MACE Legal and Ethical Issues 4 — Questions and Answers
Question 1: Which action violates a resident's right to privacy during medication administration?
- Closing the door before giving medications
- Discussing the resident's medications loudly in a common area (Correct answer)
- Using a medication cart in a private room
- Verifying the resident's identity before administration
Correct answer: Discussing the resident's medications loudly in a common area
Discussing a resident's medications in a public area violates their right to privacy and confidentiality under both HIPAA and resident rights regulations.
Question 2: What is the purpose of an incident report following a medication error?
- To punish the aide who made the error
- To document facts for quality improvement and legal protection (Correct answer)
- To notify the resident's insurer automatically
- To replace the nurse's progress note
Correct answer: To document facts for quality improvement and legal protection
Incident reports are factual documentation used for quality improvement, pattern identification, and legal protection of the facility and staff.
Question 3: Scope of practice for a medication aide is primarily defined by:
- The resident's physician
- State law and the employing facility's policies (Correct answer)
- The medication aide's personal comfort level
- The pharmacist dispensing the medications
Correct answer: State law and the employing facility's policies
Scope of practice is established by state statutes and regulations, further refined by facility policies within those legal boundaries.
Question 4: A resident has a valid Do Not Resuscitate (DNR) order. The medication aide finds the resident unresponsive. The aide should:
- Begin CPR because the DNR may have expired
- Follow the DNR order, call for the nurse, and do not initiate CPR (Correct answer)
- Ignore the DNR and call 911 for full resuscitation
- Administer emergency medication from the crash cart
Correct answer: Follow the DNR order, call for the nurse, and do not initiate CPR
A valid DNR order must be honored; the aide should summon the nurse and not initiate CPR in accordance with the resident's documented wishes.
Question 5: Which behavior by a medication aide represents a breach of professional boundaries?
- Addressing the resident by their preferred name
- Accepting a large cash gift from a resident (Correct answer)
- Reporting a medication error to the supervisor
- Knocking before entering a resident's room
Correct answer: Accepting a large cash gift from a resident
Accepting gifts of significant value from residents crosses professional boundaries and may constitute exploitation of a vulnerable adult.
Question 6: A medication aide notices that a colleague frequently documents medications as given but leaves the medication on the tray. This should be reported because it represents:
- An acceptable time-saving documentation practice
- Falsification of medical records and potential harm to residents (Correct answer)
- A minor charting error corrected at end of shift
- A facility policy variation, not a legal issue
Correct answer: Falsification of medical records and potential harm to residents
Documenting medications as administered when they were not given is falsification of medical records, a serious legal violation that endangers residents.
Question 7: Under the Americans with Disabilities Act (ADA), a facility must make reasonable accommodations for a resident with a disability. In medication administration, this may include:
- Exempting the resident from all medication policies
- Providing communication aids for a resident with hearing impairment when explaining medications (Correct answer)
- Administering medications without consent if the resident cannot communicate
- Charging higher fees for residents requiring additional assistance
Correct answer: Providing communication aids for a resident with hearing impairment when explaining medications
The ADA requires reasonable accommodations, such as communication aids, to ensure residents with disabilities can participate in their own care.
MACE Legal and Ethical Issues 4
Which action violates a resident's right to privacy during medication administration?