Module 1 Week 1 Exam Ethics and Delegation

A nurse discovers that a colleague has been documenting medications as administered that were not given to the client. Which actions should the nurse take to address this situation? Select all that apply. Report the incident to the nursing supervisor immediately. Confront the colleague about the falsified documentation. Document the observed discrepancies in the client’s medical record. Notify the state board of nursing directly about the situation. Follow institutional policies for reporting unethical or unsafe practices.

A client with end-stage renal disease (ESRD) has signed an advance directive refusing dialysis. The nurse observes the client's family insisting on initiating dialysis, claiming that the client does not understand the consequences of the decision. What is the priority nursing action?. Inform the family that dialysis will be started immediately. Notify the healthcare provider about the family's concern. Advocate for the client's expressed wishes as documented in the advance directive. Arrange for an ethics committee consultation to resolve the issue.

The nurse is preparing to administer care to a client who has refused blood transfusions for religious reasons. Which actions by the nurse demonstrate ethical and legal compliance? Select all that apply. Document the client's refusal and notify the healthcare provider. Explain the potential risks of refusing the blood transfusion. Obtain a court order to administer the blood transfusion. Respect the client's decision while providing alternative treatments. Provide the client with a Leaving Against Medical Advice (AMA) form to sign, acknowledging their refusal of treatment.

While teaching a group of new graduate nurses, the nurse is reviewing cases where ethical principles and legal standards must guide decision-making. Identify whether each nursing action reflects the ethical principle of beneficence, autonomy, nonmaleficence, or justice. Only one principle should be selected for each nursing action. Administering pain medication as ordered. Respecting a client's choice to refuse treatment. Ensuring equal access to resources for all clients. Providing culturally competent care to diverse clients. Advocating for a client to receive a needed procedure.

The education nurse is teaching a group of nurses on the medical-surgical floor about ethical and legal guidelines. For each scenario described, determine whether the action is appropriate or not appropriate based on the ethical and legal principles. Preventing a competent client from leaving the hospital against medical advice. Applying restraints to a client with a physician's order for a documented clinical need. Sedating a client without justification to prevent them from leaving the emergency room. Threatening to restrain a client for screaming profanities. Placing a client in seclusion for aggressive physical behavior with proper documentation and orders. Threating a client about withholding pain medication until they calm down.

The education nurse is conducting a teaching session on the legal guidelines regarding assault and battery in nursing. Identify whether the following nursing actions constitute assault or battery by placing a checkmark in the appropriate column. Only one column should be selected for each nursing action. Threating a client by stating, "If you don't cooperate, I will restrain you.". Administering an injection to a client who has refused it. Raising a hand toward a client in a threatening manner, attempting to slap but missing and not making physical contact. Placing a restraint on a client without clinical justification or proper orders. Verbally threatening a client with harm for refusing a procedure. Touching a client's body to perform a procedure without explaining or obtaining consent.

The education nurse is conducting a teaching session on organ donation and transplantation. For each nursing action or statement described, determine whether it is appropriate or not appropriate based on legal and ethical guidelines. Informing a client that they can indicate their wish to become an organ donor on their driver's license. Explaining to the family that organ donation will delay funeral arrangements. Ensuring a donor is free of infectious diseases and cancer before transplantation. Removing tissues from a deceased individual without consent from their next of kin. Informing the client that certain organs can only be donated after brain death has been confirmed. Allowing a nurse without specialized training to request organ donation from a deceased client's family.

The education nurse is teaching a session on cultural and religious considerations regarding organ donation. Which of the following statements reflect these considerations accurately? Select all that apply. The Catholic Church prohibits organ donation and transplantation. The Orthodox Church discourages organ donation. Islam prohibits the removal or donation of body parts for transplantation. Jehovah's Witnesses accept any organ transplantation. In Orthodox Judaism, organ transplantation may be allowed with a rabbi's approval. Christianity universally prohibits organ donation and transplantation.

