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Flashcards in Learn system Leadership Deck (10)
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Informed consent is based on the ethical principle of?
a. beneficence
b. autonomy
c. paternalism
d. justice

b. autonomy - informed consent is based on the ethical principle of autonomy (the right to self-determination, independence, freedom of choice)


Wotf observations made by a RN should be reported to the nurse manager as a violation against HIPAA?
a. admitting a client who requested a private room to a semi-private room due to unavailability.
b. placing a confused client in restraints
c. talking about p's with other nurses in the cafeteria
d. wheeling a p who is wearing only a sheet down the hall into the shower room

c. talking about p's w/other nurses in the cafeteria. No info about p's should be discussed w/anyone who is not directly involved in the p's care. (HIPAA violation).


RN is working with all LPNs and an AP. One p has a SBO, is NPO, and has a NG tube w/continous drainage. Wotf can't be delegated?
a. obtain an abd girth mxmt once q8h
b. inspect the p's oral cavity for dryness qhr
c. mx and record the ng tube output q4h
d. assess bowel sounds q2h

d. assess for bowel sounds q2h. Axmts are w/in the scope of practice for RNs only. While the lpn can also auscultate the p's abdomen for the presence of sounds, only the RN is qualified to eval the sounds and qualify them as hypoactive, normal, hyperactive.


A p receiving care from a home health nurse asks what is included in a living will. The RN explains that a living will is a document that?
a. establishes who will make HC decisions for the p. if the p. is not able
b. allows the p to express personal wishes regarding HC decisions.
c. serves as an informed consent form for any procedure Rx'd by a HCP
d. is only valid when a p is lucid and able to make informed decisions independently

b. The purpose of a living will is to allow the p an opportunity to specify what aspects of care and txmt are to be accepted or refused in the event that the p can no longer communicate those decisions. Option A describes a HC proxy document, which is not considered part of a living will. Living wills do not serve in the same capacity as informed consent (consent must be obtained by p or by DPOA). Living wills are not valid or necessary when a p is able to make informed HC decisions independently


RN completing an incident report after giving an incorrect dose of med to a p., although he didn't exp any SEs. The purpose of completing a variance report is to?
a. alert hosp administration of a possible litigation situation.
b. track employee performance for possible disciplinary action.
c. identify situations that contribute to the occurrence of med errors
d. gather data for statistical analysis

c. purpose of incident reports is to identify factors contributing to med errors. This is one aspect of quality improvement efforts in hc facilities


AP appears to be under influence of alcohol. Wotf is an appropriate response by the charge nurse?
a. confront the AP and remove him from care
b. ask the nrs supervisor to observe the AP and validate
c. document observations made about the APs behaviors in a factual manner
d. report the incident to the RN manager in the morning

b. The RN must first validate suspicions with another observer, then take the appropriate action to safeguard p's., then document the incident.


First action for an RN to take if charge nurse on the unit is making sexual references and promising a better schedule it the nurse agreed to dating?
a. submit a formal written grievance
b. put a statement in writing telling the charge nurse that the behaviors are inappropriate
c. keep a written journal of any events that the nurse feels are harassment
d. tell the charge nurse in clear terms that this conduct is discomforting and should be stopped

d. first action is to immediately confront the harasser and state that the behavior is unwanted and should be stopped. The incident should then be reported to the supervisor, documented in detail and maintained in a secure file


P is being transferred to a level 1 emergency department for immediate surgical intervention. The p. received IV meperidine (demerol). The receiving RN understands that consent for the surgery
a. can be obtained from the p
b. should be obtained from a relative of the p.
c. is implied since the p agreed to be transported to the level 1 emergency department
d. will be delayed until the meperidine is metabolized

b. Consent cannot be obtained from a p. who has received a medication that can alter the ability to understand the consent process. Consent should be obtained from a relative in this case. If a relative is unavailable and the surgery is determined to be critical, the surgery may proceed without consent


A p. in a ECF falls out of bed, fracturing his lt. hip. The side rails on the bed were not raised at bedtime, although the p. was identified to be at risk for falling. This is an incident of?
a. negligence
b. battery
c. an intentional tort
d. a criminal offense

a. negligence - this occurs when a p is exposed to an unreasonable risk of injury. Raised side rails help to decrease the risk of falling out of bed and are a standard of care for ps identified at risk.


Wotf situations requires the completion of a variance report?
a. clarification of a med dosage prescribe by a HCP
b. a dispute w/a coworker about p assignments
c. idenfication of a safety concern with a piece of equipment
d. the discovery that preop p has received and eaten a meal

d. the discovery that preop p has received and eaten breakfast. This situation represents a variation from the standard of care. A change in the p's POC is necessary for the p bc the surg procedure will need to be delayed.