Health Care Ethics, Law, and Policy

The nurse observes the physician enter the room of a patient with pneumococcal pneumonia without donning personal protective equipment. Which response by the nurse is appropriate?

The nurse is riding the staff elevators with several other healthcare professionals and overhears a provider discussing the lab results for another nurse’s patient. Which response by the nurse is most appropriate?

The provider left a patient’s electronic health record (EHR) open on the computer screen in the nurse’s station when he left to assess a patient. Which action by the nurse is most appropriate?

The nurse receives report that the patient will undergo brain death testing and is aware the patient must meet which criteria to be diagnosed with brain death? Select all that apply.

The patient is awake and alert when being admitted directly to the unit from the cardiac catheterization lab after transferring from the primary care doctor. The patient’s spouse calls the unit looking for the patient. Which response by the nurse is most appropriate?

Which situations prompt the use of four-point restraints? Select all that apply.

The 14-year-old patient was admitted following surgical reduction of an open femur fracture. The patient, who has reported good pain control with the patient-controlled analgesia (PCA) pump, is sleeping peacefully. During hourly rounding, the nurse observes the parent press the button to administer the bolus of pain medication. Which action by the nurse is appropriate?

The LPN/LVN informs the supervising RN, “I didn’t realize until after administering the medication, but I was supposed to give the patient a half tablet of levothyroxine; I gave him a whole tablet.” Which action does the nurse take first?

To which team member does the registered nurse delegate a fecal occult blood test for the patient who requires assistance to ambulate to the restroom?

The patient is being transferred from a nursing home to an acute care facility. The receiving nurse performs which actions during the medication reconciliation process? Select all that apply.

The nurse mistakenly administered a long-acting benzodiazepine to the patient with end-stage liver disease, a drug that was not ordered. As a result, the patient had to remain in the hospital an extra night. The nurse wants to apologize to the patient for the mistake. Which of the following is most accurate?

The nurse is caring for a woman wearing a hijab. The woman does not speak English and has come to the emergency department (ED) with fever, vaginal bleeding, and abdominal pains. An interpreter is present for the interaction. Which question is appropriate for the nurse to ask first?

The nurse receives report at the beginning of the shift. Which task is appropriate to delegate to the unlicensed assistive personnel?

The nurse does not administer a physician-ordered medication because it is contraindicated for the patient. This is an example of which principle?

During an active shooter situation, the nurse closes patient’s rooms and bars entry to the unit. This is an example of which ethical principle?

The patient with severe, symptomatic anemia who is a Jehovah's Witness refuses a blood transfusion for religious reasons. The nurse instructs the provider to discontinue the order. This is an example of which ethical principle? 

After a mass casualty event, the nurse triages care of dozens of patients in the emergency department (ED) based on the severity of their injury and likelihood of survival. This is an example of which principle?

Which actions does the nurse take to prevent infection around the use of a peripheral IV? Select all that apply.

The nurse is reviewing the medication list of the patient who wishes to become pregnant. One of the medications is listed as Category X. The nurse knows this medication poses which level of risk to the fetus?

Which is a patient responsibility?

Which situation prompts the patient to be compelled to a healthcare facility without consent?

The patient is verbally aggressive with a nurse and threatens physical violence unless he is given an IV dose of hydromorphone (Dilaudid). Which initial action by the nurse is appropriate?

Which patients are seen first in the hospital following a mass casualty event?

The nurse learns the patient's blood drawn on admission was positive for human immunodeficiency virus (HIV). Which action by the nurse is appropriate?

The nurse is discussing palliative care with the patient with metastatic colorectal cancer. The patient responds, "I'm not ready to give up. I want to keep fighting this disease." Which response from the nurse is most appropriate? 

Which patient with dyspnea is seen first in the emergency department?

The nurse is reviewing the chart of the patient who is scheduled for a laparoscopic cholecystectomy in one hour. Signed consent is found, as well as blood transfusion consent, anesthesia evaluation, blood type, and emergency contacts. The nurse asks the patient, “Do you have any questions about your upcoming gallbladder removal surgery?” The patient replies, “Gallbladder removal? I thought they were just taking out my gallstones. I’ll be glad to get rid of those.” Which response by the nurse is most appropriate?

