NRSG 1125 PrepU Legal Issues

A client with end-stage pulmonary hypertension tells the physician they don't want any heroic measures should their heart stop, and doesn't want to be placed on a ventilator. The physician enters a do-not-resuscitate order into the hospital's computer system. Which ethical principle is the nurse upholding by supporting the client's decision?

Autonomy

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?

Battery

Which is true of the Occupational Safety and Health Act?

It helps to reduce workforce injuries and illness in the workplace.

If the dosage is inappropriate for a client, who is responsible?

Nurse

What might a nurse need to do to ensure the continuation of his or her nursing license?

Obtain continuing education credits

A nurse enters a client's room and finds that the client is lying on the floor. The nurse makes the client comfortable on the bed and completes an assessment. The nurse then informs the health care provider and the nursing supervisor about this incident and also completes an incident report. Which actions by the nurse indicates correct knowledge of handling an incident report?

completes a full incident report

Good Samaritan laws

provide legal immunity to passersby who provide emergency first aid to victims of accidents.

A mentally incapacitated client is scheduled for surgery. Considering the principle of autonomy, who should give the consent for surgery?

surrogate decision maker

A nurse is working in a clinic where a family member's spouse is treated for a sexually transmitted disease. The nurse is concerned about the risk to family members. What is the most appropriate action for the nurse to take?

encourage the client to speak with the family member about the diagnosis if the client has not already done so.

While a client admitted to the medical-surgical unit is in the radiology department, a visitor claiming to be the client's cousin arrives on the medical-surgical unit and asks the nurse to provide a brief outline of the client's illness. Which response by the nurse would be most appropriate, both legally and professionally?

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

A client who is positive for human immunodeficiency virus (HIV) tells the nurse that the client's significant other is the only family member who knows the client's health status. What should the nurse do to keep the client's health status confidential? Select all that apply.

1. Ask all family members, except the clients significant other to wait outside when she is educating the client 2. Use the hospital code for HIV when documenting

A client made a formal request to review his or her medical records. With review, the client believes there are errors within the medical record. What is the most appropriate nursing response?

According to HIPAA legislation, you have a right to request changes to inaccurate information.

A client with depression who is undergoing a colonoscopy tomorrow is receiving preoperative education regarding the procedure. Which nursing task best describes the explanation of the procedure and the associated risks and benefits?

Acquiring informed consent

A nurse must restrain a client to ensure the safety of other clients. When using restraints, which principle is a priority?

Use an organized, efficient team approach to apply and secure the restraints

Which nursing student would most likely be held liable for negligence?

A nursing student administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home.

A nurse is caring for an older adult client with advanced Parkinson's disease. Which client statement about advance directives indicates a need for further instruction?

"I don't really need to sign anything. I'm depending on my health care provider to tell my family what to do if something bad happens."

A nurse was informed that a family member was involved in a car accident and transported to the emergency department in the same facility. What action by the nurse best demonstrates understanding of client privacy?

Calling the client information desk to find out the room number of the family member

A client with a history of heroin addiction is admitted to the hospital intensive care unit with a diagnosis of opioid drug overdose. While talking with a nurse, the client's parent reports a plan to have his child declared legally incompetent. Which response by the nurse is most therapeutic?

"I'll help you contact the hospital legal representative for help with the paperwork."

A 15-year-old client who is 26 weeks pregnant has been admitted to the labor and delivery unit with reports of abdominal pain. Her parents want to speak with a nurse about her condition. How should the nurse respond?

"I'll need a signed consent from your daughter to give you medical information."

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?

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

A client in a long-term care facility signed a form requesting not to be resuscitated. The client develops pneumonia, and the client's health rapidly deteriorates. The client is no longer competent, but the family wants everything possible done for the client. When the family asks the nurse what will be done, what is the best response by the nurse?

"We will continue to use antibiotics to treat the pneumonia."

A nurse overhears another nurse say to a client, "If you do not stop spitting, I'm going to leave you outside in your wheelchair so that you miss your dinner." What is the most appropriate response by the nurse who overhears this conversation?

"Your verbal threats to the client are legally considered assault."

