illegal to perform HIV testing without the patient's consent or knowledge. The nurse cannot force the patient to undergo testing. However, the nurse can discuss the potential risk of HIV transmission and the importance of testing for the safety of both the patient and the nurse. The nurse can also undergo post-exposure prophylaxis (PEP) to reduce the risk of acquiring HIV infection.

Question 9

Which of the following elements must be included in an informed consent?

Accepted Answer

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

Question 10

A nurse is caring for a patient with cancer who describes using meditation, guided imagery, and mega intravenous doses of vitamin C as part of her treatment. Which of the following nursing actions would take into consideration the patient's ability for self-determination?

Accepted Answer

The nurse should honour the patient's right to use therapies other than conventional medicine to address their health care needs. This respects the patient's autonomy and allows the patient to make informed decisions about their own care. The nurse should provide education on the therapies and their potential risks and benefits, but ultimately it is up to the patient to decide which modalities they want to use. However, the nurse should also encourage the patient to communicate with their healthcare team about all therapies they are using to eliminate potential harmful interactions.

Question 11

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

Accepted Answer

The legal protection of a patient's right to personal autonomy is called informed consent. Informed consent is the process of obtaining permission from a patient before performing a medical procedure or treatment. It involves providing the patient with information about the treatment or procedure, including the risks and benefits, alternatives, and possible outcomes. The patient has the right to make an informed decision about whether or not to proceed with the treatment or procedure. Paternalism is the opposite of informed consent, where the physician makes decisions on behalf of the patient without consulting them. Advanced directives refer to legal documents that allow the patient to specify their wishes for medical treatment in the event that they cannot communicate them. Competence refers to the patient's ability to make decisions for themselves.

Question 12

A patient is refusing to participate in his plan of care. The nurse is aware that the patient's refusal will negatively affect his health outcome. According to the Canadian Nurses Association Code of Ethics, what must the nurse take into consideration?

Accepted Answer

According to the Canadian Nurses Association Code of Ethics, the nurse must ensure that the quality of nursing care is not affected even if the patient refuses to participate in his plan of care. The nurse must also take into consideration the patient's right to make decisions about his own health care. Therefore, the nurse should explore the patient's reasons for refusal and work together with the patient to find an alternative approach, if possible. The nurse should also document the patient's refusal and any discussions held about it.

Question 13

What does a nurse's advocacy role regarding a patient's advance directives (AD) include?

Accepted Answer

The answer of What does a nurse's advocacy role regarding...

Question 14

A nurse encourages a patient to take narcotics for severe cancer pain. The patient is concerned about the possible side effects. The nurse gives the patient the narcotic and tells the patient; "It's for your own good and it's important to get your pain under control." What is the nurse's behaviour an example of?

Accepted Answer

The nurse's behavior is an example of paternalism because the nurse is making decisions on behalf of the patient without fully considering the patient's wishes or concerns. The nurse is acting as if he/she knows what is best for the patient, rather than empowering the patient to make his/her own decisions about pain management.

Question 15

Which of the following elements must be present when evaluating a patient's decision-making capacity?

Accepted Answer

Communication skills are necessary for a patient to demonstrate their understanding of the situation, risks, and benefits of a particular treatment option. Other factors that must be present when evaluating a patient's decision-making capacity include the ability to make and communicate a choice, the ability to understand and appreciate the situation and its consequences, and the absence of any external influences that could impair judgment. The ability to determine a positive outcome, behaving in an ethical manner, and understanding medical terminology may be helpful but are not essential elements of decision-making capacity.

Question 16

A patient asks the surgeon what will be gained by having the procedure and the surgeon does not respond. Which patient right is being violated?

Accepted Answer

The patient's right to informed consent is being violated. Informed consent requires that patients receive clear and accurate information about the procedure, including potential benefits and risks, in order to make an informed decision about their care. The surgeon's failure to answer the patient's question violates this right.

Quiz 11: Practice Issues Related to Patient Self-Determination