PrepU Legal Issues

When it is discovered that a nurse did not act reasonably when providing care in accordance with the standards of professional practice, which factor would confirm the nurse has been negligent? A) The nurse was responsible for client injury B) The nurse was responsible for a client's injury and it was serious C) The nurse was responsible for a client injury that resulted in permanent disability D) The client's actions played a part in the nurse's reaction

A) The nurse was responsible for client injury

A client is having elective surgery under general anesthesia. Who is responsible for obtaining the informed consent? A) the nurse B) the surgeon C) the anesthesiologist D) the social worker

B) the surgeon

The nursing is caring for a client who requests to see a copy of his health care records. What action by the nurse is most appropriate? A) Review the hospital's process for allowing clients to view their health care records. B) Access the health care record at the bedside and show the client how to navigate the electronic health record. C) Discuss how the hospital can be fined for allowing clients to view their health care records. D) Explain that only a paper copy of the health care record can be viewed by the client.

A) Review the hospital's process for allowing clients to view their health care records.

A nursing student is making notes that include client data on a clipboard. Which statement by the nursing instructor is most appropriate? A) "Be sure to write down specific information for your clinical paperwork." B) "You can get an electronic print out of client lab data to take with you." C) "Clipboards with client data should not leave the unit." D) "Be sure to put the client's name and room number on all paperwork."

C) "Clipboards with client data should not leave the unit."

A client asks to be discharged from the health care facility against medical advice (AMA). What should the nurse do first? A) Prevent the client from leaving. B) Notify the physician. C) Have the client sign an AMA form. D) Call a security guard to help detain the client.

B) Notify the physician.

The nurse fails to contact the physician regarding a client who had an open-reduction internal fixation of the tibia and has experienced increasing leg pain (unrelieved by pain medication) for the past 4 hours. Which element of liability has been violated? A) Breach of duty B) Causation C) Damages D) Duty

A) Breach of duty

A nurse is caring for a voluntary client in the health care facility. The client doesn't show signs of suicidal ideation or pose harm to others. The client states, "I would really like to leave tonight and sleep in my own bed." Although the client wants discharge tonight, the physician at this time. What is the most appropriate response of the nurse? A) "You will need to sign a written request for discharge." B) "I need to check with your family members if they think it would be okay." C) "You are free to leave at your will." D) "I will contact your landlord and let the landlord know you will be home."

A) "You will need to sign a written request for discharge."

A client receives a court order for commitment. Which best exemplifies the concept of "least restrictive environment"? A) Involuntary commitment to an outpatient community mental health center B) Medication administration for sedation so the client cannot get out of bed C) Placement of client in a secured padded room in response to threats of self-harm D) Admission of client to a locked inpatient psychiatric unit

A) Involuntary commitment to an outpatient community mental health center

A school nurse assesses that an 8-year-old child is preoccupied with sexual comments and activities. The nurse is concerned that the child may have been sexually abused at home. What is the nurse's best response to this situation? A) Notify the local Child Protective Services. B) Continue to observe the behavior of the child. C) Discuss the child's behavior with the parents. D) Advise the child that the inappropriate behavior must stop.

A) Notify the local Child Protective Services.

During hospitalization for a suicide attempt, a client informs the nurse that she does not want to return to work because her boss expects sexual favors each week before he pays her. The client informs the nurse that she needs the job but is embarrassed that she performs these favors. The nurse informs the client that this is illegal behavior called: A) Quid pro quo harassment. B) Fetishism. C) Environmental harassment. D) Hostile environment harassment.

A) Quid pro quo harassment.

During hospitalization for a suicide attempt, the client informs the nurse that she does not want to return to work because her boss expects sexual favors each week before he gives her a paycheck. The client informs the nurse that she needs the job but is embarrassed that she performs these favors. The nurse informs the client that this is illegal behavior and is called what? A) Quid pro quo harassment. B) Fetishism. C) Environmental harassment. D) Hostile environment harassment.

A) Quid pro quo harassment.

On a crisis shelter hotline, the nurse talks to two 11-year-old boys who think a friend sniffs glue. They say his breath sometimes smells like glue and he acts drunk. They say they are afraid to tell their parents about the friend. When formulating a reply, what is the most important factor for the nurse to consider? A) The boys probably fear punishment. B) Sniffing glue is illegal. C) The boys' observations could be wrong. D) Glue-sniffing is a minor form of substance abuse.

A) The boys probably fear punishment.

A psychiatric treatment team is planning care for a client who was involuntarily admitted for treatment of depression and suicide ideation. When planning care, of what legal parameters of care must the nurse be aware? A) The client can refuse medication. B) The client can obtain release against medical advice. C) The client is in need of a public guardian. D) The client is considered incompetent.

A) The client can refuse medication.

What is the nurse expected to do when filing a report about an incident of finding an elderly client with mild dementia on the floor? A) The nurse must file an incident or adverse event report. B) The nurse must chart about the incident and communicate in a report about the event. C) The nurse must communicate the event to the charge nurse, who will document the fall in an adverse reporting system. D) The nurse is aware that adverse reports are not confidential material, so only documentation in the chart should be completed.

A) The nurse must file an incident or adverse event report.

Two nurses meet at their home, where one of the nurses discusses a client who had been physically abused. The next day, the client is shifted to another nursing unit after a surgical procedure and becomes the care of the second nurse who had been part of the original discussion. Nurse No. 2 asks the client about the physical abuse. The client discovers that his original nurse revealed the information and is hurt. What would be the charges if the client files a suit? A) The nurses could be charged for slander. B) The nurses could be charged for libel. C) No charges are valid because the revelation took place in off-duty hours. D) No charges are valid because Nurse No. 2 is also involved in client care.

A) The nurses could be charged for slander.

A health care provider (HCP) is calling the pediatric unit and asking the nurse to go into the medical record for test results of a fellow pediatrician. How should the nurse respond to this request? A) Verify that the caller is the HCP of record or has a need to know. B) Access the medical record, and give the HCP the test results. C) Decline to give the HCP the information requested. D) Determine whether the nurse can access the medical record.

A) Verify that the caller is the HCP of record or has a need to know.

A client with severe acute respiratory syndrome privately informs a nurse that he does not want to be placed on a ventilator if his condition worsens. The client's wife and children have repeatedly expressed their desire that every measure be taken for the client. The most appropriate intervention by the nurse would be to: A) encourage the client to consider a living will or power of attorney. B) ask the physician to discuss the client's prognosis with the client and and the family. C) arrange a conference to discuss the matter with all involved. D) assure the client that all possible measures will be taken.

