Introduction Critical Care Nursing 7th Edition By Sole Klein
Introduction Critical Care Nursing 7th Edition By Sole Klein
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Chapter 03: Ethical and Legal Issues in Critical Care Nursing
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | family if the patient is in critical condition. |
| b. | patient as part of the hospital admission process. |
| c. | patient before hospitalization. |
| d. | patient’s health care surrogate. |
ANS: C
Advance directives should be made and signed while a person is in good health and in a state of mind to make decisions about what should happen if he or she becomes incapacitated (e.g., during a critical illness). Families help to make decisions based on written advance directives, but families are not responsible for developing them for the patient. Developing advance directives during the admission process is not feasible, and the patient may not be capable of making an advance directive. The surrogate or proxy is one who has been already designated by a person to make health care decisions based on written advance directives.
DIF: Cognitive Level: Remember/Knowledge REF: p. 36
OBJ: Discuss ethical principles and legal concepts related to critical care nursing.
TOP: Integrated Process: Communication and Documentation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment
| a. | Autonomy |
| b. | Beneficence |
| c. | Justice |
| d. | Nonmaleficence |
ANS: A
Autonomy is respect for the individual and the ability of individuals to make decisions with regard to their own health and future. The spouse is violating the patient’s autonomy in decision making. Beneficence consists of actions intended to benefit the patients or others. Justice means being fair. Nonmaleficence is the duty to prevent harm.
DIF: Cognitive Level: Analyze/Analysis REF: p. 31 | Box 3-1
OBJ: Discuss ethical principles and legal concepts related to critical care nursing.
TOP: Integrated Process: Communication and Documentation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment
| a. | A living will is the same as a health care proxy. |
| b. | A signed donor card ensures that organ donation will occur in the event of brain death. |
| c. | A surrogate is a competent adult designated by a person to make health care decisions in the event the person is incapacitated. |
| d. | A persistent vegetative state is the same as brain death in most states. |
ANS: C
A surrogate is a competent adult designated by a person to make health care decisions if that person becomes incapacitated. A living will is a witnessed document that states a person’s wishes regarding life-prolonging procedures, whereas a health care proxy is a person authorized by state statute to make health care decisions. In many states, consent by family members or health care proxy is required for organ donation even if an individual has a signed donor card. A persistent vegetative state is a permanent, irreversible unconscious condition that demonstrates an absence of voluntary action or cognitive behavior, or an inability to communicate or interact; brain death is cessation of brain function.
DIF: Cognitive Level: Remember/Knowledge REF: p. 34
OBJ: Discuss ethical principles and legal concepts related to critical care nursing.
TOP: Integrated Process: Communication and Documentation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment
| a. | Family members should never be present during resuscitation. |
| b. | It is not necessary for a physician to write “do not resuscitate” orders in the chart if a patient has a health care surrogate. |
| c. | “Slow codes” are ethical and should be considered in futile situations if advanced directives are unavailable. |
| d. | Withholding “extraordinary” resuscitation is legal and ethical if specified in advance directives and physician orders. |
ANS: D
Withholding resuscitation and other care is legal and ethical if based on the patient’s wishes. Formal orders should be written that specify what is to be done if a patient suffers a cardiopulmonary arrest. Family presence during resuscitation and invasive procedures should be encouraged. A written order for “do not resuscitate” must be documented in the medical record. The decision to write the order is made in collaboration with the health care surrogate. “Slow codes” sometimes occur in the clinical setting while attempts are made to contact the health care surrogate or proxy; however, they are neither legal nor ethical. Specific written orders determine what is to be done for resuscitation efforts.
DIF: Cognitive Level: Remember/Knowledge REF: p. 36
OBJ: Discuss ethical and legal issues that arise in the critical care setting.
TOP: Integrated Process: Communication and Documentation
MSC: NCLEX Client Needs Category: Safe and Effective Care Environment
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