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WorksheetsNCLEX - LEGAL ETHICAL Day1
Total questions: 25
Worksheet time: 25mins
Name
Class
Date
1.
The nurse in the emergency department is caring for a client who is unconscious and requires an emergency craniotomy. The client has no identification. The nurse should recognize that it would be a priority to
a)
document medical necessity of the surgical procedure in the client's medical record
b)
transport the client to the operating room under the premise of implied consent
c)
contact the local police to help identify the client and locate family members
d)
obtain court permission for the client's surgical procedure
e)
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2.
A housekeeping employee tells the staff nurse of having a headache and asks for acetaminophen. How should the nurse respond?
a)
Ask about liver disease and give acetaminophen from the nurse's personal supply
b)
Assess the employee's blood pressure
c)
Check for allergies to drugs before giving acetaminophen from hospital stock
d)
Refer employee to the employee health provider
e)
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3.
The nurse finds a client on the floor in the client's room. Based on the documentation shown in the exhibit, the nurse made an incorrect entry in the client's medical record at what time?
a)
1700
b)
1710
c)
1740
d)
1810
e)
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4.
The nurse in the outpatient care facility is caring for a client with metastatic lung cancer who received chemotherapy 3 days ago. The client states, "I have decided that I do not want to continue treatment." Which of the following responses would be appropriate for the nurse to make?
a)
That is not an easy choice to make. I will notify your health care provider of your decision.
b)
Have you considered how this decision might affect your spouse and children?
c)
I do not think it is wise to stop chemotherapy. You will become too sick to enjoy your life.
d)
Have you discussed this decision with someone else that you trust?
e)
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5.
A newly reassigned nurse enters a hospital room at the beginning of the shift and finds the client unconscious and unresponsive. Resuscitation is initiated and then continued by the rapid response team. The nurse realizes that there is a do not resuscitate (DNR) prescription posted in the client's chart. Which action is correct?
a)
Stop all resuscitation activity immediately
b)
Continue resuscitation until DNR status is verified with health care provider
c)
If client shows any signs of life, follow advanced cardiovascular support protocol until stable
d)
Once resuscitation has begun, complete it regardless of client code status
e)
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6.
The nurse is caring for a client who has no pulse and is experiencing the cardiac rhythm in the ECG strip shown below. The client has a do not attempt resuscitation directive. The health care provider orders initiation of resuscitative measures. Which of the following actions should the nurse take?
a)
Initiate chest compressions.
b)
Clarify the order with the HCP.
c)
Prepare the client for defibrillation.
d)
Verify the client's wishes with the family.
e)
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7.
The nurse is providing end-of-life care to a client who has a do not attempt resuscitation directive. The client's respirations are 6/min. Which of the following actions should the nurse take?
a)
Administer oxygen at 2 L/min via nasal cannula.
b)
Obtain the spouse's consent for endotracheal intubation.
c)
Determine if the client has a power of attorney for health care.
d)
Ask the client if any changes have been made to the DNAR directive.
e)
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8.
Which client in the emergency department would be allowed to leave against medical advice after the risks are discussed with the primary health care provider?
a)
5-year-old client with meningitis whose parent refuses antibiotics
b)
Client who attempted suicide by taking a handful of acetaminophen an hour ago
c)
Client with a urinary tract infection who is disoriented to time and place
d)
Client with coffee-ground emesis from chronic use of high-dose aspirin
e)
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9.
The acute care clinic nurse administers a prescribed narcotic for a client with renal colic and then discharges the client without ensuring that the client has a designated driver. The client is subsequently involved in a motor vehicle accident causing injury to self and others. Which ethical principle did the nurse violate?
a)
Autonomy
b)
Nonmaleficence
c)
Paternalism
d)
Veracity
e)
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10.
A client receiving end-of-life care is no longer able to make decisions. The client's appointed medical power of attorney is considering placement of a feeding tube. The MPOA asks the nurse, "What would you do if this was your family member?" How should the nurse respond?
a)
I'm not sure what I would do, but I feel confident that you will make the right decision.
b)
I will call the chaplain to help you sort through the options and discuss the issue.
c)
What do you think are the advantages and disadvantages of a feeding tube?
d)
You should meet with the family to discuss what the patient would have wanted.
e)
-
11.
A visiting family member of a hospitalized client reports sudden onset of a headache and numbness in half of the body. The visitor asks the nurse to take a blood pressure reading. What is the most appropriate response by the nurse?
a)
Encourage the visitor to lie down to see if symptoms change
b)
Initiate protocol to assist the visitor to the emergency department
c)
Proceed to take the visitor's blood pressure
d)
Suggest that the visitor call the health care provider
e)
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12.
The nurse has attended a staff education program about ethical practices in nursing. Which of the following statements by the nurse would indicate a correct understanding of the program?
a)
Accountability is notifying the health care provider after making a medication error.
b)
Autonomy is informing the client of the care decisions the family has made for the client.
c)
Confidentiality is respecting a client's request to keep suicidal ideation a secret from other members of the health care team.
d)
Fidelity is returning to the client's room with pain medication at the time that was promised to the client.
e)
Nonmaleficence is reporting suspected elder abuse of a client with Alzheimer disease.
13.
The nurse is talking with the spouse and sibling of a client with a terminal illness who is unresponsive and experiencing respiratory distress. The sibling is the agent holding the client's power of attorney for health care. Which of the following actions should the nurse take?
a)
Ask the client's sibling if the client has a living will.
b)
Ask the spouse about the client's preferences for medical care.
c)
Inform the client's spouse that the client requires emergency intubation.
d)
Obtain guidance from the client's sibling regarding medical care decisions.
e)
-
14.
