Fundamentals Final CH 7

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?

Assault

Which are torts rather than crimes? Select all that apply.

Assault Defamation of character Negligence

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?

Duty

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 agency's risk manager

After caring for a pediatric client, the nurse is surprised to learn about being named in a malpractice lawsuit.

The client suffered an injury. The nurse has the duty to care for the client. The nurse failed to provide appropriate care. The nurse's lack of action directly resulted in harm.

Nurse Practice Acts are an example of __________ laws, which must adhere to both the federal and the state constitution.

statutory

Standards which are developed and implemented by the nursing profession itself are called __________ standards.

voluntary

Failure by a registered nurse to follow a standard of care is an example of professional negligence known as _______________.

malpractice

A nurse has been asked to serve as an expert witness in a malpractice case in which an infant died in the newborn nursery. Which questions should the nurse consider prior to accepting this job? Select all that apply.

"How much clinical experience do I have in the newborn nursery?" "How much education do I have about caring for newborns?"

A nursing student administers an overdose of an opioid to a 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.

"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."

Which statement made by the nurse providing care to a group of clients indicates that the nurse requires further education regarding negligence?

"I don't need to assess distal pulses on a client after a femoral arteriography."

Nursing students are discussing the requirement that they carry personal professional liability insurance as students. The nurse instructor should offer additional information when which statements are made? Select all that apply.

"Since I am a student, my instructor is the one liable if I make a mistake." "I will be protected both as a student and at my CNA job." "I think this is an unnecessary expense." "I thought we would be covered by the hospital's malpractice insurance."

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?

"Take it with you. It is recognized universally in the United States."

A lawyer is describing the litigation process to a nurse named in a malpractice lawsuit. Which statements by the lawyer accurately describe this process? Select all that apply.

"The process of bringing and trying this lawsuit is called litigation." "The opinions of appellate judges are published and become common law." "Common law is based on the principle of stare decisis."

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?

"The rules made by the board of nursing don't reflect my practice."

An older adult client has expressed to the nurse a desire to specify and document the care they want to receive and do not want to receive if they become incapacitated. The nurse should encourage the client to explore what option?

A living will

The client being admitted to the oncology unit conveys wishes regarding the use of tube feedings if the client becomes unable to feed by mouth. The nurse advises the client that it would be in the client's best interest to obtain which document?

A living will

Which is an example of an unintentional tort?

A nurse gives the client a medication, and the client has an adverse reaction to it.

Nurses may commit both intentional and unintentional torts when practicing within the profession. What intentional torts may occur in nursing practice? Select all that apply.

A nurse threatens to hit an older client who has dementia and is screaming. A nurse seeks employment in a hospital after falsifying credentials on a resume. A nurse places a client who is a fall risk in restraints without an order from the health care provider. A nurse makes disparaging remarks to the staff about a client who has a sexually transmitted infection (STI).

Which scenario is an example of certification?

A nurse who demonstrates advanced expertise in a content area of nursing through special testing

Which nursing student would most likely be held liable for negligence?

A nursing student administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home.

Which process evaluates and recognizes educational programs as having met certain standards?

Accreditation

The nurse manager is using voluntary standards as a guideline for developing policies on the unit. What voluntary standards are available for the nurse to use? Select all that apply.

American Nurses Association Standards of Practice Professional standards for certification of individual nurses in general practice Process of certification

During a nursing shift, which events warrant completion of an incident report? Select all that apply.

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.

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?

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?

Battery

Defamation of character and invasion of privacy are two examples of unintentional torts that occur in nursing practice.

FALSE

The American Nurses Association (ANA) standards of practice are considered legal standards.

FALSE

A nurse talks with family members about an AIDS client from the clinic where the nurse works. Which tort has the nurse committed?

Invasion of privacy

A nurse is providing care to an older adult client. The client has been alert and independent with ambulation but now is exhibiting some confusion along with being unsteady when getting out of bed and walking. The nurse fails to report and document this change in status. No safety measures are taken and the client falls while getting out of bed to use the bathroom and fractures a hip. The client is experiencing significant pain from the fractured hip and requires surgery to repair the fracture. The nurse is sued for malpractice. Which action reflects the element of causation in this case?

Lack of safety measures implemented with status change

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.

Scope of practice Educational requirements of nurses

A client who is scheduled for hernioplasty needs clarification regarding the procedure. The nurse calls the health care provider at the client's insistence. The health care provider, who is in a bad mood, is overheard telling the client that the nurse does not know anything. Which legal tort has the health care provider committed?

Slander

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?

The health care provider performing the surgical procedure

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.

