Ch 7: Legal Dimensions of Nursing Practice - PrepU

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While riding in the elevator, a nurse discusses the HIV-positive status of a client with other colleagues. The nurse's action reflects: invasion of privacy. defamation of character. professional negligence . false imprisonment.

invasion of privacy. The nurse's action reflects an invasion of the client's privacy. Disclosing confidential information to an inappropriate third party subjects the nurse to liability for invasion of privacy, even if the information is true. Defamation of character includes false communication that results in injury to a person's reputation. Negligence is an act of omission or commission. Prevention of movement or unjustified retention of a person without consent may be false imprisonment.

A medical surgical client is in the radiology department. The client's cousin arrives on the medical surgical unit and asks to speak with the nurse caring for his cousin. The visitor asks the nurse to provide a brief outline of the client's illness. Which response, if given by the nurse, would demonstrate application of legal safeguard in her practice? "I will call the client and ask his permission." "I cannot give you that information due to client confidentiality." "Do you have any identification proving you are related to the client?" "I'm busy right now, but can talk later."

"I cannot give you that information due to client confidentiality." Sharing a client's information without his or her consent is an invasion of privacy. The nurse cannot give out the information even if the client proves a relationship or at a later time without the client's consent. It is inappropriate to call the client to ask for permission.

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?" What is the most appropriate response made by the nurse? "A living will can only be used in the state it was created in." "Take it with you. It is recognized universally in the United States." "As long as your family knows your medical wishes, you will not need it." "We have it on file here, so any hospital can call and get a copy."

"Take it with you. It is recognized universally in the United States." A separate or different advance directive is not needed for each state, so it can be used in any state and does not matter where it was created. A living will is recognized in each state as valid so a client should be advised to take it with them as they travel out of state. The other responses are incorrect or inappropriate given this scenario.

A student is preparing to graduate from nursing school and understands that professional regulations and laws that govern nursing practice are in place. These regulations and laws are in place for which reason? -to limit the number of nurses in practice -to ensure that practicing nurses are of good moral standing -to protect the safety of the public -to ensure that enough new nurses are always available

-to protect the safety of the public Governing bodies, professional regulations, and laws are in place to protect the public by ensuring that nurses are accountable for safe, competent, and ethical nursing practice. The other options do not describe accurately the role and responsibility of the governing bodies and the regulations and laws of nursing.

Which nursing student would most likely be held liable for negligence? A nursing student performs a dressing change using sterile technique and documents the presence of necrotic tissue in the wound. A nursing student reports that insulin was not administered to the client by the nurse on the previous shift. A nursing student administers medication to a resident, while working as an unlicensed assistive personnel (UAP) at a local nursing home. A nursing student completes an incident report after administering a medication to a client, who then experienced an adverse reaction to the medication.

A nursing student administers medication to a resident, while working as an unlicensed assistive personnel (UAP) at a local nursing home. The nursing student who administers medication to a resident, while working as an unlicensed assistive personnel (UAP) at a local nursing home, is performing a task outside the scope of the job responsibilities of a UAP. The other options demonstrate legally defensible actions by the nursing student.

A client informs the nurse that he is leaving the health care facility because he is not satisfied with the treatment. The nurse knows that the client's treatment is incomplete and further testing and evaluations are scheduled. Which action by the nurse would be most appropriate to prevent false imprisonment? Restrain the client to prevent him from leaving. Call the physician to speed up the discharge process. Ask the client to sign a release without medical approval. Tell the client that he will not be able to get access again.

Ask the client to sign a release without medical approval. If a client wants to leave the health care facility, the nurse should ask him to sign a release stating that he left without medical approval. The nurse cannot restrain the client because it amounts to false imprisonment. Calling the physician is not an appropriate measure. Telling the client that he may not be able to access the health care facility again is an inappropriate response because health care is a right and the client can access it whenever necessary.

An oncology nurse is caring for a client suffering from metabolic encephalopathy and end stage kidney disease. The client has no known family and no advanced directives. Upon entering the room, the nurse observes the client is pale and has no spontaneous respiration. What is the priority action the nurse should take? Contact the physician. Call the coroner. Notify the charge nurse. Begin CPR.

Begin CPR. A code status refers to how healthcare providers are required to manage care in the case of cardiac or respiratory arrest. A full code means that all measures to resuscitate the client are used. The nurse should immediately begin CPR. Although it is necessary to notify the physician and charge nurse, this is not the priority. It is not appropriate to contact the coroner at this time.

A nurse fails to administer a medication that prevents seizures, and the client has a seizure. The nurse is in violation of the Nurse Practice Act. What type of law is the nurse in violation of? Criminal Federal Civil Supreme

Civil Malpractice cases are generally civil litigation cases that involve nurses.

A registered nurse has had her license suspended after being convicted of being impaired at work. What governing body has the authority to revoke or suspend a nurse's license? The State Board of Nurse Examiners The employing health care institution The National League for Nursing The Supreme Court

The State Board of Nurse Examiners The State Board of Nurse Examiners in the United States may revoke or suspend a nurse's license or registration for drug or alcohol abuse.

A client is being prepared for an elective surgical procedure and the consent form has not been signed. Who should the nurse have obtain consent for the procedure? -The health care provider performing the surgical procedure -The client's family or significant other -The perioperative nurse -The nursing supervisor

The health care provider performing the surgical procedure

A nurse is caring for a client with vertigo. During data collection, the nurse finds multiple bruises on the client's arms and back; and suspects the client is being abused. When questioned, the client denies any abuse by the daughter she lives with. Despite the client's denial, which rationale would the nurse use for reporting the suspected abuse? The client does not want anyone to know what is happening in her home. The client is ashamed to admit that her daughter is beating her. The nurse wants her peers to see her as a hero. The nurse has a legal and ethical responsibility to report the suspected abuse.

The nurse has a legal and ethical responsibility to report the suspected abuse. Nurses are legally and ethically responsible to report suspected abuse. Because nurses are legally obligated, it does not depend upon the client's fear or reluctant to report the abuse. Being labeled a hero is not the correct rationale for reporting suspected abuse.

A client is received in a postoperative nursing unit after undergoing abdominal surgery. During this time, the nurse failed to recognize the significance of abdominal swelling, which significantly increased during the next 6 hours. Later, the client had to undergo emergency surgery. The lack of action on the nurse's part is liable for action. Which of the following legal terms describes the case? Misdemeanor Felony Tort Fraud

Tort A tort is a litigation in which one person asserts that a physical, emotional, or financial injury was a consequence of another person's actions or failure to act. The lack of action on the nurse's part truly indicates unintentional tort. A misdemeanor or felony would be an offense under criminal law, and neither is applicable in this case. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property.

The nurse educator provides an educational session to the nursing staff on protection of a client's privacy. Which circumstances, identified by the staff, would indicate to the educator that the teaching was effective? Select all that apply. During a bed bath, the nurse exposed the client's upper torso while washing the client's face. With the client's permission, the nurse explained the client's diagnosis to the client's spouse. The nurse questioned the client about her social life even though it did not affect care planning. The nurse removed the client from the emergency department waiting room into a private area to collect assessment data. Because the facility is a teaching facility, the nurse allowed the nursing student to take the client's picture for his care plan.

