NCLEX Legal and Ethical Considerations

Question 1

Which statement would best explain the role of the nurse when planning care for a culturally diverse population? The nurse will plan care to:

1. ) Include care that is culturally congruent with the staff from predetermined criteria
2. ) Focus only on the needs of the client, ignoring the nurse’s beliefs and practices
3. ) Blend the values of the nurse that are for the good of the client and minimize the client’s individual values and beliefs during care
4. ) Provide care while aware of one’s own bias, focusing on the client’s individual needs rather than the staff’s practices

Answer 1

4.) Provide care while aware of one’s own bias, focusing on the client’s individual needs rather than the staff’s practices

Without understanding one’s own beliefs and values, a bias or preconceived belief by the nurse could create an unexpected conflict or an area of neglect in the plan of care for a client (who might be expecting something totally different from the care). During assessment values, beliefs, practices should be identified by the nurse and used as a guide to identify the choices by the nurse to meet specific needs/outcomes of that client. Therefore identification of values, beliefs, and practices allows for planning meaningful and beneficial care specific for this client.

Question 2

Which factor is least significant during assessment when gathering information about cultural practices?

1. ) Language, timing
2. ) Touch, eye contact
3. ) Biocultural needs
4. ) Pain perception, management expectations

Answer 2

3.) Biocultural needs

Cultural practices do not influence biocultural needs because they are inborn risks that are related to a biological need and not a learned cultural belief or practice.

Question 3

Transcultural nursing implies:

1. ) Using a comparative study of cultures to understand similarities and differences across human groups to provide specific individualized care that is culturally appropriate
2. ) Working in another culture to practice nursing within their limitations
3. ) Combining all cultural beliefs into a practice that is a nonthreatening approach to minimize cultural barriers for all clients’ equality of care
4. ) Ignoring all cultural differences to provide the best generalized care to all clients.

Answer 3

1.) Using a comparative study of cultures to understand similarities and differences across human groups to provide specific individualized care that is culturally appropriate

Transcultural care means that by understanding and learning about specific cultural practices the nurse can integrate these practices into the plan of care for a specific individual client who has the same beliefs or practices to meet the client’s needs in a holistic manner of care.

Question 4

What should the nurse do when planning nursing care for a client with a different cultural background? The nurse should:

1. ) Allow the family to provide care during the hospital stay so no rituals or customs are broken
2. ) Identify how these cultural variables affect the health problem
3. ) Speak slowly and show pictures to make sure the client always understands
4. ) Explain how the client must adapt to hospital routines to be effectively cared for while in the hospital

Answer 4

2.) Identify how these cultural variables affect the health problem

Without assessment and identification of the cultural needs, the nurse cannot begin to understand how these might influence the health problem or health care management.

Question 5

A bioethical issue should be described as:

1. ) The physician’s making all decisions of client management without getting input from the client
2. ) A research project that included treating all the white men and not treating all the black men to compare the outcomes of a specific drug therapy.
3. ) The withholding of food and treatment at the request of the client in a written advance directive given before a client acquired permanent brain damage from an accident.
4. ) After the client gives permission, the physician’s disclosing all information to the family for their support in the management of the client.

Answer 5

2.) A research project that included treating all the white men and not treating all the black men to compare the outcomes of a specific drug therapy.

The ethical issue was the inequality of treatment based strictly upon racial differences. Secondly, the drug was deliberately withheld even after results showed that the drug was working to cure the disease process in the white men for many years. So after many years, the black men were still not treated despite the outcome of the research process that showed the drug to be effective in controlling the disease early in the beginning of the research project. Therefore harm was done. Nonmaleficence, veracity, and justice were not followed.

Question 6

The distribution of nurses to areas of “most need” in the time of a nursing shortage is an example of:

1. ) Utilitarianism theory
2. ) Deontological theory
3. ) Justice
4. ) Beneficence

Answer 6

3.) Justice

Justice is defined as the fairness of distribution of resources. However, guidelines for a hierarchy of needs have been established, such as with organ transplantation. Nurses are moved to areas of greatest need when shortages occur on the floors. No floor is left without staff, and another floor that had five staff will give up two to go help the floor that had no staff.

Question 7

Most litigation in the hospital comes from the:

1. ) Nurse abandoning the clients when going to lunch
2. ) Nurse following an order that is incomplete or incorrect
3. ) Nurse documenting blame on the physician when a mistake is made
4. ) Supervisor watching a new employee check his or her skills level

Answer 7

2.) Nurse following an order that is incomplete or incorrect

The nurse is responsible for clarifying all orders that are illegible, unreasonable, unsafe, or incorrect. The failure of the nurse to question the physician about an order creates an area of liability on the nurse’s part because this is perceived as a medical action and not the role of the nurse to write orders. Some RNs do have prescriptive privileges based upon advanced degrees and certification. Therefore the nurse who cannot correct the order must document that the physician was called and clarification or a new order was given to correct the unclear or illegible one that was currently on the chart. Phone calls, follow-up, and lack of follow-up by the physician should also be documented if there is a problem with getting the information in a timely manner. The nurse must show the sequence of events of a situation in a clear manner if there is any conflict or question about any orders or procedures that were not appropriate. Assessments and documentation of the client’s status should also be included if there is a potential risk for harm present. Contact of the staff’s chain of command should also be specifically stated for the proof of the responsibilities being followed according to hospital policy.

