EAQ ch. 23 Legal Implications

A patient who has tested positive for human immunodeficiency virus (HIV) tells the nurse, "I feel helpless. My boss fired me because I'm HIV positive." Which is the best response by the nurse? "Don't worry. You're protected by Good Samaritan laws." "Don't lose hope. Take this as an opportunity to spend time with your family." "I understand your feelings, but I think you should concentrate on your health now." "You should approach a lawyer. You're protected by the Americans with Disabilities Act."

"You should approach a lawyer. You're protected by the Americans with Disabilities Act."

Following an accident at a job site, a patient's employer contacts the hospital and asks the nurse about the patient's condition to determine the patient's likelihood of returning to work in the future. Which is the best response by the nurse to the employer? "You need to speak to the primary healthcare provider." "We can send the patient's medical records for your reference." "The patient is doing well and will definitely be able to return to work." "You will have to get the patient's permission to receive any related information."

"You will have to get the patient's permission to receive any related information." According to the Health Insurance Portability and Accountability Act (HIPAA) of 1996, the patient's information should be kept confidential and the patient's privacy should be respected. Patient-related information should not be divulged to anybody without the patient's permission. Therefore, the nurse should ask the employer to seek the patient's permission to receive any patient-related medical information, including information about the feasibility of a patient returning to work. The primary healthcare provider is also not authorized to divulge patient information without the patient's consent. Providing the patient's medical records to others is a violation of HIPAA.

The nurse notes that an advance directive is on a patient's medical record. Which statement best describes an advance directive guideline? A living will allows an appointed person to make healthcare decisions when the patient is in an incapacitated state. A living will is invoked only when the patient has a terminal condition or is in a persistent vegetative state. The patient cannot make changes in the advance directive once admitted to the hospital. A durable power of attorney for health care is invoked only when the patient has a terminal condition or is in a persistent vegetative state.

A living will is invoked only when the patient has a terminal condition or is in a persistent vegetative state. A living will does not assign another individual to make decisions for the patient. A durable power of attorney for healthcare is active when the patient is incapacitated or cognitively impaired. A cognitively intact patient may change an advance directive at any time.

A surgeon obtains patient consent for an appendectomy. While operating, the surgeon also removes the patient's gall bladder. This mistake could be classified as which type of tort? Assault Battery False imprisonment Defamation of character

Battery

A nursing student is learning about the role of the State Board of Nursing. Which are functions of the State Board of Nursing? Provides for the rights of patients and protects employees Gives nursing home residents the right to be free of restraints Can suspend the license of the nurse who violates licensing provisions Licenses all registered nurses in the state in which they practice Has to follow due process before revoking or suspending a license

Can suspend the license of the nurse who violates licensing provisions Licenses all registered nurses in the state in which they practice Has to follow due process before revoking or suspending a license The State Board of Nursing can suspend or revoke a license if the nurse's conduct violates provisions in the licensing statute. The State Board of Nursing is the governing body and issues licenses to all registered nurses in the state in which they practice. The State Board has to follow due process before revoking or suspending a license; nurses must be notified of the charges against them and be given an opportunity to defend themselves in a hearing. The rights of patients and protection of employees were formulated under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). The right of residents of registered nursing homes to be free of restraints was granted by the Federal Nursing Home Reform Act (1987).

A nursing student is learning about the standards of care for nursing. Which should the student do to maintain high nursing standards? Learn about the Nurse Practice Act in the state. Follow updates in laws and policies practiced. Read current nursing literature in specified practice areas. Avoid using procedures given by the employment agency. Understand current legal issues affecting nursing practice.

Learn about the Nurse Practice Act in the state. Follow updates in laws and policies practiced. Read current nursing literature in specified practice areas. Understand current legal issues affecting nursing practice.

The nurse is explaining the Americans with Disabilities Act (ADA) to a patient with human immunodeficiency virus (HIV). Which information should the nurse include? People with HIV who are asymptomatic also come under the category of disabled people. People with HIV have the right to decide whether to disclose their infection. Healthcare workers have the choice to not treat patients who are HIV positive. Healthcare professionals who are HIV positive can also choose to decide whether to disclose their infection. The motive of ADA is to provide equal opportunities for people with disabilities.

People with HIV who are asymptomatic also come under the category of disabled people. People with HIV have the right to decide whether to disclose their infection. Healthcare professionals who are HIV positive can also choose to decide whether to disclose their infection. The motive of ADA is to provide equal opportunities for people with disabilities.

A patient is admitted to the emergency department with a head injury. The team decides that the patient requires an emergency surgery to stop internal hemorrhage, but the patient's family is not yet at the hospital to provide the consent. Which is the most appropriate action for the team in this situation? Perform the surgery without the informed consent. Provide nonsurgical interventions to stop the hemorrhage. Arrange for an order from the court to perform the surgery. Wait for the family members to arrive to get informed consent.