A) encourage the client to consider a living will or power of attorney.

Screening for this most common birth defect is required by law in most states. Each nurse should know the law for his or her state and the requirements for screening. The nurse would expect a newborn to be screened for which defect as the most common? A) hearing B) vision C) genetic-linked D) skeletal malformations

A) hearing

When a client is admitted to the hospital, admissions personnel are required to determine if the client has a document indicating advanced directives. If so, a copy is made for the client's medical record. The advanced directive document indicates: A) that the client has made his wishes for terminal care known. B) that an attorney has verified the living will papers. C) that he refuses to have resuscitation measures or any life-prolonging care. D) that the client assigned a relative to act on his or her behalf.

A) that the client has made his wishes for terminal care known.

The nurse is participating in a discussion about controlled substances. Which statement by the nurse indicates she is aware of laws governing the distribution of controlled substances? A) "When a nurse abuses controlled substances in the workplace and gets help, she will not be charged with a criminal act." B) "Nurses are responsible for adhering to specific documentation about controlled substances." C) "An impaired nurse is promptly punished by being terminated and having his or her license suspended." D) "The nurse is only at risk if she diverts medication from the client; using personal drugs decrease your risk."

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

When a nurse can legally order the primary interventions to achieve a goal, which part of the nursing process is being developed? A) Evaluation B) Nursing Diagnosis C) Nursing Assessment D) Collaborative Problems

B) Nursing Diagnosis

A nurse needs to administer a prescribed dosage of oral medication to a client with influenza. Which action should the nurse perform when administering oral medication to the client? A) Prepare the exact dosage of medication in front of the client. B) Avoid administering medication prepared by another nurse. C) Bring the prescribed medication in a ceramic cup or glass container. D) Check the label of the medication container three times at the bedside.

B) Avoid administering medication prepared by another nurse.

A client comes to the outpatient department complaining of vaginal discharge, dysuria, and genital irritation. Suspecting a sexually transmitted disease (STD), the physician orders diagnostic testing of the vaginal discharge. Which STD must be reported to the public health department? A)Bacterial vaginitis B) Gonorrhea C) Genital herpes D) Human papillomavirus (HPV)

B) Gonorrhea

A nurse is explaining client rights for psychiatric patients to a client who has voluntarily sought admission to an inpatient psychiatric facility. Which rights would the nurse include in the discussion? Select all that apply. A) Right to select health care team members. B) Right to refuse treatment. C) Right to a written treatment plan. D) Right to obtain disability benefits. E)Right to confidentiality. F) Right to personal mail.

B) Right to refuse treatment. C) Right to a written treatment plan. E)Right to confidentiality. F) Right to personal mail.

Parents of a 5-year-old call the clinic to tell the nurse that they think their child has been abused by her day-care provider. What should the nurse advise them to do? A) Make an appointment to speak with the day-care provider. B) Schedule an immediate appointment with their health care provider. C) Call the child protective services to file a complaint. D) Talk to their attorney to file charges against the accused.

B) Schedule an immediate appointment with their health care provider.

What should be charted by the nurse when the client has an involuntary commitment or formal admission status? A) Nothing should be charted. The forms are in the chart; there is no need to duplicate. B) The client's receipt of information about status and rights should be charted. C) The client's willingness to cooperate with seclusion should be charted. D) The name of the physician officially signing the certificates should be charted.

B) The client's receipt of information about status and rights should be charted.

A nurse hears a client state, "I have had it with this marriage. It would be so much easier to just hire someone to kill my husband!" What action should the nurse take? A) Since the client is still admitted to the hospital, the nurse must hold the statement in confidence. B) The nurse must start the process to warn the client's husband. C) An assessment of the client's response to treatment must be performed. D) The comment must be held in confidence because the client did not report the statement directly to the nurse.

B) The nurse must start the process to warn the client's husband.

The nurse is preparing a client for a colonoscopy at the hospital. Who does the nurse understand is responsible for obtaining the informed consent from this client? A) The nurse B) The physician C) The anesthesiologist D) The physician's office nurse

B) The physician

Which client would a nurse determine to be the most likely candidate for involuntary commitment? The client who: A) refuses to take the prescribed medication. B) is screaming in the street and disturbing neighbors. C) refuses to participate in the planned therapy. D) is homeless and has been diagnosed with a mental disorder.

B) is screaming in the street and disturbing neighbors.

What is the nurse accountable for, according to state nurse practice acts? A) managing the care team effectively B) making nursing diagnoses C) prescribing PRN (as needed) medications D) mentoring other nurses

B) making nursing diagnoses

The nurse is completing discharge teaching with a client who had a long hospital stay. The client gives the nurse a handmade sweater for the personal nursing care. What is the best response by the nurse? Select all that apply. A) "I cannot take this gift while I am at work." B) "Maybe I can meet you for coffee next week" C) "My hospital has a policy that does not allow a nurse to accept gifts." D) "Thank you for recognizing my work, I will enjoy wearing this sweater." E) "I appreciate the gift but it not appropriate for me to take a personal gift."

C) "My hospital has a policy that does not allow a nurse to accept gifts." E) "I appreciate the gift but it not appropriate for me to take a personal gift."

A 15-year-old female is being seen for an annual physical examination. The teen asks the nurse if what they talk about will be kept private. What is the appropriate response by the nurse? A) "Until you are 16 years of age you will not be afforded total privacy from your parents with regard to your health care concerns." B) "Privacy is important and I will not share anything we talk about with your parents." C) "There are some things I may need to share with your parents or physician." D) "Since you are 15 there are some things we can keep private if you wish."

C) "There are some things I may need to share with your parents or physician."

The adult daughters of an elderly male client inform the nurse that they fully expect their father to be combative after surgery. Preoperatively, they request that the nurse put all four side rails up and use restraints to keep him safe. The nurse should tell the daughters: A) "Certainly; we will want to be sure to keep your father safe, too." B) "We will call the health care provider to get a prescription right away." C) "We will first try to keep him safe without restraint." D) "Restraint use is prohibited at our hospital at all times."

C) "We will first try to keep him safe without restraint."

Prescription practices of primary health care providers for controlled substances are monitored by which agency? A) U.S. Pharmacopeia (USP) B) Food and Drug Agency (FDA) C) Drug Enforcement Agency (DEA) D) World Health Organization (WHO)

C) Drug Enforcement Agency (DEA)

A nursing assistant escorts a client in the early stages of labor to the bathroom. When the nurse enters the client's room, she detects a strange odor coming from the bathroom and suspects the client has been smoking marijuana. What should the nurse do next? A) Tell the client that smoking is prohibited in the facility, and that if she smokes again, she'll be discharged. B) Explain to the client that smoking poses a danger of explosion because oxygen tanks are stored close by. C) Notify the physician and security immediately. D) Ask the nursing assistant to dispose of the marijuana so that the client can't smoke anymore.

