Chapter 7: Legal Dimensions of Nursing Practice
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?" What is the most appropriate response made by the nurse? "A living will can only be used in the state it was created in." "Take it with you. It is recognized universally in the United States." "As long as your family knows your medical wishes, you will not need it." "We have it on file here, so any hospital can call and get a copy."
"Take it with you. It is recognized universally in the United States." A separate or different advance directive is not needed for each state, so it can be used in any state and does not matter where it was created. A living will is recognized in each state as valid so a client should be advised to take it with them as they travel out of state. The other responses are incorrect or inappropriate given this scenario.
A nurse assesses a client with psychotic symptoms and determines that the client needs vest restraints. However, the client asks the nurse not to put on vest restraints. What would be the best nursing action? Contact the physician and obtain necessary orders. Restrain the client with vest restraints. Apply restraints after giving a sedative. Apply wrist restraints instead of vest restraints.
Contact the physician and obtain necessary orders. If a nurse feels that a client needs to be restrained, the nurse should inform the physician and obtain necessary orders. The nurse should also discuss this with the client's family members and ask their opinion. The nurse should not sedate the client and then restrain him, as the nurse could be charged with battery if there is restraint without orders. Applying a wrist restraint instead of a vest restraint is like compromising with the client, which is unethical.
The student nurse tells her family about a client with AIDS that she cared for in clinical yesterday. Which tort has the student committed? Slander Assault Invasion of privacy Fraud
Invasion of privacy Invasion of privacy involves a breach of keeping client information confidential. Slander is oral defamation of character. Assault is a threat or attempt to make bodily contact with another person without that person's consent.
When the nurse informs a client's employer of his autoimmune deficiency disease, the nurse is committing the tort of: Breach of contract Assault Invasion of privacy Battery
Invasion of privacy Nurses have access to information recorded in the medical record, information shared or observed through care or interactions with friends and family, and through access to the client's body. A loss of privacy occurs if others inappropriately use their access to a person.
A registered nurse has had her license suspended after being convicted of being impaired at work. What governing body has the authority to revoke or suspend a nurse's license? The State Board of Nurse Examiners The employing health care institution The National League for Nursing The Supreme Court
The State Board of Nurse Examiners The State Board of Nurse Examiners in the United States may revoke or suspend a nurse's license or registration for drug or alcohol abuse.
A legal document that states a client's health-related wishes — such as a preference for pain management if the client becomes terminally ill — and also allows the client's daughter to direct his care, is a(an): will. standard of care. license. advance directive.
advance directive. Clients communicate their wishes to health care providers by verbally participating in health care decision making and by employing written documents called advance directives.
A nurse is overheard in the hospital cafeteria making false comments about a client. The nurse is guilty of: slander. libel. invasion of privacy. assault.
slander. Slander is oral defamation of character. Libel is written defamation of character. Assault is a threat or attempt to make bodily contact with another person without that person's consent. Invasion of privacy involves a breach of keeping client information confidential.
Professional regulations and laws that govern nursing practice are primarily in place for which reason? to limit the number of nurses in practice to ensure that practicing nurses are of good moral standing to protect the safety of the public to ensure that enough new nurses are always available
to protect the safety of the public Governing bodies, professional regulations, and laws are in place to protect the public by ensuring that nurses are accountable for safe, competent, and ethical nursing practice. The other options do not describe accurately the role and responsibility of the governing bodies and the regulations and laws of nursing.
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 3 times. As usual, health care provider did not respond. 1300: Client temperature elevated. Health care provider paged, but did not respond. Administered Tylenol without an order because I knew this health care provider does not return calls. 1300: Client temperature elevated. Telephoned health care provider's service several times with no response. Will notify nursing supervisor during rounds. 1300: Client temperature elevated. Telephoned health care provider's service 3 times without a response. Tepid sponge bath given and nursing supervisor notified.
1300: Client temperature elevated. Telephoned health care provider's service 3 times without a response. Tepid sponge bath given and nursing supervisor notified. Documentation must have the correct, factual, and timely information. The nurse must document when the health provider was called and response or lack of response; what nursing action was done, if any, and notification of appropriate personnel. The nurse cannot administer medication without an order. The nurse should be careful and not make incriminating statements, such as, "as usual health care provider did not respond." The nurse should not wait until rounds are made to inform the supervisor.
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? Assault Battery Libel Slander
Battery The nurse has committed a mistake and can be sued for battery because of unlawfully carrying out a procedure that the client had refused. Battery is an assault and includes negligent touching of another person's body or clothes or anything attached to or held by that other person. Assault is the threat of touching another person without his or her consent. Negligence may be an act of omission or commission. Defamation of character in spoken words is called slander. Libel is defamation of character in written words.
A nurse fails to communicate a change in the client's condition to the physician. Which element related to proving malpractice has been met? Duty Breach of duty Proximate cause Damages
Breach of duty Failing to communicate a change in the client's condition reflects a breach of duty. Duty describes the relationship between the person and the person being sued. Nurses have a duty to care for their clients. The existence of a duty is rarely an issue in a malpractice suit. The action or lack of action must be proven as the cause of the injury. Damages refer to the injury suffered by the client.
Nurses follow nursing practice rules when working within the profession. What are examples of state-mandated rules? (Select all that apply.) Nurse practice acts Medicare and Medicaid provisions for reimbursement of nursing services Nursing educational requirements Delegation trees Composition and disciplinary authority of board of nursing Medication administration
Nurse practice acts Nursing educational requirements Composition and disciplinary authority of board of nursing Examples of state-mandated rules would include nurse practice acts, nursing educational requirements, and composition and disciplinary authority of boards of nursing. Delegation trees, medication administration, and Medicare and Medicaid provision for reimbursement of nursing services are not examples of state-mandated rules.
During the admission assessment of a female client age 40 years with a suspected mandibular fracture, the client discloses to the nurse that her injury came as a result of her husband hitting her. Which action should the nurse prioritize when responding to this disclosure? Reporting the abuse to the appropriate authorities Ensuring the client's statement is confirmed by another nurse Performing an assessment to confirm the client's statement Informing the client of her right to keep this information private
Reporting the abuse to the appropriate authorities Nurses have a legal and ethical obligation to report cases of abuse. It would be inappropriate and likely unethical to require a third party witness to the statement or to withhold action pending assessment results. The nurse's obligation to report abuse legally supersedes the client's right to privacy.
A client is unhappy with the health care provided to him. He approaches the nurse and informs her that he is leaving the facility. The client has not been discharged by the physician. The nurse finds that the client has dressed and is ready to go. What would the nurse's action be in this situation? The nurse should get the client restrained and call the physician. The nurse should let the client go because she cannot do anything. The nurse should call the nursing supervisor and inform her about the situation. The nurse should warn the client that he cannot come to the hospital again.
The nurse should call the nursing supervisor and inform her about the situation. The nurse should call the nursing supervisor and inform her about the situation. The client should be made to sign the document stating that he is responsible for his own actions. The nurse cannot keep the client restrained because that would be false imprisonment. Likewise, the nurse cannot overlook the incident because there is a responsibility for client care. Additionally, the nurse cannot warn the client that he will not be allowed to come back to the hospital because it is the client's right to access health care whenever required.
A medical surgical client is in the radiology department. The client's cousin arrives on the medical surgical unit and asks to speak with the nurse caring for his cousin. The visitor asks the nurse to provide a brief outline of the client's illness. Which response, if given by the nurse, would demonstrate application of legal safeguard in her practice? "I will call the client and ask his permission." "I cannot give you that information due to client confidentiality." "Do you have any identification proving you are related to the client?" "I'm busy right now, but can talk later."
"I cannot give you that information due to client confidentiality." Sharing a client's information without his or her consent is an invasion of privacy. The nurse cannot give out the information even if the client proves a relationship or at a later time without the client's consent. It is inappropriate to call the client to ask for permission.
A client admitted with Hodgkin disease has a handwritten prescription for vinblastine 3.7 mg intravenously (IV) weekly. The nurse interprets the prescription as vincristine 3.7 mg and administers the wrong medication. The client becomes neurovascularly compromised and has a fatal reaction to the medication. The client's family begins a litigious suit against the facility and the nurse's license is suspended by the board of nursing. In preparation for the lawsuit, the nurse meets with the nurse attorney to review the events. Which appropriate statement, if given by the nurse, indicates he has an understanding of the lawsuit? "I could not read the health care provider's handwriting, so I am not at fault." "I checked the medication before giving it and literature states it is for Hodgkin disease." "I had a duty and it was my responsibility to double check the medication, which I did, yet this still happened." "I had a duty and it was my responsibility to get clarification before administering the medication, which I did not."
"I had a duty and it was my responsibility to get clarification before administering the medication, which I did not." The nurse has a legal obligation to carry out health care provider's prescriptions unless the order is ambiguous (the nurse could not read provider's handwriting), contraindicated (vincristine dosage was too high), and contraindicated (wrong medication). The nurse had a duty and needed to get clarification, which he did not. The nurse is liable because there was a duty, which was breached, causation (wrong medication), and harm (client's death). Checking the medication is the correct thing to do, but the priority was assuring the medication was the correct one as prescribed.
The nurse is participating in a discussion about controlled substances. Which statement, made by the nurse, indicates the nurse is aware of laws governing the distribution of controlled substances? "When a nurse abuses controlled substances in the workplace and gets help, she will not be charged with a criminal act." "Nurses are responsible for adhering to specific documentation about controlled substances." "An impaired nurse is promptly punished by being terminated and having his or her license suspended." "The nurse is only at risk if she diverts medication from the client; using personal drugs decrease your risk."
"Nurses are responsible for adhering to specific documentation about controlled substances." Nurses have specific responsibilities regarding controlled substances, including specific documentation. Violation of controlled substances at the workplace is serious and is considered a criminal act. Substance abuse is treatable and the objective is to detect and treat the problem early. It does not matter where the nurse obtains the drugs; she is still liable for her actions.
A nurse hired to work in an ambulatory setting attends new employee orientation. The nurse never worked in ambulatory before and is concerned about the Scope and Standards of Practice for Professional Ambulatory Care Nursing. Which response, given by the nurse educator, would further explain the Scope and Standards of Practice for Professional Care Nursing to the new nurse? "The Scope and Standards of Practice for Professional Ambulatory Care Nursing takes precedent over the facility's policies and procedures." "The Scope and Standards of Practice for Professional Ambulatory Care Nursing sets the standards for the nursing supervisor to assess a nurse." "The Scope and Standards of Practice for Professional Ambulatory Care Nursing determines if a nurse is minimally competent to receive a license to practice as a nurse." "The Scope and Standards of Practice for Professional Ambulatory Care Nursing deal with the professional obligations of a nurse working in the ambulatory setting."
"The Scope and Standards of Practice for Professional Ambulatory Care Nursing deal with the professional obligations of a nurse working in the ambulatory setting." The Scope and Standards of Practice for Professional Ambulatory Care Nursing are the standards of care for nurses working in the ambulatory arena. It does not take precedent over the facility's policies and procedures, but must be worked in conjunction with the policies and procedures. It is not used for assessing nurses. NCLEX determines if a nurse is minimally competent to practice as a nurse.
The client being admitted to the oncology unit conveys his wishes regarding resuscitation in the event of cardiopulmonary arrest. The nurse advises the client that it would be in his best interest to obtain which document? A will A living will Proof of health care power of attorney A proxy directive
A living will A living will is an advance directive that specifies the type of medical treatment clients do or do not want to receive should they be unable to speak for themselves in a terminal or permanently unconscious condition.
Which of the following is an example of certification? A nurse who demonstrates advanced expertise in a content area of nursing through special testing. A hospital meets the standards of the Joint Commission. An education program that meets standards of the National League for Nursing. A graduate of a nursing education program who passes NCLEX-RN.
A nurse who demonstrates advanced expertise in a content area of nursing through special testing. Certification is a voluntary process where a person who has met criteria established by a nongovernmental association is granted special recognition in a specified practice area. Licensure is granted by the state to a graduate of a nursing education program who passes NCLEX-RN. Accreditation is a voluntary process by which a nursing education program is recognized as having met certain standards by the National League for Nursing Accrediting Commission and/or the American Association of Colleges of Nursing. The Joint Commission can also accredit healthcare agencies.
Which of the following is an example of certification? A nurse who demonstrates advanced expertise in a content area of nursing through special testing. A graduate of a nursing education program who passes NCLEX-RN. An education program that meets standards of the National League for Nursing. A hospital that meets the standards of the Joint Commission.
A nurse who demonstrates advanced expertise in a content area of nursing through special testing. Certification is a voluntary process whereby a person who has met criteria established by a nongovernmental association is granted special recognition in a specified practice area. Licensure is granted by the state to a graduate of a nursing education program who passes NCLEX-RN. Accreditation is a voluntary process by which a nursing education program is recognized as having met certain standards by the National League for Nursing Accrediting Commission and/or the American Association of Colleges of Nursing. The Joint Commission can also accredit health care agencies.
Which of the following is an example of certification? A nurse who demonstrates advanced expertise in a content area of nursing through special testing. A graduate of a nursing education program who passes NCLEX-RN. An education program that meets standards of the National League for Nursing. A hospital that meets the standards of the Joint Commission.
A nurse who demonstrates advanced expertise in a content area of nursing through special testing. Certification is a voluntary process whereby a person who has met criteria established by a nongovernmental association is granted special recognition in a specified practice area. Licensure is granted by the state to a graduate of a nursing education program who passes NCLEX-RN. Accreditation is a voluntary process by which a nursing education program is recognized as having met certain standards by the National League for Nursing Accrediting Commission and/or the American Association of Colleges of Nursing. The Joint Commission can also accredit health care agencies.
Which nursing student would most likely be held liable for negligence? A nursing student performs a dressing change using sterile technique and documents the presence of necrotic tissue in the wound. A nursing student reports that insulin was not administered to the client by the nurse on the previous shift. A nursing student administers medication to a resident, while working as an unlicensed assistive personnel (UAP) at a local nursing home. A nursing student completes an incident report after administering a medication to a client, who then experienced an adverse reaction to the medication.
A nursing student administers medication to a resident, while working as an unlicensed assistive personnel (UAP) at a local nursing home. The nursing student who administers medication to a resident, while working as an unlicensed assistive personnel (UAP) at a local nursing home, is performing a task outside the scope of the job responsibilities of a UAP. The other options demonstrate legally defensible actions by the nursing student.
Which process evaluates and recognizes educational programs as having met certain standards? Accreditation Credentialing Licensure Certification
Accreditation Accreditation is the process by which an educational program is evaluated and recognized as having met certain standards. Credentialing refers to ways in which professional competence is ensured and maintained. Licensure is the process by which a state determines that a candidate meets certain minimum requirements to practice in the profession and grants the license to do so. Certification is the process by which a person who has met certain criteria established by a nongovernmental association is granted recognition in a specified practice area.
Which process evaluates and recognizes educational programs as having met certain standards? Accreditation Credentialing Licensure Certification
Accreditation Accreditation is the process by which an educational program is evaluated and recognized as having met certain standards. Credentialing refers to ways in which professional competence is ensured and maintained. Licensure is the process by which a state determines that a candidate meets certain minimum requirements to practice in the profession and grants the license to do so. Certification is the process by which a person who has met certain criteria established by a nongovernmental association is granted recognition in a specified practice area.
A student nurse is assisting an elderly patient to ambulate following hip replacement surgery, and the patient falls and reinjures the hip. Who is potentially responsible for the injury to this patient? The student nurse The nurse instructor The hospital All of the above
All of the above As a student nurse, you are responsible for your own acts, including any negligence that may result in patient injury. A hospital may also be held liable for the negligence of a student nurse enrolled in a hospital-controlled program because the student is considered an employee of the hospital. The status of students enrolled in college and university programs is less clear, as is the liability of the educational institution in which they are enrolled and the health care agency offering a site for clinical practice. Nursing instructors may share responsibility for damages in the event of patient injury if an assignment called for clinical skills beyond a student's competency or the instructor failed to provide reasonable and prudent clinical supervision.
A student nurse is assisting an elderly patient to ambulate following hip replacement surgery, and the patient falls and reinjures the hip. Who is potentially responsible for the injury to this patient? The student nurse The nurse instructor The hospital All of the above
All of the above As a student nurse, you are responsible for your own acts, including any negligence that may result in patient injury. A hospital may also be held liable for the negligence of a student nurse enrolled in a hospital-controlled program because the student is considered an employee of the hospital. The status of students enrolled in college and university programs is less clear, as is the liability of the educational institution in which they are enrolled and the health care agency offering a site for clinical practice. Nursing instructors may share responsibility for damages in the event of patient injury if an assignment called for clinical skills beyond a student's competency or the instructor failed to provide reasonable and prudent clinical supervision.
Nurses practice within the legal and mandatory standards of the nursing profession. What are examples of voluntary standards in nursing? (Select all that apply.) State nurse practice acts Rules and regulations of nursing American Nurses Association Standards of Practice Professional standards for certification of individual nurses in general practice Process of certification
American Nurses Association Standards of Practice Professional standards for certification of individual nurses in general practice Process of certification Voluntary standards in nursing would include the American Nurses Association (ANA) Standards of Practice, the process of certification, and professional standards for certification of individual nurses in general practice. State nurse practice acts is not an example of voluntary standards in nursing. Rules and regulations of nursing are not examples of voluntary standards in nursing.
During a nursing shift, which events warrant completion of an incident report? (Select all that apply.) A nurse reports that a client is crying and distraught over a diagnosis of metastatic cancer. 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 registered nurse asks an unlicensed assistive personal (UAP) to feed a client.
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. An incident report is a written account of an unusual, potentially injurious event involving a client, employee, or visitor. Late administration of medication is considered a medication error and is potentially injurious to the client. A visitor fall and a client fall are both reportable situations. A client crying following a diagnosis of cancer could be expected, and a registered nurse delegating appropriate care to a UAP is not reportable. Therefore, these actions do not require an incident report to be filed.
A client informs the nurse that he is leaving the health care facility because he 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 most appropriate to prevent false imprisonment? Restrain the client to prevent him from leaving. Call the physician to speed up the discharge process. Ask the client to sign a release without medical approval. Tell the client that he will not be able to get access again.
Ask the client to sign a release without medical approval. If a client wants to leave the health care facility, the nurse should ask him to sign a release stating that he left without medical approval. The nurse cannot restrain the client because it amounts to false imprisonment. Calling the physician is not an appropriate measure. Telling the client that he may not be able to access the health care facility again is an inappropriate response because health care is a right and the client can access it whenever necessary.
When the nurse inserts an ordered urinary catheter into the client's urethra after the client has refused the procedure, and then the client suffers an injury, the client may sue the nurse for which type of tort? Battery Assault Invasion of privacy Dereliction of duty
Battery Battery is the actual carrying out of such a threat (unlawful touching of a person's body). A nurse may be sued for battery if there is failure to obtain consent for a procedure.
An oncology nurse is caring for a client suffering from metabolic encephalopathy and end stage kidney disease. The client has no known family and no advanced directives. Upon entering the room, the nurse observes the client is pale and has no spontaneous respiration. What is the priority action the nurse should take? Contact the physician. Call the coroner. Notify the charge nurse. Begin CPR.
Begin CPR. A code status refers to how healthcare providers are required to manage care in the case of cardiac or respiratory arrest. A full code means that all measures to resuscitate the client are used. The nurse should immediately begin CPR. Although it is necessary to notify the physician and charge nurse, this is not the priority. It is not appropriate to contact the coroner at this time.
Nurses practicing in a critical care unit must acquire specialized skills and knowledge to provide care to the critically ill client. These nurses can validate this specialty competence through what process? Certification Accreditation Licensure Litigation
Certification
Having recently completed a specialty nursing program in neonatal care, a nurse is now preparing to leave her current position on a medical unit and begin providing care in the hospital's neonatal intensive care unit (NICU). The nurse has completed which of the following processes of credentialing? Certification Licensure Accreditation Validation
Certification The process of certification involves the attainment and validation of specialized nursing knowledge and skills. Certification is often necessary in order to ensure that the nursing care that is provided in specialized and high-acuity settings is safe and appropriate. Accreditation is the process by which an educational program, rather than an individual nurse, identifies that standards are being met. The process of licensure involves the determination that a nurse meets minimum requirements to practice, but not necessarily the specialized knowledge that is necessary for some care settings. Validation is not a specific aspect of the process of credentialing.
A nurse fails to administer a medication that prevents seizures, and the client has a seizure. The nurse is in violation of the Nurse Practice Act. What type of law is the nurse in violation of? Criminal Federal Civil Supreme
Civil Malpractice cases are generally civil litigation cases that involve nurses.
A client states that his recent fall was caused by the fact that his scheduled antihypertensive medications were 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 prioritize when anticipating that legal action may follow? Document the client's claims and the events surrounding the alleged incident. Consult with the hospital's legal department as soon as possible. Consult with practice advisors from the state board of nursing. Enlist support from nursing and non-nursing colleagues from the unit.
Document the client's claims and the events surrounding the alleged incident. It is imperative for nurses to carefully and accurately document assessment findings and the nursing care that they provide, a fact that is especially salient when legal action is anticipated. This thorough and accurate assessment should precede consultation with the legal department, the state board of nursing, and colleagues.
A client states that his recent fall was caused by the fact that his scheduled antihypertensive medications were 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 prioritize when anticipating that legal action may follow? Document the client's claims and the events surrounding the alleged incident. Consult with the hospital's legal department as soon as possible. Consult with practice advisors from the state board of nursing. Enlist support from nursing and non-nursing colleagues from the unit.
Document the client's claims and the events surrounding the alleged incident. It is imperative for nurses to carefully and accurately document assessment findings and the nursing care that they provide, a fact that is especially salient when legal action is anticipated. This thorough and accurate assessment should precede consultation with the legal department, the state board of nursing, and colleagues.
The nurse educator is presenting a lecture on the Occupational Safety and Health Act. Which situations, if identified by the nursing staff, would indicate to the educator that the staff understands which actions about the Occupational Safety and Health Act? Requires nurses to report abuse of infants, children, and adults of all ages Helps reduce workforce injuries and illness in the workplace Acts as an information clearing house for nurses who engage in unprofessional conduct Protects nurses who are recovering from drug or alcohol addiction or have communicable diseases
Helps reduce workforce injuries and illness in the workplace The Occupational Safety and Health Act helps to reduce injuries and illness in the workplace. The National Practitioner Data Bank is a clearinghouse for health care practitioners who engage in unprofessional conduct and restrict them from moving from state to state. Nurses are obligated to report abuse because of the nurse-patient relationship; it is not a requirement of the Occupational Safety and Health Act. The American with Disabilities Act protects people with communicable diseases and those recovering from drug or alcohol addiction.
The nursing student talks with the student's family about an AIDS client from the clinical experience. Which tort has the student committed? Invasion of privacy Fraud Assault Slander
Invasion of privacy Invasion of privacy involves a breach of keeping client information confidential. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property. Slander is oral defamation of character. Assault is a threat or attempt to make bodily contact with another person without that person's consent.
While caring for an infant, the nurse hears another child screaming in the next room. She rushes to the other room to check on the screaming child, forgetting to put the side rails up on the infant's crib. She returns to the room to find the infant has fallen out of the crib and sustained a head injury. Based on the nurse's action, which tort is the nurse liable for? Defamation Malpractice Assault Battery
Malpractice The nurse did not ensure the safety of the infant by pulling up the side rails before leaving the infant unattended. Therefore, the nurse may be charged with malpractice because she had a duty that she breached; there was causation with harm to the infant. Assault occurs when a person threatens to touch a client without consent. Battery is carrying out the threat by touching the client without consent, whereas defamation occurs when a derogatory remark is made about another person.
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 most appropriate action of the nurse? Sedate the client. Get written consent. Obtain a medical order. Notify the family.
Obtain a medical order. Nurses must obtain a medical order before each and every instance in which they use restraints. Due to the severity of the client illness requiring endotracheal intubation, the client may not be able to provide a written consent. The client does not need to be sedated unless medically necessary, and although it is appropriate to notify the family, this is not the priority.
The health care provider prescribes orders for a client with newly diagnosed uncontrolled seizure activity. When reviewing the prescriptions, the nurse correctly identifies which prescription, if followed, puts him at risk for negligence charges? Neurologic assessments every 5 minutes Oxygen 2/L via nasal cannula Diazepam (Valium) 5 mg intravenously now Restrain all four extremities
Restrain all four extremities The nurse is obligated to carry out health care provider's orders unless it is unclear or incorrect. The client with seizures must be protected from harm. Restraints restricts the client's movement and can cause harm. Diazepam, oxygen, and frequent neurologic assessments are correct interventions for a client with uncontrolled seizure activity.
A client who is scheduled for hernioplasty needs clarification regarding the procedure. The nurse calls the physician at the client's insistence. The physician, who is in a bad mood, is overheard telling the client that the nurse does not know anything. Which legal tort has the physician committed? Libel Battery Assault Slander
Slander The physician has committed slander by defaming the nurse orally. Slander is a character attack uttered orally in the presence of others. Libel refers to damaging statements written and read by others. Assault is an act in which bodily harm is threatened or attempted. Battery is unauthorized physical contact, not applicable in this situation.
A nurse who comments to her coworkers at lunch that her client with a sexually transmitted infection (STI) has been sexually active in the community may be guilty of what tort? Slander Libel Fraud Assault
Slander Defamation of character is an intentional tort in which one party makes derogatory remarks about another, with those remarks harming the other party's reputation. Slander is spoken defamation of character; libel is written defamation. Assault is a threat or an attempt to make bodily contact with another person without that person's consent. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property.
A nurse, while off-duty, tells the physiotherapist that a client who was admitted to the nursing unit contracted AIDS due to exposure to sex workers at the age of 18. The client discovers that the nurse has revealed the information to the physiotherapist. With what legal action could the nurse be charged? Libel Slander Negligence Malpractice
Slander The nurse can be charged with slander, which is a verbal attack on a person's character. Libel pertains to damaging written statements read by others. Both libel and slander are considered defamation of character - an intentional tort in which one party makes derogatory remarks about another that diminish the other party's reputation. Negligence and malpractice pertain to actions which are committed or omitted, thereby causing physical harm to a client.
A client on a surgical unit asks for the nurse's opinion of the surgeon. The nurse replies, "He is rude. His clients always end up with infections." The nurse is at risk of being accused of which of the following? Libel Slander/defamation Negligence Assault
Slander/defamation Slander/defamation involves words communicated verbally to a third party that harm or injure the personal or professional reputation of another person. The other options do not define the situation described in the question.
A client is in a persistent vegetative state. The client has no immediate family and is a ward of the state. Under these circumstances, who will speak on this client's behalf? Surrogate decision maker Church-appointed guardian A significant other Her best friend
Surrogate decision maker Infants, young children, people who are severely mentally handicapped or incapacitated, and people in a persistent vegetative state or coma do not have the capacity to participate in decision making about their health care. For such people, a surrogate decision maker must be identified to act on their behalf.
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 of the following statements is true regarding the Good Samaritan law? The Good Samaritan law will provide legal immunity to the nurse. The Good Samaritan law will not protect the nurse because she did not accept compensation. The Good Samaritan law is not applicable to health care workers. The Good Samaritan law will provide absolute exemption from prosecution.
The Good Samaritan law will provide legal immunity to the nurse. The Good Samaritan laws provide legal immunity to passersby who provide emergency first aid to victims of accidents. Therefore, the law is applicable to the nurse as well; moreover, the nurse did not accept any compensation for the service provided. The law is equally applicable to everyone, but does not provide absolute exemption from prosecution in cases of negligence. Paramedics, ambulance personnel, physicians, and nurses who stop to provide assistance are still held to a higher standard of care because they have training above and beyond that of average laypeople. In cases of gross negligence, health care workers may be charged with a criminal offense.
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 of the following statements is true regarding the Good Samaritan law? The Good Samaritan law will provide legal immunity to the nurse. The Good Samaritan law will not protect the nurse because she did not accept compensation. The Good Samaritan law is not applicable to health care workers. The Good Samaritan law will provide absolute exemption from prosecution.
The Good Samaritan law will provide legal immunity to the nurse. The Good Samaritan laws provide legal immunity to passersby who provide emergency first aid to victims of accidents. Therefore, the law is applicable to the nurse as well; moreover, the nurse did not accept any compensation for the service provided. The law is equally applicable to everyone, but does not provide absolute exemption from prosecution in cases of negligence. Paramedics, ambulance personnel, physicians, and nurses who stop to provide assistance are still held to a higher standard of care because they have training above and beyond that of average laypeople. In cases of gross negligence, health care workers may be charged with a criminal offense.
When making client rounds, the charge nurse observes which action by a staff nurse that would constitute battery? The elderly client refuses the intramuscular injection, but the staff nurse administered it. The staff nurse threatens to restrain the client if she did not take her medication. While bathing a client behind pulled curtains, two nurses are discussing a different client. The nurse tells the client she cannot leave the hospital because she is seriously ill.
The elderly client refuses the intramuscular injection, but the staff nurse administered it. If the client refuses a procedure or medication and the nurse proceeds with it, it is battery. Threatening a client is assault. Discussing another client within earshot of others is an invasion of privacy. Keeping a client against her wishes, regardless of her health status, is false imprisonment.
The health care facility is involved in litigation by four clients. When reviewing the cases, which legal case would the nurse attorney identify to best describe malpractice? The nurse applies an ice pack to a client's lower back without an order and he feels better . The nurse using proper mechanics assists a client to a locked bed. He slips and breaks his left femur. The nurse administers amoxicillin (Amicar) to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest. The nurse administered the wrong medication to the client, who had one episode of vomiting 5 minutes after consuming the medication with no further adverse reactions.
The nurse administers amoxicillin (Amicar) to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest. All elements of liability are in place for administering amoxicillin to a client with documented allergies to penicillin: the nurse had a duty, but breached it when giving the medication. There also was causation (amoxicillin) and harm (seizures and respiratory arrest). The nurse is negligent when applying an ice pack without an order. The nurse used proper mechanics, so the client fall is an accident even though harm occurred. Giving the wrong medication could be cause for malpractice, but there was no harm.
A nurse is caring for a client with vertigo. During data collection, the nurse finds multiple bruises on the client's arms and back; and suspects the client is being abused. When questioned, the client denies any abuse by the daughter she lives with. Despite the client's denial, which rationale would the nurse use for reporting the suspected abuse? The client does not want anyone to know what is happening in her home. The client is ashamed to admit that her daughter is beating her. The nurse wants her peers to see her as a hero. The nurse has a legal and ethical responsibility to report the suspected abuse.
The nurse has a legal and ethical responsibility to report the suspected abuse. Nurses are legally and ethically responsible to report suspected abuse. Because nurses are legally obligated, it does not depend upon the client's fear or reluctant to report the abuse. Being labeled a hero is not the correct rationale for reporting suspected abuse.
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 are examples of legal safeguards for the nurse? Select all that apply. The nurse obtains informed consent from a client to perform a procedure. The physician is responsible for administration of a wrongly prescribed medication. The nurse educates the client about The Patient Care Partnership. The nurse executes physician orders without questioning them. The nurse documents all client care in a timely manner. The nurse claims management is responsible for inadequate staffing leading to negligence.
The nurse obtains informed consent from a client to perform a procedure. The nurse educates the client about The Patient Care Partnership. The nurse documents all client care in a timely manner. Examples of legal safeguards for the nurse would include the nurse obtaining informed consent from a client, the nurse educating the client about The Patient Care Partnership, and the nurse documenting all client care in a timely manner. Legal safeguards for the nurse would not include the nurse executing physician orders without questioning them. Legal safeguards for the nurse would not include the nurse claiming management is responsible for inadequate staffing leading to negligence. Legal safeguards for the nurse would not include the physician being responsible for administration of a wrongly prescribed medication.
A physician is called to see a client with angina. During the visit the physician advises the nurse to decrease the atenolol to 12.5 mg. However, since the physician is late for another visit, she requests that the nurse write down the order for her. What should be the appropriate nursing action in this situation? The nurse should ask the physician to come back and write the order. The nurse should write the order and implement it. The nurse should inform the client of the change in medication. The nurse should remind the physician later to write the work order.
The nurse should ask the physician to come back and write the order. The nurse should ask the physician to come back and write down the order. Nurses are discouraged from following any verbal orders, except in an emergency. The nurse should never write an order on a physician's behalf because this is a wrong practice. The client should be informed about the change of medications, but this is not an appropriate action. The nurse should not leave the work for a later time, because the nurse may forget it.
After reporting to work for a night shift, the nurse learns that the unit will be understaffed because two RNs called out sick. As a result, each nurse on the unit will need to provide care for an additional four acute clients, in addition to her regular client assignment. Which statement is true for this nurse when working in understaffed circumstances? The nurse will be legally held to the same standards of care as when staffing levels are normal. Understaffing constitutes an extenuating circumstance that creates a temporarily lower expectation for care for the nurse. The nurse must document that float staff, nurses on overtime, and part-time staff were contacted in an effort to fill the gaps in care. The nurse is legally obliged to refuse to provide care when understaffing creates the potential for unsafe conditions.
The nurse will be legally held to the same standards of care as when staffing levels are normal. The claim of being overworked does not constitute a legal defense, and both the potential for liability and standards of care remain unchanged despite an increased client assignment. While it is prudent to make all realistic attempts to fill the gaps in staffing, documenting these efforts does not change the nurse's legal position. A nurse has the right to refuse an unsafe client assignment but the nurse is not legally obliged to withhold care.
A nurse enters the client's room and finds the client lying on the floor experiencing a seizure activity. After stabilizing the client, the nurse informs the physician. The physician advises the nurse to prepare an incident report. What is the purpose of an incident report? To provide a method for deciding the nurse's fault in the incident To evaluate quality care and potential risks for injury to the client To provides information to local, state, and federal agencies To evaluate the immediate care provided by the nurse to the client
To evaluate quality care and potential risks for injury to the client An incident report is a written account of an unusual, potentially injurious event involving a client, employee, or visitor. Incident reports determine how to prevent hazardous situations and serve as a reference in case of future litigation. Accurate and detailed documentation often helps to prove that the nurse acted reasonably or appropriately in the circumstances. It may not always serve as a method of determining the nurse's fault in the incident. The document does not evaluate the immediate care provided to the client but states the actions taken.
A nurse is caring for a client who has undergone coronary angioplasty. The cardiac monitor is showing abnormal ECG waves, indicating arterial 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 of the following describes the nurse's legal liability? Felony Defamation Tort Slander
Tort A tort is a cause of action in which one person asserts that a physical, emotional, or financial injury was a consequence of another person's actions or failure to act. A tort implies that a person breached his duty to another person. In this case, the nurse had a duty that was breached. A felony is a serious criminal offense, such as murder. Defamation is an act in which untrue information harms a person's reputation. Slander is a character attack uttered orally in the presence of others.
A client is received in 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 of the following legal terms describes the case? Misdemeanor Felony Tort Fraud
Tort A tort is a litigation in which one person asserts that a physical, emotional, or financial injury was a consequence of another person's actions or failure to act. The lack of action on the nurse's part truly indicates unintentional tort. A misdemeanor or felony would be an offense under criminal law, and neither is applicable in this case. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property.
The nurse educator provides an educational session to the nursing staff on protection of a client's privacy. Which circumstances, identified by the staff, would indicate to the educator that the teaching was effective? Select all that apply. During a bed bath, the nurse exposed the client's upper torso while washing the client's face. With the client's permission, the nurse explained the client's diagnosis to the client's spouse. The nurse questioned the client about her social life even though it did not affect care planning. The nurse removed the client from the emergency department waiting room into a private area to collect assessment data. Because the facility is a teaching facility, the nurse allowed the nursing student to take the client's picture for his care plan.
With the client's permission, the nurse explained the client's diagnosis to the client's spouse. The nurse removed the client from the emergency department waiting room into a private area to collect assessment data. To prevent invasion of privacy, all client information is considered confidential and private; this includes name and all identifiers (e.g., social security number, address, date of birth). With the client's permission, information can be shared with a spouse. A client should be taken to a private soundproof area to collect data. Unnecessary exposure of a client's body, taking pictures of a client, and questioning a client's social life when it does not affect care planning are examples of invasion of privacy.
A nurse observes another nurse place an unused dose of narcotics in their pocket. If caught, the nurse could be charged with which type of crime? negligence misdemeanor felony tort
felony
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. defamation of character. professional negligence . false imprisonment.
invasion of privacy. The nurse's action reflects an invasion of the client's privacy. Disclosing confidential information to an inappropriate third party subjects the nurse to liability for invasion of privacy, even if the information is true. Defamation of character includes false communication that results in injury to a person's reputation. Negligence is an act of omission or commission. Prevention of movement or unjustified retention of a person without consent may be false imprisonment.
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? malpractice slander libel negligence
libel Libel is damaging statements written and read by others. Since there were defaming comments written in the chart, libel charges could be appropriate. Malpractice, slander, and negligence are not charges in this scenario.
Which situation is an example of battery that the nurse may experience while performing her duties at the health care facility? telling the client that he cannot leave the hospital performing a surgical procedure without getting consent taking the client's photographs without consent witnessing a procedure done on a client without his consent
performing a surgical procedure without getting consent Performing a surgical procedure without the client's consent is an example of battery. To protect health care workers from being charged with battery, adult clients are asked to sign a general permission for care and treatment during admission, and additional written consent forms for tests, procedures, or surgery. Telling the client not to leave the hospital is a false imprisonment. Taking the client's photographs without his permission and witnessing a procedure done on him without consent is violation of the client's privacy.
In comparison with licensure, which measures entry-level competence, what does certification validate? innocence of any disciplinary violation specialty knowledge and clinical judgment more than 10 years of nursing practice ability to practice in more than one area
specialty knowledge and clinical judgment Whereas licensure measures entry-level competence, certification validates specialty knowledge, experience, and clinical judgment. Certification does not validate innocence, years of practice, or ability in multiple practice areas.
Nurses complete incident reports as dictated by the agency protocol. What is the primary reason nurses fill out an incident report? to document everyday occurrences to document the need for disciplinary action to improve quality of care to initiate litigation
to improve quality of care The primary reason to fill out an incident report is to improve the quality of care. Incident reports are not designed to be a means for disciplinary action. Incident reports are designed to identify risks, either in the form of actual risks or potential risks, that can be identified and addressed to improve quality of care. Incident reports are not intended to initiate litigation or document everyday occurrences.
