310 midtern, Legs 2, Module 1/2 Quiz, Module 3A Quiz, Module 3B/3C Quiz, Legal Exam Questions Modules 1-3
The advanced nurse practitioner is routinely addressed as "doctor" by clinic patients. What is the best way for the nurse to handle this mistake?
Be certain patients are aware that the nurse is not a physician.
The nurse has a strong religious conviction against elective sterilization procedures. When seeking employment, how should the nurse handle this belief?
Be up front and discuss the issue during the employment interview.
As discussed by Professor Derrico, what type of malpractice lawsuits are actually decreasing in numbers?
Bedsores
Which ethical principle supports the argument that all newborns should be screened for HIV?
Beneficence
In an effort to attract clinic physicians, the hospital has agreed to provide a nurse to work in the physician's office. The nurse will work under the direction and supervision of the physician whose clinic is housed with the hospital building. Which doctrine most closely describes the conditions in which this nurse is working?
Borrowed servant
Upon entering a patient's room to complete discharge instructions the nurse discovers the patient in tears. The business office has stated that the patient cannot leave until someone pays a portion of the hospital bill. What should the nurse do?
Continue preparations for discharge, comforting the patient as much as possible.
The most frequently breached confidentiality is _________ (i think this is part of invasion of privacy)
patient update by phone
contributory negligence rule
patients who hold any part in the adverse consequences were barred from any compensation- so if they were noncompliant they dont get any thing
criminal and civil fall under which source of law
statutory
source of law for nurse practice acts
statutory
source of law for nursing licence laws
statutory
which source of law does license rules fall under
statutory
which source of law is nurse practice acts
statutory
deliberate altering of medical record or writing in an incorrect record may subject nurse to _____
statutory sanction- take away license
deontology= duty= we have a duty to do what 2 things
tell truth and not murder
b. The consequences of the action determine its merit
teological
utilitarianism
teological- is it right or wrong depends on how useful it is
_____ is all about the outcome, while ______ is all about the intent
teotological deontological
in given situations, the nature and degree of reasonable care expected of people providing care may differ depending upon which factor?
the individual's status as a professional
who deposes the witnes
the opposing attorney
which attorney usually doesnt want there to be a pre litigation panel
the plaintiff attorney
Standards of care exist for a number of reasons. what is their most basic purpose?
to protect & safeguard the public as a whole
6 types of intentional torts
1. assault 2. battery 3. trespass 4. conversion of property 5. false imprisonment 6. intentionally inflicting emotional distress
All AIDS cases must be reported to the Centers for Disease Control and Prevention or to the state health department.
. In general AIDS status is considered confidential.
A person who was injured in a motor vehicle accident sued the driver to recover hospital costs. Which type of law would be enforced in this situation?
1. Tort law
Which scenario best reflects direct supervision of a nursing assistant?
The nurse and the nursing assistant work together to provide care to a team of six patients.
A nurse who has an obvious physical disability applies for a staff nurse position. Which question, asked by the nurse recruiter, is legal?
"Are you able to fulfill the requirements of this job?"
A nurse executive has requested that additional budgetary funds be allocated to support staff seeking a baccalaureate degree in nursing or specialty certification. Which information should this executive provide during discussions of this funding?
"Nurse specialty certification has been shown to lower patient mortality." Lower failure-to-rescue rates "Education at the BSN level, when coupled with specialty certification, has been shown to reduce adverse patient outcomes."
A newly licensed nurse complains to the preceptor about the amount of time spent documenting in the medical record. What is the preceptor's best response?
"The most important reason we document is to help us communicate the patient's condition to the rest of the health care team."
Which statement, made by a staff nurse, would the nurse manager evaluate as evidence of good understanding of the importance of the electronic medical record?
"They say that our patient care will improve while we are using this system."
The limits of liability on an insurance policy are $1,000,000 for each claim, $4,000,000 aggregate. A nurse is charged in a serious situation in which five separate lawsuits have been filed. What is the most the insurance company will likely pay in this situation?
$1,000,000
which source of law is the board of nursing
administrative- they enforce statutory law
The nurse is searching for information about nurses' responsibility and accountability for appropriate delegation of tasks. Where should this nurse look for this information? Choose all that apply.
-ANA Code for Nurses -ANA Nursing Scope and Standards of Practice -State nurse practice acts -Nursing rules and regulations as promulgated by the state
The differences between medicine and nursing are becoming increasingly difficult to identify. Which options are reasons for the movement of these two professions toward each other? Choose all that are correct.
-Advent of specialty care units -Advancement of nursing skills -Changes in cultural climate -Increased focus on psychosocial components of care
When President Clinton signed the Health Insurance Portability and Accountability Act in 1996, many provisions concerning confidentiality of medical records became law. What were other provisions of this act? Choose all that apply.
-An antifraud and abuse program -Streamlining of transfer of patient information between insurers and providers
Which options reflect what the nurse should consider prior to administering medication? Choose all that are correct.
-Correct, common dosage for this patient -Action of the medication -Signs of untoward reaction to the medication
A growing body of research supports linkages between the educational status of nurses and which outcomes? Select all that are discussed in the textbook.
-Lower patient mortality rates -Fewer adverse outcomes
What elements does the insurance company that offers professional liability insurance verify under the exclusion portion of the policy? Choose all correct answers
-Nature of the insured's work -Licensure of the insured
What are care components common in the independent practice of a certified nurse midwife? Choose all that apply.
-Normal newborns -PAP smears -Physical examinations -Family planning counseling
Nurses who work on a medical unit do not have personal professional liability coverage. In the event of a lawsuit, which options are true? Choose all that are correct.
-They can be covered under the employer's insurance policy. -They need to contact their own attorneys. -They may be refused coverage under the employer's insurance policy.
A plaintiff's attorney decides to use the doctrine of res ipsa loquitor in a case against the urologist who perforated a patient's urethra during a cystoscopy. What must the plaintiff prove? Select all possible correct answers.
-This complication does not generally occur unless someone provided negligent care -The plaintiff had no control over the development of the perforation.
The limits of liability on an insurance policy are $1,000,000 for each claim, $4,000,000 aggregate. A nurse is charged in a serious situation in which five separate lawsuits have been filed. What is the most the insurance company will likely pay in this situation?
1,000,000 becasue all from same incident
A patient says, "I was told my back pain is the result care I received when I was in the hospital a year ago. How long do I have to file a lawsuit?" Which statements made by the nurse are appropriate?
1. "A general rule is 2 years from the time you knew what caused your injury." 2. "State laws differ on the statute of limitation for personal injury." 5. "In some cases it depends if the injury was due to trauma or disease."
ANA code of ethics
1. "This document describes nursing's own understanding of its commitments to society."
An emergency department patient was injured while attacking his neighbor with a knife. After treatment the patient was arrested and charged with battery and assault. Which classification or type of law would determine the case against this defendant?
1. Criminal law
Which situation creates an ethical dilemma for the nurse serving as an expert witness in a jury trial?
1. The documentation in the medical record contradicts itself. 2. There are time lapses in the documentation of the event resulting in the suit. 3. The interventions implemented only minimally met the standards of care.
A nurse is named in a lawsuit and has no professional malpractice insurance coverage. What is true of this situation?
1. The nurse can be held personally responsible for all damages assessed. 5. The nurse's best interests may not be protected during the case.
The health care facility has sponsored a continuing education offering on emergency management of pandemic influenza. At lunch, a nurse is overheard saying, "I'm not going to take care of anyone that might have that flu. I have kids to think about." What is true of this statement?
1. The nurse has a greater obligation than a lay person to care for the sick or injured in an emergency. 4. This statement is a breach of the Code of Ethics for Nurses.
What would the nurse identify as the most basic purpose of standards of care?
1. To protect and safeguard the public as a whole
give examples of malpractice charges (6)
1. didnt follow standards of care 2. didnt use equipment in reasonable manner 3. failure to communicate 4. failure to document 5. failure to assess and monitor 6. failure to act as patient advocate 7. medication error 8. bad teaching
6 elements of malpractice that must be proven by the plaintiff
1. duty owed 2. breach of duty 3. forseeability 4. causation 5. injury 6. damages
give 3 other examples of breaches of duty owed and therefore malpractice
1. giving wrong med 2. failure to report a change in status 3. omitting a scheduled med
To be considered an applied ethical issue, two key characteristics are important
1. issue is controversial 2. issue concerns a moral issue
3 differences between arbitration and real court
1. no court reporter 2. no record made 3. no rules of evidence
The nurse has been sued for defamation after charting that the patient is a prostitute. What is the nurse's best defense in this case?
2. Prove that the statement is true.
The nurse believes that a physician's order written at the end of a shift is contrary to the accepted standard of care and could potentially harm the patient. What should the nurse do?
2. Question the physician regarding the order.
A patient incident occurred on the nursing unit. What should the nurse caring for the patient do in regard to the incident report?
3. Include only the facts and the nurse's observations in the incident report. 5. Include documentation in the medical record about the event that mandated completion of an incident report.
The nurse is preparing a patient for a procedure. The patient has signed a consent form but states, "I don't really know anything about this procedure. I wonder if there is something else I could do instead?" How should the nurse proceed?
3. Stop the preparation as the patient can revoke consent at any time.
The court is establishing liability in a case in which several actions caused the plaintiff's injury. Which test of causation would be most useful in this case?
3. Substantial factor test- best test to pinpoint liability when several causes occur to bring a given injury. The but-for test is used to determine if the act or omission actually caused the injury or harm sustained and is not as related to the percentage of cause.
Which person would best qualify as an expert in a nursing malpractice case filed because of failure of a postanesthesia care unit nurse to recognize the early signs and symptoms of respiratory arrest?
4. A critical care nurse who holds a BS in nursing and certification from the American Association of Critical Care Nurses (AACN)
Which situation supports the charge of malpractice against a professional nurse?
4. A failure on the part of the nurse to exercise reasonable and prudent care in treating a patient
The nurse holds national certification as a wound care specialist and works in a small, rural hospital. What standard of skill and care applies to this nurse's practice?
4. It should be the same as that of an average nurse who also holds national wound care certification.
An emergency department nurse has agreed to testify as an expert witness in a lawsuit involving a child. The opposing attorney questions the nurse's qualifications as a pediatric nurse. Which type of law does this scenario reflect?
4. Procedural law
The patient scheduled for an above-the-knee amputation for a gangrenous toe received preoperative medication 20 minutes ago. When the transfer team arrives to take the patient to the operating suite, the nurse overhears the patient say, "I'll be so glad to get rid of my sore toe. I was afraid they would have to take my whole foot." What action should be taken by the nurse?
4. Stop the transfer and notify the surgeon of the patient's comment.- doesnt matter that he is medicated
A nurse is leaving the parking lot at the hospital and carelessly runs over a patient who was just discharged. Ironically, the nurse had been assigned to care for that patient that day. If the patient sues this nurse, which statement is true?
4. The nurse can be held liable for negligence but not malpractice.
In nursing school, the student learns that the nurse should always consider the possible outcomes of any nursing action taken. What ethical concept does this consideration support?
4. Therapeutic jurisprudence
In which case would the manufacturer of a drug designated as unavoidably unsafe be held liable for injuries to a patient receiving the drug?
If the physician was not warned of risks by the manufacturer
Home health care is an area in which the risk of lawsuit is higher than in many other practice areas.
: Home health care joins critical care, emergency departments, operating rooms, and maternal/child care as areas where the risk of lawsuits is higher.
