Chapter 7 (legality) Nclex Q&A
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?" What is the most appropriate response made by the nurse?
"Take it with you. It is recognized universally in the United States." Explanation: A separate or different advance directive is not needed for each state, so it can be used in any state and does not matter where it was created. A living will is recognized in each state as valid so a client should be advised to take it with them as they travel out of state. The other responses are incorrect or inappropriate given this scenario
A nurse working in a coronary care unit resuscitates a client who had expressed wishes not to be resuscitated. Which tort has the nurse committed?
Battery
A nurse exits the room of a confused client without raising the side rails on the bed. The failure to raise the side rails would constitute which element of liability related to malpractice?
Breach of duty
A nurse completing admission paperwork asks the client about having an advanced directive. The client states, "I do not know, what is an advanced directive?" What is the nurse's best response?
"It is a written document that identifies a person's preferences regarding which medical interventions to use in the event of a terminal condition."
Which of the following 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. Explanation: The nursing student who administers medication to a resident, while working as an unlicensed assistive personnel (UAP) at a local nursing home, is performing a task outside the scope of the job responsibilities of a UAP. The other options demonstrate legally defensible actions by the nursing student.
Which process evaluates and recognizes educational programs as having met certain standards?
Accreditation Explanation: 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 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.
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?
Libel is damaging statements written and read by others. Since there were defaming comments written in the chart, libel charges could be appropriate. Malpractice, slander, and negligence are not charges in this scenario
Injuries related to lifting or transferring patients occur in the health care setting and may be considered a work-related injury. Which law was intended to reduce work-related injuries and illnesses?
The Occupational Safety and Health Act of 1970 Explanation: The Occupational Safety and Health Act of 1970 set legal standards in the United States in an effort to ensure safe and healthful working conditions for men and women. The Health Care Quality Improvement Act of 1986 was enacted to encourage health care practitioners to identify and discipline practitioners who engage in unprofessional conduct, and to restrict the ability of incompetent practitioners to move from state to state without disclosure of the practitioner's previous performance. Title VII of the Civil Rights Act of 1964 protects employees from discrimination. The Americans with Disabilities Act of 1990 prohibits discrimination against disabled people and requires covered entities to reasonably accommodate individuals who are protected by the Act.
Newly hired nurses in a busy suburban hospital are required to read the state Nurse Practice Act as part of their training. Which topics are covered by this act? Select all that apply. a. Violations that may result in disciplinary action b. Clinical procedures c. Medication administration d. Scope of practice e. Delegation policies f. Medicare reimbursement
a, d. Each state has a Nurse Practice Act that protects the public by broadly defining the legal scope of nursing practice. Practicing beyond those limits makes nurses vulnerable to charges of violating the state Nurse Practice Act.
A nurse hired to work in an ambulatory setting attends new employee orientation. The nurse never worked in ambulatory before and is concerned about the Scope and Standards of Practice for Professional Ambulatory Care Nursing. Which response, given by the nurse educator, would further explain the Scope and Standards of Practice for Professional Care Nursing to the new nurse?
"The Scope and Standards of Practice for Professional Ambulatory Care Nursing deal with the professional obligations of a nurse working in the ambulatory setting." Explanation: The Scope and Standards of Practice for Professional Ambulatory Care Nursing are the standards of care for nurses working in the ambulatory arena. It does not take precedent over the facility's policies and procedures, but must be worked in conjunction with the policies and procedures. It is not used for assessing nurses. NCLEX determines if a nurse is minimally competent to practice as a nurse.
A nurse caring for an older adult client following a total abdominal hysterectomy documents administration of morphine 4 mg intravenously for pain of 8 on 1-10 scale, bed in the lowest position, bed alarm on, side rails up times two, and call light in reach. After the nurse leaves the room, the client gets out of bed and falls. In which order should the nurse proceed?