The nurse is interviewing a pediatric client and family in a clinic after the client had a fever at home. The parent said she gave the client one adult acetaminophen earlier in the day because she ran out of children's acetaminophen. What is the nurse's next action? Select all that apply.

1. Document that the parent administered adult acetaminophen. 2. Teach the parent not to use adult medications with children. 3. Continue to complete the physical assessment of the client.

The nurse is in the process of reporting to the health care provider the changes in the client's status. Which are appropriate ways for the nurse to communicate information about the client to the health care provider? Select all that apply.

1. Informing the provider of the client's present heart rate of 116 beats/min 2. Showing the provider the trends from baseline to present in blood pressure 3. Faxing the results of blood chemistry levels to the provider's office

Which actions should the nurse perform to limit casual access to the identity of clients? Select all that apply

1. obscuring identifiable names of clients and private information about clients on clipboards 2. placing fax machines, filing cabinets, and medical records in areas off-limit to the public 3. keeping record of people who have access to clients' records

The nursing student is studying violence and mistreatment against the older woman. While researching it, the student learns that laws require health care professionals to report elder or vulnerable person mistreatment. How many states currently have these laws?

50

A client was hit in the eye with a stick. The nurse notes edema to the conjunctiva. What documentation by the nurse describes the assessment findings?

Chemosis

Which type of law protects each person's freedom and property rights?

Civil law

Which is an example of an unintentional tort?

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

Which scenario is an example of certification?

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

A nurse is caring for a client with bruises on her face and arms. Her partner refuses to leave the client's bedside and answers all of the questions for the client. Which intervention by the nurse would be most appropriate?

Collaborate with the physician to make a referral to social services.

The nurse used a secure access code to obtain a morphine 2 mg/ml vial from the computerized automated dispensing cabinet (ADC). Before exiting the system, the nurse is prompted to count the remaining vials. The nurse counts 10 remaining vials, but the system reads 9 remaining vials. What is the next action by the nurse?

Ask another nurse to assist with following the procedure to resolve the discrepancy.

A graduate nurse enters a client's room and finds the client unresponsive, not breathing, and without a carotid pulse. The graduate nurse is aware that the client has mentioned that he does not wish to be resuscitated, but there is no DNR order on the client's chart. What is the nurse's best action?

Call a code and begin resuscitating the client.

A nurse is caring for a client who is well known in society. A person inquires about the medical details of the client, saying that they are a family member. The nurse reveals the requested information. Later, the nurse comes to know that the inquirer was not a family member. Which ethical rule of professional-client relationships has the nurse violated?

Confidentiality

A family with two new foster children in the school system has made an appointment to visit with the school nurse concerning the placement of these two children. The family shares with the nurse that the children's parents are both addicted to drugs and no longer able to provide for the children's basic needs. During this session, the school nurse should ascertain which vital piece of information related to the health care needs of the children?

Do the children have any allergies to drugs or food items?

A nurse is reluctant to provide care at an accident scene. Which legal definition is true regarding the provision of nursing care?

Good Samaritan laws are designed to protect the caregiver in emergency situations.

On a particular 12-hour day shift, the nurse-client ratio on a busy floor is lower than usual because a member of the health care team called in sick for the day. Which example shows this nurse practicing with a good sense of legal competence in response to this challenge?

Following the chain of command, the nurse requests help completing the tasks essential to client care that day.

A visitor to the surgical unit asks the nurse about another client on the unit. The visitor viewed the client's name on the computer screen of another nurse at the nurses' station and recognized the client as a relative. What is the first action of the nurse in relation to this situation?

Inform the other nurse that the viewed screen resulted in a breach of confidentiality.

A client informs the nurse that the client wants to discontinue 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 that the client is going against medical advice.

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?

Malpractice

Assessment of visual acuity reveals that the client has blurred vision when looking at distant objects but no difficulty seeing near objects. The nurse documents this as which of the following?

Myopia

A school nurse assesses that an 8-year-old child is preoccupied with sexual comments and activities. The nurse is concerned that the child may have been sexually abused at home. What is the nurse's best response to this situation?

Notify the local Child Protective Services.

Which statement about laws governing the distribution of controlled substances is true?