With the client's permission, the nurse explained the client's diagnosis to the client's spouse. The nurse removed the client from the emergency department waiting room into a private area to collect assessment data. To prevent invasion of privacy, all client information is considered confidential and private; this includes name and all identifiers (e.g., social security number, address, date of birth). With the client's permission, information can be shared with a spouse. A client should be taken to a private soundproof area to collect data. Unnecessary exposure of a client's body, taking pictures of a client, and questioning a client's social life when it does not affect care planning are examples of invasion of privacy.

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 daughter to direct his care, is a(an): will. standard of care. license. advance directive.

advance directive. 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 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? negligence misdemeanor felony tort

felony

A nurse is overheard in the hospital cafeteria making false comments about a client. The nurse is guilty of: slander. libel. invasion of privacy. assault.

slander. Slander is oral defamation of character. Libel is written defamation of character. Assault is a threat or attempt to make bodily contact with another person without that person's consent. Invasion of privacy involves a breach of keeping client information confidential.

In comparison with licensure, which measures entry-level competence, what does certification validate? innocence of any disciplinary violation specialty knowledge and clinical judgment more than 10 years of nursing practice ability to practice in more than one area

specialty knowledge and clinical judgment Whereas licensure measures entry-level competence, certification validates specialty knowledge, experience, and clinical judgment. Certification does not validate innocence, years of practice, or ability in multiple practice areas.

Nurses complete incident reports as dictated by the agency protocol. What is the primary reason nurses fill out an incident report? to document everyday occurrences to document the need for disciplinary action to improve quality of care to initiate litigation

to improve quality of care The primary reason to fill out an incident report is to improve the quality of care. Incident reports are not designed to be a means for disciplinary action. Incident reports are designed to identify risks, either in the form of actual risks or potential risks, that can be identified and addressed to improve quality of care. Incident reports are not intended to initiate litigation or document everyday occurrences.

Professional regulations and laws that govern nursing practice are primarily in place for which reason? to limit the number of nurses in practice to ensure that practicing nurses are of good moral standing to protect the safety of the public to ensure that enough new nurses are always available

to protect the safety of the public Governing bodies, professional regulations, and laws are in place to protect the public by ensuring that nurses are accountable for safe, competent, and ethical nursing practice. The other options do not describe accurately the role and responsibility of the governing bodies and the regulations and laws of nursing.

The charge nurse overhears a staff nurse threatening to restrain a verbally abusive client if the abuse continues. The charge nurse meets with the staff nurse to discuss this behavior. Which legal tort, if identified by the charge nurse, would alert the staff nurse to potential criminal charges? -Invasion of privacy -Negligence -Assault -Defamation of character

-Assault Assault is threatening to touch a person, such as by applying restraints, without consent. Sharing a client's confidential information without consent is an invasion of privacy. When a person performs an act that a reasonable person would not do under the same circumstance, it is negligence. Defamation of character occurs when derogatory statements that are defamatory against another person's character/reputation are made.

A nursing student administers an overdose of a narcotic to a client and the client arrests. When discussing the incident with nursing faculty, which statements made by the student indicate the need for further teaching? Select all that apply. -"I realize that I am held to the same standards as a registered nurse." -"I have also put the nursing faculty at risk with my action." -"I am glad I am a student because nursing faculty will be blamed, not me." -"I should have informed you that I felt unprepared for my assignment." -"I cannot be held liable because this is only my second time at this facility."

-"I am glad I am a student because nursing faculty will be blamed, not me." -"I cannot be held liable because this is only my second time at this facility." A nursing student is responsible and held liable for his or her own actions. The student is responsible for being familiar with the facility's policies and procedures. The student is held to the same standards as a registered nurse, and should inform faculty when unprepared for an assignment. The student nurse puts the clinical faculty at risk by performing actions that are deemed negligent.

When the nurse inserts an ordered urinary catheter into the client's urethra after the client has refused the procedure, and then the client suffers an injury, the client may sue the nurse for which type of tort? -Battery -Assault -Invasion of privacy -Dereliction of duty

-Battery Battery is the actual carrying out of such a threat (unlawful touching of a person's body). A nurse may be sued for battery if there is failure to obtain consent for a procedure.

Which statement made by the nurse providing care to a group of clients indicates that the nurse requires further education regarding negligence? -"Please avoid bringing fresh fruit to a client with neutropenia." -"I am going to assess for collateral circulation before preforming an arterial blood gas (ABG)." -"I am going to auscultate breath sounds every 8 hours on a client receiving enteral feedings." -"I don't need to assess distal pulses on a client after a femoral arteriography."

-"I don't need to assess distal pulses on a client after a femoral arteriography." Distal pulses should be checked immediately after a femoral arteriography; therefore, the nurse is negligent for checking three hours after the procedure. Fresh fruit may contain bacteria and further compromise a client with neutropenia. The Allen test confirms that there is proper circulation to the hand before drawing an ABG. The nurse checks breath sounds at least every 8 hours for adventitious sounds that may indicate aspiration.

Nurse Practice Acts are examples of which type of laws? -Statutory laws -Constitutional laws -Administrative law -Common law

-Statutory laws

A nurse is named as a defendant in a malpractice lawsuit. Which action would be recommended for this nurse? -Discuss the case with the plaintiff to ensure understanding of each other's positions. -If a mistake was made on a chart, change it to read appropriately. -Be prepared to tell your side to the press, if necessary. -Do not volunteer any information on the witness stand.

-Do not volunteer any information on the witness stand. The nurse on the witness stand should be polite, but not volunteer any information. The nurse should only answer the questions asked. The other answers are not examples of what a nurse should do in a malpractice lawsuit.

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 -Breach of duty -Causation -Damages

-Duty 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.

A client with end-stage renal disease decides against further treatment and requests a "Do Not Resuscitate" (DNR) order. The DNR status is part of the change-of-shift report. The client stops breathing and a nurse begins cardiopulmonary resuscitation. The family is upset and makes a complaint to the charge nurse. The charge nurse appropriately identifies that nurse has committed: -defamation. -battery. -assault. -fraud.

-battery. The nurse has committed battery by performing CPR against the client's wishes. Assault occurs when a person threatens to touch a client without consent. Fraud is a willful and purposeful misrepresentation, whereas defamation occurs when a derogatory remark is made about another person.

