NCLEX-RN Practice Test
Which of the following principles is affected by a nurse’s cultural or ethnic background?
The term ethics refers to the decisions that a nurse makes during her practice. She often pulls from a variety of ethical theories to help shape those decisions. Morals are related to ethics but are also supported by the nurse’s culture and ethnic background. The code of conduct outlines her responsibilities and the appropriate behavior within the organization. Veracity refers to the need for health care providers to always tell the truth when giving information to their patients.
The doctrines found in the Nursing Code of Ethics have all of the following attributes EXCEPT they are not.
The Nursing Code of Ethics refers to principles that guide a nurse’s decision-making and standards of practice. The standards in the Code are universal, meaning that they should apply to every nurse, regardless of their location or type of nursing practice. Adherence to the Code of Ethics is not optional.
The right to self-determination refers to the
The patient’s right to self-determination describes the right that a patient has for decision-making during care. The patient has the ultimate responsibility for making his or her own decisions, regardless of whether the physician or nurse agrees. This may include completely withdrawing care or choosing a less popular option. The practitioner must be careful to avoid coercing the patient but must be sure that the patient has all of the information needed to make an informed decision. If a patient is unable to make his or her own decisions, he or she has the right to appoint someone (usually family or a close friend) to make those decisions.
What is the final step in the ethical decision-making process?
There are multiple steps in making ethical decisions, including: identifying the problem and ethical issue, researching the issue, determining who will make the final decision, evaluating the ethical issues surrounding the health problem, looking for alternatives, carrying out the plan, and modifying it based on an evaluation of the proposal.
Which term listed below describes the idea that the nurse should do no harm to the patient?
Beneficence is the principle of doing right by the patient, as in acting in his or her best interest. Autonomy refers to the patient’s right to make his or her own decisions regarding care. Veracity refers to the idea that health care providers are required to be honest with their patients and always tell the truth. Nonmaleficence is the idea that the nurse should do no harm to their patients.
Which of the following theories describes the idea that ethical conflicts should be resolved, according to the obligations of the nurse?
The answer is deontology, which focuses on the obligations of the nurse as the basis for making ethical decisions. The primary focus of utilitarianism is to do the most good for the most number of people. Virtue theory looks at the intention of the action; the belief is that actions done with good intentions are ethical. Egoist theory focuses on the best interests of the individual.
All of the following provisions are included in the Health Insurance Portability and Accountability Act EXCEPT
The Health Insurance Portability and Accountability Act is legislation that was designed to protect a patient’s privacy. It requires health care providers to obtain written permission from the patient before sharing any protected health information with another individual or organization. This includes protecting the electronic medical record to ensure that data are not compromised. The patient is entitled to share personal information with whomever they choose.
All of the following statements about informed consent are correct EXCEPT
Informed consent should only be obtained by the physician and must be done before any procedure or treatment. The physician is responsible for counseling the patient, including risks, benefits, alternatives, processes, procedures, and prognoses. The nurse’s role is to help the patient sign the forms, once the patient has been appropriately counseled by the physician. If informed consent has not been obtained, it is the nurse’s responsibility to bring it to the attention of the physician.
A patient comes into the emergency room with a gunshot wound to his back. He states that the gun accidentally went off while he was cleaning it. What should the nurse do?
While it is true that patients have a right to privacy, the nurse is also responsible for reporting suspicious injuries. The patient reports that the gun went off while cleaning it, but the entrance wound is in his back, making his story suspicious. Because it appears that the gunshot wound is the result of criminal activity, the nurse must make the report to the police department.
All of the following are one of the five rights of delegation EXCEPT the
The five rights of delegation are the right task, right circumstances, right person, right communication, and right supervision/evaluation. The nurse is ultimately responsible for all delegated tasks and must ensure that she delegates the correct task to a person who is qualified and able to perform the task. The right department is not one of the five rights of delegation.
Which of the following statements about advocacy is correct?
Advocacy is the act of speaking up for one’s vulnerable patients to ensure that their rights and needs are met and protected and that they are receiving safe, appropriate care. This may mean helping the patient to disagree with the physician in an effective manner. Nurses are never to obtain informed consent; they can assist the patient in signing the forms, but it is the responsibility of the physician to counsel the patient. Talking a patient into a treatment decision with which they are not comfortable is not advocacy.
What is one way that a nurse can minimize the chances of being found negligent in court if sued by a patient?
Ensuring that nursing practice is in accordance with the standards of care is the best way that nurses can defend themselves in court if sued for negligence. Following a physician’s instructions blindly is not appropriate, as the physician may have made a mistake. Going against a physician’s instructions is also not appropriate; the nurse should communicate her concerns to the physician and move up the chain of command if she still has serious concerns about his orders. The nurse must only follow the wishes of the patient or the person whom the patient appoints to make decisions for them if they are unable.
The nurse is caring for a patient who is newly diagnosed with stage IV breast cancer. The patient is expressing anxiety and concerns about an upcoming surgical procedure. The nurse consults the chart and notes that the patient has not signed consent forms for the procedure. How should the nurse respond?
Offering false reassurance to the patient is not an effective method of communication and may make patients feel that are not being heard. The nurse is not responsible for obtaining the consent form, especially when it is clear that the patient still has serious concerns. Using difficult medical terminology does not clarify the patient’s concerns. The nurse should inform the physician about the patient’s concerns and have him or her speak with the patient before the patient signs the consent forms.
Which of the following processes will assist patients in obtaining necessary treatments or therapies for optimal outcome?
Case management is the process of assisting patients in obtaining necessary treatments or therapies for optimal outcome. Case management is a very individualized process and is specially tailored toward the needs of an individual patient.
Health maintenance organizations and preferred provider organizations are examples of what type of organization?
Health maintenance organizations and preferred provider organizations are examples of managed care organizations. Managed care is a system of health care delivery and reimbursement. There is usually a prearranged payment system at which providers agree to be reimbursed.
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