C) Notify the physician and security immediately.

During the nurse's assessment of a new client on a medical unit, the client confides in the nurse that the client's spouse often "slaps me around" after the client has been drinking. What action should the nurse take in response to this statement? A) Ask the client to write down descriptions of these instances and make these documents part of the client's medical record. B) Discuss with the client the possible triggers that set off the spouse's behavior. C) Report the client's statement promptly to the appropriate authorities. D) Elicit further detail from the client to determine the validity of the accusation.

C) Report the client's statement promptly to the appropriate authorities.

A home health nurse is visiting a 74-year-old client with Alzheimer's disease. During the visit, the nurse notes bruising on the client's upper arms, and the client is more withdrawn than normal. The client is unable to communicate effectively because of his disease progression. The nurse suspects elder abuse. What is the nurse's responsibility in this situation? A) Do nothing because the nurse has no proof of wrongdoing. B) Monitor the situation during subsequent visits. C) Report the suspicion to the local agency on aging within 24 hours of the visit. D) Try to convince the client to report the problem.

C) Report the suspicion to the local agency on aging within 24 hours of the visit.

What statement should the nurse include in a discussion to a community group about patent drugs? A) A patent is effective until the manufacturer voluntarily allows the protection to lapse. B) The drug may be manufactured or sold by other companies but only under it's generic name. C) The patent prevents other drug manufacturers from making or selling that drug D) Manufacturers can not develop, manufacture or sell a drug similar to one protected by a patent

C) The patent prevents other drug manufacturers from making or selling that drug

What law requires that official drugs must meet standards of purity and strength as determined by chemical analysis or by animal response to specified doses? A) the Durham-Humphrey Amendment B) the Food and Drug Administration laws C) the Food, Drug, and Cosmetic Act of 1938 D) the Comprehensive Drug Abuse Prevention and Control Act

C) the Food, Drug, and Cosmetic Act of 1938

A nurse is considering using restraint and seclusion for a client who is acting out. Which is the primary guideline for the use of restraint and seclusion? A) Use should be limited to times when a client has demonstrated violence and has inflicted harm to self or others. B) Use should be limited to times when medications have been unsuccessful in de-escalating a situation. C)Use should be limited to emergencies in which the risk of a client physically harming self, staff, or others is imminent. D) Use should be limited to emergency situations in which the client is demonstrating a potential to be violent.

C)Use should be limited to emergencies in which the risk of a client physically harming self, staff, or others is imminent.

A nurse is determining whether or not informed consent has been obtained from the family of a child who is going to have abdominal surgery. Which statement by the family would lead the nurse to suspect that informed consent is lacking? A) "Although there are risks involved, our son needs the surgery to cure the problem." B) "He might miss some school afterwards, but he'll be feeling much better." C) "We are amazed that he'll be up and walking around the day after surgery." D) "We had to sign the form right away so the surgery could get scheduled."

D) "We had to sign the form right away so the surgery could get scheduled."

The school nurse is concerned about the week-long absence of Jerry, a third grader. The nurse visits the home and learns that Jerry has been diagnosed with appendicitis by a local clinic doctor. The parents, who are Christian Science church members, have had several church groups in to pray over Jerry. He is not improving and is getting worse. The nurse should do which of the following? A) Allow the parents their religious rights B) Insist that the parents take Jerry to the hospital C) Threaten the parents with a lawsuit D) Contact Child Protection Services

D) Contact Child Protection Services

A mother of a 5-year-old child who was admitted to the hospital has a Protection from Abuse order for the child against his father. A copy of the order is kept on the pediatric medical surgical unit where the child is being treated. The order prohibits the father from having any contact with the child. One night, the father approaches the nurse at the nurses' station, politely but insistently demanding to see his child, and refusing to leave until he does so. What should the nurse do first? A) Firmly tell the father he must leave. B) Notify the nursing coordinator on duty. C) Notify the nurse-manager. D) Notify hospital security or the local authorities.

D) Notify hospital security or the local authorities.

The healthy adult client is given a narcotic prior to a surgical procedure. The nurse is completing the chart and notices the consent form was not signed by the client. Which of the following should the nurse do first? A) Immediately have the client sign the consent form. B) Have the client's family member sign the consent form. C) Ask the client if he still wants to proceed with the procedure. D) Notify the physician of the oversight.

D) Notify the physician of the oversight.

The nurse enters the nondiabetic client's room shortly after a group of health care providers has made rounds. The client asks, "Why did the doctor tell the others that I am not compliant with my diabetes regimen?" The nurse is aware that which ethical principle has been violated? A) respect for persons B) trust C) fidelity D) confidentiality

D) confidentiality

A client has designated her daughter as a person to make healthcare decisions for the client if he is not able to do so. What type of advance directive is this considered? A) Power of attorney B) Do-not-resuscitate order (DNR) D) Living will E) Durable power of attorney (DPOA) for healthcare

E) Durable power of attorney (DPOA) for healthcare

A nurse has administered 1 unit of glucose to the client as per order. What is the correct documentation of this information? A) 1 Unit of glucose B) 1 bottle of glucose C) One U of glucose D) 1U of glucose

A) 1 Unit of glucose

Which client of a forensic nurse has most likely been found not guilty but mentally ill (not guilty by reason of insanity) following the commission of a serious crime? A) A client who is being held involuntarily in a secure psychiatric setting B) A client with a history of mental illness who is serving a lengthy term in a federal prison C) A client who is receiving care involuntarily on a community hospital's psychiatric unit D) A client who has been released into the community with strict limits on activity

A) A client who is being held involuntarily in a secure psychiatric setting

A male client 79 years of age who is postoperative Day 3 following hip replacement surgery has been approached by a nurse researcher and asked to participate in a research study. This study will test a new rehabilitation strategy. What aspect of the nursing research process addresses the client's understanding of the potential risks and benefits of this study? A) going through the informed consent process with the client B) obtaining the client's signature on a permission document C) meeting with the hospital's institutional review board (IRB) D) giving the client the opportunity to ask questions about the study

A) going through the informed consent process with the client

A charge nurse is at the front desk when a woman demands information about a child who has been admitted on the unit. The nurse should: A) inform the woman that confidentiality prevents her from disclosing the information. B) direct the woman to the child's room so as to prevent her behavior from escalating. C) call security because of the woman's angry demeanor. D) refer to the child's chart and tell the woman only the condition of the child, which is public knowledge.

