320 Legal Dimensions of Nursing Practice
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. Causation Damages Duty Breach of confidentiality Breach of duty
Causation Damages Duty Breach of duty
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." "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."
Which process evaluates and recognizes educational programs as having met certain standards? Accreditation Credentialing Licensure Certification
Accreditation
While walking down the hall, a nurse manager overhears a staff member telling a client, "If you don't stay in this chair and stop wandering, I'm going to tie you to it." The nurse manager pulls the staff member aside and discusses what was said. The nurse manager intervenes because the staff member's statement is which type of tort? Assault Battery False imprisonment Invasion of privacy
Assault
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? Breach of duty Causation Damages Duty
Breach of duty
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? Slander Assault Invasion of privacy Fraud
Invasion of privacy
A nurse is part of a group named in a malpractice lawsuit. The plaintiff is suing for general damages. Which items would be addressed? Select all that apply. Pain Suffering Disfigurement Disability Medical expenses Lost wages
Pain Suffering Disfigurement Disability General damages include pain and suffering, disfigurement, and disability. Special damages are for losses and expenses related to the injury, such as medical expenses and lost wages.
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? The student nurse The nurse instructor The hospital The student nurse, the nurse instructor, and the hospital
The student nurse, the nurse instructor, and the hospital
A nurse is caring for a client who has undergone coronary angioplasty. The cardiac monitor is showing abnormal electrocardiogram waves, indicating atrial fibrillation. The nurse does not recognize the importance of the sign; as a result, the client's condition deteriorates and the client has to be taken up for an emergency procedure. Which describes the nurse's legal liability? Felony Defamation Tort Slander
Tort
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 adult child to direct the client's care, is: a will. a standard of care. a license. an advance directive.
an 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 will is a legal document where one communicates wishes of how to dispose of personal effects and belongings upon one's death. The terms license and standard of care have no application in this scenario.
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
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 Assault Fraud Defamation of character
Battery
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
A nurse asks a coworker about the condition of the nurse's next-door neighbor, who has been admitted to the unit. If the coworker shares the neighbor's client information with the nurse, the coworker could be held liable for committing which act? Invasion of privacy Negligence Assault Defamation of character
Invasion of privacy
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? Negligence Malpractice Assault Battery
Malpractice The facility and nurse could be charged with malpractice, which is failing to perform (or performing) an act that causes harm to a client. Administering the medication intravenously instead of orally as prescribed has caused harm to a client. Negligence is failing to perform care for a client. When a person threatens to touch a client without consent, it is assault, whereas battery is carrying out the implied threat (assault).
A nurse is reviewing the nurse practice act of the state in which the nurse is licensed. The nurse understands that this act was derived from which source of law? Constitutional Statutory Administrative Common
Statutory Nurse practice acts are an example of statutory laws, which are enacted by a legislative body. Constitutional law is based on federal and state constitutions, which indicate how the federal and state governments are created, grant them authority, and list the principles and provisions for establishing specific laws. Administrative law is administered by agencies that, among other functions, are responsible for law enforcement. Common law has evolved from accumulated judiciary decisions. Common law is thus court-made law.
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 nurse asks an unlicensed assistive personnel (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 nurse delegating appropriate care to a UAP is not reportable. Therefore, these actions do not require an incident report to be filed.
Which are torts rather than crimes? Select all that apply. Manslaughter Robbery Assault Defamation of character Negligence
Assault Defamation of character Negligence
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 physician's order or the client's consent. The nurse is at risk of being accused of which action? Slander Negligence Battery Malpractice
Battery
A client has asked that a nurse witness the signing of the client's will. What should the nurse do prior to witnessing this signature? Select all that apply. Check to see whether state laws allow the nurse to witness this signature. Assess the client's state of mind. Review the client's medical record. Ask the beneficiaries to leave the room. Talk to the client about why the client is signing the will now.
