Chapter 7 Course Points

An HIV-positive client discovers that the client's name is published in a research report on HIV care prepared by the client's nurse. The client is hurt and files a lawsuit against the nurse. Which offense has the nurse committed? a. Unintentional tort b. Invasion of privacy c. Defamation of character d. Negligence of duty

b. Invasion of privacy

An older adult client has expressed to the nurse a desire to specify and document the care they want to receive and do not want to receive if they become incapacitated. The nurse should encourage the client to explore what option? a. A will b. A do-not-resuscitate (DNR) order c. Assignment of a surrogate decision-maker d. A living will

d. A living will A living will is an advance directive that specifies the types of medical treatment patients do and do not want to receive should they become unable to speak for themselves in a terminal or permanently unconscious condition. A will is a legal document where one communicates wishes of how to dispose of personal effects and belongings upon one's death. The scope of a DNR order is limited to CPR and other heroic life-saving interventions. A surrogate decision-maker can makes choices on the client's behalf but does not necessarily record or convey the client's specific wishes.

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

a. invasion of privacy.

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? a. Libel b. Slander c. Negligence d. Malpractice

b. Slander

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

c. To protect the safety of the public

A student nurse is assisting an older adult client to ambulate following hip replacement surgery when the client falls and reinjures the hip. Who is potentially responsible for the injury to this client? a. The student nurse b. The nurse instructor c. The hospital d. The student nurse, the nurse instructor, and the hospital

d. The student nurse, the nurse instructor, and the hospital

A family brings the client to the emergency department in an unconscious state with a head injury. The client requires surgery to remove a blood clot. What would be the appropriate nursing intervention in keeping with the policy of informed consent prior to a surgical procedure? a. The nurse informs the family about advance directives. b. The nurse informs the family about the living will. c. The nurse confirms that the client has signed the consent form. d. The nurse confirms that the client's family has signed the consent form.

c. The nurse confirms that the client has signed the consent form.

Action has been taken against a nurse's license based on a claim that the nurse acted outside of nursing's scope of practice. The nurse's attorney determines that the nurse needs more education about the purpose of the board of nursing when the nurse makes which statement? a. "The rules made by the board of nursing don't reflect my practice." b. "The board of nursing exists to protect the safety of the public." c. "The board of nursing is established by state legislation." d. "Board of nursing rules keep unlicensed people from practicing nursing."

a. "The rules made by the board of nursing don't reflect my practice."

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

c. Battery

A client is in a persistent vegetative state following a severe motor vehicle accident. The client has no immediate family. Whom should the nurse consult when seeking direction for care? a. A surrogate decision maker b. The interdisciplinary care team c. The primary care provider d. An impartial lawyer with experience in healthcare

a. A surrogate decision maker

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

a. A nurse who demonstrates advanced expertise in a content area of nursing through special testing

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

a. A nurse who demonstrates advanced expertise in a content area of nursing through special testing

A client is in a persistent vegetative state following a severe motor vehicle accident. The client has no immediate family. Whom should the nurse consult when seeking direction for care? a. A surrogate decision maker b. The interdisciplinary care team c. The primary care provider d. An impartial lawyer with experience in healthcare

a. A surrogate decision maker Infants, young children, people with severe cognitive impairment or who are incapacitated, and people in a persistent vegetative state or coma do not have the capacity to participate in decision-making about their health care. For such people, a surrogate decision maker must be legally designated to act on their behalf. This individual's authority would supersede that of the care team, the primary care provider or an outside legal representative.

Which process evaluates and recognizes educational programs as having met certain standards? a. Accreditation b. Credentialing c. Licensure d. Certification

a. Accreditation

Which action constitutes battery? a. An older adult client refuses an intramuscular injection, but the nurse administers it. b. The nurse threatens to restrain a client if the client does not take a medication. c. While bathing a client behind pulled curtains, two nurses discuss a different client. d. The nurse tells a client that the client cannot leave the hospital because the client is seriously ill.

a. An older adult client refuses an intramuscular injection, but the nurse administers it.