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 does not know anything. Which legal tort has the physician committed? Libel Battery Assault Slander

Slander 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 client admitted with Hodgkin disease has a handwritten prescription for vinblastine 3.7 mg intravenously (IV) weekly. The nurse interprets the prescription as vincristine 3.7 mg and administers the wrong medication. The client becomes neurovascularly compromised and has a fatal reaction to the medication. The client's family begins a litigious suit against the facility and the nurse's license is suspended by the board of nursing. In preparation for the lawsuit, the nurse meets with the nurse attorney to review the events. Which appropriate statement, if given by the nurse, indicates he has an understanding of the lawsuit? "I could not read the health care provider's handwriting, so I am not at fault." "I checked the medication before giving it and literature states it is for Hodgkin disease." "I had a duty and it was my responsibility to double check the medication, which I did, yet this still happened." "I had a duty and it was my responsibility to get clarification before administering the medication, which I did not."

"I had a duty and it was my responsibility to get clarification before administering the medication, which I did not." The nurse has a legal obligation to carry out health care provider's prescriptions unless the order is ambiguous (the nurse could not read provider's handwriting), contraindicated (vincristine dosage was too high), and contraindicated (wrong medication). The nurse had a duty and needed to get clarification, which he did not. The nurse is liable because there was a duty, which was breached, causation (wrong medication), and harm (client's death). Checking the medication is the correct thing to do, but the priority was assuring the medication was the correct one as prescribed.

The nurse is participating in a discussion about controlled substances. Which statement, made by the nurse, indicates the nurse is aware of laws governing the distribution of controlled substances? "When a nurse abuses controlled substances in the workplace and gets help, she will not be charged with a criminal act." "Nurses are responsible for adhering to specific documentation about controlled substances." "An impaired nurse is promptly punished by being terminated and having his or her license suspended." "The nurse is only at risk if she diverts medication from the client; using personal drugs decrease your risk."

"Nurses are responsible for adhering to specific documentation about controlled substances." Nurses have specific responsibilities regarding controlled substances, including specific documentation. Violation of controlled substances at the workplace is serious and is considered a criminal act. Substance abuse is treatable and the objective is to detect and treat the problem early. It does not matter where the nurse obtains the drugs; she is still liable for her actions.

The client being admitted to the oncology unit conveys his wishes regarding resuscitation in the event of cardiopulmonary arrest. The nurse advises the client that it would be in his best interest to obtain which document? -A will -A living will -Proof of health care power of attorney -A proxy directive

-A living will 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 permanently unconscious condition.

The nurse is participating in a discussion about controlled substances. Which statement by the nurse indicates she is aware of laws governing the distribution of controlled substances? -"When a nurse misuses controlled substances in the workplace and gets help, she will not be charged with a criminal act." -"Nurses are responsible for adhering to specific documentation about controlled substances." -"An impaired nurse is promptly punished by being terminated and having his or her license suspended." -"The nurse is only at risk if she diverts medication from the client; using personal drugs decrease your risk."

"Nurses are responsible for adhering to specific documentation about controlled substances." Nurses have specific responsibilities regarding controlled substances, including specific documentation. Violation of controlled substances at the workplace is serious and is considered a criminal act. Substance use is treatable and the objective is to detect and treat the problem early. It does not matter where the nurse obtains the drugs; the nurse is still liable for personal actions.

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, given 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 takes precedent over the facility's policies and procedures." "The Scope and Standards of Practice for Professional Ambulatory Care Nursing sets the standards for the nursing supervisor to assess a nurse." "The Scope and Standards of Practice for Professional Ambulatory Care Nursing determines if a nurse is minimally competent to receive a license to practice as a nurse." "The Scope and Standards of Practice for Professional Ambulatory Care Nursing deal with the professional obligations of a nurse working in the ambulatory setting."

"The Scope and Standards of Practice for Professional Ambulatory Care Nursing deal with the professional obligations of a nurse working in the ambulatory setting." 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.

The nurse attorney provides an educational session to the nursing staff on acts of negligence. Which responses by the staff would indicate to the attorney that the staff can accurately identify acts of negligence? Select all that apply. -"I can be charged with negligence if I apply a heating pad to the client's skin and the client suffers a superficial or first-degree burn." -"I can be charged with negligence if I follow the policy for administering insulin and the client has a reaction to it." -"I can be charged with negligence if I am following the standards of care for my specialty, which is ambulatory nursing." -"When I am using a new piece of equipment for the first time, I must make sure I know how to properly operate it." -"I can be charged with negligence if I notify the health care practitioner about a change in a client's status but do not follow up or document.

-"I can be charged with negligence if I apply a heating pad to the client's skin and the client suffers a superficial or first-degree burn." -"I can be charged with negligence if I notify the health care practitioner about a change in a client's status but do not follow up or document. Negligence occurs when a nurse fails to provide care that another nurse with the same educational background would perform. Applying heat and burning the client's skin is not an act another prudent nurse would do. The nurse must act as the client's advocate by following up and documenting when a health care provider does not respond to a change in the client's condition. When a nurse follows correct policies for administering medications, follows the standards of care, and uses equipment in the correct manner, this eliminates the risk of practicing in a negligent manner.

A lawyer is describing the litigation process to a nurse named in a malpractice lawsuit. Which statements by the lawyer accurately describe this process? Select all that apply. -"The defendant is the person who is initiating the lawsuit." -"The process of bringing and trying this lawsuit is called litigation." -"As the defendant, you will be presumed guilty until proven innocent." -"We will start litigation in the first-level court known as the appellate court." -"The opinions of appellate judges are published and become common law." -"Common law is based on the principle of stare decisis."

-"The process of bringing and trying this lawsuit is called litigation." -"The opinions of appellate judges are published and become common law." -"Common law is based on the principle of stare decisis." The process of bringing and trying a lawsuit is called litigation. The opinions of appellate judges are published and become common law. Common law is based on the principle of stare decisis, or "let the decision stand." After a decision has been made in a court of law, the principle in that decision becomes the rule to follow in other similar cases (precedent). The other options listed are not true about the litigation process.

While teaching about advance care planning, which fact is important for the nurse to share with a client who has been diagnosed with a terminal illness? -Living wills provide specific instructions related to the client's personal property upon death. -A durable power of attorney for health care appoints an agent the person trusts to make decisions. -The Patient Self-Determination Act of 1990 requires hospital clients to have an advance directive. -Advance directives must be completed 30 days prior to hospitalization in order to be valid.

-A durable power of attorney for health care appoints an agent the person trusts to make decisions.

-A durable power of attorney for health care appoints an agent the person trusts to make decisions. Advance directives can minimize difficulties by allowing people to state in advance what their choices would be for health care if certain circumstances arise. A durable power of attorney for health care appoints an agent the person trusts to make decisions in the event of subsequent incapacity. Living wills provide specific instructions about the kinds of health care that should be provided or foregone in particular situations. In the United States, the Patient Self-Determination Act of 1990 requires all hospitals to inform patients about advance directives. Advance directives do not have to be completed prior to hospitalization in order to be valid.

The nursing faculty is lecturing on unintentional and intentional torts. The faculty asks a nursing student to provide an example of an unintentional tort. Which example would indicate the student has a clear understanding of torts? -Nurses are in the elevator discussing a client's laboratory values. -A nurse is telling a client he cannot leave the hospital until he pays his bill. -A nurse is threatening to restrain a client if he does not stop talking. -A nurse gives a medication and client has an adverse reaction.

