Chapter 07: Legal Dimensions of Nursing Practice
A nurse threatens to restrain a verbally abusive client if the abuse continues. Which legal tort has the nurse committed? -Negligence -Assault -Invasion of privacy -Defamation of character
Assault Explanation: Assault is threatening to touch a person, such as by applying restraints, without consent. Sharing a client's confidential information without consent is an invasion of privacy. When a person performs an act that a reasonable person would not do under the same circumstance, it is negligence. Defamation of character occurs when one makes statements that damage another person's reputation. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 125.
A client admitted to a mental health unit has exhibited physical behaviors that put the client and others at risk. The nurse applies four-point restraints on the client without obtaining a health care provider's order or the client's consent. The nurse is at risk of being accused of which action? -Negligence -Slander -Malpractice -Battery
Battery Explanation: Battery is intentional and wrongful physical contact with a person that entails an injury or offensive touching. Performing treatment without permission or receiving informed consent from the client might constitute both assault and battery. Judgments of battery suits have been based on the application of restraints to confused clients. Slander is a verbal attack on a person's character. Malpractice pertains to actions committed and negligence to actions omitted that cause physical harm to a client. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, pp. 125-126.
Which action constitutes battery? -An older adult client refuses an intramuscular injection, but the nurse administers it. -The nurse tells a client that the client cannot leave the hospital because the client is seriously ill. -The nurse threatens to restrain a client if the client does not take a medication. -While bathing a client behind pulled curtains, two nurses discuss a different client.
An older adult client refuses an intramuscular injection, but the nurse administers it. Explanation: If the client refuses a procedure or medication and the nurse proceeds with it, it is battery. Threatening to touch a client without consent is assault. Discussing a client within earshot of others is an invasion of privacy. Keeping a client against the client's wishes, regardless of health status, is false imprisonment. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 125.
When talking with family over dinner, the nurse shares about a client with infertility at the hospital, identifying the person by name. Which tort has the nurse committed? -Invasion of privacy -Slander -Assault -Fraud
Invasion of privacy Explanation: Invasion of privacy involves a breach in keeping client information confidential. Slander is oral defamation of character. Assault is a threat or attempt to make bodily contact with another person without that person's consent. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 126.
The nurse is providing care to a client whose condition has progressively declined. The nurse assesses and makes appropriate interventions as well as notifies the health care provider. Despite the nurse's efforts, the client expires. What element of liability has the nurse demonstrated? -Duty -Breach of duty -Causation -Damages
Duty Explanation: Duty refers to an obligation to use due care. The nurse assessed the client and made appropriate interventions and notifications. Breach of duty is the failure to meet the standard of care. An example of breach of duty would be not performing assessments, appropriate interventions, and notifications of the health care provider. Causation is when the breach of duty caused the injury. An example of causation would be failure to perform assessment and appropriate interventions when providing client care, and this caused injury to the client. Damages are the harm or injury that occurred to the client. In this situation, it would be the death of the client. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 128.
A nurse is called to a deposition for a malpractice charge that has resulted in the death of a client. As the chart is reviewed, the prosecuting attorney questions the nurse about several defaming comments written in the medical record about the client. What charges can be filed against the nurse due to these comments? -Malpractice -Libel -Slander -Negligence
Libel Explanation: Libel is damaging statements written and read by others. Because defaming comments were written in the chart, libel charges could be appropriate. Malpractice is negligence in performing or failing to perform expected duties of one's profession. Slander is oral defamation of character. Negligence is performing an action a reasonable person would not perform or failing to perform an action that a reasonable person would perform, resulting in harm to another. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 125.
A nurse is caring for a client following endotracheal intubation. Before applying soft wrist restraints to prevent the client from pulling out the endotracheal tube, what is the most appropriate action of the nurse? -Obtain a medical order. -Notify the family. -Get written consent. -Sedate the client.
Obtain a medical order. Explanation: Nurses must obtain a medical order before each and every instance in which they use restraints. Due to the severity of the client illness requiring endotracheal intubation, the client may not be able to provide a written consent. The client does not need to be sedated unless medically necessary, and although it is appropriate to notify the family, this is not the priority. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 127.
A nurse and the facility have been named as defendants in a malpractice lawsuit. In addition to the nurse's attorney, whom else would be appropriate for the nurse to talk with about the case? -The local press -The agency's risk manager -A colleague -The plaintiff's lawyer
The agency's risk manager Explanation: A nurse who is named a defendant should work closely with an attorney while preparing the defense. With the exception of the nurse's attorney and the agency's risk manager, the nurse should not discuss the case with anyone, including anyone at the agency, the plaintiff, the plaintiff's lawyer, anyone testifying for the plaintiff, or reporters. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, Nurse as a Defendant, p. 137.
Nurses complete incident reports as dictated by the agency protocol. What is the primary reason nurses fill out an incident report? -To improve quality of care -To document the need for disciplinary action -To document everyday occurrences -To initiate litigation
To improve quality of care Explanation: The primary reason to fill out an incident report is to improve the quality of care. Incident reports are not designed to be a means for disciplinary action. Incident reports are designed to identify actual or potential risks that can be addressed to improve quality of care. Incident reports are not intended to initiate litigation or document everyday occurrences. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 138.
Professional regulations and laws that govern nursing practice are in place for which reason? -To protect the safety of the public -To ensure that practicing nurses are of good moral standing -To ensure that enough new nurses are always available -To limit the number of nurses in practice
To protect the safety of the public Explanation: Governing bodies, professional regulations, and laws are in place to protect the public by ensuring that nurses are accountable for safe, competent, and ethical nursing practice. The other options do not describe accurately the role and responsibility of the governing bodies and the regulations and laws of nursing. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, pp. 121-123.
A legal document that states a client's health-related wishes — such as a preference for pain management if the client becomes terminally ill — and also allows the client's adult child to direct the client's care, is: -a standard of care. -a license. -an advance directive. -a will.
an advance directive. Explanation: Clients communicate their wishes to health care providers by verbally participating in health care decision making and by employing written documents called advance directives. A will is a legal document where one communicates wishes of how to dispose of personal effects and belongings upon one's death. The terms license and standard of care have no application in this scenario. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 140.
