Patient Rights and Autonomy

1. Mr. Durocher, 72, is scheduled for a carotid endarterectomy. The surgeon briefly visited earlier and left a consent form at the bedside, but Mr. Durocher tells the LPN, “I didn’t understand half of what he said. I just nodded because he seemed in a rush.” His daughter insists he sign the form now because “the surgery is important.” The patient appears anxious but oriented and asks the LPN, “Do I have to sign if I’m not sure?” What is the LPN’s best action to support the patient’s rights? *

Encourage the daughter to explain the procedure again to her father

Tell the patient to sign because the physician already explained it

Ask the RN to witness the consent since the patient is oriented

Notify the RN/physician that the patient needs more information before signing

2. Ms. Raymond, 45, is hospitalized for uncontrolled type 2 diabetes. The physician recommends starting insulin therapy, but Ms. Raymond hesitates, saying, “I’m scared of injections and want to try diet first.” The LPN notices the RN preparing educational materials for insulin teaching and preparing to bring them to the patient. What action best supports patient autonomy? *

Encourage the patient to accept insulin because it is the safest plan

Inform the RN that the patient wishes to discuss other options

Avoid communicating the patient’s concerns because the doctor already ordered insulin

Teach the patient how to do insulin injections even if she is unsure

3. A post-operative patient, Mr. Ng, keeps asking the LPN, “How long am I staying? Will you remove my drain today?” The LPN does not know the specific plan but notices the care team has been too rushed to provide explanations. The patient appears frustrated, saying, “I feel like no one tells me anything.” What should the LPN do first to uphold patient rights? *

Avoid answering because only physicians can give information

Tell the patient to stop asking repeated questions

Provide all clinical details even if unsure

Seek accurate information from the RN or care plan and update the patient

4. A dementia-early-stage patient, Mrs. Hamel (MMSE 24/30), is scheduled for a CT scan with IV contrast. When the LPN arrives to prepare her, she says, “No, I don’t want the dye. It made me sick last time.” Her son insists she must go through with it and asks the LPN to “convince her quickly.” Which action by the LPN best respects autonomy and voluntary choice? *

Tell the son that the decision is his since he is the caregiver

Assess the patient’s understanding of the test and her reasons for refusing

Persuade the patient to comply since the exam is ordered

Proceed with preparing her to avoid delays

5. Mr. Beaulieu, 68, is admitted for heart failure. During medication teaching, the RN explains the need for a new anticoagulant. After she leaves, Mr. Beaulieu privately tells the LPN, “I felt pressured. I’m not sure I want that medication. I want time to think.” His wife keeps insisting, “Just take it, don’t complicate things.” What is the most appropriate LPN action? *

Tell the patient to follow his wife’s advice for safety

Tell him it is too late; he must take the medication

Give him space to express concerns and relay them to the RN

Avoid documenting the conversation to prevent conflict

6. Mrs. Benali, 53, is awaiting test results for a possible cancer diagnosis. The physician spoke with her husband first, and he later tells the LPN, “Please don’t tell her anything yet. She gets very anxious. We’ll tell her when she’s stronger.” When checking her vitals, Mrs. Benali quietly asks the LPN, “Do you know what they found? Nobody will tell me.” She seems emotionally stable and clearly seeking information. What should the LPN do to respect the patient’s rights? *

Respect the husband’s request and avoid answering

Tell her everything you know, even without confirming details

Inform her that you will ask the RN/physician to come update her

Tell her to wait until her husband feels ready to explain

7. A hospitalized patient with COPD, Mr. Villeneuve, refuses his nebulizer treatment, saying it “makes his heart race.” The LPN notices mild dyspnea (RR 24) but no acute distress. The respiratory therapist is on the way and the RN is planning discharge teaching. The patient insists, “I’m not taking it until someone explains why it feels like that.” What is the most appropriate LPN action? *

Document refusal and move on without informing anyone

Forcefully encourage him to take it for his own good

Explore his concerns and inform the RN and respiratory therapist

Tell him refusal is not allowed because the treatment is prescribed

8. Mr. Lefebvre, 81, is admitted with end-stage renal disease. He tells the LPN, “If my heart stops, don’t bring me back. I already told my doctor last year.” His chart, however, does not contain a written DNR order. His daughter, present in the room, insists, “Ignore what he says—he doesn’t mean it.” What is the best LPN action? *

Communicate the patient’s expressed wishes to the RN and physician immediately

Reassure the daughter that the patient’s wishes don’t matter without a form

Tell the patient that verbal requests are automatically valid

Follow the daughter’s instructions to avoid conflict

9. A newly admitted patient, Ms. Ortega, requests that her brother be present during all discussions about her treatment. The physician prefers speaking privately with patients and asks the LPN to “bring her alone” for teaching. Ms. Ortega becomes distressed, stating, “I need my brother to help me understand. It’s part of my culture.” Which action best supports autonomy and patient-centered care? *

Tell the patient she must follow hospital rules and attend alone

Support her request and communicate it to the RN and physician

Apologize and tell her family should not be part of medical discussions

Provide teaching alone even if she expresses discomfort

10. During morning rounds, Mrs. Allard, a 63-year-old stroke patient, tells the LPN she is embarrassed by urinary incontinence and doesn’t want anyone except nursing staff to know. Later, her neighbor from the same town visits and casually asks, “She’s here for bladder problems, right?” The visitor is insistent and seems to expect confirmation. What is the LPN’s best response? *

Redirect the visitor respectfully and protect the patient’s confidentiality

Give a vague answer to avoid upsetting the visitor

Confirm the information since the visitor seems to know already

Share the information because it is not a sensitive diagnosis