Transitions Chapter 7: Legal Dimensions of Nursing Practice

Which scenario is an example of certification?

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

In some cases, the act of providing nursing care in unexpected situations is covered by the Good Samaritan laws. Which nursing action would most likely be covered by these laws?

Emergency care for a choking victim in a restaurant *Good Samaritan laws are designed to protect health practitioners when they give aid to people in emergency situations in which the practitioner is off duty, such as providing emergency care to a choking victim in a restaurant. The other examples listed are not situations covered by the Good Samaritan law. Reference:

What governing body has the authority to revoke or suspend a nurse's license?

The State Board of Nurse Examiners

While riding in the elevator, a nurse discusses the HIV-positive status of a client with other colleagues. The nurse's action reflects:

invasion of privacy

Which is an example of an unintentional tort?

A nurse gives the client a medication, and the client has an adverse reaction to it.

When the nurse informs a client's employer of the client's autoimmune deficiency disease, the nurse is committing the tort of:

invasion of privacy *Nurses have access to information recorded in the medical record, shared or observed through care or interactions with the client's friends and family, and obtained through access to the client's body. A loss of privacy occurs if others obtain unauthorized information about someone from a nurse. Assault and battery refer to verbal and physical actions that are not described in this scenario. Details revealed as described here do not reflect a breach of the contract between nurse and client.

A client is in a persistent vegetative state. The client has no immediate family and is a ward of the state. Under these circumstances, who will speak on this client's behalf?

A surrogate decision maker *Infants, young children, people with severe cognitve impairment or who are incapacitated, and people in a persistent vegetative state or coma do not have the capacity to participate in decision-making about their health care. For such people, a surrogate decision maker must be legally designated to act on their behalf. The surrogate decision maker may be any one of the individuals listed in the other answers, if properly identified by the hospital authorities.

Which action constitutes battery?

An older adult client refuses an intramuscular injection, but the nurse administers it. *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.

Which are torts rather than crimes? Select all that apply.

Assault Defamation of character Negligence *Torts are intentional or unintentional acts of wrongdoing. Some of the intentional torts for which nurses may be held liable include assault and battery, defamation of character, negligence, invasion of privacy, false imprisonment, and fraud. Manslaughter and robbery are crimes.

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?

Battery *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.

The nurse is providing care to a client whose condition has progressively declined. The nurse assesses and makes appropriate interventions as well as notifies the health care provider. Despite the nurse's efforts, the client expires. What element of liability has the nurse demonstrated?

Duty *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.

Which is true of the Occupational Safety and Health Act?

It helps to reduce workforce injuries and illness in the workplace. *The Occupational Safety and Health Act of 1970 helps to reduce injuries and illness in the workplace. The National Practitioner Data Bank is a clearinghouse for health care practitioners who engage in unprofessional conduct and prevents them from moving from state to state. Mandatory reporting laws, not the Occupational Safety and Health Act, require nurses to report abuse. The Americans with Disabilities Act protects people with communicable diseases and those recovering from drug or alcohol addiction.

A nurse, while off-duty, tells the physiotherapist that a client who was admitted to the nursing unit contracted AIDS due to exposure to sex workers at the age of 18. The client discovers that the nurse has revealed the information to the physiotherapist. With what legal action could the nurse be charged?

Slander *he 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.

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 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.

Which best exemplifies malpractice?

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.

After reporting to work for a night shift, the nurse learns that the unit is understaffed because two RNs called out sick. As a result, each nurse on the unit must provide care for four acute clients in addition to the nurse's regular clients. Which statement is true for this nurse when working in understaffed circumstances?

The nurse is legally held to the same standards of care as when staffing levels are normal. *The claim of being overworked does not constitute a legal defense, and both the potential for liability and standards of care remain unchanged despite an increased client assignment. Although it is prudent to make all realistic attempts to fill the gaps in staffing, documenting these efforts does not change the nurse's legal position. A nurse has the right to refuse an unsafe client assignment but the nurse is not legally obliged to withhold care.

Which are examples of a nurse appropriately protecting a client's privacy? Select all that apply.

With the client's permission, the nurse explains the client's diagnosis to the client's spouse. The nurse moves the client from the emergency department waiting room to a private area to collect assessment data. *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.

When talking with family over dinner, the nurse shares about a client with infertility at the hospital, identifying the person by name. Which tort has the nurse committed?

invasion of privacy *Invasion of privacy involves a breach in keeping client information confidential. Slander is oral defamation of character. Assault is a threat or attempt to make bodily contact with another person without that person's consent. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property.