ECPI 2020 NUR164 CHAPTER 7: LEGAL DIMENSIONS OF NURSING PRACTICE
an advance directive.
A legal document that states a client's health-related wishes -such as a preference for pain management if the client becomes terminally ill- and also allows the client's adult child to direct the client's care, is:
The agency's risk manager
A nurse and the facility have been named as defendants in a malpractice lawsuit. In addition to the nurse's attorney, whom else would be appropriate for the nurse to talk with about the case?
The nurse documents a complete description of the happenings in the client's records.
A nurse enters a client's room and finds that the client is lying on the floor. The nurse makes the client comfortable on the bed and completes an examination. She informs the physician and the nursing supervisor about this incident and also completes an incident report. Which action by the nurse indicates correct knowledge of handling an incident report?
Slander
A nurse who comments to coworkers at lunch that a client with a sexually transmitted infection has been sexually active in the community may be guilty of what tort?
Health care institution
During the orientation to the hospital, the staff development educator discusses unit and institutional-based policies. What is the source of the practice rules that result in unit and institutional-based policies?
Battery
A client admitted to a mental health unit has exhibited physical behaviors that put the client and others at risk. The nurse applies four-point restraints on the client without obtaining a physician's order or the client's consent. The nurse is at risk of being accused of which action?
"Take it with you. It is recognized universally in the United States."
A client being discharged from the hospital asks the nurse, "When I go visit my family out of state, should I take my living will with me, or do I need a new one for that state?" Which is the most appropriate response by the nurse?
Document the client's claims and the events surrounding the alleged incident.
A client states that the client's recent fall was caused by his scheduled antihypertensive medications being mistakenly administered by two different nurses, an event that is disputed by both of the nurses identified by the client. Which measure should the nurses prioritize when anticipating that legal action may follow?
Slander
A client who is scheduled for hernioplasty needs clarification regarding the procedure. The nurse calls the physician at the client's insistence. The physician, who is in a bad mood, is overheard telling the client that the nurse does not know anything. Which legal tort has the physician committed?
The nurse confirms that the client's family has signed the consent form.
A family brings the client to the emergency department in an unconscious state with a head injury. The client requires surgery to remove a blood clot. What would be the appropriate nursing intervention in keeping with the policy of informed consent prior to a surgical procedure?
"Wait and give me a report in the room at the bedside."
A nurse from the postanesthesia care unit (PACU) transports a client in the elevator with a nurse from the intensive care unit (ICU). There are staff members and visitors in the elevator as well. Which response from the ICU nurse is appropriate when the PACU nurse begins the report?
Libel
A nurse is called to a deposition for malpractice charge that has resulted in the death of a client. As the chart is reviewed, the prosecuting attorney questions the nurse about several defaming comments written in the medical record about the client. What charges can be filed against the nurse due to these comments?
Do not volunteer any information on the witness stand.
A nurse is named as a defendant in a malpractice lawsuit. Which action would be recommended for this nurse?
Invasion of privacy
A nurse talks with family members about an AIDS client from the clinic where the nurse works. Which tort has the nurse committed?
Slander
A nurse, while off-duty, tells the physiotherapist that a client who was admitted to the nursing unit contracted AIDS due to exposure to sex workers at the age of 18. The client discovers that the nurse has revealed the information to the physiotherapist. With what legal action could the nurse be charged?
-"I am glad I am a student because nursing faculty will be blamed, not me." -"I cannot be held liable because this is only my second time at this facility."
A nursing student administers an overdose of a narcotic to client and the client arrests. When discussing the incident with nursing faculty, which statements made by the student indicate the need for further teaching? Select all that apply.
Is the program accredited?
A registered nurse who has an associate degree would like to obtain a baccalaureate degree in nursing. The nurse works full time and has several family obligations and would like to find a program that fits into that lifestyle. What is the nurse's priority question about an educational program?
"The rules made by the board of nursing don't reflect my practice."
Action has been taken against a nurse's license based on a claim that the nurse acted outside of nursing's scope of practice. The nurse's attorney determines that the nurse needs more education about the purpose of the board of nursing when the nurse makes which statement?
Invasion of privacy
An HIV-positive client discovers that the client's name is published in a research report on HIV care prepared by the client's nurse. The client is hurt and files a lawsuit against the nurse. Which offense has the nurse committed?
