ATI LPN
Legal and Ethical Aspects of Healthcare Questions
Question 1 of 5
Which of the following does the text identify as a common problem in obtaining informed consent from research participants?
Correct Answer: D
Rationale: Misunderstanding by participants is a frequent barrier to true informed consent, per ethical discussions.
Question 2 of 5
You are a psychiatrist in session with a patient who tells you he thinks his boss at work is persecuting him. The patient has had mild schizophrenia. The patient asks you if you can keep a secret and then tells you that he is planning to kill his boss 'when the time is right.' You say, 'Of course, everything you tell me during the session will always be confidential.' What should you do?
Correct Answer: D
Rationale: A patient's right to confidentiality ends where another person's right to safety begins. Your duty to protect the life of the person at risk is more important than keeping the patient's medical information confidential. You must see that the person at risk is duly warned and law enforcement is informed.
Question 3 of 5
You are a resident invited to a dinner given by a pharmaceutical company. In addition to the dinner there is a lecture given on a medical subject as well as a $500 gift certificate to a department store for attending the presentation. Which of the following is the most appropriate action in this case?
Correct Answer: C
Rationale: Educational activities and modest meals from pharmaceutical companies are acceptable, but direct monetary payments to attendees are not, as they could influence prescribing behavior.
Question 4 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 5 of 5
You are a resident managing a private patient with cellulitis. The patient has a history of congestive heart failure and a normal EKG. The patient is on digoxin, an ACE inhibitor and a diuretic, but not a beta-blocker. You cannot find a contraindication to the use of beta-blockers either in the chart or in discussion with the patient. You ask the private attending why there is no beta-blocker and he looks at you as if you had anoxic encephalopathy. He says, 'I have been in practice for 40 years. Don't you think I know what I am doing? Beta-blockers are dangerous in congestive failure.' The patient looks proudly at the attending and says, 'I have the smartest doctor in the world.' What should you do about this disagreement?
Correct Answer: D
Rationale: You cannot alter treatment without the attending's knowledge; escalating to the chief of service respects hierarchy and patient care.