Nursing Acceleration Challenge Exam I PN-RN Ethical and Legal Principles Questions and Answers

Question 1

A competent 80-year-old client with end-stage chronic obstructive pulmonary disease (COPD) has a living will that explicitly states they do not want mechanical ventilation. The client develops acute respiratory failure and becomes lethargic. The client's family insists that 'everything be done' to save them. Which action by the nurse demonstrates proper legal and ethical practice?

Accepted Answer

Honor the client's advance directive and advocate for comfort care measures.

Answer

A living will is a legal advance directive that outlines a competent client's wishes for medical treatment at the end of life. The nurse has an ethical and legal obligation to honor these documented wishes. The principle of autonomy dictates that the client's right to self-determination be respected. The nurse's primary role is to advocate for the client's wishes, which in this case involves providing comfort care rather than initiating unwanted life-sustaining treatment.

Question 2

A nurse is caring for a client who is verbally refusing a prescribed antipsychotic medication. The nurse proceeds to crush the medication, mix it in applesauce, and administer it to the client without their knowledge. This action constitutes which of the following intentional torts?

Accepted Answer

Battery

Answer

Battery is the intentional and wrongful physical contact with a person without their consent. Administering medication to a competent client who has refused it, especially through concealment, is a form of unwanted touching and a violation of the client's right to autonomy. Assault is the threat of harmful contact, while negligence and malpractice are unintentional torts related to failing to meet the standard of care.

Question 3

Which of the following actions by a nurse represents a violation of the Health Insurance Portability and Accountability Act (HIPAA)?

Accepted Answer

Accessing the electronic health record of a neighbor who is a patient on a different unit.

Answer

Accessing the protected health information (PHI) of any individual for whom the nurse is not providing direct care is a serious HIPAA violation. This action is often referred to as 'snooping' and is prohibited, regardless of the nurse's personal relationship with the individual. Access to PHI is based on a 'need-to-know' basis for the purpose of treatment, payment, or healthcare operations.

Question 4

The ethical principle of beneficence requires a nurse to take what type of action?

Accepted Answer

Taking positive actions to help others and promote the well-being of clients.

Answer

Beneficence is the ethical principle of acting for the good and welfare of others. It involves taking positive, proactive steps to help clients, such as providing effective pain management, offering emotional support, or educating them to promote health. Ensuring equal access relates to justice, respecting a client's decision relates to autonomy, and truth-telling relates to veracity.

Question 5

An RN delegates the task of obtaining routine vital signs on a stable client to an unlicensed assistive personnel (UAP). The UAP later reports to the RN that the client's blood pressure is 188/102 mmHg. What is the RN's most critical next step?

Accepted Answer

Personally reassess the client's blood pressure and overall condition.

Answer

While tasks can be delegated, the RN retains full accountability for the nursing process, which includes assessment, interpretation, and intervention. When an abnormal finding is reported, the RN must personally validate the data, perform a focused assessment on the client, and then decide on the appropriate action, such as notifying the provider. Delegating assessment or clinical judgment is not appropriate.

Nursing Acceleration Challenge Exam (NACE) I PN-RN Practice Test

Nursing Acceleration Challenge Exam (NACE) I PN-RN Practice Test

Nursing Acceleration Challenge Exam I PN-RN Ethical and Legal Principles Questions and Answers