Ch 3 Laws & Ethics
A client who is scheduled for hernioplasty needs clarification regarding the procedure. The nurse calls the physician at the client's insistence. The physician, who is in a bad mood, is overheard telling the client that the nurse is incompetent and does not know anything. Which of the following legal torts has the physician committed? A) Libel B) Battery C) Assault D) Slander
Ans: D Feedback: The physician has committed slander by defaming the nurse orally. Slander is a character attack uttered orally in the presence of others. Libel refers to damaging statements written and read by others. Assault is an act in which bodily harm is threatened or attempted. Battery is unauthorized physical contact, not applicable in this situation.
A nurse witnesses a traffic accident in which a child is badly hurt. The nurse dresses the open wounds sustained by the child. The family tries to give monetary compensation, which the nurse refuses. Later, in the hospital, the child develops complications due to infection in the wound. The family holds the nurse responsible for the complications and wants 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, as she did not accept the compensation. C) The Good Samaritan law is not applicable to health care workers. D) The Good Samaritan law provides absolute exemption from all forms of prosecution.
Ans: A Feedback: 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 lay people. In cases of gross negligence, health care workers may be charged with a criminal offense.
A client informs the nurse that he wants to discontinue his treatment and go home. Later, the nurse finds the client dressed to leave. What action should the nurse take in this situation? A) Let the client go after signing a document stating he is going against medical advice. B) Restrain the client until his medical treatment is over. C) Call the physician and get his discharge paper signed. D) Warn the client that he may not be able to access health care again.
Ans: A Feedback: If a client wishes to go before his medical treatment is finished, he should sign a document indicating personal responsibility for leaving against medical advice. The nurse should not restrain the patient, as it would make the nurse liable for legal action. The nurse may call the physician and get the discharge paper signed, but this is not appropriate. The nurse cannot warn the client that he will be denied health care in future, because it is his right to access the health care facility whenever he needs.
A nurse assesses a client with psychotic symptoms and determines that the client likely poses a safety threat and needs vest restraints. The client is adamantly opposed to this. What would be the best nursing action? A) Contact the physician and obtain necessary orders B) Restrain the client with vest restraints C) Ask a family member to come in to supervise the client D) Apply wrist restraints instead of vest restraints
Ans: A Feedback: If a nurse feels that a client needs to be restrained, the nurse should inform the physician and obtain necessary orders. The nurse should also discuss this with the client's family members and ask their opinion. Applying a wrist restraint instead of a vest restraint is inappropriate if a vest restraint is genuinely necessary. It would be inappropriate to delegate this aspect of care to a family member.
After several years of providing bedside care in an inpatient setting, a nurse has taken a position with the state board of nursing. In this role, the nurse may contribute to which of the following activities of a state board of nursing? A) Issuing and transferring nursing licenses within the state B) Providing consultation on ethically challenging clinical situations C) Promoting the visibility of the nursing profession within the state D) Allocating financial resources within clinics and hospitals in the state
Ans: A Feedback: State boards of nursing perform multiple roles, including issuing and transferring licenses of nurses in the state. Consultations on ethics, allocation of resources, and promotion of the nursing profession are not typical activities of state boards of nursing.
A home care nurse is caring for a paralyzed client who needs regular position changes and back massages. A man identifying himself as a family friend inquires if he can be of any help to the family. What should be the nurse's response be? A) The nurse should ask the man to talk to the family directly. B) The nurse should invite the man to learn the caring techniques. C) The nurse should state that the family does not need any help. D) The nurse should refer the man to the local social worker.
Ans: A Feedback: The nurse should ask the man to talk to the family directly. Revealing information about the client's care is a violation of the client's privacy. The nurse should not invite the gentleman for a learning session because it would be a breach of the client's right to privacy. Referring him to a social worker is not an appropriate choice.
A client is admitted with symptoms of psychosis. The nurse hurries to the client's room when she hears the client calling for help. She finds the client lying on the ground. The nurse assists the client back to the bed and performs a thorough assessment. The nurse informs the physician and completes the incident report. Which of the following statements should the nurse document in the incident report? A) The client was trying to lower the side rails. B) The client was found lying on the floor. C) The client was trying to get out of the bed. D) The client was not aware that he had fallen.
Ans: B Feedback: An incident report is a written account of an unusual, potentially injurious event involving a client, an employee, or a visitor. All of the details given in the incident report should be accurate and not assumed. Accurate and detailed documentation helps to prove that the nurse acted reasonably or appropriately in the circumstance. The nurse should document that the client was found lying on the floor. The other statements are assumptions and should not be included in the incident report.
A client who has undergone resection of the intestine is on a liquid diet with a nasogastric tube in place. He refuses the food tray with regular food that comes to his room and insists that a physician be called. The nurse insists that it is the right food and makes the client to take it. The client develops complications and has to be reoperated upon. How is negligence determined in this situation? A) The nurse did not call the physician when the client asked. B) The nurse did not realize the importance of the tube. C) The dietary department sent the wrong diet for the client. D) The nurse did not communicate clearly with the client.