-An intravenous antibiotic was administered 2 hours late because the IV site infiltrated. -A visitor slipped and fell in the hallway, but was not injured. -A client falls while being transferred from the bed to the chair.
During a nursing shift, which events warrant completion of an incident report? Select all that apply.
Certification
Having recently completed a specialty nursing program in neonatal care, a nurse is now preparing to leave the medical unit and begin providing care in the hospital's neonatal intensive care unit (NICU). The nurse has completed which process of credentialing?
Emergency care for a choking victim in a restaurant
In some cases, the act of providing nursing care in unexpected situations is covered by the Good Samaritan laws. Which nursing action would most likely be covered by these laws?
-The nurse confirms informed consent was give by the client to perform a procedure. -The nurse educates the client about what to expect during the hospital stay. -The nurse documents all client care in a timely manner.
Legal safeguards are in place in the nursing practice to protect the nurse from exposure to legal risks as well as to protect the client from harm. What is an example(s) of legal safeguards for the nurse? Select all that apply.
Witnesses to a signature do not need to read the wilI.
Nurses are occasionally asked to witness a testator's (person who makes the willI) signing of a will. Which guideline is true regarding a nurse's role in witnessing a testator's signature?
To improve quality of care
Nurses complete incident reports as dictated by the agency protocol. What is the primary reason nurses fill out an incident report?
To protect the safety of the public
Professional regulations and laws that govern nursing practice are in place for which reason?
"Will this case be precedent setting?"
Report A nurse has been named in a malpractice lawsuit. Prior to taking the nurse's deposition, the attorney explains that the case will be governed by common law. Which question by the nurse is indicated?
-"I am going to insert a catheter in you, if you do not get up to go to the bathroom." -"Hold still for these stitches; otherwise, I am going to have to hold you down."
The nurse is assigned to various clients on a medical unit. Which statement(s) made to a client by the nurse constitutes assault? Select all that apply.
Call the provider to clarify the medication
The nurse is preparing to administer a prescribed medication and notes the dosage is well above the suggested therapeutic range. Which action should the nurse take?
Duty
The nurse is providing care to a client whose condition has progressively declined. The nurse assesses and makes appropriate interventions as well as notifies the health care provider. Despite the nurse's efforts, the client expires. What element of liability has the nurse demonstrated?
The State Board of Nurse Examiners
What governing body has the authority to revoke or suspend a nurse's license?
-The nurse documents that the client's blood pressure has increased from 118/72 to 188/98 mm Hg and decides to retake the blood pressure in an hour. -The nurse fails to document refusal by the client to ambulate following surgery.
Which are areas of potential liability for the nurse? Select all that apply.
-With the client's permission, the nurse explains the client's diagnosis to the client's spouse. -The nurse moves the client from the emergency department waiting room to a private area to collect assessment data.
Which are examples of a nurse appropriately protecting a client's privacy? Select all that apply.
-Assault -Defamation of character -Negligence
Which are torts rather than crimes? Select all that apply.
A nurse gives the client a medication, and the client has an adverse reaction to it.
Which is an example of an unintentional tort?
Accreditation
Which process evaluates and recognizes educational programs as having met certain standards?
A nurse who demonstrates advanced expertise in a content area of nursing through special testing
Which scenario is an example of certification?
Breach of duty
A nurse fails to communicate a change in the client's condition to the physician. Which element related to proving malpractice has been met?
The nurse should ask the physician to come back and write the order.
A physician is called to see a client with angina. During the visit the physician advises the nurse to decrease the dosage of atenolol to 12.5 mg. However, because the physician is late for another visit, the physician requests that the nurse write down the order for the physician. What should be the appropriate nursing action in this situation?
The student nurse, the nurse instructor, and the hospital
A student nurse is assisting an older adult client to ambulate following hip replacement surgery when the client falls and reinjures the hip. Who is potentially responsible for the injury to this client?
Reporting the abuse to the appropriate authorities
During the admission assessment of a client with a suspected mandibular fracture, the client discloses to the nurse that the injury results from the client's spouse hitting the client. Which action should the nurse prioritize when responding to this disclosure?
Certification
Nurses practicing in a critical care unit must acquire specialized skills and knowledge to provide care to the critically ill client. These nurses can validate this specialty competence through what process?
The Good Samaritan law will provide legal immunity to the nurse.
