NACE Ethical and Legal Principles 4 — Questions and Answers
Question 1: A nurse discovers a colleague has been accessing patient records of celebrities out of curiosity. What is the nurse's primary obligation under HIPAA?
- Warn the colleague privately before escalating
- Report the breach to the facility privacy officer (Correct answer)
- Document the incident in the patient's chart
- Notify the affected patients directly
Correct answer: Report the breach to the facility privacy officer
HIPAA requires healthcare organizations to investigate and report breaches; the nurse must notify the privacy officer who initiates the formal response process.
Question 2: A competent adult patient refuses a blood transfusion on religious grounds despite a life-threatening hemorrhage. The nurse should:
- Administer the transfusion to save the patient's life
- Contact the ethics committee to override the decision
- Respect the refusal and document it, ensuring the patient understands the consequences (Correct answer)
- Obtain a court order to proceed with treatment
Correct answer: Respect the refusal and document it, ensuring the patient understands the consequences
Competent adults have the right to refuse any treatment, including life-saving measures; the nurse must respect this autonomy and document the informed refusal.
Question 3: Which legal doctrine holds hospitals responsible for the negligent acts of their employed nurses?
- Res ipsa loquitur
- Respondeat superior (Correct answer)
- Charitable immunity
- Contributory negligence
Correct answer: Respondeat superior
Respondeat superior ('let the master answer') holds employers vicariously liable for employees' negligent acts performed within the scope of employment.
Question 4: A nurse administers the wrong medication and the patient suffers harm. Which element of negligence establishes the link between the action and the injury?
- Duty
- Breach
- Causation (Correct answer)
- Damages
Correct answer: Causation
Causation (proximate cause) is the element that establishes the direct link between the nurse's breach of duty and the patient's resulting harm.
Question 5: An older adult patient with mild dementia is being discharged. When obtaining consent for a home health referral, the nurse should:
- Obtain consent only from the next of kin
- Assess the patient's decision-making capacity for this specific decision (Correct answer)
- Skip consent because the patient has a dementia diagnosis
- Refer the matter to the hospital attorney
Correct answer: Assess the patient's decision-making capacity for this specific decision
A dementia diagnosis does not automatically negate decision-making capacity; the nurse must assess capacity for each specific decision.
Question 6: A nurse suspects a patient is experiencing elder abuse. Under mandatory reporting laws, the nurse must:
- Confirm the abuse before reporting
- Report the suspicion to Adult Protective Services (Correct answer)
- Discuss findings only with the attending physician
- Wait for the patient to disclose the abuse voluntarily
Correct answer: Report the suspicion to Adult Protective Services
Mandatory reporting laws require nurses to report suspected elder abuse to Adult Protective Services; confirmation is not required before reporting.
Question 7: Which ethical principle is most directly applied when a nurse ensures a patient receives accurate information about all treatment alternatives?
- Justice
- Fidelity
- Veracity (Correct answer)
- Beneficence
Correct answer: Veracity
Veracity is the duty to tell the truth; ensuring patients receive accurate information about treatment alternatives directly reflects this principle.
NACE Ethical and Legal Principles 4
A nurse discovers a colleague has been accessing patient records of celebrities out of curiosity.
What is the nurse's primary obligation under HIPAA?