01.07 Legal Considerations

Question 6 of 10 Which of the following is an example of negligence on the part of the nurse? Select all that apply. A nurse did not provide assistance right away when a client fell on the floor A nurse failed to give prescribed medications that would have helped a client's deteriorating condition A nurse did not use phototherapy correctly and an infant was burned A nurse used restraints on a client who was hurting himself A nurse knowingly gave the incorrect dose of pain medication

Answe ✅A nurse failed to give prescribed medications that would have helped a client's deteriorating condition Nurses could potentially become involved in forms of malpractice by practicing nursing care inappropriately. Negligence describes the nurse's failure to act in a reasonable manner or to perform tasks that anyone else of sound mind would do. Therefore, failing to give prescribed medications to help a client's deteriorating condition is an act of negligence. ✅A nurse did not provide assistance right away when a client fell on the floor A nurse failing to provide assistance right away to a client who fell is an act of negligence. A nurse knowingly gave the incorrect dose of pain medication Since the nurse knowingly gave the incorrect dose of pain medication, this does not describe a nurse acting in a negligent manner. A nurse used restraints on a client who was hurting himself It is appropriate to utilize restraints when a client is harmful to himself or others. ✅A nurse did not use phototherapy correctly and an infant was burned A nurse who causes harm to a client by incorrect use of equipment can be found negligent.

Question 4 of 10 A client is upset about the treatment received while in the hospital, and wants to leave AMA. The nurse should inform the client that it is within the client's right to leave the hospital but should also include what information when care is refused? Select all that apply. Tell the client that he has a right to refuse care even if it is not the best decision Ask the client about what could be done to make it better Inform the client that leaving AMA means that insurance will not pay for the visit Remind the client that he can always return for treatment if he changes his mind The client cannot return again to this facility for treatment if he refuses care now

Answer The client cannot return again to this facility for treatment if he refuses care now If the client refuses treatment but returns later, he or she is allowed to receive care again. ✅Ask the client about what could be done to make it better Since it is not in the best interest of the client to leave AMA, the nurse should discuss the issue with the client and try to find a way to resolve the issue. ✅Remind the client that he can always return for treatment if he changes his mind Even if a client does leave AMA, it does not prevent the client from returning and receiving care at a later time. ✅Tell the client that he has a right to refuse care even if it is not the best decision The competent client has the right of autonomy, which is the right to make decisions about his or her own healthcare. The client may decide to leave AMA even if it is not the best decision. ✅Inform the client that leaving AMA means that insurance will not pay for the visit A client has the right to leave against medical advice (AMA) which means that the client can leave the facility even though it is not recommended by the healthcare provider. When a client wants to leave AMA, the nurse cannot stop him, but can inform the client that insurance will not cover the visit and the client is responsible to pay the full bill. This is usually a deterrent for clients who want to leave.

Question 5 of 10 A nurse takes the NCLEX exam and passes to obtain a license to practice. The license is issued by the State Board of Nursing. What are other examples of roles of the State Board of Nursing? Select all that apply. Accrediting nursing programs Implementing laws that govern nursing practice Determining salary information for registered nurses within the state Disciplining a nurse who has been charged with malpractice Promoting the use of evidence-based practice

Answer ✅Accrediting nursing programs Each state has a State Board of Nursing that governs many of the activities of nursing within the state. While some of the exact tasks may vary, a State Board of Nursing is typically responsible for issuing a license for a nurse to practice after passing the NCLEX, accrediting nursing school programs, and disciplining nurses that have been charged with malpractice. Therefore, the accreditation of nursing programs is a role of the State Board of Nursing. ✅Disciplining a nurse who has been charged with malpractice Discipline of a nurse charged with malpractice is a role of the State Board of Nursing. ✅Implementing laws that govern nursing practice The implementation of laws that govern the nurse practice act is a role of the State Board of Nursing. Promoting the use of evidence-based practice This is not within the role of the State Board of Nursing. Determining salary information for registered nurses within the state This is not within the role of the State Board of Nursing.

