Chapter 7

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, if made by the student, indicate the need for further teaching? a) "I have also put the nursing faculty at risk with my action." b) "I realize that I am held to the same standards as a registered nurse." c) "I should have informed you that I felt unprepared for my assignment." d) "I cannot be held liable because this is only my second time at this facility." e) "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." • "I am glad I am a student because nursing faculty will be blamed, not me."

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? a) "I cannot give you that information due to client confidentiality." b) "Do you have any identification proving you are related to the client?" c) "I will call the client and ask his permission." d) "I'm busy right now, but can talk later."

"I cannot give you that information due to client confidentiality."

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? a) "The Scope and Standards of Practice for Professional Ambulatory Care Nursing sets the standards for the nursing supervisor to assess a nurse." b) "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." c) "The Scope and Standards of Practice for Professional Ambulatory Care Nursing takes precedent over the facility's policies and procedures." d) "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."

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. a) The nurse documents all client care in a timely manner. b) The nurse educates the client about The Patient Care Partnership. c) The nurse obtains informed consent from a client to perform a procedure. d) The nurse claims management is responsible for inadequate staffing leading to negligence. e) The nurse executes physician orders without questioning them. f) The physician is responsible for administration of a wrongly prescribed medication.

A B C

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, if provided by the student, would indicate the student has a clear understanding of torts? a) A nurse is telling a client he cannot leave the hospital until he pays his bill. b) A nurse gives a medication and client has an adverse reaction. c) A nurse is threatening to restrain a client if he does not stop talking. d) Nurses are in the elevator discussing a client's laboratory values.

A nurse gives a medication and client has an adverse reaction.

Which of the following 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) A graduate of a nursing education program who passes NCLEX-RN. d) An education program that meets standards of the National League for Nursing.

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

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

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

Accreditation

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? a) The student nurse b) All of the above c) The nurse instructor d) The hospital

All of the above

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

B

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? a) Disclosure b) Competence c) Comprehension d) Voluntariness

Competence

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? a) "I had a duty and it was my responsibility to get clarification before administering the medication, which I did not." b) "I could not read the health care provider's handwriting, so I am not at fault." c) "I had a duty and it was my responsibility to double check the medication, which I did, yet this still happened." d) "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 get clarification before administering the medication, which I did not."

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

Invasion of privacy

A client has a prescription for amoxicillin (Amoxil) 500 mg P.O. (by mouth) every 8 hours. The nurse administers the medication via the intravenous route. Based on the nurse's action, the client develops a pulmonary embolus, experiences respiratory distress, and is transferred to the intensive care unit. The client's family files a lawsuit against the facility and the nurse. While reviewing the case, which legal action has the nurse attorney identified that meets the criteria for the client's lawsuit? a) Malpractice b) Assault c) Negligence d) Battery

Malpractice

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) Malpractice b) Libel c) Negligence d) Slander

Slander

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? a) Reporting the abuse to the appropriate authorities b) Informing the client of her right to keep this information private c) Ensuring the client's statement is confirmed by another nurse d) Performing an assessment to confirm the client's statement

Reporting the abuse to the appropriate authorities

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? a) Oxygen 2/L via nasal cannula b) Neurologic assessments every 5 minutes c) Diazepam (Valium) 5 mg intravenously now d) Restrain all four extremities

Restrain all four extremities

A registered nurse enters a client's room and observes the unlicensed assistive personnel (UAP) pushing a client down on the bed. The client starts crying and informs the UAP that he needs to go to the bathroom. The UAP holds the client down and tells him he was just in the bathroom. The nurse observing this incident is aware that the UAP's action is an example of: a) assault. b) fraud. c) battery. d) defamation of character.

battery.

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

The nurse ensures that the client's family signs the consent form.

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? a) Consult with the hospital's legal department as soon as possible. b) Enlist support from nursing and non-nursing colleagues from the unit. c) Document the client's claims and the events surrounding the alleged incident. d) Consult with practice advisors from the state board of nursing.

c

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

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

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? a) Obtain a medical order. b) Get written consent. c) Sedate the client. d) Notify the family.

a

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) false imprisonment. c) defamation of character. d) professional negligence.

invasion of privacy.

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

performing a surgical procedure without getting consent

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

to protect the safety of the public

The nurse educator is presenting an in-service on nursing and malpractice. Which statements, made by the nursing staff, would indicate to the educator that further teaching is required? Select all that apply. a) "If I make a mistake, I will not tell anyone" b) "I will have the supervisor fill out the incident report when I make an error." c) "I am accountable for any task that I delegate." d) "The nursing plan of care must be accurate and be followed. It is part of the client's permanent record." e) "When I document, I make sure it is factual, accurate, complete, and timely."

• "If I make a mistake, I will not tell anyone" • "I will have the supervisor fill out the incident report when I make an error."

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.) a) "The process of bringing and trying this lawsuit is called litigation." b) "As the defendant, you will be presumed guilty until proven innocent." c) "Common law is based on the principle of stare decisis." d) "The defendant is the person who is initiating the lawsuit." e) "The opinions of appellate judges are published and become common law." f) "We will start litigation in the first-level court known as the appellate court

• "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 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. a) The nurse questioned the client about her social life even though it did not affect care planning. b) Because the facility is a teaching facility, the nurse allowed the nursing student to take the client's picture for his care plan. c) With the client's permission, the nurse explained the client's diagnosis to the client's spouse. d) The nurse removed the client from the emergency department waiting room into a private area to collect assessment data. e) 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 removed the client from the emergency department waiting room into a private area to collect assessment data.