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NCLEX-RN (2) Management of Care > Ethics & Legal > Flashcards

Flashcards in Ethics & Legal Deck (51)
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Can nurses give their opinions to clients?

No. Never give your opinion or advice on what the nurse would do in the client's situation.

Nurses provide non-judgemental care.


What is an advance directive?

An advance directive is a legal document in which a client specifies what actions should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity. 

It includes both:

  • living will
  • health care power of attorney/health care proxy


What is a living will?

A living will is a type of advance directive that has written instructions on what the client would like done with their health if they are unable to make their own decisions.


What is a health care power of attorney/health care proxy?

A health care power of attorney/health care proxy is a type of advance directive that designates a person the client has declared to make health care decisions if the client isn't able to. 


What is informed consent?

Informed consent is a document for invasive surgery or a procedure that the client signs:

  • the HCP explains the risks
  • the client signs the form and the nurse can sign as a witness
  • if the client doesn't understand the procedure or risks, the nurse informs the HCP

If it's an emergency, the informed consent does not need to be signed.


What should the nurse do if the client does NOT understand the risks of the procedure?

Contact the HCP to let them know.


What type of medications are held before the client signs the informed consent?

Don't give any meds that could sedate the client before they sign the informed consent. 

If the client gets a sedative (such as an opioid), the client may not be cognitively aware of what they are signing.


What does the nurse do if the client doesn't speak English while providing care?

If the client does not speak English:

  • get an interpreter
  • provide written information in the client's native language


In what kind of situations is the informed consent by an adult NOT needed when dealing with minors? 

Situations that minors (<18 years old) do NOT need adult consent:

  1. treatment for drug abuse
  2. treatment for sexually transmitted diseases or getting contraceptives


Emancipated minor

An emancipated minor is a person < 18 years old and has been deemed to make their own medical decisions by a judge.


What situations would a minor be considered emancipated?

Clients <18 years old may be emancipated if:

  • in the military
  • married
  • pregnant
  • deemed by a court to be emancipated for other reasons


Health Insurance Portability and Accountability Act (HIPAA)

HIPAA is a confidentiality law that states that a health care team member can't talk about clients except to those that are directly involved in the care. 


What is a hand-off report?

A hand-off report is when one nurse gives a report to another nurse about the client.

It needs to be thorough and in-person is best.


What does SBAR stand for?


  • Situation
  • Background
  • Assessment
  • Recommendation

It is a way to communicate with others on the healthcare team, especially the HCP when there is a problem with a client.


What does it mean to be an advocate for the client?

Advocate or Advocacy means to:

  • respect client's wishes
  • teach about how to care for themselves
  • speak up when client is unable to
  • get an interpreter if needed


What are client rights?

Client rights are a list of rights the client has when being cared for by a health professional.


What are the most common and important client rights?

The most common and important client rights are:

  1. right to receive care 
  2. right to refuse care
  3. right to have visitors
  4. right to privacy


What is the Nurse Practice Act (NPA)?

Nurse Practice Act:

  • defines the nurse's scope of practice
  • protects the public from harm

Each state and province has its own NPA.


What is the Hospital Policies and Procedures?

The Hospital Policies and Procedures is a document that gives more detail on how and what the nurse is allowed to do when caring for clients.


What is Evidence-Based Practice?

Evidence-Based Practice (EBP) is used to make safe and informed decisions about client care and standards of care.

Many policies are based on published national standards which are based on EBP.


What are the 4 points that make up evidence-based practice (EBP)?

EBP is:

  1. what the client prefers
  2. the experience and expertise of the nurse
  3. what the research shows
  4. availability of resources


What is Quality Improvement?

Quality Improvement is collecting data to make sure clients are being cared for properly.

A common quality improvement project is hand-washing practices by the staff.


What are 2 ways that show a client is an organ donor?

Organ donation is:

  1. indicated on the driver's license or state ID
  2. indicated on the advance directive


What age must a client be in order to be an organ donor?

18 years old


What are the reasons a client can NOT be an organ donor?

