legal prep u

Which clinical situation is addressed by the provisions of the Health Insurance Portability and Accountability Act (HIPAA)?

A client has asked a nurse if he can read the documentation that his health care provider wrote in his chart.

Which client would a nurse determine to be the most likely candidate for involuntary commitment?

An elderly client who is screaming obscenities in the street and disturbing neighbors

A visitor to the surgical unit asks the nurse about another client on the unit. The visitor viewed the client's name on the computer screen of another nurse at the nurses' station and recognized the client as a relative. What is the first action of the nurse in relation to this situation?

Inform the other nurse that the viewed screen resulted in a breach of confidentiality.

The nurse hears an unlicensed assistive personnel (UAP) discussing a client's allergic reaction to a medication with another UAP in the cafeteria. What is the priority nursing action?

Remind the UAP about the client's right to privacy.

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

In comparison with licensure, which measures entry-level competence, what does certification validate?

Specialty knowledge and clinical judgment

In which circumstance may the nurse legally and ethically disclose confidential information about a client?

A taxi driver's diagnosis of an uncontrolled seizure disorder to a state agency

A nurse is preparing to administer diazepam 1 mg I.V. The available dose is diazepam 2 mg/ml vial. After drawing 0.5 ml of medication into a syringe, what is the next action by the nurse?

Ask another nurse to witness 0.5 ml medication waste into the sink.

DNA fingerprinting is based in part on recombinant DNA technology and in part on those techniques originally used in medical genetics to detect slight variations in the genomes of different individuals. These techniques are used in forensic pathology to compare specimens from the suspect with those of the forensic specimen. What is being compared when DNA fingerprinting is used in forensic pathology?

The banding pattern

The nurse is discussing deinstitutionalization of mentally ill persons at a community forum. What is a consequence of the trend towards deinstitutionalization?

The number of persons with mental illness in prison has increased.

When a nurse delegates a task to another person, who is ultimately responsible for the action and its outcome?

The nurse

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

To protect the safety of the public

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 removes and discards a newborn's diaper before placing the newborn on the scales for a daily weight. The nurse realizes there are no clean diapers at the scale. The supply closet is located down the hallway. What will the nurse do?

Place newborn in the bassinet and cover with blanket while obtaining diapers.

A nurse explains the guidelines for the unit's seclusion room to a client with an impulse control disorder. Which client statement indicates that the nurse has adequately communicated the client's rights?

"Although I don't think I will, I can ask to go into seclusion, but I know you can make me go into the seclusion room."

The nurse is interviewing a client with a diagnosis of depression and the client states, "Honestly, I know my family would be a lot better off if I wasn't around to be a burden on them. That's just between you and me, though, okay?" What is the nurse's best response?

"I'm obliged to share what we talk about with the other people on your care team."

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?

"Take it with you. It is recognized universally in the United States."

A community nurse arrives at the home of a client. The client is in soiled clothes due to the inability to make it to the bathroom in time. The nurse overhears the unregulated care provider (UCP) scolding the client for the soiled clothes. What is the most appropriate response by the nurse to the UCP?

"Your behavior in this situation is considered verbal abuse."

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

Having recently completed a specialty nursing program in neonatal care, a nurse is now preparing to leave the medical unit and begin providing care in the hospital's neonatal intensive care unit (NICU). The nurse has completed which process of credentialing?

Certification

At the beginning of the shift on the postpartum unit, a charge nurse notices that the licensed practical nurse (LPN) working with the charge nurse is acting inappropriately and smells of alcohol. When the charge nurse confronts the LPN, the LPN apologizes and promises never report to work in this condition again. Which step should the charge nurse take next?

Notify the shift supervisor and rearrange the client care assignment.

A nurse is conducting a physical assessment on an adolescent who does not want her parents informed that she had an abortion in the past. Which statement best describes the information security measures the nurse would implement in this situation?

Respect the adolescent's wishes and maintain her confidentiality.

Nurses must maintain the privacy of clients. Which example is a breach in privacy and would pose an ethical problem?

Taking a picture of a client with the nurse's cell phone

Which situation violates a hospitalized adolescent's right to confidentiality?

Two nurses talk about the adolescent on an elevator on their way to lunch.

A client with stage IV heart failure has a living will indicating a ventilator may not be used. The client begins experiencing severe dyspnea. What should the nurse who is caring for this client do?

administer oxygen, morphine, and a bronchodilator for client comfort.

A nurse is considering relocating to another state to practice nursing. Which is the most appropriate action by the nurse to ensure ability to practice in the new state?

applying for a reciprocal license in the new state

A client with end-stage pulmonary hypertension tells the physician they don't want any heroic measures should their heart stop, and doesn't want to be placed on a ventilator. The physician enters a do-not-resuscitate order into the hospital's computer system. Which ethical principle is the nurse upholding by supporting the client's decision?

autonomy

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 nurse discusses the HIV-positive status of a client with other colleagues. The client can sue the nurse for which violation?

invasion of privacy

When documenting the care of a client, the nurse is aware of the need to use abbreviations conscientiously and safely. This includes:

limiting abbreviations to those approved for use by the institution.

The nurse is writing a medication order that a health care provider provided by telephone. Which should be included when writing the order?

medication dosage date the order is written medication ordered route of administration

Over the past few weeks, a client in a long-term care facility has become increasingly unsteady. The nurses are worried that the client will climb out of bed and fall. Which measure does not comply with a least restraint policy?

raising all side rails while the client is in bed

The nurse is assigned to clients who are having the following procedures: amniocentesis, fetal nonstress test, chorionic villus sampling, percutaneous umbilical blood sampling, and Doppler assessment of fetal heart rate. For which clients will the nurse ensure that signed informed consent has been given and is in the client's record?