Check to see whether state laws allow the nurse to witness this signature. Assess the client's state of mind. Review the client's medical record. Talk to the client about why the client is signing the will now. Rules regulating wills vary from state to state. The nurse should be sure that the client is of sound mind and not under the influence of mind-altering drugs. There is no requirement that beneficiaries leave the room. The nurse should know why the client is signing the will now to assess for possible coercion.
The evening nurse received a change-of-shift report from the day nurse. The day nurse's report states, "The client required intubation for respiratory distress this morning, but has been stable all day." The evening nurse collects the following information during the first assessment: Skin flushed. Client lethargic. Temperature 103.0°F (39.4°C). A review of the client's chart reveals that the client's last assessment was done 7 hours earlier. A review of the findings by the nurse attorney determines which facts might be in place regarding liability? Select all that apply. Duty has not occurred since the evening nurse just started the shift. The facility will have to fire the nurse for malpractice. Breach of duty has occurred. The facility will settle the case. The spouse was notified of the change in condition.
Breach of duty has occurred. The nurses had a duty to care for the client and breached duty by not assessing the client in 7 hours. No determination of the nurse or facility's response is made until a complete investigation is done.
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 at this point, which element of informed consent would be violated? Disclosure Comprehension Competence Voluntariness
Competence
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.
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? 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.
A nurse has applied soft wrist restraints to a client following endotracheal intubation. Documentation of which information is essential when using restraints on a client? Select all that apply. Findings from patient assessment, performed every 2 hours Family presence at the bedside Foley catheter draining clear yellow urine 0.9 normal saline infusing intravenously at 100 mL/hr Chest physiotherapy completed
Findings from patient assessment, performed every 2 hours Foley catheter draining clear yellow urine 0.9 normal saline infusing intravenously at 100 mL/hr When restraints are applied, charting must indicate regular client assessment findings; provision or administration of fluids and nutrition; bowel and bladder elimination; and attempts to release the client from the restraints for a trial period.
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
A nurse talks with family members about an AIDS client from the clinic where the nurse works. Which tort has the nurse committed? Invasion of privacy Fraud Assault Slander
Invasion of privacy
A nurse is providing care to an older adult client. The client has been alert and independent with ambulation but now is exhibiting some confusion along with being unsteady when getting out of bed and walking. The nurse fails to report and document this change in status. No safety measures are taken and the client falls while getting out of bed to use the bathroom and fractures a hip. The client is experiencing significant pain from the fractured hip and requires surgery to repair the fracture. The nurse is sued for malpractice. Which action reflects the element of causation in this case? Responsibility to report changes in status Failure to document and report the change Lack of safety measures implemented with status change Fractured hip, pain, and need for surgery
Lack of safety measures implemented with status change
A nurse is called to a deposition for a malpractice charge that has resulted in the death of a client. As the chart is reviewed, the prosecuting attorney questions the nurse about several defaming comments written in the medical record about the client. What charges can be filed against the nurse due to these comments? Malpractice Slander Libel Negligence
Libel
A new graduate wants to be knowledgeable 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
Nurse practice acts are examples of which type of laws? Statutory laws Constitutional laws Administrative laws Common laws
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? The Good Samaritan law will provide legal immunity to the nurse. The Good Samaritan law will not protect the nurse because the nurse 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. Not absolute exemption because In cases of gross negligence, health care workers may be charged with a criminal offense.
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 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
A nurse becomes concerned that a coworker may have a substance use disorder. Which behaviors by the coworker would increase this concern? Select all that apply. The last two times the nurse has needed help turning a client, the coworker could not be found. The coworker has needed to leave early "to pick up my kids" several times in the last 2 months. The coworker mentioned going to the primary care provider's office twice in the last month. The coworker has stopped eating lunch in the breakroom with other nurses. The coworker made a medication error last week.