-A nurse gives a medication and client has an adverse reaction. Unintentional tort occurs when the nurse did not intend harm, but harm occurred (administration of medication and client has an adverse reaction). The other three responses are intentional torts.

The health care provider prescribes cold therapy every 4 hours for a client after foot surgery. The nurse places the ice pack directly on the client's skin and returns 60 minutes later. After removal of the ice pack, the skin is pale and cold to the touch. The client develops frostbite and begins a lawsuit for malpractice. When reviewing the case, the nurse attorney recognizes which most important statement about the malpractice suit? -The client has a responsibility to report loss of sensation to prevent frostbite. -The standard of care was established, so the nurse will not be held liable. -The client will have difficulty finding causation. -All elements are in place to hold the nurse liable.

-All elements are in place to hold the nurse liable. All four elements are met: The nurse had a duty. The duty was breached. It is easy to find causation (an ice pack directly on skin for 60 minutes), and harm (development of frostbite) was done. The client is not responsible since the lack of sensation may have occurred early and it was the nurse's responsibility to ensure safety.

During a nursing shift, which events warrant completion of an incident report? (Select all that apply.) -A nurse reports that a client is crying and distraught over a diagnosis of metastatic cancer. -An intravenous antibiotic was administered 2 hours late because the IV site infiltrated. -A visitor slipped and fell in the hallway, but was not injured. -A client falls while being transferred from the bed to the chair. -A registered nurse asks an unlicensed assistive personal (UAP) to feed a client.

-An intravenous antibiotic was administered 2 hours late because the IV site infiltrated. -A visitor slipped and fell in the hallway, but was not injured. -A client falls while being transferred from the bed to the chair. 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 working in a coronary care unit resuscitates a client who had expressed wishes not to be resuscitated. Which tort has the nurse committed? -Assault -Battery -Libel -Slander

-Battery The nurse has committed a mistake and can be sued for battery because of unlawfully carrying out a procedure that the client had refused. Battery is an assault and includes negligent touching of another person's body or clothes or anything attached to or held by that other person. Assault is the threat of touching another person without his or her consent. Negligence may be an act of omission or commission. Defamation of character in spoken words is called slander. Libel is defamation of character in written words.

A client admitted to a mental health unit has exhibited physical behaviors that put him and others at risk. The nurse applies four-point restraints on the client without obtaining a physician's order or the client's consent. The nurse is at risk of being accused of which of the following? -Slander -Negligence -Battery -Malpractice

-Battery Battery is intentional and wrongful physical contact with a person that entails an injury or offensive touching. Performing treatment without permission or receiving informed consent from the client might constitute both assault and battery. Judgments of battery suits have been based on the application of restraints to confused clients. The other options do not meet the definition described in the question.

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 -Duty -Causation -Damages

-Breach of duty 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.

The nurse is providing care to a client who had orthopedic surgery. The nurse has medicated the client for pain. However, the client reports pain is unrelieved. The nurse takes no further action regarding assessment and intervention for the client's pain. The nurse does not notify the surgeon regarding the client's pain. What element of liability has been violated? -Breach of duty -Causation -Damages -Duty

-Breach of duty Breach of duty is the failure to assess, intervene, or notify the health care provider regarding the client's condition. It does not meet the expected standard of care. Duty refers to an obligation to use due care and is defined by the standard of care appropriate for the nurse-client relationship. Causation is when the failure to meet the standard of care caused injury. Damages are the harm or injury to the client.

-Civil Malpractice cases are generally civil litigation cases that involve nurses.

A client is scheduled for a colonoscopy. The nurse realizes immediately after administering medications to induce conscious sedation that the client has not signed the informed consent. If the nurse has the client sign the informed consent, which element of informed consent would be violated? -Disclosure -Comprehension -Competence -Voluntariness

-Competence

-Competence The client under conscious sedation would not be considered competent to make a decision to undergo an invasive procedure such as a colonoscopy. Disclosure ensures that the following information has been given to the client: the nature of the treatment, possible alternative treatments, and potential risks and benefits of the treatment. Comprehension is met when the client demonstrates understanding by describing in his own words to what he is consenting. The client's consent must be given voluntarily.

A nurse assesses a client with psychotic symptoms and determines that the client needs vest restraints. However, the client asks the nurse not to put on vest restraints. What would be the best nursing action? -Contact the physician and obtain necessary orders. -Restrain the client with vest restraints. -Apply restraints after giving a sedative. -Apply wrist restraints instead of vest restraints.

-Contact the physician and obtain necessary orders. 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. The nurse should not sedate the client and then restrain him, as the nurse could be charged with battery if there is restraint without orders. Applying a wrist restraint instead of a vest restraint is like compromising with the client, which is unethical.

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? -Health care institution -Federal legislation -State legislation -Board of nursing

-Health care institution 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.

The nursing supervisor is preparing to delegate some aspects of the nursing care plan interventions to other healthcare providers on the unit. Which are requirements of supervisory nursing? Select all that apply. -In-depth knowledge of the job descriptions and capabilities of each person on the team. -Each member of the team to state which tasks they enjoy and assign accordingly to improve staff moral. -The person assigned to the task is ultimately responsible for the care they provide. -Registered nurses cannot delegate the practice-pervasive functions of assessment. -Registered nurses must assure the care was delivered accurately and appropriately.

-In-depth knowledge of the job descriptions and capabilities of each person on the team. -Registered nurses cannot delegate the practice-pervasive functions of assessment. -Registered nurses must assure the care was delivered accurately and appropriately. Nurses may delegate specific aspects of care to nonprofessional staff, but registered nurses are held accountable for selecting appropriate nursing care measures for these personnel to perform. Registered nurses cannot delegate the practice-pervasive functions of assessment, planning, diagnosis, evaluation, and nursing judgment (NCSBN, 2005). Registered nurses may delegate technical activities (i.e., feeding, ambulating) or provision of amenities (i.e., hospitality services, including making beds, setting up meals, cleaning the care environment), but the activities must not require critical thinking or professional judgment (American Nurses Association, 2005). Nurses also maintain responsibility to ensure that nursing care measures have been carried out correctly.

A client informs the nurse that he wants to discontinue his treatment and go home. Later, the nurse finds the client dressed to leave. Which action should the nurse take in this situation? -Let the client go after signing a document stating he is going against medical advice. -Restrain the client until his medical treatment is over. -Call the physician and get his discharge paper signed. -Warn the client that he may not be able to access health care again.

-Let the client go after signing a document stating he is going against medical advice. 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 client, 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 new graduate wants to be knowledgable about state-mandated rules to better practice within the scope of nursing. What are the best resources for this nurse to research? Select all that apply. -Nurse practice acts -Medicare and Medicaid provisions for reimbursement of nursing services -Nursing educational requirements -Delegation trees Composition and disciplinary authority of board of nursing -Medication administration

-Nurse practice acts -Nursing educational requirements -Composition and disciplinary authority of board of nursing Examples of state-mandated rules would include nurse practice acts, nursing educational requirements, and composition and disciplinary authority of boards of nursing. Delegation trees, medication administration, and Medicare and Medicaid provision for reimbursement of nursing services are not examples of state-mandated rules.

