ch 7 legal dimensions of nursing

Which statements made by a nurse would indicate to a nurse manager that the nurse requires further training? Select all that apply.

"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."

Which scenario is an example of certification?

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

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 client is in a persistent vegetative state. The client has no immediate family and is a ward of the state. Under these circumstances, who will speak on this client's behalf?

A surrogate decision maker

A client informs the nurse about leaving the health care facility because the client is not satisfied with the treatment. The nurse knows that the client's treatment is incomplete and further testing and evaluations are scheduled. Which action by the nurse would be most appropriate to prevent false imprisonment?

Ask the client to sign a release without medical approval.

A nurse is named as a defendant in a malpractice lawsuit. Which action would be recommended for this nurse?

Do not volunteer any information on the witness stand.

Which is true of the Occupational Safety and Health Act?

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

Which best exemplifies malpractice?

The nurse administers amoxicillin to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest.

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 is protected by the Good Samaritan Act, which states that the nurse may give emergency care using good judgment

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, and the hospital

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

To protect the safety of the public

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:

an advance directive.

Which action constitutes battery?

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

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?

Obtain a medical order.

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 confirms that the client's family has signed the consent form.

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

accreditation Accreditation is the process by which an educational program is evaluated and recognized as having met certain standards. Credentialing refers to ways in which professional competence is ensured and maintained. Licensure is the process by which a state determines that a candidate meets certain minimum requirements to practice in the profession—and grants that person the license to do so. Certification is the process by which a person who has met certain criteria established by a nongovernmental association is granted recognition in a specified practice area.

An alert, older adult has been deemed to be in imminent danger of harm to self and is being held on the mental health unit for 72 hours. The client begins to scream and demand they be discharged now. The nurse informs the client that if they do not stop screaming, they will be given a sedative and placed on restraints.

assault and verbally threatening to administer a sedative

A client with end-stage renal disease decides against further treatment and requests a "Do Not Resuscitate" (DNR) order. The DNR status is part of the change-of-shift report. The client stops breathing and a nurse begins cardiopulmonary resuscitation. The family is upset and makes a complaint to the charge nurse. The charge nurse appropriately identifies that nurse has committed: 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?

battery

While riding in the elevator, a nurse discusses the HIV-positive status of a client with other colleagues. The nurse's action reflects:

invasion of privacy. The nurse's action reflects an invasion of the client's privacy. Disclosing confidential information to an unauthorized third party subjects the nurse to liability for invasion of privacy, even if the information is true. Defamation of character includes false communication that results in injury to a person's reputation. Negligence is an act of omission or commission. Prevention of movement or unjustified retention of a person without consent may be false imprisonment.

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?

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. The lack of action on the nurse's part indicates unintentional tort. A misdemeanor or felony would be an offense under criminal law, and neither is applicable in this case. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property.

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?

battery Battery is intentional and wrongful physical contact with a person that entails an injury or offensive touching. Performing treatment without permission or receiving informed consent from the client might constitute both assault and battery. Judgments of battery suits have been based on the application of restraints to confused clients. Slander is a verbal attack on a person's character. Malpractice pertains to actions committed and negligence to actions omitted that cause physical harm to a client.

Which statement(s) by a nurse to a charge nurse indicates that the nurse requires further training? Select all that apply.

"When I sign the consent form as a witness, I am saying that the person knows all the risks and benefits of the procedure." "I must make sure I give the client all necessary information about the procedure before I have the client sign the consent form." "When a client is having surgery, it is my responsibility to get the consent."

Which are torts rather than crimes? Select all that apply.

Assault Defamation of character Negligence

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 Breach of duty is the failure to assess, intervene, or notify the health care provider regarding the client's condition. It does not meet the expected standard of care. Duty refers to an obligation to use due care and is defined by the standard of care appropriate for the nurse-client relationship. Causation is when the failure to meet the standard of care caused injury. Damages are the harm or injury to the client

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

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

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?

Slander The nurse can be charged with slander, which is a verbal attack on a person's character. Libel pertains to damaging written statements read by others. Both libel and slander are considered defamation of character-an intentional tort in which one party makes derogatory remarks about another that diminish the other party's reputation. To be found guilty of slander or libel, the statement must be proved false. Negligence and malpractice pertain to actions which are committed or omitted, thereby causing physical harm to a client.

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

The State Board of Nurse Examiners The State Board of Nurse Examiners in the United States may revoke or suspend a nurse's license or registration. 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. The National League for Nursing is a national organization for faculty nurses and leaders in nurse education.

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 has stopped eating lunch in the breakroom with other nurses.

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, educates the client about what to expect during the hospital stay, and documents all client care in a timely manner.

Nurses complete incident reports as dictated by the agency protocol. What is the primary reason nurses fill out an incident report?

To improve quality of care

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, should name the city and state where the nurse lives and votes, and should restate exactly what the legislator should do at the end of the letter.

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. 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.

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 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.

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 The staff member's statement reflects a threat of contact with another person without the person's consent. This is considered assault. Battery is an assault that is carried out and includes willful, angry, and violent or negligent touching of another's body or clothes (or anything attached to or held by that person). False imprisonment is the unjustified retention or prevention of the movement of another person without proper consent. This would apply if the staff member did in fact tie the client to the chair. Invasion of privacy involves the disclosure of information without the person's consent.

The nurse is providing care to a client whose condition has progressively declined. The nurse assesses and makes appropriate interventions as well as notifies the health care provider. Despite the nurse's efforts, the client expires. What element of liability has the nurse demonstrated?

duty Duty refers to an obligation to use due care. The nurse assessed the client and made appropriate interventions and notifications. Breach of duty is the failure to meet the standard of care. An example of breach of duty would be not performing assessments, appropriate interventions, and notifications of the health care provider. Causation is when the breach of duty caused the injury. An example of causation would be failure to perform assessment and appropriate interventions when providing client care, and this caused injury to the client. Damages are the harm or injury that occurred to the client. In this situation, it would be the death of the client.

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 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).

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 Certification validates specialty knowledge, experience, and clinical judgment. A nurse in a critical care unit having specialized skills and knowledge to provide care would be an example of certification. Licensure is a specialized form of credentialing based on laws passed by a state legislature. Licensure endorses entry-level competence. Legal accreditation is granted to educational programs by state agencies endorsing the approval of the program's design and mission to meet the needs of state requirements. Litigation is not a method for validation.