The last two times the nurse has needed help turning a client, the coworker could not be found. The coworker has needed to leave early "to pick up my kids" several times in the last 2 months. The coworker has stopped eating lunch in the breakroom with other nurses. Frequent absences from the unit, leaving early or being late, and isolation from others may be signs associated with a substance use disorder
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? The nurse withholds the medication and notifies the health care practitioner. The nurse administers the medication and reassesses the client after 30 minutes. The nurse withholds the medication, retakes the heart rate, and gives the medication at a later time. The nurse administers the medication after reviewing the client's serum potassium level.
The nurse withholds the medication and notifies 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.
Professional regulations and laws that govern nursing practice 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
A client was admitted to 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 legal term 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.
A nurse confides in a nurse friend, "I never report minor incidents. The charge nurse always wants a variance report filled out and they take so much time." Which responses by the friend are indicated? Select all that apply. "As long as no one is hurt, I don't see a problem with not reporting minor incidences." "I don't blame you, I think the charge nurse is just trying to get us in trouble." "Having documentation might keep you out of trouble someday." "Reporting helps us fix problems that result in danger to clients." "I usually document the problem in the chart, but don't fill out a report."
"Having documentation might keep you out of trouble someday." "Reporting helps us fix problems that result in danger to clients."
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."
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. "I will withhold your cell phone until you pay full attention to these discharge instructions." "I am going to insert a catheter in you, if you do not get up to go to the bathroom." "Give me your hand to hold, I can see you are upset by the bad news." "Hold still for these stitches; otherwise, I am going to have to hold you down." "Let me help you get your shirt off, so I can listen to your lungs."
"I am going to insert a catheter in you, if you do not get up to go to the bathroom." "Hold still for these stitches; otherwise, I am going to have to hold you down."
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.
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 will call the client and ask for permission to share this information with you." "I cannot give you that information due to client confidentiality." "Do you have any identification proving that 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."
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 living will can only be used in the state in which it was created." "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 LIVING WILL IS A TYPE OF ADVANCED DIRECTIVE A separate or different advance directive is not needed for each state; an advance directive can be used in any state, regardless of where it was created. The nurse should advise the client to take it when travelling out of state. The client should not assume that the family knows the client's wishes; the whole purpose of having an advance directive is to avoid the ambiguity and potential confusion that making such assumptions can cause. Other hospitals may not know who to contact to request a copy of the advance directive; therefore, it would be much safer for the client to take a copy of it while travelling.
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? "The rules made by the board of nursing don't reflect my practice." "The board of nursing exists to protect the safety of the public." "The board of nursing is established by state legislation." "Board of nursing rules keep unlicensed people from practicing nursing."
"The rules made by the board of nursing don't reflect my practice."
A nurse has been named in a malpractice lawsuit. Prior to taking the nurse's deposition, the attorney explains that the case will be governed by common law. Which question by the nurse is indicated? "Why is this not a statutory case?" "Does that mean the findings of the case are not binding?" "Will this case be precedent setting?" "Will the board of health be involved?"
"Will this case be precedent setting?" Most law involving malpractice is common law. If a case is the first to set down a rule by its decision, a precedent will be set. Statutory law, such as state nurse practice acts, is enacted by the legislature. The findings of the case are binding in a common law case. The law establishing a board of health is known as administrative law.
Which is an example of an unintentional tort? Nurses discuss a client's laboratory values in the elevator. A nurse tells a client that the client cannot leave the hospital until the client pays the bill. A nurse threatens to restrain a client if the client does not stop talking. A nurse gives the client a medication, and the client has an adverse reaction to it.
A nurse gives the client a medication, and the client has an adverse reaction to it.
Nurses may commit both intentional and unintentional torts when practicing within the profession. What intentional torts may occur in nursing practice? Select all that apply. A nurse forgets to put the side rails up on a crib and the toddler falls out. A nurse does not report a change in client condition in a timely manner. A nurse threatens to hit an older client who has dementia and is screaming. A nurse seeks employment in a hospital after falsifying credentials on a resume. A nurse places a client who is a fall risk in restraints without an order from the health care provider. A nurse makes disparaging remarks to the staff about a client who has a sexually transmitted infection (STI).