A client newly diagnosed with congestive heart failure has a prescription for digoxin. The nurse counts the heart rate before administration of the medication and obtains a heart rate of 51 beats per minute. Which action by the nurse demonstrates adherence to the standards of nursing care? -Nurse withheld the medication and notified the health care practitioner. -Nurse administered the medication and reassessed the client after 30 minutes. -Nurse withheld the medication, retook the heart rate, and gave the meds at a later time. -Nurse administered the medication after reviewing the client's serum potassium level.

-Nurse withheld the medication and notified the health care practitioner. Nurses are responsible for following the standards of care for their particular work area. A reasonably prudent nurse would withhold the medication and notify the health care practitioner. All other options put the client's safety at risk and would not be done by a reasonably prudent nurse.

In comparison with licensure, which measures entry-level competence, what does certification validate? -Innocence of any disciplinary violation -Specialty knowledge and clinical judgment -More than 10 years of nursing practice -Ability to practice in more than one area

-Specialty knowledge and clinical judgment Whereas licensure measures entry-level competence, certification validates specialty knowledge, experience, and clinical judgment. Certification does not validate innocence, years of practice, or ability in multiple practice areas.

Nurse Practice Acts are examples of which type of laws? -Statutory laws -Constitutional laws -Administrative law -Common law

-Statutory laws Nurse Practice Acts are statutory laws. Statutory laws must be in keeping with both the federal constitution and the state constitution. Constitutional law refers to rights carved out in the federal and state constitutions. The majority of this body of law has developed from state and federal supreme court rulings, which interpret their respective constitutions and ensure that the laws passed by the legislature do not violate constitutional limits. Administrative law is the body of law that governs the activities of administrative agencies of government. Common law is the body of English law as adopted and modified separately by the different states of the US and by the federal government and is in contrast with statutory law.

A registered nurse has had her license suspended after being convicted of being impaired at work. What governing body has the authority to revoke or suspend a nurse's license? -The State Board of Nurse Examiners -The employing health care institution -The National League for Nursing -The Supreme Court

-The State Board of Nurse Examiners The State Board of Nurse Examiners in the United States may revoke or suspend a nurse's license or registration for drug or alcohol misuse. 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 Surpreme Court does not rule on nurse's license.

-The health care provider performing the surgical procedure The nurse should inform the surgeon the consent has not been signed. Obtaining informed consent is the responsibility of the person who will be performing the diagnostic or treatment procedure or the research study. In this particular case, the surgeon, the client, and a witness, all need to sign the consent form. The nurse's roles are to confirm that a signed consent form is present in the client's chart and to answer any client questions about the consent.

Which of the following is an area of potential liability for the nurse? Select all that apply. -The nurse fails to document refusal by the client to ambulate following surgery. -The nurse notifies the physician of the client's adverse reaction to a medication. -The nurse administers the client's preoperative medication after the informed consent is signed. -The nurse documents that the client's blood pressure has increased from 118/72 to 188/98 and decides to retake the blood pressure in an hour. -The nurse documents that the client accurately prepared the correct amount of insulin after instruction was given.

-The nurse fails to document refusal by the client to ambulate following surgery. -The nurse documents that the client's blood pressure has increased from 118/72 to 188/98 and decides to retake the blood pressure in an hour. Areas of potential liability would include failure to document refusal by the client to participate in the treatment regimen (such as ambulation after surgery), and failure to assess the client in a timely manner. Waiting an hour to reassess a significant elevation in blood pressure does not meet the standard of care. Reporting a client's adverse reaction to a medication, administering preoperative medication after the informed consent is signed, and documenting the client's response to education are nursing behaviors that meet the standard of care.

A nurse is caring for a client with vertigo. During data collection, the nurse finds multiple bruises on the client's arms and back and suspects the client is being abused. When questioned, the client denies any abuse by the daughter she lives with. Despite the client's denial, which rationale would the nurse use for reporting the suspected abuse? -The client does not want anyone to know what is happening in her home. -The client is ashamed to admit that her daughter is beating her. -The nurse wants her peers to see her as a hero. -The nurse has a legal and ethical responsibility to report the suspected abuse.

-The nurse has a legal and ethical responsibility to report the suspected abuse. Nurses are legally and ethically responsible to report suspected abuse. Because nurses are legally obligated, it does not depend upon the client's fear or reluctance to report the abuse. Being labeled a hero is not the correct rationale for reporting suspected abuse.

Legal safeguards are in place in the nursing practice to protect the nurse from exposure to legal risks as well as to protect the client from harm. What are examples of legal safeguards for the nurse? Select all that apply. -The nurse obtains informed consent from a client to perform a procedure. -The physician is responsible for administration of a wrongly prescribed medication. -The nurse educates the client about The Patient Care Partnership. -The nurse executes physician orders without questioning them. -The nurse documents all client care in a timely manner. -The nurse claims management is responsible for inadequate staffing leading to negligence.

-The nurse obtains informed consent from a client to perform a procedure. -The nurse educates the client about The Patient Care Partnership. -The nurse documents all client care in a timely manner. Examples of legal safeguards for the nurse would include the nurse obtaining informed consent from a client, the nurse educating the client about The Patient Care Partnership, and the nurse documenting all client care in a timely manner. Legal safeguards for the nurse would not include the nurse executing physician orders without questioning them. Legal safeguards for the nurse would not include the nurse claiming management is responsible for inadequate staffing leading to negligence. Legal safeguards for the nurse would not include the physician being responsible for administration of a wrongly prescribed medication.

Two nurses meet at their home, where one of the nurses discusses a client who had been physically abused. The next day, the client is shifted to another nursing unit after a surgical procedure and becomes the care of the second nurse who had been part of the original discussion. Nurse No. 2 asks the client about the physical abuse. The client discovers that his original nurse revealed the information and is hurt. What would be the charges if the client files a suit? -The nurses could be charged for slander. -The nurses could be charged for libel. -No charges are valid because the revelation took place in off-duty hours. -No charges are valid because Nurse No. 2 is also involved in client care.

-The nurses could be charged for slander Slander is the character attack uttered orally in the presence of others. The injury is considered to occur because the derogatory remarks attack a person's character and good name. In this case, the nurse can be charged with slander. If the defamation had been written, it would be libel. Even if the discussion took place at home and Nurse No. 2 was involved in the care, the revelation was without the client's consent. Even if the nurse is off-duty or may not be directly involved in the client's care, the nurse can still be charged with slander.

When making client rounds, the charge nurse observes which action by a staff nurse that would constitute battery? -The older adult client refuses the intramuscular injection, but the staff nurse administered it. -The staff nurse threatens to restrain the client if she did not take her medication. -While bathing a client behind pulled curtains, two nurses are discussing a different client. -The nurse tells the client she cannot leave the hospital because she is seriously ill.