A lawsuit has been filed claiming that a nurse's actions caused the death of a neonate. Why does the attorney for the plaintiff want to prove proximate cause? a) proximate cause determines how far the nurse's liability extends for consequences of the alleged negligent actions b) the need for expert witnesses is eliminated because harm can be approximated c) a direct line of causation, from incident to injury, is proved d) to identify if the harm could have been predicted to result from the action of the defendant
A
A medical technician working in a physician's office routinely refers to herself as a nurse. Which type of licensure protects that title as well as the professional actions associated with nursing? a) mandatory b) institutional c) transitional d) permissive
A
A newly licensed RN complains to the preceptor about the amount of time spent documenting in the medical record. What is the preceptor's best response? a) "The most important reason we document is to help us communicate the patient's condition to the rest of the health care team" b) "Since you just took a course in nursing research, you should realize the value of accurate documentation as a source of research data" c) "We have to document so that charges are clear to third-party payers" d) "The medical record protects us as if a lawsuit is filed"
A
A nurse appointed to the Florida Board of Nursing would expect work focused on which primary purpose? a) establishing a means of protecting the public at large b) ensuring that all schools of nursing seek national accreditation c) ensuring that all practicing nurses are competent d) restricting nursing practice through regulations
A
A nurse has agreed to participate in a videotaped deposition in a malpractice case. What does this indicate? a) the nurse's testimony can be presented in court, even though the nurse is unavailable for the trial date b) the nurse is testifying as an expert witness c) the plaintiff's attorney believes the nurse is a liability for personal trial appearance, but will be credible on tape d) the nurse is afraid testimony will adversely affect
A
A nurse named in a malpractice case may wish to avoid the expense of a trail by going to arbitration. What is another rationale for using this process? a) there is no formal record made of the arbitration process b) arbitration is not binding, so if the parties do not like the outcome, nothing is lost c) there is no need to have attorney representation d) witnesses do not testify under oath and are easier to obtain
A
A nurse returning to practice remarks that delegation is much more regulated and complicated than when she last practiced 20 years ago. What rationale would the nurse manager provide for this change? a) "The shortage of nurses has been the major reason that there are so many rules to follow when delegating." b) "Since nursing is trying to move back to the team approach to care delegation has become more important." c) "The introduction of multiple levels of professional staff members increases need for delegation rules and regulations." d) "The widespread return to primary nursing makes delegation more risky."
A
A physician reported a case of possible nursing malpractice to the Florida Board of Nursing. What action will be taken by the board? a) the complaint will be screened and an investigation initiated if appropriate b) nothing will be done as only another professional nurse is qualified to report nursing malpractice c) the nurse or nurses will be placed on probation pending investigation of the complaint d) the incident will be recorded as a "first strike" against the nurse or nurses invovled
A
Criminal charges have been brought against a nurse who made a medication error that resulted in a child's death. Which level of evidence is expected in this case? a) evidence beyond a reasonable doubt b) clear and convincing evidence c) discovery evidence d) preponderance of evidence
A
During a jury trial, the presence of a nurse-patient relationship is questioned. What kind of question is this and who would determine it? a) fact to be determined by the jury b) fact to be determined by the judge c) law to be determined by the judge d) law to be determined by the jury
A
Knowing the contents of one's job description can assist in providing care within the scope of the role. a) true b) false
A
Punitive damages of one million dollars were awarded to the family of a patient who died following a nursing medication error. What is true of these punitive damages? a) these damages are awarded to set an example to other nurses b) the jury believes the nurse's actions were an honest mistake c) this jury identified this case as representing simple negligence d) the damages are awarded instead of the nurse serving prison time
A
The ICU nurse manager has concerns that a staff nurse is no longer capable of competent patient care because of alcohol use. Repeated counseling sessions with the nurse have not changed the behaviors that are of concern. What action should be taken by the supervisor? a) report the concerns to the state board of nursing b) terminate the nurse's hospital employment c) transfer the nurse to a non-patient care position d) nothing as the nurse might sue the supervisor
A
The cardiac telemetry unit nurses repeatedly cautioned a patient not to leave the floor because input from telemetry monitors is limited to that area. The patient went to the cafeteria and suffered a fatal dysrhythmia. What is the nurses' best defense in the negligence lawsuit brought for the patient's survivors? a) assumption of risk b) defense of the fact c) immunity d) exculpatory agreement
A
The nurse is involved as an expert witness in a civil court case where life support was withdrawn and the patient subsequently died. Which level of evidence is expected for this case? a) clear and convincing evidence b) voir dire evidence c) preponderance of evidence d) evidence beyond a reasonable doubt
A
The patient demands to see the actual medical record of a hospitalization that occurred 1 year ago. How should the hospital handle this request? a) have the patient come to the hospital to review the original record b) do not comply with this demand unless the patient provides a subpoena for the record c) send the patient a copy of the medical record by registered mail d) deny the demand; the patient has no legal right to this record
A
The registered nurse has delegated the task of ambulating a patient to two nursing assistants. The patient appears to ambulate without assistance, but must be ambulated with two assistants due to a history of unexpected fall. What is the most important aspect of delegating this task? a) the aides understand the importance of walking with the patient b) the patient is comfortable walking with the aides c) the aides understand the patient is to be ambulated twice daily d) the patient understands the need for assistance
A
The registered nurse who works in the obstetrics department is walking by the emergency department waiting room when a person cries out, "Help me! My mother is not breathing!" Does this nurse have a duty to assist? a) yes, the general duty of care exists to help in times of crisis or imminent harm b) no, the nurse is out of the normal working environment and should not interfere c) no, the nurse has no more duty to assist in this situation than a lay person d) yes, the nurse has the duty to provide the same standard of care as an emergency department nurse
A
What would the nurse identify as the most basic purpose of standards of care? a) to protect and safeguard the public as a whole b) to ensure that all patients receive state-of-the-art care c) to protect health care providers and prevent their giving less than quality care d) to ensure administrative agencies are protected from frivolous lawsuits
A
Which common practice puts the nurse at liability for invasion of patient privacy? a) during care the nurse reveals information about the patient to those in the room b) the nurse releases information about the patient to nursing students who will be caring for the patient the next day c) the nurse conducts a patient care session about a patient whose care is difficult and challenging d) confidential information regarding an admitted patient is released to third-party payers
A
Which nurse would be most likely to be protected under the Age Discrimination Employment Act of 1967?
A 45-year-old nurse who was fired after complaining about a new policy
While vacationing in a different state the nurse encounters an emergency in which a person needs immediate care. What should the nurse assume about the Good Samaritan law of the state? Select all that apply.
A Good Samaritan law exists in the state. The Good Samaritan law in the state may be different than the one in the state of licensure.
A plaintiff's attorney decides to use the doctrine of res ipsa loquitur in a case against the urologist who perforated a patient's urethra during a cystoscopy. What must the plaintiff prove? Select all that apply. a) this complication doesn't generally occur unless someone provided negligent care b) the locality rules was in effect at the time of the procedure c) several agencies, from the manufacturer to the physician, were involved in the negligence d) the plaintiff had no control over the development of the perforation e) the event causing the perforation was deliberate
A and D
A patient incident occurred on the nursing unit. What should the nurse caring for the patient do in regard to the incident report? Select all that apply. a) include documentation in the medical record about the event that mandated completion of an incident report b) write a recommendation for future prevention of such incidents in the report c) carefully document the completion of an incident report in the nurse's notes d) assist the nursing supervisor who will write the report e) include only the facts and the nurse's observations in the incident report
A and E
The administration of a health care facility takes the ethical obligation of protecting patients very seriously. Which actions would help nurses meet standards of care? Select all that apply. a) create clearly written policy and procedure manuals b) encourage practitioners to find alternate, quicker ways to implement interventions c) refuse to tolerate those who are slow to adapt new standards of care d) emphasize protection of the hospital when developing internal standards and policies e) schedule regular views of policy and procedure manuals
A and E
The nurse discussing the Health Insurance Portability and Accountability Act (HIPAA) says, "I am aware that this act changed the way we handle confidential information." What other provisions of this act should the nurse consider? Select all that apply. a) an anti-fraud and anti-abuse program b) a law preventing portability of health care coverage c) establishment of state government as health care regulators d) tax incentives for preventive care e) streamlining of transfer of patient information between insurers and providers
A and E
Which situation supports the charge of malpractice against a professional nurse?
A failure on the part of the nurse to exercise reasonable and prudent care in treating a patient
Which situation supports the charge of malpractice against a professional nurse?
A failure on the part of the nurse to exercise reasonable and prudent care in treating a patient (Malpractice is based on the nurse breaching the standard to provide reasonable and prudent care or duty owed to the patient.)
Which person would be the best choice as an interpreter for a non-English-speaking patient?
A hospital-provided interpreter
What was the major impetus for more stringent delegation and supervision rules and regulations as they are applied today?
A major nursing shortage
In which situation is an occurrence-based policy most beneficial to the nurse?
A nurse had insurance coverage during 20 years of practice, but is now retired and no longer has an active policy- this is the answer because the rest have to do with buying the policy after the incident occured
Which situation meets the criteria of sexual favoritism or preferential treatment?
A nurse is awarded a position after having an affair with a supervisor.
In which situation is an occurrence-based policy most beneficial to the nurse?
A nurse who had insurance coverage during 20 years of practice, but is now retired and no longer has an active policy
Which person qualifies under the Americans with Disabilities Act?
A person who is a recovering alcoholic
The patient has just been admitted to the intensive cardiac care unit. Who should assess and document the patient's nursing needs?
A registered nurse
Which person best meets the criteria as a "member of a protected class" in a quid pro quo sexual harassment lawsuit?
A staff nurse as compared to his or her supervisor
The hospital policy and procedure manual states that medications should be charted immediately after administration. The nurse routinely charts the medications as they are being prepared for administration. What does this practice reflect?
A violation of hospital policy and procedure
The hospital policy and procedure manual states that medications should be charted immediately after administration. The nurse routinely charts the medications as they are being prepared for administration. What does this practice reflect?
A violation of hospital policy and procedure (This practice is a violation of the policy and procedures of the hospital and therefore is a violation of standard of care.)
A lawsuit has been filed against the hospital for terminating an employee for excessive tardiness and absenteeism. The defendant's attorney has contacted nurses who worked with this employee to testify in the case. Which statements would best support the defendant's case? Select all that apply.
A) "Her absences affected the work flow on our unit." B) "She often asked me to cover for her while she took her kids to school." D) "The employee called in sick on several consecutive Fridays."
A nurse reads that a case involving the care provided in a hospital will be reviewed by the United States Supreme Court. The nurse suspects that which situations could have occurred? Select all that apply.
A) The hospital involved is a military hospital. (Typically the care in a civilian hospital would be under the jurisdiction of state courts. Cases involving military, veterans', or other federally funded health centers are frequently settled in federal courts. This may result in Supreme Court review.) B) Two lower federal courts have reached different conclusions in the case. C) The case involves a constitutional issue. (The U.S. Supreme Court reviews cases in which constitutional issues have been decided.)
Which action could result in the nurse being charged with conversion of property? Select all that apply. a) the nurse removes the patient's shirt and bra during treatment of a fractured ankle b) the nurse removes a package of cigarettes from a patient's robe pocket c) the nurse takes the patient's picture without permission d) the nurse searches a patient's suitcase for evidence of illegal drugs e) the nurse places a patient in four point restraints to place an NG tube
A, B
In providing quality nursing care, the following can be utilized and followed. Select all that apply. a) Identify and know your personal strengths and weaknesses b) follow safety protocols with medication administration of a drug when you are unfamiliar with the pharmacodynamics c) use SBAR only when you don't understand the provider's orders d) become and remain a life-long learned in the nursing profession e) safe and clear delegation of tasks to assistive personnel
A, B, D, E
A patient says, "I was told that my back pain is the result of care I received when I was in the hospital a year ago. How long do I have to file a lawsuit?" Which statements made by the nurse are appropriate? Select all that apply. a) "State laws differ on the statute of limitation for personal injury" b) "A general rule is 2 years from the time you knew what caused your injury" c) "It is too late if you knew you had back pain right after the fall" d) "You should move to Washington because their statute of limitation is longer" e) "In some cases it depends if the injury was due to trauma or disease"
A, B, and E
A nurse has delegated the task of ambulating a patient to two nursing assistants. Despite the patient's appearance, assistance of two people is needed for safe ambulation. The nurse discovers the patient being ambulated by only one aide. What should be the nurse's first action?
