Concepts Ch. 7 PrepU
When the nurse reports for duty, she finds out her neighbor is admitted to one of units in her facility. The nurse asks a coworker about the neighbor's condition. The coworker is uncomfortable with the nurse's request and confers with the charge nurse. The charge nurse informs the coworker of which potential tort violation she could be charged with if she honors the nurse's request for client information? a) Assault b) Defamation of character c) Negligence d) Invasion of privacy
Invasion of privacy
A medical surgical client is in the radiology department. The client's cousin arrives on the medical surgical unit and asks to speak with the nurse caring for his cousin. The visitor asks the nurse to provide a brief outline of the client's illness. Which response, if given by the nurse, would demonstrate application of legal safeguard in her practice? a) "I cannot give you that information due to client confidentiality." b) "Do you have any identification proving you are related to the client?" c) "I'm busy right now, but can talk later." d) "I will call the client and ask his permission."
"I cannot give you that information due to client confidentiality."
The nurse is participating in a discussion about controlled substances. Which statement, made by the nurse, indicates the nurse is aware of laws governing the distribution of controlled substances? a) "Nurses are responsible for adhering to specific documentation about controlled substances." b) "The nurse is only at risk if she diverts medication from the client; using personal drugs decrease your risk." c) "An impaired nurse is promptly punished by being terminated and having his or her license suspended." d) "When a nurse abuses controlled substances in the workplace and gets help, she will not be charged with a criminal act."
"Nurses are responsible for adhering to specific documentation about controlled substances."
Which of the following nursing students would most likely be held liable for negligence? a) A nursing student who completes an incident report after administering a medication to a client who experiences an adverse reaction to the medication. b) A nursing student who performs a dressing change using sterile technique and documents the presence of necrotic tissue in the wound. c) The nursing student who reports that insulin was not administered to the client by the nurse on the previous shift. d) A nursing student administers medication to a resident, while working as a nursing assistant at a local nursing home.
A nursing student administers medication to a resident, while working as a nursing assistant at a local nursing home.
A client admitted to a mental health unit has exhibited physical behaviors that put him 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 of the following? a) Battery b) Negligence c) Malpractice d) Slander
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. When discussing the nurse's action, the charge nurse appropriately identifies which wrongdoing the nurse has violated? a) Fraud b) Battery c) Defamation d) Assault
Battery
A nurse exits the room of a confused client without raising the side rails on the bed. The failure to raise the side rails would be which of the following elements of liability related to malpractice? a) Causation b) Damages c) Breach of duty d) Duty
Breach of duty
Nurses practicing in a critical care unit must acquire specialized skills and knowledge to provide care to the critically ill patient. These nurses can validate this specialty competence through what process? a) Litigation b) Accreditation c) Certification d) Licensure
Certification
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, which element of informed consent would be violated? a) Comprehension b) Voluntariness c) Disclosure d) Competence
Competence
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? a) Apply restraints after giving a sedative. b) Restrain the client with vest restraints. c) Apply wrist restraints instead of vest restraints. d) Contact the physician and obtain necessary orders.
Contact the physician and obtain necessary orders.
A client states that his recent fall was caused by the fact that his scheduled antihypertensives were mistakenly administered by two different nurses, an event that is disputed by both of the nurses identified by the client. Which of the following measures should the nurses prioritize when anticipating that legal action may follow? a) Consult with practice advisors from the state board of nursing. b) Enlist support from nursing and nonnursing colleagues from the unit. c) Document the client's claims and the events surrounding the alleged incident. d) Consult with the hospital's legal department as soon as possible.
Document the client's claims and the events surrounding the alleged incident.
In some cases, the act of providing nursing care in unexpected situations is covered by the Good Samaritan laws. Which nursing actions would most likely be covered by these laws? a) Negligent acts performed in an emergency situation b) Medical advice given to a neighbor regarding her child's rash c) Emergency care for a choking victim in a restaurant d) Any emergency care where consent is given
Emergency care for a choking victim in a restaurant
A nurse who obtains a license to practice nursing by misrepresenting him or herself is guilty of what tort? a) Fraud b) Libel c) Slander d) Assault
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? a) Healthcare institution b) State legislation c) Federal legislation d) Board of nursing
Healthcare institution
A client has a prescription for amoxicillin (Amoxil) 500 mg P.O. (by mouth) every 8 hours. The nurse administers the medication via the intravenous route. Based on the nurse's action, the client develops a pulmonary embolus, experiences respiratory distress, and is transferred to the intensive care unit. The client's family files a lawsuit against the facility and the nurse. While reviewing the case, which legal action has the nurse attorney identified that meets the criteria for the client's lawsuit? a) Battery b) Assault c) Negligence d) Malpractice
Malpractice
Which of the following situations is an example of battery that the nurse may experience while performing her nursing duties at the health care facility? a) Telling the client that he cannot leave the hospital b) Performing a surgical procedure without getting consent c) Taking the client's photographs without consent d) Witnessing a procedure done on a client without his consent.
