Exam 1.0
Standards of care are:
..., the legal requirements for nursing practice that describe the minimum acceptable nursing care
A home care nurse working for a proprietary agency instructed a patient to change his dressing every day and to observe the wound for signs of infection. When the nurse returned two weeks later, the original dressing was still in place. The wound showed signs of infection, and the patient required antibiotic therapy. The wound became worse and resulted in tissue damage. In a malpractice action against the nurse one year later, the patient claimed negligent supervision of the wound. A defense that would most likely be available for the defendant nurse to raise would be...
..Comparative or contributory negligence.
A nurse is a fact witness in a personal injury lawsuit. The attorney representing the plaintiff asks the nurse a question at a deposition about the plaintiff's injuries, but the nurse isn't sure if the attorney is asking about the state of the plaintiff's injuries on admission or on discharge to her nursing unit. The nurse should:
.Ask the attorney to be more specific..
In most states the Good Samaritan Act provides immunity from civil liability to: A) Volunteers providing emergency medical care when there is no legal duty to assist B) Professionals providing emergency medical care in emergency department or acute care settings C) Nonmedical volunteers for ordinary negligence and professional medical volunteers for gross negligence D) None of the above
A
Mandatory licensure for registered nurses (RNs) means that: A) Anyone who works as a nurse for compensation must be registered with the state as an RN B) Anyone can work as a nurse for compensation but cannot use the title RN unless registered with the state as an RN C) Not only are nurses required to be registered but they must also be certified D) A nursing license from a neighboring state would be recognized as valid in the state in which the nurse is practicing
A
The nurse has just learned some information of a sensitive nature from a patient. To fulfill an ethical duty to the patient and maintain confidentiality, the nurse should: A) Determine if the information has any bearing on the patient's healthcare needs before it is charted B) Document the information in the healthcare record before it is forgotten C) Maintain the confidentiality of the information and not chart/report it regardless of what it is about D) Communicate the information only if the nurse feels it is in the best interest of the patient
A
A home health care nurse visits a patient who had surgery three weeks prior to the visit. As part of the patient's care plan, the patient was instructed to perform a range of motion exercises. However, he has not done the exercises during the three weeks after the surgery. The patient is complaining that he is having difficulty walking and he continues to have problems with his recovery for several months. If a lawsuit is later filed claiming malpractice against the nurse and physician:
A defense that could be raised is one of contributory negligence.
As an advocate for the client, the nurse must make sure that "safe, effective care" is given in conformity with the A. Nurse Practice Act (NPA). B. American Nursing Association (ANA) C. National Council for Lisensure Examinations D. State Board of Licensure
A. Nurse Practice Act (NPA).
Obtaining informed consent is the responsibility of A. The physician B. The RN manager C. The nurse D. The CNA
A. The physician Rationale: The physician is RESPONSIBLE for obtaining an informed consent.
When providing care to patients, the nurse INCREASES the risk of liability when he or she...
Administers predrawn injections prepared by another nurse.
A nurse has given the wrong medication to a patient. The nurse should do all of the following except: A) Chart the medication in the patient's medical record B) Take no action if there is no apparent patient injury C) Fill out an incident report D) Monitor the pt and document observations and assessment data
B
A patient assigned to a nurse fell while in the bathroom. The nurse had instructed the UAP to assist patient with walking on an as-needed basis. Assuming the patient should have been assisted and was not, who is legally liable for the patient's fall? A) The nurse because he or she is in charge of the UAP B) The UAP because direction was given by the nurse C) Neither the nurse nor UAP because each acted properly D) Both the nurse and UAP could be liable because each had an independent duty to the patient
D
A nurse is caring for a patient who is heavily sedated. The patient previously told the nurse that he does not want chemotherapy; however, the family now wants to begin treatment. The best course of action for the nurse is to: A) Start the chemotherapy because the physician has provided orders for it B) Refuse to begin the chemotherapy because the patient now lacks the capacity to consent to therapy and has given clear notice that he does not want it C) Request that the social worker initiate guardianship proceedings because the family cannot give valid consent without a court order D) Consult the hospital ethics committee
B
Informed consent requires which three elements? A) Confidential communications, patient competence, and consent standard B) Information, patient competence, and voluntary consent C) Voluntary consent, patient competence, and patient's signature D) Voluntary consent, information, and patient's signature
B
A nurse discovers that a primary care provider has prescribed an unusually large dosage of a medication. Which is the most appropriate action? 1. Administer the medication 2. Notify the prescriber 3. Call the pharmacist. 4. Refuse to administer the medication.