Assist the aide in completion of the ambulation.
A nurse is scheduled to appear before the state board of nursing in regard to action against the nurse's license. Which occurrences would violate due process of law? Select all that apply. a) the time of the hearing was changed without adequate notice to the nurse b) the nurse was suspended by her private employer pending the outcome of this action c) the nurse was told the meeting was in regard to a complaint about the agency where the nurse was employed d) a tropical storm forced postponement of the board meeting until next month e) other nurses involved in the situation leading to the action were not similarly summoned before the board
A, C
In which scenarios would the nurse assume that apparent consent has been provided? Select all that apply. a) the patient follows directions to swallow sips of water as the nurse inserts an NG tube b) the patient's family member signed the consent to treat c) the patient smiled and held out his arm when the nurse said, "I need to start an IV line" d) the patient voluntarily signed a consent form for an invasive procedure e) an unconscious patient is brought to the hospital following a motor vehicle accident
A, C
A nurse working in the intensive care unit (ICU) notes that a patient is more confused and agitated than yesterday. Which nursing actions are evidence of patient advocacy? Select all that apply. a) the nurse assesses for common causes of confusion and agitation b) tell the family that confusion and agitation frequently occur after ICU admission c) the nurse contacts the patient's primary care provider regarding the confusion d) the nurse documents findings and actions in the medical record e) ask for assistance from the nurse manager if necessary
A, C, D, and E
Hospital administration requires that the committee seeking to change nursing policy and procedures review external sources for these standards. Where should the committee look for these standards? Select all that apply. a) current nursing literature b) individual nurse's experience and education c) federal organizations d) the hospital's position job descriptions e) state boards of nursing
A, C, E
While vacationing in a different state, the nurse encounters an emergency in which a person needs immediate care. What should the nurse assume about the Good Samaritan law of this state? Select all that apply. a) a Good Samaritan law exists in the state b) the nurse has a legal obligation to provide emergency care c) the nurse will be protected by the Good Samaritan law in the state of licensure d) the Good Samaritan law in this state may be different than the one in the state of licensure e) there is a standard definition of what constitutes an emergency
A, D
guide to carry out nursing responsibilities in a manner consistent with quality in nursing
ANA code of ethics
are the judgements legally binding and can they be appealed
ARE binding and CANNOT be repealed
A patient who is terminally ill is experiencing extreme pain and suffering. The patient says, "If I were an animal, you would put me out of this misery." Which intervention would the nurse be ethically correct in providing as a last-resort option for this patient?
Administer sedative medications sufficient to cause unconsciousness.Sedation to unconsciousness is a valid alternative at the end-of-life.
What is the most important driving force behind the movement for multistate licensure?
Advancing technologies, especially telehealth and telephone triage
Which information would the nurse provide as rationale for supporting the nurse licensure and mutual recognition movements?
Advancing technologies, especially telehealth and telephone triage makes single state licensure problematic.
A nurse is preparing information to be distributed at a national conference on AIDS. What should be included regarding mandatory disclosure of AIDS status?
All AIDS cases must be reported to the Centers for Disease Control and Prevention or to the state health department.
A nurse is preparing information to be distributed at a national conference on HIV/AIDS. What should be included regarding mandatory disclosure of HIV/AIDS status? Select all that apply.
All HIV/AIDS cases must be reported to the Centers for Disease Control and Prevention or to the state health department. In general HIV/AIDS status is considered confidential.
The medical staff of a hospital express concern that advanced nurse practitioners are in direct competition with them for patients. The physicians advise hospital management that they will stop admitting patients if admitting privileges are granted to the ANPs. Which type of laws might be useful to help the ANPs obtain hospital admittance privileges?
Antitrust laws
The nurse says, "I'm not spending my money and my time off to go to continuing education." How should this statement be interpreted in relation to the duty owed the employer?
As unreasonable. Staying current is a duty the nurse owes to the employer.
The nurse comes upon a motor vehicle accident with injury and stops to help. What should be the nurse's first action?
Ask for permission to help.
The nurse is stopped at the scene of a motor vehicle accident with injury. What actions should the nurse take? Select all that apply.
Ask the injured person for permission to help. Move the patient only if it is necessary to prevent further harm. Instruct someone to call for additional aid.
The cardiac telemetry unit nurses repeatedly cautioned a patient not to leave the floor because input from telemetry monitors is limited to that area. The patient went to the cafeteria and suffered a fatal dysrhythmia. What is the nurses' best defense in the negligence lawsuit brought for the patient's survivors?
Assumption of risk
The cardiac telemetry unit nurses repeatedly cautioned a patient not to leave the floor because input from telemetry monitors is limited to that area. The patient went to the cafeteria and suffered a fatal dysrhythmia. What is the nurses' best defense in the negligence lawsuit brought for the patient's survivors?
Assumption of risk (States that the plaintiffs are partially responsible for consequences if they understood the risks involved when they proceeded with the action.)
The cardiac telemetry unit nurses repeatedly cautioned a patient not to leave the floor because input from telemetry monitors is limited to that area. The patient went to the cafeteria and suffered a fatal dysrhythmia. What is the nurses' best defense in the negligence lawsuit brought for the patient's survivors?
Assumption of risk states that plaintiffs (in this case the patient) are partially responsible for consequences if they understood the risks involved when they proceeded with the action
A nurse has been called to testify in a malpractice lawsuit. Which information should the attorney provide about the process of cross-examination? a) cross examination allows the nurse to ask questions of the opposing counsel b) during this process opposing counsel will try to refute the nurse's testimony c) cross examination is a process to ensure that both attorneys question all witnesses d) this process allows opposing counsel to explain the meaning of the nurse's testimony
B
A nursing advocacy organization would like to advocate for a modification of the Florida Nurse Practice Act and believes the best strategy is to contact the persons with authority to write and change this statutory law. Whom should the organization contact? a) Florida Nursing Association b) State legislature c) Governor of Florida d) Florida Board of Nursing
B
A patient brought suit against a hospital for injuries sustained in a fall. The case went to trial and the jury found for the hospital. Can the patient take this same suit and evidence to another trial court in hopes of a different decision? a) no, this is a landmark decision b) no, because of the doctrine of res judicata c) yes, stare decisis allows retrial d) yes, because of the doctrine of precedent
B
In caring for a 6-year-old who entered the emergency center for treatment of a broken arm, the nurse noted that the child had multiple bruises on his trunk and legs. When questioned, the child said his father hit him and broke his arm so that the child would remember to be good. What should the nurse do? a) chart that the child is a victim of child abuse, so that there is a record of the abuse should such behavior reoccur b) report the incident immediately to the nursing supervisor or physician so that the incident will be reported to the proper authorities c) do nothing, because the nurse can't prove the child was really abused, and saying anything could open the institution to a possible defamation lawsuit d) downplay the child's comments, because children often exaggerate
B
In which scenario is the nurse providing indirect supervision of a nursing assistant? a) the nursing assistant and nurse work on the same team, jointly providing care to inpatients b) the nurse is easily contactable by phone but is not present in the care environment c) the nurse makes rounds on the patient care units, observing the nursing assistant's work, at least every 2 hours d) the nursing assistant receives constant instruction regarding patient care from the nurse
B
The hospital-employed nurse volunteered to assist with physical examinations for athletes at the local high school. How does this situation affect the nurse's hospital malpractice insurance? a) the nurse is covered by the hospital's malpractice insurance as a community volunteer b) the nurse is very likely not covered by any malpractice insurance c) the nurse is covered by the school's insurance d) the nurse is exempt from liability for any occurrences because of the volunteer status of the work
B
The nurse has been sued for defamation after charting that the patient is a prostitute. What is the nurse's best defense in this case? a) define the contributing factors b) prove that the statement is true c) no defense exists for defamation d) provide hearsay evidence
B
The parents of a 17-year-old who is receiving state-funded substance abuse treatment have asked the provider for information about their child. What is the correct action by the health care provider? a) refuse the request as it is likely to interfere with the treatment plan b) release information only if the patient has signed consent to do so c) refuse the request pursuant to the provision of the common-law duty to disclose d) release the information immediately as parents always can receive information on minor children
B
The student nurse is searching for the legal guide to the practice of registered nurses. Which document should the nurse review? a) ANA code of ethics b) state nurse practice act c) nurse's bill of rights d) nightingale pledge
B
Upon entering a patient's room to complete discharge instructions, the nurse discovers the patient in tears. The business office has stated that the patient cannot leave until someone pays a portion of the hospital bill. What should the nurse do? a) call social services to request an immediate financial evaluation b) continue preparations for discharge, comforting the patient as much as possible c) stop discharge preparations until the patient is cleared by the billing office d) cancel the discharge plans and notify the physician of the patient's status
B
What does the court consider in determining the nurse's legal liability for standards of care? a) professional conduct, but not experience or education b) professional education, experience, and specific conduct c) professional education, but not experience or conduct d) professional experience, but not education or conduct
B
What is the single most critical factor in determining whether a particular nurse acted with reasonable care in a given situation? a) the number of years the nurse has practiced as a professional nurse b) how the nurse's conduct compares to that of nurses with similar background and experience c) the experience the nurse has in the particular clinical setting in which the situation occurred d) the ability of the nurse to perform according to his or her job description
B
Which statement, made by a staff nurse, would the nurse manager evaluate as evidence of good understanding of the importance of the electronic medical record? a) "Since nurses are the only ones using this system, I won't have to wait to document anymore" b) "They say that our patient care will improve while we are using this system" c) "I hope we don't have to keep changing passwords" d) "I'm gland that it will take less time for us to document"
B
A nurse is preparing information to be distributed at a national conference on HIV/AIDS. What should be included regarding mandatory disclosure of HIV/AIDS status? Select all that apply. a) all babies born in the U.S. are tested for presence of HIV at birth b) in general HIV/AIDS status is considered confidential c) all HIV/AIDS cases must be reported to the CDC and Prevention or to the state health department d) every state requires that all sexual contacts of a person diagnosed with HIV/AIDS be contacted and treated e) HIV/AIDS status must be disclosed to any health care provider who has cared for the patient within the last 18 months and to any future health care provider
B and C
The patient brings suit against a health care provider. In which ways would the nurse expect this action will affect the confidentiality of the patient's medical record? Select all that apply. a) the record loses confidentiality and is discoverable by any interested party b) the record will be released to the defendant's attorney c) the patient's attorney will have access to the information in the record d) the confidentiality of the record will remain intact e) only the judge will have full access to the medical record
B and C
The patient decides to discontinue standard medical treatment for diabetes mellitus and to rely on diet and herbal medications for blood sugar control. Which statements, made by the nurse, are appropriate? Select all that apply. a) "You are an adult and can do anything you want to do" b) "We need to talk about how medications work to control diabetes mellitus" c) "Tell me more about why you decided to make this change" d) "Don't you know that you are gambling with your health?" e) "I think that would be a mistake"
B and C
In which situations would the state board of nursing have probable grounds for disciplining a nurse? Select all that apply. a) the nurse can no longer lift 30 pounds b) the nurse fails to report a co-worker who is working outside his scope of practice c) the nurse questioned a direct physician order d) the nurse made a false statement on the licensure application e) the nurse told a co-worker that she is taking antidepressant medications
B and D
Which scenarios would the nurse identify as a quasi-intentional tort rather than an intentional tort? Select all that apply. a) a visitor refuses to leave the patient's room after upsetting the patient and being asked to leave b) the physician accuses the nurse of incompetence in front of the patient's family c) the nurse tells the patient that if he does not start drinking fluids, and IV line will be necessary d) the nurse physically restrains a patient so that IV access can be obtained e) the nursing student takes a cellphone picture of a patient's leg wound to show her classmates
B and E
A patient says, "I was told my back pain is the result care I received when I was in the hospital a year ago. How long do I have to file a lawsuit?" Which statements made by the nurse are appropriate? Select all that apply.
