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

Ethics & Legal Flashcards

Review ethical/legal concerns and problems.

1
Q

Can nurses give their opinions to clients?

A

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

Nurses provide non-judgemental care.

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2
Q

What is an advance directive?

A

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
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3
Q

What is a living will?

A

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.

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4
Q

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

A

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.

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5
Q

What is informed consent?

A

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.

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6
Q

What does it mean when a nurse is a “witness” for informed consent?

A

As a witness, the nurse confirms that the client was with it mentally to understand the procedure and risks; And that the nurse confirmed the identity of the client.

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7
Q

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

A

Contact the HCP to let them know.

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8
Q

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

A

Any meds that could sedate the client.

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

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9
Q

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

A
  • get an interpreter
  • provide written information in the client’s native language
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10
Q

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

(minors are <18 years old)

A
  1. treatment for drug abuse
  2. treatment for sexually transmitted diseases or getting contraceptives
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11
Q

Define:

Emancipated minor

A

A person < 18 years old and has been deemed to make their own medical decisions by a judge.

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12
Q

What situations would a minor be considered emancipated?

(minors are <18 years old)

A
  • in the military
  • married
  • pregnant
  • deemed by a court to be emancipated for other reasons
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13
Q

Define:

Health Insurance Portability and Accountability Act

(HIPAA)

A

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.

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14
Q

What is a hand-off report?

A

When one nurse gives a report to another nurse about the client.

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

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15
Q

What does SBAR stand for?

A
  • 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.

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16
Q

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

A
  • to respect client’s wishes
  • to teach about how to care for themselves
  • to speak up when client is unable to
  • to get an interpreter if needed
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17
Q

What are client rights?

A

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

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18
Q

What are the most common and important client rights?

A
  1. right to receive care
  2. right to refuse care
  3. right to least restrictive care
  4. right to have visitors
  5. right to privacy
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19
Q

What is the Nurse Practice Act?

(NPA)

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

Each state and province has its own NPA.

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20
Q

What is the Hospital Policies and Procedures?

A

A document that gives more detail on how and what the nurse is allowed to do when caring for clients.

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21
Q

What is Evidence-Based Practice?

(EBP)

A

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.

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22
Q

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

A
  1. what the client prefers
  2. the experience and expertise of the nurse
  3. what the research shows
  4. availability of resources
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23
Q

What is Quality Improvement?

A

Collecting data to make sure clients are being cared for properly.

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

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24
Q

What is the Good Samaritan Law?

A

States that the nurse (or other health care professional) can stop to help people in a medical emergency without being sued.

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25
Q

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

A

Organ donation is:

  1. indicated on the driver’s license or state ID
  2. indicated on the advance directive
26
Q

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

A

18 years old

27
Q

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

A

If they have:

  • cancer
  • an infectious disease
28
Q

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?

A

An organ donor expert.

29
Q

What is an ethical principle?

A

A guiding principle for giving care in a way that benefits the client.

30
Q

What is the Code of Ethics?

A

A document that explains the ethical principles.

31
Q

What is an ethical dilemma?

A

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.

32
Q

Define:

Ethical principle: Veracity

A

To tell the truth.

33
Q

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

A
  • 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
34
Q

Define:

Ethical principle: Fidelity

A

Do what you promise.

35
Q

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

A
  • 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
36
Q

Define:

Ethical principle: Beneficence

A

To do good.

37
Q

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

A
  • 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
38
Q

Define:

Ethical principle: nonmaleficence

A

Do no harm.

39
Q

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

A
  • 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
40
Q

Define:

Ethical principle: Justice

A

To be fair.

41
Q

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

A

To show justice is to spend adequate time with all the clients under the nurse’s care.

42
Q

Define:

Assault

A

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.

43
Q

Define:

Battery

A

To touch the 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.

44
Q

What does duty to warn and protect mean?

A

When the nurse is legally allowed to notify the police or relatives if the client is making threats of death or harm to themselves or others.

45
Q

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

A
  • determine if the client is stable or unstable
  • tell the HCP and await further instructions
46
Q

What is an incident report?

A

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.

47
Q

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

A

No.

  • 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.

48
Q

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

A
  • the wrong medication was given
  • a client fell
  • needle stick injury to the nurse
  • didn’t implement a prescription
  • a visitor got injured
49
Q

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

A
  • 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
50
Q

Define:

malpractice/negligence

A

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.

51
Q

What are some common situations of malpractice/negligence?

A
  • 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
52
Q

What is mandatory reporting?

A

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.

53
Q

What is a voluntary admission?

A

When the client agrees to be admitted for care.

54
Q

What is an involuntary admission?

A

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.

55
Q

What is Against Medical Advice?

(AMA)

A

When a voluntary client is discharged even though the HCP has advised against leaving.

56
Q

What does DNR stand for?

A

Do Not Resuscitate

57
Q

Define:

Libel and Slander

A

Sharing information that is detrimental to a person’s reputation (has to be malacious and false).

  • Libel: done in writing
  • Slander: done verbally
58
Q

Define:

False Imprisonment

A

Using restraints or seclusion to a voluntarily committed client against their will and who is NOT an immediate danger to themsleves or others.

Examples are hiding clothes or personal belongings so the client can’t leave.

59
Q

What types of gifts can a nurse accept from a client?

A

The nurse cannot accept any personal gifts from the client.

Food, beverages or flowers for the entire unit would be OK to accept.

60
Q

Can the nurse use social media to keep in touch with a client?

A

The nurse should NOT use social media with any clients.

This action breaks the professinal boundary.

61
Q

Define:

Ethical Principle: Autonomy

A

Respect decisions made by the client.

61
Q

Give an example when autonomy would be used with a client?

A

Allowing the client to perform their own ADLs (activities of daily living) even though the nurse believes they can do it faster or better.

NCLEX-RN (2) Management of Care (3 decks)

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