Legal Aspects of Providing Care
Which actions by the nurse could result in both criminal and civil law sanctions? Select all that apply.
*Applying physical restraints without a written prescription from the healthcare provider. *Taking controlled substances that are diverted from clients for whom they were prescribed.
An older adult presents to the clinic with their adult daughter. After the physical examination is completed, the client asks to speak with the nurse in private. Once alone, the client explains that the daughter dictates their healthcare-related decisions regarding medications, sometimes against their wishes. The client asks if they have any legal rights to assure they are able to make healthcare decisions for themselves. What information will the nurse provide? Select all that apply.
*Discuss the client's wishes for resuscitation status, desire for blood transfusions, and artificial nutrition. *Relay the information to the healthcare provider. *Encourage the client to consider appointing a durable power of attorney for health care (DPOA) who will assure their choices are followed should the client become unable to make their choices known. *Document the client's wishes in the medical record. *Refer the client to the colleague responsible for assisting with the drafting of advanced directive for healthcare documents.
A client has a fractured femur that is placed in skeletal traction with a fresh plaster cast applied. The client experiences decreased sensation and a cold feeling in the toes of the affected leg. The nurse observes that the client's toes have become pale and cold but forgets to document this because one of the nurse's other clients experienced cardiac arrest at the same time. Two days later the client in skeletal traction has an elevated temperature, and he is prepared for surgery to amputate the leg below the knee. Which statements regarding a breach of duty apply to this situation? Select all that apply.
*Failure to notify a healthcare provider about a change in the client's condition. *Failure to document a significant change in assessment data.
Match the definition below with the type of law it describes:
*STATUTORY LAW* Legislation passed by US Congress and state legislatures that is civil or criminal. *CIVIL LAW* Protect the rights of individuals by settling disputes between citizens. *NURSE PRACTICE ACT* Define nursing standards that must be met within individual states. *CRIMINAL LAW* Defines offenses and punishments for those who threaten, harm, or endanger society. *CASE LAW* Decisions made based on previous court cases.
The nurse stops at the scene of a motor vehicle crash intending to assist individuals who were injured. The nurse understands their actions are supported by which principles? Select all that apply.
*The nurse is functioning within the guidelines of the Good Samaritan Law for the state in which they practice. *As long as the nurse provides care within their scope of practice they cannot be held liable for a negative outcome. *The victims have the right to refuse the nurse's offer of help.
Ordinarily minors may not consent to medical treatment for themselves. The nurse understands that this does not apply to emancipated minors and unemancipated minors in certain situations. For each situation listed, indicate if consent can be provided by an emancipated or unemancipated minor by placing a check in the appropriate column.
-Select everything for emancipated minor -Select everything EXCEPT elective surgery, organ donation, and sports related physical examination
Place the actions the nurse will take, in the order in which they should be completed, starting with the first.
1. Assess the newborn. 2. Establish nursing diagnosis and outcomes of care for the newborn. 3. Assess the parent's knowledge of caring for the newborn. 4. Provide teaching as needed. 5. Document visit. 6. End the visit. 7. Contact the nursing supervisor to report the suspected abuse of the 2-year-old.
1. Malpractice 2. Not Malpractice
1. Does not complete the client assessment. -Leaves work without providing hand-off report. -Does not follow up on client's complaints. -Instructs the unlicensed assistive personnel to administer medications. -Documents care that was not provided. 2. Notifies healthcare provider of critical lab values in a timely manner. -Increases frequency of assessment for an unstable client. -Earns certification on new piece of equipment. -Does not allow an unsteady client to ambulate without assistance. -Documents client's drug allergies.
For each action associated with enacting a Do Not Resuscitate Order (DNR), indicate which individual is responsible for completion by placing a check in the appropriate column or columns. Select all that apply for each action. (Labeled 1-8) KEY: Client or Family (CF) Health Care Provider (HCP) Nurse (N)
1. HCP 2. CF 3. HCP & N 4. HCP & N 5. HCP & N 6. CF 7. HCP 8. CF
For each situation, use the first drop down menu to indicate if the actions involved were intentional, quasi-intentional, or unintentional. Use the second drop down menu to indicate which tort was committed.
1a. Intentional 1b. Assault 2a. Intentional 2b. False imprisonment 3a. Quasi-intentional 3b. Invasion of privacy 4a. Unintentional 4b. Negligence
The nurse notes that a living will is in the client's medical record. Which of the following statements represents the best description of guidelines a nurse would follow in this case?
A living will is invoked only when the client has a terminal condition or is in a persistent vegetative state.
For each client described below, indicate if a durable power of attorney for healthcare (DPOA) or living will is recommended by placing a check in the appropriate column or columns. Select one or both for each client.
All EXCEPT A teenager awaiting a kidney transplant whose parents agree with their desire to not be on dialysis for more than a year. Under DPOA
Fill in the Blank
Although the client refused the procedure, the nurse insisted and inserted a nasogastric tube in the right nostril. This is an example of *BATTERY* which is an *INTENTIONAL* *TORT*.
Fill in the Blank
Informed consent is an agreement from the *CLIENT* to have a medical procedure and requires full disclosure of the *RISKS* and benefits of *TREATMENT*, alternative care options, and the consequences of taking no action from the healthcare provider. The information provided to obtain consent must be done using terms that the client understands. Elements of informed consent: diagnosis and *PURPOSE* of proposed action; risks and benefits of action; alternatives; risks and benefits of alternatives; and risks and benefits of no action. It also requires that the client has the *CAPACITY* to understand their options for care.
A healthcare provider prescribes one tablet of a medication, but the nurse accidentally administers two. The nurse monitors the client for untoward effects of which there are none, then notifies the healthcare provider. Is the client likely to be successful in suing the nurse for malpractice?
No, because the client was not harmed.
A middle-aged adult presents to the clinic for follow-up after having been diagnosed with pulmonary hypertension. The client works as a local politician and has a history of sarcoidosis. Their vital signs are within normal reference ranges. The client states that they wish to discuss options for care as their conditions worsen. Which provision of the Patient Self-Determination Act (PSDA) requires health professionals participate in this discussion?
The requirement to inform clients of their health-related rights under state laws.