Perform the surgery without the informed consent. When the intervention is necessary to save the patient's life in an emergency, and there is no family member available to give the consent, the emergency procedure can be performed. The surgery is performed assuming that the patient would have wished to be treated. Providing nonsurgical measures may not be therapeutic and beneficial for the patient. Arranging for a court order to perform the surgery may be time-consuming and may lead to the patient's death. Waiting for the family members to arrive and provide consent may complicate the patient's condition.

The nurse is planning care for a patient going to surgery. Who is responsible for informing the patient about the surgery and possible risks, complications, and benefits? Family member Surgeon Nurse Nurse manager

Surgeon The person performing the procedure is responsible for informing the patient about the procedure and its risks, benefits, and possible complications. Thus, the surgeon is responsible for informing the patient about surgery.

Which actions, if performed by a registered nurse, would result in both criminal and administrative sanctions against the nurse? Taking or selling controlled substances Refusing to provide healthcare information to a patient's child Reporting suspected abuse and neglect of children Applying physical restraints without a written physician's order Administering the wrong medication to the patient

Taking or selling controlled substances Applying physical restraints without a written physician's order The inappropriate use of controlled substances is prohibited by every Nurse Practice Act. A physical restraint can be applied only on the written order of a healthcare provider based on Joint Commission and Medicare guidelines. Refusing to provide healthcare information to a patient's child, reporting suspected abuse and neglect of children, and administering the wrong medication to a patient would not result in both criminal and administrative sanctions against the nurse.

A group of nurses makes a list of patients who require organ transplantation. Which patient would be given priority for organ transplantation? The patient who is most critically ill The patient who is a very young age The patient who will pay more for the intervention The patient who lives in close proximity to the healthcare center

The patient who is most critically ill The patient who is most critically ill or is unstable would be given priority, because receiving the organ transplant can save the patient's life. Young patients would not be given priority for receiving an organ transplant, because they are relatively stable. Being partial toward the patient who is willing to pay more for the intervention is unethical and biased. Giving preference for an organ transplant to a patient who lives in close proximity is inappropriate, because other patients may require it more based on their health condition.

The hospital administrators warn the nurse about being negligent while providing patient care. Which is the most appropriate reason for the warning? The nurse has threatened a patient with the use of physical restraints to control the patient. The nurse has published the wrong assessment findings of a patient in a scientific journal. The nurse has given an excessive dose of hepatotoxic drug to a patient with liver failure. The nurse has informed the spouse about the patient's disease without the patient's consent.

The nurse has given an excessive dose of hepatotoxic drug to a patient with liver failure. Giving an excessive dose of hepatotoxic drug to a patient with liver failure is an example of a negligent act by the nurse. Threatening the patient with the use of physical restraints is an example of assault by the nurse, not a negligent act. Publishing the wrong assessment findings of a patient in a scientific journal is an example of defamation of character tort (libel) but is not considered as negligence in providing care. Informing the spouse regarding the patient's diagnosis without the patient's consent is an example of invasion of privacy; it is not considered an act of negligence.

The nurse has been charged for committing a misdemeanor. Which action will be taken against the nurse? The nurse will be given a warning. The nurse will be asked to pay a fine. The nurse will be suspended from duty. The nurse will be imprisoned for more than 1 year.

The nurse will be asked to pay a fine.

A patient was rushed to the emergency department and then to surgery to repair injuries sustained in a hit-and-run car accident. After surgery, the patient was transferred to the medical-surgical unit for postsurgical management. The healthcare provider informs the nurse that the patient has a durable power of attorney for health care (DPAHC). How should the nurse interpret this information? The patient can decide which medical procedures not to undergo. The patient has designated a person who is solely responsible for making financial decisions when the patient is unable. The patient has expressed in written form the wish not to be sustained on life support. The patient has designated a person who makes healthcare decisions when the patient is not able to make decisions. The patient has designated a person who is solely responsible for making healthcare decisions according to the patient's wishes.

The patient has designated a person who makes healthcare decisions when the patient is not able to make decisions. The patient has designated a person who is solely responsible for making healthcare decisions according to the patient's wishes. A healthcare proxy, or durable power of attorney for healthcare (DPAHC), is a legal document that designates a person or persons of one's choosing to make healthcare decisions when patients can no longer make decisions on their own behalf. This designated person also makes healthcare treatment decisions based on the patient's wishes. A living will is a written document of the patient's wishes regarding measures to be taken in the event of a terminal illness or condition.

The surgical nurse is collecting the necessary documents to obtain a patient's informed consent before a surgery. In which instance should the nurse refrain from obtaining informed consent? The patient voices no concerns regarding the surgery. The patient was administered morphine. The patient's family members are not present. The surgery is associated with risk for severe complications.

