Which statement reflects the ethical principle of justice?
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Which statement reflects the ethical principle of justice?

Patients should be able to go to the physician of their choice.

Patients should be treated equally regardless of socioeconomic status. submitted

If a health care provider agrees to care for a patient, there is an obligation to follow through.

Competent care is a patient's right and a provider's obligation.


Which ethical principle is implicit in the statement "Provision of safe, competent care without patient harm is a healthcare provider's duty."?

Nonmaleficence submitted

Justice

Veracity

Autonomy


Which statement made during a meeting of a hospital's ethics committee is based on the ethical principle of autonomy?

Costly treatment measures should not be prohibited for the elderly based on age.

This treatment is not appropriate for this patient because the danger of destroying the liver is greater than any potential beneficial effect.

The nurse agreed to be present when the patient talked to family about surgical treatment, however the nurse did not show up.

Patients have a right to refuse pain medication even when they admit to having severe pain. submitted


Which of the following is a contributing factor to the higher patient mortality rates in the United States as compared to other developed countries?

Diversity of the population.

Limited access to healthcare. submitted

Population density.

Aging of the population.


Which step in the ethical decision-making process does the RN explore personal bias about an ethical issue?

Assessment submitted

Evaluation

Diagnosis

Planning


An RN states, "I feel emotionally drained and physically sick after caring for some patients who receive aggressive treatments. It seems like we are only prolonging their dying process." What is this RN experiencing?

Cultural shock

Disillusionment in nursing

Work overload

Moral distress submitted


Which ethical principle is the nurse violating when the nurse tells a crying child, "If you don't swallow this pill, I am going to give you a shot into your leg."?

Justice

Obligation

Fidelity

The RN is teaching the student nurse about the ANA Standards of Ethical Practice. Which statement by the student nurse indicates additional teaching is necessary regarding patient protection and impaired practice?

"Assistance is available for impaired nurses from professional associations."

"Impaired nurses may return to practice after recovery."

"Nurses who report impaired colleagues risk retaliation from the institution." submitted

"Report all concerns regarding an impaired co-worker to the nursing supervisor."


A terminally ill patient who is considering withdrawal of treatment asks the RN if the family should be told. What is the next step in ethical decision making for the RN?

Review the possible options of disclosure. submitted

Consult with a member of the ethics committee.

Identify a physician who can write the necessary prescriptions.

Discuss the patient's feelings and concerns.


The RN who speaks up when a health care worker does not perform hand hygiene is upholding which ethical principle?

Veracity

Autonomy

Justice

A student nurse asks an RN "What strategies are useful when faced with an ethical dilemma in professional practice?" How does the RN respond? Select all that apply.

"I defer to the healthcare provider to make the correct decision."

"I focus on myself and what I would I do if faced with the issue."

"I use the nursing process to organize my thought process."

"I consult the ethics committee when the problem is complex."

"I use the Nursing Code of Ethics for guidance."


A patient with end stage heart disease is seeking a heart transplant. What ethical principle supports the eligibility criteria that reviews the patient's history of adherence to the medical treatment plan?

Veracity

Distributive justice submitted

Autonomy

Beneficence


A patient refused to receive blood products based on religious beliefs. The patient had unexpected blood loss during surgery. Which action by the healthcare team is consistent with patient autonomy?

Convince the family that administering blood is the right thing to do.

Give blood products in the operating room to stabilize the patient.

Aggressively treat the patient with therapies that exclude blood products. submitted

Encourage the family to agree to a do not resuscitate order.


A patient who is considering enrolling in a clinical research trial asks the RN "What would you do?" How does the RN respond in an ethical manner?

"I would agree to be enrolled because the study will also help other people."

"The study offers you a hope of a cure, it would be worth a try."

"I prefer to be treated with the medications that other people have used."

"It is a difficult decision, we will support you in whatever you chose." submitted


Which RN actions are supported by the 2015 ANA Code of Ethics? Select all that apply.

Participate in scientific inquiry to advance nursing practice.

Collaborate with others to promote health initiatives.

Accept accountability for delegation of nursing activities.

Advocate for patient rights.

Address patient needs as the priority before personal duties.

submitted


A teenager with a chronic disease disagrees with their parents regarding aggressive or palliative care treatment options. Which is the best response by the RN?

"In my experience, aggressive care has the best results."

"The ethics committee can assist with the decision-making process." submitted

"Your parents are ultimately responsible for making this decision."

"It is best to rely on the decision by your healthcare provider."


A patient with no health care directives is admitted to the hospital with a devastating stroke. The family asks the RN about options regarding resuscitation efforts. What is the RN's best initial response?

"Gather your family to make the best decision."

"What do you think the patient would want done?"

"Do you want to discuss all possible outcomes?"

"It is too early to make this decision."

unanswered


The RN is returning to work after placing a family member in Hospice care. Which response should the RN use when a terminally ill client asks, "Should I sign a do not resuscitate order?"

"I would choose not to be resuscitated, too."

"If you would like to seek spiritual counseling, I can call pastoral care."

"I just put my mother in Hospice care with a do not resuscitate order."

