ATI RN
Contemporary Ethical Issues in Nursing Questions
Question 1 of 5
A client is admitted with chest pain. A series of diagnostic tests are ordered, and the client undergoes coronary artery bypass grafting. The cost of care for this client is increased because of a four-pack-per-day smoking history that resulted in extension of the client's intensive care unit (ICU) stay by 3 days because of respiratory problems. The case manager realizes that under the terms of the diagnosis-related group (DRG) payment system for this diagnosis:
Correct Answer: B
Rationale: The correct answer is B. The DRG payment system is a fixed reimbursement amount for a specific diagnosis or procedure. In this case, the cost of care exceeded the DRG reimbursement amount due to the extended ICU stay caused by the client's smoking history. The hospital will only be reimbursed at the set fee specified by the DRG, regardless of the actual cost incurred. Choice A is incorrect because the hospital cannot collect additional fees from the insurance company beyond the DRG reimbursement amount. Choice C is incorrect as the client is not typically held responsible for the additional costs incurred. Choice D is incorrect because physician payment is not directly impacted by the hospital's financial losses. The DRG system focuses on fixed reimbursements based on diagnoses, not individual physician payments.
Question 2 of 5
A patient is upset because her health insurance plan refused to pay for a mammogram and services by a women's health specialist because the primary care physician did not order the referral or the mammogram. Which type of insurance plan adheres to this type of payment system?
Correct Answer: B
Rationale: The correct answer is B: Health Maintenance Organization (HMO). In an HMO, services are typically provided by a primary care physician who acts as a gatekeeper for all medical services, including referrals to specialists and diagnostic tests like mammograms. The primary care physician must authorize and order these services for them to be covered by the insurance plan. This system helps control costs and ensures coordinated care. A: Fee for Service does not require a primary care physician to authorize referrals or services. C: PPO allows patients to see out-of-network providers without referrals. D: POS plans offer more flexibility in choosing healthcare providers without requiring a primary care physician's referral.
Question 3 of 5
A nurse is caring for a client with malignant hypertension whose blood pressure has increased by 40 mm Hg during the past hour. The nurse goes to lunch and fails to report the change to the physician. The nurse is at risk for being charged with:
Correct Answer: A
Rationale: Correct Answer: A - Negligence Rationale: 1. Negligence is the failure to provide the standard of care resulting in harm to the patient. 2. The nurse failed to report a significant change in the patient's condition, breaching the duty of care. 3. The increase in blood pressure could lead to serious complications, indicating the severity of negligence. Summary: B: Assault - Involves intentional threat or harm, not applicable in this scenario. C: Defamation of character - Involves false statements damaging reputation, not relevant in the context of patient care. D: Tort - A broader legal term encompassing various civil wrongs, but negligence is a specific type of tort applicable here.
Question 4 of 5
A client states, "I am leaving. No one here knows what they are doing." The nurse completing the Against Medical Advice form must:
Correct Answer: C
Rationale: Rationale: Choice C is correct because informing the client of potential complications and impairment is essential to ensure the client makes an informed decision. This aligns with the principle of autonomy and informed consent. Choice A is incorrect as delaying notification can jeopardize the client's safety. Choice B is incorrect because using medical jargon may not effectively communicate the risks to the client. Choice D is incorrect as using restraints is a violation of the client's rights and autonomy.
Question 5 of 5
Although a hospital reversed all charges when a client was the victim of wrong site surgery, the court awarded the client $5 million. The client was able to return to work in 6 weeks and had no permanent damages. This monetary compensation is termed:
Correct Answer: B
Rationale: The correct answer is B: punitive damages. Punitive damages are awarded to punish the defendant for their wrongful actions. In this case, the hospital's negligence in performing wrong site surgery resulted in harm to the client, even though the hospital reversed the charges. The court awarded $5 million to punish the hospital for their negligence, as the client suffered emotional distress and the potential risk of harm. The other choices are incorrect because: A: res ipsa loquitur is a legal doctrine used to shift the burden of proof from the plaintiff to the defendant in cases where the negligence is obvious. C: vicarious liability holds an employer responsible for the actions of their employees, which is not directly applicable in this scenario. D: immunity refers to protection from legal liability, which is not relevant in a case where the court awarded monetary compensation.