Chapter 7: Legal Dimensions of Nursing Practice

Which is an example of an unintentional tort? A nurse threatens to restrain a client if the client does not stop talking. 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. A nurse tells a client that the client cannot leave the hospital until the client pays the bill.

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.

A nurse threatens to restrain a verbally abusive client if the abuse continues. Which legal tort has the nurse committed? Defamation of character Invasion of privacy Assault Negligence

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.

A nurse fails to communicate a change in the client's condition to the physician. Which element related to proving malpractice has been met? Duty Proximate cause Damages Breach of duty

Breach of duty Explanation:Failing to communicate a change in the client's condition reflects a breach of duty. Duty describes the relationship between the person and the person being sued. Nurses have a duty to care for their clients. The existence of a duty is rarely an issue in a malpractice suit. The action or lack of action must be proven as the cause of the injury. Damages refer to the injury sustained by the client.

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 Unintentional tort Invasion of privacy Negligence of duty

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.

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? Negligence Assault Malpractice Battery

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).

In comparison with licensure, which measures entry-level competence, what does certification validate? Specialty knowledge and clinical judgment Ability to practice in more than one area Innocence of any disciplinary violation More than 10 years of nursing practice

Specialty knowledge and clinical judgment Explanation:Whereas licensure measures entry-level competence, certification validates specialty knowledge, experience, and clinical judgment. Certification does not validate innocence, years of practice, or ability in multiple practice areas.

A nurse observes another nurse place an unused dose of narcotics in their pocket. If caught, the nurse could be charged with which type of crime? felony misdemeanor tort negligence

felony Explanation: A felony is a serious criminal offense, and includes actions such as stealing narcotics, murder, falsifying medical records, and insurance fraud. A misdemeanor is a minor criminal offense; a tort is a lawsuit in which a plaintiff charges that a defendant committed a deliberately aggressive act. Negligence is harm that results because a person did not act reasonably.

A nurse exits the room of a confused client without raising the side rails on the bed. The failure to raise the side rails would constitute which element of liability related to malpractice? breach of duty causation damages duty

breach of duty Explanation: Breach of duty is failing to meet the standard of care, and in this case, it was the failure to execute and document the use of appropriate safety measures. Causation is the failure to use appropriate safety measures, which results in injury to the client. Duty refers to an obligation to use due care and is defined by the standard of care appropriate for the nurse-client relationship. Damages refers to the actual harm or injury that the client incurs.

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? "The rules made by the board of nursing don't reflect my practice." "The board of nursing exists to protect the safety of the public." "Board of nursing rules keep unlicensed people from practicing nursing." "The board of nursing is established by state legislation."

"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.

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 will Proof of health care power of attorney A proxy directive A living 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 otherrwise 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.

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? 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. A beneficiary to a will is allowed to act as a witness.

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.

A client informs the nurse that the client wants to discontinue treatment and go home. Later, the nurse finds the client dressed to leave. Which action should the nurse take in this situation? Call the physician and get the discharge paper signed. Restrain the client until medical treatment is over. Let the client go after signing a document stating that the client is going against medical advice. Warn the client that the client may not be able to access health care again.

Let the client go after signing a document stating that the client is going against medical advice. Explanation: If a client wishes to go before the client's medical treatment is finished, the nurse should have the client sign a document indicating personal responsibility for leaving against medical advice. The nurse should not restrain the client, as it would make the nurse liable for legal action. The nurse may call the physician and get the discharge paper signed, but this is not appropriate. The nurse should not warn the client that the client will be denied health care in the future, because it is the client's right to access the health care facility whenever needed.

The nurse inserts a prescribed urinary catheter into the client's urethra after the client has refused the procedure. The client suffers an injury. The client may sue the nurse for which type of tort? Assault Battery Invasion of privacy Dereliction of duty

Battery Explanation: Battery is touching a person's body without consent. A nurse may be sued for battery if the nurse fails to obtain consent for a procedure. Assault is a threat or attempt to touch a person without that person's consent. Invasion of privacy is sharing a client's personal information with others without consent. There is no evidence of dereliction of duty by the nurse in this case, which would be negligence or deviation from standard nursing care.

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: defamation. assault. battery. 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.

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 Fraud Assault Battery

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.

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

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? Litigation Certification Accreditation Licensure

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.

During the admission assessment of a client with a suspected mandibular fracture, the client discloses to the nurse that the injury results from the client's spouse hitting the client. Which action should the nurse prioritize when responding to this disclosure? Reporting the abuse to the appropriate authorities Ensuring that the client's statement is confirmed by another nurse Informing the client of the client's right to keep this information private Performing an assessment to confirm the client's statement

Reporting the abuse to the appropriate authorities Explanation: Nurses have a legal and ethical obligation to report cases of abuse. It would be inappropriate and likely unethical to require a third party witness to the statement or to withhold action pending assessment results. The nurse's obligation to report abuse legally supersedes the client's right to privacy.

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 will provide legal immunity to the nurse. The Good Samaritan law is not applicable to health care workers. 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, physicians, 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.