Performing a surgical procedure without getting consent
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? a) Negligence b) Slander c) Libel d) Malpractice
Slander
When making client rounds, the charge nurse observes which action by a staff nurse that would constitute battery? a) While bathing a client behind pulled curtains, two nurses are discussing a different client. b) The staff nurse threatens to restrain the client if she did not take her medication. c) The nurse tells the client she cannot leave the hospital because she is seriously ill. d) The elderly client refuses the intramuscular injection, but the staff nurse administered it.
The elderly client refuses the intramuscular injection, but the staff nurse administered it.
The nurse educator is presenting an in-service on nursing and malpractice. Which statements, made by the nursing staff, would indicate to the educator that further teaching is required? Select all that apply. a) "When I document, I make sure it is factual, accurate, complete, and timely." b) "The nursing plan of care must be accurate and be followed. It is part of the client's permanent record." c) "I will have the supervisor fill out the incident report when I make an error." d) "If I make a mistake, I will not tell anyone" e) "I am accountable for any task that I delegate."
The nurse administers amoxicillin (Amicar) to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest.
A client is brought 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? a) The nurse ensures that the client's family signs the consent form. b) The nurse ensures that the client signs the consent form. c) The nurse informs the family about advance directives. d) The nurse informs the family about the living will.
The nurse ensures that the client's family signs the consent form.
A nurse is caring for a client with vertigo. During data collection, the nurse finds multiple bruises on the client's arms and back; and suspects the client is being abused. When questioned, the client denies any abuse by the daughter she lives with. Despite the client's denial, which rationale would the nurse use for reporting the suspected abuse? a) The nurse wants her peers to see her as a hero. b) The client does not want anyone to know what is happening in her home. c) The nurse has a legal and ethical responsibility to report the suspected abuse. d) The client is ashamed to admit that her daughter is beating her.
The nurse has a legal and ethical responsibility to report the suspected abuse.
A client is unhappy with the health care provided to him. He approaches the nurse and informs her that he 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 go. What would the nurse's action be in this situation? a) The nurse should let the client go because she cannot do anything. b) The nurse should warn the client that he cannot come to the hospital again. c) The nurse should call the nursing supervisor and inform her about the situation. d) The nurse should get the client restrained and call the physician.
The nurse should call the nursing supervisor and inform her about the situation.
A physician is called to see a client with angina. During the visit the physician advises the nurse to decrease the atenolol to 12.5 mg. However, since the physician is late for another visit, she requests that the nurse write down the order for her. What should be the appropriate nursing action in this situation? a) The nurse should remind the physician later to write the work order. b) The nurse should write the order and implement it. c) The nurse should ask the physician to come back and write the order. d) The nurse should inform the client of the change in medication.
The nurse should ask the physician to come back and write the order.
Two nurses meet at their home, where one of the nurses discusses a client who had been physically abused. The next day, the client is shifted to another nursing unit after a surgical procedure and becomes the care of the second nurse who had been a part of the discussion. Nurse No. 2 asks the client about the physical abuse. The client discovers that his original nurse revealed the information and is hurt. What would be the charges if the client files a suit? a) The nurses could be charged for libel. b) No charges are valid because Nurse No. 2 is also involved in client care. c) No charges are valid because the revelation took place in off-duty hours. d) The nurses could be charged for slander.
The nurses could be charged for slander.
A nurse enters the client's room and finds the client lying on the floor experiencing a seizure activity. 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? a) To provides information to local, state, and federal agencies b) To provide a method for deciding the nurse's fault in the incident c) To evaluate quality care and potential risks for injury to the client d) To evaluate the immediate care provided by the nurse to the client
To evaluate quality care and 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? a) To document the need for disciplinary action b) To improve quality of care c) To document everyday occurrences d) To initiate litigation
To improve quality of care
A nurse has been assigned to the ICU by her supervisor because there is an emergency there. However, the nurse is not aware of the setup and working of the ICU. What would be the appropriate action by the nurse? a) To report to the ICU and take leave on the pretext of some illness b) To call the lawyer and seek her advice regarding the sudden change c) To refuse to go to the ICU and keep working in the previously assigned unit d) To report to the nurse-in-charge for duty and tell her the tasks she can help with
To report to the nurse-in-charge for duty and tell her the tasks she can help with.