B) "A general rule is 2 years from the time you knew what caused your injury." C) "State laws differ on the statute of limitation for personal injury." (State laws differ widely on statutes of limitations. This is a fact that the nurse would be justified in providing to a patient.) E) "In some cases it depends if the injury was due to trauma or disease."
A nurse is scheduled to appear before the state board of nursing in regard to action against the nurse's license. Which occurrences would violate due process of law? Select all that apply.
B) The time of the hearing was changed without adequate notice to the nurse. C) The nurse was told the meeting was in regard to a complaint about the agency where the nurse was employed.
Which statement best describes the rule regarding expert testimony in nursing malpractice cases?
B) Whether expert testimony is needed is decided on a case-by-case basis after analyzing the facts of the case. (Expert testimony is used to help the jury make conclusions that may involve facts or scientific information that is more than common knowledge. Use of expert testimony is considered on a case-by-case basis.)
The nurse is stopped at the scene of a motor vehicle accident with injury. What actions should the nurse take? Select all that apply. a) start assessing the injured as is required by all registered nurses b) ask the injured person for permission to help c) move the patient only if it is necessary to prevent further harm d) instruct someone to call for additional aid e) graciously accept any payment the injured patient may offer
B, C, and D
A nurse has been called to testify in a case that will be tried in family court. The nurse anticipates that the case will involve one of which situations? Select all that apply. a) child abuse b) divorce c) child custody d) estate division e) adoption
B, C, and E
A lawsuit has been filed against the hospital for terminating an employee for excessive tardiness and absenteeism. The defendant's attorney has contacted nurses who worked with this employee to testify in the case. Which statements would best support the defendant's case? Select all that apply. a) "I didn't really know, I don't work the same shift" b) "She often asked me to cover for her while she took her kids to school" c) "She was never late or absent during the 6 months I worked with her" d) "Her absences affected the work flow on our unit" e) "The employee called in sick on several consecutive Fridays"
B, D, and E
The nurse has recently assumed the position of chief nurse in a long-term care facility with a record of poor patient care. How should this nurse approach the issue of effective discipline regarding patient care activities? Select all that apply. a) fire any nurse who doesn't meet established standards of care b) firmly enforce the standards of care guiding the facility c) set variable standards of care depending upon the nurse's previous experience d) establish a discipline system that is progressive e) encourage supervisors to be consistent in applying discipline
B, D, and E
The nurse is providing care to a patient whose family has previously brought suit against another hospital and two physicians. How should the nurse provide care to this patient? Select all that apply. a) spend as little time as possible interacting with the patient and family so that there will be less chance of saying the wrong thing or performing in an incompetent manner b) provide care in a compassionate, competent manner c) assign the patient to a different nurse each day so that no one nurse has to work under this stress d) keep the patient will informed by explaining all interventions before and during their completion e) review standards of care that pertain to this patient before providing care
B, D, and E
A lawsuit is brought against a nurse in a rural hospital. The nurse replies that the standard of care for rural nurses is different from that for nurses working in large urban facilities. Is this a defensible position? a) no; rural nurses work in a slower paced environment, so they have more time to provide quality personal care b) yes; the rural nurse does not have access to the same quality of inservice education as the urban nurse c) no; nurses in rural settings must meet the same standards as those practicing in large urban areas d) yes; it is well known that rural health care is substandard as compared to urban health care.
C
A newly hired nursing assistant can work only when under direct supervision by a registered nurse. In which way can this assistant provide care? a) the nursing assistant charts care in the patient's medical record and the nurse reviews that charting on a regular basis b) the nursing assistant provides hygienic care according to protocols approved by the nurse c) the nurse and the nursing assistant work together to provide care to a team of six patients d) the nurse is available on the unit while the nursing assistant provides care
C
A patient became confused and used a pocket knife to threaten others. The nurse confiscated the knife. What is the nurse's best defense for this action? a) privilege b) self-defense c) necessity d) consent
C
A patient brought into the emergency department was injured while he subsequently attacking his neighbor with a knife. After treatment for his wounds, the patient was arrested and charged with assault and battery. Which classification or type of law would determine the case against this individual (the defendant)? a) civil law b) constitutional law c) criminal law d) private law
C
A person who was injured in a motor vehicle accident sued the driver to recover hospital and therapy costs. Which type of law would be enforced in this situation? a) public law b) procedural law c) tort law d) constitutional law
C
As part of conversion to a new electronic medical record format, a hospital is also instituting charting by exception. The nurse manager would caution staff nurses that charting by exception has which major drawback? a) it is not admissible in court because there is not enough background in the documentation b) this method takes much more time than narrative charting c) it may not provide enough information to support trending of the patient's condition d) it does not allow for use of uniform standards
C
Hospital management has identified quality of care issues that center around coordination of multidisciplinary services. Which classification of advanced practice nurse would be the best choice to help address these issues?
Clinical nurse leader
The charge nurse has delegated a task to another staff member. Who assumes accountability for the task? a) it is held jointly by the charge nurse and the person performing the task b) it can be imputed to either the charge nurse or the person performing the task c) the charge nurse retains the accountability d) accountability is transferred to the person performing the task
C
The hospital nursing group has reviewed current nursing and federal literature to establish standards of care for a newly organized patient care unit. The final report generated by this group should assure hospital administration that the standards meet which level of care? a) mutually acceptable b) worldwide c) national d) locality
C
The nurse has been named in a lawsuit claiming a patient was injured due to her negligence. The nurse dropped her personal professional liability insurance several months ago, but believes the policy may have been in effect at the time of the incident. In which part of the policy would the nurse look for information about the coverage period? a) deductibles b) exclusions c) declarations d) liabilities
C
The nurse has been named in a lawsuit claiming a patient was injured due to her negligence. The nurse dropped her personal professional liability insurance several months ago, but believes the policy may have been in effect at the time of the incident. In which part of the policy would the nurse look for information about the coverage period? a) deductibles b) excusions c) declarations d) liabilities
C
The plaintiff was injured by a defective intravenous catheter. In order to win a product liability case, what must the plaintiff prove first? a) the IV catheter was defective b) the IV catheter was used incorrectly c) the IV catheter was sold to him d) the hospital purchases the poorly manufactured IV catheters
C
When a patient became confused and dangerous to himself and others in the setting, restraints were applied, and the patient was confined to bed. What is the nurse's best defense for applying restraints? a) necessity b) consent c) self-defense d) privilege
C
The home health nurse discovers that a home-bound cancer patient is using marijuana to control nausea from chemotherapy. What advice should the nurse give this patient? Select all that apply. a) the effect of marijuana on decreasing nausea is fleeting and not worth the health problems caused by using it b) since the patient is home-bound, it is likely the use of marijuana will not be discovered by anyone else c) possession of marijuana is illegal under federal law d) some states have current legislative guidelines for legal possession of medical marijuana e) as long as it is documented that an illness exists that can be treated with marijuana, no risk of prosecution is present
C and D
A nurse is served with a summons alerting him that he has been named in a malpractice lawsuit. What information can the nurse learn from this summons? Select all that apply. a) breaches in standards of care, injuries, or damages alleged by the defendant b) expected length of the trial c) names of any other defendants in the case d) name of the plaintiff in the case e) date to appear before the court
C, D, and E
The nurse working in a physician's office recorded assessment data in the wrong patient's medical record about 1 hour ago. How should the nurse correct this error? Select all that apply. a) black out the error with a marker and enter the new information b) enclose the corrected information in brackets to set if off from the original post c) indicate the date and time the correction was made d) indicate the reason the correction is being made by writing "wrong patient chart" along with the new information e) either initial or sign the correction
C, D, and E
Under a claims-made insurance policy, for which claim is the nurse protected?
Claims that are filed for incidents during the active period of the policy
Upon entering a patient's room to complete discharge instructions, the nurse discovers the patient in tears. The business office has stated that the patient cannot leave until someone pays a portion of the hospital bill. What should the nurse do?
Continue preparations for discharge, comforting the patient as much as possible. (The nurse must continue to practice within the nursing scope of practice. This situation could be construed to represent false imprisonment.)
The hospital has recently eliminated all nursing assistant positions and has replaced them with unlicensed assistive personnel (UAP) to provide patient care. How should the professional nursing staff work with these new employees?
Continue to delegate and supervise them as they did with the nursing assistants.
A confused patient frequently calls out for "help" throughout the shift. When nursing staff respond to the call, the patient is unable to explain what is needed. What action should be taken by the nurse?
Continue to respond and attempt to reorient the patient.
The hospital acts to revoke the clinical privileges of a physician who has repeatedly refused to respond to emergency calls from nursing staff. Under which doctrine is this action advisable?
Corporate liability
How can health care best ensure that all of its practitioners meet current standards of care?
Create clearly written, easily updated policy and procedure manuals.
An emergency department patient was injured while attacking his neighbor with a knife. After treatment the patient was arrested and charged with battery and assault. Which classification or type of law would determine the case against this defendant?
Criminal Law (Criminal Law is appropriate in this case because the act against the neighbor was of a nature that was offensive and harmful)
A nurse is leaving the parking lot at the hospital and carelessly runs over a patient who was just discharged. Ironically, the nurse had been assigned to care for that patient that day. If the patient sues this nurse, which statement is true? a) the nurse cannot be held liable for either malpractice or negligence based upon this set of facts b) the nurse can be held liable for both negligence and malpractice c) the nurse can be held liable for malpractice but not negligence d) the nurse can be held liable for negligence but not malpractice
D
A patient refused to ambulate postoperatively and subsequently developed bilateral pneumonia, causing his hospital stay to be lengthened. After discharge, the patient filed a lawsuit claiming his primary nurse was negligent in allowing him to develop pneumonia. What is the nurse's best defense in this case? a) the patient was told that complications could arise when signing the informed consent form b) the patient should have anticipated a longer hospital stay if complications arose c) the patient was aware of the substandard care at the time it occurred d) the patient's conduct contributed to his complications
D
A patient, injured at work, was seen by the factory occupational nurse. The nurse treated the wound and instructed the patient to get a tetanus antitoxin injection at the county health department. The patient failed to follow instructions, developed tetanus, and subsequently filed a suit against the nurse. What is the most likely result of the ensuing trial? a) the nurse is not liable, because tetanus is a reportable disease and the health department should have insisted the patient take the injection b) the nurse is liable, because there was no follow-up to ensure that the patient received the injection c) the nurse is liable, because tetanus is easily treatable after diagnosis d) the nurse is not liable for damages, because the nurse has a right to expect that instructions will be followed
D
An out-of-state caller becomes irate when the nurse cannot provide information over the telephone about a hospitalized friend. The caller says, "If you know what is good for you, you had better tell me." Has a civil assault occurred? a) yes, there is an indication that the caller has the physical strength to do harm b) yes, the threat of harm is assault c) no, actual physical contact must be made for it to be assault d) no, the caller is out of state and cannot reach the nurse
D
The Board of Directors for General Hospital, state funded hospital elects to limit surgical procedures for morbid obesity to male patients. Female patients receive pharmacologic therapy, counseling, and instruction for diet and exercise, but are excluded from operative procedures. Under which legal concept is this illegal? a) stare decisis b) due process of law c) res judicata d) equal protection under the law
D
The hospital policy and procedure manual states that medications should be charted immediately after administration. The nurse routinely charts the medications as they are being prepared for administration. What does this practice reflect? a) use of the two schools of thought doctrine b) logical and appropriate variation in practice c) an honest error in judgment d) a violation of hospital policy and procedure
D
The nurse believes that her need for individual malpractice insurance is decreased because she practices in a small-town home health agency. What is true about this situation? a) residents of small towns are less likely to bring suit than residents of urban areas b) slower paced environments, such as home health care, are less likely to create situations in which the nurse makes an error c) nurses working in home health are covered by mandatory federal malpractice insurance policies d) home health care is an area in which the risk of lawsuit is higher than in many other practice areas
D
The nurse holds national certification as a wound care specialist and works in a small, rural hospital. What standard of skill and care applies to this nurse's practice? a) it should be equal to that of any other wound care specialist in the nation b) it should be the same as that of any nurse who provides wound care c) it should be equal to the practice of a wound care specialist working in the largest facility in the state d) it should be the same as that of an average nurse who also holds national wound certification
D
The 4-year-old child developed a seizure disorder that may be related to a medication error that occurred 3 years ago. What is true of the statute of limitations in this case?
