Chapter 07: Legal Dimensions of Nursing Practice

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 Federal legislation State legislation Board of nursing

Health care institution

A nurse asks a coworker about the condition of the nurse's next-door neighbor, who has been admitted to the unit. If the coworker shares the neighbor's client information with the nurse, the coworker could be held liable for committing which act? Invasion of privacy Negligence Assault Defamation of character

Invasion of privacy

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 realize that I am held to the same standards as a registered nurse." "I have also put the nursing faculty at risk with my action." "I am glad I am a student because nursing faculty will be blamed, not me." "I should have informed you that I felt unprepared for my assignment." "I cannot be held liable because this is only my second time at this facility."

"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."

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." "The board of nursing exists to protect the safety of the public." "The board of nursing is established by state legislation." "Board of nursing rules keep unlicensed people from practicing nursing."

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

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? "Before you begin we need to ensure a family member is present." "You can just put the report on the foot of the bed and I will look at it when I get to the room." "I will look at the EHR when I get to the nurse's station." "Wait and give me a report in the room at the bedside."

"Wait and give me a report in the room at the bedside."

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? A will A living will Proof of health care power of attorney A proxy directive

A living will

Which is an example of an unintentional tort? Nurses discuss a client's laboratory values in the elevator. A nurse tells a client that the client cannot leave the hospital until the client pays the bill. A nurse threatens to restrain a client if the client does not stop talking. A nurse gives the client a medication, and the client has an adverse reaction to it.

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

Which scenario is an example of certification? A nurse who demonstrates advanced expertise in a content area of nursing through special testing A graduate of a nursing education program who passes NCLEX-RN An education program that meets standards of the National League for Nursing A hospital that meets the standards of the Joint Commission

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 performs a dressing change using sterile technique and documents the presence of necrotic tissue in the wound. A nursing student reports that insulin was not administered to the client by the nurse on the previous shift. A nursing student administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home. A nursing student completes an incident report after administering a medication to a client who then experienced an adverse reaction to the medication.

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 Credentialing Licensure Certification

Accreditation

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 Calling the health care provider about abnormal lab results Obtaining vital signs on a newly admitted client Delegating oral medication administration to the LPN/LVN

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

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? Slander Negligence Battery Malpractice

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 Assault Fraud Defamation of character

Battery

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 Causation Damages Duty

Breach of duty

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? Duty Breach of duty Causation Damages

Causation

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. Consult with the hospital's legal department as soon as possible. Consult with practice advisors from the state board of nursing. Enlist support from nursing and non-nursing colleagues from the unit.

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

An alert, older adult has been deemed to be in imminent danger of harm to self and is being held on the mental health unit for 72 hours. The client begins to scream and demand they be discharged now. The nurse informs the client that if they do not stop screaming, they will be given a sedative and placed on restraints. Complete the following sentence by choosing from the lists of options. Legally, the nurse may be charged with _________ because of ___________

Legally, the nurse may be charged with assault because of verbally threatening to administer a sedative

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? Negligence Malpractice Assault Battery

Malpractice

Which statement about laws governing the distribution of controlled substances is true? When a nurse misuses controlled substances in the workplace and gets help, the nurse will not be charged with a criminal act. Nurses are responsible for adhering to specific documentation about controlled substances. Substance use is not treatable. The nurse is only at risk if diverting medication from the client; a nurse using the nurse's own personal drugs is not at risk.

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

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? Sedate the client. Get written consent. Obtain a medical order. Notify the family.

Obtain a medical order

Injuries related to lifting or transferring clients occur in the health care setting and may be considered a work-related injury. Which law was intended to reduce work-related injuries and illnesses? The Occupational Safety and Health Act of 1970 The Health Care Quality Improvement Act of 1986 Title VII of the Civil Rights Act of 1964 Americans with Disabilities Act of 1990

The Occupational Safety and Health Act of 1970

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 informs the family about advance directives. The nurse informs the family about the living will. The nurse confirms that the client has signed the consent form. The nurse confirms that the client's family has signed the consent form.

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

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 nurse should ask the physician to come back and write the order. The nurse should write the order and implement it. The nurse should inform the client of the change in medication. The nurse should remind the physician later to write the work order.

The nurse should ask the physician to come back and write the order.

Professional regulations and laws that govern nursing practice are in place for which reason? To limit the number of nurses in practice To ensure that practicing nurses are of good moral standing To protect the safety of the public To ensure that enough new nurses are always available

To protect the safety of the public

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? Felony Defamation Tort Slander

Tort

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. Witnesses do not need to observe the signing of the will and can sign it at a later time. A beneficiary to a will is allowed to act as a witness. A single witness is sufficient for a will.

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

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: a will. a standard of care. a license. an advance directive.

an advance directive.

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: defamation. battery. assault. fraud.

battery.

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. defamation of character. professional negligence. false imprisonment.

invasion of privacy.

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."

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.

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 will call the client and ask for permission to share this information with you." "I cannot give you that information due to client confidentiality." "Do you have any identification proving that you are related to the client?" "I'm busy right now but can talk later."

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

Which statement made by the nurse providing care to a group of clients indicates that the nurse requires further education regarding negligence? "Please avoid bringing fresh fruit to a client with neutropenia." "I am going to assess for collateral circulation before preforming an arterial blood gas (ABG)." "I am going to auscultate breath sounds every 8 hours on a client receiving enteral feedings." "I don't need to assess distal pulses on a client after a femoral arteriography.

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

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? Unintentional tort Invasion of privacy Defamation of character Negligence of duty

Invasion of privacy

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? Libel Slander Negligence Malpractice

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? The first nurse could be charged with slander. The second nurse could be charged with libel. No charges are valid because the revelation took place during off-duty hours and off-site. No charges are valid because both nurses are involved in the client's care.

The first nurse could be charged with slander.

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. The nurse administers the medication and reassesses the client after 30 minutes. The nurse withholds the medication, retakes the heart rate, and gives the medication at a later time. The nurse administers the medication after reviewing the client's serum potassium level.

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