An elderly person, age 80, is finding it difficult to live alone and the family is considering long-term care. The elderly person is reasonably healthy, with only normal aging declines, and maintains a healthy appetite. All medications are administered orally and require only minimal assistance. She is financially secure with an income based on retirement from both the military and factory from her deceased husband and herself. The family contacts long- term care and is told that, based on this patient's information:

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Contemporary Ethical Issues in Nursing Questions

Question 1 of 5

An elderly person, age 80, is finding it difficult to live alone and the family is considering long-term care. The elderly person is reasonably healthy, with only normal aging declines, and maintains a healthy appetite. All medications are administered orally and require only minimal assistance. She is financially secure with an income based on retirement from both the military and factory from her deceased husband and herself. The family contacts long- term care and is told that, based on this patient's information:

Correct Answer: C

Rationale: Rationale for Correct Answer (C): Medicare will pay for home health services should these additional services meet the needs of the individual. 1. Medicare covers home health services for individuals who meet specific criteria, which may include being homebound, needing skilled nursing care, and having a care plan established by a healthcare provider. 2. In this scenario, the elderly person is reasonably healthy and only requires minimal assistance with oral medications, indicating that she may benefit from home health services rather than long-term care. 3. Since the elderly person is financially secure, it is likely that she does not meet the eligibility criteria for Medicaid, which is a need-based program for individuals with limited income and resources. 4. Medicare does not cover long-term care in a nursing home unless specific criteria are met, such as requiring skilled services on a short-term basis. In this case, the elderly person's need for assistance with oral medications does not necessarily qualify as a skilled service for nursing home care. Summary of Incorrect Choices: A

Question 2 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 3 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 4 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.

Question 5 of 5

A physician shares with the patient's family that, while a central line was being inserted, the patient's lungs were inadvertently punctured, which required oxygen administration. The physician also explains that a chest x-ray indicated the lung remained intact and no additional treatment was required. The physician's role in this instance is based on the legal principle of:

Correct Answer: C

Rationale: The correct answer is C: disclosure. In this scenario, the physician shared information about the accidental lung puncture with the patient's family, demonstrating transparency and honesty. This aligns with the legal principle of disclosure, which emphasizes the importance of informing patients and their families about relevant medical information. The physician's actions foster trust and open communication, ensuring that the patient and family are informed about the situation. Choice A: comparative negligence, is incorrect because it involves assessing the degree of negligence by both parties involved, which is not applicable in this context. Choice B: gross negligence, is incorrect because the physician's actions do not demonstrate recklessness or a complete disregard for the patient's safety. Choice D: the Emergency Medical Treatment and Active Labor Act (EMTALA), is incorrect because this law primarily addresses the provision of emergency medical care and ensuring access to necessary services, not the disclosure of medical errors.

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