Chapter 3 - Nursing Practice and the Law
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? 1. The hospital was supportive and assistive as the nurse coped with this event 2. The nurse was dismissed for incompetence 3. The hospital quality department advised the nurse not to tell the patient about the error 4. The nurse was reassigned to an area in which there is no direct patient care responsibility
Answer: 1 Rationales 1. Nurses must be held accountable for errors but should be treated in a professional and assistive manner 2. Dismissal for incompetence fails to demonstrate ethical or supportive behavior 3. Advising a professional not to discuss the error is unethical 4. Reassigning is punitive
Which common practice puts the nurse at liability for invasion of patient privacy? 1. During care, the nurse reveals information about the patient to those in the room 2. The nurse releases information about the patient to nursing students who will be caring for the patient the next day 3. The nurse conducts a patient care session about a patient whose care is difficult and challenging 4. Confidential information regarding an admitted patient is released to third-party payers
Answer: 1 Rationales: 1. Giving out information about a patient without permission is an invasion of privacy 2. Providing information about the patient to those who will be caring for him or her is appropriate 3. Sharing information with those who are responsible fr the patient's care in order to ensure safe and effective care is appropriate 4. Patients sign release of information forms to allow this; if a form has not been signed, third-party payers will not reimburse
An RN has asked a licensed practical nurse (LPN) to trim the toenails of a diabetic patient. The LPN trims them too short, which results in a toe amputation from infection. The patient files a lawsuit against the hospital, the RN, and the LPN. What might all three be found guilty of? 1. Unintentional tort 2. Intentional tort 3. Negligence 4. Malpractice
Answer: 4 Rationales: 1. Although this was performed without malice and is considered an unintentional tort, harm occurred, making the action malpractice 2. The licensed practical nurse (LPN) did not intend to hurt the patient 3. Negligence falls in the category of an unintentional tort 4. Malpractice occurs when an unintentional tort causes an injury to a client
A patient is transported to the emergency department by rescue after being involved in a motor vehicle accident. The patient is alert and oriented but keeps stating he is having trouble breathing. Oxygen is started, but the patient is still showing signs of dyspnea. The patient suddenly develops respiratory arrest and dies. During the resuscitation process, it is discovered that the nurse failed to open the correct oxygen valve. The family sues the hospital and the nurse for: 1. Malpractice 2. Negligence 3. Nonmaleficence 4. Equipment failure
Answer: 1 Rationales: 1. Malpractice occurs when an unintentional tort causes an injury to a client 2. Malpractice falls under negligence 3. Nonmaleficence is an ethical principle 4. The nurse failed to open the valve; there is not any evidence that the equipment malfunctioned
A patient tells a nurse that he has an advance directive from 6 years ago. The nurse looks at the medical record for the advance directive. What content should the nurse expect to find in the advance directive? Select all that apply 1. Decisions regarding treatments 2. When to take the patient to the hospital 3. Do not resuscitate orders 4. Who should be notified in the case of illness, injury, or death 5. Durable power of attorney for health care 6. HIPAA protocols
Answer: 1, 2, 3, 5 Rationales: The advance directive provides instructions for future health-care decisions if the patient becomes unable to make personal treatment choices
An RN is obtaining a signature on a surgical informed consent document. Before obtaining the signature, the RN must ensure which of the following? Select all that apply. 1. The client is not sedated 2. The doctor is present 3. A family member is a witness 4. The signature is in ink 5. The patient understands the procedure
Answer: 1, 5 Rationales: 1, 5. Before surgery, the nurse needs to ensure that the patient fully understands what the physician told him or her about the procedure and that the consent form has been signed before any preoperative sedation is administered 2. The physician needs to provide the information so that the patient is fully informed; the nurse may obtain the signature but needs to ensure that the patient is aware and understands 3. The nurse acts as the witness 4. Although the signature should be in ink, often electronic signatures are obtained
An RN sees an older woman fall in the mall. The RN helps the woman. The woman later complains that she twisted and sprained her ankle. The RN is protected from litigation under: 1. Hospital malpractice insurance 2. Good faith agreement 3. Good Samaritan law 4. Personal professional insurance
Answer: 3 Rationales: 1. The incident occurred outside of the hospital 2. A good-faith agreement implies that a contract exists 3. The Good Samaritan Law protects persons who assist at an accident scene if they act in good faith. Professional insurance is not in effect because the actions were not performed while on duty. 4. Professional liability insurance does not necessarily cover this type of litigation
An RN new to the emergency department documented that "the patient was intoxicated and acted in a crazy manner." The team leader told the RN that this type of documentation can lead to: 1. Assault 2. Wrongful publication 3. Defamation of character 4. Slander
Answer: 3 Rationales: 1. Assault is a threat to do harm 2. wrongful publication refers to erroneous information in writing 3. Charing or saying unsupported defamatory statements can lead to tort litigation 4. Slander is making an untrue statement that causes harm to someone's reputation
An RN calls a health-care provider to report that a patient's condition is deteriorating. The physician gives orders on the telephone to draw arterial blood gases. What should the nurse do next when receiving telephone orders from a health-care provider? 1. Call the respiratory therapist to obtain the blood gases 2. Give the order to the unit secretary to ensure it is entered quickly 3. Enter the order directly into the system as it was given to the RN 4. Write the order down and read it back to the provider
Answer: 4 Rationales: 1, 2 and 3 area ll steps the nurse needs to take; however verifying the order is the most important action to take first. 4. The Joint Commission on National Safety Goals requires that all telephone orders be written down and read back. This ensures the accuracy of the order. Failure to follow this procedure leaves the nurse and the facility open to negligence because it is a standard of care.
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 who might have that flu. I have kids to think about." What is true of this statement? Select all that apply. 1. The nurse has a greater obligation than a layperson to care for the sick or injured in an emergency 2. This statement reflects defamation and may result in legal action against the nurse 3. This statement is a breach of the Code of Ethics for Nurses 4. The nurse has this right as no nurse-patient contract has been established
Answer: 1, 3 Rationales: 1. Because nurses have greater ability to provide care, their obligations to provide care is higher than that of laypersons 2. The nurse has not made an inflammatory or false statement 3. According to the Code of Ethics, nurses need to care for patients without judgment 4. Caring for a patient is an expectation of the role. Nurses do not establish contracts with patients to deliver care
