NURSE CH8 Online Exam Review Questions
When is it acceptable for a nurse to post information about a pt on a social networking site?
It is inappropriate to post pt information online Patients can still be identified even if their name is not provided. Individuals can be identified even if the posting is done anonymously or by using a pseudonym. There is a mistake and believe the privacy controls allow the communication to be viewed only by the intended recipient. It is the nurses role to safeguard all patient information learned in the course of treatment. It is to be shared only on a need to know basis with members of the healthcare team directly involved in the patient's care, when legally required, or where failure to disclose may lead to significant harm
Which of the following persons can legally give consent to a procedure?
A legal guardian of a child. A legal guardian is an individual who has been appointed by a court and has full legal rights to make choices regarding care for another individual. A person who received narcotics more than 1 hour ago may be sedated, unable to fully understand the consequences of his or her decisions, or both. The usual age at which a patient can give permission for procedures is 18 years, as long as the patient is legally competent. An advocate does not have a legal right to choose care management. An advocate speaks for a child or an adult when the person cannot speak for himself or herself, but the advocate does not have the legal right to make choices about care or to give consent.
When a nurse stops to help in an emergency at the scene of an accident, if the injured party files suit and the insurance of the nurse's employing institution does not cover the nurse, she would probably be covered by which of the following?
A provincial/territorial Good Samaritan law, which grants immunity from suit if there is no gross negligence. Some provinces and territories have Good Samaritan laws, which grant immunity from lawsuits if the nurse follows the standards of care that a nurse of his or her experience would prudently have followed.
The nurse notes that an advance directive is in the patient's medical record. The nurse recognizes which correct interpretation of advance-directive provisions?
A proxy directive allows an appointed person to make health care decisions when the patient is in an incapacitated state. An advance-care directive allows an appointed person to make health care decisions for the patient when the patient is unable to do so. A durable power of attorney is invoked only when the patient can no longer speak for himself or herself. A living will provides for end-of-life wishes such as anticipatory refusal of life-prolonging measures during a future state of mental incompetence. The patient may change an advance directive at any time.
Treating a patient without his or her consent is considered
Battery Any intention of physical contact such as treating a patient without the patient's consent is considered battery
Which of the following regulates hospitals to ensure safety in the provision of services, establishes criteria that must be met for a hospital to receive funding from the government, and provides for penalties if guidelines are not followed?
Canadian Council on Health Services Accreditation. Hospitals in Canada must be accredited in order to provide service to patients. If a hospital fails to meet the criteria of the Canadian Council on Health Services Accreditation, service must be altered to adhere to the accreditation guidelines. Hospitals follow quality improvement and risk management programs to ensure ongoing improvement to service delivery.
The nurse notes that the health care unit keeps a list of patients' names at the front desk in clear view so that health care providers can more efficiently locate patients. The nurse knows that this action is a violation of which of the following?
Common law tort relating to invasion of privacy. Canadian common law provides for patient privacy and confidentiality.
Which of the following statements is correct?
Consent for medical treatment may be given by anyone who understands the risks, benefits, and consequences of both having and not having a treatment or procedure. Laws differ between provinces and territories, but in general, if a person is able to understand the benefits and risks to both having and not having a procedure and alternatives to a procedure, then that person's consent is legally valid. No formal laws govern therapeutic abortion in Canada, although legal precedents exist that enable some provinces and territories to choose to provide these services. Student nurses are liable for their performance according to their level of knowledge at the time of providing care. Patient abandonment rules do apply if the nurse leaves without waiting for a replacement to arrive, talking directly to the supervisor, or both.
The nurse must follow standards of care to avoid potential litigation such as negligence suits. Which of the following describe a potential nursing malpractice situation?
Failure to question a health care provider about the appropriateness of a patient order Failure to make a nursing diagnosis. Failure to properly use medical equipment ordered for patient monitoring. Failure to follow the "seven rights" of medication administration. Failure to provide discharge instructions. All of the answers represent possible nursing malpractice situations.
The best way for a nurse to avoid being liable for negligence might be to do which of the following?
Follow standards of care Give safe, competent care in a caring manner Document assessments, interventions, and evaluations as soon as possible after performing them Of the actions listed, failure to report a person whose professional behaviour is questioned is the only one that would expose the nurse to liability for negligence. By law and the guidelines of the nursing practice act in a given province or territory, the nurse is required to report any unsafe or unethical professional behaviours that are observed. Failing to report negligent behaviour is against the law.