The patient was administered morphine. Informed consent is usually obtained when the patient is alert, is able to understand and process information, and can make decisions. Morphine may cause drowsiness, preventing the patient from making informed decisions. Even if the patient voices no concerns or has no questions, the consent form still needs to be presented and explained to the patient. Presence of family members is not necessary for giving informed consent unless the patient is unable to do so for any reason. Every surgery is associated with risks, which are explained in the associated documentation, so this is not a valid reason for not obtaining an informed consent.

The nurse is speaking to a patient who has been diagnosed with human immunodeficiency virus (HIV). The patient could lose his current job if information about the disease is revealed. Which law should the nurse discuss with the patient? Mental Health Parity Act Americans with Disabilities Act Uniform Anatomical Gift Act Patient Self-Determination Act

Americans with Disabilities Act The Americans with Disabilities Act (ADA) protects a person who has been diagnosed as human immunodeficiency virus (HIV)-positive but does not have acquired immunodeficiency syndrome (AIDS). This act protects patients' privacy and gives them the opportunity to decide whether to disclose their disability. The Mental Health Parity Act allows patients with mental illnesses to have insurance benefits. The Uniform Anatomical Gift Act gives any person older than 18 years of age the right to make decisions regarding organ donation. According to the Patient Self-Determination Act, the healthcare institutions should provide written information to patients concerning their right to make decisions.

The nurse is caring for a patient who is extremely irritable and agitated. The nurse first transfers the patient forcefully to an isolated room to avoid disturbing other patients in the ward. The nurse then sedates the patient by giving a morphine injection. Which torts has the nurse committed? Assault Battery False imprisonment Invasion of privacy Defamation of character

Battery False imprisonment The nurse has committed battery and false imprisonment. Battery is intentional touching without the patient's consent. The nurse gives a morphine injection without requesting consent. This is indicative of battery. Transferring the patient to an isolated room indicates false imprisonment. The tort of false imprisonment refers to the unjustified restraint of a person without legal warrant. Assault is an action that places an apprehensive patient within harmful or offensive contact without consent. Threatening the patient to give the injection is an example of assault. Invasion of privacy refers to the unwanted intrusion into the personal matters of the patient. Defamation of character is the publication of false statements about a person that could damage a person's reputation.

The nurse is caring for a patient who is in early stages of cardiac failure. The patient tells the healthcare provider and the nurse that he wishes to end his life without any suffering as soon as possible. Which would be the most appropriate action? Assist the patient in suicide as per his wish. Explain to the patient that his life can be extended. Ask the patient's family to make decisions regarding the patient's death. Ask the patient to wait for court orders regarding the decision.

Explain to the patient that his life can be extended.

A patient is abusive and rude with the student nurse. The student nurse documents that the patient is uncooperative and shows symptoms of alcohol withdrawal. As a result the patient will be transferred to a different floor. Which is the best classification of this nurse's error? Libel Slander Malpractice Invasion of privacy

Libel Libel is documentation of false entries or defamation of character. The nurse is offended by the patient's behavior, so the nurse documents signs of alcohol withdrawal, even though this is not indicated by rude behavior alone. Slander is oral defamation of character. The nurse is documenting the report, but not verbalizing it, so this is not considered slander. Malpractice is negligence of a professional role. This nursing action does not indicate negligence. Invasion of privacy typically involves releasing a patient's private information without the patient's consent. The nurse has not violated the patient's privacy in this instance.

A patient who is hospitalized with chronic illness is depressed and demands to go home. The nurse applies a physical restraint and administers medication to the patient. What does this nursing intervention indicate? The nurse is following Good Samaritan laws. The nurse may be charged with malpractice. The nurse is guilty of invading the patient's privacy. The nurse may be charged with false imprisonment.

The nurse may be charged with false imprisonment. Patients cannot be forced to stay in the hospital against their will, because this constitutes false imprisonment. Good Samaritan laws help protect health care professionals from charges of negligence in providing emergency care. In this case, the patient is not restrained during emergency care, so the nurse is not following Good Samaritan laws. Malpractice is professional negligence, in which the nurse does not provide standard care for the patient. Applying physical restraints does not indicate that the nurse is providing substandard care. Using restraints to stop the patient from going home does not indicate that the nurse is invading the privacy of the patient.

Hospital administrators have warned the healthcare team about invasion of a patient's privacy. Which could have been the reason for this warning? The nurse read text messages on the patient's cell phone. The health care provider asked the nurse to catheterize the patient. The nurse published a report on the patient's condition without his or her consent. The healthcare team provided cardiopulmonary resuscitation (CPR) without the family's consent.

The nurse read text messages on the patient's cell phone.