AZ Ethical Legal/Nursing Jurisprudence adaptive quiz

A nursing supervisor sends an unlicensed assistive personnel (UAP) to help relieve the burden of care on a short-staffed medical-surgical unit. Which tasks can be delegated to the UAP? Select all that apply. 1 Taking routine vital signs 2 Applying a sterile dressing 3 Answering clients' call lights 4 Administering saline infusions 5 Changing linens on an occupied bed 6 Assessing client responses to ambulation

1, 3, 5 Taking routine vital signs is a universal activity that all UAPs are taught to perform regardless of the setting; it is within the job description for UAPs. Answering call lights is a universal activity that all UAPs are taught to perform regardless of the setting; it is within the job description for UAPs. Making an occupied bed is a universal activity that all UAPs are taught to perform regardless of the setting; it is within the job description for UAPs. UAPs do not have the expertise or credentials to apply sterile dressings. UAPs do not have the expertise or credentials to administer intravenous solutions. Registered nurses are not permitted to delegate assessment.

In all states of the United States, what is the professional nurse's legal responsibility regarding child abuse? 1 Honor the request of the parents not to report the suspected abuse. 2 Report any suspected abuse to local law enforcement authorities. 3 Return the child to the legal parent even if he or she is suspected of abuse. 4 Provide the parents with a copy of the child's medical record.

2 In all states in the United States, nurses and physicians are legally responsible for reporting suspected or actual abuse. Child protective services may obtain a court order to grant temporary guardianship if it is found that the child is in immediate danger. The other answer options do not fulfill the nurse's duty to report suspected child abuse.

When a client files a lawsuit against a nurse for malpractice, the client must prove that there is a link between the harm suffered and actions performed by the nurse that were negligent. This is known as: 1 Evidence 2 Tort discovery 3 Proximate cause 4 Common cause

3 Proximate cause is the legal concept meaning that the client must prove that the nurse's actions contributed to or caused the client's injury. Evidence is data presented in proof of the facts, which may include witness testimony, records, documents, or objects. A tort is a wrongful act, not including a breach of contract of trust that results in injury to another person. Common cause means to unite one's interest with another's.

What are the best ways for a nurse to be protected legally? Select all that apply. 1 Ensure that a therapeutic relationship with all clients has been established. 2 Provide care within the parameters of the state's nurse practice act. 3 Carry at least $100,000 worth of liability insurance. 4 Document consistently and objectively. 5 Clearly document a client's non-adherence to the medical regimen.

2, 4, 5 Malpractice or negligence must be proven legally. If a nurse is providing the best possible care under the circumstances, and within the scope of nursing practice, it would be difficult to prove allegations. It is unrealistic that the nurse will have a therapeutic relationship with all clients. Liability insurance protects the nurse if found guilty and a monetary award is made, but it does not reduce the possibility of litigation. Consistent, objective, and clear documentation also support practice within legal parameters.

A client is scheduled for surgery. Legally, the client may not sign the operative consent if: 1 Ambivalent feelings are present and acknowledged 2 Any sedative type of medication has been given recently 3 A discussion of alternatives with two health care providers has not occurred 4 A complete history and physical has not been performed and recorded

2 Sedation may interfere with the client's knowledge of the consent form. Many clients face contradictory feelings regarding their impending surgery, but their consent is legal unless they withdraw the consent. A second opinion is not required for a consent to be legal. A complete history and physical examination are needed before surgery, but they do not affect the legality of consent.

A nurse is preparing a lecture for a group of nursing students related to ethics and legal principles. Which statement would be appropriate to include? 1 Beneficence emphasizes the importance of preventing harm and ensuring the client's well-being. 2 After the nurse has delegated a task or activity, the unlicensed assistive personnel (UAP) is accountable for the task or activity. 3 Social justice is an obligation to protect a client as an advocate when a client is not capable of self-determination. 4 There is a universal list that all states use that describes tasks that can be safely delegated and assigned to nursing team members

1 Beneficence is the ethical principle that emphasizes the importance of preventing harm and ensuring the client's well-being. The nurse is always accountable for the task or activity that is delegated. Social justice refers to equality; that is, all patients should be treated equally and fairly. Each state designates which tasks may be safely delegated and assigned to nursing team members. Test-Taking Tip: Try putting questions and answers in your own words to test your understanding.

A nurse is caring for a terminally ill client who is considering signing an "allow natural death" (AND) document rather than the traditional do-not-resuscitate (DNR) order. In light of the process of grieving, what feeling associated with end-of-life decisions is the AND advance directive attempting to alleviate? 1 Guilt 2 Anger 3 Denial 4 Sadness

1 Many bereaved people blame themselves for not following the correct course of action in preventing the death. By framing the death as part of a natural process rather than the removal of an intervention, the nurse lessens the client's guilt. Anger may occur no matter what course of action is taken. Denial of death is less likely to occur when a DNR or AND is signed. Sadness may occur no matter what course of action is taken.