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.

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?

The nurse is legally held to the same standards of care as when staffing levels are normal.

Which situation violates an element of informed consent?

The nurse says, "You have to sign this before we can do the surgery."

A nurse is writing a letter to a U.S. congressman to support the promotion of health care issues. Which guidelines would ensure a properly written letter? Select all that apply.

The nurse should state the purpose of the letter briefly and clearly in the first paragraph. The nurse should name the city and state where the nurse lives and votes. The nurse should restate exactly what the legislator should do at the end of the letter.

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?

The nurse withholds the medication and notifies the health care practitioner.

Which are examples of a nurse appropriately protecting a client's privacy? 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.

Nurses are occasionally asked to witness a testator's (person who makes the will) signing of a will. Which guideline is true regarding a nurse's role in witnessing a testator's signature?

Witnesses to a signature do not need to read the will.

While riding in the elevator, a nurse discusses the HIV-positive status of a client with other colleagues. The nurse's action reflects:

invasion of privacy

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.

"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 attorney provides an educational session to the nursing staff on acts of negligence. Which responses by the staff would indicate to the attorney that the staff can accurately identify acts of negligence? Select all that apply.

"I can be charged with negligence if I apply a heating pad to the client's skin and the client suffers a superficial or first-degree burn." "I can be charged with negligence if I notify the health care practitioner about a change in a client's status but do not follow up or document."

A nurse is caring for a client following endotracheal intubation. Before applying soft wrist restraints to prevent the client from pulling out the endotracheal tube, what is the most appropriate action of the nurse?

Obtain a medical order

Professional regulations and laws that govern nursing practice are in place for which reason?

To protect the safety of the public

Which statement about laws governing the distribution of controlled substances is true?

Nurses are responsible for adhering to specific documentation about controlled substances.

Nurse practice acts are examples of which type of laws?

Statutory laws

An unexpected occurrence involving death or a serious physical or psychological injury (e.g., wrong side surgery) is called a ___________ event.

sentinel

A nurse is reviewing the nurse practice act of the state in which the nurse is licensed. The nurse understands that this act was derived from which source of law?

Statutory

A nurse working on a busy medical-surgical 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?

Fraud

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?

Health care institution

A nurse is overheard in the hospital cafeteria making false, derogatory comments about a client. The nurse is guilty of:

slander

Which statements made by a nurse would indicate to a nurse manager 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 statement(s) by a nurse to a charge nurse indicates that the nurse requires further training? Select all that apply.

"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."

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?

"Will this case be precedent setting?"

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?

Breach of duty

A nurse is caring for a client in the community who is at risk for sudden death from a chronic health condition. To reduce the legal risks associated with working with this client, the nurse carries out which action(s)? Select all that apply.

Follow the prescribed plan of care for the client. Explain every nursing intervention in detail. Document nursing actions shortly after completion.

The evening nurse received a change-of-shift report from the day nurse. The day nurse's report states, "The client required intubation for respiratory distress this morning, but has been stable all day." The evening nurse collects the following information during the first assessment: Skin flushed. Client lethargic. Temperature 103.0°F (39.4°C). A review of the client's chart reveals that the client's last assessment was done 7 hours earlier. A review of the findings by the nurse attorney determines which facts might be in place regarding liability? Select all that apply.

Breach of duty has occurred.

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?

Call the provider to clarify the medication prescription.

A client has been in the emergency department for 3 hours for treatment of a migraine headache. Care has been delayed due to a multiple fatality car accident. The client gets up to go to the bathroom unattended, faints, and suffers a subdural hematoma. The family threatens to sue for malpractice. Which element of malpractice will be the most difficult for the attorney to prove?

Causation

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?

Ask the client to sign a release without medical approval.

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?

Asking the LPN/LVN to teach a new diabetic client how to administer insulin

A nurse threatens to restrain a verbally abusive client if the abuse continues. Which legal tort has the nurse committed?

Assault

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 health care provider's order or the client's consent. The nurse is at risk of being accused of which action?

Battery

The nurse recognizes that liability requires specific elements that must be established to prove that malpractice or negligence has occurred. Identify the specific elements. Select all that apply.

Causation Damages Duty Breach of duty

A client has asked that a nurse witness the signing of the client's will. What should the nurse do prior to witnessing this signature? Select all that apply.

Check to see whether state laws allow the nurse to witness this signature. Assess the client's state of mind. Review the client's medical record. Talk to the client about why the client is signing the will now.

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?

Competence

A nurse is named as a defendant in a malpractice lawsuit. Which action would be recommended for this nurse?

