Prep U legal questions

Legal Safeguards for Nurses

1. competent practice 2. informed consent or refusal 3. contracts 4. collective bargaining 5. patient education 6. executing physician orders 7. documentation 8. adequate staffing 9. whistle- blowing 10. professional liability insurance 11. risk management programs 12. incident, variance, or occurrence reports sentinel events and never events 13. patients' rights 14. Good Samaritan laws.

A nurse observes another nurse place an unused dose of narcotics in their pocket. If caught, the nurse could be charged with which type of crime?

A felony is a serious criminal offense, and includes actions such as stealing narcotics, murder, falsifying medical records, and insurance fraud. A misdemeanor is a minor criminal offense; a tort is a lawsuit in which a plaintiff charges that a defendant committed a deliberately aggressive act. Negligence is harm that results because a person did not act reasonably.

A client being discharged from the hospital asks the nurse, "When I go visit my family out of state, should I take my living will with me, or do I need a new one for that state?" Which is the most appropriate response by the nurse?

A separate or different advance directive is not needed for each state; an advance directive can be used in any state, regardless of where it was created. The nurse should advise the client to take it when travelling out of state. The client should not assume that the family knows the client's wishes; the whole purpose of having an advance directive is to avoid the ambiguity and potential confusion that making such assumptions can cause. Other hospitals may not know who to contact to request a copy of the advance directive; therefore, it would be much safer for the client to take a copy of it while travelling.

Which process evaluates and recognizes educational programs as having met certain standards?

Accreditation is the process by which an educational program is evaluated and recognized as having met certain standards. Credentialing refers to ways in which professional competence is ensured and maintained. Licensure is the process by which a state determines that a candidate meets certain minimum requirements to practice in the profession—and grants that person the license to do so. Certification is the process by which a person who has met certain criteria established by a nongovernmental association is granted recognition in a specified practice area.

What is an example of an unintentional tort?

An unintentional tort occurs when the nurse does not intend harm, but harm occurs (e.g., the nurse administers a medication and the client has an adverse reaction to it). The other three responses are intentional torts.

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 constitute which element of liability related to malpractice?

Breach of duty is failing to meet the standard of care, and in this case, it was the failure to execute and document the use of appropriate safety measures. Causation is the failure to use appropriate safety measures, which results in injury to the client. Duty refers to an obligation to use due care and is defined by the standard of care appropriate for the nurse-client relationship. Damages refers to the actual harm or injury that the client incurs.

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:

Clients communicate their wishes to health care providers by verbally participating in health care decision making and by employing written documents called advance directives. A will is a legal document where one communicates wishes of how to dispose of personal effects and belongings upon one's death. The terms license and standard of care have no application in this scenario.

A nurse talks with family members about an AIDS client from the clinic where the nurse works. Which tort has the nurse committed?

Invasion of privacy involves a breach of keeping client information confidential. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property. Slander is oral defamation of character. Assault is a threat or attempt to make bodily contact with another person without that person's consent.

Patient Care Partnership

Replacing the AHA's Patients' Bill of Rights, this plain language brochure informs patients about what they should expect during their hospital stay with regard to their rights and responsibilities.

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 statement is true regarding how the Good Samaritan law applies to this case?

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 in this scenario; moreover, Good Samaritan laws apply to those who do not accept any compensation for services 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 lay people. In cases of gross negligence, health care workers may be charged with a criminal offense.

What governing body has the authority to revoke or suspend a nurse's license?

The State Board of Nurse Examiners in the United States may revoke or suspend a nurse's license or registration. The employing health care institution may have submitted the paperwork regarding the allegation of the issue but does not suspend or revoke the nurse's license. The National League for Nursing is a national organization for faculty nurses and leaders in nurse education. The Supreme Court is the highest judicial court in a country or state. The Supreme Court does not rule on a nurse's license.

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 the signature on a will do not need to read it, but they should be sure the document being signed is a will and not some other document. Witnesses should watch the testator sign the will, and they should sign it in the presence of each other. A beneficiary to a will is not allowed to act as a witness in most states. Two or three witnesses are most commonly required on a will.

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 living will is an advance directive that specifies the type of medical treatment clients do or do not want to receive should they be unable to speak for themselves in a terminal or otherrwise unconscious condition. A will is a legal document detailing how to dispose of one's assets and belongings upon death. Proof of health care power of attorney and a proxy directive are documents identifying another person to legally make health care decisions for the client. In this case the client is stating the client's own decisions in advance of potential incapacitation.