The standard-practice legal definition of death that facilitates organ donation is cessation of which of the following?
Functions of the entire brain. Manitoba is the only province that has a statutory definition of death: the "irreversible cessation of all brain function." This definition allows for the recovery of organs for transplantation. Individuals who are not donors typically are pronounced dead when there is a total cessation of circulatory and respiratory functions.
Which of the following is an appropriate task that a nursing student may perform while employed as a nursing aid?
Give a bed bath Even if a student has learned a skill while in nursing school, student nurses should not perform tasks that do not appear in the job description for the level of caregiving in which they are employed.
A nurse stops to help in an emergency at at the scene of an accident. The injured party files a suit and the nurse's employing institution insurance does not cover the nurse. What would probably cover the nurse in this situation?
Good samaritan laws, which grant immunity from suit if no gross negligence is involved A nurse is providing emergency assistance at an accident scene would not be covered by homeowners or an employer is insurance policy because the caregiver and would not be the responsibility of the employer. However some provinces have passed good Samaritan laws the prevent voluntary rescuers from being sued for wrongdoing unless it can be proved that they displayed gross negligence. Alberta has the Alberta's emergency medical act
A patient who is confused is left alone in bed with the side rails down and the bed in a high position, and the patient falls and breaks a hip. In legal terms, what has occurred?
Negligence Knowing what to do to prevent injury is part of the standard of care that nurses must follow. Negligence is conduct that falls below the standard of care that protects others against unreasonable risk of harm. Assault is the threat to engage in harmful or offensive contact. Battery is the actual unlawful touching of another, whether threat of harm is included or not. Intentional touching without permission or consent is not lawful. A civil tort is a civil wrong committed against a person or property. An example of a tort involving property would be to lose the patient's dentures by misplacing them.
A confused pt falling out of bed because side rails were not used when they were ordered is an example of which type of liability?
Negligence Negligence in nursing is conduct that falls below a standard of care established by the law. No intent is needed for negligence to occur. It is characterized chiefly by inadvertence, thoughtlessness, or in attention. Therefore, feeling to raise the side rails when they're ordered is negligence
What should you do if you think the pt does not understand the procedure for which he or she is being asked to give consent?
Notify the physician or nursing supervisor Obtaining informed consent is part of the physician patient relationship. If a nurse suspects that the patient does not understand the procedure for which he or she is being asked to give consent or has consented to, the nurse must notify the physician or nursing supervisor
Canadian common law provides patients with basic privacy rights pertaining to their medical records. Which of the following is a violation of these provisions?
Posting daily nursing care information along with the medical condition of patients on a message board in the patient's room. Posting information including the medical condition of patients on a message board is a violation of invasion-of-privacy common law provisions. This information should be kept confidential and should not be placed in a location where visitors might view it. Because the patient has given permission for the family to have the information, releasing the information to them is not a violation of privacy. It is common practice for the student to review only the chart of an assigned patient, and only the student assigned to that patient may see it. Discussing patient conditions in the nursing report room is the sharing of the information in a private setting with other health care providers for the patient.
The nurse working on a cardiac unit is taking care of a patient who recently underwent coronary bypass surgery. Which of the following represent legal sources of standards of care that nurses use to deliver safe health care?
Regulations identified by the provincial/territorial association or college manual. Policies and procedures of the employing hospital. Nursing practice act of the province/territory in which the nurse is working. Canadian Nurses Association standards of nursing practice. All except the information provided by the head nurse provide legal guidelines for minimum acceptable nursing care.
The nursing practice acts are an example of
Statute law Statute law is created by elective legislation body such as Parliament and provincial or territorial legislature's. Examples of provincial statutes are the nursing practice act throughout the country, which describe and define nursing practice with in each province
Nurses are bound by a variety of laws. Which of the following descriptions of types of law is correct?
Statutory law is created by elected legislatures, such as the provincial or territorial legislature that defines the nursing practice act. Statutory law is created by legislatures. These bodies enact statutes such as the nursing practice act, which defines the role of the nurse and expectations of the nurse's performance of his or her duties and explains what is contraindicated as guidelines for the breach of those regulations. Regulatory law or administrative law is created by a provincial/territorial administrative body such as the association or college of nursing, which passes rules and regulations. Common law is created by judicial decisions in court on the basis of individual cases that are decided. Criminal law is intended to prevent harm to society and provide punishment for crimes.
