NU 270: Legal Issues
The nurse is caring for a client whose spouse wishes to see the electronic health record. What is the appropriate nursing response? "Let me get that for you." "Only authorized persons are allowed to access client records." "The provider will need to give permission for you to review." "I am sorry I can't access that information."
"Only authorized persons are allowed to access client records." The client must give a formal permission for anyone outside of the interdisciplinary healthcare team who is directly involved in client care to review the records. The other answers are therefore inappropriate responses.
The nurse expects informed consent to be obtained for insertion of: An indwelling urinary catheter An intravenous catheter A gastrostomy tube A nasogastric tube
A gastrostomy tube Informed consent is required for invasive procedures that require sedation and are associated with more than usual risk to the client.
A client reveals in a therapy session that the client has thought about killing a neighbor. What is the therapist's obligation regarding this revelation? The therapist must keep the comment confidential, because the disclosure is protected by therapist-client confidentiality. The therapist must evaluate the threat and notify authorities if it meets credibility criteria. The therapist must meet with an ethics committee to determine the course of action. The therapist must notify authorities and the potential victim.
The therapist must notify authorities and the potential victim. As a result of the Tarasoff decision, it is mandatory in most (but not all) states to report any clear threats that psychiatric clients make to harm specific people. Psychiatrists, psychotherapists, and other mental health care providers must warn authorities (if specified by law) and potential victims of possible dangerous actions of their clients, even if the clients protest.
For which medication(s) will the nurse ask another nurse to witness the disposal of a partial dose in the phamaceutical waste container? Select all that apply. alprazolam losartan amlodipine hydrocodone meperidine
alprazolam hydrocodone meperidine Federal law requires two nurses to witness and document the waste of all controlled subsatnces in order to prevent diversion and misuse of these substances. Alprazolam, hydrocodone, and meperidine are controlled substances. These medications require the nurse to have another nurse witness the waste in a pharmaceutical waste container. Losartan and amlodipine are not controlled substances and do not require special procedures for the waste of a partial dose.
A nurse is considering relocating to another state to practice nursing. Which is the most appropriate action by the nurse to ensure ability to practice in the new state? asking the current state to transfer the license applying for a reciprocal license in the new state taking the new state's licensing exam No action is needed by the nurse.
applying for a reciprocal license in the new state Nurses gain legal rights to practice nursing in another state by applying to that state's board of nursing and receiving reciprocal licensure. The nurse does not need to retake the licensure exam. The nursing licenses are not transferable.
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 Accreditation Licensure Litigation
Certification 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 her first prenatal visit, a pregnant client admits to the nurse that she uses cocaine at least once per day. What is the nurse's priority implementation? Obtain urine and serum drug screens. Refer the client for drug counseling. Report the client to child protective services. Explain why the pregnancy is at risk.
Obtain urine and serum drug screens. Even though this client disclosed the use of cocaine, it does not mean there may not be other illicit drugs involved. It is important for all healthcare personnel to know what drugs are involved so the risks can be indentified and any necessary interventions performed. In an adult, cocaine will be present in the urine for 24-48 hours. The nurse should be proactive, supportive, and caring for the client. The key to success is being nonjudgmental. Assure the client that all information is confidential. The nurse should provide counseling about the effects of cocaine on the pregnancy and the fetus. The client should be referred to outreach programs or therapy. The mother is not reported to child protective services; this would be done after delivery if the baby tests positive for drugs.
An adolescent presents to a community clinic for treatment of vulvar lesions associated with Type 2 herpes simplex. Which action does the nurse take? Call the adolescent's parents for permission to assess and treat. Show the adolescent to a private examination room for further assessment. Inform the adolescent that parents will be informed by the insurance company. Ask the adolescent if the parents know that their child is seeking treatment for a condition.
Show the adolescent to a private examination room for further assessment. The nurse should take the adolescent client to an examination room to provide privacy. Federal law states that adolescents may obtain treatment for sexually transmitted diseases without parental notification, although the parents may find out if insurance is used. This adolescent is guaranteed the same confidentiality as older clients.
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? Libel Slander Negligence Malpractice
Slander 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 the statement must be proved false. Negligence and malpractice pertain to actions which are committed or omitted, thereby causing physical harm to a client.
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, 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 the wrong medication to a client, who then has one episode of vomiting 5 minutes later but no further adverse reactions.
The nurse administers amoxicillin to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest. 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.
A client is transferred from the emergency department to the locked psychiatric unit after attempting suicide by taking 200 acetaminophen tablets. The client is now awake and alert but refuses to speak with the nurse. In this situation, the nurse's first priority is to: establish a rapport to foster trust. place the client in full leather restraints. try to communicate with the client in writing. ensure safety by initiating suicide precautions.
ensure safety by initiating suicide precautions. The nurse's first priority is to keep a suicidal client safe and alive. Although establishing a rapport and promoting trust are important in psychiatric nursing, neither is the highest priority. Using restraints is inappropriate and could be interpreted as punishment of the client or a convenience for the nurse. Trying to communicate in writing is also inappropriate because there is no indication that the client can't hear.