Depending upon the state, the statute of limitations might not begin to be calculated until the child reaches the age of majority.
The nurse manager is aware that several patients will be admitted to the unit today. Today's staff includes three registered nurses, two licensed practical nurses, and three unlicensed nursing assistants. Who should the manager expect to assess and document the admitted patient's nursing needs? a) the nursing assistant b) the admitting physician c) a licensed practical or vocational nurse d) a registered nurse
D
The nursing student began a case study paper by writing, "J.P., a 65-year-old Asian male, was admitted to the intensive care unit at Southwest Hospital." What is the significance of this statement? a) it is incomplete, as the patient's physician's name should be included b) it is incomplete, as the date and time of admission should be included c) it is a good description of the patient to begin the paper d) it violates HIPAA regulations
D
Which situation supports the charge of malpractice against a professional nurse? a) a failure on the part of the nurse to allay a patient's fears about an upcoming procedure b) a failure on the part of the nurse to ensure that patients only received care for which they could pay c) a failure on the part of the nurse to establish a therapeutic relationship with the patient d) a failure on the part of the nurse to exercise reasonable and prudent care in treating a patient
D
Depositions will be taken of witnesses in a wrongful termination suit filed against the hospital by a former employee. Which information should the attorneys provide to the witnesses that will be deposed? Select all that apply. a) witnesses being deposed will be questioned by their attorney b) once the testimony is recorded no changes can be made to the record c) the deposition will be taken in a courtroom with a judge in attendance d) the witnesses may refer to notes during the disposition e) the testimony provided is sworn testimony
D and E
The 8-year-old child developed a seizure disorder that may be related to a medication error that occurred 3 years ago. What is true of the statue of limitations in this case?
Depending upon the state, the statute of limitations might not begin to be calculated until the child reaches the age of majority.
The survivors of a patient who unexpectedly died in a hospital contact an attorney regarding a wrongful death against the hospital and two nurses. Review of the hospital's pertinent policy and procedures found them to be current. Review of the medical record revealed that policy and procedures were followed by the nurses. Based on this information, what is the likely strength of this case? Select all that apply. a) the survivors have a good case since hospital policy and procedures do not supersede national standards b) the survivors have a good case since the death was unexpected c) since the patient is dead and can't report variation from the standards no case is possible d) the case against the nurse is weak since they followed hospital policy and procedures e) the case against the hospital is weak since policies and procedures are current
D and E
An employee asks for time off to be a juror in a case before the state appellate court. The unit is very busy and this employee's absence would affect patient care. How should the nurse manager respond to this request? Select all that apply.
D) Tell the employee that service as a juror for this case is not required. E) Ask the employee more questions about the request.
Depositions will be taken of witnesses in a wrongful termination suit filed against the hospital by a former employee. Which information should the attorneys provide to the witnesses that will be deposed? Select all that apply.
D) The testimony provided is sworn testimony. (The deposing witness is under oath during the entire deposition. Once the deposition is reviewed and signed by the witness it becomes sworn testimony.) E) The witness may refer to notes during the disposition. (The witness may bring medical records, notes, and literature sources to the deposition, and may refer to them as needed during the deposition.)
A nurse has been called as a lay witness in a malpractice lawsuit. What information should be provided to the nurse regarding this testimony? Select all that apply.
D) These witnesses tell only what has transpired from their perspective. (Testimony is a presentation of factual information that an individual can relay relevant to his or her own perspective.) E) The lay witness must have a direct connection to the case. (Nurses may be called to serve as a lay witness to describe for the jury what, when and how a particular event occurred. The nurse must have a direct connection to the case in order to provide this information.)
The nurse is reviewing a professional liability policy for the time period the policy is in effect. Under which section of the policy should this nurse look?
Declarations
The nurse has been named in a lawsuit claiming a patient was injured due to her negligence. The nurse dropped her personal professional liability insurance several months ago, but believes the policy may have been in effect at the time of the incident. In which part of the policy would the nurse look for information about the coverage period?
Declarations- Declarations include the "demographics" of the policy: the policyholder's name, address, covered professional occupation, and the covered time period.
Which option reflects one of the more convincing arguments for the nurse having individual malpractice insurance?
Defending against a lawsuit is costly in today's society.
Which option reflects a change that may occur in the roles of advanced practice nurses?
Development of a new category to include clinical nurse specialists and advanced nurse practitioners
A nurse has been called to testify in a case that will be tried in family court. The nurse anticipates that the case will involve one of which situations? Select all that apply.
Divorce Adoption Child Custody
Which impairments are covered by the Americans with Disabilities Act?
Either physical or mental impairments
A county-supported hospital elects to limit surgical procedures for morbid obesity to male patients. Female patients receive pharmacologic therapy, counseling, and instruction for diet and exercise, but are excluded from operative procedures. Under which legal concept is this illegal?
Equal protection under the law (Equal protection under the law holds that all similarly situated persons will be affected similarly.)
In passing the Americans with Disabilities Act of 1990, Congress attempted to combine disability with which other legal concept?
Equality
The nurse has recently assumed the position of chief nurse in a long-term care facility with a record of poor patient care. How should this nurse approach the issue of effective discipline regarding patient care activities?
Establish a formal discipline plan to be used when standards of care are not followed.
During a jury trial, the presence of a nurse-patient relationship is questioned. What kind of question is this and who would determine it?
Fact to be determined by the jury
As discussed by Professor Derrico, events related to the use of patient-controlled analgesia (PCA) are not common reasons for malpractice lawsuit to be initiated.
False
The survivors of a patient who unexpectedly died in a hospital brought suit for wrongful death against the hospital and two nurses. Review of the hospital's pertinent policy and procedures found them to be current. Review of the medical record revealed that policy and procedures were followed by the nurses. What is the likely outcome of this suit?
Find for the nurses, since they followed hospital policy and procedures.
A nurse was granted twelve weeks' leave under the Family and Medical Leave Act for care of an adult son. At the conclusion of the twelve weeks the nurse does not want to return to work. Under which situation might the leave be extended?
If the son is a member of the National Guard
A nurse would like to advocate for a modification of the state's nursing practice act and believes the best strategy is to contact the persons with authority to write and change this statutory law. Whom should the nurse contact?
Florida Legislature (State legislative bodies create and pass the individual nursing practice acts (statutory laws) and create state boards of nursing or state boards of nurse examiners (state administrative agencies) to implement and enforce those acts.)
How has the present legal environment affected the frequency with which nurses are named in suits for malpractice?
Frequency is greater than 15 years ago.
How should the nurse proceed when caring for a suit-prone patient?
Give the same compassionate, competent care that all patients receive
A nursing student reports that her grandmother served as a nurse in World War II. At the end of the war, her grandmother was licensed as a nurse, even though she never graduated from nursing school. Which type of exemption from licensure does this reflect?
Grandfather clause
The patient demands to see the actual medical record of a hospitalization that occurred 1 year ago. How should the hospital handle this request?
Have the patient come to the hospital to review the original record.
The patient demands to see the actual medical record of a hospitalization that occurred one year ago. How should the hospital handle this request?
Have the patient come to the hospital to review the original record.
The nurse believes that her need for individual malpractice insurance is decreased because she practices in a small-town home health agency. What is true about this situation?
Home health care is an area in which the risk of lawsuit is higher than in many other practice areas.
The hospital nursing group establishing standards of care for a newly organized patient care unit is looking for internal sources for these standards. Where should these nurses look?
Hospital policy and procedures manuals
What is the single most critical factor in determining whether a particular nurse acted with reasonable care in a given situation?
How the nurse's conduct compares to that of nurses with similar background and experience
What is the single most critical factor in determining whether a particular nurse acted with reasonable care in a given situation?
How the nurse's conduct compares to that of nurses with similar background and experience. (While the characteristics of the individual nurse are relevant factors, the nurse's practice will be compared to internal and external standards of care that are practiced by other nurses possessing similar background and experience.)
As discussed by Professor Derrico, what is the common stance of the plaintiff related to documentation?
If it is not documented, it was not done.
A patient incident occurred on the nursing unit. What should the nurse caring for the patient do in regard to the incident report?
Include only the facts and the nurse's observations in the incident report.
The plaintiff was awarded monetary damages from the hospital in a suit resulting from a nurse's negligence. Under which principle is it possible for the hospital to sue the nurse to recover the amount of the damages?
Indemnification
Why is proving proximate harm cause important in the outcome of a professional negligence suit?
It determines how far the liability extends for consequences following negligent actions.
The physician, in telling the nurse to follow an order, states, "If anything happens, I'll take full responsibility." What effect would the physician's statement have in a subsequent lawsuit for malpractice?
It does not alter the nurse's personal accountability at all.
The physician makes a calculation error that leads to the patient receiving a serious medication error. This error was overlooked by the pharmacist and the nurse who administered the dose as ordered. What is true of the liability in this case?
It is shared by all three of these professionals.
What is the main purpose of documentation in the medical record?
It is used to communicate patient condition to the health care team.
How does the doctrine of respondeat superior alter the liability of the nurse for negligent conduct?
It makes the nurse liable to the employer.
What is the major problem associated with charting by exception?
It may not provide enough information to support trending of the patient's condition.
Hospital policy states that a registered nurse must cosign all charts that licensed practical nurses complete. What is the effect of this policy on the registered nurse?
It places the RN in the position of endorsing and authenticating the entries made in the charts cosigned
Nursing home policy states that a registered nurse must cosign all charts that licensed practical nurses complete. What is the effect of this policy on the registered nurse?
It places the RN in the position of endorsing and authenticating the entries made in the charts cosigned.
The nurse holds national certification as a wound care specialist and works in a small, rural hospital. What standard of skill and care applies to this nurse's practice?
It should be the same as that of an average nurse who also holds national wound care certification.
The nurse holds national certification as a wound care specialist and works in a small, rural hospital. What standard of skill and care applies to this nurse's practice?
It should be the same as that of an average nurse who also holds national wound certification. (A person holding himself or herself out as a specialist should be held to the same standard of skill and care as an average member of that specialty.)
The nursing student began a case study paper by writing, " J.P., a 65-year-old Asian male, was admitted to the intensive care unit at Southwest Hospital." What is the significance of this statement?
It violates Health Insurance Portability and Accountability Act regulations.
which court case delt with Standards of care and said legal duty of care standards or standards of care means a nurse must have and use the knowledge and skills ordinarily possessed and used by nurses actively practicing in the nurse's specialty area
Kings vs state of Louisiana 1999
Standards of care are found with the _______
LASBN
A medical technician working in a physician's office routinely refers to herself as a nurse. Which type of licensure protects that title as well as the professional actions associated with nursing?
Mandatory
Which type of licensure protects the title "nurse" as well as professional actions associated with nursing?
Mandatory
What is the principal reason that a higher standard of care may be required for safeguarding mentally ill persons?
Mentally ill persons cannot fully appreciate their exposure to potential harm.
The hospital nursing group has reviewed external standards of care to establish standards of care for a newly organized patient care unit. These external sources serve to set which level of standard of care?
