Legal and Ethical Issues of Nursing

NCLEX-PN Multiple Choice Questions

1.
When a nurse is tried under criminal law, the nurse is being brought to trial by: [Hint] society as a whole. the plaintiff's lawyer. an organization. an individual.

2.

The newly licensed practical/vocational nurse begins work on a hospital unit where LPNs/LVNs are allowed to start intravenous fluids. The physician orders intravenous fluids to be started on one of this nurse's assigned clients. Which of the following actions would be most necessary on the part of this newly hired and newly licensed nurse before starting an intravenous on the client? [Hint] Check the hospital policy and check on any certification required. Ask another nurse to do a supervised check on administering IVs. Ask one of your nursing-school instructors to refresh your skills. Take a continuing-education IV course to make sure you have the skills.

3.

When working as a licensed vocational nurse, you determine that your client scheduled for surgery does not understand the physician's earlier explanation of the surgery. The client is asking many questions about the risks and seems worried. Which of the following actions would be best on your part? [Hint] Quickly explain the surgery procedures and the risks to the client. Cancel the surgery. Ask your supervising RN to explain the surgery procedure and its risks. Notify the physician.

4.

You are the nurse working with an elderly, competent client who refuses a vitamin B injection ordered by the physician. The family insists that this injection be given, and you give it while the client is objecting. Even though the client improves, the client contacts a lawyer. From your knowledge of nursing and the law, you realize that you: [Hint] did the right thing because the client improved. should have had the family put their request in writing. have commited an assault against the client.

have committed an act of battery against the client.

5.

When an LVN/LPN is working for a health-care organization that has professional liability insurance, the nurse needs to base a decision on whether to buy individual professional liability insurance on which of the following things? [Hint] the possibility that the organization could countersue the nurse in a lawsuit the cost of professional liability insurance to the nurse the amount and type of coverage the health-care organization carries the number of hours worked and the type of nursing work

6.

When documenting an assigned client's record during and at the end of the shift, the nurse must keep in mind which of the following facts? [Hint] In order to get the care done for all assigned clients, the charting must be as brief as possible. The proper format, such as SOAP or PIE, as chosen by the hospital, must be adhered to. The chart is a legal document and may be all a nurse has to support care that was given if called to court. Clients need to be assessed and the care documented at least once every hour during the shift.

7.

When the licensed practical/vocational nurse is checking the physician's orders against the medication record prior to setting up medications, the nurse discovers a medication error made on the previous shift. The nurse reports this error to the supervising nurse. Which of the following persons will need to fill out an incident report? [Hint] licensed practical/vocational nurse who discovered the error licensed nurse who committed the medication error the previous shift supervising nurse who is in charge of the nursing care unit primary nurse assigned to this client the previous day

8.

You are a student nurse working as a part-time or temporary nursing assistant in a nursing home. The nurse on duty asks you to insert a nasogastric tube in a patient. You have recently passed an examination on putting in a nasogastric tube. Which of the following actions is best on your part? [Hint] Go ahead and insert the nasogastric tube. Ask the nurse to supervise you while you insert the tube.

Call your school instructor for help with your decision. Tell the nurse that you cannot legally insert this tube.

9.

According to the nursing code of ethics, when working as a nurse and a conflict comes up between your client's needs and what the family and/or the physician wants, and/or the hospital policies, your first loyalty is to the: [Hint] hospital. client. family. physician.

10 .

Which of the following strategies can most help you as a nurse to enhance your ethical practice and client advocacy? [Hint] reading a book on religions of the world examining and clarifying your own values talking with peers about their beliefs and values buying a nursing book on ethical decisions When a nurse is tried under criminal law, the nurse is being brought to trial by:

Your Answer: the plaintiff's lawyer. Correct Answer: society as a whole. Civil charges are brought by individuals while criminal charges are brought by society as a whole.