Assess the client for injury. Assist the client back into bed. Notify the physician. Document the incident. Complete an incident report. Explanation Following a fall, the nurse should assess the client before moving the client. If the client can be moved, safely return the client to bed and make sure the client is secure per safety procedures. The nurse should then notify the physician. The nurse should document the incident and interventions or treatments provided. Finally, an incident report should be completed
"Jean," a veteran nurse, pleaded guilty to a misdemeanor negligence charge in the case of a 75-year-old woman who died after slipping into a coma during routine outpatient eye surgery at an eye surgery center. Jean admitted that she failed to monitor the woman's vital signs during the procedure. The surgeon who performed the procedure called the nurse's action pure negligence, saying that the patient could have been saved. The patient was a vibrant grandmother of 10 who walked three quarters of a mile the morning of her surgery and had sung in her church choir the day before. As part of her plea arrangement, the nurse agreed to serve 6 months of probation - the first 2 months on house arrest - and surrender her nursing license. Jean's attorney was careful to explain in her defense that Jean had specialty knowledge, experience, and clinical judgement and had met certain criteria established by the nongovernmental association, as a result of which she was granted recognition in a specified practiced area. What is this sort of credential called? A. Accreditation B. Licensure C. Certification D. Board approval
C. Certification is the process by which a person who has met certain criteria established by a nongovernmental association is granted recognition in a specific area.
The nursing student talks with the student's family about an AIDS client from the clinical experience. Which tort has the student committed?
Invasion of privacy Explanation: Invasion of privacy involves a breach of keeping client information confidential. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property. Slander is oral defamation of character. Assault is a threat or attempt to make bodily contact with another person without that person's consent
A client has a prescription for amoxicillin (Amoxil) 500 mg P.O. (by mouth) every 8 hours. The nurse administers the medication via the intravenous route. Based on the nurse's action, the client develops a pulmonary embolus, experiences respiratory distress, and is transferred to the intensive care unit. The client's family files a lawsuit against the facility and the nurse. While reviewing the case, which legal action has the nurse attorney identified that meets the criteria for the client's lawsuit?
Malpractice
A registered nurse has had her license suspended after being convicted of being impaired at work. What governing body has the authority to revoke or suspend a nurse's license?
The State Board of Nurse Examiners in the United States may revoke or suspend a nurse's license or registration for drug or alcohol abuse.
"Jean," a veteran nurse, pleaded guilty to a misdemeanor negligence charge in the case of a 75-year-old woman who died after slipping into a coma during routine outpatient eye surgery at an eye surgery center. Jean admitted that she failed to monitor the woman's vital signs during the procedure. The surgeon who performed the procedure called the nurse's action pure negligence, saying that the patient could have been saved. The patient was a vibrant grandmother of 10 who walked three quarters of a mile the morning of her surgery and had sung in her church choir the day before. As part of her plea arrangement, the nurse agreed to serve 6 months of probation - the first 2 months on house arrest - and surrender her nursing license. When the attorney representing the patient's family calls Jean and asks to talk with her about the case so that he can better understand her actions, how should Jean respond? A. "I'm sorry, but i can't talk with you. You'll have to contact my attorney. B. Answer the attorney's questions honestly and make sure that he understands her side of the story. C. Appeal to the attorney's sense of compassion and try to enlist his sympathy by telling him how busy it was that morning. D. "Why are you doing this to me? This could ruin me!"
a. One of the cardinal rules for nurse defendants is: Do not discuss the case with anyone at your agency (with the exception of the risk manager), with the plaintiff, with the plaintiff's lawyer with anyone testifying for the plaintiff, or with reporters
"Jean," a veteran nurse, pleaded guilty to a misdemeanor negligence charge in the case of a 75-year-old woman who died after slipping into a coma during routine outpatient eye surgery at an eye surgery center. Jean admitted that she failed to monitor the woman's vital signs during the procedure. The surgeon who performed the procedure called the nurse's action pure negligence, saying that the patient could have been saved. The patient was a vibrant grandmother of 10 who walked three quarters of a mile the morning of her surgery and had sung in her church choir the day before. As part of her plea arrangement, the nurse agreed to serve 6 months of probation - the first 2 months on house arrest - and surrender her nursing license. What must be established to prove that malpractice or negligence has occurred in this case? A. The surgeon who performed the procedure called the nurse's action pure negligence, saying that the patient could have been saved. B. The fact that this patient should not have died - she was a vibrant grandmother of 10 who had walked three quarters of a mile the morning of her surgery and had sung in her church choir the day before. C. The nurse intended to harm the patient and was willfully negligent. D. The nurse had a duty to monitor the patient's vital signs, failed to do so, the patient died, and it was Jean's failure to do her duty that caused the patient's death
d. Liability involves four elements that must be established to prove that malpractice or negligence occurred.