A nurse is overheard in the hospital cafeteria making false, derogatory comments about a client. The nurse is guilty of: -invasion of privacy. -libel. -assault. -slander.
slander. Explanation: Slander is oral defamation of character. Libel is written defamation of character. Assault is a threat or attempt to make bodily contact with another person without that person's consent. Invasion of privacy involves a breach in keeping client information confidential. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, pp. 125-126.
A nurse suspects that a client is a prostitute. The nurse documents this suspicion in the medical record and includes it in report to the oncoming shift. The nurse also mentions the suspicion to the nurse's sister saying, "I had a client named Susan in room 126 today who I think is a prostitute." Which violations has this nurse committed? Select all that apply. -Battery -Slander -Assault -Libel -HIPAA
-Libel -HIPAA -Slander Explanation: Slander is the spoken defamation of character (e.g., including in the change-of-shift report); libel is written defamation (e.g., including in the client record). HIPAA rules are violated when a client's personal information is disclosed (e.g., informing one's sister). The use of the client's room number and name make the client's presence in the facility discoverable. The nurse did not threaten the client (assault) or physically touch the client (battery). Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 126.
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? -Libel -Battery -Assault -Slander
Battery Explanation: The nurse has committed battery by unlawfully carrying out a procedure that the client had refused. Battery is an assault and includes negligent touching of another person's body or clothes or anything attached to or held by that other person. Assault is the threat of touching another person without the person's consent. Defamation of character in spoken words is called slander. Libel is defamation of character in written words. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 125.
A client states that the client's recent fall was caused by his scheduled antihypertensive medications being 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? -Enlist support from nursing and non-nursing colleagues from the unit. -Consult with the hospital's legal department as soon as possible. -Document the client's claims and the events surrounding the alleged incident. -Consult with practice advisors from the state board of nursing.
Document the client's claims and the events surrounding the alleged incident. Explanation: It is imperative for nurses to carefully and accurately document assessment findings and the nursing care that they provide, especially when legal action is anticipated. This thorough and accurate assessment should precede consultation with the legal department, the state board of nursing, and colleagues. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 128.
Which is true of the Occupational Safety and Health Act? -It helps to reduce workforce injuries and illness in the workplace. -It establishes an information clearinghouse for nurses who engage in unprofessional conduct. -It requires nurses to report abuse of infants, children, and adults of all ages. -It protects nurses who are recovering from drug or alcohol addiction or have communicable diseases.
It helps to reduce workforce injuries and illness in the workplace. Explanation: The Occupational Safety and Health Act of 1970 helps to reduce injuries and illness in the workplace. The National Practitioner Data Bank is a clearinghouse for health care practitioners who engage in unprofessional conduct and prevents them from moving from state to state. Mandatory reporting laws, not the Occupational Safety and Health Act, require nurses to report abuse. The Americans with Disabilities Act protects people with communicable diseases and those recovering from drug or alcohol addiction. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 141.
While at a coworker's house, a nurse discusses with the coworker a client whom the nurse suspects of physically abusing the client's child. The next day, the client is moved to another nursing unit after a surgical procedure and comes under the care of the coworker, who is also a nurse. The coworker confronts the client about the alleged physical abuse. The client is shocked and angered by the accusation and denies it categorically. What would be the charge if the client were to file a suit? -No charges are valid because both nurses are involved in the client's care. -The second nurse could be charged with libel. -No charges are valid because the revelation took place during off-duty hours and off-site. -The first nurse could be charged with slander.
The first nurse could be charged with slander. Explanation: Slander is a character attack uttered orally in the presence of others. Injury is considered to occur because the derogatory remarks attack a person's character and good name. In this case, the first nurse (and possibly the second, depending on context) could be charged with slander. If the defamation had been written, it would be libel. Even though the discussion took place offsite and during off-duty hours and both nurses are involved in the client's care, the defamatory remarks could constitute slander. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 125.
A health care provider is called to see a client with angina. During the visit the health care provider advises the nurse to decrease the dosage of atenolol to 12.5 mg. However, because the health care provider is late for another visit, the health care provider requests that the nurse write down the order for the health care provider. What should be the appropriate nursing action in this situation? -The nurse should write the order and implement it. -The nurse should inform the client of the change in medication. -The nurse should remind the health care provider later to write the work order. -The nurse should ask the health care provider to come back and write the order.
The nurse should ask the health care provider to come back and write the order. Explanation: The nurse should ask the health care provider to come back and write down the order. Nurses are discouraged from following any verbal orders, except in an emergency. The nurse should never write an order on a health care provider's behalf because this is a wrong practice. The client should be informed about the change of medications, but this is not an appropriate action. The nurse should not leave the work for a later time, because the nurse may forget it. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, pp. 135-136.
A client newly diagnosed with congestive heart failure has a prescription for digoxin. The nurse counts the heart rate before administration of the medication and obtains a heart rate of 51 beats per minute. Which action by the nurse demonstrates adherence to the standards of nursing care? -The nurse withholds the medication and notifies the health care practitioner. -The nurse administers the medication and reassesses the client after 30 minutes. -The nurse withholds the medication, retakes the heart rate, and gives the medication at a later time. -The nurse administers the medication after reviewing the client's serum potassium level.
The nurse withholds the medication and notifies the health care practitioner. Explanation: Nurses are responsible for following the standards of care for their particular work area. A reasonably prudent nurse would withhold the medication and notify the health care practitioner. All other options put the client's safety at risk and would not be done by a reasonably prudent nurse. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 141.
While a client admitted to the medical-surgical unit is in the radiology department, a visitor claiming to be the client's cousin arrives on the medical-surgical unit and asks the nurse to provide a brief outline of the client's illness. Which response by the nurse would be most appropriate, both legally and professionally? -"I cannot give you that information due to client confidentiality." -"I will call the client and ask for permission to share this information with you." -"I'm busy right now but can talk later." -"Do you have any identification proving that you are related to the client?"