Answer #2 Rationale: The nurse should call the person who wrote the order for clarification. Administering the medication is incorrect because knowing the dose is outside the normal range and not questioning it could lead to client harm and liability for the nurse.
Although the client refused the procedure, the nurse insisted and inserted a nasogastric tube in the right nostril. The administrator of the hospital decides to settle the lawsuit because the nurse is most likely to be found guilty of which of the following? 1. An unintentional tort 2. Assault 3. Invasion of Privacy 4. Battery
Answer #4 Rationale: Battery is the willful touching of a person without permission. Another name for an unintentional tort is malpractice. This situation is an intentional tort because the nurse executed the act on purpose.
The primary care provider wrote a do-not-resuscitate (DNR) order. The nurse recognizes that which applies in the planning of nursing care for this client? 1. The client may no longer make decisions regarding his or her own health care. 2. The client and family know that the client will most likely die within the next 48 hours. 3. The nurses will continue to implement all treatments focused on comfort and symptom management. 4. A DNR order from a previous admission is valid for the current admission
Answer: #3 Rationale: A DNR order only controls CPR and similar life-saving treatments. All other care continues as previously ordered. Competent clients can still decide about their own care (including the DNR order.)
A primary care provider's orders indicated that a surgical consent form needs to be signed. Since the nurse was not present when the primary care provider discussed the surgical procedure, which statement "best" illustrates the nurse fulfilling the client advocate role? 1. "The doctor has asked that you sign the consent form." 2. "Do you have any questions about the procedure?" 3. "What were you told about the procedure you are going to have?" 4. "Remember that you can change your mind and cancel the procedure."
Answer: #3 Rationale: This is the best answer because the nurse is assessing the client's level of knowledge as a result of the discussion with the primary care provider. Based on this assessment, the nurse may initiate other actions (call the primary care provider if the client has any questions)
The nurse's partner/spouse undergoes exploratory surgery at the hospital where the nurse is employed. Which practice is most appropriate 1, Because the nurse is an employee, access to the chart is allowed. 2. The relationship with the client provides the nurse special access to the chart. 3. Access to the chart requires a signed release form 4. The nurse can ask the surgeon to discuss the outcome of the surgery.
Answer: #3 Rationale: The only person entitled to information without written consent is the client and those providing direct care. The nurse has open access to information regarding assigned clients only.
A primary care provider prescribes on tablet, but the nurse accidentally administers two. After notifying the primary care provider, the nurse monitors the client carefully for untoward effects of which there are none. Is the client likely to be successful in suing the nurse for malpractice? 1. No, the client was not harmed 2.No, the nurse notified the primary care provider 3. Yes, a breach of duty exists 4. Yes, foreseeability is present
Answer: 1 Rationale: All elements such as duty, foreseeability causation, harm/injury and damages must be present for malpractice to be proven.
The nurse notices that a colleague's behaviors have changed during the past month. Which behaviors could indicate signs of impairment? Select all that apply 1. Is increasingly absent from the nursing unit during the shift. 2. Interacts well with others 3. "Forgets" to sign out for administration of controlled substances. 4. Offers to administer prn opiates for other nurse's clients 5. Is able to say "no" to requests to work more shifts.