Which of the following are examples of nursing malpractice? Select all that apply. Waiting several hours to notify the provider when a client requests vertigo medication Administering the wrong drug resulting in harm to the client Refusing to give permission for a client to leave the floor to smoke outside Forgetting to do a sponge count during surgery and leaving a sponge inside the client Failure to notify the provider about a client's declining level of consciousness

Answer ✅Administering the wrong drug resulting in harm to the client Medical malpractice describes nursing care that resulted in harm toward the patient. When a nurse is charged with medical malpractice, there are 4 basic elements that must be present for a case. These include duty, breach of duty, damages, and causation. Refusing to give permission for a client to leave the floor to smoke outside This action does not result in harm to the client, and are not examples of negligence in nursing. Waiting several hours to notify the provider when a client requests vertigo medication This action does not result in harm to the client, and are not examples of negligence in nursing. ✅Failure to notify the provider about a client's declining level of consciousness Medical malpractice describes nursing care that resulted in harm toward the patient. When a nurse is charged with medical malpractice, there are 4 basic elements that must be present for a case. These include duty, breach of duty, damages, and causation. ✅Forgetting to do a sponge count during surgery and leaving a sponge inside the client Medical malpractice describes nursing care that resulted in harm toward the patient. When a nurse is charged with medical malpractice, there are 4 basic elements that must be present for a case. These include duty, breach of duty, damages, and causation.

Question 7 of 10 A registered nurse is asked to administer a drug that is considered an anesthesia induction agent. The nurse is not sure if this is within her scope of practice. Which of the following describes the nursing scope of practice? Select all that apply. The scope of practice dictates the legal actions taken against the nurse if the nurse practices outside of nursing boundaries The scope of practice is a law set forth by the American Nurses' Association The scope of practice outlines what the nurse can and cannot do based on experience and education The scope of practices defines the actions permitted by law for the nursing profession The scope of practice is identical to policies and procedures in healthcare institutions

Answer ✅The scope of practices defines the actions permitted by law for the nursing profession The scope of practice for a nurse is defined by the nurse's state of licensure ✅The scope of practice outlines what the nurse can and cannot do based on experience and education It defines the actions that the nurse can and cannot perform based on education and experience. The scope of practice is a law set forth by the American Nurses' Association The scope of practice is a law passed in each individual state. The ANA reviews the nursing scope of practice and approves the nursing scope of practice statement. The scope of practice is identical to policies and procedures in healthcare institutions There is some variability between policies and procedures in individual institutions and the nursing scope of practice. The scope of practice dictates the legal actions taken against the nurse if the nurse practices outside of nursing boundaries Legal actions against a nurse would be determined by the nurse's local jurisdiction, not the scope of practice.

Question 8 of 10 A client has been brought into the emergency department after being injured during a construction accident. During assessment and treatment, a law enforcement officer arrives and asks for information about the client. Which information can the healthcare center disclose to law enforcement? The client's name and address The client's employment status The intentions of the client for being at a construction site The insurance company paying for the treatment

Answer A ✅The client's name and address Some situations that involve law enforcement require the nurse to provide information to officials. Nurses may be limited on the type and amount of information they are able to provide and it usually means that only information that is pertinent to the case is required. Information the nurse may give includes the patient's name, address, date of birth and place of birth, distinguishing physical characteristics (tattoos, etc), blood type, date and time of treatment, and type of injury. Information a nurse may NOT give to law enforcement include DNA, dental records, or analysis of blood or tissue. The intentions of the client for being at a construction site A nurse may not disclose these types of information to law enforcement. The insurance company paying for the treatment A nurse may not disclose these types of information to law enforcement. The client's employment status A nurse may not disclose these types of information to law enforcement.

Question 3 of 10 A nurse made a mistake with administering a medication, which caused her client to become ill and to stay in the hospital an extra day. The nurse is considering telling the client that it was the nurse's mistake that caused the complications. Which implications should the nurse consider when disclosing this information to the client? The client may be angry at the hospital instead The nurse manager should be informed prior to talking to a client The client will be more likely to sue the nurse The client will no longer be upset

Answer B The nurse manager should be informed prior to talking to a client When a nurse makes a mistake while performing an aspect of care, the nurse should admit the mistake to the client, but should involve the nurse manager before talking to the client. Clients usually appreciate straightforwardness and honesty. Admitting a mistake does not necessarily change the situation, but the client may be more likely to trust the nurse because of honesty. The client will be more likely to sue the nurse When a nurse is straightforward about a mistake, it builds trust and may decrease the potential for the client to sue the nurse. The client may be angry at the hospital instead Rather than shifting the blame to another entity, the nurse communicating with the client about the mistake usually improves the relationship between client and nurse. The client will no longer be upset It is likely the client will be upset after the nurse admits a mistake, but the consequences could be much worse if the nurse did not admit the mistake, and the client found out later.