The education nurse is leading a workshop on informed consent. Determine whether the nursing actions listed below align with legal and ethical standards. Identify if the nursing action is appropriate or not appropriate. Asking a client who has been sedated to sign the consent form. Ensuring that the client's questions about the procedure are answered before the consent is signed. Witnessing the client's signature on the informed consent form after the provider has explained the procedure. Allowing a competent 16-year-old client to sign the consent form for a surgical procedure. Allowing a 17-year-old client who is married to sign the consent form for a surgical procedure. Documenting that the client waived the right to receive information about the procedure before signing the consent. Asking a family member to sign the consent for a competent adult client. Proceeding with a procedure without consent during an urgent life-threatening situation, following institutional policy.

The education nurse is reviewing guidelines for documenting incident reports. Which of the following statements by a nurse should be included in an incident report? Select all that apply. "The client was found on the floor next to the bed at 08:30.". "The client fell because they were attempting to walk to the bathroom without assistance.". "The client stated, I slipped and fell when trying to get up.". "The nurse didn't answer the call light quickly, which is why the client fell.". "The client looked tired and unsteady before the fall occurred.". "It seems like the client forgot to use the call light before attempting to get out of bed.".

A registered nurse (RN) is working on a busy medical-surgical floor with a licensed practical nurse (LPN) and an unlicensed assistive personnel (UAP). The RN must delegate tasks to ensure that all client needs are met safely and efficiently. Which task is appropriate for the UAP to perform? Select all that apply. Monitoring a client with heart failure for shortness of breath and reporting changes. Assisting a client with Parkinson's disease in eating and drinking to prevent aspiration. Performing sterile dressing changes for a client with a post-operative wound. Measuring and recording intake and output for a client with renal failure. Reinforcing client education on deep breathing exercises post-surgery. Applying an external urinary catheter to a male client with urinary incontinence.

The charge nurse on the surgical floor is making assignments for the day. Which client is most appropriate to assign to a nurse who is in the first trimester of pregnancy?. A client with Clostridioides difficile (C. difficile) infection requiring frequent bed changes. A client with methicillin-resistant Staphylococcus aureus (MRSA) who needs a wound dressing change. A client with active tuberculosis (TB) requiring airborne precautions. A client with chronic obstructive pulmonary disease (COPD) needing oxygen titration.

The charge nurse in the emergency department is determining assignments for the shift. Which client is appropriate to assign to a nurse who is pregnant?. A client who is being monitored for dehydration after severe gastroenteritis. A client with a new diagnosis of meningococcal meningitis. A client with a laceration who needs a tetanus booster. A client with confirmed influenza A virus presenting with high fever and cough.

The registered nurse is caring for a group of clients on a telemetry unit. For each potential intervention, specify if the intervention is appropriate or not appropriate for the registered nurse to delegate to the licensed practical nurse (LPN). Administer subcutaneous insulin to a client with diabetes. Monitor a client cardiac rhythm admitted with Atrial Fibrillation. Provide education on a low-sodium diet for heart failure. Change a sterile dressing for a client with a central venous catheter. Assess a client's pain level 30 minutes after receiving IV morphine. Reinforce teaching on using an incentive spirometer post-operatively.

The registered nurse (RN) manages a group of clients on a pediatric unit. For each potential intervention, specify if it is appropriate or not appropriate for the RN to delegate to the licensed practical nurse (LPN). Administer a scheduled dose of acetaminophen to a child with fever. Perform initial assessment on a newly admitted client with suspected meningitis. Reinforce dietary restrictions with the parents of a child diagnosed with celiac disease. Monitor a child with sickle cell disease for signs of vaso-occlusive crisis. Provide discharge teaching for a child newly diagnosed with Type 1 diabetes. Collect a urine sample from a child for a urinalysis.

The nursing team consists of a registered nurse (RN), licensed practical nurse (LPN), and two unlicensed assistive personnel (UAP). The nurse considers the assignment appropriate if the LPN is assigned to provide care for which pediatric client?. A 3-year-old with croup who is receiving racemic epinephrine treatments every 2 hours. A 6-month-old recovering from pyloric stenosis surgery 3 days ago, requiring enteral feeding. A 9-year-old newly admitted with diabetic ketoacidosis requiring hourly blood glucose monitoring. A 2-year-old with new-onset seizures and altered mental status.