"This is a difficult situation; what are your views on end of life care?" submitted


A patient receiving home care is prescribed an analgesic medication that is twice the dose recommended by the manufacturer. Before administering the initial dose of the medication, what is the best response by the RN?

Inform the patient the dose might be lethal and cannot be administered.

Use nursing judgment and give half of the dose prescribed by the health care provider.

Contact the prescribing provider for clarification of the dose. submitted

Administer the dose as prescribed because it has been dispensed by a pharmacist.


Which element of health care reform provides the greatest opportunity to reduce health care costs?

Electronic health record

Organization accreditation

Experience rating systems

Insurance recission

unanswered


Which statement by the RN demonstrates an understanding of the benefit of The Joint Commission hospital accreditation?

"Accreditation provides a competitive edge in the healthcare marketplace."

"Accreditation validates efforts on improving the workplace environment." submitted

"Accreditation signifies the organization will be the best choice for clients to receive care."

"Accreditation certifies increased staffing levels on the nursing units."


What information does the RN include when explaining to a nursing student the advantages of being employed at a magnet hospital?

The preferred leadership style in a magnet hospital is authoritative.

Magnet hospitals undergo an external review to document standards of nursing excellence. submitted

Magnet hospitals have better benefit packages than non-magnet hospitals.

Non-magnet hospitals always have low patient satisfaction scores.


Which collaborative has the mission to work with federal and state agencies to strengthen policies and practices with the outcome of making people healthier?

Quality and Safety Education for Nurses

American Association of Retired People

Healthy People 2020 submitted

The Institute of Medicine


A patient awaiting surgery states "I chose the hospital for my surgery because it received high ratings on the internet." What is the most appropriate response by the RN?

"Tell me about the internet source you used for decision making." submitted

"Social media sites are a good source of information about local hospitals."

"Make sure you always choose a recently updated website for this information."

"The internet is what I use to check hospital ratings."


Which nurse would best assist a patient diagnosed with breast cancer requiring radiation and chemotherapy?

Nurse navigator submitted

Forensic nurse

Client safety nurse

Nurse researcher


The hospital is planning to implement a new bar code system for medication administration. Which statement describes the role of the RN to decrease medical errors?

"Training sessions should be optional for experienced nurses."

"A bar code system will eliminate the need for the RN to review medications."

"I will learn to bypass the system during patient care emergencies."

"I will ask to participate on the committee for bar code system design." submitted


The RN is caring for an older adult patient admitted with frequent falls at home. Which initial strategy is most effective to improve patient outcomes?

Coordination of care with an interdisciplinary team. submitted

Frequent hospitalizations help to manage illness effectively.

Maintain bedrest with close supervision.

Prepare for transfer to skilled nursing facility.


The RN is participating in a community forum on Health Care reform and is asked to comment on the projected impact of the Affordable Care Act for the profession of nursing. Which elements would the RN include in the response? Select all that apply.

Greater need for RNs to care for an increased number of persons seeking health care.

Increased use of Advanced Practice Nurses in the acute care and primary care settings.

Heightened demand for RNs in specialty fields such as informatics and case management.

Bolster the power of the American Nurses Association as a result of requirement for employment.

Development and implementation of new nursing roles.


A student nurse asks the RN "Is there anything special to consider when teaching prevention strategies to the older adult?" What is the best response by the RN?

"Older adults are less likely to be interested in learning new things."

"The chronically ill older adult may have limitations that require special teaching methods." submitted

"Older adults tend not to be motivated and don't make lifestyle changes."

"The nursing educational plan is the same for all adults regardless of age."


An older adult patient with a newly diagnosed illness tells the RN, "It looks like I need to make peace with God." What is the RN's best initial response?

"The clergy is much better trained to address your concerns."

"Do you want me to pray with you?"

"I can contact your family and friends who can support you during this time."

"Are you distressed about your condition?" submitted


What is an advantage of the telehealth technology?

Minimizes liability issues for the caregiver.

Requires minimal preparation for health providers and patients.

Allows healthcare providers to treat patients from distant sites. submitted

Private health care insurance fully covers costs.


What is a benefit of the Affordable Care Act?

Increases administrative costs for insurance companies.

Decreases Medicaid payments to primary care physicians.

Financially rewards technology driven acute hospital based services.

Eliminates co-pays for preventative services. submitted


Which action by a health care worker demonstrates a potential violation of patient privacy information when using a computerized medical record?

Using institutional communication devices for work related issues.

Using a privacy filter on computers that can be seen by others.

Posting a personal computer password in the nursing station. submitted

Logging out of the computer screen when finished with documentation.


A patient requires a transfer to a long-term nursing care facility after an extended acute care hospitalization. Which member of the health care team would best assist the patient and family with the process?

Nurse manager

Nurse care coordinator submitted

Bedside nurse

Client safety nurse


What does the RN anticipate as a societal health care need in the future?.

Expansion of acute care capacity.

Growth in the aging population. submitted

Increase use of task orientated nurses.

Paternalistic approach to the plan of care.


Which statement demonstrates the purpose of The Joint Commission (TJC)?

