NSG 310 FINAL EXAM STUDY GUIDE
TOPIC 4:
1. Identify the ethical principles nurses must consider when making decisions regarding
client care.
• Privacy and confidentiality
o Treat information as private
o Protect client privacy
o Health Insurance Portability and Accountability Act (HIPAA)
...
nsg 310 final exam study guide topic 4 1 identify the ethical principles nurses must consider when making decisions regarding client care • privacy and confidentialit
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EXAM 2_310
NSG 310 FINAL EXAM STUDY GUIDE
TOPIC 4:
1. Identify the ethical principles nurses must consider when making decisions regarding
client care.
• Privacy and confidentiality
o Treat information as private
o Protect client privacy
o Health Insurance Portability and Accountability Act (HIPAA)
• Veracity: Obligation to tell the truth and not to lie or deceive others
• Fidelity: Obligation to others or to organizations (such as keeping up your CPR training)
• ANA Code of Ethics
o Code of Ethics which speaks to the nurse’s obligation to:
▪ The Client
▪ To Self
▪ To Colleagues
▪ To the Nursing Profession
2. Describe ethical nursing behaviors that build trust and promote client-centered goals.
• Ethics in client care
o Respect for autonomy- nurse must find out what the client’s preferences, needs
and wants are.
o Beneficence- this principle is about doing good for our clients and making sure no
harm will befall their care (preventing or removing harm)
o Nonmalificence- this principle involves harm to the client but the difference is
that the focus is not on inflicting harm, rather than preventing or removing harm
as in beneficence.
o Justice- this principle is about distributive justice where all care is equal, goods
and services equally distributed as well as care for all individuals
3. Examine key elements of management of care, including advance directives, advocacy,
client rights, HIPAA, confidentiality, and informed consent.
• Board of nursing: State agency legislatively created by NPA in states:
o Licensing board for nurses
o Establishes entry requirements into the profession
o Sets definitions of nursing practice
o Establishes guidelines for professional discipline when a nurse fails to obey the
law or becomes incompetent
• Licensure: Used to protect the health, safety, and welfare of its citizens
o State licensure statutes control entry into the profession, the discipline of licensees
who fail to comply with minimal standards, and the nursing activity of unlicensed
practitioners (“nurse imposters”).
o Licensure and protection of health, safety, and welfare of citizens
▪ Entry to practice
▪ Multistate license and telehealth
▪ Advanced practice nurses
▪ Control over nursing practice
▪ Delegation in nursing practice
,EXAM 2_310
• Nurse Multi-State Licensure Compact:
o Approved by the National Council of State Boards of Nursing (NCSBN) in 1998
o Allows a nurse who holds a license in the state of legal residency to practice in
other states that have enacted the Compact. Currently, 23 states participate (2009).
o Advanced practice nurses are excluded from the Compact and must obtain
certification in each state where they practice.
• Regulatory power: Authorizes the board to develop rules and regulations for nursing
licensure, nursing education, and nursing practice
• Adjudicatory power: Authorizes the board to investigate, hear, and decide the outcomes
of complaints that involve violations of the NPA and of the rules and regulations
promulgated by the board
• ROLE OF NURSING BOARDS
o As mandated by the NPA, the board must ensure that a licensed nurse continues
to practice within the standard of care, behaves professionally and ethically, and
obeys all relevant state laws.
o The disciplinary action is on the license of the nurse, and that license may be
suspended or revoked by the board.
o Boards can only limit or deny a nursing license.
o Administrative Procedure Act – in each state
o A professional license is protected property by the U.S. Constitution. A license
cannot be limited or taken away without due process: requires both the right to be
heard and notice. A nurse has the right to appeal any decision made by the board.
• Know the requirements of the NPA for licensure.
• Know the boundaries and definitions of practice, the areas for discipline on practice, and
the procedures in place to protect the nurse when the board challenges the license.
• NPAs leave public consumers of nursing care dependent to a large degree on members of
the profession to control access to nursing services and to maintain the quality of care.
• ALL NPAs have commonalities.
o A nurse who moves from one state to another or practices in multiple states
through the Compact should obtain a copy of each state’s NPA. The differences in
state NPAs can be significant. For example, one state may impose no legal duty
on a nurse to report the incompetence of a physician. In another state, the nurse
may find that failure to report such a physician can result in the loss of license.
o The nurse needs to be familiar with the requirements of the NPA for licensure, the
boundaries and definitions of practice, the areas for discipline on practice, and the
procedures in place to protect the nurse in case the board challenges the license.
• Nurses with disabilities
o Confidentiality
o As long as consistent with client safety
o Treatment
o Self-reporting
o Access to practice
▪ Nurses with disabilities, such as those with drug dependence who are
compliant with treatment, those with physical impairments, and those with
a mental illness, are granted special confidentiality as long as it is
consistent with client safety. This is intended to encourage nurses to seek
, EXAM 2_310
treatment and self-report, to report other nurses who need treatment, and
to ensure nurses with disabilities are not the object of discrimination.
• Contract law: Nurses work under contract, a promissory agreement between two or more
parties that creates a legal relationship:
o Employment at will: The employee has the right to terminate employment for any
reason “at will,” and the employer has the parallel right to terminate the employee
at any time for any reason, also “at will.”
o Labor law: Collective bargaining agreement establishes a contractual agreement
between the union and the employer
• AN ENFORCEABLE CONTRACT
o 1. For performance of legal goods or services. A nurse cannot contract to practice
medicine.
o 2. The parties must have legal capability to make the contract. For example, they
must all have the mental ability to understand their actions and must be old
enough to make a legal agreement.
o 3. All parties at the time of the contract must agree to do something, and they
must agree on what that something is.
o 4. There must be “consideration” (i.e., some kind of trade in which each party gets
something from the contract).
o “Statute of frauds” that limits the enforcement of some contracts not written
o State “parole evidence rule.” This rule provides that if oral agreements are made
that differ from the written contract, the courts will not allow them to add to or
change the written contract.
• Contract Termination
o Completely performed: Terms met
o Both parties agree to a change or annul
o Becomes impossible (e.g., death of a party or the destruction of the subject)
o Breach: One party fails to meet the terms of the agreement
▪ Other party can sue in civil court for any damages
• National Labor Relations Act (NLRA)
o Collective bargaining
▪ Bargain with the employer as a group, in good faith, to make an agreement
regarding similar interests in wages, hours, and working conditions
▪ Grievance procedures guaranteed to all employees
▪ Protect the nurse employee from discharge except for “good cause”
▪ Cannot bargain individually with the employer
o This means they had formed a collective bargaining unit and could bargain with
the employer as a group, in good faith, to make an agreement regarding similar
interests in wages, hours, and working conditions. Collective bargaining
agreements contain grievance procedures guaranteed to all employees.
Furthermore, they usually contain a clause protecting the nurse employee from
discharge except for “good cause.” Nurses who work in a unionized facility
cannot bargain individually with the employer. The employer must bargain with
the union, which must represent all employees, whether or not they join the union
• Labor Law: Compliance Programs Purpose
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