Law in Nursing Exam 4

In comparison with licensure, which measures entry-level competence, what does certification validate?

specialty knowledge and clinical judgment

A nurse confides in a nurse friend, "I never report minor incidents. The charge nurse always wants a variance report filled out and they take so much time." Which responses by the friend are indicated? Select all that apply.

"Having documentation might keep you out of trouble someday." "Reporting helps us fix problems that result in danger to clients."

A nurse moves from Ohio to Missouri. Where can a copy of the Nurse Practice Act in Missouri be obtained?

Missouri State Board of Nursing

4. Damages

Must be proven @ greater than 50% of EACH element. Economic (loss of income) / Non - economic very difficult to quantify pain, suffering interference with relationships fractured left hip, pain and suffering, lengthened hospital stays, and need for rehabilitation

Torts (Правонарушения)

Negligence Intentional versus unintentional

What is the legal source of rules of conduct for nurses?

Nurse Practice Acts

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

Assault

Which are areas of potential liability for the nurse? ответственность медсестрa несет 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.

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.

Which of the following statements accurately describe an aspect of the credentialing process used in nursing practice? Select all that apply.

Credentialing refers to the way in which professional competence is ensured and maintained. Certification grants recognition in a specified practice area to people who meet certain criteria. Once earned, a license to practice is a property right and may not be revoked without due process.

What are the three divisions of law in the state of Washington?

Criminal - purpose is to punish wrongdoers. Purposeful misconduct. Burden of proof required, 99% beyond a reasonable doubt. 12/2 jurors. Civil - medical negligence; purpose is to make the patient "whole". Administrative - purpose to protect the public. NQAC- legislates in the form of statues. Has power to enact rules, governs private practice.

How do you best defend against being charged with negligence?

Documentation, follow the protocols Liability insurance Standards of Care Competent, knowledgeable care Record Keeping

A client informs the nurse that the client wants to discontinue treatment and go home. Later, the nurse finds the client dressed to leave. Which action should the nurse take in this situation?

Let the client go after signing a document stating that the client is going against medical advice.

Which of the following accreditations is a legal requirement for a school of nursing to exist?

State Board of Nursing accreditation

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.

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

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

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

Which of the following is the most frequent reason for revocation or suspension of a nurse's license?

alcohol or drug abuse

A patient refuses to have a pain medication administered by injection. A nurse says, if you don't let me give you the shot, I will get help to hold you down and give it. With what crime might the nurse be charged?

assault

What type of law regulates the practice of nursing?

civil law

A lawyer quotes a precedent for punishment of a crime committed by the defendant in a trial. What iscourt-made law is known as?

common law

Which of the following is the nurses best legal safeguard?

competent practice

A nurse is arrested for possession of illegal drugs. What kind of law is involved with this type of activity? A nurse is arrested for possession of illegal drugs. What kind of law is involved with this type of activity?

criminal

A lawsuit has been brought against a nurse for malpractice. The patient fell and suffered a skull fracture, resulting in a longer hospital stay and need for rehabilitation. What does the description of the patient represent as proof of malpractice?

damages

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

Who defines our scope of practice

regulated by our state, Revised Code of Washington (RCW), (WAC) Nurse Practice Acts

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." "When I document, I make sure it is factual, accurate, complete, and timely." "I will have the supervisor fill out the incident report when I make an error." "I am accountable for any task that I delegate." "The nursing plan of care must be accurate and must be followed. It is part of the client's permanent record."

"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."

What are the four elements of Negligence? Be able to label each in a scenario.

1. Duty to care 2. Breach of Duty to Care 3. Proximate Cause 4. Damages

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

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

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

Which of the following nursing actions would be considered a violation of HIPPA regulations?

A) A nurse ambulates a patient through a hospital hallway in a hospital gown that is open in the back. D) A nurse uses a patient's chart as a sample teaching case without changing the patient's name. E) A nurse reports the condition of a patient to the patient's employer.

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.

A nurse assesses a client with psychotic symptoms and determines that the client needs vest restraints. However, the client asks the nurse not to put on vest restraints. What would be the best nursing action?

Contact the health care provider and obtain necessary orders.

1. Duty to Care

Must provide reasonable care to patients - Legal duty is to everyone on hospital property Must provide reasonable care to everyone including giving advice to persons over the telephone. You are liable for the consequences of your advice to others. Hospital staff nurses are responsible for: Accurate assessment of patients assigned to their care Alerting responsible health care professionals to changes in a patient's condition. Competent execution of safety measures for patients

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?

Slander клевета

2. BREACH of Duty to Care

The failure to provide reasonable (at the time) care. How do we determine what is reasonable care? The judge will consult with academic & clinical people. Based on either act of OMISSION (didn't do what should be done) or Acts of COMISSION (did what should not be done).*Whether duty to care was breached depends upon whether or not the injury was foreseeable (предсказуемый) Failure to note and report that an older adult patient assessed as alert on admission is exhibiting periods of confusion Failure to execute and document use of appropriate safety measures (e.g., upper and lower bedside rails, use of restraints, if necessary, assisted ambulation)

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 health care provider is responsible for administration of a wrongly prescribed medication. The nurse educates the client about what to expect during the hospital stay. The nurse executes the health care provider's prescriptions without questioning them. The nurse documents all client care in a timely manner. The nurse claims management is responsible for inadequate staffing leading to negligence.

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.

While walking through a park, the nurse encounters a child with a swollen and reddened arm that hurts to move due to being struck with a baseball bat. The nurse splints the arm using two baseball bats. The child is transported to the hospital and later develops compartmental syndrome in the arm. Which statement regarding the nurse's liability in this case is accurate?