During a nursing shift, which events warrant completion of an incident report? Select all that apply.

An incident report is a written account of an unusual, potentially injurious event involving a client, employee, or visitor. Late administration of medication is considered a medication error and is potentially injurious to the client. A visitor fall and a client fall are both reportable situations. A client crying following a diagnosis of cancer could be expected, and a registered nurse delegating appropriate care to a UAP is not reportable. Therefore, these actions do not require an incident report to be filed.

A nurse who comments to coworkers at lunch that a client with a sexually transmitted infection has been sexually active in the community may be guilty of what tort?

Defamation of character is an intentional tort in which one party makes derogatory remarks about another, with those remarks harming the other party's reputation. Slander is spoken defamation of character; libel is written defamation. Assault is a threat or an attempt to make bodily contact with another person without that person's consent. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property.

The nurse is providing care to a client whose condition has progressively declined. The nurse assesses and makes appropriate interventions as well as notifies the health care provider. Despite the nurse's efforts, the client expires. What element of liability has the nurse demonstrated?

Duty refers to an obligation to use due care. The nurse assessed the client and made appropriate interventions and notifications. Breach of duty is the failure to meet the standard of care. An example of breach of duty would be not performing assessments, appropriate interventions, and notifications of the health care provider. Causation is when the breach of duty caused the injury. An example of causation would be failure to perform assessment and appropriate interventions when providing client care, and this caused injury to the client. Damages are the harm or injury that occurred to the client. In this situation, it would be the death of the client.

During the admission assessment of a client with a suspected mandibular fracture, the client discloses to the nurse that the injury results from the client's spouse hitting the client. Which action should the nurse prioritize when responding to this disclosure?

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.

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?

Sharing a client's information without the client's consent is an invasion of privacy. The nurse should not give out the information even if the visitor provides proof of a relationship without the client's consent. It is inappropriate to call the client to ask for permission. The nurse claiming to be busy and offering to talk later does not address the issue but only delays it, perhaps leading the visitor to assume that the nurse will disclose information then.

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 by the nurse educator would further explain the Scope and Standards of Practice for Professional Care Nursing to the new nurse?

The Scope and Standards of Practice for Professional Ambulatory Care Nursing are the standards of care for nurses working in the ambulatory arena. It does not take precedent over the facility's policies and procedures, but must be worked in conjunction with the policies and procedures. It is not used for assessing nurses. NCLEX determines if a nurse is minimally competent to practice as a nurse.

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?

The facility and nurse could be charged with malpractice, which is failing to perform (or performing) an act that causes harm to a client. Administering the medication intravenously instead of orally as prescribed has caused harm to a client. Negligence is failing to perform care for a client. When a person threatens to touch a client without consent, it is assault, whereas battery is carrying out the implied threat (assault).

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?

The health care institution determines the unit and institutional policies. These policies may vary from institution to institution. Such policies may include clinical procedures, policies specific to the institution, and personnel and employment policies. Unit and institutional-based policies are not derived from federal legislation, state legislation, or the board of nursing.

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?

The nurse should ensure that the client's family signs the consent form. However, in some states and health care facilities, it is the physician who ensures that the client's family signs the consent form. The client cannot sign the consent form if not in an alert state or unable to communicate. If the client is not in a condition to sign the consent form, a family member may sign the consent form on the client's behalf. Advance directives are written statements identifying a competent person's wishes concerning terminal care and are not applicable here. A living will is an instructive form of advance directive; that is, it is a written document that identifies a person's preferences regarding medical interventions to use in a terminal condition, irreversible coma, or persistent vegetative state with no hope of recovery.

Having recently completed a specialty nursing program in neonatal care, a nurse is now preparing to leave the medical unit and begin providing care in the hospital's neonatal intensive care unit (NICU). The nurse has completed which process of credentialing?

The process of certification involves the attainment and validation of specialized nursing knowledge and skills. Certification is often necessary to ensure that the nursing care provided in specialized and high-acuity settings is safe and appropriate. Accreditation is the process by which an educational program, rather than an individual nurse, is identified as meeting standards. The process of licensure involves the determination that a nurse meets minimum requirements to practice but not necessarily that the nurse has the specialized knowledge that is necessary for some care settings. Validation is not a specific aspect of the process of credentialing.