ATI LPN
Legal and Ethical Aspects of Healthcare Questions
Question 1 of 5
A 52-year-old man with cerebral palsy is being evaluated for screening colonoscopy. He has a mental age of 8 and a second grade reading level in terms of comprehension. He lives alone and survives on a combination of public assistance and a low paying part-time job sweeping floors. You have thoroughly explained the procedure to him in terms of risks and benefits. He repeatedly refuses the procedure entirely on the basis of 'I just don't want it.' What should you do?
Correct Answer: C
Rationale: A patient can refuse a procedure if they understand the risks and benefits, regardless of cognitive impairment in other areas.
Question 2 of 5
You are a fourth-year medical student on a subinternship in obstetrics. You notice that the resident has come in with alcohol on his breath and some abnormal behavior. No one except you seems to notice. What should you do?
Correct Answer: D
Rationale: Patient safety requires reporting impaired colleagues to the appropriate authority, such as the program director.
Question 3 of 5
Mrs. Franklin, an 81-year-old Alzheimer's patient hospitalized under your care has been asked to participate in a clinical trial testing a new drug designed to help improve memory. You were present when the clinical investigator obtained a signed informed consent from Mrs. Franklin a few days ago. However, when you visit Mrs. Franklin today and ask her if she is ready to begin the study tomorrow, she looks at you blankly and seems to have no idea what you are talking about. What should you do?
Correct Answer: D
Rationale: Her current lack of understanding casts doubt on her consent; all steps are necessary to reassess her participation.
Question 4 of 5
A 65-year-old heavy smoker with a lengthy history of chronic obstructive pulmonary disease comes to the office due to recent-onset hemoptysis. He reports 3-5 episodes of coughing up blood in the past month. He also reports a 9.1-kg (20-lb) weight loss in the past 2 months. Chest radiograph reveals a suspicious lesion, and a bronchoscopy followed by biopsy establishes the diagnosis of squamous cell carcinoma of the lung. When the patient is informed of his condition and the prognosis, he asks that no one in his family be told the news yet. He seems tearful but cognitively intact. His wife, who usually brings him to his visits and is also his health care proxy, calls the next day to inquire about the pathology report. She says she is deeply concerned because her husband is reluctant to discuss his condition. Which of the following is the most appropriate course of action?
Correct Answer: D
Rationale: Confidentiality must be respected, but the patient should be encouraged to share with his wife due to her role and impact.
Question 5 of 5
A 28-year-old married woman who works with you in the clinic as a nurse privately comes to you because she 'missed a period' this month. An over-the-counter urine pregnancy test confirms that she is pregnant. First-trimester laboratory testing reveals that she is also HIV positive. When you inform the patient of her HIV status, she is devastated. She hesitantly reveals that she had unprotected sexual intercourse with a former boyfriend several months ago. You explain that her husband's HIV status must be evaluated. The patient is horrified and says 'No, I cannot tell him about this. He would never forgive me!' Which of the following is the most appropriate first step?
Correct Answer: D
Rationale: HIV is reportable, but encouraging her to inform her husband first respects her autonomy while meeting public health obligations.