"I cannot give you that information due to client confidentiality." Explanation: Sharing a client's information without the client's consent is an invasion of privacy. The nurse should not give out the information even if the visitor provides proof of a relationship without the client's consent. It is inappropriate to call the client to ask for permission. The nurse claiming to be busy and offering to talk later does not address the issue but only delays it, perhaps leading the visitor to assume that the nurse will disclose information then. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 126.
Which statement made by the nurse providing care to a group of clients indicates that the nurse requires further education regarding negligence? -"Please avoid bringing fresh fruit to a client with neutropenia." -"I don't need to assess distal pulses on a client after a femoral arteriography." -"I am going to assess for collateral circulation before preforming an arterial blood gas (ABG)." -"I am going to auscultate breath sounds every 8 hours on a client receiving enteral feedings."
"I don't need to assess distal pulses on a client after a femoral arteriography." Explanation: Distal pulses should be checked immediately after a femoral arteriography; therefore, the nurse is negligent for checking three hours after the procedure. Fresh fruit may contain bacteria and further compromise a client with neutropenia. The Allen test confirms that there is proper circulation to the hand before drawing an ABG. The nurse checks breath sounds at least every 8 hours for adventitious sounds that may indicate aspiration. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 125.
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? -"We have it on file here, so any hospital can call and get a copy." -"A living will can only be used in the state in which it was created." -"As long as your family knows your medical wishes, you will not need it." -"Take it with you. It is recognized universally in the United States."
"Take it with you. It is recognized universally in the United States." Explanation: A separate or different advance directive is not needed for each state; an advance directive can be used in any state, regardless of where it was created. The nurse should advise the client to take it when travelling out of state. The client should not assume that the family knows the client's wishes; the whole purpose of having an advance directive is to avoid the ambiguity and potential confusion that making such assumptions can cause. Other hospitals may not know who to contact to request a copy of the advance directive; therefore, it would be much safer for the client to take a copy of it while travelling. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 140.
Action has been taken against a nurse's license based on a claim that the nurse acted outside of nursing's scope of practice. The nurse's attorney determines that the nurse needs more education about the purpose of the board of nursing when the nurse makes which statement? -"Board of nursing rules keep unlicensed people from practicing nursing." -"The rules made by the board of nursing don't reflect my practice." -"The board of nursing is established by state legislation." -"The board of nursing exists to protect the safety of the public."
"The rules made by the board of nursing don't reflect my practice." Explanation: A nurse's practice should reflect the rules of the board of nursing rather than vice versa. Boards of nursing are established by state legislation through the state's nurse practice act and exist to protect the public. These rules help to keep unlicensed people from practicing nursing. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 112.
A nurse from the postanesthesia care unit (PACU) transports a client in the elevator with a nurse from the intensive care unit (ICU). There are staff members and visitors in the elevator as well. Which response from the ICU nurse is appropriate when the PACU nurse begins the report? -"I will look at the EHR when I get to the nurse's station." -"You can just put the report on the foot of the bed and I will look at it when I get to the room." -"Wait and give me a report in the room at the bedside." -"Before you begin we need to ensure a family member is present."
"Wait and give me a report in the room at the bedside." Explanation: It is appropriate for the ICU nurse to ask the PACU nurse to wait to give a report at the bedside. Discussing client information in the elevator with family or other workers violates client confidentiality and must be avoided. This also prevents discussions even in the presence of family members. If the report is left on the foot of the bed others may be able to see information. The electronic health record (EHR) is not the place to obtain transfer information so this would not be appropriate. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, Principle-Based Approach, p. 103.
A nursing student administers an overdose of an opioid to a client and the client arrests. When discussing the incident with nursing faculty, which statements made by the student indicate the need for further teaching? Select all that apply. -"I should have informed you that I felt unprepared for my assignment." -"I am glad I am a student because nursing faculty will be blamed, not me." -"I cannot be held liable because this is only my second time at this facility." -"I have also put the nursing faculty at risk with my action." -"I realize that I am held to the same standards as a registered nurse."
-"I am glad I am a student because nursing faculty will be blamed, not me." -"I cannot be held liable because this is only my second time at this facility." Explanation: A nursing student is responsible and held liable for his or her own actions. The student is responsible for being familiar with the facility's policies and procedures. The student is held to the same standards as a registered nurse, and should inform faculty when unprepared for an assignment. The student nurse puts the clinical faculty at risk by performing actions that are deemed negligent. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, pp. 125-141.
Which statements made by a nurse would indicate to a nurse manager that the nurse requires further training? Select all that apply. -"I am accountable for any task that I delegate." -"When I document, I make sure it is factual, accurate, complete, and timely." -"The nursing plan of care must be accurate and must be followed. It is part of the client's permanent record." -"If I make a mistake, I will not tell anyone." -"I will have the supervisor fill out the incident report when I make an error."
-"If I make a mistake, I will not tell anyone." -"I will have the supervisor fill out the incident report when I make an error." Explanation: Nurses should report errors and mistakes and complete incident reports themselves, not have supervisors do it. Documentation should be accurate, factual, complete, and timely. Nurses are accountable for any designated task. The nursing plan is part of the client's permanent record. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 137.
The nurse manager is using voluntary standards as a guideline for developing policies on the unit. What voluntary standards are available for the nurse to use? Select all that apply. -Professional standards for certification of individual nurses in general practice -State nurse practice acts -American Nurses Association Standards of Practice -Process of certification -Rules and regulations of nursing
-American Nurses Association Standards of Practice -Professional standards for certification of individual nurses in general practice -Process of certification Explanation: Voluntary standards in nursing would include the American Nurses Association (ANA) Standards of Practice, the process of certification, and professional standards for certification of individual nurses in general practice. State nurse practice acts are not an example of voluntary standards in nursing. Rules and regulations of nursing are not examples of voluntary standards in nursing. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 124.
During a nursing shift, which events warrant completion of an incident report? Select all that apply. -A visitor slipped and fell in the hallway, but was not injured. -A nurse asks an unlicensed assistive personnel (UAP) to feed a client. -A nurse reports that a client is crying and distraught over a diagnosis of metastatic cancer. -A client falls while being transferred from the bed to the chair. -An intravenous antibiotic was administered 2 hours late because the IV site infiltrated.