Question 8

When caring for a terminally ill client, it is important for the nurse maintain the client’s dignity. This can be facilitated by:

1. ) Spending time to let clients share their life experiences
2. ) Decreasing emphasis on attending to the clients’ appearance because it only increases their fatigue
3. ) Making decisions for clients so they do not have to make them
4. ) Placing the client in a private room to provide privacy at all times

Answer 8

1.) Spending time to let clients share their life experiences

Spending time to let clients share their life experiences enables the nurse to know clients better. Knowing clients then facilitates choice of therapies that promote client decision making and autonomy, thus promoting a client’s self-esteem and dignity.

Question 9

Bereavement may be defined as:

1. ) The emotional response to loss
2. ) The outward, social expression of loss
3. ) Postponing the awareness of the reality of the loss.
4. ) The inner feeling and outward reactions of the survivor

Answer 9

4.) The inner feeling and outward reactions of the survivor

Question 10

A client who had a “Do Not Resuscitate” order passed away. After verifying there is no pulse or respirations, the nurse should next:

1. ) Have family members say goodbye to the deceased
2. ) Call the transplant team to retrieve vital organs
3. ) Remove all tubes and equipment (unless organ donation is to take place), clean the body, and position appropriately.
4. ) Call the funeral director to come and get the body

Answer 10

3.) Remove all tubes and equipment (unless organ donation is to take place), clean the body, and position appropriately.

The body of the deceased should be prepared before the family comes in to view and say their goodbyes. This includes removing all equipment, tubes, supplies, and dirty linens according to protocol, bathing the client, applying clean sheets, and removing trash from the room.

Question 11

Which of the following is not included in evaluating the degree of heritage consistency in a client?

1. ) Gender
2. ) Culture
3. ) Ethnicity
4. ) Religion

Answer 11

1.) Gender

Question 12

To respect a client’s personal space and territoriality, the nurse:

1. ) Avoids the use of touch
2. ) Explains nursing care and procedures
3. ) Keeps the curtains pulled around the clients bed
4. ) Stands 8 feet away from the bed, if possible

Answer 12

2.) Explains nursing care and procedures

Question 13

A health care issue often becomes an ethical dilemma because:

1. ) A clients legal rights coexist with a health professionals obligation
2. ) Decisions must be made quickly, often under stressful conditions
3. ) Decisions must be made based on value systems
4. ) The choices involved do not appear to be clearly right or wrong

Answer 13

4.) The choices involved do not appear to be clearly right or wrong

Question 14

A document that lists the medical treatment a person chooses to refuse if unable to make decisions is the:

1. ) Durable power of attorney
2. ) Informed consent
3. ) Living will
4. ) Advance directives

Answer 14

4.) Advance directives

Question 15

Which statement about loss is accurate?

1. ) Loss is only experienced when there is an actual absence of something valued
2. ) The more the individual has invested in what is lost, the less the feeling of loss
3. ) Loss may be maturational, situational, or both.
4. ) The degree of stress experienced is unrelated to the type of loss

Answer 15

3.) Loss may be maturational, situational, or both.

Question 16

Trying questionable and experimental forms of therapy is a behavior that is characterized of which stage of dying?

1. ) Anger
2. ) Depression
3. ) Bargaining
4. ) Acceptance

Answer 16

3.) Bargaining

Question 17

All of the following are crucial needs of the dying client except:

1. ) Control of pain
2. ) Preservation of dignity and self-worth
3. ) Love and belonging
4. ) Freedom from decision making

Answer 17

4.) Freedom from decision making

Question 18

Cultural awareness is an in-depth self-examination of one’s:

1. ) Background, recognizing biases and prejudices
2. ) Social, cultural, and biophysical factors
3. ) Engagement in cross-cultural interactions
4. ) Motivation and commitment to caring

Answer 18

1.) Background, recognizing biases and prejudices

Cultural awareness is an in-depth examination of one’s own background, recognizing biases and prejudices and assumptions about other people.

Question 19

Cultural competence is the process of:

1. ) Learning about vast cultures
2. ) Acquiring specific knowledge, skills, and attitudes
3. ) Influencing treatment and care of clients
4. ) Motivation and commitment to caring.

Answer 19

2.) Acquiring specific knowledge, skills, and attitudes

Cultural competence is the process of acquiring specific knowledge, skills, and attitudes that ensure delivery of culturally congruent care.