-The older adult client refuses the intramuscular injection, but the staff nurse administered it. If the client refuses a procedure or medication and the nurse proceeds with it, it is battery. Threatening a client is assault. Discussing another client within earshot of others is an invasion of privacy. Keeping a client against her wishes, regardless of her health status, is false imprisonment.

Nurses are occasionally asked to witness a testator's (person who makes the will) signing of his or her will. Which guideline is true regarding a nurse's role is witnessing a testator's signature? -Witnesses to a signature do not need to read the will. -Witnesses do not need to observe the signing of the will and can sign it at a later time. -A beneficiary to a will is allowed to act as a witness. -A single witness is sufficient for a will.

-Witnesses to a signature do not need to read the will. 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 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.

While riding in the elevator, a nurse discusses the HIV-positive status of a client with other colleagues. The nurse's action reflects: -invasion of privacy. -defamation of character. -professional negligence. -false imprisonment.

-invasion of privacy. The nurse's action reflects an invasion of the client's privacy. Disclosing confidential information to an inappropriate third party subjects the nurse to liability for invasion of privacy, even if the information is true. Defamation of character includes false communication that results in injury to a person's reputation. Negligence is an act of omission or commission. Prevention of movement or unjustified retention of a person without consent may be false imprisonment.

Which situation is an example of battery that the nurse may experience while performing her duties at the health care facility? -telling the client that he cannot leave the hospital -performing a surgical procedure without getting consent -taking the client's photographs without consent -witnessing a procedure done on a client without his consent

-performing a surgical procedure without getting consent Performing a surgical procedure without the client's consent is an example of battery. To protect health care workers from being charged with battery, adult clients are asked to sign a general permission for care and treatment during admission, and additional written consent forms for tests, procedures, or surgery. Telling the client not to leave the hospital is a false imprisonment. Taking the client's photographs without his permission and witnessing a procedure done on him without consent is violation of the client's privacy.

The nurse attempts to notify a health care provider about a client's elevated temperature, but does not get a response. Which statement, if documented by the nurse, would indicate that the nurse is following proper protocol for nursing documentation? 1300: Client temperature elevated. Telephoned health care provider 3 times. As usual, health care provider did not respond. 1300: Client temperature elevated. Health care provider paged, but did not respond. Administered Tylenol without an order because I knew this health care provider does not return calls. 1300: Client temperature elevated. Telephoned health care provider's service several times with no response. Will notify nursing supervisor during rounds. 1300: Client temperature elevated. Telephoned health care provider's service 3 times without a response. Tepid sponge bath given and nursing supervisor notified.

1300: Client temperature elevated. Telephoned health care provider's service 3 times without a response. Tepid sponge bath given and nursing supervisor notified. Documentation must have the correct, factual, and timely information. The nurse must document when the health provider was called and response or lack of response; what nursing action was done, if any, and notification of appropriate personnel. The nurse cannot administer medication without an order. The nurse should be careful and not make incriminating statements, such as, "as usual health care provider did not respond." The nurse should not wait until rounds are made to inform the supervisor.

The client being admitted to the oncology unit conveys his wishes regarding resuscitation in the event of cardiopulmonary arrest. The nurse advises the client that it would be in his best interest to obtain which document? A will A living will Proof of health care power of attorney A proxy directive

A living will 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 permanently unconscious condition.

When the nurse informs a client's employer of his autoimmune deficiency disease, the nurse is committing the tort of: Breach of contract Assault Invasion of privacy Battery

Invasion of privacy Nurses have access to information recorded in the medical record, information shared or observed through care or interactions with friends and family, and through access to the client's body. A loss of privacy occurs if others inappropriately use their access to a person.

Which of the following is an example of certification? A nurse who demonstrates advanced expertise in a content area of nursing through special testing. A hospital meets the standards of the Joint Commission. An education program that meets standards of the National League for Nursing. A graduate of a nursing education program who passes NCLEX-RN.

A nurse who demonstrates advanced expertise in a content area of nursing through special testing. Certification is a voluntary process where a person who has met criteria established by a nongovernmental association is granted special recognition in a specified practice area. Licensure is granted by the state to a graduate of a nursing education program who passes NCLEX-RN. Accreditation is a voluntary process by which a nursing education program is recognized as having met certain standards by the National League for Nursing Accrediting Commission and/or the American Association of Colleges of Nursing. The Joint Commission can also accredit healthcare agencies.

Which of the following is an example of certification? A nurse who demonstrates advanced expertise in a content area of nursing through special testing. A graduate of a nursing education program who passes NCLEX-RN. An education program that meets standards of the National League for Nursing. A hospital that meets the standards of the Joint Commission.

A nurse who demonstrates advanced expertise in a content area of nursing through special testing. Certification is a voluntary process whereby a person who has met criteria established by a nongovernmental association is granted special recognition in a specified practice area. Licensure is granted by the state to a graduate of a nursing education program who passes NCLEX-RN. Accreditation is a voluntary process by which a nursing education program is recognized as having met certain standards by the National League for Nursing Accrediting Commission and/or the American Association of Colleges of Nursing. The Joint Commission can also accredit health care agencies.

Which process evaluates and recognizes educational programs as having met certain standards? Accreditation Credentialing Licensure Certification

Accreditation 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 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.

Which process evaluates and recognizes educational programs as having met certain standards? Accreditation Credentialing Licensure Certification

A student nurse is assisting an elderly patient to ambulate following hip replacement surgery, and the patient falls and reinjures the hip. Who is potentially responsible for the injury to this patient? The student nurse The nurse instructor The hospital All of the above

All of the above As a student nurse, you are responsible for your own acts, including any negligence that may result in patient injury. A hospital may also be held liable for the negligence of a student nurse enrolled in a hospital-controlled program because the student is considered an employee of the hospital. The status of students enrolled in college and university programs is less clear, as is the liability of the educational institution in which they are enrolled and the health care agency offering a site for clinical practice. Nursing instructors may share responsibility for damages in the event of patient injury if an assignment called for clinical skills beyond a student's competency or the instructor failed to provide reasonable and prudent clinical supervision.

During a nursing shift, which events warrant completion of an incident report? (Select all that apply.) A nurse reports that a client is crying and distraught over a diagnosis of metastatic cancer. An intravenous antibiotic was administered 2 hours late because the IV site infiltrated. A visitor slipped and fell in the hallway, but was not injured. A client falls while being transferred from the bed to the chair. A registered nurse asks an unlicensed assistive personal (UAP) to feed a client.

An intravenous antibiotic was administered 2 hours late because the IV site infiltrated. A visitor slipped and fell in the hallway, but was not injured. A client falls while being transferred from the bed to the chair. 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 working in a coronary care unit resuscitates a client who had expressed wishes not to be resuscitated. Which tort has the nurse committed? Assault Battery Libel Slander

Battery The nurse has committed a mistake and can be sued for battery because of unlawfully carrying out a procedure that the client had refused. Battery is an assault and includes negligent touching of another person's body or clothes or anything attached to or held by that other person. Assault is the threat of touching another person without his or her consent. Negligence may be an act of omission or commission. Defamation of character in spoken words is called slander. Libel is defamation of character in written words.