-An intravenous antibiotic was administered 2 hours late because the IV site infiltrated. -A visitor slipped and fell in the hallway, but was not injured. -A client falls while being transferred from the bed to the chair. Explanation: An incident report is a written account of an unusual, potentially injurious event involving a client, employee, or visitor. Late administration of medication is considered a medication error and is potentially injurious to the client. A visitor fall and a client fall are both reportable situations. A client crying following a diagnosis of cancer could be expected, and a nurse delegating appropriate care to a UAP is not reportable. Therefore, these actions do not require an incident report to be filed. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 138.
A client is to undergo surgery for removal of the gallbladder. Which action related to the client's informed consent falls within the nurse's scope of practice? Select all that apply. -Answering questions about elements of the consent -Acting as a witness to the client's signature on the form -Explaining the details about the procedure to be done -Ensuring the signed form is on the chart -Identifying the risks and benefits associated with the procedure
-Ensuring the signed form is on the chart -Acting as a witness to the client's signature on the form -Answering questions about elements of the consent Explanation: Obtaining informed consent is the responsibility of the person who will perform the diagnostic or treatment procedure or the research study. This person is responsible for explaining the procedure along with any risks and benefits associated with it. The nurse's role is to confirm that a signed consent form is present in the client's chart and to answer client questions about the elements of the consent. Unless the nurse is obtaining consent for a nurse-prescribed and nurse-initiated intervention, the nurse signs the consent form as a witness to having seen the client sign the form, not as having obtained the consent. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, Informed Consent or Refusal, p. 129.
A nurse becomes concerned that a coworker may have a substance use disorder. Which behaviors by the coworker would increase this concern? Select all that apply. -The coworker made a medication error last week. -The coworker mentioned going to the primary care provider's office twice in the last month. -The last two times the nurse has needed help turning a client, the coworker could not be found. -The coworker has stopped eating lunch in the breakroom with other nurses. -The coworker has needed to leave early "to pick up my kids" several times in the last 2 months.
-The last two times the nurse has needed help turning a client, the coworker could not be found. -The coworker has needed to leave early "to pick up my kids" several times in the last 2 months. -The coworker has stopped eating lunch in the breakroom with other nurses. Explanation: Frequent absences from the unit, leaving early or being late, and isolation from others may be signs associated with a substance use disorder. Having primary care provider appointments and an isolated medication error would not be particular concerns related to potential substance use. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 133.
Legal safeguards are in place in the nursing practice to protect the nurse from exposure to legal risks as well as to protect the client from harm. What is an example(s) of legal safeguards for the nurse? Select all that apply. -The nurse executes the health care provider's prescriptions without questioning them. -The health care provider is responsible for administration of a wrongly prescribed medication. -The nurse confirms informed consent was give by the client to perform a procedure. -The nurse claims management is responsible for inadequate staffing leading to negligence. -The nurse educates the client about what to expect during the hospital stay. -The nurse documents all client care in a timely manner.
-The nurse confirms informed consent was give by the client to perform a procedure. -The nurse educates the client about what to expect during the hospital stay. -The nurse documents all client care in a timely manner. Explanation: Examples of legal safeguards for the nurse include the nurse confirming that informed consent was obtained from a client, the nurse educating the client about what to expect during the hospital stay, and the nurse documenting all client care in a timely manner. Legal safeguards for the nurse would not include the nurse executing health care provider's prescriptions without questioning them. Legal safeguards for the nurse would not include the nurse claiming management is responsible for inadequate staffing leading to negligence. Legal safeguards for the nurse would not include the health care provider being responsible for administration of a wrongly prescribed medication. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 130.
Which are examples of a nurse appropriately protecting a client's privacy? Select all that apply. -With the client's permission, the nurse explains the client's diagnosis to the client's spouse. -The nurse moves the client from the emergency department waiting room to a private area to collect assessment data. -During a bed bath, the nurse exposes the client's upper torso while washing the client's face. -Because the facility is a teaching facility, the nurse allows a nursing student to photograph a client for a care plan. -The nurse questions the client about the client's social life even though it does not affect care planning.
-With the client's permission, the nurse explains the client's diagnosis to the client's spouse. -The nurse moves the client from the emergency department waiting room to a private area to collect assessment data. Explanation: To prevent invasion of privacy, all client information is considered confidential and private; this includes name and all identifiers (e.g., social security number, address, date of birth). With the client's permission, the nurse may share information with the client's spouse. A client should be taken to a private, soundproof area to collect data. Unnecessary exposure of a client's body, taking photos of a client, and questioning a client's social life when it does not affect care planning are examples of invasion of privacy. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 126.
While teaching about advance care planning, which fact is important for the nurse to share with a client who has been diagnosed with a terminal illness? -Advance directives must be completed 30 days prior to hospitalization in order to be valid. -Living wills provide specific instructions related to the client's personal property upon death. -A durable power of attorney for health care appoints an agent the person trusts to make decisions. -The Patient Self-Determination Act of 1990 requires hospital clients to have an advance directive.
A durable power of attorney for health care appoints an agent the person trusts to make decisions. Explanation: Advance directives can minimize difficulties by allowing people to state in advance what their choices would be for health care if certain circumstances arise. A durable power of attorney for health care appoints an agent the person trusts to make decisions in the event of subsequent incapacity. Living wills provide specific instructions about the kinds of health care that should be provided or foregone in particular situations. In the United States, the Patient Self-Determination Act of 1990 requires all hospitals to inform clients about advance directives. Advance directives do not have to be completed prior to hospitalization in order to be valid. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 140.
The client being admitted to the oncology unit conveys wishes regarding resuscitation in the event of cardiopulmonary arrest. The nurse advises the client that it would be in the client's best interest to obtain which document? -A proxy directive -Proof of health care power of attorney -A living will -A will
A living will Explanation: A living will is an advance directive that specifies the type of medical treatment clients do or do not want to receive should they be unable to speak for themselves in a terminal or otherwise unconscious condition. A will is a legal document detailing how to dispose of one's assets and belongings upon death. Proof of health care power of attorney and a proxy directive are documents identifying another person to legally make health care decisions for the client. In this case the client is stating the client's own decisions in advance of potential incapacitation. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 140.