Answer: 1, 3, 4 Rationale: Interacting with others (versus isolating self from others) and setting limits on the number of hours working are positive behaviors and not indicative of possible impairment. The other options are warning signs for impairment
Following a motor vehicle crash, a nurse stops and offers assistance. Which of the following actions are most appropriate? Select all that apply 1. The nurse needs to know the Good Samaritan Act for the state. 2. The nurse is not held liable unless there is gross negligence 3. After assessing the situation, the nurse can leave to obtain help. 4. The nurse can expect compensation for helping. 5. The nurse offers to help but cannot insist on helping.
Answer: 1,2,5 Rationale: The nurse is subject to the limitations of state law and should be familiar with the Good Samaritan laws in the specific state. Gross negligence would be described by the individual state law. Unless there is another equally or more qualified person present, the nurse needs to stay until the injured person leaves. The nurse should ask someone else to call or go for additional help. The same client rights apply at the scene of an accident as well as those in the workplace.
Which nursing actions could result in malpractice? Select all that apply 1. Learns about a new piece of equipment 2. Forgets to complete the assessment of a client 3. Does not follow up on client's complaints. 4. Charts client's drug allergies 5. Questions primary care provider about an illegible order
Answer: 2 and 3 Rationale: Standards of practice require a complete assessment. A nurse needs to be sure the client's needs have been met. They both can impact client safety and do not follow standards of care.
A nursing student is employed and working as an unlicensed assistive personnel (UAP) on a busy surgical unit. The nurses know that the UAP is enrolled in a nursing program and will be graduating soon. A nurse asks the UAP if he has performed a urinary catheterization on clients while in school. When the UAP says yes, the nurses asks him to help her by doing a urinary catheterization on a post surgical client. What is the best response by the UAP? 1. "Let me get permission from the client first." 2. "Sure, which client is it?" 3. "I can't do it unless you supervise me." 4. "I can't do it. is there something else I can help you with."
Answer: 4 Rationale: A sterile invasive procedure that places the client at significant risk for infection is generally outside the scope of practice of a UAP. Even though the UAP is a nursing student, the agency job description should be followed.
Nurses may disclose a patient's HIV information: A) When a known sexual partner is also a patient of the nurse B) To a family member who requests the information C) Never D) To other HCP for the purpose of medical treatment when the information is in the medical record
D
A registered nurse arrives at work and is told to "float" to the ICU for the day because the ICU is understaffed and needs an additional nurse to care for the clients. The nurse has never worked in the ICU. Which of the following is the most appropriate nursing action? A. refuse to float in the ICU B. call the hospital lawyer C. call the nursing supervisor D. report to the ICU and identify tasks that can be safely performed
Answer: D Rationale - floating is acceptable and legal practice. The nurse floated to a unit until will be given orientation; be assigned to care for stable patients or those with conditions similar to her training experience.
The nurse practice acts are an example of civil law. A. True B. False
Answer: False Rationale: Nurse practice acts fall under Statutory law
In states with mandatory licensure for RN's:
Anyone who works for compensation must be registered with the state as an RN
A homecare nurse visits a patient who had surgery 3 weeks ago. As part of the patient's care plan, he was instructed to perform range-of-motion exercises. However, he has not done so by the time when the nurse visits 3 weeks later. The patient is complaining that he is having difficulty walking and continues to have problems with his recovery for several months. If a lawsuit is later filed claiming malpractice against the nurse and physician: A) The patient is entitled to a recovery because his informed consent amounted to a contract for services that was not successfully fulfilled B) A defense that could be raised in contributory negligence C) The patient will not recover because he assumed the risks of failure when he signed the surgical consent form D) The nurse cannot be sued because she works for an agency
