Understanding Medical Surgical Nursing, 4th Edition Test Bank

Understanding Medical Surgical Nursing 4th Edition Williams Test Bank Full Download: https://testbanklive.com/download/understanding-medical-surgical-nursing-4th-edition-williams-test-bank/ Chapter 3. Issues in Nursing Practice Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. After working a 12-hour shift, the nurse is asked to work part of the next shift due to short staffing. The nurse is under which type of obligation to work? a. Justice b. Welfare c. Moral d. Legal ____ 2. The family of a patient who has been diagnosed with cancer does not want the patient told about the diagnosis. The patient asks the nurse, “Do I have cancer?” Which ethical principles should the nurse consider to resolve this situation? a. Autonomy and veracity b. Beneficence and justice c. Nonmaleficence and legal obligations d. Welfare rights and moral obligations ____ 3. A patient tells the nurse that the Patient’s Bill of Rights gives patients the legal right to read their medical information. Which of these responses would be appropriate for the nurse to make? a. “The Patients’ Bill of Rights is a legal document that is enforceable by law.” b. “The Patients’ Bill of Rights is a legal document that is open to interpretation.” c. “The Patients’ Bill of Rights is valid if the physician prescribes that it be followed.” d. “The Patients’ Bill of Rights is an ethical or moral right not enforceable by law.” ____ 4. The nurse is assigned to care for a patient who has HIV. The nurse accepts the patient assignment despite believing that the patient’s condition is a punishment from God. Which ethical principle did the nurse follow in accepting this patient assignment? a. Beneficence b. Justice c. Nonmaleficence d. Veracity ____ 5. Which of these actions can nurses take to increase their limitation of liability? a. Ensure patient rights. b. Follow directions exactly as given. c. Verify employer’s liability insurance. d. Follow verbal orders. ____ 6. A physician is conducting an experiment with a new medication and needs several more patients in the study. The physician asks the nurse to give the medication to an adult patient who is unable to understand the experiment but willingly takes any medication. Which ethical principle should the nurse cite in objecting to the inclusion of this patient in the experiment? a. Autonomy b. Nonmaleficence c. Standard of Best Interest d. Veracity ____ 7. New technology used in health care has had which of these effects on nurses’ use of the ethical decision-making process? Full download all chapters instantly please go to Solutions Manual, Test Bank site: TestBankLive.com a. b. c. d. Nurses have fewer ethical decisions because computers now make many decisions. Nurses can postpone ethical decisions because technology allows patients to live longer. Ethical dilemmas have become more complex owing to technologies that prolong life. Ethical situations remain similar to what they have always been in health care. ____ 8. Which of these would most interfere in a patient’s ability to make an autonomous decision about his or her own health care? a. Authoritarian family relationships b. Past experience with hospitalization c. Lower socioeconomic status d. Lack of information about treatment ____ 9. A patient has a living will and gives it to the nurse to follow. The patient says, “Do not tell my family about the living will.” Which of these actions should the nurse take? a. Encourage the patient to discuss the living will with the family. b. Assure the patient that the nurse will not tell anyone. c. Send a copy of the living will to medical records. d. Return the living will to the patient until the family is informed. ____ 10. The nurse is caring for Mrs. Genevieve Gristham, who is 80 years old. Which of these statements by the nurse conveys dignity and respect to the patient? a. “Honey, I have your medications.” b. “I have your medications for you, dear.” c. “Ms. Genevieve, I have your medications for you.” d. “Mrs. Gristham, I have your medications for you.” ____ 11. Which of these observations by the nurse would require taking action for breach of confidentiality? a. Use of patient initials on nurse’s assignment worksheet b. A nurse asking an unknown physician for identification c. A physician asking a nurse if a friend has cancer d. A nurse reviewing charts of assigned patients for orders ____ 12. Which of these types of laws establish the parameters within which nurses must practice to obtain and maintain their licenses? a. Administrative law b. Moral law c. Tort law d. Civil law ____ 13. Which of these legal terms refers to the nurse’s failure to follow a prescribed duty of care? a. Crime b. Summons c. Malpractice d. Respondeat superior ____ 14. The nurse is served with a summons relating to the care of a patient. Which of these actions should the