Which is an example of an unintentional tort? -A nurse tells a client that the client cannot leave the hospital until the client pays the bill. -A nurse threatens to restrain a client if the client does not stop talking. -A nurse gives the client a medication, and the client has an adverse reaction to it. -Nurses discuss a client's laboratory values in the elevator.
A nurse gives the client a medication, and the client has an adverse reaction to it. Explanation: An unintentional tort occurs when the nurse does not intend harm, but harm occurs (e.g., the nurse administers a medication and the client has an adverse reaction to it). The other three responses are intentional torts. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 125.
Which scenario is an example of certification? -An education program that meets the standards of the National League for Nursing -A graduate of a nursing education program who passes the NCLEX-RN -A hospital that meets the standards of the Joint Commission -A nurse who demonstrates advanced expertise in a content area of nursing through special testing
A nurse who demonstrates advanced expertise in a content area of nursing through special testing Explanation: Certification is a voluntary process whereby a person who has met criteria established by a nongovernmental association is granted special recognition in a specified practice area. Licensure is granted by the state to a graduate of a nursing education program who passes the NCLEX-RN. Accreditation is a voluntary process by which a nursing education program is recognized as having met certain standards by the NLN Commission for Nursing Education Accreditation and/or the American Association of Colleges of Nursing. The Joint Commission can also accredit health care agencies. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 124.
Which nursing student would most likely be held liable for negligence? -A nursing student reports that insulin was not administered to the client by the nurse on the previous shift. -A nursing student administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home. -A nursing student performs a dressing change using sterile technique and documents the presence of necrotic tissue in the wound. -A nursing student completes an incident report after administering a medication to a client who then experienced an adverse reaction to the medication.
A nursing student administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home. Explanation: The nursing student who administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home is performing a task outside the scope of the job responsibilities of a UAP. The other options demonstrate legally defensible actions by the nursing student. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 122.
Which process evaluates and recognizes educational programs as having met certain standards? -Accreditation -Certification -Licensure -Credentialing
Accreditation Explanation: Accreditation is the process by which an educational program is evaluated and recognized as having met certain standards. Credentialing refers to ways in which professional competence is ensured and maintained. Licensure is the process by which a state determines that a candidate meets certain minimum requirements to practice in the profession—and grants that person the license to do so. Certification is the process by which a person who has met certain criteria established by a nongovernmental association is granted recognition in a specified practice area. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 124.
While walking down the hall, a nurse manager overhears a staff member telling a client, "If you don't stay in this chair and stop wandering, I'm going to tie you to it." The nurse manager pulls the staff member aside and discusses what was said. The nurse manager intervenes because the staff member's statement is which type of tort? -Battery -Assault -False imprisonment -Invasion of privacy
Assault Explanation: The staff member's statement reflects a threat of contact with another person without the person's consent. This is considered assault. Battery is an assault that is carried out and includes willful, angry, and violent or negligent touching of another's body or clothes (or anything attached to or held by that person). False imprisonment is the unjustified retention or prevention of the movement of another person without proper consent. This would apply if the staff member did in fact tie the client to the chair. Invasion of privacy involves the disclosure of information without the person's consent. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, Assault and Battery, p. 125.
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? -Defamation of character -Assault -Battery -Fraud
Battery Explanation: The UAP is engaging in battery, which is an assault that is carried out and includes willful, angry, and violent or negligent touching of another person's body or clothes or anything attached to (or held by) that other person. Assault is a threat or an attempt to make bodily contact with another person without that person's consent. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property. Defamation of character is an intentional tort in which one party makes derogatory remarks about another that harm the other party's reputation. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 125.
The nurse is providing care to a client who had orthopedic surgery. The nurse has medicated the client for pain. However, the client reports that the pain is unrelieved. The nurse takes no further action regarding assessment and intervention for the client's pain. The nurse does not notify the surgeon regarding the client's pain. The nurse's failure to take further action represents which element of liability in this case? -Causation -Damages -Duty -Breach of duty
Breach of duty Explanation: Breach of duty is the failure to assess, intervene, or notify the health care provider regarding the client's condition. It does not meet the expected standard of care. Duty refers to an obligation to use due care and is defined by the standard of care appropriate for the nurse-client relationship. Causation is when the failure to meet the standard of care caused injury. Damages are the harm or injury to the client. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 128.
The evening nurse received a change-of-shift report from the day nurse. The day nurse's report states, "The client required intubation for respiratory distress this morning, but has been stable all day." The evening nurse collects the following information during the first assessment: Skin flushed. Client lethargic. Temperature 103.0°F (39.4°C). A review of the client's chart reveals that the client's last assessment was done 7 hours earlier. A review of the findings by the nurse attorney determines which facts might be in place regarding liability? Select all that apply. -The facility will have to fire the nurse for malpractice. -Duty has not occurred since the evening nurse just started the shift. -The facility will settle the case. -The spouse was notified of the change in condition. -Breach of duty has occurred.
Breach of duty has occurred. Explanation: The nurses had a duty to care for the client and breached duty by not assessing the client in 7 hours. No determination of the nurse or facility's response is made until a complete investigation is done. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 128.
A client has been in the emergency department for 3 hours for treatment of a migraine headache. Care has been delayed due to a multiple fatality car accident. The client gets up to go to the bathroom unattended, faints, and suffers a subdural hematoma. The family threatens to sue for malpractice. Which element of malpractice will be the most difficult for the attorney to prove? -Causation -Duty -Damages -Breach of duty
Causation Explanation: Typically, causation is the most difficult component of malpractice to prove. Causation asks the question, "Did the nurse's actions directly cause the damages?" Duty is typically outlined in standards of care, breach of duty can be proved by documentation of the visit, and damages are clearly evident. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 128.
