MACE Legal and Ethical Issues 2 — Questions and Answers
Question 1: A resident refuses to take their prescribed medication. What is the medication aide's correct first action?
- Crush the medication and hide it in food
- Document the refusal and notify the nurse (Correct answer)
- Insist the resident must take the medication
- Contact the family without notifying the nurse
Correct answer: Document the refusal and notify the nurse
Respecting a competent resident's right to refuse medication is a legal obligation; the aide must document and report to the nurse immediately.
Question 2: Which action by a medication aide constitutes medication diversion?
- Giving a medication one hour late
- Taking unused resident medications home (Correct answer)
- Documenting a medication before administering it
- Asking a nurse to verify a dose
Correct answer: Taking unused resident medications home
Taking controlled or any resident medications for personal use is medication diversion, a criminal offense that leads to license revocation.
Question 3: The Health Insurance Portability and Accountability Act (HIPAA) primarily protects:
- Staff wages and benefits
- Resident financial accounts
- Protected health information (PHI) (Correct answer)
- Medication administration records from state auditors
Correct answer: Protected health information (PHI)
HIPAA mandates safeguarding Protected Health Information (PHI), including medical records, diagnoses, and treatment details.
Question 4: A medication aide witnesses a co-worker giving a resident an extra dose of pain medication 'to keep them calm.' This is an example of:
- Chemical restraint and potential abuse (Correct answer)
- Compassionate care
- Proper PRN administration
- Therapeutic use of medication
Correct answer: Chemical restraint and potential abuse
Using medication to subdue a resident beyond therapeutic need constitutes chemical restraint and is a form of abuse prohibited by law.
Question 5: Which document gives a designated person legal authority to make healthcare decisions for a resident who lacks decision-making capacity?
- Do Not Resuscitate order
- Durable Power of Attorney for Healthcare (Correct answer)
- Living will
- Advance directive for medications only
Correct answer: Durable Power of Attorney for Healthcare
A Durable Power of Attorney for Healthcare appoints a healthcare proxy to make medical decisions when the resident cannot do so.
Question 6: A medication aide must report suspected elder abuse to:
- Only the facility administrator
- The resident's family first
- Adult Protective Services and/or the state survey agency (Correct answer)
- The charge nurse only, who decides whether to report
Correct answer: Adult Protective Services and/or the state survey agency
Mandatory reporting laws require suspected elder abuse to be reported to Adult Protective Services or the appropriate state agency, not left solely to a supervisor's discretion.
Question 7: Informed consent for medication administration means the resident:
- Signs a general admission form once on entry
- Understands the medication's purpose, risks, and alternatives before agreeing (Correct answer)
- Cannot refuse once a physician orders it
- Must consent only for injections, not oral medications
Correct answer: Understands the medication's purpose, risks, and alternatives before agreeing
Informed consent requires that the resident receive and understand information about the medication's purpose, benefits, risks, and alternatives before agreeing to take it.
MACE Legal and Ethical Issues 2
A resident refuses to take their prescribed medication.
What is the medication aide's correct first action?