nurse take? a. Notify employer immediately. b. Seek legal counsel after 30 days. c. Acknowledge liability promptly. d. Answer summons after 30 days. ____ 15. Which of these actions of a nursing assistant would the nurse recognize as violating a patient’s rights? a. b. c. d. Knocking before entering the patient’s room Identifying name and title to the patient Asking the patient which beverage is preferred Telling the patient to bathe right now ____ 16. The nurse understands that an employer’s insurance provides liability coverage for the nurse’s action when which of these conditions occurs? a. The nurse provides professional nursing care. b. The nurse follows institutional policies. c. The nurse has payroll-deducted premiums. d. The nurse understands the state’s tort laws. ____ 17. A civil liability suit begins with which of these actions? a. Serving the defendant a copy of the complaint b. Answering a summons c. Filing a complaint with a court d. Determination of a respondent superior ____ 18. A patient remarks to the LPN that she has decided not to have a hysterectomy even though her gynecologist recommends it. The LPN says, “Oh, you should have it done. You have had your children already, and this surgery would be good for you. I’ll tell the RN that you have decided to have the surgery.” This is an example of which ethical principle? a. Nonmaleficence b. Autonomy c. Paternalism d. Beneficence ____ 19. Which of these is a bioethical theory that states outcomes are the most important factor to consider in decision making? a. Deontology b. Utilitarianism c. Religion d. Theological ____ 20. What is the final step when making an ethical decision? a. Clarify the values of all the participants. b. Implement the decision. c. Evaluate the outcomes. d. Determine which action has the strongest ethical support. ____ 21. Which law/act/regulations have been established nationally to protect a patient’s medical and personal information? a. Medicare b. Patients’ Bill of Rights c. Department of Health and Human Services regulations d. Health Insurance Portability and Accountability Act (HIPAA) ____ 22. While standing in the lunchroom, the nurse recognizes friends of a patient who was recently transferred to the intensive care unit (ICU). The nurse approaches them saying, “Did you know that Mr. Robinson had to go to ICU? I can take you there if you are looking for him.” This action is an example of which of the following? a. Defamation b. False Imprisonment c. Disclosure of Confidential Information d. Compassion Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 23. The nurse is performing a procedure while caring for a patient and unintentionally eliminates a step in the procedure. Which of these may result from the nurse’s action? (Select all that apply.) a. No personal liability b. Breach of duty c. Civil liability for employer d. Unintentional tort e. Negligence f. Assault and battery ____ 24. What may be included in tort reform legislation as it pertains to health-care workers and institutions? (Select all that apply.) a. Limiting dollar amounts allowable for a patient’s damages b. Requiring expert medical evaluation before a lawsuit is filed c. Acquiring individual malpractice or liability insurance d. Shortening the time in which a patient may file a lawsuit e. Reading institutional policies before procedures f. Requiring continuing education for caregivers ____ 25. Which of the following is included in The National Council of State Boards of Nursing’s (NCSBN) five rights of delegation? (Select all that apply.) a. Right communication b. Right circumstances c. Right day d. Right person e. Right supervision f. Right place ____ 26. A nurse is working on a medical unit in a hospital undergoing a Joint Commission review. The investigator asks the nurse to explain “never events.” Which of the following could be included in the nurse’s reply? (Select all that apply.) a. “Never events result in the nurse or physician never being allowed to practice again.” b. “Never events are serious reportable adverse events that should never occur to a patient.” c. “Hospitals will not be paid or reimbursed by Medicare/Medicaid for treatment related to never events.” d. “It is a new Joint Commission policy related to bioterrorism or other catastrophic events that will probably never happen.” e. “Never events are sentinel events that are devastating to patients.” f. “Institutional policies and procedures are in place to promote patient safety and prevent the occurrence of never events.” ____ 27. The LPN is working in a senior center and is approached by a participant who asks the nurse, “Can you help me understand my Medicare benefits?” The nurse would base a response on which of the following? (Select all that apply.) a. Medicare is a federally funded program for individuals 65 and over. b. Medicare is a payment system for the working poor. c. Medicare bases payment to individuals on their current medical diagnosis. d. Medicare Part A covers inpatient hospital care and is free to those who qualify for Social Security. e. Medicare Part B covers outpatient services and has a monthly cost. f. Perscription drug coverage for those with Medicare coverage is available. Completion Complete each statement. 