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? -Licensure -Certification -Accreditation -Validation
Certification Explanation: The process of certification involves the attainment and validation of specialized nursing knowledge and skills. Certification is often necessary to ensure that the nursing care provided in specialized and high-acuity settings is safe and appropriate. Accreditation is the process by which an educational program, rather than an individual nurse, is identified as meeting standards. The process of licensure involves the determination that a nurse meets minimum requirements to practice but not necessarily that the nurse has the specialized knowledge that is necessary for some care settings. Validation is not a specific aspect of the process of credentialing. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 124.
Nurses practicing in a critical care unit must acquire specialized skills and knowledge to provide care to the critically ill client. These nurses can validate this specialty competence through what process? -Certification -Licensure -Litigation -Accreditation
Certification Explanation: Certification validates specialty knowledge, experience, and clinical judgment. A nurse in a critical care unit having specialized skills and knowledge to provide care would be an example of certification. Licensure is a specialized form of credentialing based on laws passed by a state legislature. Licensure endorses entry-level competence. Legal accreditation is granted to educational programs by state agencies endorsing the approval of the program's design and mission to meet the needs of state requirements. Litigation is not a method for validation. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 125.
A client is scheduled for a colonoscopy. The nurse realizes immediately after administering medications to induce conscious sedation that the client has not signed the informed consent. If the nurse has the client sign the informed consent at this point, which element of informed consent would be violated? -Voluntariness -Comprehension -Disclosure -Competence
Competence Explanation: The client under conscious sedation would not be considered competent to make a decision to undergo an invasive procedure such as a colonoscopy. Disclosure ensures that the following information has been given to the client: the nature of the treatment, possible alternative treatments, and potential risks and benefits of the treatment. Comprehension is met when the client demonstrates understanding by describing in the client's own words to what he is consenting. The client's consent must be given voluntarily. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 133.
A nurse assesses a client with psychotic symptoms and determines that the client needs vest restraints. However, the client asks the nurse not to put on vest restraints. What would be the best nursing action? -Apply restraints after giving a sedative. -Restrain the client with vest restraints. -Contact the health care provider and obtain necessary orders. -Apply wrist restraints instead of vest restraints.
Contact the health care provider and obtain necessary orders. Explanation: If a nurse feels that a client needs to be restrained, the nurse should inform the health care provider and obtain necessary orders. The nurse should also discuss this with the client's family members and ask their opinion. The nurse should not sedate the client and then restrain him, as the nurse could be charged with battery if there is restraint without orders. Applying a wrist restraint instead of a vest restraint is like compromising with the client, which is unethical. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 125.
A nurse is named as a defendant in a malpractice lawsuit. Which action would be recommended for this nurse? -Do not volunteer any information on the witness stand. -Discuss the case with the plaintiff to ensure understanding of each other's positions. -Be prepared to tell your side to the press, if necessary. -If a mistake was made on a chart, change it to read appropriately.
Do not volunteer any information on the witness stand. Explanation: The nurse on the witness stand should be polite, but not volunteer any information. The nurse should only answer the questions asked. The other answers are not examples of what a nurse should do in a malpractice lawsuit. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 130.
In some cases, the act of providing nursing care in unexpected situations is covered by the Good Samaritan laws. Which nursing action would most likely be covered by these laws? -Emergency care for a choking victim in a restaurant -Any emergency care given when consent is obtained -Medical advice given to a neighbor regarding a child's rash -A negligent act performed in an emergency situation
Emergency care for a choking victim in a restaurant Explanation: Good Samaritan laws are designed to protect health practitioners when they give aid to people in emergency situations in which the practitioner is off duty, such as providing emergency care to a choking victim in a restaurant. The other examples listed are not situations covered by the Good Samaritan law. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 141.
A nurse who obtains a license to practice nursing through self-misrepresentation is guilty of what tort? -Fraud -Assault -Libel -Slander
Fraud Explanation: Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property. A nurse obtaining a license to practice through misrepresentation is committing fraud. Assault is a threat or an attempt to make bodily contact with another person without that person's consent. Slander is one form of defamation of character. Defamation of character is an intentional tort in which one party makes derogatory remarks about another, remarks that harm the other party's reputation. Slander is spoken defamation of character; libel is written defamation. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 127.
During the orientation to the hospital, the staff development educator discusses unit and institutional-based policies. What is the source of the practice rules that result in unit and institutional-based policies? -Health care institution -Federal legislation -Board of nursing -State legislation
Health care institution Explanation: The health care institution determines the unit and institutional policies. These policies may vary from institution to institution. Such policies may include clinical procedures, policies specific to the institution, and personnel and employment policies. Unit and institutional-based policies are not derived from federal legislation, state legislation, or the board of nursing. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 123.
An HIV-positive client discovers that the client's name is published in a research report on HIV care prepared by the client's nurse. The client is hurt and files a lawsuit against the nurse. Which offense has the nurse committed? -Defamation of character -Negligence of duty -Unintentional tort -Invasion of privacy
Invasion of privacy Explanation: The nurse has committed the tort of invasion of privacy. Personal names and identities should be concealed or obliterated in case studies or research work. Invasion of privacy is a type of intentional tort. Defamation is an act in which untrue information harms a person's reputation and is therefore not applicable here. Negligence is the harm that results because a person did not act reasonably. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 126.
A nurse talks with family members about an AIDS client from the clinic where the nurse works. Which tort has the nurse committed? -Fraud -Invasion of privacy -Slander -Assault
Invasion of privacy Explanation: Invasion of privacy involves a breach of keeping client information confidential. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property. Slander is oral defamation of character. Assault is a threat or attempt to make bodily contact with another person without that person's consent. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 126.
A registered nurse who has an associate degree would like to obtain a baccalaureate degree in nursing. The nurse works full time and has several family obligations and would like to find a program that fits into that lifestyle. What is the nurse's priority question about an educational program? -What is the NCLEX pass rate? -Is it online? -How much does it cost? -Is the program accredited?
Is the program accredited? Explanation: The most important consideration is whether the program is accredited. Unaccredited programs should be avoided. Cost is important and method of delivery may be very important to this student. They are not as important as whether the program is accredited. NCLEX pass rate is not important in this case as the nurse is already registered. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 124.