A) inform the woman that confidentiality prevents her from disclosing the information.

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? A) "A living will can only be used in the state it was created in." B) "Take it with you. It is recognized universally in the United States." C) "As long as your family knows your medical wishes, you will not need it." D) "We have it on file here, so any hospital can call and get a copy."

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

Which criterion is acceptable for a bystander rescuer to use to discontinue cardiopulmonary resuscitation (CPR) in an out-of-hospital cardiac arrest? A) The victim will not survive. B) The rescuer is exhausted. C) After 30 minutes of CPR the victim is without a pulse rate. D) The family requests discontinuation.

B) The rescuer is exhausted.

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? A) Giving the client the preoperative analgesic at the scheduled time B) Asking the client to sign the consent form C) Notifying the surgeon that the client hasn't signed the consent form D) Canceling the surgery

C) Notifying the surgeon that the client hasn't signed the consent form

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? A) Sedate the client. B) Get written consent. C) Obtain a medical order. D) Notify the family.

C) Obtain a medical order.

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? A) Tarasoff v. Regents of the University of California B) The Patient Self-Determination Act C) The Mental Health Systems Act of 1980 D) Public Law 99-319, The Protection and Advocacy for Mentally Ill Individuals Act of 1986

A) Tarasoff v. Regents of the University of California

The nurse obtains a unit of blood for the client, Donald D. Smith. The name on the label on the unit of blood reads Donald A. Smith. All the other identifiers are correct. The nurse A) Administers the unit of blood B) Checks with Blood Bank first and then administers the blood with their permission C) Refuses to administer the blood D) Asks the client if he was ever known as Donald A. Smith

C) Refuses to administer the blood

Which scenario is an example of certification? A) A nurse who demonstrates advanced expertise in a content area of nursing through special testing B) A hospital meets the standards of the Joint Commission C) An education program that meets standards of the National League for Nursing D) A graduate of a nursing education program who passes NCLEX-RN

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

Which process evaluates and recognizes educational programs as having met certain standards? A) Accreditation B) Credentialing C) Licensure D) Certification

A) Accreditation

Regarding medication administration, what must occur at the change of shifts? A) The client's medications must be drawn up. B) The medications for the division are counted. C) The narcotics for the division are counted. D) Only the LPNs on the division count medications.

C) The narcotics for the division are counted.

The nurse hears an unlicensed assitive personel (UAP) discussing a client's allergic reaction to a medication with another UAP in the cafeteria. What is the priority nursing action? A) Remind the UAP about the client's right to privacy. B) Report the UAP to the nurse manager. C) Notify the client relations department about the breach of privacy. D) Document the UAP's conversation.

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

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 are examples of legal safeguards for the nurse? Select all that apply. A) The nurse obtains informed consent from a client to perform a procedure. B) The physician is responsible for administration of a wrongly prescribed medication. C) The nurse educates the client about The Patient Care Partnership. D) The nurse executes physician orders without questioning them. E) The nurse documents all client care in a timely manner. F) The nurse claims management is responsible for inadequate staffing leading to negligence.

A) The nurse obtains informed consent from a client to perform a procedure. C) The nurse educates the client about The Patient Care Partnership. E) The nurse documents all client care in a timely manner.

After reporting to work for a night shift, the nurse learns that the unit will be understaffed because two RNs called out sick. As a result, each nurse on the unit will need to provide care for an additional four acute clients, in addition to her regular client assignment. Which statement is true for this nurse when working in understaffed circumstances? A) The nurse will be legally held to the same standards of care as when staffing levels are normal. B) Understaffing constitutes an extenuating circumstance that creates a temporarily lower expectation for care for the nurse. C) 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. D) The nurse is legally obliged to refuse to provide care when understaffing creates the potential for unsafe conditions.

A) The nurse will be legally held to the same standards of care as when staffing levels are normal.

A client who is positive for human immunodeficiency virus (HIV) tells the nurse that her significant other is the only family member who knows her health status. What should the nurse do to keep the client's health status confidential? Select all that apply. A) Use the hospital code for HIV when documenting care. B) Ask all family members, except the client's significant other, to wait outside when she's educating the client. C) Discuss the case with the client's mother, who is an immediate family member. D) Discuss the case at lunch to educate other staff members. E) Keep a unit log of all clients infected with HIV for research purposes.

A) Use the hospital code for HIV when documenting care. B) Ask all family members, except the client's significant other, to wait outside when she's educating the client.

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? A) battery. B) assault. C) fraud. D) defamation of character.

A) battery.

The nurse is completing an admission assessment for a client receiving interstitial implants for prostate cancer. The nurse documents this as A) brachytherapy. B) external beam radiation therapy. C) systemic radiation. D) a contact mold.

A) brachytherapy.

According to the Health Insurance Portability and Accountability Act (HIPAA) passed in 1996, clients: A) have the right to copy their health records. B) need to obtain legal representation to update their health records. C) can be punished for violating guidelines. D) are required to obtain health record information through their insurance company.

A) have the right to copy their health records.

The nurse is assigned to clients who are having the following procedures: <br />Amniocentesis<br />Fetal nonstress test<br />Chorionic villus sampling<br />Percutaneous umbilical blood sampling<br />Doppler assessment of fetal heart rate<br />For which clients will the nurse ensure that the informed consent is on the chart? A) Amniocentesis, chorionic villus sampling, fetal nonstress test B) Amniocentesis, chorionic villus sampling, percutaneous umbilical blood sampling C) Fetal nonstress test, Doppler assessment of fetal heart rate D) Amniocentesis, percutaneous umbilical blood sampling, Doppler assessment of fetal heart rate

B) Amniocentesis, chorionic villus sampling, percutaneous umbilical blood sampling

A nurse is caring for a 4-year-old undergoing a laparoscopy for a possible ruptured appendix and the surgeon determines that the child has a mass on the colon that requires removal and biopsy. Which best describes the use of informed consent in this case? A) Informed consent will be waived because the procedure is emergent. B) The surgeon may meet with the parents while the client is prepped for an open procedure to obtain consent. C) The surgery should be postponed since the surgeon didn't get consent to remove the mass. D) Informed consent should be obtained when the surgeon meets with the family after the procedure.

B) The surgeon may meet with the parents while the client is prepped for an open procedure to obtain consent.

