M V…
APEAY3PYEXAMYPREP7YETHICSYPROFESSIONA
LYISSUESYQUESTIONSYANDY100%YVERIFIEDYA
NSWERSYWITHYEXPANATIONS
AnYolderYadultYmaleYwithYmoderatelyYsevereYdementiaYpr
esentsYwithYhisYcaregiverYdaughter.YHisYBMIYisY18.YHisYclo
thesYhaveYfoodYstainsYonYthemYandYheYlooksYasYthough YheY
hasn’tYbeenYbathedYinYdays.YHowYshouldYtheYnurseYpractit
ionerYhandleYthis?
TheYNPYshouldYcommentYtoYtheYdaughte
rYaboutYhisYpoorYcare.
TheYNPYshouldYreportYthisYasYpotentialYeld
erYabuse.
TheYpatientYshouldYbeYaskedYaboutYhisYcare.
TheYdaughterYshouldYbeYaskedYaboutYtheYtypeYofYcareY
heYreceives.
ThisYpatientYpresentsYasYthoughYheYisYbeingYpoorlyYcaredYfo
rYandYmistreated.YThisYoccursYinYaboutY3-
8%YofYtheYadultYpopulationYinYtheYUnitedYStates.YThereYisYno
YevidenceYthat YtheYpatientYhasYbeen YphysicallyYabused,YbutYh
eYobviouslyYsuffersYfromYneglect.YThisYisYaYformYofYelderYab
use,YjustYasYphysical,Ysexual,Ypsychological,YorYfinancialYabus
eYis.YOlderYadultsYwithYdementiaYoftenYsufferYabuseYmostYfre
quently.
AYnurseYpractitionerYisYworkingYinYaYminorYcareYareaYofYanY
emergencyYdepartment.YAnYillegalYimmigrantYhasYaYpunctur
eYwoundYcausedYbyYanYunknownYsharpYobjectYinYaYtrash
about:blank 1/26
,3/12/24,Y5:00YP APEAY3PYEXAMYPREP7YEthicsYProfessionalYIssuesYQuestionsYANDY100%Y
M V…
container.YAYdirtyYneedleYisYsuspected.YTheYnurs
eYpractitioner:
ShouldYadministerYaYtetanusYinjectionYonlyYsinceYtheYpatie
ntYhasYnoYmedicalYinsurance.
ShouldYprescribeYappropriateYmedicationsYforYHIVYexposur
eYevenYthoughYtheYnurseYpractitionerYknowsYtheYpatientYca
n’tYaffordYthem.
ShouldYnotYmentionYtheYpossibilityYofYHIVYexposureYfrom
YaYdirtyYneedle YtoYtheY patient.
CanYofferYtoYbuyYtheYHIVYmedicationsYforY$50YwithYth
eirYprofessionalYdiscountYatYtheYpharmacyYnextYdoor.
TheYstandardYofYcareYfollowedYbyYtheYnurseYpractitioner Ysh
ouldYnotYdependYonYwhetherYtheYpatientYhasYinsuranceYorY
not.YItYisYunethicalYtoYnotYproperlyYinformYtheYpatientYofYris
ksYheYmayYhaveYbeenYexposedYtoYfromYtheYpunctureYwound.
OfferingYtoYbuyYtheYmedicationsYforYtheYpatientYisYnobleYbut
YisYnotYaYsustainable Ypractice.YTheYnurse Ypractitioner Yshould
YprescribeYtheYmedications YasYforY anyoneYwithYpossibleYHIV
YexposureYand YreferYto YsocialYservicesYorYaYcommunity Yrefer
ralYagencyYthatYcanYhelpYthisYpatientYacquireYtheYappropriat
eYmedications.
AYnurseYpractitionerYisYworkingYinYaYminorYcareYclinic.YShe
YrealizesYthatYaYpatientYwithYaYminorYlacerationYdoesYnotYh
aveYinsuranceYandYisYusingYhisYbrother’sYinsuranceYinforma
tionYtodayYsoYthatYhisYvisitYwillYbeYcovered.YHowYshouldYsh
eYproceed?
SheYshouldYletYhimYknowYthatYsheYkno
wsYwhatYheYisYdoing.YSheYshouldYignoreY
this
about:blank 2/26
, 3/12/24,Y5:00YP APEAY3PYEXAMYPREP7YEthicsYProfessionalYIssuesYQuestionsYANDY100%Y
M V…
andYproceedYtoYsutureYhisYwound.
SheYshouldYletYtheYclinic'sYbusinessYofficeYkno
wYwhatYisYhappening.
SheYshouldYnotYsutureYhisYwoundYandYaskYhimY
toYleave.
TheY nurseY practitionerY cannotY ignoreY theY factY thatY thisY patie
ntYisYattemptingYtoYdefraudYtheYclinicYandYinsuranceYcompanyYi
nYorderYtoYreceiveYfreeYcare.YIfYsheYYdoesYnotYYletYYtheYYbusiness
YofficeYknow,YsheYisYaYparty YtoYtheYfraud.YSheYshouldYletYtheYbus
inessY officeY knowY whatY isY happeningY andY haveY theY patientYpr
esentY documentsYverifyingY thatY heY isY whoY heY statesY thatY heY is.Y
IfYheYcannot,YheYcanYstillYreceiveYcareYifYheYisYYwillingYYtoYYpayYYf
orYit.Y AnY alternativeY careY siteY shouldY beY offeredY toY him.
WhichYstudyYlistedYbelowYisYconsideredYa
nYexperimentalYstudy?YCaseYseries
Cross-
sectionalYstudy
Y CohortYstudy
Meta-analysis
ObservationalYstudiesYareYstudiesYinYwhichYsubjectsYareYob
served.YNoYinterventionYtakesYplaceYwithYthem.YExamplesYo
fYtheseYareYfoundYinYtheYfirstYthreeYchoices.YAYmeta-
analysisYtakesYpublishedYinformationYfromYotherYstudiesYa
ndYcombinesYtheYinformationYtoYarriveYatYaYconclusion.
AlthoughYaYmeta-analysisYcanYuseYobservationalYstudies,
about:blank 3/26