PART III

1. The best explanation of what Title VI of the Civil Rights Act mandates is the freedom to:
A. Pick any physician and insurance company despite one’s income.
B. Receive free medical benefits as needed within the county of residence.
C. Have equal access to all health care regardless of race and religion.

2. Which statement would best explain the role of the nurse when planning care for a culturally diverse
population? The nurse will plan care to:
A. Include care that is culturally congruent with the staff from predetermined criteria.
Focus only on the needs of the client, ignoring the nurse’s beliefs and practices.
C. Blend the values of the nurse that are for the good of the client and minimize the client’s individual
values and beliefs during care.
D. Provide care while aware of one’s own bias, focusing on the client’s individual needs rather than the
staff’s practices.

3. A retired nurse stops to help in an emergency at the scene of an accident if the injured party files suit
and the nurse would probably be covered by:
A. Her homeowner's insurance
B. Her automobile insurance
C. National Care Act
D. The Good Samaritan Law
4. Which factor is least significant during assessment when gathering information about cultural
practices?
A. Which factor is least significant during assessment when gathering information about cultural
practices?
B. Touch, eye contact
C. Bio-cultural needs
D. Pain perception, management expectations

5. Obtaining informed consent is the responsibility of:

A. The physician
B. The RN manager
C. The nurse
D. The CNA

6. Transcultural nursing implies:

A. Working in another culture to practice nursing within their limitations.
B. Using a comparative study of cultures to understand similarities and differences across human groups
to provide specific individualized care that is culturally appropriate.
C. Combining all cultural beliefs into a practice that is a non-threatening approach to minimize cultural
barriers for all clients’ equality of care.
D. Ignoring all cultural differences to provide best-generalized care to all clients.

7. The nurse notes that an advance directive is in the client's medical record. Which of the following
statements represents the best description of guidelines a nurse would follow in this case?
A. A durable power of attorney for health care is invoked only when the client has a terminal condition
or is in a persistent vegetative state.
B. A living will allows an appointed person to make health care decisions when the client is in an
incapacitated state.
C. A living will is invoked only when the client has a terminal condition or is in a persistent vegetative
state.
D. The client cannot make changes in the advance directive once the client is admitted into the hospital.
8. What should the nurse do when planning nursing care for a client with a different cultural background?
The nurse should:
A. Allow the family to provide care during the hospital stay so no rituals or customs are broken
B. Identify how these cultural variables affect the health problem.
C. Speak slowly and show pictures to make sure the client always understands.
D. Explain how the client must adapt to hospital routines to be effectively cared for while in the hospital.

9. As an advocate for the client, the nurse must make sure that "safe, effective care" is given in
conformity with the:
A. Nurse Practice Act (NPA).
B. American Nursing Association (ANA).
C. National Council for Licensure Examinations.
D. State Board of Licensure.
 10. Ethical principles for professional nursing practice in a clinical setting are guided by the principles of
conduct that are written as the:
A. American Nurses Association’s (ANA’s) Code of Ethics.
B. Nurse Practice Act (NPA) written by state legislation.
C. Standards of care from experts in the practice field.
D. Good Samaritan laws for civil guidelines.

11. Nurses are bound by a variety of laws. Which of the following descriptions of types of law is correct?
A. Statutory law is created by elected legislatures, such as the state legislature that defines the Nurse
Practice Act (NPA).
B. Regulatory law provides for prevention of harm to the public and punishment when those laws are
broken.
C. Common law protects the rights of the individual within society to fair and equal treatment.
D. Criminal law creates boards that pass rules and regulations to control society.

12. A bioethical issue should be described as:

A. The physician’s making all decisions of client management without getting input from the client.
B. A research project that included treating all the white men and not treating all the black men to
compare the outcomes of specific drug therapy.
C. The withholding of food and treatment at the request of the client in a written advance directive given
before a client acquired permanent brain damage from an accident.
D. After the client gives permission, the physician’s disclosing all information to the family for their
support in the management of the client.