A nurse threatens to hit an older client who has dementia and is screaming. A nurse seeks employment in a hospital after falsifying credentials on a resume. A nurse places a client who is a fall risk in restraints without an order from the health care provider. A nurse makes disparaging remarks to the staff about a client who has a sexually transmitted infection (STI).
Which scenario 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
Which scenario is an example of certification? A nurse who demonstrates advanced expertise in a content area of nursing through special testing A hospital that meets the standards of the Joint Commission An education program that meets the standards of the National League for Nursing A graduate of a nursing education program who passes the NCLEX-RN
A nurse who demonstrates advanced expertise in a content area of nursing through special testing Accreditation is a voluntary process by which a nursing education program is recognized as having met certain standards by the NLN Commission for Nursing Education Accreditation and/or the American Association of Colleges of Nursing. The Joint Commission can also accredit health care agencies.
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.
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? Defamation Malpractice Assault Battery
Malpractice
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? Asking the LPN/LVN to teach a new diabetic client how to administer insulin Calling the health care provider about abnormal lab results Obtaining vital signs on a newly admitted client Delegating oral medication administration to the LPN/LVN
Asking the LPN/LVN to teach a new diabetic client how to administer insulin Teaching is not in the current scope of practice for a LPN/LVN, and thus the RN's delegation of this task to the LPN/LVN could be considered negligence. The other actions are within the scope of practice for a LPN/LVN.
A client has been in the emergency department for 3 hours for treatment of a migraine headache. Care has been delayed due to a multiple fatality car accident. The client gets up to go to the bathroom unattended, faints, and suffers a subdural hematoma. The family threatens to sue for malpractice. Which element of malpractice will be the most difficult for the attorney to prove? Duty Breach of duty Causation Damages
Causation Typically, causation is the most difficult component of malpractice to prove. Causation asks the question, "Did the nurse's actions directly cause the damages?" Duty is typically outlined in standards of care, breach of duty can be proved by documentation of the visit, and damages are clearly evident.
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
A client is to undergo surgery for removal of the gallbladder. Which action related to the client's informed consent falls within the nurse's scope of practice? Select all that apply. Ensuring the signed form is on the chart Acting as a witness to the client's signature on the form Answering questions about elements of the consent Explaining the details about the procedure to be done Identifying the risks and benefits associated with the procedure
Ensuring the signed form is on the chart Acting as a witness to the client's signature on the form Answering questions about elements of the consent he nurse's role is to confirm that a signed consent form is present in the client's chart and to answer client questions about the elements of the consent. Unless the nurse is obtaining consent for a nurse-prescribed and nurse-initiated intervention, the nurse signs the consent form as a witness to having seen the client sign the form, not as having obtained the consent. THEY DONT OBTAIN CONSENT THEN CONFIRM IT IS THERE
A nurse is caring for a client in the community who is at risk for sudden death from a chronic health condition. To reduce the legal risks associated with working with this client, the nurse carries out which action(s)? Select all that apply. Follow the prescribed plan of care for the client. Explain every nursing intervention in detail. Document nursing actions shortly after completion. Avoid physically touching the client when possible. Ensure client compliance with safety warnings.
Follow the prescribed plan of care for the client. Explain every nursing intervention in detail. Document nursing actions shortly after completion. Any decisions made outside of this plan of care may not be within the nurse's scope of practice and leaves the nurse liable for negative client outcomes. Being transparent about the plan of care with the client ensures that the nurse is providing both competent and compassionate care. The nurse uses caution, not avoidance, with physical touch to ensure appropriate boundaries are not breached. While the nurse can educate the client about safety precautions, the nurse is not able to enforce these on the client.