28. The principle of ____________________ is the obligation to be faithful to commitments made to self and others. Chapter 3. Issues in Nursing Practice Answer Section MULTIPLE CHOICE 1. ANS: C Morals are standards set by our own conscience and they guide one’s decision to work. Justice is the ethical principle of fairness and equality. Welfare or legal rights are guaranteed by laws. PTS: 1 DIF: Easy REF: Page 26 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Comprehension | Question to Guide Your Learning: 7 2. ANS: A A. Autonomy in health care refers to those individuals who are considered capable and competent making health-care decisions for themselves. Veracity is the virtue of truthfulness that requires health-care providers whenever possible to tell the truth and not intentionally deceive or mislead patients. B. Beneficence is considering and offering treatments that are likely to provide relief. Justice is the ethical principle of fairness and equality. C. Nonmaleficence is doing no harm. Legal rights are guaranteed by laws. D. Welfare rights are guaranteed by laws. Morals are standards set by our own conscience. PTS: 1 DIF: Medium REF: Page 26 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Application | Integrated Processes: Caring | Question to Guide Your Learning: 8 3. ANS: D Laws guarantee some rights. Others, such as the Patients’ Bill of Rights, are moral rights based on values and ethical principles but are not enforceable by law. PTS: 1 DIF: Medium REF: Page 29 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Application | Integrated Processes: Teaching and Learning | Question to Guide Your Learning: 6 4. ANS: B Justice is the ethical principle of fairness and equality. Beneficence is considering and offering treatments that are likely to provide relief. Nonmaleficence is doing no harm. Veracity is the virtue of truthfulness. PTS: 1 DIF: Medium REF: Page 31 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Comprehension | Integrated Processes: Caring | Question to Guide Your Learning: 8 5. ANS: A A. To provide quality care and limit liability, understand and provide the rights your patient is entitled to. B, D. Directions that are controversial, given verbally, concern situations of high liability, or involve a discrepancy between the direction and standard policy should be questioned. C. Having insurance is not an action that limits liability. Insurance provides liability coverage and may be offered by some employers but not all. PTS: 1 DIF: Easy REF: Page 35 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Recall | Question to Guide Your Learning: 12 6. ANS: B B. The principle of nonmaleficence requires a nurse to protect from harm those who cannot protect themselves, such as the mentally incompetent or the unconscious. A. Autonomy in health care refers to those individuals who are considered capable and competent, making health-care decisions for themselves. C. The best interest standard involves the determination of what action is in the best interest of the patient. Family members together with health-care providers usually make the best interest determination. D. Veracity is the virtue of truthfulness. PTS: 1 DIF: Hard REF: Page 30 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Application | Integrated Processes: Caring | Question to Guide Your Learning: 8 7. ANS: C Today’s sophisticated technology and complex treatments have resulted in more complex ethical issues that caregivers, not computers, must consider in decision making. PTS: 1 DIF: Medium REF: Page 26 KEY: Client Need: Caring | Cognitive Level: Comprehension | Integrated Processes: Clinical Problem-Solving Process | Question to Guide Your Learning: 9 8. ANS: D Autonomy in health care refers to those individuals who are considered capable and competent making health-care decisions for themselves, but to do so, individuals must first have the information to make the decision. The other choices could influence decisions but not as greatly as information. PTS: 1 DIF: Medium REF: Page 30 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Comprehension | Question to Guide Your Learning: 8 9. ANS: A The second step in the ethical decision-making model is to clarify the values of all the participants involved in a patient’s care. This would include the patient’s family, and it is best that the patient discusses this with the family. The other options do not support this clarification or ensure that the patient’s wishes will be known or followed if the