The nurse is participating in staff training about protecting clients' privacy and confidentiality. Which of the following incidents does the nurse recognize as a violation of client confidentiality?
a)
A visitor talking in the waiting room states that the client has alcoholism
b)
The licensed practical nurse has the client's report sheet in a pocket when going home
c)
The nursing assistant tells a client that the hospital roommate went for a gallbladder test
d)
The registered nurse tells a visitor to wear a mask because the client is on isolation precautions
e)
Two LPNs are discussing a possible cure for AIDS on a crowded elevator
15.
A nurse is documenting notes in the client's electronic record after making rounds on assigned clients. Which entry is an appropriate documentation?
a)
Client appears to be sleeping. Eyes closed.
b)
Client reports, "I'm in pain." Medication provided.
c)
Inspiratory wheezes heard in bilateral lower lung fields
d)
Voided x 1
e)
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16.
Which emergency department clients cannot be allowed to sign out against medical advice?
a)
Client in sickle cell crisis receiving oxygen via face mask
b)
Client who drank a 1 L bottle of vodka 2 hours ago
c)
Client who hears voice commands to kill a coworker
d)
Client with mania who has not eaten in 5 days
e)
Client with ST elevation on ECG monitoring
17.
The hospital nurse coming on duty notifies the unit of a delay due to a motor vehicle accident. The off-going nurse has an important appointment and must leave on time. How should the off-going nurse handle the situation?
a)
Ask another nurse to watch the current assigned clients until the incoming nurse arrives
b)
Tape-record a report and leave a cell phone number to call if there are any questions
c)
Tell the charge nurse of the impending need to leave and that client coverage is required
d)
Write out a report about the clients for the incoming nurse prior to leaving
e)
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18.
Which of the following are violations of protected client health information?
a)
Client overhears the nurse give report on the client's roommate through the room curtain
b)
Nurse calls a client by the first and last names in the public waiting room
c)
Nurse gives a pregnancy result to the client's partner without the client's permission
d)
Nurse tells the transporting tech that the client has breast cancer
e)
Unlicensed assistive personnel tells a discharged client, "You take care now!"
19.
The nurse is caring for a hospitalized client. Which are the best examples of narrative documentation to provide legal malpractice protection for the nurse after an adverse event?
a)
Client found on floor this morning at 6:50 AM. No verbalized symptoms. I think client tripped over a cord. Client instructed on safety during ambulation
b)
Client reports that IV pole hit head at 7:30 AM. Denies pain. IV pole removed for client safety. Will continue to monitor. Health care provider (HCP) notified
c)
Heparin infusion running at 15 units/kg/hr at 7:15 AM; infusion rate adjusted to prescription of 12 units/kg/hr. Labs drawn at 7:20 AM, aPTT 65 sec. HCP notified; will draw labs again at 1:20 PM
d)
IV site in right hand is red and swollen at 9:30 AM. IV removed, bleeding controlled, and warm compress administered at 9:40 AM. Will reassess for swelling and pain every hour
e)
Package of green leaves found in client drawer at 1:00 PM. Client acting suspicious at 2:00 PM. HCP notified. Will call security. Client has multiple tattoos and piercings
20.
The nurse prepares to teach an in-service on legal issues related to nursing. Which legal terms are followed by an appropriate example?
a)
Assault: Threatening to administer a benzodiazepine if the client does not comply
b)
Battery: Misinforming a client that a painful injection will not create discomfort
c)
False imprisonment: Storing a competent client's clothes to prevent the client from leaving prior to a prescribed treatment
d)
Informed consent: Calling the parent of an emancipated minor for approval prior to providing care
e)
Invasion of privacy: Posting a medical update on the social media page of a client who is a friend
21.
The medical-surgical nurse cares for a group of clients. Which client situations would prompt the nurse to notify the health care provider during the middle of the night?
a)
Client develops right-sided upper and lower extremity drift
b)
Client found lying unconscious on the floor
c)
Client has order for heparin with surgery planned for the morning
d)
Client has serum sodium of 124 mEq/L (124 mmol/L)
e)
Client refuses a prescribed, routine pain medication
22.
During shift change, the night nurse notices that the graduate nurse administered IV dopamine instead of the prescribed norepinephrine for a client with sepsis. What should the night nurse do first?
a)
Administer the correct medication and obtain current vital signs
b)
Alert the graduate nurse and complete an incident report
c)
Assess the client and notify the health care provider
d)
Discontinue the dopamine and inform the nursing supervisor
e)
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23.
A nurse discontinues patient-controlled analgesia per the health care provider's prescription, and notes that there is 10 mL of morphine sulfate left in the cartridge. All other nurses on the unit appear busy. What is the most appropriate action by the nurse?
a)
Ask unlicensed assistive personnel to witness the wasting of the medication
b)
Document that another nurse was not available to waste the medication
c)
Wait until another nurse is available and then witness the waste together
d)
Waste the morphine alone and then show the empty cartridge to the charge nurse
e)
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24.
The nurse is caring for a client on life support who has been declared brain dead. The client is a registered organ donor. Which of the following actions should the nurse take?
a)
Contact the local organ procurement organization
b)
Discontinue nursing care and provide postmortem care
c)
Remove life support as requested by the spouse and the family
d)
Ask the family members about their plans for the funeral service
e)
-
25.
The nurse is caring for a client who is attempting to leave the hospital against medical advice. The client is competent to make decisions. Which of the following actions would be essential for the nurse to take?
a)
Provide the client with a copy of the client's medical record
b)
Tell the client that discharge forms must be signed before leaving
c)
Inform the client that the client cannot return for medical care after leaving
d)
Ensure the health care provider explains the risks of leaving the hospital to the client
e)
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