A registered nurse who has an associate degree would like to obtain a baccalaureate degree in nursing. The nurse works full time and has several family obligations and would like to find a program that fits into that lifestyle. What is the nurse's priority question about an educational program? How much does it cost? Is it online? What is the NCLEX pass rate? Is the program accredited?
Is the program accredited? The most important consideration is whether the program is accredited. Unaccredited programs should be avoided. Cost is important and method of delivery may be very important to this student. They are not as important as whether the program is accredited. NCLEX pass rate is not important in this case as the nurse is already registered.
Which is true of the Occupational Safety and Health Act? It requires nurses to report abuse of infants, children, and adults of all ages. It helps to reduce workforce injuries and illness in the workplace. It establishes an information clearinghouse for nurses who engage in unprofessional conduct. It protects nurses who are recovering from drug or alcohol addiction or have communicable diseases.
It helps to reduce workforce injuries and illness in the workplace. The Occupational Safety and Health Act of 1970 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 prevents them from moving from state to state. Mandatory reporting laws, not the Occupational Safety and Health Act, require nurses to report abuse. The Americans with Disabilities Act protects people with communicable diseases and those recovering from drug or alcohol addiction.
A nurse suspects that a client is a prostitute. The nurse documents this suspicion in the medical record and includes it in report to the oncoming shift. The nurse also mentions the suspicion to the nurse's sister saying, "I had a client named Susan in room 126 today who I think is a prostitute." Which violations has this nurse committed? Select all that apply. Libel Assault HIPAA Slander Battery
Libel HIPAA Slander
A nurse is preparing a presentation for a group of staff nurses about the rules affecting nursing practice and the parties involved. When describing the role of different sources for the rules, which issue would the nurse identify as being addressed specifically by state legislation? Select all that apply. Scope of practice Educational requirements of nurses Position statements related to medication administration Unprofessional conduct Clinical procedures
Scope of practice Educational requirements of nurses State legislation is involved with issues such as scope of practice and educational requirements for nursing. Position statements related to medication administration and unprofessional conduct are issues addressed by the Board of Nursing. Clinical procedures are associated with rules established by the specific health care institution.
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
A nurse and the facility have been named as defendants in a malpractice lawsuit. In addition to the nurse's attorney, whom else would be appropriate for the nurse to talk with about the case? A colleague The agency's risk manager The plaintiff's lawyer The local press
The agency's risk manager
Which best exemplifies malpractice? The nurse applies an ice pack to a client's lower back without an order and the client feels better. The nurse, using proper body mechanics, assists a client into a locked bed. The client slips and breaks a femur. The nurse administers amoxicillin to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest. The nurse administers the wrong medication to a client, who then has one episode of vomiting 5 minutes later but no further adverse reactions.
The nurse administers amoxicillin to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest. Giving the wrong medication could be cause for malpractice, but in this case, the client was not harmed.
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. The nurse confirms informed consent was give by the client to perform a procedure. The health care provider is responsible for administration of a wrongly prescribed medication. The nurse educates the client about what to expect during the hospital stay. The nurse executes the health care provider's prescriptions 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 confirms informed consent was give by the client to perform a procedure. The nurse educates the client about what to expect during the hospital stay. The nurse documents all client care in a timely manner.
While walking through a park, the nurse encounters a child with a swollen and reddened arm that hurts to move due to being struck with a baseball bat. The nurse splints the arm using two baseball bats. The child is transported to the hospital and later develops compartmental syndrome in the arm. Which statement regarding the nurse's liability in this case is accurate? The nurse was negligent because the client developed compartmental syndrome due to the nurse's treatment at the scene. The nurse should have waited for help because the Good Samaritan Act states that the nurse is not obligated to assist. The nurse is protected by the Good Samaritan Act, which states that the nurse may give emergency care using good judgment. The nurse is not protected by the Good Samaritan Act because the nurse was negligent in the care rendered.
The nurse is protected by the Good Samaritan Act, which states that the nurse may give emergency care using good judgment.