B
A homecare nurse working for a proprietary agency instructed a patient to change his dressing every day and to observe the wound for signs of infection. When the nurse returned 2 weeks later, the original dressing was still in place. The wound showed signs of infection, and the patient required antibiotic therapy. The wound became worse and resulted in tissue damage. In a malpractice action against the nurse 1 year later, the patient claimed negligent supervision of the wound. A defense that would most likely be available for the defendant nurse to raise would be: A) Assumption of the risk B) Comparative or contributory negligence C) Charitable immunity D) Statute of limitations
B
A malpractice claim is brought against a nurse in the year 2000. The case involves an incident that occurred at a previous job in 1996. The nurse will be covered for this incident: A) Only if the nurse is still working for the previous employer (employer's policy will cover) B) If the nurse was covered by an individual or employer occurrence policy at the time of the incident C) If the nurse was covered by a claims made policy in 1996 D) By the nurses' new employer's policy as long as it is an occurrence policy
B
A nurse caring for several patients becomes ill while on duty and decides that she cannot continue to work that day. To avoid a later claim against her for patient abandonment, she should: A) Tell her supervisor that she is leaving B) Inform both her coworkers and the supervisor that she needs to leave the work area due to illness C) Go to a physician to get a note to validate her illness D) Not worry about letting anyone know because her shift will be over in an hour anyhow
B
The nurse is caring for a 40-year-old woman who underwent a colon resection under general anesthesia 12 hours earlier. Upon arrival to her room, she is holding her abdomen, is not moving in bed, and is clenching her teeth. She complains of pain that has been present in the incisional area for the last hour. She is also complaining of nausea. She requested pain medication earlier. However, it was approximately 30 minutes too early for her prn dose of meperidine (Demerol), 75 mg IM every 4 hours. Her vital signs are as follows: temp 100, BP 140/90, RR 20, and HR 100. All of these values are increased over her last set of vital signs. What should the nurse do first? A) Administer the meperidine B) Ask the patient additional question about her pain to determine the nature, source, and intensity of pain C) Notify the physician for an increase in dosage of meperidine D) Medicate the patient for nausea
B
The purpose of the HIV status related to public health and safety is to: A) Provide confidentiality B) Encourage early detection and tx and prevent further transmission C) Disclose information to protect third parties D) Make HIV a protected disability
B
When incorporating concepts of law and ethics in practice, the nurse must consider that: A) Ethical codes do not have the fore of law and will not be looked at by courts for guidance B) Legal duties are often minimal, and ethical codes may require conduct beyond legal accountability C) Fulfilling legal duties will prevent any ethical conflicts D) Patients' wishes will always supersede ethical or legal codes
B
When providing care to patients, the nurse increases the risk of liability when: A) Refusing to implement an incomplete physician's order B) Administering predrawn and labeled injections prepared by another nurse C) Notifying a physician's supervisor when an order may be harmful to a patient D) Doing non of the above
B
Which of the following would typically not be included in a state's Nurse practice act (NPA)? A) Scope of practice guidelines B) Definition of what constitutes practice outside the scope of nursing (the practice of medicine) C) Definition of what constitutes unprofessional conduct D) Requirements for maintaining licensure
B
The nurse puts a restraint jacket on a client without the client's permission and without the physicians order. The nurse may be guilty of assault. A. True B. False
B. False Rationale: Battery is physical in nature. Assault is a threat.
A student nurse who is employed as a nursing assistant may perform any functions that she taught in school. A. True B. False