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: A) the physician on call. B) the social worker on call. C) Women in Distress (local provincial/territorial, regional or aboriginal shelter). D) a lawyer.

B) the social worker on call.

A nurse is performing an admission assessment on a client admitted with a pelvic fracture. Which statement by the client requires the nurse to seek more information from a legal standpoint? A) "I'm so clumsy." B) "I'm afraid I'll lose my job because I'm going to miss so much work." C) "Sometimes my husband gets so angry with me." D) "I'm going to need help at home after I'm discharged."

C) "Sometimes my husband gets so angry with me."

If a client receives the wrong medication and harm has resulted, which legality has occurred? A) Tort B) Duty C) Liability D) Battery

C) Liability

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? A) Ignore the client's question and continue with morning care. B) Tell the client "I'm not sure how the other woman is doing today." C) Tell the client "I need to ask the woman's permission before discussing her well-being." D) Explain to the client that "Nurses are not allowed to discuss other clients on the unit."

D) Explain to the client that "Nurses are not allowed to discuss other clients on the unit."

An elderly client who has been diagnosed with delusional disorder for many years is exhibiting early symptoms of dementia. His daughter lives with him to help him manage daily activities, and he attends a day care program for seniors during the week while she works. A nurse at the day care center hears him say, "If my neighbor puts up a fence, I will blow him away with my shotgun. He has never respected my property line, and I have had it!" Which action should the nurse take? A) Observe the client more closely, but do not report his threat since he will likely not be able to follow through with it because of his dementia. B) Report the comment to the client's daughter so she can observe him more closely, but refrain from telling the neighbor due to privacy regulations. C) Report the comment to the neighbor, the intended victim, but refrain from telling the daughter since she will just worry about actions of her father she cannot control. D) Report the comment to the neighbor, the daughter, and the police since there is the potential for a criminal act.

D) Report the comment to the neighbor, the daughter, and the police since there is the potential for a criminal act.

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 daughter to direct his care, is a(an): A) will. B) standard of care. C) license. D) advance directive.

D) advance directive.

A nurse is named as a defendant in a malpractice lawsuit. Which action would be recommended for this nurse? A) Discuss the case with the plaintiff to ensure understanding of each other's positions. B) If a mistake was made on a chart, change it to read appropriately. C) Be prepared to tell your side to the press, if necessary. D) Do not volunteer any information on the witness stand.

D) Do not volunteer any information on the witness stand.

A staff nurse is caring for a client who is a potential heart donor. The client's family is concerned that the recipient will have access to personal donor information. Which response by the nurse demonstrates knowledge of the organ donation process? A) "I will have the transplant coordinator speak with you to answer your questions." B) "There is never contact between the donor's family and the recipient." C) "The recipient is allowed to ask questions about the donor and have them answered." D) "It is important that the recipient know where to send Thank-You cards."

A) "I will have the transplant coordinator speak with you to answer your questions."

The nurse has provided preoperative instructions to a client scheduled for surgery at an ambulatory care center. Which statement, made by the client, would indicate that further instruction is needed? A) "If I do not follow the instructions, my surgery could be cancelled." B) "The nurse will explain the details of the surgery before I sign a consent." C) "My medical records will be sent to the ambulatory care center prior to my surgery." D) "The physician will update my family after the procedure and provide specific discharge instructions."

B) "The nurse will explain the details of the surgery before I sign a consent."

The client being admitted to the oncology unit conveys his wishes regarding resuscitation in the event of cardiopulmonary arrest. The nurse advises the client that it would be in his best interest to obtain which document? A) A will B) A living will C) Proof of health care power of attorney D)A proxy directive

B) A living will

A nurse-manager of an intensive care unit (ICU) can't be held legally responsible in a court of law for which action performed by the unit's staff? A) A nursing assistant administers medications to a client in ICU. B) A staff nurse refuses to follow a physician's order to administer medication because administering the dosage ordered could seriously harm the client. C) A nursing assistant attempts to initiate I.V. therapy. D) A staff nurse fills a client prescription at the hospital pharmacy because the pharmacist on duty is busy.

B) A staff nurse refuses to follow a physician's order to administer medication because administering the dosage ordered could seriously harm the client.

The nursing student is studying violence and abuse against the older woman. While researching it, she learns that laws require health care professionals to report elder or vulnerable person abuse. How many states currently have these laws? A) 40 B) 32 C) 52 D) 50

D) 50

A client with end-stage pulmonary hypertension tells the physician he doesn't want any heroic measures should his heart stop, and he 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? A) Nonmaleficence B) Beneficence C) Justice D) Autonomy

D) Autonomy

A nurse is assisting an anesthetist during the intubation of a client. The anesthetist visualizes the vocal cords with the laryngoscope and says to the nurse, "This is an easy one. Why don't you give it a try?" indicating that the nurse should insert the endotracheal tube. What would be the most appropriate response by the nurse? A) "Thanks. I would be happy to try as long as you supervise me." B) "This will be great experience in case I need to do it in an emergency." C) "I have done this before, but still need more practice." D) "This procedure is not within my scope of practice."

D) "This procedure is not within my scope of practice."

It is determined that a patient is legally blind and will be unable to drive any longer. Legal blindness refers to a best-corrected visual acuity (BCVA) that does not exceed what reading in the better eye? A) 20/50 B) 20/100 C) 20/150 D) 20/200

D) 20/200

A nurse is named as a defendant in a pediatric client case. What are guidelines for the nurse to follow prior to the trial? Select all that apply. A) Discuss the case with the involved physician. B) Limit contact with the assigned attorney. C) Add comments during the questioning to build the story. D) Use polite language while answering questions. E) Be prepared to answer questions about the case during the trial.

D) Use polite language while answering questions. E) Be prepared to answer questions about the case during the trial.

A 15-year-old female who is 26 weeks pregnant has been admitted to the labor and delivery unit with a complaint of abdominal pain. Her parents want to speak with a nurse about to her condition. How should the nurse respond? A) "I'll need a signed consent from your daughter to give you medical information." B) "The physician can give you more information without consent." C) "She will be OK. It's just a stomachache." D) "She is experiencing Braxton Hicks contractions and is too young to understand the difference between these contractions and labor pains."

A) "I'll need a signed consent from your daughter to give you medical information."

Which statement is correct regarding the Omnibus Reconciliation Act of 1986? A) All families of clients who are nearing death, or who have died, must be asked about organ and tissue donation. B) The medical examiner should be notified whenever donated organs or tissues may be available. C) The facility may not release the donor's name without the family's permission. D) Hospitals need not have designated requesters who approach families for organ and tissue donation.