Which situation violates an element of informed consent? The nurse signs the consent as a witness to the client's signature. The nurse says, "You have to sign this before we can do the surgery." The client asks a question about the surgery prior to signing the consent form. The client says, "I wish there was a guarantee this procedure will be successful."
The nurse says, "You have to sign this before we can do the surgery." The elements of informed consent are disclosure, comprehension, competence, and voluntariness.
A physician is called to see a client with angina. During the visit the physician advises the nurse to decrease the dosage of atenolol to 12.5 mg. However, because the physician is late for another visit, the physician requests that the nurse write down the order for the physician. 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.
A nurse is writing a letter to a U.S. congressman to support the promotion of health care issues. Which guidelines would ensure a properly written letter? Select all that apply. The nurse should state the purpose of the letter briefly and clearly in the first paragraph. The nurse should name the city and state where the nurse lives and votes. The nurse should avoid using specific examples from the workplace to support the position. The nurse should restate exactly what the legislator should do at the end of the letter. The nurse should write a longer email and shorter letter. The nurse should address the letter to as many legislators as possible.
The nurse should state the purpose of the letter briefly and clearly in the first paragraph. The nurse should name the city and state where the nurse lives and votes. The nurse should restate exactly what the legislator should do at the end of the letter.
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? 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 it 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.
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."
Nursing students are discussing the requirement that they carry personal professional liability insurance as students. The nurse instructor should offer additional information when which statements are made? Select all that apply. "Since I am a student, my instructor is the one liable if I make a mistake." "I will be protected both as a student and at my CNA job." "I think this is an unnecessary expense." "I thought we would be covered by the hospital's malpractice insurance." "We are held to the same standards of care as the RNs at the hospital."
"Since I am a student, my instructor is the one liable if I make a mistake." "I will be protected both as a student and at my CNA job." "I think this is an unnecessary expense." "I thought we would be covered by the hospital's malpractice insurance." Students are responsible for their own actions and are held to the same standards as the RNs at the hospital. The insurance protects students only in their educational role, not in the role as a CNA as well. Malpractice insurance is a good protection for nurses. The hospital does carry malpractice insurance, but it may not cover students as individuals.
The client being admitted to the oncology unit conveys wishes regarding resuscitation in the event of cardiopulmonary arrest. The nurse advises the client that it would be in the client's 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 otherwise unconscious condition. A will is a legal document detailing how to dispose of one's assets and belongings upon death. Proof of health care power of attorney and a proxy directive are documents identifying another person to legally make health care decisions for the client. In this case the client is stating the client's own decisions in advance of potential incapacitation
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? The nurse informs the family about advance directives. The nurse informs the family about the living will. The nurse confirms that the client has signed the consent form. The nurse confirms that the client's family has signed the consent form.
The nurse confirms that the client's family has signed the consent form. 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 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 examination. She informs the physician and the nursing supervisor about this incident and also completes an incident report. Which action by the nurse indicates correct knowledge of handling an incident report? The nurse documents a complete description of the happenings in the client's records. The nurse makes a copy of the incident report and places it in the client's records. The nurse makes a copy of the incident report to give to the physician. The nurse mentions in the client's report that an incident report was completed.
The nurse documents a complete description of the happenings in the client's records It should not be placed in the client's records; however, the nurse can mention the incident in the client's records without mentioning the incident report.
Which are areas 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 mm Hg 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 mm Hg and decides to retake the blood Waiting an hour to reassess a significant elevation in blood pressure does not meet the standard of care.
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? The nurse is 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 is legally held to the same standards of care as when staffing levels are normal.
A nurse enters the client's room and finds the client lying on the floor experiencing a seizure. 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 determine the nurse's fault in the incident To evaluate the quality of care provided and assess the potential risks for injury to the client To provide information to local, state, and federal agencies To evaluate the immediate care provided by the nurse to the client
To evaluate the quality of care provided and assess the 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.