The nursing team consists of a registered nurse (RN), licensed practical nurse (LPN), and two unlicensed assistive personnel (UAP). The nurse considers the assignment appropriate if the LPN is assigned to provide care for which postpartum client?. A 28-year-old 2 hours post-cesarean section with moderate bleeding. A 30-year-old with a history of postpartum hemorrhage who is emotional about the infant being in the Neonatal Intensive Care Unit (NICU). A 22-year-old with pre-eclampsia on IV magnesium sulfate therapy. A 35-year-old with an episiotomy 3 hours ago, experiencing increasing pain and difficulty voiding.

The nursing team consists of a registered nurse (RN), licensed practical nurse (LPN), and two unlicensed assistive personnel (UAP). The nurse considers the assignment appropriate if the LPN is assigned to provide care for which geriatric client?. A 78-year-old who is confused with a history of dementia. An 82-year-old with a hip fracture, post-operative day 1, requiring frequent neurovascular checks. A 90-year-old with a blood pressure of 170/90 mmHg requiring administration of PO metoprolol. An 88-year-old with a urinary tract infection requiring continuous IV fluids and antibiotics.

A registered nurse (RN) on a surgical unit is working with a licensed practical nurse (LPN) and an unlicensed assistive personnel (UAP). Which tasks are appropriate for the UAP to perform? Select all that apply. Assisting a client who was diagnosed with a stroke in performing active range-of-motion exercises. Ambulating a client 3-day post-operative after an abdominal hysterectomy who is complaining of increasing pain. Measuring and documenting the daily weight of a client with congestive heart failure. Administering a prescribed enema to a client with constipation. Reporting to the nurse the client's statement about increasing pain after ambulation. Obtaining a bedside glucose test on a diabetic client reporting dizziness.

The registered nurse (RN) is working with a licensed practical nurse (LPN) to provide care to a group of clients on a medical-surgical unit. Which of the following assignments should not be delegated to the LPN?. Monitoring a client with stable hypertension who is receiving PO antihypertensive medication. Administering subcutaneous insulin to a client with type 2 diabetes. Changing a sterile dressing on a client 5-days post-operative after abdominal surgery. Developing a plan of care for a client newly admitted with congestive heart failure.

The charge nurse on a medical-surgical unit is delegating tasks to a licensed practical nurse (LPN) and an unlicensed assistive personnel (UAP). Which of the following tasks should the charge nurse delegate to the LPN? Select all that apply. Administering a subcutaneous heparin injection to a post-operative client who is 2 days post-surgery. Monitoring a client with atrial fibrillation and administering their first dose of warfarin. Explaining how to use a metered-dose inhaler for a client with chronic obstructive pulmonary disease (COPD). Performing wound care on a client with a pressure ulcer requiring sterile technique. Administering oral medications to a client with hypertension. Initiating blood transfusion for a client with a hemoglobin level of 7.0 g/dL.

The charge nurse is reviewing tasks that are inappropriate to delegate to the licensed practical nurse (LPN). Which tasks should the charge nurse not delegate to the LPN? Select all that apply. Assessing vital signs for a client with myxedema coma. Assisting a client with dysphagia post stroke to eat lunch. Administering intravenous nitroglycerin to a client with chest pain. Performing endotracheal suctioning on a client with a new tracheostomy. Administering oral medications to a stable client with hypertension.

The charge nurse is reviewing tasks that are inappropriate to delegate to the licensed practical nurse (LPN). Which tasks should the charge nurse not delegate to the LPN? Select all that apply. A client with acute respiratory distress syndrome (ARDS) requiring a STAT ABG analysis. A client diagnosed with asthma with a sudden decrease of expiratory wheezing. A client post-appendectomy requesting the incentive spirometer. A client with a tracheostomy who is 24 hours post-op from surgery for laryngeal cancer, requiring suctioning. A client with chronic renal failure receiving dialysis who requires ongoing blood pressure monitoring.

The nurse is caring for a client recovering from a stroke in the medical-surgical unit. Which client care tasks can the nurse safely delegate to the unlicensed assistive personnel (UAP)? Select all that apply. Assisting the client with feeding during breakfast. Repositioning the client every 2 hours to prevent pressure injuries. Monitoring the amount and color of secretions from a client's tracheostomy. Monitoring the client for changes in neurological status. Documenting intake and output after assisting with toileting.