B. False Rationale: You may only perform functions that you are licensed to perform while on the job.
A 78-year-old widow presets to the emergency department after a reported fall down the stairs at her home. She is disoriented and frail, and her clothing appears to be somewhat disheveled and wrinkled. She is complaining of back and neck pain. Upon removing her clothing, the nurse notices several bruised areas on her arms. She is unable to tell what happened. Her adult son, however, is quick to point out how clumsy his mother is and how she won't change her clothing from day to day. He also will not leave the examining room while the nurse attempts to assist her in putting on a hospital gown. The nurse should: A) Contact protective services immediately B) Order the adult son to leave the room C) Discuss concerns with the charge nurse or the social worker D) Ask the patient directly if her son has harmed her
C
A colleague who is busy asks a nurse to help administer her medications. The nurse is not familiar with one of the IV drugs to be given. The most reasonable action for the nurse to take is to: A) Give the medication following steps she has used with other IV drugs B) Refuse to give the medication because she is unfamiliar with it, and take no further action C) Look up the medication in authoritative drug references or check with a pharmacist regarding administration D) Consult with another nurse about how to administer the drug
C
A homecare nurse notices that an elderly patient is having trouble managing her affairs. There is evidence that she is not eating properly and does not follow through on taking medications. There are no immediate family members to monitor her. The nurse should: A) Consider this to be a problem for the social worker and make a referral before her next appointment, which is scheduled for next month B) Continue to observe the patient but take no further action until after a few more visits C) Document the observations in the healthcare record, initiate a social worker referral, and make some temporary arrangements (with the patient's permission) for assistance through the agency D) Initiate guardianship proceedings, because the elder is not competent to care for herself
C
A man in a white lab coat is seen perusing a patient's chart. although the nurse assumes he is a physician or on staff at the hospital, the nurse has never seen him before. The nurse should: A) Ignore him because the nurse is too busy to stop and ask him who he is B) Look for some kind of identification on his person that would indicate a connection to the hospital C) Identify himself or herself as the patient's nurse and ask the man his name D) Ask other staff members if they have seen him before, and if someone recognizes him, let it go
C
A nurse is a fact witness in a personal injury lawsuit. The attorney representing the plaintiff asks the nurse a question at a deposition about the plaintiff's injuries, but the nurse isn't sure if the attorney is asking about the state of the plaintiff's injuries on admission or on discharge to the nursing unit. The nurse should: A) Give as much information as possible to cover both possibilities. B) Decide to answer about the state of injuries upon admission C) Ask the attorney to be more specific D) Decide to answer about the state of the injuries upon discharge
C
A nurse is assigned to a group of patients during the evening shift. An UAP employee is working with the nurse. Which of the following intervention can be assigned to the UAP? A) Administer an antibiotic cream to a patient's arm after the UAP gives the patient a bath. B) Complete a health history and admission assessment on a patient because the patient is not in acute distress. C) Take vital signs on a patient who has had surgery 4 hours earlier. D) Monitor and adjust the patient's IV line after the nurse instructs the UAP how to perform the task properly.
C
A nurse is making rounds on the surgical floor when Ms. Clark, who just had a hysterectomy says to him "You people are wretched humans; you get pleasure out of using me as a pincushion." The nurse should: A) Identify her as a difficult patient and resolve to only enter her room when a nursing procedure needs to be done B) Defend himself by explaining the necessity of needle sticks for lab procedures and pain medications C) Offer her special attention, offer to work with her for a solution, and visit her when no nursing procedure needs to be done D) Ask another nurse to switch assignments because he has a personality conflict with the patient and does not want to antagonize her further
C
An employer's malpractice insurance will generally cover a nurse's actions if the negligent act is: A) Of an extremely reckless nature, such as to endanger a patient through outrageous conduct B) Outside the scope of the NPA C) Within the employee's job description D) One that occurred when the nurse was off duty but constituted performing volunteering nursing duties
C
Informed consent is obtained prior to: A) All nursing procedures that involve touching the patient B) Only surgical procedures C) Invasive medical procedures that involve risks D) All emergency treatment
C
Professional negligence occurs when a nurse: A) Provides nursing care that results in an adverse outcome B) Fails to provide the optimal level of nursing care C) Fails to act as a reasonable, prudent nurse would in the same or similar circumstances D) Exercises an error in judgment
C
Standards of care are: A) The optimal degree of professional skill B) Used to show gross negligence and incompetence C) Used to determine what is negligent performance D) None of the above
C
The nurse should be vigilant in protecting private patient information. Which of the following indicates the nurse is following proper legal and ethical duties in this regard? A) Visitors are informed of the patient's progress if they are close relatives B) Spouses are automatically informed of their spouse's medical procedures if reproductive information is involved C) Work papers with patient-identifying information are kept behind the desk where only staff members are allowed D) A newspaper reporter calls for information on a patient and the nurse reveals only favorable information of the patient's status
C
The nurse notes that an advance directive is in the client's medical record. Which of the following statements represents the best description of guidelines a nurse would follow in this case? A. A durable power of attorney for health care is invoked only when the client has a terminal condition or is in a persistent vegetative state B. A living will allows an appointed person to make health care decisions when the client is in an incapacitated state. C. A living will is invoked only when the client has a terminal condition or is in a persistent vegetative state. D. The client cannot make changes in the advance directive once the client is admitted into the hospital.