An RN is working on a medical-surgical unit with a licensed practical/vocational nurse (LPN/LVN). Which action by the RN is considered negligent if injury results from this action? a. Asking the LPN/LVN to teach a new diabetic client how to administer insulin b. Calling the health care provider about abnormal lab results c. Obtaining vital signs on a newly admitted client d. Delegating oral medication administration to the LPN/LVN

a. Asking the LPN/LVN to teach a new diabetic client how to administer insulin

An RN enters a client's room and observes the unlicensed assistive personnel (UAP) forcefully pushing a client down on the bed. The client starts crying and informs the UAP of the need to go to the bathroom. What action is the RN witnessing that should be immediately reported to the supervisor? a. Battery b. Assault c. Fraud d. Defamation of character

a. Battery

The nurse is providing care to a client who had orthopedic surgery. The nurse has medicated the client for pain. However, the client reports that the 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. The nurse's failure to take further action represents which element of liability in this case? a. Breach of duty b. Causation c. Damages d. Duty

a. Breach of duty

The nurse recognizes that liability requires specific elements that must be established to prove that malpractice or negligence has occurred. Identify the specific elements. Select all that apply. a. Causation b. Damages c. Duty d. Breach of confidentiality e. Breach of duty

a. Causation b. Damages c. Duty e. Breach of duty

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

a. Certification

A client states that the client's recent fall was caused by his scheduled antihypertensive medications being 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? a. Document the client's claims and the events surrounding the alleged incident. b. Consult with the hospital's legal department as soon as possible. c. Consult with practice advisors from the state board of nursing. d. Enlist support from nursing and non-nursing colleagues from the unit.

a. Document the client's claims and the events surrounding the alleged incident.

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? a. Duty b. Breach of duty c. Causation d. Damages

a. Duty

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? a. Health care institution b. Federal legislation c. State legislation d. Board of nursing

a. Health care institution

A nurse talks with family members about an AIDS client from the clinic where the nurse works. Which tort has the nurse committed? a. Invasion of privacy b. Fraud c. Assault d. Slander

a. 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.

Nurse practice acts are examples of which type of laws? a. Statutory laws b. Constitutional laws c. Administrative laws d. Common laws

a. 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 U.S. and by the federal government and is in contrast with statutory law.

A nurse witnesses a traffic accident and dresses the open wounds sustained by a child. Later, in the hospital, the child develops complications from an infection in the wound. The family holds the nurse responsible for the complications and attempts to file a lawsuit. Which statement is true regarding how the Good Samaritan law applies to this case? a. The Good Samaritan law will provide legal immunity to the nurse. b. The Good Samaritan law will not protect the nurse because the nurse did not accept compensation. c. The Good Samaritan law is not applicable to health care workers. d. The Good Samaritan law will provide absolute exemption from prosecution.

a. The Good Samaritan law will provide legal immunity to the nurse.

Injuries related to lifting or transferring clients occur in the health care setting and may be considered a work-related injury. Which law was intended to reduce work-related injuries and illnesses? a. The Occupational Safety and Health Act of 1970 b. The Health Care Quality Improvement Act of 1986 c. Title VII of the Civil Rights Act of 1964 d. Americans with Disabilities Act of 1990

a. The Occupational Safety and Health Act of 1970

What governing body has the authority to revoke or suspend a nurse's license? a. The State Board of Nurse Examiners b. The employing health care institution c. The National League for Nursing d. The Supreme Court

a. The State Board of Nurse Examiners

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? a. The health care provider performing the surgical procedure b. The client's family or significant other c. The perioperative nurse d. The nursing supervisor

a. 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.

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 is an example(s) of legal safeguards for the nurse? Select all that apply. a. The nurse confirms informed consent was give by the client to perform a procedure. b. The health care provider is responsible for administration of a wrongly prescribed medication. c. The nurse educates the client about what to expect during the hospital stay. d. The nurse executes the health care provider's prescriptions without questioning them. e. . The nurse documents all client care in a timely manner. f. The nurse claims management is responsible for inadequate staffing leading to negligence.

a. The nurse confirms informed consent was give by the client to perform a procedure. c. The nurse educates the client about what to expect during the hospital stay e. . The nurse documents all client care in a timely manner.

After reporting to work for a night shift, the nurse learns that the unit is understaffed because two RNs called out sick. As a result, each nurse on the unit must provide care for four acute clients in addition to the nurse's regular clients. Which statement is true for this nurse when working in understaffed circumstances? a. The nurse is legally held to the same standards of care as when staffing levels are normal. b. Understaffing constitutes an extenuating circumstance that creates a temporarily lower expectation for care for the nurse. c. 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. d. The nurse is legally obliged to refuse to provide care when understaffing creates the potential for unsafe conditions.

a. The nurse is legally held to the same standards of care as when staffing levels are normal.

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

a. The nurse should ask the health care provider to come back and write the order.