When the nurse inserts an ordered urinary catheter into the client's urethra after the client has refused the procedure, and then the client suffers an injury, the client may sue the nurse for which type of tort? Battery Assault Invasion of privacy Dereliction of duty

Battery Battery is the actual carrying out of such a threat (unlawful touching of a person's body). A nurse may be sued for battery if there is failure to obtain consent for a procedure.

A nurse fails to communicate a change in the client's condition to the physician. Which element related to proving malpractice has been met? Duty Breach of duty Proximate cause Damages

Breach of duty Failing to communicate a change in the client's condition reflects a breach of duty. Duty describes the relationship between the person and the person being sued. Nurses have a duty to care for their clients. The existence of a duty is rarely an issue in a malpractice suit. The action or lack of action must be proven as the cause of the injury. Damages refer to the injury suffered by the client.

Nurses practicing in a critical care unit must acquire specialized skills and knowledge to provide care to the critically ill client. These nurses can validate this specialty competence through what process? Certification Accreditation Licensure Litigation

Certification

Having recently completed a specialty nursing program in neonatal care, a nurse is now preparing to leave her current position on a medical unit and begin providing care in the hospital's neonatal intensive care unit (NICU). The nurse has completed which of the following processes of credentialing? Certification Licensure Accreditation Validation

Certification The process of certification involves the attainment and validation of specialized nursing knowledge and skills. Certification is often necessary in order to ensure that the nursing care that is 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, identifies that standards are being met. The process of licensure involves the determination that a nurse meets minimum requirements to practice, but not necessarily the specialized knowledge that is necessary for some care settings. Validation is not a specific aspect of the process of credentialing.

A nurse assesses a client with psychotic symptoms and determines that the client needs vest restraints. However, the client asks the nurse not to put on vest restraints. What would be the best nursing action? Contact the physician and obtain necessary orders. Restrain the client with vest restraints. Apply restraints after giving a sedative. Apply wrist restraints instead of vest restraints.

Contact the physician and obtain necessary orders. 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. The nurse should not sedate the client and then restrain him, as the nurse could be charged with battery if there is restraint without orders. Applying a wrist restraint instead of a vest restraint is like compromising with the client, which is unethical.

A client states that his recent fall was caused by the fact that his scheduled antihypertensive medications were mistakenly administered by two different nurses, an event that is disputed by both of the nurses identified by the client. Which measure should the nurses prioritize when anticipating that legal action may follow? Document the client's claims and the events surrounding the alleged incident. Consult with the hospital's legal department as soon as possible. Consult with practice advisors from the state board of nursing. Enlist support from nursing and non-nursing colleagues from the unit.

Document the client's claims and the events surrounding the alleged incident. It is imperative for nurses to carefully and accurately document assessment findings and the nursing care that they provide, a fact that is especially salient when legal action is anticipated. This thorough and accurate assessment should precede consultation with the legal department, the state board of nursing, and colleagues.

The nurse educator is presenting a lecture on the Occupational Safety and Health Act. Which situations, if identified by the nursing staff, would indicate to the educator that the staff understands which actions about the Occupational Safety and Health Act? Requires nurses to report abuse of infants, children, and adults of all ages Helps reduce workforce injuries and illness in the workplace Acts as an information clearing house for nurses who engage in unprofessional conduct Protects nurses who are recovering from drug or alcohol addiction or have communicable diseases

Helps reduce workforce injuries and illness in the workplace The Occupational Safety and Health Act helps to reduce injuries and illness in the workplace. The National Practitioner Data Bank is a clearinghouse for health care practitioners who engage in unprofessional conduct and restrict them from moving from state to state. Nurses are obligated to report abuse because of the nurse-patient relationship; it is not a requirement of the Occupational Safety and Health Act. The American with Disabilities Act protects people with communicable diseases and those recovering from drug or alcohol addiction.

The nursing student talks with the student's family about an AIDS client from the clinical experience. Which tort has the student committed? Invasion of privacy Fraud Assault Slander

Invasion of privacy 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.

The student nurse tells her family about a client with AIDS that she cared for in clinical yesterday. Which tort has the student committed? Slander Assault Invasion of privacy Fraud

Invasion of privacy Invasion of privacy involves a breach of keeping client information confidential. Slander is oral defamation of character. Assault is a threat or attempt to make bodily contact with another person without that person's consent.

While caring for an infant, the nurse hears another child screaming in the next room. She rushes to the other room to check on the screaming child, forgetting to put the side rails up on the infant's crib. She returns to the room to find the infant has fallen out of the crib and sustained a head injury. Based on the nurse's action, which tort is the nurse liable for? Defamation Malpractice Assault Battery

Malpractice The nurse did not ensure the safety of the infant by pulling up the side rails before leaving the infant unattended. Therefore, the nurse may be charged with malpractice because she had a duty that she breached; there was causation with harm to the infant. Assault occurs when a person threatens to touch a client without consent. Battery is carrying out the threat by touching the client without consent, whereas defamation occurs when a derogatory remark is made about another person.

A nurse is caring for a client following endotracheal intubation. Before applying soft wrist restraints to prevent the client from pulling out the endotracheal tube, what is the most appropriate action of the nurse? Sedate the client. Get written consent. Obtain a medical order. Notify the family.

Obtain a medical order. Nurses must obtain a medical order before each and every instance in which they use restraints. Due to the severity of the client illness requiring endotracheal intubation, the client may not be able to provide a written consent. The client does not need to be sedated unless medically necessary, and although it is appropriate to notify the family, this is not the priority.

During the admission assessment of a female client age 40 years with a suspected mandibular fracture, the client discloses to the nurse that her injury came as a result of her husband hitting her. Which action should the nurse prioritize when responding to this disclosure? Reporting the abuse to the appropriate authorities Ensuring the client's statement is confirmed by another nurse Performing an assessment to confirm the client's statement Informing the client of her right to keep this information private

Reporting the abuse to the appropriate authorities 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.

The health care provider prescribes orders for a client with newly diagnosed uncontrolled seizure activity. When reviewing the prescriptions, the nurse correctly identifies which prescription, if followed, puts him at risk for negligence charges? Neurologic assessments every 5 minutes Oxygen 2/L via nasal cannula Diazepam (Valium) 5 mg intravenously now Restrain all four extremities

Restrain all four extremities The nurse is obligated to carry out health care provider's orders unless it is unclear or incorrect. The client with seizures must be protected from harm. Restraints restricts the client's movement and can cause harm. Diazepam, oxygen, and frequent neurologic assessments are correct interventions for a client with uncontrolled seizure activity.