A) All families of clients who are nearing death, or who have died, must be asked about organ and tissue donation.

HIPAA allows incidental disclosures of client health information as long as it cannot reasonably be prevented, is limited in nature, and occurs as a byproduct of an otherwise permitted use or disclosure of client health information. What are examples of this type of client health information disclosure? Select all that apply. A) The nurse uses sign-in sheets that contain information about the reason for the client visit. B) A visitor hears a confidential conversation between two nurses in surroundings that are appropriate and with voices that are kept low. C) The nurse uses white boards on an unlimited basis. D) The nurse uses x-ray light boards that can be seen by passersby; however, client x-rays are not left unattended on them. E) The nurse calls out names in the waiting room, but does not disclose the reason for the client visit. F) The nurse leaves a detailed appointment reminder message on a client's voice mail.

B) A visitor hears a confidential conversation between two nurses in surroundings that are appropriate and with voices that are kept low. D) The nurse uses x-ray light boards that can be seen by passersby; however, client x-rays are not left unattended on them. E) The nurse calls out names in the waiting room, but does not disclose the reason for the client visit.

An HIV-positive client discovers that his name is published in a report on HIV care prepared by his nurse. He strongly opposes this and files a lawsuit against the nurse. Which of the following offenses has this nurse committed? A) Unintentional tort. B) Invasion of privacy. C) Defamation. D) Negligence of duty.

B) Invasion of privacy.

A client and her boyfriend of 5 months are celebrating the birth of a healthy baby boy when the client's estranged partner arrives to visit the baby he believes is his son. The nurse caring for the client knows that the estranged partner has the right to: A) see the neonate through the nursery glass window. B) hold the neonate after the mother gives permission. C) ask security to remove the boyfriend from his estranged wife's hospital room. D) decide to circumcise his son.

B) hold the neonate after the mother gives permission.

Four months ago, the son and daughter of a client who was in a vegetative state gave consent for a feeding tube and agreed to long-term care placement. Nurses in the long-term care facility note that the son and daughter have recently become more distraught over their mother's condition. One day while visiting together, the son and daughter approach the nurse about having the feeding tube removed. Which statement by the nurse best explains the legal rights of individuals in this situation? A) "It's too late; there is nothing that can be done now." B) "I understand your concern; it has to be difficult to see your mother like this." C) "Legally, there are no time constraints on previous decisions made." D) "Are you looking for other means of nutritional support?"

C) "Legally, there are no time constraints on previous decisions made."

A woman is in labor with her second child. She knows that she will want epidural anesthesia, and she has already signed her consent form. What must the nurse do before the woman receives the epidural? A) Review the woman's medical history and laboratory results, and interview her to confirm all information is accurate and up to date. B) Place the woman in the fetal position on the table, and keep her steady so that she won't move during the procedure. C) Administer a fluid bolus through the IV line to reduce the risk of hypotension. D) Prepare a sterile field with the supplies and medications that will be needed.

C) Administer a fluid bolus through the IV line to reduce the risk of hypotension.

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? A) Persuade the client to take the medication as ordered. B) Ensure that the client understands the rationale for taking the medication. C) Ask the client's spouse to encourage the client to take the chemotherapy. D) Document the client's choice and offer to discuss feelings about the chemotherapy.

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

A family member expresses that a client who is aphasic after a cerebral vascular accident (CVA) has not been incontinent at home and questions why a urinary catheter has been inserted without consent. The nurse would recognize this treatment best aligns with which standard of care? A) Treatment without consent of the patient, which is an invasion of rights B) Treatment for the patient's benefit C) Inability to obtain consent for treatment because the patient was aphasic D) Treatment that does not need special consent

D) Treatment that does not need special consent

When the nurse researcher informs the participant that his identity will not be linked with the information that is collected, the researcher is ensuring the participant's: A) anonymity. B) protection from harm. C) ability to withdraw. D) confidentiality.

D) confidentiality.

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: A) establish a rapport to foster trust. B) place the client in full leather restraints. C) try to communicate with the client in writing. D) ensure safety by initiating suicide precautions.

D) ensure safety by initiating suicide precautions.

A nurse presents a client with the informed consent form for an abdominal paracentesis. The client asks the nurse what the procedure involves. The nurse should: A) have the client sign the form and ask the physician explain the procedure again. B) explain the form and have the client's health care power of attorney sign it. C) explain the procedure and the benefits and risks associated with it, then have the client sign the form. D) notify the physician that the client doesn't understand the procedure.

D) notify the physician that the client doesn't understand the procedure.

A client admitted to a 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 which of the following? A) Slander B) Negligence C) Battery D) Malpractice

C) Battery

A 15-year-old client gives birth to a healthy neonate. The neonate's adolescent father arrives on the unit demanding to see his baby. Both sets of grandparents are also present and asking to see their grandchild. The newly hired nurse assigned to the nursery should take which action? A) Notify security because the neonate's father is demanding to see his baby. B)Teach the grandparents how to scrub and gown before entering the nursery. C) Discuss the unit's policy with the charge nurse. D) Invite everyone into the large conference room to see the neonate.

C) Discuss the unit's policy with the charge nurse.

The use of patient restraints limits which ethical principle? A) Beneficence B) Justice C) Autonomy D) Trust

C) Autonomy

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? A) "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." B) "If I lose my temper in the community room, I'll be locked up in the seclusion room." C) "When I go into seclusion, I won't be able to see my physician until I calm myself down." D) "Every time I decide that I won't attend a group meeting, I'll be put in seclusion."

A) "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."

A student nurse is questioning a nursing instructor about the responsibility to have malpractice insurance. The nursing instructor confirms the safeguard of malpractice insurance by emphasizing which points regarding student liability? Select all that apply. A) The student nurse is responsible for his or her actions. B) The student nurse is held to the same standard of care as a nurse. C) The student can practice as an employee during clinical experiences. D) The student nurse is not responsible for knowing the facility's policy and procedures. E) The nursing instructor can be liable if the assignment is above the student's competency.

A) The student nurse is responsible for his or her actions. B) The student nurse is held to the same standard of care as a nurse. E) The nursing instructor can be liable if the assignment is above the student's competency.

An infant is brought to the emergency department. The infant is limp and has central cyanosis, a heart rate of 60 beats/minute, and a respiratory rate of 12 breaths/minute. The parents state that they have an advance directive for their infant, who has a terminal illness. A nurse's initial action should be to: A) ask to see a copy of the advance directive. B) administer oxygen to the infant while awaiting the physician's orders. C) provide palliative care for the infant and his family. D) contact the nursing supervisor for assistance.