C. A living will is invoked only when the client has a terminal condition or is in a persistent vegetative state. Rationale: A living will directs the client's healthcare in the event of a terminal illness or condition. A durable power of attorney is invoked when the client is no longer able to make decisions on his or her own behalf. The client may change an advance directive at any time.
Nurses agree to be advocates for their patients. Practice of advocacy calls for the nurse to: A. Seek out the nursing supervisor in conflicting situations B. Work to understand the law as it applies to the client's clinical condition. C. Assess the client's point of view and prepare to articulate this point of view. D. Document all clinical changes in the medical record in a timely manner.
C. Assess the client's point of view and prepare to articulate this point of view. Rationale: Nurses strengthen their ability to advocate for a client when nurses are able to identify personal values and then accurately identify the values of the client and articulate the client's point of view.
Miss Magu, an 88-year old woman, believes that life should not be prolonged when hope is gone. She has decided that she does not want extraordinary measures taken when her life is at its end. Because she feels this way, she has talked with her daughter about her desires, completing a living will and left directions with her physician. This is an example of: A. Affirming a value B. Choosing a value C. Prizing a value D. Reflecting a value
C. Prizing a value
The nurse administers pentobarbital to a patient when phenobarbital was ordered. There was no injury to the patient; however, the nursing supervisor reported the incident to the state board of nursing. The nurse is notified of the charges brought against her, and a disciplinary hearing is held. What is the role of that state board of nursing? A) To protect the public B) To uphold standards of nursing practice C) To investigate all complaints to determine if disciplinary action is appropriate D) All of the above
D
The state board of nursing cannot take which of the following actions against a nurse? A) Suspension of the nurse's license for a period of time B) Censure of a nurse C) Placing a nurse on probation D) Imprisonment
D
To ensure that the SOC is met when the nurse is providing discharge instructions, the nurse should do all of the following except: A) Provide written instructions B) Assess the patient's literacy level C) Request the patient to demonstrate any skill needed for home care (such as dressing change) D) Take no further action if the pt refuses to participate in discharge teaching
D
The nurse is obligated to follow a physicians order unless: A. The order is a verbal order B. The order is illegible C. The order has not been transcribed D. The order is an error, violates hospital policy, or would be detrimental to the client
D. The order is an error, violates hospital policy, or would be detrimental to the client.
Which of the following would typically NOT be included in a state's nurse practice act (NPA)?
