INACE Ethics and Legal Responsibilities 3 — Questions and Answers
Question 1: A resident who is alert and oriented refuses to take a bath. The nurse aide should:
- Insist because hygiene is medically necessary
- Inform the charge nurse and document the refusal (Correct answer)
- Ask a family member to convince the resident
- Perform the bath while the resident is distracted
Correct answer: Inform the charge nurse and document the refusal
A competent resident has the legal right to refuse care; the nurse aide must inform the charge nurse and document the refusal.
Question 2: Which federal law primarily governs the rights of nursing home residents?
- HIPAA
- OSHA
- OBRA (Correct answer)
- ADA
Correct answer: OBRA
The Omnibus Budget Reconciliation Act (OBRA) of 1987 established comprehensive standards for nursing home care and resident rights.
Question 3: A nurse aide shares details about a resident's medical condition with friends outside of work. This violates:
- OSHA regulations
- HIPAA privacy rules (Correct answer)
- OBRA resident rights only
- The nurse aide's employment contract only
Correct answer: HIPAA privacy rules
HIPAA prohibits disclosure of protected health information to unauthorized persons, including discussing residents outside of work.
Question 4: Informed consent means a resident has been given:
- A consent form to sign before any procedure
- Information about a procedure, risks, benefits, and alternatives before agreeing (Correct answer)
- Permission by the doctor to proceed with treatment
- The ability to consent only after family approval
Correct answer: Information about a procedure, risks, benefits, and alternatives before agreeing
Informed consent requires that patients receive complete information about a proposed treatment, including risks, benefits, and alternatives, before they agree.
Question 5: A nurse aide notices bruising in unusual locations on a resident who is not mobile. This should FIRST be:
- Documented in the nurse aide's personal notes
- Reported immediately to the charge nurse (Correct answer)
- Discussed with the resident's roommate
- Photographed by the nurse aide for evidence
Correct answer: Reported immediately to the charge nurse
Unexplained bruising on an immobile resident is a potential sign of abuse that must be reported immediately to the charge nurse.
Question 6: What does 'scope of practice' mean for a nurse aide?
- The geographic area where the aide is licensed to work
- The range of tasks the aide is legally permitted to perform (Correct answer)
- The number of residents the aide can care for at one time
- The hours the aide is allowed to work per week
Correct answer: The range of tasks the aide is legally permitted to perform
Scope of practice defines the specific tasks and procedures a nurse aide is legally authorized to perform based on their training and state certification.
Question 7: A resident's family member demands to see the resident's medical records. The nurse aide should:
- Provide the records if the family seems genuinely concerned
- Refer the family member to the charge nurse or administration (Correct answer)
- Explain that only the doctor can share records
- Make copies of the records for the family immediately
Correct answer: Refer the family member to the charge nurse or administration
The nurse aide should refer the family member to the charge nurse or administration, as releasing medical records requires proper authorization under HIPAA.
INACE Ethics and Legal Responsibilities 3
A resident who is alert and oriented refuses to take a bath.
The nurse aide should: