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1. What are the possible activities sometimes a.

Stewardship
considered as euthanasia, name one only. b. Integrity or Totality
c. Human Dignity
Answer: withholding treatment
d. Inviolability of life

2. A patient tells his family that he would never want


6. What does the bible say about euthanasia. Give a
to be "kept alive like a vegetable." The term
certain verse from the bible
vegetable should be understood by the doctor to
mean Answer: "You shall not murder (Exodus 20:13)
a. The patient does not want any heroics or
extraordinary treatments.
7. What are the three values relevant to the nurse in
b. The doctor should interpret the term as vague
assisting client/patient with the end-of-life decision-
and not helpful in advance care planning
making? Select all that apply.
discussions unless it is clarified
c. If the patient is in a comatose state let him die  Quality of life
d. Pull the plug if the patient is ever in terminal  Human dignity
state on a respirator  Choice
 Health and well being
 Equality
3. In professional boundaries, brief excursions across  Protection of life
boundaries that may be inadvertent, thoughtless, or
even purposeful if done to meet a specific therapeutic
need, would mean: 8. A form/type of euthanasia by hastening of death by
altering some form of support
a. disclosure
b. crossings a. Passive voluntary
c. harrassment b. passive
d. violations c. active voluntary
d. active

4. A patient who has coronary artery disease and


congestive heart failure shows his physician his 9. Which of the following is important for meeting
advance directive that states he wants to receive the needs of a dying person's family?
cardiopulmonary resuscitation and other forms life-
sustaining treatment has deeply held beliefs that a. Strictly enforce visiting hours and limitations on
suggest that not trying to live is tantamount to number of visitors
committing suicide. What should the doctor do and b. Make firm predictions about the patient's exact
say to the patient in response to this? clinical course.
c. Restrict family members from performing
a. The doctor should educate the patient about the simple care tasks.
near futility of CPR under these circumstances. d. Provide a clear description of what the dying
b. The doctor might want to ask the patient to process will look like
explore this further with the chaplain
c. All of the choices above are correct
d. The patient's expression of a preference should 10. Which of the following is TRUE about end-of-life
be explored to understand its origins care?
a. It is defined by a specified time period.
5. The principle that declares human life comes from b. It is synonymous with palliative care
God, and no individual is the master of his/her own c. It is one aspect of palliative care
body d. It does not include a focus on the family,
D. Privacy and confidentiality
11. A written document specifying the patient's wish E. Protection of life
to be allowed to die without heroic or extraordinary
F. Quality of life
measures
G. Truthfulness and full disclosure
a. Physician orders for life sustaining treatment
b. Directive to physician a. E, B, A, C, F.D.G
c. Health care proxy b. E, B, A, F, C, D, G
d. Medical power of attorney c. F, A, D, E, B, G, C
d. A.C.B.E.F.G, D
16. In professional boundaries, brief excursions
12. Which nursing actions could result in
across boundaries that may be inadvertent
malpractice? Select all that apply
thoughtless, or even purposeful if done to meet a
 Charts client's drug allergies specific therapeutic need, would mean:
 Does not follow up on client's complaints
a. disclosure
 Forgets to complete the assessment of a client
b. crossings
 Learns about a new piece of equipment
c. harassment
 Questions primary care provider about an
d. violations
illegible order

17. A good practice for providing adequate end-of-


13. Which of the following is not an example of
life care is:
boundary crossings?
a. Use appropriate medical jargon when talking
a. Secretive behavior
about diagnosis, prognosis and care options
b. Excessive self-disclosure
b. Not let the patient talk about religion or spiritual
c. Selective communication
concerns
d. Sexual misconduct
c. Ask open-ended questions to help identify the
patient's values concerns and goals for care
d. Avoid giving up on the patient by shifting from
14. A nurse has asked a second staff nurse to sign for
curative to palliative care
a wasted narcotic, which was not witnessed by
another person. This seems to be a recent pattern of
behavior. What is the appropriate INITIAL action?
18. It may be considered as an undue prolongation of
a. Report this immediately to the nurse manager life, of suffering of individual who are artificially
b. Sign the narcotic sheet but document the kept alive in situations they couldn't survive without
incident life support
c. Confront the nurse of suspected drug use
a. dysthanasia
d. Course the colleague about the risky behaviors
b. euthanasia
c. orthothanasia
d. suicide
15. Lowenberg and Dolgoff (1992) have prioritize
ranking of ethical principles. This is an approach for
ordering social work values that might help you get
19. An elderly man with end-stage emphysema
off the horns of a dilemma." Rank the following
presents to the emergency room awake and alert and
principles from the highest to the lowest
complaining of shortness of breath. An evaluation
A. Autonomy and freedom reveals that he has pneumonia. His condition
deteriorates in the emergency room and he has
B. Equality
impending respiratory failure, though he remains
C. Least harm awake and alert. A copy of a signed and witnessed
living will is in his chart stipulates that he wants no a. TRUE
"invasive medical procedures that would serve only b. FALSE
to prolong my death." No Surrogate decision maker
is available. Should mechanical ventilation be
instituted? 23. The patient for whom you are caring needs a liver
transplant to survive. This patient has been out of
a. The living will is NOT a helpful guide to
work for several months and doesn't have health
mechanical ventilation decision-making in this
insurance or enough cash. Even though several
patient.
ethical principles are at work in this case, list the
b. Mechanical ventilation should be instituted
principles from highest to lowest priority,
because of the intent of the directive in the
living will is evident 1. Accountability: You as the nurse are accountable
c. Mechanical ventilation should be instituted for the well-being of this patient
because the patient's pneumonia represents a
potentially reversible condition from which the 2. Respect for autonomy: This patient's autonomy
patient may recover fully will be violated if he does not receive the liver
d. Mechanical ventilation should NOT be instituted transplant.
because it serves only to prolong death in this 3. Ethics of care. The caring thing that a nurse could
patient. provide this patient is resources for a liver transplant
4. Justice: The greatest question in this situation is
20. A 75 years old male patient suffering from how to determine the just distribution of resources
metastatic cancer of prostate is admitted in hospice a. 2,4, 1,3
for palliative comfort care. He requests doctor to b. 2, 1,4, 3
increase the dose of narcotics analgesics to relieve his c. 4, 2, 2, 1
pain and suffering. Physician is reluctant to increase d. 4.2, 3,1
the dose as patient is already have maximum possible
dose of analgesics and further increase in dose will
only hasten patient's death. Under the rule of double
24. The patient has right-sided hemiplegia as a result
effect (RDE), to maximize comfort and to decrease
of a stroke and wants a cup of hot coffee. Even
pain and suffering, analgesics' dose could be
though the patient is insistent, the nurse does not
increased. Physician can take decisions only if it
permit her to drink the coffee unsupervised. This
satisfies the following:
nurse is using the moral principle of
a. All other choices and/or conditions must be
a. Nonmaleficence
fulfilled to justify that benefits outweigh harm.
b. Autonomy
b. The agent's intention
c. Beneficence
c. Proportionality between good effect and the bad
d. Justice
effect
d. The distinction between means and effects

25. Many legal systems in the world treat all forms of


euthanasia
21. A requires a choice to be made
between two equally undesirable actions a. has double effect
b. legitimate action
a. equality and truthfulness
c. criminal offense
b. privacy and confidentiality
d. morally permissible
c. ethical and moral dilemma
d. autonomy and freedom

26. Euthanasia as causing terminal sedation maybe to


the doctrine of double effect
22. The Principle of Human Dignity! Human Life is
Sacred every person has God-given dignity. Answer: double effect
31. According to double effect, murdering a possible
terrorist's son, say, with the purpose of getting the
27. Is considered to be the least controversial form of
possible terrorist to give information that might save
euthanasia.
the lives of many would
a. Voluntary Passive Euthanasia (UPE)
a. never be wrong
b. Non-voluntary Passive Euthanasia (NPE)
b. would depend on certain other factors
c. Voluntary Active Euthanasia (VAE)
c. always be wrong
d. Non-voluntary Active Euthanasia (NA)
d. morally permissible

28. What are the four fundamental responsibilities of


32. A written physician's order instructing health
nurses?
care providers not to attempt Cardio-Pulmonary
Answer: to promote health, to prevent illness, to restore Resuscitation, often requested by family and must be
health, alleviate suffering signed by a physician to be valid.
a. Advance directives in health (ADHC)
b. Do not resuscitate (DNR)
29. An elderly man with end-stage emphysema c. Allowing natural death (AND)
presents to the emergency room awake and alert and d. Physician orders for life sustaining treatment
complaining of shortness of breath. An evaluation POLST)
reveals that he has pneumonia. His condition
deteriorates in the emergency room and he has
impending respiratory failure, though he remains
33. Which of the following is NOT a priority for
awake and alert. A copy of a signed and witnessed
patients with a life-limiting illness receiving palliative
living will is in his chart stipulates that he wants no
care?
"invasive medical procedures that would serve only
to prolong my death. No surrogate decision maker is a. Strengthening relationships with loved ones
available. Should mechanical ventilation be b. Obtaining a sense of control
instituted? c. Prolonging life at all costs
d. Relieving burden
a. The potential risks and benefits of mechanical
ventilation need not be presented to the patient
because of the presence of a valid living will
34. A nurses point of view is valuable in an ethical
b. Even if the patient refuses mechanical
committee because it is recommended by the nurses'
ventilation therapy, his wishes need not be
code of ethics.
honored because he is in the emergency room
c. If the patient has remained awake and alert, his a. TRUE
living will is irrelevant to medical decision b. FALSE
making
d. The presence of a living will or other advance
directive obviates the responsibility to involve a 35. The philosophy sometimes called the code of
competent patient in medical decision making ethics of care suggests that ethical dilemmas can best
be solved by attention to

30. It is allowing a person to die a dignified and a. Code of ethics for nurses.
natural death. b. Ethical principles
c. Clients
a. dysthanasia d. Relationships
b. Oeuthanasia
c. orthothanasia 36. Killing or letting die when the patient is unable to
d. suicide express such a desire
a. voluntary euthanasia
b. non-voluntary euthanasia
c. active euthanasia d. Civil laws
d. passive euthanasia