13. Eligibility to receive low-income loans or reimbursement for expenses is provided to hospitals that
follow safety provisions of service established by:
A. Board of Nursing Examiners (BNE)
B. Nurse Practice Act (NPA)
C. American Nurses Association (ANA)
D. Americans With Disabilities Act (ADA)
 14. When the nurse described the client as “that nasty old man in 354,” the nurse is exhibiting which
ethical dilemma?
A. Gender bias and ageism
B. HIPPA violation
C. Beneficence
D. Code of ethics violation

15. The distribution of nurses to areas of “most need” in the time of a nursing shortage is an example of:
A. Utilitarianism theory
B. Deontological theory
Justice
Beneficence

16. Besides the Joint Commission on Accreditation of Healthcare Organizations (JACHO), which
governing agency regulates hospitals to allow continued safe services to be provided, funding to be
received from the government and penalties if guidelines are not followed?
A. Board of Nursing Examiners (BNE)
B. Nurse Practice Act (NPA)
C. American Nurses Association (ANA)
D. Americans With Disabilities Act (ADA)

17. When signing a form as a witness, your signature shows that the client:
A. Is fully informed and is aware of all consequences.
B. Was awake and fully alert and not medicated with narcotics.
C. Was free to sign without pressure.
D. Understands the language of the form.
E. None of the above.

18. Nurses who follow orders that are incomplete or incorrect are the leading cause of litigation in the
hospital.
A. True
B. False

19. A client has recently been told he has terminal cancer. As the nurse enters the room, he yells, “My
eggs are cold, and I’m tired of having my sleep interrupted by noisy nurses!” The nurse may interpret the
client’s behavior as:
A. An expression of the anger stage of dying.
B. An expression of disenfranchised grief.
C. The result of maturational loss.
D. The result of previous losses.

20. When helping a person through grief work, the nurse knows:
A. Coping mechanisms that were effective in the past are often disregarded in response to the pain of a
loss.
B. A person’s perception of a loss has little to do with the grieving process.
C. The sequencing of stages of grief may occur in order, they may be skipped, or they may reoccur.
D. Most clients want to be left alone.

21. When caring for a terminally ill client, it is important for the nurse to maintain the client’s dignity.
This can be facilitated by:
A. Spending time to let clients share their life experiences.
B. Decreasing emphasis on attending to the clients’ appearance because it only increases their fatigue.
C. Making decisions for clients so they do not have to make them.
D. Placing the client in a private room to provide privacy at all times.

22. What are the stages of dying according to Elizabeth Kubler-Ross?

A. Numbing; yearning and searching; disorganization and despair; and reorganization.
B. Accepting the reality of loss, working through the pain of grief, adjusting to the environment without
the deceased, and emotionally relocating the deceased and moving on with life.
C. Anticipatory grief, perceived loss, actual loss, and renewal.
D. Denial, anger, bargaining, depression, and acceptance.

23. Bereavement may be defined as:

A. The emotional response to loss.
B. The outward, social expression of loss.
C. Postponing the awareness of the reality of the loss.
D. The inner feeling and outward reactions of the survivor.

24. A client who had a “Do Not Resuscitate” order passed away. After verifying there is no pulse or
respirations, the nurse should next:
A. Have family members say goodbye to the deceased.
B. Call the transplant team to retrieve vital organs.
C. Remove all tubes and equipment (unless organ donation is to take place), clean the body, and position
appropriately.
D. Call the funeral director to come and get the body.

25. A client’s family member says to the nurse, “The doctor said he will provide palliative care. What
does that mean?” The nurse’s best response is:
A. “Palliative care is given to those who have less than 6 months to live.”
B. “Palliative care aims to relieve or reduce the symptoms of a disease.”
C. “The goal of palliative care is to affect a cure of a serious illness or disease.”
D. “Palliative care means the client and family take a more passive role and the doctor focuses on the
physiological needs of the client. The location of death will most likely occur in the hospital setting.”