What governing body has the authority to revoke or suspend a nurse's license? The State Board of Nurse Examiners The employing health care institution The National League for Nursing The Supreme Court

The State Board of Nurse Examiners Explanation: The State Board of Nurse Examiners in the United States may revoke or suspend a nurse's license or registration. The employing health care institution may have submitted the paperwork regarding the allegation of the issue but does not suspend or revoke the nurse's license. The National League for Nursing is a national organization for faculty nurses and leaders in nurse education. The Supreme Court is the highest judicial court in a country or state. The Supreme Court does not rule on a nurse's license.

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: an advance directive. a standard of care. a will. a license.

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.

A nursing student administers an overdose of a narcotic 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 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 should have informed you that I felt unprepared for my assignment." "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.

A client admitted with Hodgkin lymphoma has a handwritten prescription for vinblastine 3.7 mg intravenously (IV) weekly. The nurse interprets the prescription as vincristine 3.7 mg and administers the wrong medication. The client becomes neurovascularly compromised and has a fatal reaction to the medication. The client's family begins a lawsuit against the facility and the nurse's license is suspended by the board of nursing. In preparation for the lawsuit, the nurse meets with the nurse attorney to review the events. Which appropriate statement given by the nurse indicates he has an understanding of the lawsuit? "I had a duty and it was my responsibility to double check the medication, which I did, yet this still happened." "I could not read the health care provider's handwriting, so I am not at fault." "I checked the medication before giving it and literature states it is for Hodgkin lymphoma." "I had a duty and it was my responsibility to get clarification before administering the medication, which I did not."

"I had a duty and it was my responsibility to get clarification before administering the medication, which I did not." Explanation: The nurse has a legal obligation to carry out health care provider's prescriptions unless the order is ambiguous (the nurse could not read provider's handwriting), contraindicated (vincristine dosage was too high), and contraindicated (wrong medication). The nurse had a duty and needed to get clarification, which he did not. The nurse is liable because there was a duty, which was breached, causation (wrong medication), and harm (client's death). Checking the medication is the correct thing to do, but the priority was assuring the medication was the correct one as prescribed.

Which statements made by a nurse would indicate to a nurse manager that the nurse requires further training? Select all that apply. "When I document, I make sure it is factual, accurate, complete, and timely." "I am accountable for any task that I delegate." "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." "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." 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.

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? "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." "A living will can only be used in the state in which it was created." "We have it on file here, so any hospital can call and get a copy."

"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.

A nurse hired to work in an ambulatory setting attends new employee orientation. The nurse never worked in ambulatory before and is concerned about the Scope and Standards of Practice for Professional Ambulatory Care Nursing. Which response by the nurse educator would further explain the Scope and Standards of Practice for Professional Care Nursing to the new nurse? "The Scope and Standards of Practice for Professional Ambulatory Care Nursing deals with the professional obligations of a nurse working in the ambulatory setting." "The Scope and Standards of Practice for Professional Ambulatory Care Nursing takes precedent over the facility's policies and procedures." "The Scope and Standards of Practice for Professional Ambulatory Care Nursing sets the standards for the nursing supervisor to assess a nurse." "The Scope and Standards of Practice for Professional Ambulatory Care Nursing determines if a nurse is minimally competent to receive a license to practice as a nurse."

"The Scope and Standards of Practice for Professional Ambulatory Care Nursing deals with the professional obligations of a nurse working in the ambulatory setting." Explanation: The Scope and Standards of Practice for Professional Ambulatory Care Nursing are the standards of care for nurses working in the ambulatory arena. It does not take precedent over the facility's policies and procedures, but must be worked in conjunction with the policies and procedures. It is not used for assessing nurses. NCLEX determines if a nurse is minimally competent to practice as a nurse.

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? Living wills provide specific instructions related to the client's personal property upon death. The Patient Self-Determination Act of 1990 requires hospital clients to have an advance directive. Advance directives must be completed 30 days prior to hospitalization in order to be valid. A durable power of attorney for health care appoints an agent the person trusts to make decisions.

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 patients about advance directives. Advance directives do not have to be completed prior to hospitalization in order to be valid.

Nurses may commit both intentional and unintentional torts when practicing within the profession. What intentional torts may occur in nursing practice? Select all that apply. A nurse threatens to hit an older client who has dementia and is screaming. A nurse forgets to put the side rails up on a crib and the toddler falls out. A nurse does not report a change in client condition in a timely manner. A nurse places a client who is a fall risk in restraints without an order from the health care provider. A nurse makes disparaging remarks to the staff about a client who has a sexually transmitted infection (STI). A nurse seeks employment in a hospital after falsifying credentials on a resume.

