Question 1

The patient is angry about the nursing care delivered on the past two shifts and demands to see his medical record. What should the nurse consider prior to granting this request?

Accepted Answer

1. This is not true in every case.
2. In most cases, the patient does have the right to view the medical record, but there are some exceptions to this rule. The nurse should review the policy and procedure manual for these exceptions.
3. In most cases, the patient does have this right.
4. There is no requirement for approval of the physician.

Question 2

On admission, the patient states, "My son can make healthcare decisions for me if it is necessary." What does this statement imply?

Accepted Answer

1. In a living will, there is no person appointed to make decisions. The living will is a statement of the patient's wishes in writing.
2. The son is a competent person who has been designated to make healthcare decisions for his parent. This is a durable power of attorney.
3. This act requires that all healthcare providers ask patients about living wills and durable powers of attorney. There is no indication that there is any violation.
4. There is no indication that this is true.

Question 3

Which strategy could the nurse use to avoid disparity in healthcare delivery?

Accepted Answer

1. Disparities often occur because the healthcare professional does not recognize cultural differences or has a cultural bias.
2. This is a consumer demand related to insurance. The nurse has little effect on this issue.
3. This is an unacceptable strategy to nursing.
4. This scenario is unlikely to have impact on health disparities.

Question 4

The risk manager is reviewing these events that occurred over the weekend. Which scenario should the risk manager be most concerned would represent malpractice?
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Accepted Answer

1. This action is not in accordance with professional standards in assessing an apical pulse prior to administering Digoxin.
2. This action is more likely to harm the nurse than it is to harm the patient.
3. This is more likely to be seen as battery than as malpractice.
4. This is an appropriate action expected from a professional nurse.

Question 5

The nursing assistant left a side rail down upon exiting the room of a patient who had just returned from the recovery room postoperatively. What does this scenario most closely illustrate?

Accepted Answer

1. It is not yet clear that any personal injury has occurred.
2. There is no indication that this nursing assistant had any criminal intent when leaving the side rail down.
3. Malpractice is the failure of a professional person to act in accordance with the prevailing professional standards or failure to foresee consequences that a professional person, having the necessary skill and education, should foresee.
4. Negligence is the failure to act as an ordinary prudent person would under similar circumstances, and is based upon that person's education and training.

Question 6

Which situation illustrates the ethical concept of autonomy?

Accepted Answer

1. This is provision of patient education.
2. Autonomy means that the patient has the right to make decisions about healthcare.
3. This concerns the matter of patient privacy.
4. This concerns the matter of patient privacy, not autonomy.

Question 7

Which scenario is an example of informed consent?

Accepted Answer

1. This was a negligent action on the part of the nurse.
2. This could be construed as assault and battery.
3. This patient is able to make an informed decision about healthcare.
4. This is a routine nursing intervention and when the nurse brings the medication consent is implied.

Question 8

Which option best illustrates a positive outcome from managed care?

Accepted Answer

1. This is not an outcome of managed care, but rather a part of the political process regarding legislation.
2. Managed care resulted in many consumers speaking out against managed care, and this led to more developed healthcare consumerism.
3. Quality is still a problem and costs have not been reduced due to managed care.
4. Managed care is not as strong as it was in the past.

Question 9

Which option represents a situation exemplifying the need for nurses to become involved in healthcare policy development?

Accepted Answer

1. This scenario represents a violation of standards and a potential malpractice issue, not an issue of healthcare planning.
2. Changes in legislation and regulation (which might be influenced by nurses involved in healthcare planning) affect nursing practice.
3. This scenario is unlikely to be altered by change in legislation or regulation.
4. This scenario is unlikely to be altered by change in legislation or regulation.

Question 10

The nurse closely follows hospital policy for recording patient charges. After attending a conference break out session on reimbursement, the nurse realizes that the hospital policy is in violation of Medicare rules. Is this nurse guilty of fraud?

Accepted Answer

1. Fraud requires intent.
2. Fraud requires intent.
3. It would have to be proved that the hospital intended to violate this policy.
4. In order to be guilty of fraud, the nurse would have to have intention of doing wrong. That is not present in this case.

Question 11

Which statements correctly apply to the process of developing public policy? Select all that apply.