Nurses are responsible for adhering to specific documentation about controlled substances.

What nursing action demonstrates the intended impact of the American Nurses Association (ANA) standards of care on mental health nursing care?

Referring to the standards to determine if a particularly prescribed treatment falls within the scope of a nurse's practice

A toddler has been admitted to the pediatric unit with pneumonia. While assessing a toddler the nurse finds bruise marks consistent with a belt buckle on the buttocks. The nurse suspects the toddler is being abused. What action should the nurse take?

Report the case to local authorities.

The nurse is caring for a confused older adult client who requires surgery for a broken hip. What steps does the nurse take to determine if the client has a durable power of attorney for health care and how to contact that person?

Review the medical chart for a copy of a durable power of attorney for health care or permission for disclosure contact.

A 16-year-old client is admitted to the emergency department following an accident. The client sustained a head injury, is unconscious, and has compound fractures of the right tibia and fibula. No family members accompanied the client and none can be reached by phone. The surgeon instructs the nurse to take the client to the operating room immediately. Which of the following actions should the nurse take regarding informed consent?

Take the client to the operating room for surgery without informed consent (The surgeon can take responsibility for consent in this situation)

Which court decision or act states that psychotherapists have a duty to exercise reasonable care in protecting the foreseeable victims of their clients' violent actions?

Tarasoff v. Regents of the University of California

Consent for urgent treatment is needed for a minor. The parents are unable to be at the hospital. What action by the nurse constitutes informed consent?

Telephone consent with two witnesses listening simultaneously.

The interdisciplinary team is discussing the best approach to planning the care for a client with complex psychiatric-mental health needs. When determining which tasks can be performed by the psychiatric-mental health registered nurse (PMH-RN) and which must be performed by the psychiatric-mental health advanced practice registered nurse (PMH-APRN), the team should prioritize guidelines from what source?

The American Nurses Association Standards of Practice

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?

The Good Samaritan law will provide legal immunity to the nurse

What governing body has the authority to revoke or suspend a nurse's license?

The State Board of Nurse Examiners

A client who was brought to the emergency room for gunshot wounds dies in intensive care 15 hours later. Which statement concerning the need for an autopsy would apply to this client?

The coroner must be notified to determine the need for an autopsy

A nurse is admitting a client to the palliative unit and discussing advanced directives. Which statement made by the client leads the nurse to believe the client requires clarification around advanced directives?

This will stop my daughter-in-law from putting me in a home."

The quality assurance nurse is reviewing orders on a client's chart. Which order transcribed by the nurse would require the quality assurance nurse to speak with the nurse manager?

Tom B. Smith 12/28 sertraline hydrochloride 25 mg oral twice Frank Bill, MD

An agitated client demands to see the chart to read what has been written about the client. Which statement is the nurse's best response to the client?

You have the right to see your chart. Please discuss your wish with your physician."

A client with terminal breast cancer is being cared for by a long-time friend who is a physician. The client has identified her sister as the agent in her healthcare power of attorney. The client loses decision-making capacity, and the sister tells the nurse, "A different physician will be caring for my sister now. I've dismissed her friend." In response, the nurse should

abide by the wishes of the sister who holds the durable power of attorney.

The client is brought to the hospital in a coma. The nurse understands that when a person is incapacitated, the document used to dictate the patient's written instructions for health care is called:

advance directive

The nurse is planning an education for new nurses on psychiatric units. Which topic should be given priority?

breach of confidentiality

When the nurse informs a client's employer of the client's autoimmune deficiency disease, the nurse is committing the tort of:

invasion of privacy.

Chemosis

is a common manifestation of pink eye (swelling of the conjunctiva). Papilledema is swelling of the optic disc due to IOP. Strabismus is unaligned eyes. Proptosis is downward displacement of the eyeball.

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.

A client tells a nurse that she's in a nontraditional same-sex relationship. The woman's partner is the healthcare surrogate for the client and her fetus. The sperm donor, who is their best friend, has waived parental rights. If the client can't make healthcare decisions for the fetus, who's responsible for making them?

the client's partner

Professional regulations and laws that govern nursing practice are in place for which reason?

to protect the safety of the public