Develops program outcomes for quality nursing education.

Creates a national agenda to eliminate health disparities.

Identifies elements to attract and retain professional nurses.

Endorses an organization that provides high-quality service. submitted


Which statement by the RN demonstrates cultural sensitivity?

"I ask each patient about practices to promote wellness." submitted

"I learned to speak another language."

"I am familiar with many different cultures."

"I treat people as I would want to be treated."


The RN is providing care for a hospitalized patient who states, "I will never be able to manage my medications and appointments with all of these doctors. How i would be able to?" Which nurse role should the RN collaborate with to help the patient?

Nurse navigator submitted

Forensic psychiatric nurse

Nurse coder

Nurse safety officer


Which task can the RN delegate to an Assistive Personnel (AP)?

Showing a patient how to empty a wound drainage device.

Checking a patient's ankles for swelling after sitting in a chair.

Obtaining a blood pressure on a patient experiencing dizziness.

Measuring oral intake and output for a geriatric patient. submitted


A student nurse asks the RN about the legal authority to delegate tasks. Which statement describes why RNs have the legal right to delegate?

Employment by an institution approved for operation by the state provides legal authority to delegate.

RNs are licensed and governed by a statutory practice act which allows legal delegation.

Completion of a specialized program of professional study allows the RN to legally delegate.

American Nurses' Association Standards of Practice allow legal delegation by the RN. submitted


An assistive personnel (AP) says "I am not sure I calculated the intake and output correctly, but I know the nurse is always responsible." Which is an appropriate response by the RN to the AP?

"You are working under the RN's license when you accept responsibility for this task."

"The RN does not need to supervise tasks that are within the AP job description." submitted

"APs cannot record intake and output, you should not have done those tasks."

"When you agree to perform a task, you are responsible for your actions in carrying it out."


An LPN is assigned to care for a patient who suddenly develops acute respiratory distress. What is the most appropriate action by the charge RN?

Assign an RN to the LPN's patient and reassign the LPN. submitted

Assign the LPN's other patients to different nurses within the team.

Assign an assistive personnel (AP) to help the LPN with patient care.

Monitor the LPNs ability to handle patient needs and reassign only if needed.



A nurse manager is fostering assertive behavior in the nursing staff. What is the best response by the nurse manager to an RN who states that an assistive personnel (AP) consistently leaves patient units untidy?

"Discuss the issue with the AP and see if the two of you can come up with a solution." submitted

"I will speak to the AP but I need you to put the problem in writing."

"Please plan to bring up environmental clutter concerns at the next unit meeting."

"Plan to meet with me and the AP; I will get back to you with the details by the end of the day."


Which task is appropriate for the RN to delegate to an LPN/LVN?

Provide stoma care for a patient with an established colostomy. submitted

Monitor a newly admitted patient with acute heart failure.

Teach a patient's spouse how to cleanse and dress a wound on the posterior thigh.

Assess the function of a newly inserted intestinal tube.


Which patient would be most appropriate for the RN to assign to the LPN/LVN?

A patient who had a stroke and is awaiting transfer to a subacute facility. submitted

A patient with newly diagnosed diabetes mellitus who needs a home care referral.

A newly admitted patient with pneumonia who needs a care plan developed.

A patient with a hip fracture who requires a blood transfusion.


The homecare RN is coordinating care for a chronically ill patient. Which task can be delegated to the assistive personnel (AP)?

Teach family to administer pain medication orally.

Assist with bathing during every visit. submitted

Auscultate lung sounds and report abnormal findings to the RN.

Evaluate gait and the potential need for a walker.


The RN delegates oral care for an unconscious client to the assistive personnel (AP) who floated to the unit. The RN should intervene when observing the AP perform which actions? Select all that apply.

Turning the client's head to the side.

Placing an emesis basin under the client's mouth.

Using a gloved finger to open the client's mouth.

Positioning the client flat with knees flexed.

Placing 120 ml of mouthwash in the client's mouth.

submitted


The RN is planning care for a group of clients and has an LPN/LVN and an assistive personnel (AP) on the team. Which client is most appropriate for the RN to delegate care for to the LPN/LVN?

A client with stable heart failure who will be discharged in the afternoon. submitted

A client who had a heart attack four days ago and is short of breath on exertion.

A client scheduled for an EKG and Chest X-ray.

A client with pneumonia who is weak and needs assistance with bathing.


A nursing student asks the RN preceptor a question about their legal responsibility in delegation. Which response by the RN preceptor most accurately answers this question?

"You must know the agency's definition of specific roles and job description of the delegatee". submitted

"You must know where the delegatee received their education".

"You must know how clients have evaluated the delegatee's performance in the past".

"You must know the actual time it takes to perform a task before you can delegate it".


The RN is assigned to a client with diabetes. Which nursing actions can the RN delegate to the assistive personnel (AP)? Select all that apply.

Assessing for signs and symptoms of dehydration.

Recording intake and output every four hours.

Obtaining a blood glucose if the client complains of being dizzy.

Reinforcing client education about diet.

Measuring vital signs every 4 hours.

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