Definitions of what constitutes malpractice
A healthcare institution markets itself as a comprehensive care center able to coordinate and meet the community's healthcare needs. A patient goes to the emergency department where the nurses are employees but the physicians are independent contractors. The patient exhibits signs of an impending cerebral vascular accident (CVA; slurred speech, drooping facial expression, and one-sided weakness) with a congested cough and wheezing. He is discharge with the diagnosis of pneumonia. Which of the following may he bring a civil action against? A) The nurse individually for failing to recognize and communicate the symptoms to the physician B) The physicians, as independent contractors, for failure to diagnose and treat the CVA C) The hospital under corporate liability for the action of the nurses as employees and the physicians as independent contractors D) All of the above
D
A nurse administers potassium chloride to a patient by IV push, although the physician's order states it is to be given IV piggyback. The patient's cardiac monitor immediately shows a flateline and the patient dies. What type of actions might the nurse become involved in as a result of this error? A) Criminal action B) Civil malpractice action C) Administrative law action (disciplinary action) D) All of the above
D
A nurse is asked to work a double shift on a unit he is unfamiliar with. Which of the following is not a recommended course of action? A) Determine whether he can safely provide care for the population of patients B) Ask to be oriented to the unit C) Request that a nurse who is familiar with the unit work with him D) Refuse the patient assignment and file a complaint with the union
D
A 75-year-old woman with strong religious beliefs against blood transfusions presented to the emergency department following a severe motor vehicle accident. Given the large lacerations and significant blood loss, the physicians wish to order several blood transfusions. She refuses, indicating that according to her religious beliefs she may not receive blood transfusions. The medical staff believes that if she does not receive blood transfusions in the next several hours, she will go into shock and possibly die. The nurse should: A) Call the risk management department immediately to help interpret the policy in this situation B) Seek intervention or consultation with the patient's spiritual adviser C) Assess whether the patient appears to be fully competent and aware D) Do all of the above
D
A 78-year-old widow presents to the emergency department after a reported fall down the stairs at her home. She appears slightly confused and frail. She is complaining of back and hip pain. The physicians have recommended hip surgery. She tells the nurse how her late husband died on the operating room table several years ago, and she has sworn never to have surgery. The nurse should: A) Contact the legal department immediately B) Tell the patient she is overreacting and she needs to have the surgery or she will never walk again C) Discuss your concerns with the charge nurse or the social worker or both D) Assess the patient's understanding and ability and ability to comprehend the information further before taking any other action
D
A Medicaid patient has confided in the nurse that he took an illegal drug prior to being admitted because he was nervous about the elective standard procedure he is to undergo. He is not acting inappropriately, but the nurse is concerned about the effects of the drug when mixed with the anesthetic. The patient's nurse should first: A) Keep the information quiet for the sake of protecting his privacy B) Recognize that Medicaid patients have little or no understanding of the ramifications of such actions and ignore it C) Tell the charge nurse and attending physician D) Speak with the patient about his fears and concerns
D
A nurse is taking care of a patient who is "pleasantly demented." The patient is always smiling and agreeable to all suggestions but doesn't understand events as they happen. The patient's family arrives to visit with an attorney and requests that the nurse witness the patient's signing of a deed to her home so that the daughter will own the property for estate planning purposes. The nurse should: A) Check with her employer to determine if there is a policy about nurses witnessing documents B) Inform the attorney that the patient, although smiling and agreeable, doesn't understand things as they happen C) Refuse to witness the document D) Prepare written documentation of the events in the chart as soon as possible E) All of the above
E
A health care institution markets itself as a comprehensive care center able to coordinate and meet the community's health care needs. A patient goes to the ER Dept where the nurses are employees but the physicians are independent contractors. The patient exhibits signs of an impending CVA (slurred speech, drooping facial expression, and 1 sided weakness) with a congested cough and wheezing. He is discharged with the diagnosis of pneumonia. Under the concept of vicarious liability, the patient can bring a civil action against the nurses individually for failing to recognize and communicate the symptoms to the physician; the physicians, as independent contractors, for failure to diagnose and treat the CVA; and the hospital under corporate liability for the action of the nurses as employees and the physicians as independent contractors.
False
Good nursing care guarantees the patient a good result.
False
A nurse is making rounds on the surgical floor when Mrs. Clark, who just had a hysterectomy, says to him," You people are wretched. You get pleasure out of using me as a pin cushion." The best response to this patient is for the nurse to...
Listen to Mrs. Clark's concerns and offer to work with her to develop a mutually acceptable pain management solution.
______ are Authoritative statements that evaluate the quality of practice
Standards
Professional malpractice is a type of ______Law
Tort
A nurse administers potassium chloride to a patient by IV push, although the physician's order reads for it to be given by IV piggyback. The patient has a cardiac arrest and dies. This nurse might become involved in criminal action, civil malpractice action, and disciplinary action (administrative law action) as a result of this error.
True
A nurse who is incompetent can be disciplined by his or her board of nursing even if the acts performed by the nurse did not cause injury to the patient.