A) ask to see a copy of the advance directive.

The nurse educator provides an educational session to the nursing staff on protection of a client's privacy. Which circumstances, identified by the staff, would indicate to the educator that the teaching was effective? Select all that apply. A) During a bed bath, the nurse exposed the client's upper torso while washing the client's face. B) With the client's permission, the nurse explained the client's diagnosis to the client's spouse. C) The nurse questioned the client about her social life even though it did not affect care planning. D) The nurse removed the client from the emergency department waiting room into a private area to collect assessment data. E) Because the facility is a teaching facility, the nurse allowed the nursing student to take the client's picture for his care plan.

B) With the client's permission, the nurse explained the client's diagnosis to the client's spouse. D) The nurse removed the client from the emergency department waiting room into a private area to collect assessment data.

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? A) Call the nursing supervisor and ask that the hospital lawyer be contacted. B) Keep the client in the emergency department until the family is contacted. C) Take the client to the operating room for surgery without informed consent. D) Contact the hospital chaplain to sign the consent on the client's behalf.

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

Assessment of visual acuity reveals that the client has blurred vision when looking at distant objects but no difficulty seeing near objects. The nurse documents this as which of the following? A) Myopia B) Astigmatism C) Hyperopia D) Emmetropia

A) Myopia

A nursing instructor is discussing a nursing student's social media post about an interesting client situation that happened during clinical. The student states, "I didn't violate client privacy because I didn't use the client's name." What response by the nursing instructor is most appropriate? A) "Any information that can identify a person is considered a breach of client privacy." B) "You may continue to post about a client you cared for during clinicals, as long as you do not use the client's name." C) "All aspects of the clinical experience are confidential and should not be discussed." D) "The information being posted on social media is inappropriate. Make sure to discuss information about clients privately with friends and family."

A) "Any information that can identify a person is considered a breach of client privacy."

When the nurse inserts an ordered urinary catheter into the client's urethra after the client has refused the procedure, and then the client suffers an injury, the client may sue the nurse for which type of tort? A) Battery B) Assault C) Invasion of privacy D) Dereliction of duty

A) Battery

The nurse is performing and documenting the findings of an abdominal assessment. When the nurse hears intestinal rumbling and the client then experiences diarrhea, the nurse documents the presence of which condition? A) Borborygmus B) Tenesmus C) Azotorrhea D) Diverticulitis

A) Borborygmus

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? A) Contact the physician and obtain necessary orders. B) Restrain the client with vest restraints. C) Ask a family member to come in to supervise the client. D) Apply wrist restraints instead of vest restraints.

A) Contact the physician and obtain necessary orders.

A client who is legally blind must undergo a colonoscopy. The nurse is helping the physician obtain informed consent. When obtaining informed consent from a client who is visually impaired, the nurse should take which step? A) Read the consent form to the client and ask him if he has any questions. B) Encourage the client to read the form. C) Make sure the client's family is present when he signs the consent form. D) Document on the consent form that the client is unable to sign the consent because he is legally blind.

A) Read the consent form to the client and ask him if he has any questions.

A nurse is witnessing a client sign the consent form for surgery. After signing the consent form, the client starts asking questions regarding the risks and benefits of a surgical procedure. What action by the nurse is most appropriate? A) Answer the client's questions. B) Request that the surgeon come and answer the questions. C) Place the consent form in the client's medical record. D) Notify the nurse manager of the client's questions.

B) Request that the surgeon come and answer the questions.

When administering medication, the nurse ensures client safety by following the rights of medication administration. Identify the "rights of medication administration." Select all that apply. A) Right room B) Right client C) Right dose D) Right medication E) Right time F) Right route

B) Right client C) Right dose D) Right medication E) Right time F) Right route

A nurse is admitting a client to the palliative unit and discussing advanced directives. Which of the following statements made by the client leads the nurse to believe the client requires clarification around advanced directives? A) "This will allow me to identify who my power of attorney will be." B) "This will stop my daughter-in-law from putting me in a home." C) "It is good to do this now before I am unable to make the decisions." D) "I can let my family know what treatment I want in the future."

B) "This will stop my daughter-in-law from putting me in a home."

The nursing instructor is working with a student in a pre-operative unit. The student notices that the informed consent has not been signed. Which is the best action taken by the student nurse for obtaining informed consent? A) Asking the primary nurse to get the informed consent B) Notifying the physician involved with the procedure that the consent has not been signed C) Asking the nurse working with the physician to get the informed consent D) Notifying the social worker

B) Notifying the physician involved with the procedure that the consent has not been signed

A nurse in the emergency department assesses a 3-year-old child with a fractured femur, a hematoma on the back of his head, and multiple 1-cm round scabs and blisters on his upper back. The parents state that their child sustained the injuries by falling out of his high chair. What is the best action for the nurse to take? A) Document the suspected child abuse in the child's health care record. B) Report the suspected child abuse to Child Protective Services. C) Refer the child and the family to social services for follow up. D) Ask the physician to question the parents about the suspected child abuse.

B) Report the suspected child abuse to Child Protective Services.

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? A) Libel B) Slander C) Negligence D) Malpractice

B) Slander

Which situation is an example of battery that the nurse may experience while performing her duties at the health care facility? A) telling the client that he cannot leave the hospital B) performing a surgical procedure without getting consent C) taking the client's photographs without consent D) witnessing a procedure done on a client without his consent

B) performing a surgical procedure without getting consent

A nurse is working in a clinic where a family member's spouse is treated for a sexually transmitted disease. The nurse is concerned about the risk to her family member. What is the most appropriate action for the nurse to take? A) Anonymously inform her family member of the spouse's diagnosis so that he or she may seek necessary treatment. B) As legally required, inform the family member of the client's diagnosis. C) Encourage the client to speak with the family member about the diagnosis if he or she has not already done so. D) Provide the local Board of Health with the family member's name so they can contact him or her with information about the client's diagnosis.

C) Encourage the client to speak with the family member about the diagnosis if he or she has not already done so.

The nurse is assigned to care for a middle-aged client who is very agitated and wants to go home. The client states that he does not have time to waste in the hospital, and no one is doing anything anyway. Which action by the nurse is most appropriate if the client insists on leaving the hospital against medical advice (AMA)? A) Have the client sign the discharge form. B) Obtain a copy of the client's care plan. C) Have the client sign the AMA form. D) Have the client sign a consent form.