A state's Nurse Practice Act does not allow a registered nurse (RN) to suture wounds. The primary health care provider offers to teach the RN how to suture and tells the RN that minor wounds may be sutured without supervision. The nurse should: 1 Refuse to suture wounds. 2 Follow the primary health care provider's instructions. 3 Report the situation to the state board of nursing. 4 Agree to suture wounds in the primary health care provider's presence.

1 A state's Nurse Practice Act is the ultimate source relative to a nurse's professional practice; a nurse may not function outside of the legal definition of nursing practice. Performing suturing, with or without supervision, conflicts with the state's Nurse Practice Actt, and the nurse would be functioning outside the legal scope of nursing practice. The state board of nursing does not have jurisdiction concerning this procedure. Performing suturing, with or without supervision, conflicts with the state's Nurse Practice Act, and the nurse would be functioning outside the legal scope of nursing practice.

A graduate nurse is preparing to apply to the State Board of Nursing for licensure to practice as a registered professional nurse. What group primarily is protected under the regulations of the practice of nursing? 1 The public 2 Practicing nurses 3 The employing agency 4 People with health problems

1 Each state or province protects the health and welfare of its populace by regulating nursing practice. Although the members of the nursing profession can benefit also from a clear description of their role, this is not the primary purpose of the law. The employing agency does assume responsibility for its employees and therefore benefits from maintenance of standards, but this is not the purpose of the law. People with health problems are just one portion of the population that is protected; this answer is too limited.

A nurse arrives for work to find that the medical unit is short-staffed. Nursing administration has called several staffing agencies, but they are unable to send a replacement nurse for three hours. The nursing care coordinator sends a recently oriented patient care assistant to help relieve the burden of care. Which activities should the nurse delegate to the patient care assistant? Select all that apply. 1 Making occupied beds 2 Taking routine vital signs 3 Answering clients' call lights 4 Watching a client take oral medications 5 Emptying a closed chest drainage system for intake and output

1 ,2, 3 Patient care assistants can make occupied and unoccupied beds. Taking routine vital signs is within the scope of practice of patient care assistants. Answering call lights and meeting clients' basic safety, hygiene, and comfort needs are within the scope of practice of patient care assistants. Watching a client take oral medications is part of procedure for administration of medications, which requires a professional license. Emptying a closed chest drainage system for intake and output is inappropriate; a closed chest drainage system is not emptied for intake and output. Documentation is indicated on the outside of the drainage collection chamber.

Which action involving client needs may a nurse delegate to a nursing assistant? 1 Assessing a newly admitted client's contraction pattern 2 Discussing pain management options with a laboring client 3 Providing ice chips to a primigravida in early labor per order 4 Obtaining a sterile urine specimen for a suspected urinary tract infection

3 Providing ice chips to a primigravida in early labor per order does not require clinical knowledge or judgment for safe, effective care. Assessment, discussion of alternative actions, and the use of sterile technique during an invasive procedure all require clinical knowledge and judgment beyond the scope of practice of a nursing assistant.

A client with coronary artery disease has a sudden episode of cyanosis and a change in respirations. The nurse starts oxygen administration immediately. Legally, should the nurse have administered the oxygen? 1 The oxygen had not been prescribed and therefore should not have been administered. 2 The symptoms were too vague for the nurse to determine a need for administering oxygen. 3 The nurse's observations were sufficient, and therefore oxygen should have been administered. 4 The health care provider should have been called for a prescription before the nurse administered the oxygen

3 The Nurse Practice Act states that nurses diagnose and treat human responses to actual or potential health problems. Administration of oxygen in an emergency situation is within the scope of nursing practice. Because the client's clinical manifestations reflected an immediate need for oxygen, postponement of treatment could have resulted in further deterioration of the client's condition.

The nurse is caring for a client with diabetes. Which task can be delegated to the unlicensed assistant personnel (UAP)? 1 Assess the client's feet for skin breakdown 2 Educate the client on self monitoring blood glucose 3 Obtain a blood glucose by finger stick 4 Answer questions on signs and symptoms of hypoglycemia

3 The UAP can obtain a blood glucose value and give this information to the nurse to evaluate the result. The UAP cannot assess, educate or evaluate knowledge, or answer questions on signs and symptoms of hypoglycemia. These are all independent functions of the registered nurse.

