Ethics and Confidentiality in Communication

1. A patient suffered a stroke that left her hemiplegic on the left side. She grows signs of dysphagia, dysphagia and hemianopsia. The physician tells her she will be transferred to physical rehabilitation. This news causes her some stress, and since then she has had trouble sleeping. The quality care provided by the LPN, and the relationship of trust she’s established with the patient over the past few weeks, is making it even more difficult for the patient to leave for another department. The day before her transfer, the patient asks the LPN to make a prognosis about her possibilities for functional rehabilitation. What should the LPN do in this situation? *
2. A 55-year-old woman at the emergency room following a sudden onset of fever associated with respiratory problems. The physician diagnoses SARS, and the patient is placed in isolation in the medical unit. Since her admission, the patient is confused and has difficulty expressing herself. When family members come to the room, they are greeted by the LPN. What should the LPN do in this situation? *
3. This morning, in the dining room of a CHSLD, a 72-year-old beneficiary with Alzheimer’s dementia is agitated, shouting, and wants to hit everyone. The LPN, who has worked for more than thirteen years in this environment, intervenes by speaking louder than the beneficiary and roughly seating louder than the beneficiary and roughly seating him back in his chair. She asks her new colleague to go get a sedative. After, the LPN tells her colleague that when dealing with disruptive behaviour, it’s necessary to act the way she did regardless of the patient’s illness. The LPN tells her colleague that when dealing with disruptive behaviour, it’s necessary to act the way she did regardless f the patient’s illness. The LPN’s colleague, however, is unsettled by what she witnessed. What should the LPN have done in this situation? *
4. A 32-year-old single mother is admitted for a second time to the psychiatric unit for drug and alcohol abuse. A few days later, the patient’s condition has greatly improved with the adequate medication. The psychiatrist signs the patient’s discharge and refers her to the CLSC. Before the patient leaves, the LPN ask her to sign a consent form allowing the CLSC to do a follow-up. The patient adamantly refuses to sign the consent form. The LPN tell the patient that she has a responsibility to her child and that failure to accept follow-up may have consequences. She suggests to the patient to reconsider her decision. What should the LPN do in this situation? *
5. A 38-year-old LPN, who works in long-term care, is often on duty for more than sixteen consecutive hours because of mandatory overtime. She is currently experiencing person and financial difficulties following a divorce. For the past few weeks, she’s had trouble concentrating while performing her duties due to exhaustion and frequent memory loss. Mistakes related to patient care are accumulating. Just today, a colleague told her that she failed to administer a patient’s morning insulin dose. The LPN is well aware her frequent errors are affecting the quality of her patient care. She finds that her professional situation is deteriorating and that she is becoming less and less empathetic with patients and colleagues. She is also afraid of receiving a disciplinary notice if she refuses to work overtime. Which of the following interventions would not be appropriate? *
6. A two-year-old boy is hospitalized in the pediatric ward for bronchitis. Around 3:45 pm, the chid wants to get out of bed ends falling. While the LPN tries to reassure the crying child, she takes his vital signs and carefully examines his skin. She notices redness and edema on his right arm. Before leaving her shift at 4:00 pm, the LPN writes the patient’s progress notes without mentioning that the child fell. When she returned to work at 8:00 the next morning, the LPN consults the progress notes made since she left, and notices that her young patient has a humerus fracture. What should the LPN have done in this situation? *
7. An LPN has been working in the medical unit for five years. She is appreciated by her colleagues for her dedication, sense of humor and availability to team members. This morning, she prepares a 4 mg tablet of narcotic analgesic (Dilaudid) to be administered to a patient recovering from orthopaedic surgery. She has it checked by the nurse in charge and signs the register. The LPN goes to the patient’s room to administer the tablet. Another LPN walking in the same direction sees her swallow the patient’s tablet and replace it with two acetaminophen tablets she removes form her uniform. Which of the following actions should be a priority for the LPN witnessing this incident? *
8. This afternoon, ambulance services inform emergency staff that a chairlift has just collapsed at a ski resort, leaving two teenagers seriously injured. The first teenage is sent to surgery for cerebral hemmorrhage. The LPN has just begun her shift in the surgical ward. As she enter the operating room, she realizes that it’s her son who has just been placed on the operating table. Terrified, she tried to regain her composure. What should the LPN do in this situation? *
9. A 53-year-old woman has just been admitted to the department of oncology for breast cancer. The oncologist is considering an ablation because the prescribed treatments have not produced the desired results. The patient’s husband, who owns a performance hall gives the LPN caring for his wife an envelope containing a pair of tickets to a concert put on by an international group. He wants to ensure that his wife receives the best care and insists at length with the LPN. He tells her he will get upset if she refuses. What should the LPN do in this situation? *
9. It is 8:15 am and a physician prescribes blood test “stat” to a diabetic patient with renal failure in order to determine treatment. Overwhelmed with work, the LPN collects the blood sample after taking her lunch break, but does not send it to the laboratory until the end of her shift. What would have been the best intervention in this situation? *
10. An LPN has been working at a CHSLD for two years. She is recognized for the quality of her interventions and the adherence to her schedules. This morning, she has to leave her house in a rush so she would not be late. It is 10:00 am, and she is about to take her scheduled break so she can finally eat something to help the nausea and dizziness caused by her morning rush. Before leaving for her break, a beneficiary stops her to say he has severe arthritic pain in his hands and that he needs a painkiller. The LPN reassures him that she will be back in 20 minutes. What would have been the best intervention in this situation? *
11. An LPN working in the medical unit receives a 42-year-old man who is in remission from lung cancer. He has been hospitalized for a virus affecting his lungs. The LPN confides in a colleague that she feels upset and very emotional every time she cares for the patient because his condition makes her relive the struggle she went through with her husband, who died the same cancer. Consequently she is starting to doubt her clinical judgement. What should the LPN do in this situation? *
12. For two weeks, a 36-year-old LPN working in a psychiatric centre has been caring for a 32-year-old patient suffering from major depression. The patient especially appreciates the listening and safety provided by the LPN. While caring for the patient, the LPN learns that the patient is currently going through a divorce. When she gets home one night, the LPN notices a friend request from the patient on one of her social networks. Which of the following behaviours is compliant with the LPN’s duties and responsibilities? *
13. An LPN has been working at the postoperative unit for five years. She is currently providing care to a patient who has sustained various gunshot wounds, one of which a splenectomy. While the LPN is changing his dressings, the patient confides in her that he knows the identity of his attacker. After giving a name, he tells the LPN that he vows to get revenge once he gets out of the hospital. He also tells the LPN to keep this information confidential. What should the LPN do in this situation? *