Ans: B Feedback: Negligence is defined as harm that occurs because the person did not act reasonably. In this case, the nurse did not realize that the client was on a nasogastric tube, and should consequently have been on liquid feeds after intestinal surgery; as a result, the patient developed complications. The acts of not calling the physician and communicating poorly do not amount to negligence. The dietary department sending the wrong food is unrelated to the nurse.
A nurse is applying for professional liability insurance. The nurse knows that professional liability insurance is important for which of the following reasons? A) To obtain sound compensation for work that is performed B) To mitigate the financial obligations arising from unexpected health outcomes C) To upgrade professional knowledge and meet standards of practice D) To meet the requirements of the state board of nursing
Ans: B Feedback: The number of lawsuits involving nurses is increasing. It is to every nurse's advantage to obtain liability insurance and to become familiar with legal mechanisms, such as Good Samaritan laws and statutes of limitations that may prevent or relieve culpability and provide a sound legal defense. Professional liability insurance does not focus on upgrading the nurse's professional knowledge, meeting state board of nursing requirements, or obtaining sound compensation.
The physiotherapist, during his usual care to the client, expresses his concern regarding his exposure to sex workers at an early age. The client discovers that the nurse has revealed the information to the physiotherapist. With what legal action could the nurse be charged? A) Libel B) Slander C) False imprisonment D) Unintentional tort
Ans: B Feedback: The nurse can be charged with slander, which is a character attack uttered orally in the presence of others. Libel includes damaging statements written and read by others. The description is also not appropriate for false imprisonment. Slander is considered to be an intentional tort.
An HIV-positive client discovers that his name is published in a report on HIV care prepared by his nurse. He strongly opposes this and files a lawsuit against the nurse. Which of the following offenses has this nurse committed? A) Unintentional tort B) Invasion of privacy C) Defamation D) Negligence of duty
Ans: B Feedback: The nurse has committed the tort of invasion of privacy. Personal names and identities are concealed or obliterated in case studies or research work. Invasion of privacy is a type of intentional tort. Defamation is an act in which untrue information harms a person's reputation, and is therefore not applicable here. Negligence is the harm that results because a person did not act reasonably.
A nurse in a psychiatric care unit finds that a client with psychosis has become violent and has struck another patient in the unit. What action should the nurse take in this case? A) Do not restrain the client, as it is equivalent to false imprisonment. B) Restrain the client, as he is harmful to the other patients. C) Do not restrain the client, as it is equivalent to battery. D) Inform the physician and complete a comprehensive assessment.
Ans: B Feedback: The nurse should restrain the client because he is potentially harmful to other patients in the psychiatric care unit. Restraints should be used as a last resort and their use should be justified. Unnecessary restraining can lead to allegations of false imprisonment and battery; both are not applicable in this case, however. The nurse should inform the physician about the client, but sometimes it may not be logical to wait for orders to restrain a violent client.
A client with a bone infection had a central venous catheter ordered for the long-term administration of antibiotics. The intravenous line was inserted at the bedside by a qualified nurse, but the nurse was observed to make a serious lapse in aseptic technique and the client developed sepsis. What type of law most directly addresses this situation? A) Criminal law B) Civil law C) Common law D) Statutory law
Ans: B Feedback: This nurse has committed a breach of duty, which is an offense under civil law. It is unlikely that this constitutes a criminal offense. Statutory law and common law do not address such events that involve an act between two individuals.
A group of nursing students are reviewing the ANA's current code of ethics. A code of ethics is important in the nursing profession because A) Nurses are highly vulnerable to criminal and civil prosecution in the course of their work B) Nurses interact with clients and families from diverse cultural and religious backgrounds C) Nursing practice involves numerous interactions between laws and individual values D) Nurses are responsible for carrying out actions that have been ordered by other individuals
Ans: C Feedback: A code of ethics is necessary to guide nurses' conduct, especially with regard to the interaction between laws and individual values. Diversity and legal liability do not provide the main justification for a code of ethics, though each is often a relevant consideration. The fact that nurses often carry out the orders of others is not the justification for a code of ethics.
A nurse is caring for a client with multiple sclerosis. The client informs the nurse that a lawyer is coming to prepare a living will and requests the nurse to sign as witness. Which of the following actions should the nurse take? A) State that the physician will be a witness B) Arrange for other colleagues to sign as a witness C) Note that the nurse caring for the client cannot be a witness D) Inform the physician about the living will
Ans: C Feedback: A living will is an instructive form of an advance directive. 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. Employees of the health care facility should not sign as witnesses; therefore, the nurse cannot sign as witness. Refusing a client may not be a good communication method; instead, the nurse could politely indicate the reason for declining. Calling for a physician or asking another colleague to sign is an inappropriate action.
