Chapter 08 Legal And Ethical Issues in Nursing 6th Edition by Ginny Wacker Guido

Chapter 08 Legal And Ethical Issues in Nursing 6th Edition by Ginny Wacker Guido

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Question 1

Type: MCSA

The nurse is preparing a patient for a procedure. The patient has signed a consent form but states, “I don’t really know anything about this procedure. I wonder if there is something else I could do instead?” How should the nurse proceed?

1. Continue with the preparation as consent may not be revoked.
2. Try to convince the patient to go through with the procedure.
3. Stop the preparation as the patient can revoke consent at any time.
4. Have the patient document the question in writing since the original consent was written.

Correct Answer: 3

Rationale 1: Since the patient has expressed lack of knowledge about the procedure, the preparation should not be continued.

Rationale 2: The nurse should not attempt to talk the patient into a procedure.

Rationale 3: The patient always retains the right to verbally revoke consent at any time during the course of treatment. The preparation should be stopped and the physician notified.

Rationale 4: Whether the question is verbal or written is not pertinent and does not make this a situation of informed consent.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8.1 Define informed consent, comparing and contrasting informed consent with consent.

 

Question 2

Type: MCSA

The patient presents to the emergency department with chest pain and collapses in the reception area before registering. Physicians and nurses rush to assist the patient. What type of consent protects these health care providers?

1. Oral
2. Implied
3. Partial
4. Expressed

Correct Answer: 2

Rationale 1: There is no indication that the patient gave oral consent before collapsing.

Rationale 2: Implied consent is consent that may be inferred by the patient’s conduct or that may be legally presumed in emergency situations. Because this patient presented to the ED, consent is implied.

Rationale 3: “Partial” is not a type of consent.

Rationale 4: Expressed consent is consent given by direct words, written or oral.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8.2 Describe means of obtaining informed consent, including expressed, implied, oral, written, complete, and partial.

 

Question 3

Type: MCMA

As a result of shared medical decision making, a patient undergoes a surgical procedure that results in paralysis. What must the patient prove to bring a successful malpractice suit based on informed consent?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. The patient had no part in the decision to operate.
2. The procedure’s known risk of paralysis was not explained to the patient.
3. Since the decision making was shared, no malpractice suit is possible.
4. It was the procedure that caused the harm.
5. That the amount of damage to the patient cannot be determined.

Correct Answer: 2,4

Rationale 1: This patient participated in shared decision making and therefore had a part in the decision to operate. There is no need to prove that this participation did not occur in order for malpractice to be proved.

Rationale 2: To bring a successful malpractice suit based on informed consent, the plaintiff must prove that the health care provider breached responsibility to know and disclose risks.

Rationale 3: It is possible for malpractice to have occurred even if the consent to operate was based on shared decision making.

Rationale 4: To bring a successful malpractice suit based on informed consent, the plaintiff must prove that the the procedure caused the harm.

Rationale 5: To bring a successful malpractice suit based on informed consent, the plaintiff must prove that plaintiff suffered injury for which damages can be assessed.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 8.3 Compare and contrast standards of informed consent.

 

Question 4

Type: MCMA

In which instances would the nurse feel comfortable providing care without first obtaining informed consent?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. The patient is deaf.
2. The physician feels the disclosure of information required for informed consent might cause the patient to commit suicide.
3. A visitor suffers a cardiopulmonary arrest in the emergency department waiting room.
4. The patient has signed a waiver at the suggestion of the primary nurse.
5. Informed consent was obtained when the patient had the same procedure last week.

Correct Answer: 2,3,5

Rationale 1: The fact that the patient is deaf does not remove the requirement to obtain consent.

Rationale 2: Therapeutic privilege exists when the health care provider believes the disclosure of information poses immediate and serious harm to the patient.

Rationale 3: Emergency situations, such as a cardiopulmonary arrest, constitute an exception to the need for informed consent.

Rationale 4: The patient must initiate a waiver; it cannot be suggested by staff.

Rationale 5: Prior patient knowledge involves the patient to whom the risks and benefits were fully explained the first time the patient consented to the procedure.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 8.4 Describe four exceptions to informed consent.