Nurses are occasionally asked to witness a testator's (person who makes the will) signing of his or her will. Which of the following guidelines is true regarding a nurse's role is witnessing a testator's signature? a) Witnesses to a signature do not need to read the will. b) Witnesses do not need to observe the signing of the will and can sign it at a later time. c) A single witness is sufficient for a will. d) A beneficiary to a will is allowed to act as a witness.
Witnesses to a signature do not need to read the will.
In comparison with licensure, which measures entry-level competence, what does certification validate? a) more than 10 years of nursing practice b) specialty knowledge and clinical judgment c) innocence of any disciplinary violation d) ability to practice in more than one area
specialty knowledge and clinical judgment
The nurse educator is presenting an in-service on nursing and malpractice. Which statements, made by the nursing staff, would indicate to the educator that further teaching is required? 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."
The nursing faculty is lecturing on unintentional and intentional torts. The faculty asks a nursing student to provide an example of an unintentional tort. Which example, if provided by the student, would indicate the student has a clear understanding of torts? a) Nurses are in the elevator discussing a client's laboratory values. b) A nurse is telling a client he cannot leave the hospital until he pays his bill. c) A nurse is threatening to restrain a client if he does not stop talking. d) A nurse gives a medication and client has an adverse reaction.
A nurse gives a medication and client has an adverse reaction.
Which of the following is an example of certification? a) A nurse who demonstrates advanced expertise in a content area of nursing through special testing. b) An education program that meets standards of the National League for Nursing. c) A graduate of a nursing education program who passes NCLEX-RN. d) 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.
The student nurse tells her family about a client with AIDS cared for in clinical yesterday. Which tort has the student committed? a) Slander b) Assault c) Fraud d) Invasion of privacy
Invasion of privacy
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? a) Libel b) Battery c) Assault d) Slander
Battery
During the admission assessment of a female client age 40 years with a suspected mandibular fracture, the client discloses to the nurse that her injury came as a result of her husband hitting her. Which of the following actions should the nurse prioritize when responding to this disclosure? a) Informing the client of her right to keep this information private b) Ensuring the client's statement is confirmed by another nurse c) Reporting the abuse to the appropriate authorities d) Performing an assessment to confirm the client's statement
Reporting the abuse to the appropriate authorities. Nurses have a legal and ethical obligation to report cases of abuse. It would be inappropriate and likely unethical to require a third party witness to the statement or to withhold action pending assessment results. The nurse's obligation to report abuse legally supersedes the client's right to privacy.
The nurse educator is presenting a lecture on the Occupational Safety and Health Act. Which situations, if identified by the nursing staff, would indicate to the educator that the staff understands which actions about the Occupational Safety and Health Act? a) Protects nurses who are recovering from drug or alcohol addiction or have communicable diseases b) Acts as an information clearing house for nurses who engage in unprofessional conduct c) Requires nurses to report abuse of infants, children, and adults of all ages d) Helps reduce workforce injuries and illness in the workplace
d) Helps reduce workforce injuries and illness in the workplace
Professional regulations and laws that govern nursing practice are in place for which of the following reasons? a) To ensure that enough new nurses are always available b) To limit the number of nurses in practice c) To ensure that practicing nurses are of good moral standing d) To protect the safety of the public
d) To protect the safety of the public
A client admitted with Hodgkin disease has a handwritten prescription for vinblastine 3.7 mg intravenously (IV) weekly. The nurse interprets the prescription as vincristine 3.7 mg and administers the wrong medication. The client becomes neurovascularly compromised and has a fatal reaction to the medication. The client's family begins a litigious suit against the facility and the nurse's license is suspended by the board of nursing. In preparation for the lawsuit, the nurse meets with the nurse attorney to review the events. Which appropriate statement, if given by the nurse, indicates he has an understanding of the lawsuit? a) "I checked the medication before giving it and literature states it is for Hodgkin disease." b) "I had a duty and it was my responsibility to double check the medication, which I did, yet this still happened." c) "I could not read the health care provider's handwriting, so I am not at fault." d) "I had a duty and it was my responsibility to get clarification before administering the medication, which I did not."
"I had a duty and it was my responsibility to get clarification before administering the medication, which I did not."