A nurse is caring for a client who has undergone coronary angioplasty. The cardiac monitor is showing abnormal ECG waves, indicating arterial fibrillation. The nurse does not recognize the importance of the sign. As a result, the client's condition deteriorates and the client has to be taken up for an emergency procedure. Which of the following describes the nurse's legal liability? A) Felony B) Defamation C) Tort D) Slander
Ans: C Feedback: A tort is a cause of action in which one person asserts that a physical, emotional, or financial injury was a consequence of another person's actions or failure to act. A tort implies that a person breached his or her duty to another person. In this case, the nurse had a duty that was breached. A felony is a serious criminal offense, such as murder. Defamation is an act in which untrue information harms a person's reputation. Slander is a character attack uttered orally in the presence of others.
A nurse who works on a palliative care unit has participated in several clinical scenarios that have required the application of ethics. Ethics is best defined as A) The relationship between law and culture B) Moral values that are considered to be universal C) The principles that determine whether an act is right or wrong D) The laws that govern acceptable and unacceptable behavior
Ans: D Feedback: Ethics involves moral or philosophical principles that direct actions as being either right or wrong. Laws are often rooted in ethics, but the two terms are not synonymous. Similarly, morals and values are closely associated with ethics, but these do not constitute the definition of ethics. Ethics are not universally agreed upon, as many different applications exist.
A nurse warns a client who has a recent history of seizures that he may fall off his bed during a seizure attack if he does not leave the side rails of the bed raised. Before leaving the client's room, the nurse puts up the side rails, but after the nurse has left, the client lowers them again. Later, the client has a fall from the bed during seizures and holds the nurse responsible for it. Which of the following legal provisions protects the nurse in this case? A) Good Samaritan law B) Statute of limitations C) Common law D) Assumption of risk
Ans: D Feedback: The nurse is protected by the provision of assumption of risk. If a client is forewarned of a potential safety hazard and chooses to ignore the warning, the court may hold the client responsible. It is essential that the nurse documents that he or she warned the client and that the client disregarded the warning. Good Samaritan laws provide legal immunity to passersby who provide emergency first aid to accident victims. The statute of limitations is the designated time within which a person can file a lawsuit. Common laws are decisions based on prior similar cases.
A nurse is caring for a very weak client with a multiple pregnancy. Which of the following views might a teleologist have in such a situation? A) Support the procedure of selective abortion B) Argue that destroying any fetus is wrong C) Avoid telling the truth to the client D) Avoid analyzing ethical dilemmas of a case
Ans: A Feedback: A teleologist may argue that selective abortion is ethical because it will ensure the full-term birth of those who remain. Teleologists analyze ethical dilemmas on a case-by-case basis. A deontologist may argue that destroying any fetus is wrong on moral grounds. Deontologists believe that lying is never acceptable because it violates the duty to tell the truth to those entitled to honest information.
A nurse enters a client's room and finds that the client is lying on the floor. The nurse makes the client comfortable on the bed and completes an assessment. The nurse then informs the physician and the nursing supervisor about this incident and also completes an incident report. Which of the following actions by the nurse indicates correct knowledge of handling an incident report? A) Documents a complete description of the happenings in the client's records B) Makes a copy of the incident report and places it in the client's records C) Makes a copy of the incident report to give to the physician D) Mentions in the client's report that an incident report was completed
Ans: A Feedback: An incident report is a written account of an unusual, potentially injurious event involving a client, employee, or visitor. It is kept separate from the medical record. The incident report is a legal document and making a copy of it is not advisable. It should not be placed in the client's records; however, the nurse can mention the incident in the client's records without mentioning the incident report.
A nurse finds that a colleague is intoxicated while on duty. What appropriate action should the nurse take? A) Inform the nursing supervisor B) Tell the colleague to take a 30-minute break C) Inform the physician D) Watch the colleague closely during the shift
Ans: A Feedback: When a colleague is intoxicated while on duty, the nurse should immediately inform the nursing supervisor, who may take necessary action. It would be an irresponsible action if the nurse tells the colleague to take rest. Likewise, informing a physician is not the appropriate response. The nurse should not ignore the incident and simply observe the colleague because client care may be affected.
A group of nurses who work at a large, long-term care facility have become embroiled in controversy over a large number of residents who are refusing a seasonal influenza vaccination. Specifically, there is controversy around the appropriate amount of influence that nurses can exercise when encouraging residents to become immunized. A teleological perspective on this issue would prioritize what consideration? A) The rightnessî or wrongnessî of coercion B) The legal rights of the individual C) The greatest good for the greatest number D) Historical precedents
Ans: C Feedback: Teleology is ethical theory based on final outcomes. It is also known as utilitarianism because the ultimate ethical test for any decision is based on what is best for the most people. Deontology focuses on the morality of an act. Teleology does not prioritize historical precedent or the legal rights of the individual.
