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