Report A nurse witnesses a traffic accident and dresses the open wounds sustained by a child. Later, in the hospital, the child develops complications from an infection in the wound. The family holds the nurse responsible for the complications and attempts to file a lawsuit. Which statement is true regarding how the Good Samaritan law applies to this case?
The nurse is legally held to the same standards of care as when staffing levels are normal.
Report After reporting to work for a night shift, the nurse learns that the unit is understaffed because two RNs called out sick. As a result, each nurse on the unit must provide care for four acute clients in addition to the nurse's regular clients. Which statement is true for this nurse when working in understaffed circumstances?
A living will
The client being admitted to the oncology unit conveys wishes regarding resuscitation in the event of cardiopulmonary arrest. The nurse advises the client that it would be in the client's best interest to obtain which document?
"I don't need to assess distal pulses on a client after a femoral arteriography."
Which statement made by the nurse providing care to a group of clients indicates that the nurse requires further education regarding negligence?
Nurses are responsible for adhering specific documentation about controlled substances.
Which statement about laws governing the distribution of controlled substances is true?
Nurses are responsible for adhering to specific documentation about controlled substances.
Which statement about laws governing the distribution of controlled substances is true?
-"When I sign the consent form as a witness, I am saying that the person knows all the risks and benefits of the procedure." -"I must make sure I give the client all necessary information about the procedure before I have the client sign the consent form." -"When a client is having surgery, it is my responsibility to get the consent."
Which statement(s) by a nurse to a charge nurse indicates that the nurse requires further training? Select all that apply.
-"If I make a mistake, I will not tell anyone." -"I will have the supervisor fill out the incident report when I make an error."
Which statements made by a nurse would indicate to a nurse manager that the nurse requires further training? Select all that apply.
Ask the client to sign a release without medical approval.
A client informs the nurse about leaving the health care facility because the client is not satisfied with the treatment. The nurse knows that the client's treatment is incomplete and further testing and evaluations are scheduled. Which action by the nurse would be most appropriate to prevent false imprisonment?
The health care provider performing the surgical procedure
A client is being prepared for an elective surgical procedure and the consent form has not been signed. Who should the nurse have obtain consent for the procedure?
A surrogate decision maker
A client is in a persistent vegetative state. The client has no immediate family and is a ward of the state. Under these circumstances, who will speak on this client's behalf?
Competence
A client is scheduled for a colonoscopy. The nurse realizes immediately after administering medications to induce conscious sedation that the client has not signed the informed consent. If the nurse has the client sign the informed consent at this point, which element of informed consent would be violated?
Battery
An RN enters a client's room and observes the unlicensed assistive personnel (UAP) forcefully pushing a client down on the bed. The client starts crying and informs the UAP of the need to go to the bathroom. What action is the RN witnessing that should be immediately reported to the supervisor?
Asking the LPN/LVN to teach a new diabetic client how to administer insulin
An RN is working on a medical-surgical unit with a licensed practical/vocational nurse (LPN/LVN). Which action by the RN is considered negligent if injury results from this action?
Reporting the abuse to the appropriate
During the admission assessment of a client with a suspected mandibular fracture, the client discloses to the nurse that the injury results from the client's spouse hitting the client. Which action should the nurse prioritize when responding to this disclosure?
Assault
Report While walking down the hall, a nurse manager overhears a staff member telling a client, "If you don't stay in this chair and stop wandering, l'm going to tie you to it." The nurse manager pulls the staff member aside and discusses what was said. The nurse manager intervenes because the staff member's statement is which type of tort?
Breach of duty
The nurse is providing care to a client who had orthopedic surgery. The nurse has medicated the client for pain. However, the client reports that the pain is unrelieved. The nurse takes no further action regarding assessment and intervention for the client's pain. The nurse does not notify the surgeon regarding the client's pain. The nurse's failure to take further action represents which element of liability in thi case?
Breach of duty
The nurse is providing care to a client who had orthopedic surgery. The nurse has medicated the client for pain. However, the client reports that the pain is unrelieved. The nurse takes no further action regarding assessment and intervention for the client's pain. The nurse does not notify the surgeon regarding the client's pain. The nurse's failure to take further action represents which element of liability in this case?
"I cannot give you that information due to client confidentiality."
