SGNA Documentation and Legal Issues 2 — Questions and Answers
Question 1: Which document allows a designated person to make healthcare decisions for an incapacitated patient?
- Healthcare proxy (durable power of attorney for healthcare) (Correct answer)
- Living will only
- DNR order
- Insurance authorization
Correct answer: Healthcare proxy (durable power of attorney for healthcare)
A healthcare proxy (durable power of attorney for healthcare) designates a surrogate decision-maker to make medical decisions when a patient lacks decision-making capacity.
Question 2: Before administering medications, the GI nurse must verify the 'five rights' of medication administration. Which of the following is one of the five rights?
- Right dose (Correct answer)
- Right hospital
- Right insurance
- Right nurse
Correct answer: Right dose
The five rights are: right patient, right drug, right dose, right route, and right time — the foundational medication safety framework.
Question 3: A patient's family member calls asking for procedure results. Under HIPAA, the nurse may share information:
- Only if the patient has given prior authorization (Correct answer)
- With any immediate family member
- With the primary insurance holder
- With anyone who calls
Correct answer: Only if the patient has given prior authorization
HIPAA prohibits sharing PHI with family members without the patient's explicit authorization, even with next of kin, unless the patient is present and agrees.
Question 4: What is the primary purpose of the Joint Commission's National Patient Safety Goals (NPSGs) in endoscopy?
- Reduce healthcare-associated harm and preventable errors (Correct answer)
- Increase hospital revenue
- Standardize insurance billing
- Reduce nursing staff
Correct answer: Reduce healthcare-associated harm and preventable errors
NPSGs are evidence-based safety standards from The Joint Commission addressing common causes of preventable patient harm, including patient identification and communication.
Question 5: Scope of practice for GI nurses regarding sedation administration is primarily determined by:
- State nurse practice acts and facility policy (Correct answer)
- Patient preference
- The endoscopist's preference only
- Medicare reimbursement rules
Correct answer: State nurse practice acts and facility policy
State nurse practice acts define the legal boundaries of nursing practice, with facility policies further specifying approved activities within those legal limits.
Question 6: A never event in GI endoscopy refers to:
- A serious preventable adverse event that should never occur (Correct answer)
- A routine complication
- An unexpected positive outcome
- A rare diagnosis
Correct answer: A serious preventable adverse event that should never occur
Never events are serious, largely preventable adverse events (e.g., wrong-site procedure, retained foreign object) that are considered unacceptable and indicate system failures.
SGNA Documentation and Legal Issues 2
Which document allows a designated person to make healthcare decisions for an incapacitated patient?