A client has a prescription for amoxicillin 500 mg P.O. every 8 hours. The nurse administers the medication via the intravenous route. Based on the nurse's action, the client develops complications and has an increased length of stay. The client files a lawsuit against the facility and the nurse. Which legal action has the nurse's attorney identified that meets the criteria for the client's lawsuit? -Malpractice -Battery -Assault -Negligence
Malpractice Explanation: The facility and nurse could be charged with malpractice, which is failing to perform (or performing) an act that causes harm to a client. Administering the medication intravenously instead of orally as prescribed has caused harm to a client. Negligence is failing to perform care for a client. When a person threatens to touch a client without consent, it is assault, whereas battery is carrying out the implied threat (assault). Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 127.
Which statement about laws governing the distribution of controlled substances is true? -When a nurse misuses controlled substances in the workplace and gets help, the nurse will not be charged with a criminal act. -Nurses are responsible for adhering to specific documentation about controlled substances. -The nurse is only at risk if diverting medication from the client; a nurse using the nurse's own personal drugs is not at risk. -Substance use is not treatable.
Nurses are responsible for adhering to specific documentation about controlled substances. Explanation: Nurses have specific responsibilities regarding controlled substances, including specific documentation. Violation of controlled substances laws at the workplace is serious and a criminal act. Substance use is treatable, and the objective is to detect and treat the problem early. It does not matter where the nurse obtains the drugs; the nurse is still liable for personal actions. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 142.
A nurse who comments to coworkers at lunch that a client with a sexually transmitted infection has been sexually active in the community may be guilty of what tort? -Slander -Fraud -Assault -Libel
Slander Explanation: Defamation of character is an intentional tort in which one party makes derogatory remarks about another, with those remarks harming the other party's reputation. Slander is spoken defamation of character; libel is written defamation. Assault is a threat or an attempt to make bodily contact with another person without that person's consent. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, pp. 125-126.
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 -Malpractice -Negligence -Libel
Slander Explanation: The nurse can be charged with slander, which is a verbal attack on a person's character. Libel pertains to damaging written statements read by others. Both libel and slander are considered defamation of character-an intentional tort in which one party makes derogatory remarks about another that diminish the other party's reputation. To be found guilty of slander or libel, the statement must be proved false. Negligence and malpractice pertain to actions which are committed or omitted, thereby causing physical harm to a client. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 125.
A nurse is reviewing the nurse practice act of the state in which the nurse is licensed. The nurse understands that this act was derived from which source of law? -Administrative -Common -Statutory -Constitutional
Statutory Explanation: Nurse practice acts are an example of statutory laws, which are enacted by a legislative body. Constitutional law is based on federal and state constitutions, which indicate how the federal and state governments are created, grant them authority, and list the principles and provisions for establishing specific laws. Administrative law is administered by agencies that, among other functions, are responsible for law enforcement. Common law has evolved from accumulated judiciary decisions. Common law is thus court-made law. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 121.
A nurse witnesses a traffic accident and dresses the open wounds sustained by a child. Later, in the hospital, the child develops complications from an infection in the wound. The family holds the nurse responsible for the complications and attempts to file a lawsuit. Which statement is true regarding how the Good Samaritan law applies to this case? -The Good Samaritan law is not applicable to health care workers. -The Good Samaritan law will provide legal immunity to the nurse. -The Good Samaritan law will not protect the nurse because the nurse did not accept compensation. -The Good Samaritan law will provide absolute exemption from prosecution.
The Good Samaritan law will provide legal immunity to the nurse. Explanation: The Good Samaritan laws provide legal immunity to passersby who provide emergency first aid to victims of accidents. Therefore, the law is applicable to the nurse in this scenario; moreover, Good Samaritan laws apply to those who do not accept any compensation for services provided. The law is equally applicable to everyone but does not provide absolute exemption from prosecution in cases of negligence. Paramedics, ambulance personnel, health care providers, and nurses who stop to provide assistance are still held to a higher standard of care because they have training above and beyond that of average lay people. In cases of gross negligence, health care workers may be charged with a criminal offense. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 141.
Which best exemplifies malpractice? -The nurse applies an ice pack to a client's lower back without an order and the client feels better. -The nurse administers the wrong medication to a client, who then has one episode of vomiting 5 minutes later but no further adverse reactions. -The nurse, using proper body mechanics, assists a client into a locked bed. The client slips and breaks a femur. -The nurse administers amoxicillin to a client with known allergies to penicillin. -The client has a seizure with resulting respiratory arrest.
The nurse administers amoxicillin to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest. Explanation: All elements of liability are in place for the scenario involving a nurse administering amoxicillin to a client with documented allergies to penicillin: the nurse had a duty and breached it by giving the medication (amoxicillin), which caused the client harm (seizures and respiratory arrest). The nurse is negligent when applying an ice pack without an order. The nurse assisting the client into bed used proper body mechanics, so the client fall is an accident even though harm occurred. Giving the wrong medication could be cause for malpractice, but in this case, the client was not harmed. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 125.
On finding multiple bruises on a client's arms and back, the nurse suspects that the client is being abused by a daughter who lives with the client. When questioned, the client denies any abuse. Despite the client's denial, the nurse should report the suspected abuse on the basis of which rationale? -The client is ashamed to admit to the abuse by the daughter. -The nurse has a legal and ethical responsibility to report the suspected abuse. -The nurse wants peers to see the nurse as a hero. -The client does not want anyone to know what is happening in the client's home.
The nurse has a legal and ethical responsibility to report the suspected abuse. Explanation: Nurses are legally and ethically responsible to report suspected abuse. Because nurses are legally obligated, the client's fear or reluctance to report the abuse is irrelevant. Being labeled a hero is not the correct rationale for reporting suspected abuse. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 142.
A family brings the client to the emergency department in an unconscious state with a head injury. The client requires surgery to remove a blood clot. What would be the appropriate nursing intervention in keeping with the policy of informed consent prior to a surgical procedure? -The nurse confirms that the client has signed the consent form. -The nurse informs the family about advance directives. -The nurse informs the family about the living will. -The nurse confirms that the client's family has signed the consent form.