5. Most litigation in the hospital comes from the


37. Which of the following is not an example of
a. Nurse abandoning the clients when going to
boundary crossings?
lunch
a. Secretive behavior b. Supervisor watching a new employee check his
b. Selective communication or her skills level
c. Excessive self-disclosure c. Nurse following an order that is incomplete or
d. Sexual misconduct incorrect
d. Nurse documenting blame on the physician
when a mistake is made
Set 2
1. When a client is confused, left alone with the side
6. The nurse practice acts are an example of:
rails down, and the bed in a high position, the client
falls and breaks a hip. What law has been broken? a. Criminal law
b. Cilaw
a. Negligence
c. Common law
b. Battery
d. Statutory low
c. Civil tort
d. Assault
7. Nursing staff members are sitting in the lounge
taking their morning break An unlicensed assistive
2. The nurse calls the health care provider (HCP)
personnel (UAP) tells the group that she thinks that
regarding a new medication prescription because the
the unit secretary has acquired immunodeficiency
dosage prescribed is higher than the recommended
syndrome (AIDS) and proceeds to tell the nursing
dosage. The nurse is unable to locate the HCP, and
staff that the secretary probably contracted the
the medication is due to administered. Which action
disease from her husband, who is supposedly a drug
should the nurse take?
addict. Which legal tort has the UAP violated?
a. Administer the dose prescribed
a. Assault
b. Administer the recommended dose until the
b. Negligence
HCP can be located
c. Slander
c. Hold the medication until the HCP can be
d. Libel
contacted
d. Contact the nursing supervisor
3. The nurse puts a restraint jacket on a client 8. The nurse who works on the night shift enters the
without the client's permission and without the medication room and finds a co-worker with a
physicians order. The nurse may be guilty of tourniquet wrapped around the upper arm. The co-
worker is about to insert a needle, attached to a
a. Neglect
syringe containing clear liquid, in the antecubital
b. Battery
area. Which is the most appropriate action by the
c. Invasion of privacy
nurse?
d. Assault
a. Call security
b. Call the police
4. The client's right to refuse treatment is an example c. Call the nursing supervisor
of: d. Lock the co-worker in the medication room until
help is obtain
a. Nurse practice acts
b. Common law
c. Statutory law
9. You have loosely applied a bed sheet around your D. The nurse can expect compensation for helping E.
client's waist to prevent a fall from the chair. What The nurse offers to help but cannot insist on helping
have you done?
Answer: A, B, E
a. Violated Respondeat Superior
b. Committed a crime
c. Violated the client's right to dignity 14. Which of these choices contains the six elements
d. Ensured the client's safety which is a high necessary for malpractice?
patient care priority
a. Causation, correlation damages to the patient a
duty that was owed to the dient and this duty
was breached, and direct and/or indirect harm to
10. The scope of Nursing Practice, the established
the dient
educational requirements for nurses, and the
b. Causation, foreseeability, damages to the
distinction between nursing and medical practice is
patient, a duty that was owed to the client and
defined by:
this duty was bresched, and direct and/or
a. Common law indirect harm to the client.
b. Nurse practice acts c. Causation, foreseeability, damages to the
c. civil law patient, a duty that was owed to the client and
d. Statutory law this duty was breached, and direct rather than
indirect harm to the client,
d. Causation, foreseeability, damages to the
11. A retired nurse stops to help in an emergency at patient, a duty that was owed to the client and
the scene of an accident, if the injured party files suit this duty was bresched, and a medical license.
and the nurse would probably be covered by
a. Her automobile insurance
15. A confused client who fell out of bed because side
b. The Good Samaritan Law
rails were not used is an example of which type of
c. National Care Act
liability?
d. Her homeowner's insurance
a. Assault
12. Select the legal term that is accurately paired with
b. Negligence
its description
c. Battery
a. Slander: False oral defamatory statements d. Felony
b. Battery: Threatening to touch a person without
their consent
c. Assault: Touching a person without their 16. The nurse notices that a colleague's behaviors
consent have changed during the past month. Which
d. Slander False written defamatory statements behaviors could indicate signs of impairment? Select
all that apply
A is increasingly absent from the nursing unit during
13. Following a motor vehicle crash, a nurse stops
the shift.
and offers assistance. Which of the following actions
are most appropriate? Select all that apply B. Interacts well with others
A The nurse needs to know the Good Samaritan Act C. "Forgets' to sign out for administration of
for the state. controlled substances.
B. The nurse is not held liable unless there is gross D. Offers to administer prn opiates for other nurse's
negligence clients
C After assessing the situation, the nurse can leave to E. is able to say "no' to requests to work more shifts.
obtain help.
Answer: A, C, D
19. This type of law governs and regulates
relationships between employers and employees.
17.
a. labor law
1.__ An act committed in violation of public (criminal
b. Administrative law
law and punishable by a fine or
c. Criminal law
imprisonment. d. Civil law

2.__An offense of a less serious nature and is usually


punishable by a fine or short-term jail sentence, or
20. A primary care provider prescribes on tablet, but
both
the nurse accidentally administers two. After
3. _ The quality or state of being legally responsible notifying the primary care provider, the nurse
for one's obligations and actions and for making monitors the client carefully for untoward effects of
financial restitution for wrongful acts. which there are none. Is the client likely to be
successful in suing the nurse for malpractice?
4_-A legal inquiry into the cause or manner of a
death a. Yes, a breach of duty exists
b. Yes, foreseeability is present
5.__ Communication that is false, or made with a c. No, the nurse notified the primary care provider
careless disregard for the truth, and results in injury d. No, the client was not harmed
to the reputation of a person
A Inquest
21. The scope of Nursing practice is legally defined
B. Misdemeanor by:
C. Defamation a. Professional nursing organizations
D. Felony b. State nurses practice acts
c. Hospital policy and procedure manuals
E Crime d. Physicians in the employing institutions
F. Liability
G. Tort
H. Damages
Answer: 1.E, 2.B 3. F, 4.A, 5.C

18. Which nursing actions could result in


malpractice? Select all that apply
A Charts client's drug allergies
B. Does not follow up on client's complaints.
C Forgets to complete the assessment of a client
D. Learns about a new piece of equipment
E Questions primary care provider about an illegible
order
Answer: B and C

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