True
The national standard of care holds a nurse in a rural community hospital to the same standard of care as a nurse in a metropolitan medical center given the similarity of the situation.
True
When incorporating concepts of law and ethics in practice, the nurse must consider that: Legal duties are often minimal and ethical codes may require conduct beyond legal accountability
True
In most states the Good Samaritan Act provides immunity from civil liability to:
Volunteers providing emergency care when there is no legal duty to assist.
A nurse is asked to work a double shift on a unit he is unfamiliar with. The nurse should do all of the following EXCEPT
ask to be oriented to the unit
A patient assigned to a nurse fell while alone in the bathroom. The nurse had instructed the UAP to assist the patient with getting up to go to the bathroom, Assuming that the patient should have been assisted and was not, who is legally liable for the patient's fall?
both
A nurse notices a change in his patient's condition and notifies the physician, who does not respond adequately or in a timely manner. The nurse documents the events, including the fact that he notified the physician. The patient's condition deteriorates and the nurse notifies the physician again. The physician states she does noit feel she needs to see the patient, The nurse documents this event and is very concerned about the patient's condition but does not notify his supervisor. The patient has a cardiac arrest and suffers severe consequences as a result. The nurse in this example
can be found liable for malpractice since he did not utilize his chain of command
The client's right to refuse treatment is an example of _________ laws.
civil
A ___________is a question and answer session during which one party to a lawsuit acquires information known only to the other party.
deposition
Professional negligence occurs when a nurse...
fails to act as a reasonable and prudent nurse.
All nurses must have an individual professional liability policy
false
Inadequate staffing is an appropriate reason for delegating tasks to UAP's,
false
The proper vehicle for documenting staff safety concerns or inappropriate behavior by a physician is in the patient's medical record
false
While the actual time iut takes for a case to come to trial may be several years, the claim itself must be filed within the statutory period, usually 8 to 10 years
false
A nurse caring for several patients becomes ill while on duty and decides she cannot continue to wrok that day. The shift is almost over. To avoid a later claim against ther for patient abandonment, she should
inform both her coworkers and the supervisor that she needs to leave the work area due to illness
Which of the following is NOT an essential element of malpractice?
intent to cause harm
A(n)____________policy is usually a broad coverage policy that covers a claim as long as the policy was in effect when the incident occurred, even if the claim is made years after the occurrence.
occurrence
The nurse is assigned to a group of patients on the evening shift. A UAP is working with the nurse. Which of the following interventions can be assigned to the UAP?
take vital signs on a patient who has had surgery 4 hours earlier
A collaborative team efforet offers the best resolution to legal and ethical concerns
true
A nurse cannot refuse an assignment for moral or religious reasons if there is no one els to care for the patient since it would constitute abandonment of the patient
true
As part of the state board of nursing disciplinary process, a nurse can appeal the board's decision about a disciplinary action.
true
Even though a nurse can delegate specific duties to a UA{, it is important for the nurse to have a clear understanding of the competencey level of the UAP and to provide instruction for the procedure or complete the task hinself or herself.
true
If a nurse believes she must accept an assignment about which she has reservations, it is important to clearly state why she wants to refuse the assignment and then notify the appropriate individuals within the organization in case a negilgence action is later filed against the organization
true
In negligence or malpractice actions, failure to prove even one of the four required elements will cause the plaintiff's claim to fail.
true
Nurses can be held liable when they know (or should know) that the physician's diagnosis does not math the assessment and patient complaints.
true
Nurses should be knowledgeable about the terms, condition, and exclusions of either their own or their employer's professional malpractive insurance policy.
true
The emplyer's malpractice insurance will typically cover the nurse's actions if the negligent act is
within the employee's job description
A nurse is taking care of a patient who is "pleasantly demented." The patient is always smiling and agreeable to all suggestions but doesn't understand events as they happen. The patient's family arrives to visit with an attorney and requests that the nurse witness the patient's signing of a deed to her homne so that the daughter will own the property for estate planning purposes. The nurse should do all the following EXCEPT
witness the document