ATI MANAGEMENT STUDY EXAMS GUIDED
QUESTIONS AND ANSWERS SURE A+
✔✔What are guidelines for refusal of treatment? - ✔✔The PSDA (Patient Self-
Determination Act) stipulates that staff *must* inform clients they admit to a HC facility
of their right to accept or refuse care.
Competent adults have right to refuse treatment, including right to leave a facility w/o a
discharge prescription from provider
(i.e. leaving AMA = Against Medical Advice)
1. If client refuses tx/procedure, must sign a document indicating he understands risk
involved with refusing tx and that he has chosen to refuse it.
2. When client decides to leave facility AMA (w/o discharge rx), the nurse notifies the
provider and discusses with client the risks to expect when leaving facility prior to d/c.
3. The nurse asks client to sign an Against Medical Advice form and documents the
incident.
✔✔What are responsibilities of the provider, the client, and the nurse individual for
informed consent? - ✔✔PROVIDER: *obtains* informed consent
To *obtain* IC, the provider must give client:
- purpose of procedure
- complete description of procedure
, - description of professionals who will perform and participate in procedure
- description of potential harm, pain, or discomfort that might occur
- options for other treatments
- option to *refuse* tx and consequences of doing so
CLIENT: *gives* informed consent
To *give* IC, the client must:
- give it voluntarily, with no coercion involved
- Be competent and of legal age or be an emancipated minor. When client is unable to
provide consent, another authorized person must give consent.
- Receive sufficient information to make a decision based on understanding of what to
expect.
NURSE: *witnesses* informed consent
To *witness* IC, the nurse must:
- Ensure the provider gave client necessary information
- Ensure client understood the info and is competent to give informed consent
- Have client sign informed consent document
- Notify provider if client has more questions or appears to not understand any of
information. *The provider is responsible for giving clarification.*
- Document questions client has, notification of provider, reinforcement of teaching, and
use of an interpreter
✔✔What are standards of care (practice)? - ✔✔Nurses base practice on est. standards
of care or legal guidelines of care, such as the following:
- The nurse practice act of each state
- Published standards of nursing practice from professional organizations and specialty
groups, like AHA, AACN, & AAOHN
- HC facilities' polices & procedures, which est. the standards of practice for employees
of that facility and they provide *detailed* info about how nurse should respond to or
provide care in *specific* situations, and while performing client care procedures.
Standards of Care define and direct the level of care nurses should give and implicate
nurses who do NOT follow these standards in malpractice lawsuits.
Nurses should *refuse* to practice beyond the legal scope of practice outside their
areas of competence (staffing shortage, lack of appropriate personnel)
Nurses should use the *formal chain of command* to verbalize concerns r/t
assignments in light of current legal scope of practice, job description, and area of
competence
✔✔What is the purpose of advance directives (ADs)? - ✔✔To communicate a client's
wishes regarding end-of-life care should the client become unable to do so
- PSDA req asking ALL clients on admission to a HC facility whether they have ADs.
QUESTIONS AND ANSWERS SURE A+
✔✔What are guidelines for refusal of treatment? - ✔✔The PSDA (Patient Self-
Determination Act) stipulates that staff *must* inform clients they admit to a HC facility
of their right to accept or refuse care.
Competent adults have right to refuse treatment, including right to leave a facility w/o a
discharge prescription from provider
(i.e. leaving AMA = Against Medical Advice)
1. If client refuses tx/procedure, must sign a document indicating he understands risk
involved with refusing tx and that he has chosen to refuse it.
2. When client decides to leave facility AMA (w/o discharge rx), the nurse notifies the
provider and discusses with client the risks to expect when leaving facility prior to d/c.
3. The nurse asks client to sign an Against Medical Advice form and documents the
incident.
✔✔What are responsibilities of the provider, the client, and the nurse individual for
informed consent? - ✔✔PROVIDER: *obtains* informed consent
To *obtain* IC, the provider must give client:
- purpose of procedure
- complete description of procedure
, - description of professionals who will perform and participate in procedure
- description of potential harm, pain, or discomfort that might occur
- options for other treatments
- option to *refuse* tx and consequences of doing so
CLIENT: *gives* informed consent
To *give* IC, the client must:
- give it voluntarily, with no coercion involved
- Be competent and of legal age or be an emancipated minor. When client is unable to
provide consent, another authorized person must give consent.
- Receive sufficient information to make a decision based on understanding of what to
expect.
NURSE: *witnesses* informed consent
To *witness* IC, the nurse must:
- Ensure the provider gave client necessary information
- Ensure client understood the info and is competent to give informed consent
- Have client sign informed consent document
- Notify provider if client has more questions or appears to not understand any of
information. *The provider is responsible for giving clarification.*
- Document questions client has, notification of provider, reinforcement of teaching, and
use of an interpreter
✔✔What are standards of care (practice)? - ✔✔Nurses base practice on est. standards
of care or legal guidelines of care, such as the following:
- The nurse practice act of each state
- Published standards of nursing practice from professional organizations and specialty
groups, like AHA, AACN, & AAOHN
- HC facilities' polices & procedures, which est. the standards of practice for employees
of that facility and they provide *detailed* info about how nurse should respond to or
provide care in *specific* situations, and while performing client care procedures.
Standards of Care define and direct the level of care nurses should give and implicate
nurses who do NOT follow these standards in malpractice lawsuits.
Nurses should *refuse* to practice beyond the legal scope of practice outside their
areas of competence (staffing shortage, lack of appropriate personnel)
Nurses should use the *formal chain of command* to verbalize concerns r/t
assignments in light of current legal scope of practice, job description, and area of
competence
✔✔What is the purpose of advance directives (ADs)? - ✔✔To communicate a client's
wishes regarding end-of-life care should the client become unable to do so
- PSDA req asking ALL clients on admission to a HC facility whether they have ADs.