The nurse confirms that the client's family has signed the consent form. Explanation: The nurse should confirm that the client's family has signed the consent form. However, the health care provider is responsible for having the client, or in this case, the client's family sign consent. This client cannot sign the consent form because the client is not in an alert state and is unable to communicate. If the client is not in a condition to sign the consent form, a family member may sign the consent form on the client's behalf. Advance directives are written statements identifying a competent person's wishes concerning terminal care and are not applicable here. A living will is an instructive form of advance directive; that is, it is a written document that identifies a person's preferences regarding medical interventions to use in a terminal condition, irreversible coma, or persistent vegetative state with no hope of recovery. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 133.
A nurse enters a client's room and finds that the client is lying on the floor. The nurse makes the client comfortable on the bed and completes an examination. She informs the health care provider and the nursing supervisor about this incident and also completes an incident report. Which action by the nurse indicates correct knowledge of handling an incident report? -The nurse mentions in the client's report that an incident report was completed. -The nurse makes a copy of the incident report and places it in the client's records. -The nurse makes a copy of the incident report to give to the health care provider. -The nurse documents a complete description of the happenings in the client's records.
The nurse documents a complete description of the happenings in the client's records. Explanation: An incident report is a written account of an unusual, potentially injurious event involving a client, employee, or visitor. It is kept separate from the medical record. The incident report is a legal document and making a copy of it is not advisable. It should not be placed in the client's records; however, the nurse can mention the incident in the client's records without mentioning the incident report. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 138.
After reporting to work for a night shift, the nurse learns that the unit is understaffed because two RNs called out sick. As a result, each nurse on the unit must provide care for four acute clients in addition to the nurse's regular clients. Which statement is true for this nurse when working in understaffed circumstances? -Understaffing constitutes an extenuating circumstance that creates a temporarily lower expectation for care for the nurse. -The nurse is legally held to the same standards of care as when staffing levels are normal. -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. -The nurse is legally obliged to refuse to provide care when understaffing creates the potential for unsafe conditions.
The nurse is legally held to the same standards of care as when staffing levels are normal. Explanation: The claim of being overworked does not constitute a legal defense, and both the potential for liability and standards of care remain unchanged despite an increased client assignment. Although it is prudent to make all realistic attempts to fill the gaps in staffing, documenting these efforts does not change the nurse's legal position. A nurse has the right to refuse an unsafe client assignment but the nurse is not legally obliged to withhold care. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 136.
A nurse enters the client's room and finds the client lying on the floor experiencing a seizure. After stabilizing the client, the nurse informs the health care provider. The health care provider advises the nurse to prepare an incident report. What is the purpose of an incident report? -To evaluate the quality of care provided and assess the potential risks for injury to the client -To provide information to local, state, and federal agencies -To evaluate the immediate care provided by the nurse to the client -To determine the nurse's fault in the incident
To evaluate the quality of care provided and assess the potential risks for injury to the client Explanation: An incident report is a written account of an unusual, potentially injurious event involving a client, employee, or visitor. Incident reports determine how to prevent hazardous situations and serve as a reference in case of future litigation. Accurate and detailed documentation often helps to prove that the nurse acted reasonably or appropriately in the circumstances. It may not always serve as a method of determining the nurse's fault in the incident. The document does not evaluate the immediate care provided to the client but states the actions taken. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 138.
Nurses are occasionally asked to witness a testator's (person who makes the will) signing of a will. Which guideline is true regarding a nurse's role in witnessing a testator's signature? -A beneficiary to a will is allowed to act as a witness. -A single witness is sufficient for a will. -Witnesses to a signature do not need to read the will. -Witnesses do not need to observe the signing of the will and can sign it at a later time.
Witnesses to a signature do not need to read the will. Explanation: Witnesses to the signature on a will do not need to read it, but they should be sure the document being signed is a will and not some other document. Witnesses should watch the testator sign the will, and they should sign it in the presence of each other. A beneficiary to a will is not allowed to act as a witness in most states. Two or three witnesses are most commonly required on a will. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 142.
Nurses are occasionally asked to witness a testator's (person who makes the will) signing of a will. Which guideline is true regarding a nurse's role in witnessing a testator's signature? -A beneficiary to a will is allowed to act as a witness. -Witnesses to a signature do not need to read the will. -Witnesses do not need to observe the signing of the will and can sign it at a later time. -A single witness is sufficient for a will.
Witnesses to a signature do not need to read the will. Explanation: Witnesses to the signature on a will do not need to read it, but they should be sure the document being signed is a will and not some other document. Witnesses should watch the testator sign the will, and they should sign it in the presence of each other. A beneficiary to a will is not allowed to act as a witness in most states. Two or three witnesses are most commonly required on a will. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 142.
A client with end-stage renal disease decides against further treatment and requests a "Do Not Resuscitate" (DNR) order. The DNR status is part of the change-of-shift report. The client stops breathing and a nurse begins cardiopulmonary resuscitation. The family is upset and makes a complaint to the charge nurse. The charge nurse appropriately identifies that nurse has committed: -assault. -battery. -defamation. -fraud.
battery. Explanation: The nurse has committed battery by performing CPR against the client's wishes. Assault occurs when a person threatens to touch a client without consent. Fraud is a willful and purposeful misrepresentation, whereas defamation occurs when a derogatory remark is made about another person. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 125.
While riding in the elevator, a nurse discusses the HIV-positive status of a client with other colleagues. The nurse's action reflects: -invasion of privacy. -defamation of character. -professional negligence. -false imprisonment.
invasion of privacy. Explanation: The nurse's action reflects an invasion of the client's privacy. Disclosing confidential information to an unauthorized third party subjects the nurse to liability for invasion of privacy, even if the information is true. Defamation of character includes false communication that results in injury to a person's reputation. Negligence is an act of omission or commission. Prevention of movement or unjustified retention of a person without consent may be false imprisonment. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 7: Legal Dimensions of Nursing Practice, p. 126.