A nurse, while off-duty, tells the physiotherapist that a client who was admitted to the nursing unit contracted AIDS due to exposure to sex workers at the age of 18. The client discovers that the nurse has revealed the information to the physiotherapist. With what legal action could the nurse be charged? Libel Slander Negligence Malpractice

Slander The nurse can be charged with slander, which is a verbal attack on a person's character. Libel pertains to damaging written statements read by others. Both libel and slander are considered defamation of character - an intentional tort in which one party makes derogatory remarks about another that diminish the other party's reputation. Negligence and malpractice pertain to actions which are committed or omitted, thereby causing physical harm to a client.

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 of the following statements is true regarding the Good Samaritan law? The Good Samaritan law will provide legal immunity to the nurse. The Good Samaritan law will not protect the nurse because she did not accept compensation. The Good Samaritan law is not applicable to health care workers. The Good Samaritan law will provide absolute exemption from prosecution.

The Good Samaritan law will provide legal immunity to the nurse. 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 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 laypeople. In cases of gross negligence, health care workers may be charged with a criminal offense.

When making client rounds, the charge nurse observes which action by a staff nurse that would constitute battery? The elderly client refuses the intramuscular injection, but the staff nurse administered it. The staff nurse threatens to restrain the client if she did not take her medication. While bathing a client behind pulled curtains, two nurses are discussing a different client. The nurse tells the client she cannot leave the hospital because she is seriously ill.

The elderly client refuses the intramuscular injection, but the staff nurse administered it. If the client refuses a procedure or medication and the nurse proceeds with it, it is battery. Threatening a client is assault. Discussing another client within earshot of others is an invasion of privacy. Keeping a client against her wishes, regardless of her health status, is false imprisonment.

The health care facility is involved in litigation by four clients. When reviewing the cases, which legal case would the nurse attorney identify to best describe malpractice? The nurse applies an ice pack to a client's lower back without an order and he feels better . The nurse using proper mechanics assists a client to a locked bed. He slips and breaks his left femur. The nurse administers amoxicillin (Amicar) to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest. The nurse administered the wrong medication to the client, who had one episode of vomiting 5 minutes after consuming the medication with no further adverse reactions.

The nurse administers amoxicillin (Amicar) to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest. All elements of liability are in place for administering amoxicillin to a client with documented allergies to penicillin: the nurse had a duty, but breached it when giving the medication. There also was causation (amoxicillin) and harm (seizures and respiratory arrest). The nurse is negligent when applying an ice pack without an order. The nurse used proper mechanics, so the client fall is an accident even though harm occurred. Giving the wrong medication could be cause for malpractice, but there was no harm.

Legal safeguards are in place in the nursing practice to protect the nurse from exposure to legal risks as well as to protect the client from harm. What are examples of legal safeguards for the nurse? Select all that apply. The nurse obtains informed consent from a client to perform a procedure. The physician is responsible for administration of a wrongly prescribed medication. The nurse educates the client about The Patient Care Partnership. The nurse executes physician orders without questioning them. The nurse documents all client care in a timely manner. The nurse claims management is responsible for inadequate staffing leading to negligence.

The nurse obtains informed consent from a client to perform a procedure. The nurse educates the client about The Patient Care Partnership. The nurse documents all client care in a timely manner. Examples of legal safeguards for the nurse would include the nurse obtaining informed consent from a client, the nurse educating the client about The Patient Care Partnership, and the nurse documenting all client care in a timely manner. Legal safeguards for the nurse would not include the nurse executing physician orders without questioning them. Legal safeguards for the nurse would not include the nurse claiming management is responsible for inadequate staffing leading to negligence. Legal safeguards for the nurse would not include the physician being responsible for administration of a wrongly prescribed medication.

A physician is called to see a client with angina. During the visit the physician advises the nurse to decrease the atenolol to 12.5 mg. However, since the physician is late for another visit, she requests that the nurse write down the order for her. What should be the appropriate nursing action in this situation? The nurse should ask the physician to come back and write the order. The nurse should write the order and implement it. The nurse should inform the client of the change in medication. The nurse should remind the physician later to write the work order.

The nurse should ask the physician to come back and write the order. The nurse should ask the physician to come back and write down the order. Nurses are discouraged from following any verbal orders, except in an emergency. The nurse should never write an order on a physician's behalf because this is a wrong practice. The client should be informed about the change of medications, but this is not an appropriate action. The nurse should not leave the work for a later time, because the nurse may forget it.

A client is unhappy with the health care provided to him. He approaches the nurse and informs her that he is leaving the facility. The client has not been discharged by the physician. The nurse finds that the client has dressed and is ready to go. What would the nurse's action be in this situation? The nurse should get the client restrained and call the physician. The nurse should let the client go because she cannot do anything. The nurse should call the nursing supervisor and inform her about the situation. The nurse should warn the client that he cannot come to the hospital again.

The nurse should call the nursing supervisor and inform her about the situation. The nurse should call the nursing supervisor and inform her about the situation. The client should be made to sign the document stating that he is responsible for his own actions. The nurse cannot keep the client restrained because that would be false imprisonment. Likewise, the nurse cannot overlook the incident because there is a responsibility for client care. Additionally, the nurse cannot warn the client that he will not be allowed to come back to the hospital because it is the client's right to access health care whenever required.

After reporting to work for a night shift, the nurse learns that the unit will be understaffed because two RNs called out sick. As a result, each nurse on the unit will need to provide care for an additional four acute clients, in addition to her regular client assignment. Which statement is true for this nurse when working in understaffed circumstances? The nurse will be legally held to the same standards of care as when staffing levels are normal. Understaffing constitutes an extenuating circumstance that creates a temporarily lower expectation for care for the nurse. The nurse must document that float staff, nurses on overtime, and part-time staff were contacted in an effort to fill the gaps in care. The nurse is legally obliged to refuse to provide care when understaffing creates the potential for unsafe conditions.

The nurse will be legally held to the same standards of care as when staffing levels are normal. The claim of being overworked does not constitute a legal defense, and both the potential for liability and standards of care remain unchanged despite an increased client assignment. While it is prudent to make all realistic attempts to fill the gaps in staffing, documenting these efforts does not change the nurse's legal position. A nurse has the right to refuse an unsafe client assignment but the nurse is not legally obliged to withhold care.

A nurse enters the client's room and finds the client lying on the floor experiencing a seizure activity. After stabilizing the client, the nurse informs the physician. The physician advises the nurse to prepare an incident report. What is the purpose of an incident report? To provide a method for deciding the nurse's fault in the incident To evaluate quality care and potential risks for injury to the client To provides information to local, state, and federal agencies To evaluate the immediate care provided by the nurse to the client

To evaluate quality care and potential risks for injury to the client An incident report is a written account of an unusual, potentially injurious event involving a client, employee, or visitor. Incident reports determine how to prevent hazardous situations and serve as a reference in case of future litigation. Accurate and detailed documentation often helps to prove that the nurse acted reasonably or appropriately in the circumstances. It may not always serve as a method of determining the nurse's fault in the incident. The document does not evaluate the immediate care provided to the client but states the actions taken.

Ch 7: Legal Dimensions of Nursing Practice - PrepU

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