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Difficulty: MediumLegal and Ethical Practice

A practical nurse (PN) is delivering care to a diverse group of clients in a community hospital. Which of the following actions by the PN demonstrate adherence to established legal and ethical standards of practice? Select all that apply.

  1. Signing an operative consent form solely to witness that the client's signature is authentic and voluntary.Answer
  2. B
    Administering an initial dose of an intravenous push (IVP) cardiac medication during a rapid response event.
  3. Declining a concerned family member's request for an update on a client's prognosis because the client has not authorized the disclosure.Answer
  4. D
    Explaining the potential complications and alternative treatment options to a client prior to an elective surgery.
  5. E
    Delaying a report of suspicious, unexplained burns on an older adult client until concrete evidence of abuse can be obtained.
  6. Documenting a client's refusal of a prescribed antibiotic along with the education provided regarding the risks of noncompliance.Answer

Answer

The correct actions are: signing the operative consent form as a witness, declining to disclose medical information to an unauthorized family member, and documenting a client's right to refuse medication alongside the provided education.
The practical nurse acts within legal and ethical boundaries by serving strictly as a witness to a client's voluntary signature on a consent form, maintaining client confidentiality by withholding information from unauthorized individuals in accordance with HIPAA, and respecting a client's autonomy to refuse treatment while ensuring proper documentation and education.

Step-by-Step Solution

1
Evaluate each nursing action against the established PN scope of practice.
Identify that administering IVP medications and providing initial surgical explanations are out of scope for the PN.
State nurse practice acts strictly limit PN practice regarding IV push medications and the initial explanation phase of informed consent to ensure client safety.
2
Analyze the actions involving confidentiality and mandated reporting.
Determine that withholding information from unauthorized family is correct, while delaying an abuse report is a legal violation.
HIPAA mandates strict confidentiality, and state laws require immediate reporting of suspected abuse without requiring the nurse to conduct an investigation or gather concrete proof.
3
Review the actions related to client rights and autonomy.
Recognize that witnessing a consent signature and respecting a client's right to refuse treatment are legally and ethically sound actions.
The PN's role in consent is solely as a witness to the signature, and competent clients retain the fundamental right to refuse any prescribed treatment.

Key Concept

Legal and Ethical Practice Boundaries for the Practical Nurse
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Topics

Legal and Ethical Practice

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