A nurse threatens to hit an older client who has dementia and is screaming. A nurse seeks employment in a hospital after falsifying credentials on a resume. A nurse places a client who is a fall risk in restraints without an order from the health care provider. A nurse makes disparaging remarks to the staff about a client who has a sexually transmitted infection (STI). Explanation:Torts may be intentional or unintentional acts of wrongdoing. Some of the intentional torts for which nurses may be held liable include assault and battery. Examples of intentional torts would include a nurse threatening to hit an older client who has dementia and who is wailing; a nurse seeking employment in a hospital after falsifying credentials on a resume; a nurse placing a client who is a fall risk in restraints without the proper order; a nurse making disparaging remarks to the staff about a client who has a sexually transmitted infection. A nurse forgetting to put the side rail up on a crib would be an example of an unintentional tort, as would a nurse not reporting a change in client condition in a timely manner.

Which scenario is an example of certification? 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 An education program that meets standards of the National League for Nursing A graduate of a nursing education program who passes NCLEX-RN

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 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.

Which process evaluates and recognizes educational programs as having met certain standards? Accreditation Credentialing Licensure Certification

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.

Which scenario is an example of certification? A nurse who demonstrates advanced expertise in a content area of nursing through special testing A hospital that meets the standards of the Joint Commission 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 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.

Which nursing student would most likely be held liable for negligence? A nursing student administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home. 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 reports that insulin was not administered to the client by the nurse on the previous shift. A nursing student performs a dressing change using sterile technique and documents the presence of necrotic tissue in the wound.

A nursing student administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home. Explanation: The nursing student who administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home is performing a task outside the scope of the job responsibilities of a UAP. The other options demonstrate legally defensible actions by the nursing student.

Which action constitutes battery? An older adult client refuses an intramuscular injection, but the nurse administers it. While bathing a client behind pulled curtains, two nurses discuss a different client. 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.

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.

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? Breach of duty 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.

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 Board of nursing Federal legislation 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.

A nurse talks with family members about an AIDS client from the clinic where the nurse works. Which tort has the nurse committed? Fraud Assault Slander Invasion of privacy

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.

Which statement about laws governing the distribution of controlled substances is true? 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. 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.

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.

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 confirms that the client's family has signed the consent form. The nurse informs the family about the living will. The nurse informs the family about advance directives.

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.

A physician is called to see a client with angina. During the visit the physician advises the nurse to decrease the dosage of atenolol to 12.5 mg. However, because the physician is late for another visit, the physician requests that the nurse write down the order for the physician. 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 ask the physician to come back and write the order. The nurse should remind the physician later to write the work order.

The nurse should ask the physician to come back and write the order. Explanation: The nurse should ask the physician 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 physician'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.

A client is unhappy with the health care provided and informs the nurse that the client is leaving the facility. The client has not been discharged by the physician. The nurse finds that the client has dressed and is ready to go. What should the nurse's action be in this situation? The nurse should have the client restrained and call the physician. The nurse should call and inform the nursing supervisor of the situation. The nurse should let the client go because the nurse cannot do anything. The nurse should warn the client that the client cannot come to the hospital again.

The nurse should call and inform the nursing supervisor of the situation. Explanation: The nurse should call and inform the nursing supervisor of the situation. The client should be made to sign the document stating that the client is responsible for the client's own actions. The nurse cannot restrain the client because that would be false imprisonment. Likewise, the nurse cannot overlook the incident because there is a responsibility for client care. Additionally, the nurse cannot warn the client that the client will not be allowed to come back to the hospital because it is the client's right to access health care whenever required.

A nurse is writing a letter to a U.S. congressman to support the promotion of health care issues. Which guidelines would ensure a properly written letter? Select all that apply. The nurse should restate exactly what the legislator should do at the end of the letter. The nurse should name the city and state where the nurse lives and votes. The nurse should state the purpose of the letter briefly and clearly in the first paragraph. The nurse should avoid using specific examples from the workplace to support the position. The nurse should write a longer email and shorter letter. The nurse should address the letter to as many legislators as possible.

The nurse should state the purpose of the letter briefly and clearly in the first paragraph. The nurse should name the city and state where the nurse lives and votes. The nurse should restate exactly what the legislator should do at the end of the letter. Explanation: Writing a letter to a U.S. congressman should be in the format of a formal letter, stating the nurse's concerns in a way that best relays this information. The formal letter should state the purpose of the letter briefly and clearly in the first paragraph, state the city and state where the nurse lives and votes, and restate exactly what the legislator should do at the end of the letter. The nurse should cite specific examples from the workplace to support the position. The letter should be kept to one page. The letter should be addressed to one legislator only, not a group of individuals.

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 after reviewing the client's serum potassium level. The nurse withholds the medication, retakes the heart rate, and gives the medication at a later time. The nurse administers the medication and reassesses the client after 30 minutes.

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.

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

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.

Which are examples of a nurse appropriately protecting a client's privacy? Select all that apply. Because the facility is a teaching facility, the nurse allows a nursing student to photograph a client for a care plan. The nurse moves the client from the emergency department waiting room to a private area to collect assessment data. With the client's permission, the nurse explains the client's diagnosis to the client's spouse. During a bed bath, the nurse exposes the client's upper torso while washing the client's face. 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.