National
The hospital nursing group has reviewed current nursing and federal literature to establish standards of care for a newly organized patient care unit. The final report generated by this group should assure hospital administration that the standards meet which level of care?
National (External standards transcend individual practitioners and single institutions. Since they are set by state and federal organizations, they are relevant to a specific society or country and are considered national standards.)
A nurse has been named in a lawsuit. The nurse's insurance company has declined to cover any costs until policy exclusions have been verified. What would the nurse expect the company to review?
Nature of the insured's work Licensure of the insured
A patient became confused and used a pocket knife to threaten others. The nurse confiscated the knife. What is the nurse's best defense for this action?
Necessity
The employee has requested the employer provide a reasonable accommodation. What does this request entail?
Needed and realistic modifications in the workplace
The nurse who has worked at a hospital for five years suffers a disability secondary to a work-related accident and requests accommodation. Does the nurse's new position have to provide the same salary as the old position?
No, but the nurse's seniority should be considered in salary negotiations.
The nurse applies to a faith-based hospital. Another applicant who is of the same faith supported by the hospital is hired instead. Is this seen as discrimination under ADA?
No, employers may offer preference to individuals of the same religion
A lawsuit is brought against a nurse in a rural hospital. The nurse replies that the standard of care for rural nurses is different from that for nurses working in large urban facilities. Is this a defensible position?
No, nurses in rural settings must meet the same standards as those practicing in large urban areas.
The preceptor nurse delegates a complex nursing procedure to a newly licensed nurse. The new nurse makes an error, which results in the patient's death. Does the preceptor hold any liability in this case?
No, since the new nurse has a license, all liability is retained by the new nurse.
A nurse calls the newspaper and reports that circumstances surrounding several deaths in the local hospital are suspicious and that a cover-up is in action. The subsequent article identifies the nurse by name and the nurse is fired. Is the nurse protected under the whistleblower law?
No, the allegations should have been made to the appropriate authorities.
The patient requests that one bed siderail be fully up for use in assisting with turning. Is this considered a restraint?
No, the bedrail in this case is being used as an assistive device, not a restraint.
An out-of-state caller becomes irate when the nurse cannot provide information over the telephone about a hospitalized friend. The caller says, "If you know what is good for you, you had better tell me." Has a civil assault occurred?
No, the caller is out of state and cannot reach the nurse.
An out-of-state caller becomes irate when the nurse cannot provide information over the telephone about a hospitalized friend. The caller says, "If you know what is good for you, you had better tell me." Has a civil assault occurred?
No, the caller is out of state and cannot reach the nurse. (Assault is defined as the action or motion that creates a "reasonable apprehension in the other person of immediate harmful or offensive contact to the plaintiff-person." While this caller may possess the physical strength to do harm, the caller is too far away to act on the threat immediately.)
A lawsuit is brought against a nurse in a rural hospital. The nurse replies that the standard of care for rural nurses is different from that for nurses working in large urban facilities. Is this a defensible position?
No; nurses in rural settings must meet the same standards as those practicing in large urban areas. (Nurses are accountable for all standards of care as they pertain to their profession, no matter their practice setting.)
A nurse has missed 10 days of work while involved as a defendant in a malpractice lawsuit. Must the hospital where this nurse is employed and that was also named in the suit pay the nurse for those days?
Not necessarily, it depends upon the hospital's insurance policy and what it covers.
Which advanced nurse practitioner role is authorized by nurse practice acts, medical practice acts, and allied health laws?
Nurse midwife
Which scenario reflects the "two schools of thought" doctrine?
Nurses on one unit vary in their choice of ways to deliver quality care.
Which type of insurance is generally the most preferable for the most nurses?
Occurrence-based
The laboratory notifies the nursing unit that a substantial amount of test data was mistakenly recorded on the wrong patient's medical record two days ago. Who has the authority to alter the patient's record?
Only administrative staff or the patient's primary physician
The nurse manager requests that a job applicant who has a physical disability receive a medical examination prior to assignment to a work station. Is this examination legal?
Only if all other applicants for similar positions are subjected to the same examination
The parents of a 17-year-old who is receiving substance abuse treatment have asked the provider for information about their child. What is the correct action by the health care provider?
Only release information if the patient has signed consent to do so.
The nurse holds original licensure in a compact state and has practice privileges in two remote states. Should practice concerns arise with this nurse, what is the status of the nurse's license?
Only the state in which the nurse holds licensure can act to suspend or revoke that license.
An ethical dilemma has arisen in regard to a patient who has been declared incompetent and who left no advance directive. Which model is likely to be of best use to the ethics committee reviewing the case?
Patient benefit
Which statement best explains the importance of electronic medical record use?
Patient care is improved.
The hospital has outsourced housekeeping services to an independent contractor. A patient, who was injured in a fall on wet flooring, brings suit against the company. Does the hospital also hold liability?
Perhaps, secondary to the doctrine of ostensible authority.
From where does the state's power to license nurses derive?
Police power within the state
A nursing student's grandmother relates a time in the 1920s when medications were selected based upon the recommendation of a nurse who lived in the neighborhood. How is this possible?
Prior to 1938, most medications were over-the-counter and nurses were instrumental in their choice.
An emergency department nurse has agreed to testify as an expert witness in a lawsuit involving a child. The opposing attorney questions the nurse's qualifications as a pediatric nurse. Which type of law does this scenario reflect?
Procedural Law
What does the court consider in determining the nurse's legal liability for standards of care?
Professional education, experience, and specific conduct
What does the court consider in determining the nurse's legal liability for standards of care?
Professional education, experience, and specific conduct (Professional education, experience, and specific conduct all could be considered internal standards. These would be used in determining liability.)
The hospital nursing group establishing standards of care for a newly organized patient care unit is looking for external sources for these standards. Where should these nurses look?
Professional journals and nursing textbooks
The nurse has been sued for defamation after charting that the patient is a prostitute. What is the nurse's best defense in the case?
Prove that the statement is true
The nurse has been sued for defamation after charting that the patient is a prostitute. What is the nurse's best defense in this case?
Prove that the statement is true.
A lawsuit has been filed claiming that a nurse's actions caused the death of a neonate. Why does the attorney for the plaintiff want to prove proximate cause?
Proximate cause determines how far the nurse's liability extends for consequences of the alleged negligent actions. (Proximate cause attempts to determine if the defendant is liable for occurrences that happen after the negligent act took place.)
The nurse is concerned about the potential of sexual harassment in her workplace. Which standard should this nurse investigate before making a decision about whether an activity is sexual harassment or not?
Reasonable woman standard for hostile work environment sexual harassment
Which action could result in the nurse being charged with conversion of property?
Removing the patient's car keys against his or her will
The hospital nurse supervisor has concerns that a staff nurse is no longer capable of competent patient care because of alcohol use. Repeated counseling sessions with the nurse have not changed the behaviors that are of concern. What action should be taken by the supervisor?
Report the concerns to the state board of nursing.
In caring for a 6-year-old who entered the emergency center for treatment of a broken arm, the nurse noted that the child had multiple bruises on his trunk and legs. When questioned, the child said his father hit him and broke his arm so that the child would remember to be good. What should the nurse do?
Report the incident immediately to the nursing supervisor or physician so that the incident will be reported to the proper authorities.
Which legal doctrine cannot apply to a nurse's practice as a private duty nurse?
Respondeat superior
The patient who has been diagnosed with metastatic cancer declines chemotherapy treatments. The nurse assists this patient in explaining this position to other health care providers. What advocacy model is this nurse exemplifying?
Rights protection model- The rights protection model is also known as the autonomy model, in which nurses assist patients in asserting their autonomy rights
When a patient became confused and dangerous to himself and others in the setting, restraints were applied, and the patient was confined to bed. What is the nurse's best defense for applying restraints?
Self-defense
Which scenario demonstrates apparent consent?
Showing by his or her conduct that he or she agrees to the treatment
The patient requires a controlled substance for the treatment of pain. What is true of the advanced nurse practitioner's role in independently prescribing this medication?
Some states allow advanced nurse practitioners to prescribe controlled substances.
Hostile or angry patients present unique nursing challenges from a legal perspective. Which option reflects a basic intervention that a nurse can take with a hostile or angry patient?
Spend additional time with the patient, showing that he or she is important.
The nurse is searching for the legal guide to the practice of registered nurse. Which document should the nurse review?
State Nurse Practice Act
Which scenario meets the Civil Rights Act of 1991 definition of hostile environment sexual harassment?
Submission to sexual innuendos, remarks, and physical acts that alter the conditions of the employee's employment, creating an abusive workplace
Which scenario meets the Civil Rights Act of 1991 definition of quid pro quo sexual harassment?
Submission to, or rejection of, sexual conduct as a basis for employment decisions
The court is establishing liability in a case in which several actions caused the plaintiff's injury. Which test of causation would be most useful in this case?
Substantial factor test
The court is establishing liability in a case in which several actions caused the plaintiff's injury. Which test of causation would be most useful in this case?
Substantial factor test (Substantial factor is considered the best test to pinpoint liability when several causes occur to bring a given injury. This test asks whether the defendant's act or omission was a substantial factor in causing the ultimate harm or injury.)
aids in pinpointing liability when several causes occur to bring about an injury
Substantial factor test (who is most responsible)
oncerns specific wrong, harm , or duty that caused lawsuit against an individual
Substantive
The nurse determines that an adult patient has signed a statutory living will, also known as a natural death act. What does this mean to the nurse?
That the health care providers who abide by the document cannot be charged with criminal negligence associated with the patient's death.
An employee has requested special accommodations secondary to a disability. The hospital refuses, citing undue hardship. What must be present for that refusal to be upheld?
The accommodation would be very difficult to implement
Fein v. Permanente Medical Group is important as the case defined the standard of care for the advanced practice nurse. How was that standard of care defined?
The advanced nurse practitioner standard of care
The registered nurse has delegated the task of ambulating a patient who has a history of unexpected falls to two nursing assistants. The patient appears to ambulate without assistance, but must be ambulated with two assistants in case of another unexpected fall. What is the most important aspect of delegating this task?
The aides understand the importance of walking with the patient.
The survivors of a patient who unexpectedly died in a hospital contact an attorney regarding a wrongful death against the hospital and two nurses. Review of the hospital's pertinent policy and procedures found them to be current. Review of the medical record revealed that policy and procedures were followed by the nurses. Based on this information, what is the likely strength of this case? Select all that apply.
The case against the nurses is weak since they followed hospital policy and procedures. (Since the nurses did follow the hospital policies and procedures some other violation would have to be found.)
The charge nurse has delegated a task to another staff member. Who assumes accountability for the task?
The charge nurse
Which option reflects assignment in nursing?
The charge nurse divides the patient load into one team for each staff nurse who works the shift.
The unit is extremely busy when the physician orders that a urinary catheter be inserted in a patient. The patient's assigned nurse is new, has seen the procedure done, but has never done it independently. How should the charge nurse handle this situation?
The charge nurse should assist the new nurse with the procedure.
: In order for the concept of double effect to be useful the undesired effect must not be the means of attaining the good effect.
The harmful effect must not occur in order for the medication to be successful in treating the cancer.
A physician reported a case of possible nursing negligence to the state board of nursing. What action will be taken by the board?
The complaint will be screened and an investigation initiated if appropriate.
The cost of the procedure is not part of the consent form.
The date and time of a procedure are often fluid and are not included in the consent form.
In which case might a default judgment be entered?
The defendant did not respond to the complaint. (Default judgments are entered when a defendant does not respond to the complaint by the plaintiff.)
The nurse cited "intolerable working conditions" as the reason for resignation. In order to claim constructive discharge, what must the nurse prove?
The employer deliberately created the work condition to force the nurse to resign.
The advanced practice nurse would like to move to a large metropolitan area. How will this move impact the advanced practice nurse's practice?
The expanding role of the advanced nurse practitioner has increased the number of lawsuits filed.
After 3 years of uneventful employment, the nurse made a medication error that resulted in patient injury. What hospital response to this event is ethical?
The hospital was supportive and assistive as the nurse coped with this event.
The advanced nurse practitioner wishes to obtain admitting privileges at an area hospital. To whom should this nurse apply for these privileges?
The individual hospital
In given situations, the nature and degree of reasonable care expected of people providing care may differ depending upon which factor?
The individual's status as a professional (Individuals of a specific profession have their own unique care standards. These define the minimal requirements of an acceptable level of care that can be expected of a given profession. They are developed to see that no unnecessary harm comes to the patient and to protect and safeguard the public as a whole.)
In which situations would the manufacturer of a drug designated as unavoidably unsafe be held liable for injuries to a patient receiving the drug? Select all that apply.
The information printed in the drug information sheet accompanying the medication was wrong. The physician prescribed the medication after being told that problems with the drug had been corrected.
The plaintiff was injured by a defective intravenous catheter. In order to win a product liability case, what must the plaintiff prove first?
The intravenous catheter was sold to him.
2. Whether expert testimony is needed is decided on a case-by-case basis after analyzing the facts of the case.
The likelihood of one side of a case winning or losing should not be the determining factor in whether to present expert testimony also the jury does not decide if expert testimony is needed
A defendant invokes the locality rule as justification for a lower standard of patient care. How does the locality rule support this claim?
The locality rule holds the professional to a standard of care in a given geographic area, rather than the national standard of care.
The female nurse works in a nursing home where many of the patients are military service veterans. She discovers that a male nurse with whom she works makes $2.80 per hour more than she makes. In which situation could this be legal under affirmative action?
The male nurse's yearly evaluations are better than the female nurse's.
The nurse and immediate supervisor have a personal conflict. The supervisor warns the nurse that the hospital is an employment-at-will institution. What does that indicate?
The nurse can be dismissed at any time, without cause.
A nurse is leaving the parking lot at the hospital and carelessly runs over a patient who was just discharged. Ironically, the nurse had been assigned to care for that patient that day. If the patient sues this nurse, which statement is true?
The nurse can be held liable for negligence but not malpractice.
A nurse is named in a lawsuit and has no professional malpractice insurance coverage. What is true of this situation?
The nurse can be held personally responsible for all damages assessed.
Which common practice puts the nurse at liability for invasion of patient privacy?
The nurse gives information about the patient to telephone callers who inquire about the patient.
Which option reflects the nurse's duty to prevent patient falls?
The nurse has a duty to assess the patient for risk for falls.
M for MORAL
The nurse investigates the opinions of everyone involved in the issue.
In which scenario is the nurse providing indirect supervision of a nursing assistant?
The nurse is easily contactable by pager but is not present in the care environment.
Which scenario best reflects indirect supervision of a nursing assistant?
The nurse is easily contactable by pager but is not present in the care environment.
A patient, injured at work, was seen by the factory occupational nurse. The nurse treated the wound and instructed the patient to get a tetanus antitoxin injection at the county health department. The patient failed to follow instructions, developed tetanus, and subsequently filed a suit against the nurse. What is the most likely result of the ensuing trial?
The nurse is not liable for damages, because the nurse has a right to expect that instructions will be followed.
Which option reflects the nurse's duty regarding use of equipment?
The nurse is required to select the proper equipment and to use it correctly.
The hospital-employed nurse volunteered to assist with physical examinations for athletes at the local high school. How does this situation affect the nurse's malpractice insurance?
The nurse is very likely not covered by any malpractice insurance.
Which situation is probable grounds for disciplinary action against a nurse's license?
The nurse made a false statement on the licensure application.
The nurse suspects that a patient's death was related to faulty monitoring equipment. What is the nurse's duty to report?
The nurse must notify hospital risk management.
What is the nurse's legal duty with regard to implementing a physician's order?
The nurse should follow the order unless the nurse has reason to believe that the patient could come to harm if the order is followed.
In a professional liability insurance policy which person or group is considered the policyholder?
The nurse who purchases the policy
As a part of a malpractice case, the hospital has decided to bring an indemnity claim against a nurse. What is the implication to the nurse?
The nurse will have to pay monetary damages to the hospital if the hospital wins the claim.
As a part of a malpractice case, the hospital has decided to bring an indemnity claim against a nurse. What is the implication to the nurse? Select all that apply.
The nurse will have to pay monetary damages to the hospital if the hospital wins the claim. The nurse should obtain a private lawyer.
A nurse has agreed to participate in a videotaped deposition in a malpractice case. What does this indicate?
The nurse's testimony can be presented in court, even though the nurse is unavailable for the trial date. (Taped depositions are frequently reserved for witnesses who will not be present for the actual trial.)
The patient's expressed wishes always take precedence over the document, and the patient can verbally revoke the living will.
The patient does not have to sign a subsequent document in order to revoke the living will. Just say so
In which scenarios would the nurse assume that apparent consent has been provided? Select all that apply.
The patient follows directions to swallow sips of water as the nurse inserts a nasogastric tube. The patient smiled and held out his arm when the nurse said "I need to start an intravenous line."
The patient brings suit against a health care provider. In which ways would the nurse expect this action will affect the confidentiality of the patient's medical record? Select all that apply.
The patient's attorney will have access to the information in the record. The record will be released to the defendant's attorney.
A patient refused to ambulate postoperatively and subsequently developed bilateral pneumonia, causing his hospital stay to be lengthened. After discharge, the patient filed a lawsuit claiming his primary nurse was negligent in allowing him to develop pneumonia. What is the nurse's best defense in this case?
The patient's conduct contributed to his complications.
Which option reflects a general criterion for restraining a patient?
The patient's immediate ability to harm self or others
Which scenario is a quasi-intentional tort rather than an intentional tort?
The physician accuses the nurse of incompetence in front of the patient's family.
Which factor was primary in driving the establishment of the advanced nurse practitioner role?
The physician shortage of the late 1960s
The patient brings suit against a health care provider. How does this action affect the confidentiality of the patient's medical record?
The record becomes discoverable by all parties to the suit.
A patient requests that records of her hospitalization for treatment of an infection following an abortion be destroyed as soon as she is discharged. What is the likely outcome of this request?
The record will be sealed.
A patient requests that records of her hospitalization for treatment of an infection following an abortion be destroyed. What is the likely outcome of this request?
The record will be sealed.
A patient who requires vasoactive intravenous medications was just admitted. Which person should the charge nurse ask to measure this patient's vital signs?
The registered nurse who has worked on this unit for 8 months
All states have enacted Good Samaritan laws.
There is no state that requires anyone to provide emergency care
Punitive damages of one million dollars were awarded to the family of a patient who died following a nursing medication error. What is true of these punitive damages?
These damages are awarded to set an example to other nurses.
The state board of nursing has brought action against a nurse's license based upon violation of a regulation. What is true about this scenario?
These rules and regulations have the force of law.
Clinical nurse specialists in hospital settings are more likely to be sued for malpractice than staff nurses for which reason?
They assume greater legal liability by virtue of their specialty credentials.
Unlicensed personnel are not licensed by the state in their own right. Why is it that these persons can perform delegated tasks?
They work under the auspices and licensure of the institution, not the professional nurse.
A week after stopping to assist at an injury accident, the nurse receives a check for $100 from the patient's family as a thank-you for the care provided. What is the best description of the effect this gift has on the nurse's protection under the Good Samaritan law?
This gift may change the nurse's care to fee-for-service, changing Good Samaritan protection.
The patient tells the nurse that the physician mentioned deep tissue massage as treatment for rheumatoid arthritis. As a part of the subsequent conversation, the nurse demonstrates techniques and encourages the patient to begin a regimen immediately. What is true regarding this situation?
This nurse may be guilty of practicing massage without a license.
The health care facility has sponsored a continuing education offering on emergency management of pandemic influenza. At lunch, a nurse is overheard saying, "I'm not going to take care of anyone that might have that flu." What is true of this statement?
This statement is a breach of the Code of Ethics for Nurses
Discrimination against which group of persons necessitated the Americans with Disabilities Act?
Those living with HIV/AIDS
To bring a successful malpractice suit based on informed consent, the plaintiff must prove that the the procedure caused the harm.
To bring a successful malpractice suit based on informed consent, the plaintiff must prove that plaintiff suffered injury for which damages can be assessed.
What is the basic purpose of the state board of nursing?
To establish a means of protecting the public at large
Which option reflects the nurse's primary obligation to the patient?
To exercise nursing judgment and intervene on behalf of the patient
What would the nurse identify as the most basic purpose of standards of care?
To protect and safeguard the public as a whole
In which case would the judge serve both as a fact-finder and determiner of questions of law?
Trial by jury is waived by both sides. (Only in the case where there is no jury does the judge address and answer both questions of law and fact.)
As discussed by Professor Derrico,patients can still have a fall event even if the standard of care was met.
True
The home health nurse discovers that a homebound cancer patient is using marijuana to control nausea from chemotherapy. What advice should the nurse give this patient?
Under certain circumstances, patients can claim exemption from the law against possession of marijuana.
A patient who is well known to be violent arrives by ambulance at the Emergency Department for care of a laceration. What action should be taken?
Use a buddy system when providing care.
The patient decides to discontinue standard medical treatment for diabetes mellitus and to rely on diet and herbal medications for blood sugar control. Which statement, made by the nurse, is most appropriate?
Why did you decide to make this change?
A lawsuit is being tried in a state that recognizes pure comparative negligence. If the plaintiff is found to have partial fault in the occurrence, can damages be recovered?
Yes, even if the plaintiff is 99% at fault
The hospital has been sued for the actions of a nurse employee. The hospital proves that the nurse was not providing care within the scope of employment as a nurse. Can the hospital still hold liability in this case?
Yes, if the plaintiff can prove the nurse was incompetent and that the hospital was aware of the incompetence.
The advanced nurse practitioner believes that he should spend as much time with each patient as the patient desires. Does this practice raise ethical challenges?
Yes, if this practice makes other patients wait past their own appointment times.
The charge nurse is aware that some staff nurses routinely "short-cut" assessment activities for long-term patients. In case of a negative patient outcome related to this practice, does the charge nurse hold any liability?
Yes, the charge nurse has a duty to ensure staff competency.
The defendant has successfully defended against a product liability cause of action. Can the plaintiff still prove the defendant was negligent?
Yes, the defendant could have used the product in a negligent manner.
The registered nurse who works in the obstetrics department is walking by the emergency department waiting room when a person cries out, "Help me, my mother is not breathing." Does this nurse have a duty to assist?
Yes, the general duty of care exists to help in times of crisis or imminent harm.
The registered nurse who works in the obstetrics department is walking by the emergency department waiting room when a person cries out, "Help me! My mother is not breathing!" Does this nurse have a duty to assist?
Yes, the general duty of care exists to help in times of crisis or imminent harm. (Even if the nurse is not assigned to a particular patient, a general duty of care arises if the patient presents with an emergency or is in need of instant help. Therefore, this nurse has a duty to assist in this situation.)
The preceptor nurse delegates a complex nursing procedure to a newly licensed nurse. The new nurse makes an error, which results in the patient's death. Does the preceptor hold any liability in this case?
Yes, the preceptor is responsible for delegating appropriately and supervising completion of tasks.
