ATI LPN
Legal and Ethical Aspects of Healthcare Questions
Question 1 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 2 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 3 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.
Question 4 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 5 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.