A nursing student is unsure about the legal liability of using skills associated with placement as a student. Which of the following is true about legal liability for a nursing student?
Student nurses, like all other nurses, are accountable for their own actions. Usually faculty members are responsible for instructing and observing students; however, there are some situations in which staff nurses may share these responsibilities. Nursing students should never perform tasks they have not been taught; instructors should supervise all new skills that are being performed. Nursing students must know their own capabilities and competencies and must not perform nursing actions unless competent to do so. Nursing students should never be assigned to perform tasks for which they are unprepared, and they should be carefully supervised by instructors as they learn new skills. Faculty members are usually responsible for instructing and observing students, but in some situations, staff nurses serving as preceptors may share these responsibilities.
What is the primary reason that the nurse should understand law?
The nurse can be an advocate for patient rights. As an advocate for the patient, the nurse must make sure that "safe, effective care" is given in conformity with the nursing practice act of the province or territory where the nurse works. The patient is the primary recipient of care and is the most important party in health care relationships. Self, hospital, and physicians are secondary to the outcomes of patient care. Nurses should focus on giving correct care to avoid lawsuits. Legal review is a good practice to follow but is not a required hospital policy. The nurse's first responsibility is to the patient. Giving proper care will protect an employer from many lawsuits.
Most litigation involving hospital care is related to which of the following situations?
The nurse follows an order that is incomplete or incorrect. The nurse is responsible for clarifying all orders that are illegible, unreasonable, unsafe, or incorrect. When a nurse leaves for lunch or leaves the floor, another person is notified and takes responsibility for the management of the patients left on the floor. Chart keeping is not meant to be punitive or to lay blame on the physician by describing everything in great detail. The supervisor is responsible for knowing the skills of every worker who provides care under that supervisor's authority.
The nurse is obligated to follow a prescriber's order unless
The order is in error, violates hospital policy, or would be detrimental to the pt This is it and is responsible for directing medical treatment. Nurses are obligated to follow physicians orders unless they believe the orders are in error, Violet hospital policy, I would harm patients
When the nurse signs a form as a witness, the nurse's signature shows which of the following regarding the patient?
The patient has signed that form and the witness saw it being done. The nurse's signature as a witness indicates only that the person signing the form was indeed the person whose name was on the form. The witness does not have to know whether the patient was fully informed or not. The witnessing agent is indicating no judgement about the level of cognitive function of the patient by signing as a witness. The nurse should assess for coercion, but the signature of the witness is not an acknowledgement of having performed such an assessment. If the witness feels that someone is forcing a patient to sign, however, then the witness may refuse to sign, and the contract is then void (unless a different witness signs).
A patient can be admitted to a mental health facility and treated without his or her consent under which of the following circumstances?
The patient has threatened to harm himself or herself or others. According to provincial and territorial mental health legislation, if the patient may cause harm to self or others, police officers (or other authorized parties) may bring the patient to a health care facility for examination and treatment without the patient's consent. The next of kin cannot override a patient's autonomy. Although a psychotic episode may have potential untoward effects, the patient must be the one to consent to treatment.
A nurse is sued for failure to monitor a patient appropriately. Which statements are correct about professional negligence lawsuits?
The person filing the lawsuit has the burden of proof The plaintiff must prove that a breach in the prevailing standard of care caused an injury The plaintiff (the person filing the suit) has the burden of proof and must prove that a breach in the prevailing standards of care caused an injury. The nurse would be a defendant in this case. The plaintiff, not the defendant, must prove injury, damage, or loss.
Even though the nurse may obtain the patient's signature on a form, who has the responsibility to obtain informed consent?
The physician The person responsible for performing the given procedure has the responsibility for obtaining the informed consent.
A nurse is sued for negligence for failure to properly monitor a patient after surgery. Which of the following statements are correct?
The pt must prove that harm or injury occurred The pt must show the nrs provided substandard of care The pt must show the nrs's actions or inactions caused the injury Essential elements of negligence are having a duty of care, bridging the duty by providing substandard care, and harm or any injury that resulted from the nurses actions or inactions
When a pt is harmed because of nursing student's actions or lack of action, the liability is generally held by the
student instructor/preceptor hospital/health care facility If a patient is harmed as a direct result of a nursing student actions or lack of action, the liability is generally shared by the student, the instructor, the hospital or healthcare facility, and the University or educational institution