Legal Issues

A nurse-manager is reviewing incidents that occurred recently. For which event will the manager need to make a report to the board of nursing?

A nurse documents administering narcotics to a client while personally using the medication.

The health care provider is in a client's room doing an assessment. The health care provider walks out of the room and says to the nurse, "I have prescribed furosemide 40 mg orally twice daily for 5 days. Enter the prescription into the computerized order entry system for me." What is the best response by the nurse?

"I will find you a computer that is not being used so you can enter the order into the computerized order entry system."

A client in a semiprivate room is diagnosed with pediculosis corporis. A nurse will initiate treatment after moving the client to another room. The client's roommate asks the nurse for information about the client. How should the nurse respond?

"I'm sorry, but I can't share confidential information."

A coworker asks another nurse if a client received their pathology report. The coworker is not directly involved in the care of the client. How should the nurse respond? Select all that apply.

"You need to review the hospital policy related to client privacy." "I'm sorry, but I'm not at liberty to give you that information." "Information can only be shared if you're involved in the client's care."

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

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

A 9-year-old child presents to a school nurse and reports arm and leg pain. Upon assessment, the nurse identifies numerous purple to yellow ecchymotic areas. When asked, the child says that the bruises are the result of "being in trouble at home." Which action by the nurse is most appropriate?

Contact the authorities immediately.

A client has been receiving chemotherapy for cancer treatment. The client is competent and has been actively involved in decisions regarding care; however, the client has now decided to refuse treatment. What should the nurse do when the client refuses the next dose of chemotherapy?

Document the client's choice and offer to discuss feelings about the chemotherapy.

While the nurse is caring for a primiparous client on the first postpartum day, the client asks, "How is that woman doing who lost her baby from prematurity? We were in labor together." Which response by the nurse would be most appropriate?

Explain to the client that "nurses are not allowed to discuss other clients on the unit."

A client is being treated in the emergency department for a leg wound and has been impatient about the wait. The nurse explains how the triage process works and the importance of being assessed. The client tells the nurse, "I am not waiting around here any longer. My leg is fine." What is the best response by the nurse?

Notify the healthcare provider of the client's intent to leave.

A preschool-age child presents to the emergency department. His father tearfully reports that his son was on his shoulders in the driveway playing when he began to fall. When the child began to fall, the father grabbed him by the leg, swinging him toward the grass to avoid landing on the pavement. As the father swung his son, the child hit his head on the driveway and twisted his right leg. After a complete examination, it is determined that the child has a skull fracture and a spiral fracture of the femur. Which action should the nurse take?

Record the father's story in the medical record.

A nurse meets a neighbor and new baby at the local market. The neighbor states that she received outstanding nursing care from one of the nurse's colleagues during her labor and childbirth. What is the best way for the nurse to recognize her nursing colleague's professional efforts?

Share the feedback with the nursing colleague directly.

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

breach of confidentiality

The standards of practice in the Nurse Practice Act describe duties of nursing practice according to the nursing process. What are examples of the implementation standard of a registered nurse? Select all that apply.

delegating vital signs. applying a warm compress for back pain. administering medication for leg pain The implementation duties include delegating vital signs, applying a warm compress, and administering medication. The nurse completing an assessment is the assessment phase and the encouragement of ambulation is the part of health promotion.

A novice nurse is caring for a client who requires a cesarean section for labor dystocia. The client's partner signs the consent form for cesarean section. Which of the following individuals is responsible for obtaining the informed consent prior to a cesarean section?

physician

Which type of medication order might read "Vitamin K 10 mg I.M. daily × 3 days?"

standing

A client who is in her third trimester presents at the labor and delivery triage area with a history of a fall. She has bruising on her back and arms. There is no vaginal bleeding and the fetal heart rate (FHR) shows accelerations. A completed Abuse Assessment Screen indicates the possibility of abuse. The nurse should refer this client to

the social worker on call.

A birthing couple informs the nurse that they would like to have the placenta after the baby is born. What is the nurse's best response?

"Let me check about how to go about doing this."

Entering a client's room, a nurse on the maternity unit sees a mother slapping the face of a crying neonate. Which action should the nurse take in this situation?

Return the neonate to the nursery, inform the physician so the physician can thoroughly examine the neonate for injuries, and notify social services for assistance.

A client is about to undergo cardiac catheterization for which informed consent was obtained. As the nurse enters the room to administer sedation for the procedure, the client states, "I'm really worried about having this open heart surgery." Based on this statement, how should the nurse proceed?

Withhold the medication and notify the physician immediately.

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

confidentiality

Several nurses from the medical unit access the electronic medical record of a well-known public official who was admitted to the emergency department. How should the the nurse manager respond to the nurses regarding this situation?

"Accessing the official's medical record is a breach of confidentiality."

The school nurse is conducting health assessments for a group of children. Which of the following situations encountered by the nurse raises suspicion of child neglect?

A child reports of constant hunger.

The nurse is planning to administer morphine 1 mg I.V. to a client who is reporting pain. The available vial is morphine 2 mg/1 ml. What is the most appropriate action by the nurse?

Draw 0.5 ml of medication into a syringe and ask another nurse to witness the waste of 0.5 ml of medication.

A client is admitted for serious complications of poorly managed diabetes. The nurse learns that this client is an undocumented illegal immigrant whose sole income is sporadic day labor. What is the most important action this nurse should take?

Establish rapport with the client to fully assess client needs.

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

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

A female client who has diagnosis of borderline personality disorder is manipulative and very disruptive on the hospital unit. She is not dangerous to herself or others, but is clearly not making any therapeutic progress. She consistently refuses any medications. The nurse realizes that legally this client has which option?

Refuse treatment.

A charge nurse enters a client's room and observes a physician instructing another nurse on how to insert a central line into the client's neck. The nurse is holding the cannula and inserting the line. What would be the appropriate response by the charge nurse?

Stop the procedure and inform the nurse that this is outside of a nurse's legal scope of practice.

Which represents an ethical breach regarding the rights of clients in psychiatric care situations?

The nurse discusses with peers in the hospital cafeteria the progress of a well-known client being cared for at the hospital.

A client is transferred from the emergency department to the locked psychiatric unit after attempting suicide by taking 200 acetaminophen tablets. The client is now awake and alert but refuses to speak with the nurse. In this situation, the nurse's first priority is to:

ensure safety by initiating suicide precautions.

A nurse is deciding whether to report a suspected case of child abuse. Which criterion is the most important for the nurse to consider?

incompatibility between the child's history and the injury

A client is scheduled for surgery at 8 a.m.(0800). While completing the preoperative checklist, the nurse sees that the surgical consent form isn't signed. It's time to administer the preoperative analgesic. Which nursing action takes the highest priority in this situation?

notifying the surgeon that the client hasn't signed the consent form

A 14-year-old adolescent tells the nurse about being in love with a 22-year-old neighbor and that they've had sex on several occasions. The client doesn't want the parents to know because the client is in love and is afraid the parents will be angry. What is the nurse's best course of action?

Tell the adolescent that the law requires the nurse to report the sexual contact because of the age difference.

A person calls the neonatal intensive care unit stating that his child is receiving care there. He tells the nurse that he and the mother "aren't together," and requests information about his child's condition. The nurse should

obtain more data before giving the caller any confidential information.

During an admission history a copy of the living will was provided by the client. The nurse's responsibility at this time is to:

place the document on the client's chart and communicate the information to the health care team.