Amniocentesis, chorionic villus sampling, percutaneous umbilical blood sampling

The nurse used a secure access code to obtain a morphine 2 mg/ml vial from the computerized automated dispensing cabinet (ADC). Before exiting the system, the nurse is prompted to count the remaining vials. The nurse counts 10 remaining vials, but the system reads 9 remaining vials. What is the next action by the nurse?

Ask another nurse to assist with following the procedure to resolve the discrepancy.

Which court decision or act states that psychotherapists have a duty to exercise reasonable care in protecting the foreseeable victims of their clients' violent actions?

Tarasoff v. Regents of the University of California

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.

A client admitted to the mental health unit has exhibited physical behaviors that put him 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 what?

battery

A group of nursing students are reviewing current nursing codes of ethics. Such a code is important in the nursing profession because:

nursing practice involves numerous interactions between laws and individual values

A nurse is caring for a client diagnosed with myocardial infarction. A person identifying himself as the client's friend asks the nurse for the client's records, but the nurse declines. The nurse's unwillingness to divulge the requested information is based on the understanding that which people would be entitled to access to the client's records?

those directly involved in the client's care

A nurse is assessing a client, and the client asks, "I just saw my neighbor leave the office. I know she was coming in for genetic testing on the baby. Is it bad?" What is the most appropriate response by the nurse?

"Health care of all individuals is a private matter."

The nurse manager and a newly licensed nurse plan to obtain informed consent for several procedures on various clients on a pediatric unit. Which statement(s) by the newly licensed nurse would alert the nurse manager to provide additional education about informed consent?

"The medical record shows the child's foster parents have legal guardianship of the child, but I am still required to have the child's mother sign the consent for the procedure." "I am still going to ask the parents to sign the consent for the procedure even though the child is legally emancipated from the parents." "After lunch, I will go into the room and explain the procedure, including the risks and benefits, and the alternative options available for the child."

A client with a history of heroin addiction is admitted to the hospital intensive care unit with a diagnosis of opioid drug overdose. While talking with a nurse, the client's parent reports a plan to have his child declared legally incompetent. Which response by the nurse is most therapeutic?

"Your child is ill and can't make decisions about health care and safety right now, but this situation is temporary."

A client is scheduled to undergo an exploratory laparoscopy. The registered nurse (RN) asks the licensed practical nurse (LPN) to prepare the client for surgery. The RN must confirm that the LPN has specialized training before delegating which task?

initiating I.V. therapy, as ordered

Which scenario is an example of certification?

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

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 medicates a client with another client's morning medicines. What is the best action by the nurse upon realizing the error?

Assess the patient for the medications' effects.

A nurse assesses a client with psychotic symptoms and determines that the client likely poses a safety threat and needs vest restraints. The client is adamantly opposed to this. What would be the best nursing action?

Contact the physician and obtain necessary orders.

The nurse is administering an oral opioid medication to a client who reported pain. The client dropped the medication on the floor. What actions would the nurse take now?

Discard the pill in an appropriate container with a witnessing nurse present. Obtain another dose of the medication for the client. Search for the pill on the floor until the pill is found.

The nurse is caring for an adolescent with cancer who is well informed about the medical condition and treatment. The adolescent refused the morning medications and states intentions of refusing all future medications. What is the best action by the nurse?

Document the adolescent's choice and offer to discuss feelings about the medication.

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.

To properly assist a victim of intimate partner violence, which action would be most appropriate for the nurse to do?

Document the details.

When attempting to preserve evidence from a possible rape with no report of oral sex, the female victim should be instructed that which self-care activities are permitted?

Drinking a glass of water

A client has designated a family member to make healthcare decisions for the client if the client is not able to do so. What type of advance directive is this considered?

Durable power of attorney (DPOA) for healthcare

Healthcare providers use a problem-solving approach for ethical dilemmas. Which is the last step of the ethical decision-making model?

Evaluate the decision in terms of effects and results.

A nurse is providing care to a client who is a victim of trauma resulting from injuries sustained in a convenience store robbery. The client has been stabbed numerous times in the abdomen and chest. His shirt is bloody and torn. Which of the following would be most appropriate when collecting forensic evidence?

Hanging up any damp or wet clothing to dry before securing

A 16-year-old client is admitted to the emergency department following an accident. The client sustained a head injury, is unconscious, and has compound fractures of the right tibia and fibula. No family members accompanied the client and none can be reached by phone. The surgeon instructs the nurse to take the client to the operating room immediately. Which of the following actions should the nurse take regarding informed consent?

Take the client to the operating room for surgery without informed consent.

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. Complete the following sentence by choosing from the lists of options. Legally, the nurse may be charged with __________ because of ____________

assault verbally threatening to adminster a sedative

The nurse is caring for a client after having various diagnostic tests. The client discusses a proxy being in attendance for the health care provider's diagnosis. The nurse requests a copy for the file, and allows the proxy to be in attendance with what type of document?

durable power of attorney

A student nurse inserts a nasogastric tube and begins a tube feeding without a radiological confirmation. The client develops pneumonia and is transferred to the intensive care unit. Which parties are liable for negligence?

the student nurse the nursing instructor the assigned nurse