Hospital administration requires that the committee seeking to change nursing policy and procedures review external sources for these standards. Where should the committee look for these standards? Select all that apply.
a) Current nursing literature b) State boards of nursing c) Federal organizations
Which action could result in the nurse being charged with conversion of property? Select all that apply.
a) The nurse removes the patient's shirt and bra during treatment of a fractured ankle. b) The nurse removes a package of cigarettes from a patient's robe pocket. (Conversion of property means that the nurse took something of the patient's without permission.)
the total for the year that the insurance will pay
agregate
Which scenarios would the nurse identify as a quasi-intentional tort rather than an intentional tort? Select all that apply.
a) The nursing student takes a cellphone picture of a patient's leg wound to show her classmates. d) The physician accuses the nurse of incompetence in front of the patient's family. (Defamatory language about a living person that would adversely affect his or her reputation is defamation. Defamation is a quasi-intentional tort.)
source of law for board of nursing
administrative
A nurse has decided to obtain individual professional liability insurance. In general, which type of insurance is best for most nurses?
occurence-based
The administration of a health care facility takes the ethical obligation of protecting patients very seriously. Which actions would help nurses meet standards of care? Select all that apply.
b) Create clearly written policy and procedure manuals. (A good way to ensure that practitioners meet current standards of care is to create policy and procedure manuals that are current and easy to understand.) d) Schedule regular reviews of policy and procedure manuals. (Regular review of policy and procedure manuals will help ensure that these documents reflect current standards of care.)
Which scenarios reflect the "two schools of thought" doctrine? Select all that apply.
b) Nurses on one unit vary in their choice of ways to deliver quality care. (Two schools of thought is a doctrine that allows the consideration that an individual can use different approaches when rendering care as long as the standards of care are met.) c) The nurse expert witness in a case describes two methods of providing the intervention in question. (There may well be more than one way to provide an intervention and still meet the standard of care. This is the basis of the two schools of thought doctrine.)
A plaintiff's attorney decides to use the doctrine of res ipsa loquitur in a case against the urologist who perforated a patient's urethra during a cystoscopy. What must the plaintiff prove? Select all that apply.
b) This complication does not generally occur unless someone provided negligent care. (In order to prove the doctrine of res ipsa loquitur, the plaintiff must prove that perforation of the urethra does not occur unless someone was providing negligent care.) d) The plaintiff had no control over the development of the perforation. (The instrument that caused the injury must be shown to have been under the management and control of the alleged wrongdoer, not the injured party.)
Can include encouraging a painful procedure if it will increase the quality of life
beneficence
the basic obligation to assist others
beneficence- the promotion of good through action
are living wills very specific or very broad
broad and vague with little direction of under what circumstance
is the act or omission a direct cause of the injury or harm
but for test
how can you defend yourself against an intentional tort
by getting consent
what class of law would battery fall under (like breaking a DNR)
criminal- but he can also sue in civil court to get my money
Assault, battery, and _________ are intentional torts even if you did not intend the harm
false imprisonment
The direct line of causation from incident to injury describes the concept of
cause in fact (the breach of duty owed caused the injury)
which law is based on rules and regulations
civil (tort)
The nurse is involved as an expert witness in a civil court case where life support was withdrawn and the patient expired. Which level of evidence is expected for this case?
civil so clear and concise evidence
what class of law does medical malpractice fall under
civil- they want your money
what class of law does a tort fall under
civil- this involves malpractice tort law is civil law
serves as the standard for professional actions
code of ethics
which law is derived from principles
common
A nurse being sued by a noncompliant patient may use __________ as a defense for nonintentional tort - because the patient is part of the reason for the adverse consequences
contributory negligence
Defense against a non intentional tort when a patient is being non compliant
contributory negligence-
_____ ______- means that the nurse took something of the patient's without permission
conversion of property- removing shirt or taking cigs from robe
harmful against society as a whole
criminal
if my license was revoke it was because ____ law was enforced
criminal
what class of law would murder fall under
criminal
what kind of law- assault and battery
criminal
which law would falsifying records fall under
criminal
2 types of statutory laws
criminal and civil
Criminal charges have been brought against a nurse who made a medication error that resulted in a child's death. Which level of evidence is expected in this case?
criminal so Evidence beyond a reasonable doubt
can a lay witness giver her opinion of what happened
no- they just explained what happened from their perspective
2 types of quasi intentional torts
defamation- The physician accuses the nurse of incompetence in front of the patient's family. invasion of privacy
when 2 or more defendants are found to have causation, it is up to the _____ to determine who is most to blame
defendants
when there is no connection between act and outcome
defense of the fact
The nurse bases individual nursing practice upon commitment to quality patient care and understanding of the nursing role. Under which broad classification of ethical theory does this fall?
deontology
all human life has value
deontology
to figure out if there was a breach of duty, what do you ask
did the nurse deviate from the standard of care
________ mandate reporting of certain types of health related info to protect public
disclosure statutes
most visible way of preventing a suit
educate your patients and be a patient advocate
a. To determine the nurse's legal liability for standards of care, the court will consider professional _____, ______, and _______
education, experience, and specific conduct
When a patient became confused and dangerous to himself and others in the setting, restraints were applied, and the patient was confined to bed. What is the nurse's best defense for applying restraints?
elf-defense
values based decision model
encourage to speak for self discuss needs and values assist patient in making choices
who enforces ethical concepts
ethical committees and professional organization
a code of ethics reflects
ethical principles
basis for ethical reasoning
ethical principles and codes
Ethics describes conduct or principles that are internalized.
ethics are not externally determined
another word for punitive damages
exemplary damages
who can state their opinion
expert witness- but they should only answer the question asked and give no additional info
which witnesses are NOT deposed
expert witnesses and legal nurse consultant
standards if by state board of nursing
external
standards from a journal or textbook
external- national
good samaritan laws fall under the ___________
non intentional tort of immunity
keeping your promises or commitments telling the truth
fidelity veracity
A nurse is frequently tardy to work causing other nurses to have to change their plans to cover the unit. The nurse never thanks those who cover for her and often criticizes the work they did in her absence. If another nurse is tardy, she refuses to stay over to cover. Which ethical theories is this nurse violating?
fidelity and beneficence Beneficence is the basic obligation to assist others which she is not doing
events that can be expected to cause specific results
forseeability
proximate cause builds on ______
forseeability
ethical concepts are interested in _______ while laws are interested in _______
good of individual society as a whole
what is an example of a rights protection model
helping other HC providers understand why the patient doesnt want sx
A 13-year-old cannot give consent for surgery, even in an emergency. In the case of an emergency, if the parents are not available to give consent, the emergency doctrine applies and surgery would proceed.
hm
The patient must initiate a waiver; it cannot be suggested by staff
if a nurse suggested the waiver than it is not valid
when would the prosecutor likely use the but for test
if the injury was caused by a breach of duty owed (malpractice case)
what kind of consent is it when an unconscious patient is brought for tx
implied not apparent apparent is like when they swallow when you tell them to when inserting an NG tube or holding out arm for IV
invasion of privacy is more than negligence, but _____ is missing
intent
so self defense and necessity are defenses against ______ torts
intentional
once again, consent can be a defense against what kind of tort
intentional and quasi intentional (not invasion of privacy if they said you can post pics)
Under pure comparative negligence, the plaintiff is allowed to recover the portion of the injury attributable to the defendant's negligence, even if the plaintiff was 99% at fault.
interesting
standard if policies and procedures
internal
public disclocure of private info
invasion of privacy
the detriment benefit analysis refers to
nonmalifencence- do not intend the harm
defamation is saying false things about a person
it is not defamtion if it is true
Emergency situations, such as a cardiopulmonary arrest, constitute an exception to the need for informed consent.
just go ahead and treat
rules of conduct moral values or priciples
laws ethics
Established facts at the trial level, stating for the judge and jury exactly what transpired
lay witness
who can only state facts
lay witness
directive created by competent adults directing medical personnel and family members to their wishes
living wills
Current literature indicates the most malpractice cases involve non-specialized RNs.
looks like i need to specialize
A charge of ______ would be supported if there was failure on part of the nurse to exercise reasonable and prudent care in the treatment of the patient
malpractice
failure of a professional person to act in accordance with the prevailing professional standards
malpractice
failure of the nurse to exercsie reasonable and prudent care
malpractice
disad. of alternate dispute
may not be as fair and may compromise due process
when an expert hears both sides and helps each side see the others position
mediation
example of failed duty owed and therefore malpractice
monitoring patient
The nurse manager is conducting a performance review with a nurse who has worked on the unit for 10 years. During the review, the nurse begins to cry and tells the manager, "I just can't do this anymore. I can't sleep because I have such bad nightmares about patients. I can't eat and I've already lost 15 pounds." The nurse manager identifies these findings as being possible signs of which problem?
moral distress
like a living will but enforced by law
natural death act
allows the nurse to interfere with patient's property rights to avoid injury
necessity- not self defense use self defense when patient is a threat to self or others
do you need to get consent every time you give injection
no
is invasion of privacy an intentional tort
no this is quasi intentional tort
do you have to prove damages for an intentional tort
no- but you do for malpractice
is autonomy an absolute right
no- not if it endagers others
does the board of nursing enforce ethics
no- they deal with law Ethical committees and professional organizations deal with ethics
Ensures the appropriateness of causes of actions
pre litigation panels- insures that there is controversy or fact questions
what is a reason to break the natural death act
pregnant
If a nurse is found liable for damages in a court case, the most extreme punishment could be
prison
normal defense against defemation is truth- but what is the defense against defamation reporting persons with specific disease or reporting people of abuse
privilege
the qualification of expert witnesses falls under which law
procedural
attempts to determine how far the liability of the defendant extends for consequences following negligent activity
proximate cause
what kind of tort is invasion of privacy
quasi intentional tort
comparative negligence rule
recovery based on % of fault
The first principle of the ANA code of ethics
respect for other- most important and incorporates all
which model of advocacy acts out of dignity of the patient- especially when they can no longer act for themselves
respect for persons model
model of advocacy that helps the patient have autonomy
rights protection model
advantages of alternate dispute (mediation and arbitration)
save time save money more private
Even though the patient has requested that the record be destroyed, medical records departments are generally unwilling to do so. In most cases, the record will be sealed rather than destroyed.
seal it
__________ethics takes into account the unique characteristics of each individual, the caring relationship between the person and the caregiver, and the most humanistic course of action given the circumstances.
situational ethics
Skills and learning commonly possessed by members of a profession
standards of care
who enforces laws
state board of nursing and courts
who sets the statute of limitations
state legislation
A nurse would like to advocate for a modification of the state's nursing practice act and believes the best strategy is to contact the persons with authority to write and change this statutory law. Whom should the nurse contact?
state legislature - State boards of nursing are involved in the implementation and enforcement of the nurse practice act but not charged with writing the law. - State nursing associations may promote or seek to change nurse practice acts, but they cannot do so independently.
This defines the period for which a lawsuit can be filed
statute of limitations
main function of incident report
to review and evaluate patient care
a civil wrong committed against a person or person's property
tort
if a patient decides to pursue a legal action against a nurse for injury, ____ law will be enforced
tort
someone violated someone else's rights through actions or omissions of actions
tort
what kind of law- pt decides to sue for an injury
tort- civil
what is the most commonly seen class of law in healthcare
tort- civil- malpractice
refusing to leave after being asked
trespass of land- intentional tort
when would the prosecutor use the but for test
when a breach of duty owed caused the injury
Arbitration is an alternative dispute resolution method. No formal record is made of the arbitration process. This allows the proceedings to be confidential.
yeah
necessity does not allow the search of a patient's stuff
yeah
nurses do not have to ensure consent but they do need to tell the dr if they notice consent is lacking
yeah
so after a deposition- can changes be made to the testimony
yeah- only topographical errors- nothing major
Relational ethics moves decisions into the context of the environment in which these decisions are made, creating more "practical action-oriented" ethics.
yep
The inclusion of the patient's initials, age, race, and place of admittance potentially makes it possible to identify the patient, which violates HIPAA.
yep
is testimony given under oath during arbitration
yep
is failure to monitor your patient malpractice
yep- this was a duty owed
would you use the but for test if the injury was due to inadequate monitoring
yes- because monitoring the patient is a duty owed
can joining the ANA prevent malpractice
yes- joining a professional org. is a way to avoid malpractice
can the dr delegate obtaining informed consent to the nurse
yes- well only to get the paper signed