Do not volunteer any information on the witness stand.

A client is to undergo surgery for removal of the gallbladder. Which action related to the client's informed consent falls within the nurse's scope of practice? Select all that apply.

Ensuring the signed form is on the chart Acting as a witness to the client's signature on the form Answering questions about elements of the consent

A nurse has applied soft wrist restraints to a client following endotracheal intubation. Documentation of which information is essential when using restraints on a client? Select all that apply.

Findings from client assessment, performed every 2 hours Foley catheter draining clear yellow urine 0.9 normal saline infusing intravenously at 100 mL/hr

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?

Invasion of privacy

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?

Is the program accredited?

A nurse is called to a deposition for a 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?

Libel

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.

Libel HIPAA Slander

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?

Malpractice

A nurse is caring for a client with hypertension whose blood pressure has increased from 154/78 mmHg to 196/98 mmHg with a heart rate of 110 beats per minute during the past hour. The nurse goes to lunch without reporting the change to the health care provider, and the client experiences a cardiac arrest. What tort has the nurse likely committed?

Negligence

A new graduate wants to be knowledgeable about state-mandated rules to better practice within the scope of nursing. What are the best resources for this nurse to research? Select all that apply.

Nurse practice acts Nursing educational requirements Composition and disciplinary authority of board of nursing

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?

Slander

Good Samaritan laws vary by state and are designed to protect health practitioners when they give aid to people in emergency situations.

TRUE

Law involving medical or nursing malpractice is based on prior legal decisions called precedents, which establish the rules to follow in similar cases.

TRUE

Licensure is a form of credentialing that permits a person to practice specific skills under legal guidelines.

TRUE

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 Good Samaritan law will provide legal immunity to the nurse

What governing body has the authority to revoke or suspend a nurse's license?

The State Board of Nurse Examiners

A nurse becomes concerned that a coworker may have a substance use disorder. Which behaviors by the coworker would increase this concern? Select all that apply.

The last two times the nurse has needed help turning a client, the coworker could not be found. The coworker has needed to leave early "to pick up my kids" several times in the last 2 months. The coworker has stopped eating lunch in the breakroom with other nurses.

Which best exemplifies malpractice?

The nurse administers amoxicillin to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest.

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?

The nurse confirms that the client's family has signed the consent form.

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 health care provider 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?

The nurse documents a complete description of the happenings in the client's records.

Which are areas of potential liability for the nurse? Select all that apply.

The nurse fails to document refusal by the client to ambulate following surgery. 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.

A health care provider is called to see a client with angina. During the visit the health care provider advises the nurse to decrease the dosage of atenolol to 12.5 mg. However, because the health care provider is late for another visit, the health care provider requests that the nurse write down the order for the health care provider. What should be the appropriate nursing action in this situation?

The nurse should ask the health care provider to come back and write the order.

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 health care provider. The nurse finds that the client has dressed and is ready to go. What should the nurse's action be in this situation?

The nurse should call and inform the nursing supervisor of the situation.

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?

The student nurse, the nurse instructor, and the hospital

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 health care provider. The health care provider advises the nurse to prepare an incident report. What is the purpose of an incident report?

To evaluate the quality of care provided and assess the potential risks for injury to the client

Nurses complete incident reports as dictated by the agency protocol. What is the primary reason nurses fill out an incident report?

To improve quality of care

A client was admitted to a postoperative nursing unit after undergoing abdominal surgery. During this time, the nurse failed to recognize the significance of abdominal swelling, which significantly increased during the next 6 hours. Later, the client had to undergo emergency surgery. The lack of action on the nurse's part is liable for action. Which legal term describes the case?

Tort

A nurse is caring for a client who has undergone coronary angioplasty. The cardiac monitor is showing abnormal electrocardiogram waves, indicating atrial fibrillation. The nurse does not recognize the importance of the sign; as a result, the client's condition deteriorates and the client has to be taken up for an emergency procedure. Which describes the nurse's legal liability?

Tort

The nursing supervisor is preparing to delegate some aspects of the nursing care plan interventions to other health care providers on the unit. The nursing supervisor has which responsibility(ies)? Select all that apply.

knowing the job descriptions and capabilities of each person on the team in depth assigning to registered nurses rather than unlicensed assistive personnel the practice-pervasive functions of assessment ensuring that care is delivered accurately and appropriately

Discharging an infant to the wrong person or performing surgery on the wrong patient are examples of _________ events, extremely rare medical errors.

never

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?

"I cannot give you that information due to client confidentiality."

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?

A durable power of attorney for health care appoints an agent the person trusts to make decisions.

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:

battery