The nurse is protected by the Good Samaritan Act, which states that the nurse may give emergency care using good judgment.

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

Which are examples of a nurse appropriately protecting a client's privacy? Select all that apply. During a bed bath, the nurse exposes the client's upper torso while washing the client's face. With the client's permission, the nurse explains the client's diagnosis to the client's spouse. The nurse questions the client about the client's social life even though it does not affect care planning. The nurse moves the client from the emergency department waiting room to a private area to collect assessment data. Because the facility is a teaching facility, the nurse allows a nursing student to photograph a client for a care plan.

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.

2. Breach of Duty to Care

You are NOT liable for an error in judgement IF you have equally good options - you do A rather than B - and it injures the patient - are you liable? NO.

Two nurses are discussing a patient's condition in an elevator full of visitors. With what crime might the nurses be charged?

invasion of privacy

A nurse does not assist with ambulation for a postoperative patient on the first day after surgery. The patient falls and fractures a hip. What charge might be brought against the nurse?

negligence

A patient is suing a nurse for malpractice. What is the term for the person bringing suit?

plaintiff

A nurse has taken a telephone order from a physician for an emergency medication. The dose of the medication is abnormally high. What should the nurse do next?

question the order for the medication

According to HIPPA regulations, which of the following is a patient right regarding the patients' medical record? Select all that apply.

to see the health record to copy the health record to restrict certain disclosures of the health record

Which scenario is an example of certification?

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

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?

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?

Certification

What is the nurses' responsibility when a patient signs an informed consent form for a procedure?

Disclosure Comprehension Competence Voluntariness

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

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?

Emergency care for a choking victim in a restaurant

Review your Intentional and Unintentional Torts.

Intentional torts Assault Battery False imprisonment (лишение свободы) Invasion of privacy (Вторжение в частную жизнь) Defamation of character (Поношение личности) Unintentional torts Negligence and malpractice Medication errors Equipment errors Falls Retained foreign bodies Failure to assess Failure to monitor Failure to report Poor communication MD orders Poor or absent client teaching

What is the purpose of the Good Samaritan Act?

Not federal laws This does NOT resolve you of your responsibility. You are held to a responsibility of GROSS negligence, Not ordinary negligence (халатность). The situation must be a TRUE emergency and you have NO expectation of compensation of ANY kind.

Who legally is responsible for delegating nursing tasks and supervising other health care providers who carry out those tasks?

Professional nurses are responsible for delegating nursing activities, but although RNs may delegate elements of care, they do not delegate the nursing process itself. As a nurse, you remain accountable for any actions you delegate.

A nurse is providing patient care in a hospital setting. Who has full legal responsibility and accountability for the nurses' actions?

the nurse

A competent adult patient is scheduled for surgery. Who signs the informed consent form to allow the surgery

the patient

What are the roles and responsibilities of a nursing student during clinical practice? Remember "prudent nurse?" What are our legal responsibilities when providing care?

As a student nurse, you are responsible for your own acts, including any negligence that may result in patient injury. Moreover, you are held to the same standard of care as an RN. You are also responsible for being familiar with facility policies and procedures. Your legal responsibilities include careful preparation for each new clinical experience and a duty to notify your clinical instructor if you feel in any way unprepared to carry out a nursing procedure. For no reason should you attempt a clinical procedure if you are unsure of the correct steps involved. A hospital may also be held liable for the negligence of a student nurse enrolled in a hospital-controlled program because the student is considered an employee. The status of students enrolled in college and university programs is less clear, the liability of the educational institution in which they are enrolled and the health care facility offering a site for clinical practice. Nursing instructors may share responsibility for damages in the event of patient injury if an assignment called for clinical skills beyond a student's competency or the instructor failed to provide reasonable and prudent clinical supervision. Because the status of patients can change rapidly, especially in an acute care setting, notify your instructor or a staff member of any significant changes in the patient's condition, even if you are unsure of the meaning of these changes. Most nursing programs require students to carry personal professional liability insurance. School policies provide coverage only for clinical nursing done for educational purposes at the direction of the school. Moreover, student nurses who work as nursing assistants or in some other health care role are legally permitted to offer only those services included in their job description. Even if you feel confident about medication administration, catheter insertion, or another professional risk disciplinary action if you perform such a procedure outside the supervised clinical practice setting.

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?

Document the client's claims and the events surrounding the alleged incident.

Which governs Nursing practice?

NQAC legislates in the form of statues -- has power to enact rules. Governs private practice of individuals. People who give nurses their licenses -Purpose: Protect Public -Burden of proof: Clear, cogent, convincing -Jury: more than 75% vote. No Jury. **An injury is not required for an action against your license.

A patient gets out of bed following hip surgery and falls and re-injures her hip. The nurse caring for her knows that it is her duty to make sure an incident report is filed. Which of the following statements accurately describes the correct procedure for filing an incident report?

The report should contain all the variables related to the incident.

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.

3. Proximate Cause

This is the LINK between #2 (Breach of Duty) & #4 (Damages) If the breach is unrelated to the damages, then there is NO LIABILITY. Failure to use appropriate safety measures; this failure causes the patient to fall while attempting to get out of bed, resulting in a fractured left hip

What is the nurses' responsibility when a patient signs an informed consent form for a procedure?

a nurse is a Witness make sure that patient read and sign the form, understand what could happen, understand that there are potential risks, benefits The nurse is responsible and accountable for the verification of and witnessing that the patient or the legal representative has signed the consent document in their presence and that the patient, or the legal representative, is of legal age and competent to provide consent.