Ms. Magu, 88 y/o women Miss Magu, an 88-year old woman, believes that life should not be prolonged
when hope is gone. She has decided that she does not want extraordinary measures taken when her life is
at its end. Because she feels this way, she has talked with her daughter about her desires, completing a
living will and left directions with her physician. This is an example of:
Affirming a value
Choosing a Value
Prizing a Value
Reflecting a Value
A nurses point of view is valuable in an ethical committee because it is recommended by the nurses' code
of ethics.
True
False
The philosophy sometimes called the code of ethics of care suggests that ethical dilemmas can best be
solved by attention to:
Relationships
The client
Code of ethics
The nurse puts a restraint jacket on a client without the client's permission and without the physician’s
order. The nurse may be guilty of assault.
TRUE
FALSE
The nurse practice acts are an example of civil law.
TRUE
FALSE
A health care issue often becomes an ethical dilemma because:
A clients legal rights coexist with a health professionals obligation.
Decisions must be made quickly, often under stressful conditions.
Decisions must be made based on value systems.
The choices involved do not appear to be clearly right or wrong.
Which statement about an institutional ethics committee is correct?
The ethics committee is an additional resource for clients and health care professionals.
The ethics committee relieves health care professionals from dealing with ethical issues.
The ethics committee would be the first option in addressing an ethical dilemma.
The ethics committee replaces decision making by the client and health care providers.
When providing care to clients with varied cultural backgrounds, it is imperative for the nurse to
recognize that:
Cultural considerations must be put aside if basic needs are in jeopardy.
Generalizations about the behavior of a particular group may be inaccurate.
Current health standards should determine the acceptability of cultural practices.
Similar reactions to stress will occur when individuals have the same cultural background.
Cultural awareness is an in-depth self-examination of one's:
Background, recognizing biases and prejudices.
Social, cultural, and biophysical factors.
Engagement in cross-cultural interactions.
Motivation and commitment to caring.
Answer and Rationale:
2. D
RATIONALE: D. Without understanding one’s own beliefs and values, bias or preconceived belief by the
nurse could create an unexpected conflict or an area of neglect in the plan of care for a client (who might
be expecting something totally different from the care). During assessment values, beliefs, practices
should be identified by the nurse and used as a guide to identifying the choices by the nurse to meet the
specific needs/outcomes of that client. Therefore identification of values, beliefs, and practices allows for
planning meaningful and beneficial care specific for this client.

4. C.
RATIONALE: C. Cultural practices do not influence bio-cultural needs because they are inborn risks that
are related to a biological need and not a learned cultural belief or practice.

7. C
RATIONALE: A living will direct the client’s healthcare in the event of a terminal illness or condition. A
durable power of attorney is invoked when the client is no longer able to make decisions on his or her
own behalf. The client may change an advance directive at any time.
12. B
RATIONALE: B. The ethical issue was the inequality of treatment based strictly upon racial differences.
Secondly, the drug was deliberately withheld even after results showed that the drug was working to cure
the disease process in the white men for many years. So after many years, the black men were still not
treated despite the outcome of the research process that showed the drug to be effective in controlling the
disease early in the beginning of the research project. Therefore harm was done. Nonmaleficence,
veracity, and justice were not followed.
13. D
RATIONALE: If a hospital fails to follow ADA guidelines for meeting the special needs of persons with
disabilities, the facility loses funding and become ineligible to receive low-income loans or
reimbursement of expenses. ADA protects the civil rights of disabled people. Its provisions apply to both
hospital clients and hospital staff.

15. C. Justice
RATIONALE: Justice is defined as the fairness of distribution of resources. However, guidelines for a
hierarchy of needs have been established, such as with organ transplantation. Nurses are moved to areas
of greatest need when shortages occur on the floors. No floor is left without staff, and another floor that
had five staff will give up two to go help the floor that had no staff.
16. D
RATIONALE: D. If the hospital fails to follow ADA guidelines for meeting special needs, the facility
loses funding and status for receiving low-income loans or reimbursement of expenses. ADA protects the
civil rights of disabled people. It applies to both the hospital clients and hospital staff. Privacy issues for
persons who are positive for human immunodeficiency virus (HIV) have been one issue in relationship to
getting information when hospital staff have been exposed to unclean sticks. The ADA allows the
infected client the right to choose whether or not to disclose that information.
17. D
23. D
26. C
27. False
Rationale: nurses develop a relationship to the client that is unique among all professional health care
providers.
28. A
29. False
RATIONALE: Battery is physical in nature. Assault is a threat.
30. FALSE
RATIONALE: Statutory law
D
A
B