University of Texas-Arlington NURS 3632 Clinical Foundations Vol. III 100 Q&A

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NURS 3632: Clinical Nursing Foundations | Volume III
Section 1: Legal, Ethical, and Professional Practice
1. A nurse discovers that a colleague has been diverting opioid medications intended for
clients. According to the ANA Code of Ethics, what is the nurse's primary obligation?
 A) Confront the colleague privately to encourage them to seek help.
 B) Document the suspected diversion in the affected clients' medical records.
 C) Report the suspicions to the nursing supervisor or unit manager immediately.
 D) Contact the State Board of Nursing before discussing it with facility management.
Elaboration: The nurse's primary duty is to protect the safety of the public and the clients.
Reporting up the chain of command within the facility ensures immediate action is taken to
protect clients from an impaired provider.
2. A competent adult client with a terminal illness decides to discontinue all life-sustaining
treatments, against the advice of their family and the healthcare team. The nurse
supports this decision based on the ethical principle of:
 A) Beneficence.
 B) Justice.
 C) Autonomy.
 D) Fidelity.
Elaboration: Autonomy is the right to self-determination. A competent adult has the absolute
right to refuse medical treatment, even if that decision hastens death, provided they fully
understand the consequences.
3. During a busy shift, a nurse accidentally administers a medication to the wrong client.
The client suffers no adverse effects. The nurse decides not to report the error because
no harm occurred. This action violates the ethical principle of:
 A) Nonmaleficence.
 B) Veracity.
 C) Confidentiality.
 D) Justice.

,Elaboration: Veracity is the duty to tell the truth. Failing to report a medication error,
regardless of the outcome, is a breach of truthfulness, compromises the facility's quality
improvement process, and breaches professional integrity.
4. A client is scheduled for an elective cholecystectomy. The client asks the nurse, "What
exactly are they going to remove during this surgery?" The nurse's most appropriate
action is to:
 A) Explain the anatomical removal of the gallbladder using simple terms.
 B) Provide the client with an informational pamphlet about the surgery.
 C) Withhold the preoperative medication and notify the surgeon.
 D) Ask the charge nurse to explain the procedure to the client.
Elaboration: The client's question indicates a lack of informed consent. The nurse cannot
legally provide the medical explanation of the procedure; the surgeon must be called back to
educate the client before any sedating medications are given or consent forms are signed.
5. The Health Insurance Portability and Accountability Act (HIPAA) permits the disclosure
of protected health information (PHI) without client consent in which scenario?
 A) A client's spouse requests the results of a biopsy.
 B) A public health department requires reporting of a newly diagnosed case of
tuberculosis.
 C) An employer requests proof of a client's hospitalization to approve sick leave.
 D) A nursing student wants to use the client's full chart for a case study presentation.
Elaboration: HIPAA includes specific exemptions for public health activities, such as tracking
communicable diseases, reporting vital statistics, and reporting suspected abuse or neglect.
6. A client attempts to leave the hospital against medical advice (AMA). The nurse blocks
the doorway and tells the client they cannot leave until the physician arrives. The nurse
could be sued for:
 A) Assault.
 B) Battery.
 C) False imprisonment.
 D) Malpractice.

, Elaboration: False imprisonment is the unjustified restraint or restriction of a person's
freedom of movement without a legal warrant or medical justification (like acute psychosis
posing an immediate threat).
7. A nurse forgets to raise the side rails on a bed for a client who is confused and sedated.
The client falls out of bed and sustains a hip fracture. In a court of law, this nurse would
most likely be charged with:
 A) An intentional tort.
 B) Negligence (Malpractice).
 C) A criminal misdemeanor.
 D) Battery.
Elaboration: Malpractice is professional negligence. It occurs when a nurse fails to meet the
standard of care (providing a safe environment), resulting in direct and measurable harm to
the patient.
8. Which document allows a client to specify the exact medical treatments they would or
would not want if they enter a persistent vegetative state?
 A) Durable Power of Attorney for Healthcare.
 B) Living Will.
 C) Do Not Resuscitate (DNR) Order.
 D) Patient Bill of Rights.
Elaboration: A living will provides specific instructions about the types of healthcare a person
wishes to receive, whereas a durable power of attorney designates a proxy to make
decisions.
9. The concept of "Fidelity" in nursing practice is best demonstrated by:
 A) Treating all clients with the same level of respect, regardless of socioeconomic status.
 B) Returning to a client's room exactly when promised to administer pain medication.
 C) Refusing to participate in a procedure that conflicts with personal beliefs.
 D) Advocating for a client's right to refuse physical therapy.
Elaboration: Fidelity means keeping promises and remaining faithful to professional
commitments made to the patient.
10. A state's Nurse Practice Act (NPA) serves which primary function?