Question 9 of 10 A 12-year-old client needs to have treatment that involves a surgical procedure that will save the child's life. The parents refuse to give consent for the procedure based on their personal convictions. Which of the following is allowable for the healthcare team in response? Allow the 12-year-old to give consent for the procedure Perform the procedure anyway, citing that it is in the client's best interest Contact the court system with the information about the case Transfer the care of the child to the next closest adult relative to sign the consent

Answer C ✅Contact the court system with the information about the case In a case where a minor child needs a life-saving procedure and the parents are unwilling to give consent, the healthcare provider may contact the court system for involvement. If the provider feels that a medical procedure would prevent death or permanent disability to the minor child, a court order could be granted quickly enough to hear the case and decide that the child can receive the treatment anyway. Allow the 12-year-old to give consent for the procedure In MOST states, the age of consent is 16. A 12-year old cannot consent for themselves. Perform the procedure anyway, citing that it is in the client's best interest This is not an appropriate action for the healthcare team if the parents (legal guardians) are refusing care. Transfer the care of the child to the next closest adult relative to sign the consent This is not appropriate as the parents are the legal decision-makers for the child. If the healthcare providers are concerned that the reason the parents are unwilling is unjustified and not in the best interest of the child, they can contact the court system.

Question 2 of 10 A nurse works in a busy and crowded clinic where there is little privacy for clients or the nursing staff. The nurse needs to discuss a client's condition with another nurse but does not want to breach the client's privacy. Which best describes how the nurse would best uphold client privacy in this environment? Walk away to as quiet of area as possible and move away from others Wait until the end of the shift and more people have left the area Write down the information and pass it back and forth in printed form Step into an area such as an elevator, where there may be fewer people

Answer a Walk away to as quiet of area as possible and move away from others Although nurses are mandated to protect patient privacy, it may be physically difficult to carry out while working in a busy and crowded facility. When the nurse must discuss a client's condition with another professional and it cannot wait, the nurse should find as quiet and private of place possible to hold the discussion. Public places, such as hallways or elevators, are not appropriate, even if it seems that no one is nearby. Wait until the end of the shift and more people have left the area It is not always possible to wait to discuss a situation. Rather than wait, the nurse should find a quiet area to talk. Write down the information and pass it back and forth in printed form Printed information is a high risk for others to read. It is better for the nurse to have a verbal conversation in this situation. Step into an area such as an elevator, where there may be fewer people An elevator constantly has people stepping in and out and is not a private area for a conversation.

Question 10 of 10 Which best describes the difference between a nurse's scope of practice and a nurse's standard of care? The scope of practice determines criteria used for job proficiency, while the standard of care determines the extent of the nurse's activities under law The scope of practice is the boundary of what the nurse can perform by law, while the standard of care determines the quality of the care given by the nurse The scope of practice is a guideline that is determined by each facility's policies, while the standard of care is governed by the nurse practice act of each state The scope of practice guides the nurse about how to provide the most appropriate client care, while the standards of care are reflected differently between various levels of nursing professionals

Answer:b ✅The scope of practice is the boundary of what the nurse can perform by law, while the standard of care determines the quality of the care given by the nurse The scope of practice and the standard of care are two terms that are often used within nursing practice. They may seem similar, but they have different meanings. The scope of practice refers to the parameters within which a registered nurse can work. It is often defined by laws in the state where the nurse practices. Alternatively, the standard of care describes the type and quality of care given by a nurse. Guidelines for standards of care are often set by healthcare facilities and institutions where nursing care is provided. The scope of practice determines criteria used for job proficiency, while the standard of care determines the extent of the nurse's activities under law A scope of practice is the boundary within which the nurse practices. The standard of care is the quality of care the nurse performs. The scope of practice is a guideline that is determined by each facility's policies, while the standard of care is governed by the nurse practice act of each state The scope of practice is defined by the state in which the nurse is working, not individual facilities. The standard of care is often set by healthcare facilities. The scope of practice guides the nurse about how to provide the most appropriate client care, while the standards of care are reflected differently between various levels of nursing professionals It is the opposite. The scope of practice describes what a nurse may and may not do under a particular license, while the standards of care is a guide to providing quality nursing care.