While a client admitted to the medical-surgical unit is in the radiology department, a visitor claiming to be the client's cousin arrives on the medical-surgical unit and asks the nurse to provide a brief outline of the client's illness. Which response by the nurse would be most appropriate, both legally and professionally?
A durable power of attorney for health care appoints an agent the person trusts to make decisions.
While teaching about advance care planning, which fact is important for the nurse to share with a client who has been diagnosed with a terminal illness?
-Scope of practice -Educational requirements of nurses
A nurse is preparing a presentation for a group of staff nurses about the rules affecting nursing practice and the parties involved. When describing the role of different sources for the rules, which issue would the nurse identify as being addressed specifically by state legislation? Select all that apply.
-Libel -HIPAA -Slander
A nurse suspects that a client is a prostitute. The nurse documents this suspicion in the medical record and includes it in report to the oncoming shift. The nurse also mentions the suspicion to the nurse's sister saying, "I had a client named Susan in room 126 today who I think is a prostitute." Which violations has this nurse committed? Select all that apply.
The Good Samaritan law will provide legal immunity to the nurse.
A nurse witnesses a traffic accident and dresses the open wounds sustained by a child. Later, in the hospital, the child develops complications from an infection in the wound. The family holds the nurse responsible for the complications and attempts to file a lawsuit. Which statement is true regarding how the Good Samaritan law applies to this case?
Battery
A nurse working in a coronary care unit resuscitates a client who had expressed wishes not to be resuscitated. Which tort has the nurse committed?
Fraud
A nurse working on a busy medical-surigcal unit does not take the vital signs of client who is preparing for discharge but instead documents the same vital signs obtained for this client earlier in the morning. For which tort would the nurse be potentially liable?
Malpractice
While caring for an infant, the nurse hears another child screaming in the next room and rushes there, forgetting to put the side rails up on the infant's crib. The nuse returns to the room to find that the infant has fallen out of the crib and sustained a head injury. Based on the nurse's action, which tort is the nurse liable for?
The nurse should call and inform the nursing supervisor of the situation.
A client is unhappy with the health care provided and informs the nurse that the client is leaving the facility. The client has not been discharged by the physician. The nurse finds that the client has dressed and is ready to What should the nurse's action be in this situation?
The nurse withholds the medication and notifies the health care practitioner.
A client newly diagnosed with congestive heart failure has a prescription for digoxin. The nurse counts the heart rate before administration of the medication and obtains a heart rate of 51 beats per minute. Which action by the nurse demonstrates adherence to the standards of nursing care?
Assault
While walking down the hall, a nurse manager overhears a staff member telling a client, "If you don't stay in this chair and stop wandering, I'm going to tie you to it." The nurse manager pulls the staff member aside and discusses what was said. The nurse manager intervenes because the staff member's statement is which type of tort?
Document the client's claims and the events surrounding the alleged incident.
A client states that the client's recent fall was caused by his scheduled antihypertensive medications being mistakenly administered by two different nurses, an event that is disputed both of the nurses identified by the client. Which measure should the nurses prioritize when anticipating that legal action may follow?
To evaluate the quality of care provided and assess the potential risks for injury to the client
A nurse enters the client's room and finds the client lying on the floor experiencing a seizure. After stabilizing the client, the nurse informs the physician. The physician advises the nurse to prepare an incident report. What is the purpose of an incident report?
The first nurse could be charged with slander.
While at a coworker's house, a nurse discusses with the coworker a client whom the nurse suspects of physically abusing the client's child. The next day, the client is moved to another nursing unit after a surgical procedure and comes under the care of the coworker, who is also a nurse. The coworker confronts the client about the alleged physical abuse. The client is shocked and angered by the accusation and denies it categorically. What would be the charge if the client were to file a suit?
Malpractice
A client has a prescription for amoxicillin 500 mg P.O. every 8 hours. The nurse administers the medication via the intravenous route. Based on the nurse's action, the client develops complications and has an increased length of stay. The client files a lawsuit against the facility and the nurse. Which legal action has the nurse's attorney identified that meets the criteria for the client's lawsuit?
battery.
A client with end-stage renal disease decides against further treatment and requests a "Do Not Resuscitate" (DNR) order. The DNR status is part of the change-of-shift report. The client stops breathing and a nurse begins cardiopulmonary resuscitation. The family is upset and makes a complaint to the charge nurse. The charge nurse appropriately identifies that nurse has committed: