Chapter 7 course point Nursing Fundamentals
Professional regulations and laws that govern nursing practice are in place for which reason?
To protect the safety of the public
Nurses are occasionally asked to witness a testator's (person who makes the will) signing of a will. Which guideline is true regarding a nurse's role in witnessing a testator's signature?
Witnesses to a signature do not need to read the will.
A nursing student administers an overdose of an opioid to a client and the client arrests. When discussing the incident with nursing faculty, which statements made by the student indicate the need for further teaching? Select all that apply.
"I am glad I am a student because nursing faculty will be blamed, not me." "I cannot be held liable because this is only my second time at this facility."
The nurse attorney provides an educational session to the nursing staff on acts of negligence. Which responses by the staff would indicate to the attorney that the staff can accurately identify acts of negligence? Select all that apply.
"I can be charged with negligence if I apply a heating pad to the client's skin and the client suffers a superficial or first-degree burn." "I can be charged with negligence if I notify the health care practitioner about a change in a client's status but do not follow up or document.
While a client admitted to the medical-surgical unit is in the radiology department, a visitor claiming to be the client's cousin arrives on the medical-surgical unit and asks the nurse to provide a brief outline of the client's illness. Which response by the nurse would be mostappropriate, both legally and professionally?
"I cannot give you that information due to client confidentiality."
Which statement made by the nurse providing care to a group of clients indicates that the nurse requires further education regarding negligence?
"I don't need to assess distal pulses on a client after a femoral arteriography."
A client being discharged from the hospital asks the nurse, "When I go visit my family out of state, should I take my living will with me, or do I need a new one for that state?" Which is the most appropriate response by the nurse?
"Take it with you. It is recognized universally in the United States."
Action has been taken against a nurse's license based on a claim that the nurse acted outside of nursing's scope of practice. The nurse's attorney determines that the nurse needs more education about the purpose of the board of nursing when the nurse makes which statement?
"The rules made by the board of nursing don't reflect my practice"
A nurse has been named in a malpractice lawsuit. Prior to taking the nurse's deposition, the attorney explains that the case will be governed by common law. Which question by the nurse is indicated?
"Will this case be precedent setting?"
The nurse attempts to notify a health care provider about a client's elevated temperature but does not get a response. Which statement, if documented by the nurse, would indicate that the nurse is following proper protocol for nursing documentation?
1300: Client temperature elevated. Telephoned health care provider's service 3 times without a response. Tepid sponge bath given and nursing supervisor notified.
While teaching about advance care planning, which fact is important for the nurse to share with a client who has been diagnosed with a terminal illness?
A durable power of attorney for health care appoints an agent the person trusts to make decisions.
An older adult client has expressed to the nurse a desire to specify and document the care they want to receive and do not want to receive if they become incapacitated. The nurse should encourage the client to explore what option?
A living will
Which is an example of an unintentional tort?
A nurse gives the client a medication, and the client has an adverse reaction to it.
Which scenario is an example of certification?
A nurse who demonstrates advanced expertise in a content area of nursing through special testing
Which nursing student would most likely be held liable for negligence?
A nursing student administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home.
A client is in a persistent vegetative state following a severe motor vehicle accident. The client has no immediate family. Whom should the nurse consult when seeking direction for care?
A surrogate decision maker.
Which process evaluates and recognizes educational programs as having met certain standards?
Accreditation
During a nursing shift, which events warrant completion of an incident report? Select all that apply.
An intravenous antibiotic was administered 2 hours late because the IV site infiltrated. A visitor slipped and fell in the hallway, but was not injured. A client falls while being transferred from the bed to the chair.
A client informs the nurse about leaving the health care facility because the client is not satisfied with the treatment. The nurse knows that the client's treatment is incomplete and further testing and evaluations are scheduled. Which action by the nurse would be mostappropriate to prevent false imprisonment?
Ask the client to sign a release without medical approval.
An RN is working on a medical-surgical unit with a licensed practical/vocational nurse (LPN/LVN). Which action by the RN is considered negligent if injury results from this action?
Asking the LPN/LVN to teach a new diabetic client how to administer insulin
Which are torts rather than crimes? Select all that apply.
Assault Defamation of character Negligence
A client admitted to a mental health unit has exhibited physical behaviors that put the client and others at risk. The nurse applies four-point restraints on the client without obtaining a health care provider's order or the client's consent. The nurse is at risk of being accused of which action?
Battery
A client with end-stage renal disease decides against further treatment and requests a "Do Not Resuscitate" (DNR) order. The DNR status is part of the change-of-shift report. The client stops breathing and a nurse begins cardiopulmonary resuscitation. The family is upset and makes a complaint to the charge nurse. The charge nurse appropriately identifies that nurse has committed:
Battery
A nurse working in a coronary care unit resuscitates a client who had expressed wishes not to be resuscitated. Which tort has the nurse committed?
Battery
A student nurse is assisting an older adult client to ambulate following hip replacement surgery when the client falls and reinjures the hip. Who is potentially responsible for the injury to this client?
The student nurse, the nurse instructor, and the hospital
The nurse is providing care to a client who had orthopedic surgery. The nurse has medicated the client for pain. However, the client reports that the pain is unrelieved. The nurse takes no further action regarding assessment and intervention for the client's pain. The nurse does not notify the surgeon regarding the client's pain. The nurse's failure to take further action represents which element of liability in this case?
Breach of duty
A client has been in the emergency department for 3 hours for treatment of a migraine headache. Care has been delayed due to a multiple fatality car accident. The client gets up to go to the bathroom unattended, faints, and suffers a subdural hematoma. The family threatens to sue for malpractice. Which element of malpractice will be the most difficult for the attorney to prove?
Causation
The nurse recognizes that liability requires specific elements that must be established to prove that malpractice or negligence has occurred. Identify the specific elements. Select all that apply.
Causation Damages Duty Breach of duty
Nurses practicing in a critical care unit must acquire specialized skills and knowledge to provide care to the critically ill client. These nurses can validate this specialty competence through what process?
Certification
A client states that the client's recent fall was caused by his scheduled antihypertensive medications being mistakenly administered by two different nurses, an event that is disputed by both of the nurses identified by the client. Which measure should the nurses prioritizewhen anticipating that legal action may follow?
Document the client's claims and the events surrounding the alleged incident.
A client has asked that a nurse witness the signing of the client's will. What should the nurse do prior to witnessing this signature? Select all that apply.
Check to see whether state laws allow the nurse to witness this signature. Assess the client's state of mind. Review the client's medical record. Talk to the client about why the client is signing the will now.
A client is scheduled for a colonoscopy. The nurse realizes immediately after administering medications to induce conscious sedation that the client has not signed the informed consent. If the nurse has the client sign the informed consent at this point, which element of informed consent would be violated?
Competence
A nurse is named as a defendant in a malpractice lawsuit. Which action would be recommended for this nurse?
Do not volunteer any information on the witness stand.
The nurse is concerned about a potential malpractice or negligence lawsuit regarding a client who was cared for on the unit. What specific elements must be established to prove that malpractice or negligence has occurred in this client? Select all that apply.
Duty• Breach of duty• Causation• Damages
A client is to undergo surgery for removal of the gallbladder. Which action related to the client's informed consent falls within the nurse's scope of practice? Select all that apply.
Ensuring the signed form is on the chart Acting as a witness to the client's signature on the form Answering questions about elements of the consent
During the orientation to the hospital, the staff development educator discusses unit and institutional-based policies. What is the source of the practice rules that result in unit and institutional-based policies?
Health care institution
A nurse talks with family members about an AIDS client from the clinic where the nurse works. Which tort has the nurse committed?
Invasion of privacy
An HIV-positive client discovers that the client's name is published in a research report on HIV care prepared by the client's nurse. The client is hurt and files a lawsuit against the nurse. Which offense has the nurse committed?
Invasion of privacy
When talking with family over dinner, the nurse shares about a client with infertility at the hospital, identifying the person by name. Which tort has the nurse committed?
Invasion of privacy
A registered nurse who has an associate degree would like to obtain a baccalaureate degree in nursing. The nurse works full time and has several family obligations and would like to find a program that fits into that lifestyle. What is the nurse's priority question about an educational program?
Is the program accredited?
Which is true of the Occupational Safety and Health Act?
It helps to reduce workforce injuries and illness in the workplace.
A nurse is providing care to an older adult client. The client has been alert and independent with ambulation but now is exhibiting some confusion along with being unsteady when getting out of bed and walking. The nurse fails to report and document this change in status. No safety measures are taken and the client falls while getting out of bed to use the bathroom and fractures a hip. The client is experiencing significant pain from the fractured hip and requires surgery to repair the fracture. The nurse is sued for malpractice. Which action reflects the element of causation in this case?
Lack of safety measures implemented with status change
A nurse suspects that a client is a prostitute. The nurse documents this suspicion in the medical record and includes it in report to the oncoming shift. The nurse also mentions the suspicion to the nurse's sister saying, "I had a client named Susan in room 126 today who I think is a prostitute." Which violations has this nurse committed? Select all that apply.
Libel HIPAA Slander
A client has a prescription for amoxicillin 500 mg P.O. every 8 hours. The nurse administers the medication via the intravenous route. Based on the nurse's action, the client develops complications and has an increased length of stay. The client files a lawsuit against the facility and the nurse. Which legal action has the nurse's attorney identified that meets the criteria for the client's lawsuit?
Malpractice
A nurse is reviewing the nurse practice act of the state in which the nurse is licensed. The nurse understands that this act was derived from which source of law?
Statutory
Nurse practice acts are examples of which type of laws?
Statutory laws
A nurse witnesses a traffic accident and dresses the open wounds sustained by a child. Later, in the hospital, the child develops complications from an infection in the wound. The family holds the nurse responsible for the complications and attempts to file a lawsuit. Which statement is true regarding how the Good Samaritan law applies to this case?
The Good Samaritan law will provide legal immunity to the nurse.
What governing body has the authority to revoke or suspend a nurse's license?
The State Board of Nurse Examiners
After caring for a pediatric client, the nurse is surprised to learn about being named in a malpractice lawsuit. Select the four actions that meet the legal requirements of malpractice.
The client suffered an injury. The nurse has the duty to care for the client. The nurse failed to provide appropriate care. The nurse's lack of action directly resulted in harm.
While at a coworker's house, a nurse discusses with the coworker a client whom the nurse suspects of physically abusing the client's child. The next day, the client is moved to another nursing unit after a surgical procedure and comes under the care of the coworker, who is also a nurse. The coworker confronts the client about the alleged physical abuse. The client is shocked and angered by the accusation and denies it categorically. What would be the charge if the client were to file a suit?
The first nurse could be charged with slander.
A client is being prepared for an elective surgical procedure and the consent form has not been signed. Who should the nurse have obtain consent for the procedure?
The health care provider performing the surgical procedure
Which best exemplifies malpractice?
The nurse administers amoxicillin to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest.
Which are areas of potential liability for the nurse? Select all that apply.
The nurse fails to document refusal by the client to ambulate following surgery. The nurse documents that the client's blood pressure has increased from 118/72 to 188/98 mm Hg and decides to retake the blood pressure in an hour.
Legal safeguards are in place in the nursing practice to protect the nurse from exposure to legal risks as well as to protect the client from harm. What is an example(s) of legal safeguards for the nurse? Select all that apply.
The nurse confirms informed consent was give by the client to perform a procedure. The nurse educates the client about what to expect during the hospital stay. The nurse documents all client care in a timely manner.
A family brings the client to the emergency department in an unconscious state with a head injury. The client requires surgery to remove a blood clot. What would be the appropriate nursing intervention in keeping with the policy of informed consent prior to a surgical procedure?
The nurse confirms that the client's family has signed the consent form.
Nurses complete incident reports as dictated by the agency protocol. What is the primaryreason nurses fill out an incident report?
To improve quality of care
A nurse enters a client's room and finds that the client is lying on the floor. The nurse makes the client comfortable on the bed and completes an examination. She informs the health care provider and the nursing supervisor about this incident and also completes an incident report. Which action by the nurse indicates correct knowledge of handling an incident report?
The nurse documents a complete description of the happenings in the client's records.
While walking through a park, the nurse encounters a child with a swollen and reddened arm that hurts to move due to being struck with a baseball bat. The nurse splints the arm using two baseball bats. The child is transported to the hospital and later develops compartmental syndrome in the arm. Which statement regarding the nurse's liability in this case is accurate?
The nurse is protected by the Good Samaritan Act, which states that the nurse may give emergency care using good judgment
Which are examples of a nurse appropriately protecting a client's privacy? Select all that apply.
The nurse moves the client from the emergency department waiting room to a private area to collect assessment data. With the client's permission, the nurse explains the client's diagnosis to the client's spouse.
Which situation violates an element of informed consent?
The nurse says, "You have to sign this before we can do the surgery."
A client is unhappy with the health care provided and informs the nurse that the client is leaving the facility. The client has not been discharged by the health care provider. The nurse finds that the client has dressed and is ready to go. What should the nurse's action be in this situation?
The nurse should call and inform the nursing supervisor of the situation.
A client newly diagnosed with congestive heart failure has a prescription for digoxin. The nurse counts the heart rate before administration of the medication and obtains a heart rate of 51 beats per minute. Which action by the nurse demonstrates adherence to the standards of nursing care?
The nurse withholds the medication and notifies the health care practitioner.
A nurse enters the client's room and finds the client lying on the floor experiencing a seizure. After stabilizing the client, the nurse informs the health care provider. The health care provider advises the nurse to prepare an incident report. What is the purpose of an incident report?
To evaluate the quality of care provided and assess the potential risks for injury to the client
While walking down the hall, a nurse manager overhears a staff member telling a client, "If you don't stay in this chair and stop wandering, I'm going to tie you to it." The nurse manager pulls the staff member aside and discusses what was said. The nurse manager intervenes because the staff member's statement is which type of tort?
assault
A client with end-stage renal disease decides against further treatment and requests a "Do Not Resuscitate" (DNR) order. The DNR status is part of the change-of-shift report. The client stops breathing and a nurse begins cardiopulmonary resuscitation. The family is upset and makes a complaint to the charge nurse. The charge nurse appropriately identifies that nurse has committed:
battery
The nurse is providing care to a client whose condition has progressively declined. The nurse assesses and makes appropriate interventions as well as notifies the health care provider. Despite the nurse's efforts, the client expires. What element of liability has the nurse demonstrated?
duty
A nurse who obtains a license to practice nursing through self-misrepresentation is guilty of what tort?
fraud
While riding in the elevator, a nurse discusses the HIV-positive status of a client with other colleagues. The nurse's action reflects:
invasion of privacy.
A nurse is called to a deposition for a malpractice charge that has resulted in the death of a client. As the chart is reviewed, the prosecuting attorney questions the nurse about several defaming comments written in the medical record about the client. What charges can be filed against the nurse due to these comments?
libel
A nurse is caring for a client following endotracheal intubation. Before applying soft wrist restraints to prevent the client from pulling out the endotracheal tube, what is the mostappropriate action of the nurse?
obtain a medical order
A client on a surgical unit asks for the nurse's opinion of the surgeon. The nurse says that the surgeon is rude and that the surgeon's clients always end up with infections. The nurse is at risk of being accused of which?
slander
A nurse, while off-duty, tells the physiotherapist that a client who was admitted to the nursing unit contracted AIDS due to exposure to sex workers at the age of 18. The client discovers that the nurse has revealed the information to the physiotherapist. With what legal action could the nurse be charged?
slander
A client was admitted to a postoperative nursing unit after undergoing abdominal surgery. During this time, the nurse failed to recognize the significance of abdominal swelling, which significantly increased during the next 6 hours. Later, the client had to undergo emergency surgery. The lack of action on the nurse's part is liable for action. Which legal term describes the case?
tort
A nurse is caring for a client who has undergone coronary angioplasty. The cardiac monitor is showing abnormal electrocardiogram waves, indicating atrial fibrillation. The nurse does not recognize the importance of the sign; as a result, the client's condition deteriorates and the client has to be taken up for an emergency procedure. Which describes the nurse's legal liability?
tort