The patient requires an indwelling catheter to be placed prior to surgery. Which action does the nurse take first?

A patient tells the nurse in an outpatient endocrinology clinic that he is unhappy with his diabetes care and wants to see another physician. The nurse provides which advice?

The resident of a large, long-term care facility has reactivated tuberculosis and is infectious. Which action does the nurse take?

Which practice is appropriate for a surgical scrub prior to donning a sterile gown?

Which statement describes the nurse's legal responsibility in administering regular insulin to the mentally competent adult patient? 

The nurse is providing discharge teaching to the patient who will be discharged with a peritoneal dialysis catheter. Which statement indicates a need for further teaching?

The grown child of an elderly woman with dementia is trying to provide his mother with in-home hospice. The caregiver providing in-home hospice for the elderly patient with dementia reports nearly constant verbal and physical abuse at the hands of the patient including degrading talk, biting, and scratching. How does the nurse manage this situation?

The patient who was admitted overnight is scheduled to receive an assortment of oral medications in the morning. The patient tells the nurse he does not recognize these pills. Which response by the nurse is appropriate?

Following traumatic bilateral leg amputations, the 5-year-old child requires a STAT blood transfusion to treat hemorrhagic shock. The child's blood type is unknown. Which action is most appropriate? 

The nurse working in the pediatric unit finds the two-year-old patient crying on the floor near his hospital crib. The child's parents were present for the fall, are visibly upset, and tell the nurse that she crawled over the edge and fell to the floor. Which action by the nurse is appropriate?

A high school wide receiver suffered substantial head trauma during a tackle. The school nurse is concerned about concussion. The nurse provides which information to the adolescent and parents? Select all that apply.

A patient seeing her primary care physician responds “no” to the domestic violence screening question, “Do you feel safe in your home?” Which action does the nurse take next?

The nurse is caring for a patient after abdominal surgery and significant blood loss. A life-saving blood transfusion has been ordered but the patient refuses it. Which action does the nurse take first?

The nurse is caring for a patient transitioning to hospice care and completing his admission assessment. Which question will help the nurse most effectively attend to his spiritual needs?

A Muslim man becomes ill on a cruise ship and is transported to a hospital in Anchorage, Alaska. While conducting his history, the nurse asks, “Are there any spiritual needs we can help you address?” The man replies that he is Muslim and will pray five times a day and asks, “Which way do I face to pray to Mecca?” Which is the best response by the nurse?

The older adult patient recently diagnosed with a spinal cord injury and limited mobility is referred to a physical therapist to discuss using a wheelchair for increased mobility. The patient asks the nurse, “Do I really have to see the physical therapist? I broke my leg as a kid and used one then.” Which response by the nurse is appropriate?

The nurse is caring for a patient with left-sided weakness in the hospital who had vocal cord surgery this morning. Which intervention is most important to promote safety?

Which patient in the emergency department (ED) must be treated first?

The nurse is assisting the provider in performing triage of 30 patients after a mass casualty incident. The nurse observes the resident changing the triage tag for the unresponsive patient with an open skull fracture who is not breathing spontaneously from black to red and calls the EMT over to transport the patient to the hospital. Which response by the nurse is most appropriate?

The nurse is first on the scene following a multivehicle accident. After activating emergency services and verifying the safety of the scene, the nurse begins the triage process. The first patient is unconscious and not breathing. Which action does the nurse take first?

The nurse preceptor is supervising the graduate nurse during shift handoff. Which statements by the graduate nurse would prompt the veteran nurse to clarify for the oncoming nurse? Select all that apply.

A fire breaks out on multiple floors of the hospital and the charge nurse has been instructed to evacuate the patients. In which order are the patients evacuated?

The patient in the intensive care unit who was intubated with a central venous catheter, peripheral arterial catheter, and chest tube has expired. Which question by the nurse who enters the room to assist the patient care nurse is most appropriate?