A visitor from a room adjacent to a client asks the nurse what disease the client has. The nurse responds, "I will not discuss any client's illness with you. Are you concerned about it?" This response is based on the nurse's knowledge that to discuss a client's condition with someone not directly involved with that client is an example of: 1 Libel 2 Negligence 3 Breach of confidentiality 4 Defamation of character

3 The release of information to an unauthorized person or gossiping about a client's activities constitutes a breach of confidentiality and an invasion of privacy. Libel occurs when a person writes false statements about another that may injure the individual's reputation. Negligence is a careless act of omission or commission that results in injury to another. Defamation of character is the publication of false statements that injure a person's reputation.

Which of the following legal defenses is the most important for a nurse to develop? 1 Dedication 2 Certification 3 Assertiveness 4 Accountability

4 The concept of accountability is of high priority in nursing practice. As a licensed professional, the nurse is always accountable, which means liable and answerable for his or her actions. Dedication means to be committed, and assertiveness means to be confident. These are desired characteristics in a nurse but not legal defenses. Certification relates to achieving a higher level of knowledge or proficiency in one's area of specialization and is also not a legal defense.

A client who recently gave birth is transferred to the postpartum unit by the nurse. What must the nurse do first to avoid a charge of abandonment? 1 Assess the client's condition. 2 Document the client's condition and the transfer. 3 Orient the client to the room and explain unit routines. 4 Report the client's condition to the responsible staff member.

4 Because the nurse is responsible for the client's care until another nurse assumes that responsibility, the nurse should report directly to the client's primary nurse. Making an assessment of the client's condition is not enough. Although documentation is important, it is insufficient. Orienting the client to the room and explaining unit routines is insufficient. Although the nurse should carry out these activities, they may be done after the nurse reports the client's condition to the staff.

A nurse working in an emergency department is concerned about a recent increase in malpractice claims against nurses. What is the best way for the nurse to avoid being named in a lawsuit? 1 Carry malpractice insurance. 2 Write vague incident reports. 3 Transfer to another department. 4 Attend professional development programs

4 The best way to prevent professional negligence (malpractice) is to attend continuing education programs and improve practice; additional education is advisable when one is working in specialty areas, such as emergency departments or intensive care areas. Insurance is helpful after an incident, but it will not prevent malpractice claims. Writing vague incident reports is not professional; incident reports should be detailed. Avoiding the issue by transferring to another department will not solve the problem. Each area of nursing practice requires expertise.

A nurse providing care in a hospital witnesses a client's spouse shaking the client vigorously because the client has had an episode of incontinence. Because of the suspicion of physical abuse, legally, the nurse should discuss the concerns with: 1 The client 2 The client's spouse 3 The client's primary health care provider 4 Adult Protective Services

4 The nurse has a legal responsibility to report suspicions of abuse to the appropriate agency, which in this instance is Adult Protective Services. The client will not be able to understand the discussion. It is not the nurse's responsibility to directly challenge the spouse's behavior in this situation; the nurse may act as a client advocate by interrupting the spouse's behavior and providing immediate physical and emotional care. The nurse should then report suspicions of abuse to Adult Protective Services. Although the nurse may report suspicions about the spouse's behavior to the health care provider, the law requires that Adult Protective Services be notified.

A client signs a legal consent for hip replacement surgery. Shortly before surgery, the client states, "I decided not to go through with the surgery." What is the best initial response by the nurse? 1 "Then you shouldn't have signed the consent." 2 "I can understand why you changed your mind." 3 "Tell me why you decided to refuse the operation." 4 "Let's talk about your concerns regarding the procedure."

4 The response "Let's talk about your concerns regarding the procedure" attempts to explore why the client is refusing the procedure and promotes communication. The response "Then you shouldn't have signed the consent" is accusatory; the client has the right to withdraw consent at any time. The response "I can understand why you changed your mind" draws a conclusion without adequate data; also, it may increase the client's anxiety level. The response "Tell me why you decided to refuse the operation" may be too direct and authoritative; also it may put the client on the defensive.

Which intervention may be delegated to nursing assistive personnel (NAP)? Select all that apply. 1 Having a client care technician obtain routine vital signs 2 Increasing oxygen from 2 to 3 L/minute if oxygen saturation is below 90% 3 Evaluating a wound during a dressing change by a licensed practical nurse (LPN) or licensed vocational nurse (LVN) 4 Having a client care technician ambulate a stable client 5 Reading and evaluating telemetry monitors by a trained monitor technician

1, 4 Some state boards of nursing identify specific activities that may be delegated to NAP, such as obtaining routine vital signs on stable clients, feeding or assisting clients at mealtimes, ambulating stable clients, and helping clients with bathing and hygiene. However, nursing interventions that require independent nursing knowledge, skill, or judgment, such as assessment, client teaching, and evaluation of care cannot be delegated. Although LPNs and LVNs may change dressings, evaluation of wounds must be done by the registered nurse (RN). Clients who have low oxygen saturation levels and telemetry readings must be evaluated by the RN