living will is not placed in the patient’s chart. PTS: 1 DIF: Hard REF: Page 32 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Analysis | Integrated Processes: Communication and Documentation | Question to Guide Your Learning: 9 10. ANS: D Respectfulness is an attitude of a nurse toward the patient which indicates valuing that patient and his or her feelings as a unique individual. Terms of endearment do not convey respect, especially to older adults, and should not be used. Using proper names or asking patients how they prefer to be addressed shows respectfulness. PTS: 1 DIF: Medium REF: Page 29 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Application | Integrated Processes: Caring | Question to Guide Your Learning: 7 11. ANS: C C. Nurses are obligated to discuss the patient only under circumstances in which it is necessary to deliver high-quality health care according to Health Insurance Portability and Accountability Act (HIPAA). A, B, and D are not breaches of confidentiality. PTS: 1 DIF: Medium REF: Page 34 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Application | Question to Guide Your Learning: 13 12. ANS: A A. State nursing practice laws and the attendant nursing regulations establish the parameters within which nurses must practice and are referred to as administrative laws. B, C, and D are not associated with nursing licensure. PTS: 1 DIF: Easy REF: Page 34 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Recall | Question to Guide Your Learning: 11 13. ANS: C C. Malpractice is a breach of the duty that arises out of the relationship that exists between the patient and the health-care worker. A. An action taken by an individual against society. B. A notice to defendants that they are being sued. D. The institution that employs the worker may also become liable for the acts or omissions of its employees. PTS: 1 DIF: Easy REF: Page 35 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Recall | Question to Guide Your Learning: 12 14. ANS: A Nurses served with a summons relating to work should notify their employers and ensure the summons is answered. If the employer does not answer the summons, the nurse must seek legal counsel to answer the summons within the specified time, 20 to 30 days. If the nurse fails to answer the summons and complaint, a default judgment may be made, which is acknowledgment of liability. PTS: 1 DIF: Easy REF: Page 34 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Recall | Question to Guide Your Learning: 12 15. ANS: D D. Not allowing patients to have a choice in their care would violate patients’ rights. A, B, and C. Knocking before entering a patient’s room, introducing oneself, and allowing patient input are examples of ensuring patients’ rights. PTS: 1 DIF: Medium REF: Page 35 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Comprehension | Question to Guide Your Learning: 12 16. ANS: B B. Employer’s insurance will provide coverage from liability when the employee follows the employer’s work policies. A, C, and D do not determine liability coverage. PTS: 1 DIF: Easy REF: Page 36 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Recall | Question to Guide Your Learning: 12 17. ANS: C C. A civil liability suit begins with the filing of a complaint with a court. A, B, and D are actions that may be taken after a suit is filed. PTS: 1 DIF: Easy REF: Page 34 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Recall | Question to Guide Your Learning: 12 18. ANS: C C. Deciding for patients without regard for their preferences is paternalism. A. Nonmaleficence is doing no harm. B. Autonomy refers to individuals making health-care decisions for themselves. D. Beneficence is considering and offering treatments that are likely to provide relief. PTS: 1 DIF: Medium REF: Page 30 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Application | Integrated Processes: Communication and Documentation | Question to Guide Your Learning: 8 19. ANS: B B. In utilitarian theory, actions are judged by their consequences, so outcomes are the most important elements to consider in ethical decision making. A. Deontology requires actions not to be judged only in terms of their consequences. C. Religious teachings are key concepts for ethical decision making for some individuals. D. Theological perspectives include the many religious traditions represented in our culture. PTS: 1 DIF: Easy REF: Page 31 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Recall | Question to Guide Your Learning: 8 20. ANS: C Evaluation of outcomes is the final step in the ethical decision-making process to learn from success or failure and gain knowledge for the next ethical dilemma. A, B, and D are other steps in the ethical decision-making process. PTS: 1 DIF: Easy REF: Page 33 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Recall | Question to Guide Your Learning: 9 