Client can NOT be an organ donor if they have:

  • cancer
  • an infectious disease


Who should the nurse refer the family member to if the client has died and the family member is upset about the decision that the client decided to be an organ donor?

Refer the family member to an organ donor expert


What is an ethical principle?

An ethical principle is a guiding principle for giving care in a way that benefits the client. 


What is the Code of Ethics?

The Code of Ethics is a document that explains the ethical principles.


What is an ethical dilemma?

An ethical dilemma is a situation in which there is a choice to be made between two options. Neither option resolves the situation in an ethically acceptable way for either party.

Refer these situations to an ethical dilemma committee.


Ethical principle: Veracity

Veracity: to tell the truth


Give an example of when veracity would be used with a client?

Example of veracity:

  • the client asks why they are taking a certain medication and the nurse is reluctant about saying what it's for
  • the nurse tells the truth about which medication the client is taking


Ethical principle: Fidelity

Fidelity: do what you promise


Give an example of when fidelity would be used with a client?

Example of fidelity:

  • the client asks for some pain medicine
  • the nurse then tells the client that they will go get it for them 
  • to show fidelity is to come back and actually give the pain medicine
  • you did what you promise


Ethical principle: Beneficence

Beneficence: to do good


Give an example of when beneficence would be used with a client?

Example of beneficence:

  • the client needs teaching about a certain diet for their disease
  • to show beneficence is to teach the client about the diet and make sure the client understands


Ethical principle: nonmaleficence

Nonmaleficence: do no harm


Give an example of when nonmaleficence would be used with a client?

Example of nonmaleficence:

  • the client needs to talk about their diagnosis and the nurse recognizes that the client needs to open up and talk
  • to show nonmaleficence is to use therapeutic communication with the client


Ethical principle: Justice

Justice: to be fair


Give an example of when justice would be used with a client?

Example of justice:

  • to show justice is to spend adequate time with all the clients under the nurse's care



Assault is a threat or to put the client in fear that harm will occur (not touching yet).

Example: the nurse tells the client if they don't take their meds, they won't give them a bath later. 



Battery is to touch client against their will.

Example: the client has an order to get a foley placed, but the client refuses. The nurse puts the foley in despite the client's rejection.


What should the nurse do if an error occurs with the client?

If an error occurs:

  • determine if the client is stable or unstable
  • tell the HCP and await further instructions


What is an incident report?

An incident report is a form that gets filled out and submitted that describes an error or unusual event.

Anyone can fill out an incident report including a client, family members, or health team members.


Can an incident report be filed or mentioned in the client's medical record/file?


  • don't put incident reports in the client's file
  • don't mention that an incident report was filed

The incident report is used by the hospital's risk assessment team to recognize and intervene appropriately to errors. 


What are some common reasons an incident report is filled out?

Incident reports are written because:

  • the wrong medication was given
  • a client fell
  • needle stick injury to the nurse
  • didn't implement a prescription
  • a visitor got injured


What are some examples of unsafe practices that would be reported to the nurse supervisor?

Unsafe practices to report to supervisor:

  • drug abuse by another co-worker
  • unsafe staff assignments such as:
    • too many clients to care for
    • not trained to care for clients with a particular problem



Malpractice/negligence is when the nurse should have done something or didn't do something and it resulted in harm to the client.

It is also called not following the standards of care.


What are some common situations of malpractice/negligence?

Examples of malpractice/negligence:

  • giving the wrong med
  • falls
  • not using sterile technique
  • burns from hot water or faulty equipment
  • didn't report changes in condition to the HCP
  • didn't monitor the client
  • didn't give a complete report to the new nurse coming on


What is mandatory reporting?

Mandatory reporting is when the nurse is legally required to report when abuse, certain infections or domestic violence has occurred or is suspected in a client.  

Reporting can be to the police, adult/child protective services or health department.



What is a voluntary admission?

A voluntary admission is when the client agrees to be admitted for care.


What is an involuntary admission?

An involuntary admission is when the client does not agree to be admitted for care.

The HCP has determined that the client is a harm to themselves or someone else or a judge has deemed the client incompetent to make the individual decision to be admitted.