The nurse attempts to notify a health care provider about a client's elevated temperature, but does not get a response. Which statement, if documented by the nurse, would indicate that the nurse is following proper protocol for nursing documentation? a) 1300: Client temperature elevated. Telephoned health care provider's service several times with no response. Will notify nursing supervisor during rounds. b) 1300: Client temperature elevated. Health care provider paged, but did not respond. Administered Tylenol without an order because I knew this health care provider does not return calls. c) 1300: Client temperature elevated. Telephoned health care provider's service 3 times without a response. Tepid sponge bath given and nursing supervisor notified. d) 1300: Client temperature elevated. Telephoned health care provider 3 times. As usual, health care provider did not respond.
1300: Client temperature elevated. Telephoned health care provider's service 3 times without a response. Tepid sponge bath given and nursing supervisor notified.
A newly hired graduate nurse meets with the nurse educator to discuss obtaining a client's informed consent for procedures. Which statements, made by the graduate, would indicate to the educator that further discussion is needed? Select all that apply. a) "My signature as a witness indicates the consent is signed and I saw the client sign it." b) "I must make sure I give the client all necessary information about the procedure before I have the client sign the consent form." c) "When a client is having surgery, it is my responsibility to get the consent." d) "In the event of an emergency that threatens a client's life or health, consent is not needed." e) "When I sign the consent form as a witness, I am saying that the person knows all the risks and benefits of the procedure."
• "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."
Nurses practice within the legal and mandatory standards of the nursing profession. What are examples of voluntary standards in nursing? (Select all that apply.) a) State nurse practice acts b) Rules and regulations of nursing c) Professional standards for certification of individual nurses in general practice d) Process of certification e) American Nurses Association Standards of Practice
• American Nurses Association Standards of Practice • Professional standards for certification of individual nurses in general practice • Process of certification
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.) a) The nurse should try to keep the letter to two pages and include a cover page with contact information. b) The nurse should avoid using specific examples from the workplace to support the position. c) The nurse should address the letter to as many legislators as possible. d) The nurse should name the city and state where he or she lives and votes. e) The nurse should restate exactly what the legislator should do at the end of the letter. f) The nurse should state the purpose of the letter briefly and clearly in the first paragraph.
• 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 he or she lives and votes. • The nurse should restate exactly what the legislator should do at the end of the letter. Writing a letter to a U.S. Congressman should be in the format of a formal letter, stating the nurse's concerns in a way that best relays this information. The formal letter should state the purpose of the letter briefly and clearly in the first paragraph, state the city and state when the nurse lives and votes, and restate exactly what the legislator should do at the end of the letter. The letter should be kept to one page. The letter should be addressed to one legislator only, not a group of individuals.
A nurse hired to work in an ambulatory setting attends new employee orientation. The nurse never worked in ambulatory before and is concerned about the Scope and Standards of Practice for Professional Ambulatory Care Nursing. Which response, given by the nurse educator, would further explain the Scope and Standards of Practice for Professional Care Nursing to the new nurse? a) "The Scope and Standards of Practice for Professional Ambulatory Care Nursing takes precedent over the facility's policies and procedures." b) "The Scope and Standards of Practice for Professional Ambulatory Care Nursing deal with the professional obligations of a nurse working in the ambulatory setting." c) "The Scope and Standards of Practice for Professional Ambulatory Care Nursing sets the standards for the nursing supervisor to assess a nurse." d) "The Scope and Standards of Practice for Professional Ambulatory Care Nursing determines if a nurse is minimally competent to receive a license to practice as a nurse."
"The Scope and Standards of Practice for Professional Ambulatory Care Nursing deal with the professional obligations of a nurse working in the ambulatory setting."
The health care provider prescribes cold therapy every 4 hours for a client after foot surgery. The nurse places the ice pack directly on the client's skin and returns 60 minutes later. After removal of the ice pack, the skin is pale and cold to the touch. The client develops frostbite and begins a lawsuit for malpractice. When reviewing the case, the nurse attorney recognizes which most important statement about the malpractice suit? a) The nurse did have a duty, so the nurse is liable for the damage. b) The client will have difficulty finding causation. c) All elements are in place to hold the nurse liable. d) The standard of care was established, so the nurse will not be held liable.
All elements are in place to hold the nurse liable.