21. ANS: D Nationally, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) creates civil and criminal liability for health-care workers who wrongfully disclose an individual’s health information. A, B, and C do not establish liability for disclosure of health information. PTS: 1 DIF: Easy REF: Page 34 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Recall | Integrated Processes: Communication and Documentation | Question to Guide Your Learning: 13 22. ANS: C The wrongful release of confidential information is an intentional tort. A. Defamation is the wrongful injury to another’s reputation. B. False imprisonment is the unlawful restriction of a person’s freedom. D. Compassion is a central virtue that allows the nurse to identify with another’s pain or suffering. PTS: 1 DIF: Easy REF: Page 35 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Application | Integrated Processes: Communication and Documentation | Question to Guide Your Learning: 13 MULTIPLE RESPONSE 23. ANS: B, C, D, E B, C, D, and E. An unintentional tort is known as negligence. Negligence occurs when injury results from the failure of the wrongdoer to exercise care. This failure to follow due care in the protection of the person injured is a breach of duty. The institution that employs the worker may become liable for the acts or omissions of its employees. A. Employees always remain responsible for their own actions as well. F. Assault and battery involves threatened or real touching or bodily harm, which is not in this scenario. PTS: 1 DIF: Medium REF: Page 35 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Comprehension | Question to Guide Your Learning: 12 24. ANS: A, B, D Tort reform legislation is directed at limiting liability for health-care professionals and institutions and includes limitations on the dollar amount allowable for a patient’s damages, shortening the time in which a patient can file a lawsuit, and requiring stringent expert medical evaluation of a claim before a lawsuit can be filed. Having liability insurance, reading policies, and continuing education can help reduce a nurse’s liability but are not part of legislative reform. PTS: 1 DIF: Medium REF: Page 35 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Comprehension | Question to Guide Your Learning: 12 25. ANS: A, B, D, E The NCSBN identifies the five rights of delegation as the right task, person, circumstances, supervision, and communication, PTS: 1 DIF: Easy REF: Page 25 KEY: Cognitive Level: Recall | Question to Guide Your Learning: 5 26. ANS: B, C, E, F The National Quality Forum (NQF) has identified serious reportable adverse events (also called “never events”) so devastating to patients that they should never occur in a health-care setting. Joint Commission considers never events to be sentinel events. The Centers for Medicare & Medicaid Services have implemented a new policy related to Hospital-Acquired Conditions (taken from NQF’s never event list); hospitals should not receive payment for medical errors that should never happen. PTS: 1 DIF: Medium REF: Page 20 KEY: Client Need: Safe and Effective Care Environment | Cognitive Level: Application | Integrated Processes: Communication and Documentation | Question to Guide Your Learning: 2 27. ANS: A, D, E, F Medicare is run by the U.S. government and currently covers all individuals age 65 and over. Several Medicare plan options are offered: Original Medicare, Medicare Health Plans, Medigap policies, and prescription drug coverage for everyone with Medicare. There are two parts of coverage in the original Medicare plan. Part A covers inpatient hospital care, skilled nursing facilities, hospice services, and some home care. There is no premium or deductible for Part A. Part B is medical insurance that covers physician costs, outpatient services, some home care, supplies, and other things not covered by Part A. Some preventive services may also be covered. A monthly premium and yearly deductible are paid for Part B coverage PTS: 1 DIF: Medium REF: Page 21 KEY: Client Need: Caring | Cognitive Level: Application | Integrated Processes: Teaching and Learning | Question to Guide Your Learning: 1 COMPLETION 28. ANS: fidelity The principle of fidelity is the obligation to be faithful to commitments made to self and others. In health care, fidelity includes faithfulness or loyalty to agreements and responsibilities accepted as part of the practice of nursing. Understanding Medical Surgical Nursing 4th Edition Williams Test Bank Full Download: https://testbanklive.com/download/understanding-medical-surgical-nursing-4th-edition-williams-test-bank/ PTS: 1 DIF: Easy REF: Page 28 KEY: Client Need: SECE—Coordinated Care | Cognitive Level: Recall | Integrated Processes: Caring | Question to Guide Your Learning: 8 Full download all chapters instantly please go to Solutions Manual, Test Bank site: TestBankLive.com