2. The newly licensed practical/vocational nurse begins work on a hospital unit where LPNs/LVNs are allowed to start intravenous fluids. The physician orders intravenous fluids to be started on one of this nurse's assigned clients. Which of the following actions would be most necessary on the part of this newly hired and newly licensed nurse before starting an intravenous on the client? Your Answer: Take a continuing-education IV course to make sure you have the skills. Correct Answer: Check the hospital policy and check on any certification required. It is best to check the hospital policy. Many hospitals certify nurses in a number of areas that often include starting an intravenous and giving intravenous medications.

3. When working as a licensed vocational nurse, you determine that your client scheduled for surgery does not understand the physician's earlier explanation of the surgery. The client is asking many questions about the risks and seems worried. Which of the following actions would be best on your part? Your Answer: Ask your supervising RN to explain the surgery procedure and its risks. Correct Answer: Notify the physician. The physician doing the surgery is responsible for obtaining informed consent and is best prepared to explain what he or she will be doing in surgery as well as the risks. If the nurse finds that the client does not understand the physician's explanation, the physician must be notified.

4. You are the nurse working with an elderly, competent client who refuses a vitamin B injection ordered by the physician. The family insists that this injection be given, and you give it while the client is objecting. Even though the client improves, the client contacts a lawyer. From your knowledge of nursing and the law, you realize that you: Your Answer: should have had the family put their request in writing. Correct Answer: have committed an act of battery against the client. Without their consent, the willful touching of a person or a person's clothes or even something the person is carrying, which may or may not cause harm, constitutes battery. Giving an injection when a person refuses it, is battery.

5. When an LVN/LPN is working for a health-care organization that has professional liability insurance, the nurse needs to base a decision on whether to buy individual professional liability insurance on which of the following things? Your Answer: the amount and type of coverage the health-care organization carries Correct Answer: the possibility that the organization could countersue the nurse in a lawsuit Since hospitals have been known to countersue nurses found to be negligent, the nurse is advised to provide their own insurance coverage.

6. When documenting an assigned client's record during and at the end of the shift, the nurse must keep in mind which of the following facts?

Your Answer: The proper format, such as SOAP or PIE, as chosen by the hospital, must be adhered to. Correct Answer: The chart is a legal document and may be all a nurse has to support care that was given if called to court. The nurse must keep in mind that the chart is a legal document and can be used in court as evidence. Failure to keep proper records can constitute negligence, and insufficient or inaccurate assessments and documentation can result in injury to the client.

7. When the licensed practical/vocational nurse is checking the physician's orders against the medication record prior to setting up medications, the nurse discovers a medication error made on the previous shift. The nurse reports this error to the supervising nurse. Which of the following persons will need to fill out an incident report? Your Answer: licensed nurse who committed the medication error the previous shift Correct Answer: licensed practical/vocational nurse who discovered the error The incident report should be completed by the person who identifies that the incident occurred. It may not be the same person who made the error.

8. You are a student nurse working as a part-time or temporary nursing assistant in a nursing home. The nurse on duty asks you to insert a nasogastric tube in a patient. You have recently passed an examination on putting in a nasogastric tube. Which of the following actions is best on your part? Your Answer: Go ahead and insert the nasogastric tube. Correct Answer: Tell the nurse that you cannot legally insert this tube. Legally the student cannot perform tasks such as a nasogastric tube insertion or injections while employed as an aide or assistant to the nurses, even though they have received instruction.

9. According to the nursing code of ethics, when working as a nurse and a conflict comes up between your client's needs and what the family and/or the physician wants, and/or the hospital policies, your first loyalty is to the: Your Answer: family. Correct Answer: client.

Your first loyalty is to the client, according to the nursing code of ethics. It is not easy to determine which action best serves the client. A good decision is one that is in the client's best interest and preserves integrity of all involved.

10. Which of the following strategies can most help you as a nurse to enhance your ethical practice and client advocacy? Your Answer: talking with peers about their beliefs and values Correct Answer: examining and clarifying your own values Nurses can enhance their ethical practice and client advocacy by clarifying their own values, understanding values of other health-care professionals, and becoming familiar with the nursing code of ethics.