C) Have the client sign the AMA form.

A group of nursing students are reviewing current nursing Codes of Ethics. Such a code is important in the nursing profession because: A) Nurses are highly vulnerable to criminal and civil prosecution in the course of their work. B) Nurses interact with clients and families from diverse cultural and religious backgrounds. C) Nursing practice involves numerous interactions between laws and individual values. D) Nurses are responsible for carrying out actions that have been ordered by other individuals.

C) Nursing practice involves numerous interactions between laws and individual values.

The nurse is obtaining informed consent from a client. To adhere to ethical and legal standards, the nurse must ensure that the informed consent consists of which of the following? Select all that apply. A) Discussion of pertinent information B) The client's agreement to the plan of care C) Freedom from coercion D) Caregiver preference and opinion E) Verification from next of kin

A) Discussion of pertinent information B) The client's agreement to the plan of care C) Freedom from coercion

Nurses are occasionally asked to witness a testator's (person who makes the will) signing of his or her will. Which guideline is true regarding a nurse's role is witnessing a testator's signature? A) Witnesses to a signature do not need to read the will. B) Witnesses do not need to observe the signing of the will and can sign it at a later time. C) A beneficiary to a will is allowed to act as a witness. D) A single witness is sufficient for a will.

A) Witnesses to a signature do not need to read the will.

A client who is taking olanzapine states he is being poisoned and refuses to take his scheduled medication. The nurse states, "If you do not take your medication, you will be put into seclusion." The nurse's statement is an example of which legal concept? A) assault B) battery C) malpractice D) invasion of privacy

A) assault

A nurse on a night shift entered an older adult client's room during a scheduled check and discovered the client on the floor beside the bed, the result of falling when trying to ambulate to the washroom. After assessing the client and assisting into the bed, the nurse has completed an incident report. What is the primary purpose of this particular type of documentation? A) identifying risks and ensuring future safety for clients B) gauging the nurse's professional performance over time C) protecting the nurse and the hospital from litigation D) following up the incident with other members of the care team

A) identifying risks and ensuring future safety for clients

An adolescent admitted for panic attacks tells the nurse that an uncle has been making sexual advances. The client begs the nurse to not say anything because of what the uncle may do. What should be the nurse's initial response? A) "You have a right not to report this, so I will not either." B) "He can't hurt you here, and we'll make sure you're safe." C) "The law requires me to make a report so you can be protected." D) "Have you told anyone else what is happening?"

C) "The law requires me to make a report so you can be protected."

The nurse is caring for a 90-year-old male who has never completed an advanced directive. The man has a son but has not seen him in several years. A neighbor has assisted him with meals and housecleaning for many years. The neighbor states that the client expressed only wanting to have comfort measures. The estranged son wants his father to be treated aggressively. Which would be the nurse's initial step? A) Follow the son's directive. B) Follow the neighbor's directive. C) Assess the client's ability to state wishes. D) Notify the physician of the discrepancy.

C) Assess the client's ability to state wishes.

Which is also known as a proxy directive? A) Medical directive B) Living will C) Durable power of attorney for health care D) Treatment directive

C) Durable power of attorney for health care

To properly assist a victim of abuse, which action would be most appropriate for the nurse to do? A) Document the details. B) Summarize the details of the incident. C) Discuss the details with the victim. D) Confront the abuser about the details.

A) Document the details.

The nurse is presenting to a shelter for abused women and children and is asked by a participant, "What does the No Child Left Behind Act mean?" How should the nurse best respond? A) "It has lead to increased research and treatment of major health issues concerning children." B) "This act provides increased funding for newborn screening grants and neonatal education." C) "It is a Federal program that will ensure all children in classrooms receive up-to-date research-based curriculum." D) "Nutritional supplementation and education to low-income families and pregnant women will be provided."

C) "It is a Federal program that will ensure all children in classrooms receive up-to-date research-based curriculum."

A client is brought 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? A) The nurse informs the family about advance directives. B) The nurse informs the family about the living will. C) The nurse ensures that the client signs the consent form. D) The nurse ensures that the client's family signs the consent form.

C) The nurse ensures that the client signs the consent form.

Professional regulations and laws that govern nursing practice are in place for which of the following reasons? A) To limit the number of nurses in practice B) To ensure that practicing nurses are of good moral standing C) To protect the safety of the public D) To ensure that enough new nurses are always available

C) To protect the safety of the public

The perioperative nurse has a number of major responsibilities when a patient is admitted to a surgical unit or center. Which of the following is the most important function? A) Completes preoperative assessment B) Develops a plan of care C) Verifies that operative consent is signed D) Provides psychological support

C) Verifies that operative consent is signed

A nurse manager overhears a nurse caring for a client with an IV make the following statement: "If you don't stop playing with your IV, I will tie your hand to the side rail." What is the most appropriate response by the nurse manager to address this situation? A) "I need to inform you that your behavior is within the definition of assault." B) "You need to think of a more creative way to stop the client from playing with the IV." C) "You will save the client from another IV insertion by restraining the client's hand." D) "I'm sure the client knows you were joking, but it was still inappropriate to say."

A) "I need to inform you that your behavior is within the definition of assault."

A client states that his recent fall was caused by the fact that his scheduled antihypertensive medications were 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? A) Document the client's claims and the events surrounding the alleged incident. B) Consult with the hospital's legal department as soon as possible. C) Consult with practice advisors from the state board of nursing. D) Enlist support from nursing and non-nursing colleagues from the unit

A) Document the client's claims and the events surrounding the alleged incident.

When assessing if a procedural risk to a client is justified, the ethical principle underlying the dilemma is known as what? A) Nonmaleficence B) Informed consent C) Self-determination D) Pro-choice

A) Nonmaleficence

During the admission assessment of a female client age 40 years with a suspected mandibular fracture, the client discloses to the nurse that her injury came as a result of her husband hitting her. Which action should the nurse prioritize when responding to this disclosure? A) Reporting the abuse to the appropriate authorities B) Ensuring the client's statement is confirmed by another nurse C) Performing an assessment to confirm the client's statement D) Informing the client of her right to keep this information private

A) Reporting the abuse to the appropriate authorities

A nurse overhears a fellow staff member talking about the mother of a child for whom the staff nurse is caring. The nurse is telling others private information that the mother had shared. What is the best response by the nurse overhearing the conversation? A) Report this incident to the nurse-manager. B) Report the incident to the organization's privacy officer. C) Talk to the staff member privately about this. D) Talk to the staff in general about confidentiality.

C) Talk to the staff member privately about this.