A nurse who comments to her coworkers at lunch that her client with a sexually transmitted infection (STI) has been sexually active in the community may be guilty of what tort?
Slander is spoken defamation of character; libel is written defamation
A state attorney decides to charge a nurse with manslaughter for allegedly administering a lethal injection. This an example of what type of law? Public Law Private Law Civil Law Criminal Law
Criminal Law
A nurse administers the wrong medication a patient and the patient harmed. The physician who ordered the medication did not read the documentation that the patient was allergic to the drug. Which statement is true regarding liability for the administration of the wrong medication? A. The nurse is not responsible, because the nurse was merely following the doctor's orders. B. Only the nurse is responsible, because the nurse actually administered the medication. C. Only the physician is responsible, because the physician actually ordered the drug. D. Both the nurse and the physician are responsible for their respective actions.
D.
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
A nurse answers a patient's call light and finds the patient on the floor by the bathroom door. After calling for assistance and examining the patient for injury, the nurse helps the patient back to bed and then fills out an incident report. Which statement accurately describe the aspects of this procedure? Select all that apply. a. An incident report is used as disciplinary action against staff members. b. An incident report is used as a means of identifying risks. c. An incident report is used for quality control. d. The facility manager completes the incident report e. An incident report makes facts available in case litigation (the process of taking legal action) occurs. f. Filing of an incident report should be documented in the patient record.
b, c, e.
"Jean," a veteran nurse, pleaded guilty to a misdemeanor negligence charge in the case of a 75-year-old woman who died after slipping into a coma during routine outpatient eye surgery at an eye surgery center. Jean admitted that she failed to monitor the woman's vital signs during the procedure. The surgeon who performed the procedure called the nurse's action pure negligence, saying that the patient could have been saved. The patient was a vibrant grandmother of 10 who walked three quarters of a mile the morning of her surgery and had sung in her church choir the day before. As part of her plea arrangement, the nurse agreed to serve 6 months of probation - the first 2 months on house arrest - and surrender her nursing license. If review of this patient's record revealed that she had never consented to the eye surgery, of which intentional tort might the surgeon have been guilty? A. Assault B. Battery C. Invasion of privacy D. False imprisonment
b. Battery. Assault is the threat or an attempt. Battery is an assault THAT IS carried out. The answer is Battery.
A nursing student asks the charge nurse about legal liability when performing clinical practice. Which statement regarding liability is true? a. Students are not responsible for their acts of negligence resulting in patient injury. b. Student nurses are held to the same standard of care that would be used to evaluate the actions of a registered nurse. c. Hospitals are exempt from liability for student negligence if the student nurse is properly supervised by an instructor. d. Most nursing programs carry group professional liability insurance unnecessary.
b. Student nurses are held to the same standard of care that would be used to evaluate the actions of a registered nurse.
"Jean," a veteran nurse, pleaded guilty to a misdemeanor negligence charge in the case of a 75-year-old woman who died after slipping into a coma during routine outpatient eye surgery at an eye surgery center. Jean admitted that she failed to monitor the woman's vital signs during the procedure. The surgeon who performed the procedure called the nurse's action pure negligence, saying that the patient could have been saved. The patient was a vibrant grandmother of 10 who walked three quarters of a mile the morning of her surgery and had sung in her church choir the day before. As part of her plea arrangement, the nurse agreed to serve 6 months of probation - the first 2 months on house arrest - and surrender her nursing license. Those bringing the charges against Jean are called: A. Appellates B. Defendants C. Plaintiffs D. Attorneys
c. The person or government bringing suit against another is called the plaintiff. Appellates are courts of law, defendants are the ones being accused of a crime or tort, and attorneys are the lawyers representing both the plaintiff and defendant.
A nurse observes another nurse place an unused dose of narcotics in their pocket. If caught, the nurse could be charged with which type of crime?
felony Explanation: A felony is a serious criminal offense, and includes actions such as stealing narcotics, murder, falsifying medical records, and insurance fraud. A misdemeanor is a minor criminal offense; a tort is a lawsuit in which a plaintiff charges that a defendant committed a deliberately aggressive act. Negligence is harm that results because a person did not act reasonably.
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.