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

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

The nurse is assigned to various clients on a medical unit. Which statement(s) made to a client by the nurse constitutes assault? Select all that apply. a. "I will withhold your cell phone until you pay full attention to these discharge instructions." b. "I am going to insert a catheter in you if you do not get up to go to the bathroom." c. "Give me your hand to hold, I can see you are upset by the bad news." d. "Hold still for these stitches; otherwise, I am going to have to hold you down." e. "Let me help you get your shirt off, so I can listen to your lungs."

b. "I am going to insert a catheter in you if you do not get up to go to the bathroom." d. "Hold still for these stitches; otherwise, I am going to have to hold you down."

A client being discharged from the hospital asks the nurse, "When I go visit my family out of state, should I take my living will with me, or do I need a new one for that state?" Which is the most appropriate response by the nurse? a. "A living will can only be used in the state in which it was created." b. "Take it with you. It is recognized universally in the United States." c. "As long as your family knows your medical wishes, you will not need it." d. "We have it on file here, so any hospital can call and get a copy."

b. "Take it with you. It is recognized universally in the United States."

The client being admitted to the oncology unit conveys wishes regarding the use of tube feedings if the client becomes unable to feed by mouth. The nurse advises the client that it would be in the client's best interest to obtain which document? a. A feeding plan b. A living will c. Proof of health care power of attorney d. A proxy directive

b. A living will

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? a. Assault b. Battery c. Libel d. Slander

b. Battery

A client has a prescription for amoxicillin 500 mg P.O. every 8 hours. The nurse administers the medication via the intravenous route. Based on the nurse's action, the client develops complications and has an increased length of stay. The client files a lawsuit against the facility and the nurse. Which legal action has the nurse's attorney identified that meets the criteria for the client's lawsuit? a. Negligence b. Malpractice c. Assault d. Battery

b. Malpractice

While caring for an infant, the nurse hears another child screaming in the next room and rushes there, forgetting to put the side rails up on the infant's crib. The nurse returns to the room to find that 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? a. Defamation b. Malpractice c. Assault d. Battery

b. Malpractice

A client who is scheduled for hernioplasty needs clarification regarding the procedure. The nurse calls the health care provider at the client's insistence. The health care provider, who is in a bad mood, is overheard telling the client that the nurse does not know anything. Which legal tort has the health care provider committed? a. Libel b. Battery c. Assault d. Slander

d. Slander

When talking with family over dinner, the nurse shares about a client with infertility at the hospital, identifying the person by name. Which tort has the nurse committed? a. Slander b. Assault c. Invasion of privacy d. Fraud

c. Invasion of privacy

A family brings the client to the emergency department in an unconscious state with a head injury. The client requires surgery to remove a blood clot. What would be the appropriate nursing intervention in keeping with the policy of informed consent prior to a surgical procedure? a. The nurse informs the family about advance directives. b. The nurse informs the family about the living will. c. The nurse confirms that the client has signed the consent form. d. The nurse confirms that the client's family has signed the consent form.

c. The nurse confirms that the client has signed the consent form. The nurse should confirm that the client's family has signed the consent form. However, the health care provider is responsible for having the client, or in this case, the client's family sign consent. This client cannot sign the consent form because the client is not in an alert state and is unable to communicate. If the client is not in a condition to sign the consent form, a family member may sign the consent form on the client's behalf. Advance directives are written statements identifying a competent person's wishes concerning terminal care and are not applicable here. A living will is an instructive form of advance directive; that is, it is a written document that identifies a person's preferences regarding medical interventions to use in a terminal condition, irreversible coma, or persistent vegetative state with no hope of recovery.

A client is unhappy with the health care provided and informs the nurse that the client is leaving the facility. The client has not been discharged by the health care provider. The nurse finds that the client has dressed and is ready to go. What should the nurse's action be in this situation? a. The nurse should have the client restrained and call the health care provider. b. The nurse should let the client go because the nurse cannot do anything. c. The nurse should call and inform the nursing supervisor of the situation. d. The nurse should warn the client that the client cannot come to the hospital again.

c. The nurse should call and inform the nursing supervisor of the situation.

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

c. To improve quality of care

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

d. "I don't need to assess distal pulses on a client after a femoral arteriography."

Which is an example of an unintentional tort? a. Nurses discuss a client's laboratory values in the elevator. b. A nurse tells a client that the client cannot leave the hospital until the client pays the bill. c. A nurse threatens to restrain a client if the client does not stop talking. d. A nurse gives the client a medication, and the client has an adverse reaction to it.

d. A nurse gives the client a medication, and the client has an adverse reaction to it.