Ethics

Question 1

What is the AANA code of ethics?

Answer 1

Dictates principles of conduct and integrity for CRNAs and holds them accountable regardless of institutional policy or a physician order

Question 2

What are practice guidelines? Should or must be followed?

Answer 2

Guidelines that assist providers that are commonly accepted in the anesthesia community

“Should” be adhered to

Question 3

What are practice standards?

Answer 3

Describe the minimum rules and responsibilities of anesthetists.

“Must” be adhered to

Question 4

What are position statements?

Answer 4

Express the AANA official positions or beliefs

Question 5

Define autonomy

Answer 5

The patient’s ability to choose without controlling interference by others

Question 6

Define nonmaleficence

Answer 6

The provider has an obligation to not inflict harm (Hippocratic oath)

Question 7

Define beneficence

Answer 7

Providers should take action for the benefit of others. Prevent harm by actively helping

Question 8

What are 6 elements of consent?

Answer 8

Competence
Able to make decisions
Disclosure of information
Understanding of said information
Voluntary consent
Documentation

Question 9

What is informed refusal? Example?

Answer 9

The patient has the right to refuse treatment

Ex: Jehovah’s witness

Question 10

What is an advanced directive?

Answer 10

Legally binding document that outlines patients wishes

Question 11

What 4 things must be proven during a lawsuit asserting malpractice ?

Answer 11

Duty
Breach of duty
Causation
Damages

Question 12

What is res Ipsa loquitur?

Answer 12

The thing speaks for itself. Can shift the burden of proof from the plaintiff to the defendant

Question 13

What 4 things must be proven in res Ipsa loquitur?

Answer 13

1. Injury would not have occurred in the absence of negligence
2. Injury was caused by something under complete control of the defendant (provider)
3. The patient did not contribute to the injury
4. The evidence for the explanation of events is solely under the control of the provider

Question 14

Libel vs slander?

Answer 14

Libel - written defamation

Slander - verbal defamation

Question 15

Assault vs battery.

Answer 15

Assault - is the attempt to touch another person

Battery - touching a person without expressed or implied consent

Question 16

What is vicarious liability? Another name?

Answer 16

One person may be liable for another’s actions.

Respondeat superior

Ex: MD is responsible for PAs actions

Question 17

What is the Affordable care act?

Answer 17

-All individuals must carry health insurance
-Standards and requirements for health insurance
-Can no longer charge more for pre-existing conditions

Question 18

What is EMTALA?

Answer 18

Emergency Medical Treatment and Labor act

Must treat the patient regardless of their ability to pay

Question 19

What is Health Insurance Portability and accountability act?

Answer 19

HIPPA

Federal law that you can’t disclose information

Question 20

What is the controlled substance act?

Answer 20

The government defines and controls-controlled substances

Question 21

What schedule 1 drugs are used in anesthesia?

Answer 21

NONE

Schedule 1 drugs have no acceptable medical use

Question 22

What schedule 2 drugs are used in anesthesia?

Answer 22

High potential for abuse

1. Opioid agonists (fent)
2. Cocaine
3. Meth
4. Phencyclidine

Question 23

What is the health information technology for economic and clinical health act?

Answer 23

An amendment to HIPAA

Intended to create a healthcare information technology infrastructure to improve quality of care

Question 24

Lawsuit steps

Answer 24

Question 25

First step in a lawsuit?

Answer 25

Notify insurance immediately

Question 26

What is an emancipated minor?

Answer 26

Patients younger than 18 who were given rights of an adult by the state Some criteria 1. Married 2. Veteran 3. A parent or pregnant 4. Economically independent

Question 27

If a Jehovah's Witness patient is having surgery with high likelihood of transfusion, what steps should be taken?

Answer 27

Seek a court order prior to surgery

Question 28

If a Jehovah's Witness patient is having life threatening hemorrhage, can blood be given before obtaining a court order?

Answer 28

Yes but must seek a court order after

Question 29

Should a Jehovah's Witness patient under the age of 18 be included on medical decisions regarding blood products?

Answer 29

Yes if close to 18

Question 30

What is anesthesia crisis resource management ?

Answer 30

?? in a crisis, people can respond without proper training?

Question 31

What are 5 complications of fatigue?

Answer 31

Diminished reaction time Impaired decision making Decreased situational awareness Impaired memory or focus Periods of microsleep

Question 32

What is microsleep?

Answer 32

Sleep that lasts seconds to minutes

Question 33

What does being awake for 24 hours equal in alcohol BAC?

Answer 33

24 hours of wakefulness is equal to a BAC of 0.1%

Question 34

When is sleep related behavior most common?

Answer 34

16 or more hours of work Night shift

Question 35

6 counter measures for fatigue?

Answer 35

Napping Caffeine Exercise Consistent sleep wake pattern Medications Recovery between shifts

Question 36

What is the OSHA limit for exposure to ionizing radiation for annual and lifetime

Answer 36

Annual = 5 rem Lifetime = (n-18) x 5 rem n= age

Question 37

Is there a limit to MRI exposure? S&S?

Answer 37

No limit but may cause dizziness, vertigo, or light flashes

Question 38

OSHA noise exposure limits?

Answer 38

8-hour span 90dB single noise level of 115dB

Question 39

What is addiction?

Answer 39

A need for a substance - loss of self-control

Question 40

What is impairment?

Answer 40

Inability to safely participate in life

Question 41

What is tolerance?

Answer 41

More drug is needed to achieve desired effect

Question 42

What is withdrawal?

Answer 42

A characteristic syndrome that is the direct result of stopping a drug

Question 43

How many years of recovery is recommended before reentry to the workplace? How long should "probation" be?

Answer 43

1 year 5 years of monitoring

Question 44

What are the steps if you suspect a coworker is abusing or impaired?

Answer 44

1. Do not let them out of your sight or drive 2. Have a treatment facility available 3. Do not let them decide their treatment 4. Threaten to call the police

Question 45

What are 6 elements of high-quality care?

Answer 45

1. Patient centered care 2. Safe 3. Effective 4. Timely 5. Efficient 6. Equitable

Question 46

What is cultural competence

Answer 46

Give the same care to every human