Accepted Answer

1. These are the two types of public policy.
2. It is difficult to develop public policy because there are often conflicts that must be considered. It is also impossible to meet the needs of all people.
3. Deals and compromises are a part of developing public policy.
4. Allocative policies provide benefits for some at the expense of others to ensure that certain public objectives are met.
5. Politics is deeply involved in developing public policy.

Question 12

What is different about today's healthcare environment that makes it crucial that nurses are involved in the development of healthcare policy? Select all that apply.

Accepted Answer

1. The focus is on care of populations.
2. Prevention is now becoming the focus of much of healthcare.
3. Cost-effectiveness is a primary issue in healthcare.
4. Nursing must reinvent its culture in light of the new healthcare environment.
5. There is a call for high quality care in all types of settings and by all providers.

Question 13

Which action, taken by the nurse, best illustrates the ethical concept of justice?

Accepted Answer

1. This is a standard role of the nurse and is associated with the legality of informed consent.
2. This illustrates the principle of beneficence.
3. This is an example of justice because the nurse is providing fair treatment and giving time to both patients.
4. This is an example of collaboration in healthcare.

Question 14

What was the American Nurses Association's stance on the healthcare reform plan supported by the Obama administration? Select all that apply.

Accepted Answer

1. "The ANA strongly believes that this law is a significant victory for the patients we serve."
2. "…we recognize that the debate over reform is not over."
3. "We are committed to helping nurses and the public understand how this change affects their lives."
4. "…they'll have better access to primary care."
5. "They'll have greater protection against losing or being denied health insurance coverage…"

Question 15

Evaluate the following: The patient is labeled as a "complainer," and has not been informed of the treatment plan. The patient has no insurance, and the nursing staff is discussing the situation in the hallway. Choose the principles that have been violated. Select all that apply.

Accepted Answer

1. There is nothing that indicates that justice is not being done for this patient. The patient is in the hospital for care.
2. The discussion in the hallway is not keeping the patient's medical information private.
3. The patient has not been informed of the treatment plan.
4. The patient has not been given information to make decisions regarding care.
5. There is nothing that indicates that harm has come to this patient yet.

Question 16

Which question, asked of a patient, reflects the observance of the Patient Self-Determination Act of 1990?

Accepted Answer

1. This is an assessment question, but has no relationship to the Patient Self-Determination Act.
2. This is an assessment question, but has no relationship to the Patient Self-Determination Act.
3. As a result of this act, healthcare providers are required to ask about living wills and durable powers of attorney.
4. This question reflects patient privacy concerns.

Question 17

Why does the process of developing public health policy seem familiar to most nurses?

Accepted Answer

1. The process whereby public health policy is developed closely replicates the nursing process.
2. This process is not taught in all schools.
3. This process is not emphasized on NCLEX-RN.
4. While much of the process does reflect common sense, the best answer is that it is similar to the nursing process.

Question 18

A staff nurse in a small, rural hospital is concerned about the future of healthcare in the rural environment. How can this nurse be involved in healthcare policy development? Select all that apply.

Accepted Answer

1. Joining nursing organizations, contacting legislators, acting as a patient advocate, and using the Internet are all ways the nurse can be involved in healthcare policy development.
2. Joining nursing organizations, contacting legislators, acting as a patient advocate, and using the Internet are all ways the nurse can be involved in healthcare policy development.
3. Joining nursing organizations, contacting legislators, acting as a patient advocate, and using the Internet are all ways the nurse can be involved in healthcare policy development.
4. Joining nursing organizations, contacting legislators, acting as a patient advocate, and using the Internet are all ways the nurse can be involved in healthcare policy development.
5. While this is considered service to the institution, it is not as likely to impact healthcare policy on a state or national level.

Question 19

Which nursing action best illustrates the ethical concept of beneficence?

Accepted Answer

1. This is the principle of doing good, inflicting no harm.
2. This is an example of patient autonomy.
3. This is required by the Patient Self-Determination Act.
4. This illustrates informed consent.

Question 20

Which nursing action is the best example of the ethical principle of veracity?

Accepted Answer

1. This is an example of autonomy.
2. Veracity is truth telling, which is essential for effective communication and trust.
3. This illustrates confidentiality.
4. This illustrates beneficence or "do no harm."

Quiz 2: Healthcare Policy, Legal Issues, and Ethics in Healthcare Delivery