A registered nurse enters a patient's room and observes the nursing assistant pushing a patient down on the bed. The patient starts crying and informs the nursing assistant that he needs to go to the bathroom. The nursing assistant holds the patient down and tells him he was just in the bathroom. The nurse observing this incident is aware that the nursing assistant's action is an example of which of the following? a) Assault b) Fraud c) Battery d) Defamation of character
Battery
A nurse fails to alert a physician of a change in a patient's condition for the worse. This is an example of what aspect of malpractice? a) Causation b) Damages c) Duty d) Breach of duty
Duty Duty refers to an obligation to use due care. An example of duty would be alerting responsible health care professionals to changes in a client's condition
An HIV-positive client discovers that his name is published in a research report on HIV care prepared by his nurse. He is hurt and files a lawsuit against her. Which of the following offenses has the nurse committed? a) Negligence of duty b) Invasion of privacy c) Unintentional tort d) Defamation of client
Invasion of privacy
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 of the following statements is true regarding the Good Samaritan law? a) The Good Samaritan law will provide legal immunity to the nurse. b) The Good Samaritan law will not protect the nurse because she did not accept compensation. c) The Good Samaritan law will provide absolute exemption from prosecution. d) The Good Samaritan law is not applicable to health care workers.
The Good Samaritan law will provide legal immunity to the nurse. The Good Samaritan laws provide legal immunity to passersby who provide emergency first aid to victims of accidents. Therefore, the law is applicable to the nurse as well; moreover, the nurse did not accept any compensation for the service provided. The law is equally applicable to everyone, but does not provide absolute exemption from prosecution in cases of negligence. Paramedics, ambulance personnel, physicians, and nurses who stop to provide assistance are still held to a higher standard of care because they have training above and beyond that of average laypeople. In cases of gross negligence, health care workers may be charged with a criminal offense.
A registered nurse has had her license suspended after being convicted of being impaired at work. What governing body has the authority to revoke or suspend a nurse's license? a) The employing health care institution b) The Supreme Court c) The State Board of Nurse Examiners d) The National League for Nursing
The State Board of Nurse Examiners
A client is received in 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 of the following legal terms describes the case? a) Felony b) Tort c) Fraud d) Misdemeano
Tort
Nurses may commit both intentional and unintentional torts when practicing within the profession. What are examples of intentional torts in nursing practice? (Select all that apply.) a) A nurse seeks employment in a hospital after falsifying credentials on a resume. b) A nurse places a patient who is a fall risk in restraints without the proper order. c) A nurse does not report a change in patient condition in a timely manner. d) A nurse threatens to hit an older patient who has dementia and is wailing. e) A nurse forgets to put the side rails up on a crib and the toddler falls out. f) A nurse makes disparaging remarks to the staff about a patient who has a sexually transmitted infection
• A nurse threatens to hit an older patient who has dementia and is wailing. • A nurse seeks employment in a hospital after falsifying credentials on a resume. • A nurse places a patient who is a fall risk in restraints without the proper order. • A nurse makes disparaging remarks to the staff about a patient who has a sexually transmitted infection.
The nurse recognizes liability requires specific elements that must be established to prove that malpractice or negligence has occurred. Identify the specific elements. Select all that apply. a) Breach of confidentiality b) Breach of duty c) Causation d) Duty e) Damages
• Breach of duty • Causation • Duty • Damages
Legal safeguards are in place in the nursing practice to protect the nurse from exposure to legal risks as well as protect the patient from harm. What are examples of legal safeguards for the nurse? (Select all that apply.) a) The nurse claims management is responsible for inadequate staffing leading to negligence. b) The physician is responsible for administration of a wrongly prescribed medication. c) The nurse executes physician orders without questioning them. d) The nurse obtains informed consent from a patient to perform a procedure. e) The nurse educates the patient about the Patient Bill of Rights. f) The nurse documents all patient care in a timely manner.
• The nurse obtains informed consent from a patient to perform a procedure. • The nurse educates the patient about the Patient Bill of Rights. • The nurse documents all patient care in a timely manner.
The nurse educator provides an educational session to the nursing staff on protection of a client's privacy. Which circumstances, identified by the staff, would indicate to the educator that the teaching was effective? Select all that apply. a) With the client's permission, the nurse explained the client's diagnosis to the client's spouse. b) Because the facility is a teaching facility, the nurse allowed the nursing student to take the client's picture for his care plan. c) The nurse questioned the client about her social life even though it did not affect care planning. d) The nurse removed the client from the emergency department waiting room into a private area to collect assessment data. e) During a bed bath, the nurse exposed the client's upper torso while washing the client's face.
• With the client's permission, the nurse explained the client's diagnosis to the client's spouse. • The nurse removed the client from the emergency department waiting room into a private area to collect assessment data.
