EAQ Health Policy / Systems- Health Care Law

A 13-month-old child is admitted with a tentative diagnosis of bacterial meningitis, and the practitioner schedules a lumbar puncture. What is the most important action the nurse should take in preparation for the lumbar puncture? 1. Asking the parents what they were told about the test 2. Using a doll to demonstrate the procedure to the child 3. Obtaining a pacifier for the child to suck on during the procedure 4. Telling the parents that they may stay with their child during the test

1. Asking the parents what they were told about the test Informed consent is required. The procedure should be explained to the parents by the practitioner, and the nurse should confirm the parents' comprehension and have them sign the consent form. The child is too young to comprehend a demonstration of the procedure. Although staying with the child may be important to the parents, it is not the priority. Although a pacifier may keep the child calm, this is not the priority, either.

What is the most appropriate approach for the school nurse to take regarding children who are to be given medications while in school? 1. Assuring the children that their privacy will be respected 2. Teaching each class about taking medications in the school setting 3. Encouraging the children to tell their friends that they are taking a medication 4. Asking teachers to answer questions when other students ask about medications given in school

1. Assuring the children that their privacy will be respected Children's and adults' confidentiality is protected by privacy laws. Although health classes may address medication as part of its curriculum, the information should be taught on a general, not a personal, level. Children and their teachers should not be encouraged to divulge private information.

A nurse is teaching staff members about the legal terminology used in child abuse. What definition of battery should the nurse include in the teaching? 1. Maligning a person's character while threatening to do bodily harm 2. A legal wrong committed by one person against property of another 3. The application of force to another person without lawful justification 4. Behaving in a way that a reasonable person with the same education would not

3. The application of force to another person without lawful justification Battery means touching in an offensive manner or actually injuring another person. Battery refers to actual bodily harm rather than threats of physical or psychological harm. Battery refers to harm against persons, not property. Behaving in a way that a reasonable person with the same education would not is the definition of negligence.

A nurse, providing care in a hospital skilled nursing unit, witnesses a client's spouse shaking the elderly client vigorously because the client has had an episode of incontinence. Because of the suspicion of physical abuse, legally the nurse should discuss the concerns with managers and report the abuse to which party? 1. The client 2. The client's spouse 3. The client's primary healthcare provider 4. Adult Protective Services

4. Adult Protective Services The nurse has a legal responsibility to report suspicions of abuse to the appropriate agency, which in this instance is Adult Protective Services. The client will not be able to understand the discussion. It is not the nurse's responsibility to directly challenge the spouse's behavior in this situation; the nurse may act as a client advocate by interrupting the spouse's behavior and providing immediate physical and emotional care. The nurse should then report suspicions of abuse to Adult Protective Services. Although the nurse may report suspicions about the spouse's behavior to the healthcare provider, the law requires that Adult Protective Services be notified. The term Adult Protective Services refers to the range of laws and regulations enacted to deal with abusive situations. The laws and regulations are typically administered by an agency within the state, for example, the Department of Social Services, which receives and investigates complaints.

What action should the nurse take if abuse of a 10-year-old child is suspected? 1. Report the suspicion to local authorities. 2. Elicit more information from the parents. 3. Refer the parents to a group therapy meeting. 4. Notify the healthcare provider of the suspicion.

1. Report the suspicion to local authorities. A nurse is mandated by law to report suspected child abuse. Child protective services are notified to make appropriate investigations. Assessment is an ongoing process throughout treatment, but legally the nurse is bound to report suspected abuse. Referring the parents to a group therapy meeting is not the primary safety action at this time. The nurse must comply with state (Canada: provincial/territorial) law because all 50 states (Canada: 12 provinces and territories) require the nurse to be a mandated reporter. The healthcare provider can be notified, but this is not the priority action.

A 3-year-old child with eczema of the face and arms has disregarded the nurse's warnings to "stop scratching, or else!" The nurse finds the toddler scratching so intensely that the arms are bleeding. The nurse then ties the toddler's arms to the crib sides, saying, "I'm going to teach you one way or another." How should the nurse's behavior be interpreted? 1. These actions can be construed as assault and battery. 2. The problem was resolved with forethought and accountability. 3. Skin must be protected, and the actions taken were by a reasonably prudent nurse. 4. The nurse had tried to reason with the toddler and expected understanding and cooperation.

1. These actions can be construed as assault and battery. Assault is a threat or an attempt to do violence to another, and battery means touching an individual in an offensive manner or actually injuring another person. The nurse's behavior demonstrates anger and does not take into account the growth and developmental needs of children in this age group. Although the behavior (scratching) needs to be decreased, this can be done with mittens, not immobilization. A 3-year-old child does not have the capacity to understand cause (scratching) and effect (bleeding).

Which is an appropriate action for the registered nurse regarding assisted suicide? 1. Nurses may have an open attitude toward the client's end of life. 2. Nurses' participation in assisted suicide violates the code of ethics. 3. Nurses may listen to the client's expressions of fear and to attempt to control the client's pain. 4. Nurses can participate in assisted suicide only if the individual could make an oral and written request.

2. Nurses' participation in assisted suicide violates the code of ethics. According to the ANA, a nurse's participation in assisted suicide will violate their code of ethics. According to the American Association of Colleges of Nursing (AACN) and the International Council of Nurses', the nurse may have an open attitude toward the client's end of life. According to the American Association of Colleges of Nursing (AACN) and the International Council of Nurses', nurses may listen to the client's expressions of fear and to attempt to control the client's pain. According to the Oregon Death with Dignity Act (1994) the primary health care provider in the state of Oregon can participate in assisted suicide only if an individual with terminal disease makes an oral and written request to end his or her life in a humane and dignified manner.

A nursing student is listing the points that need to be remembered about the loss of a client's medical records. Which point listed by the nursing student is accurate? 1. "Loss of medical records may lead to libel charges." 2. "The registered nurse should maintain accurate nursing records." 3. "There is an assumption that the care provided to the client was negligent." 4. "The healthcare facility needs to demonstrate why the medical records were lost."

3. "There is an assumption that the care provided to the client was negligent." In case a client's medical record is lost, there is an assumption that the care provided to the client was negligent. Loss of medical records may lead to a malpractice claim. The entire institution is responsible for maintaining medical records. Primary healthcare providers need to demonstrate why the medical records were lost.

A visitor from a room adjacent to a client asks the nurse what disease the client has. The nurse responds, "I will not discuss any client's illness with you. Are you concerned about it?" This response is based on the nurse's knowledge that to discuss a client's condition with someone not directly involved with that client is an example of what? 1. Libel 2. Negligence 3. Breach of confidentiality 4. Defamation of character

3. Breach of confidentiality The release of information to an unauthorized person or gossiping about a client's activities constitutes a breach of confidentiality and an invasion of privacy. Libel occurs when a person writes false statements about another that may injure the individual's reputation. Negligence is a careless act of omission or commission that results in injury to another. Defamation of character is the publication of false statements that injure a person's reputation.

What does a nurse understand by the term regulatory law as applied to nursing practice? 1. Regulatory law provides fair and equitable treatment when civil wrongs or violations occur. 2. Regulatory law describes and defines the legal boundaries of the nursing practice within each state. 3. Regulatory law reflects the decisions made by administrative bodies such as the State Boards of Nursing. 4. Regulatory law results from judicial decisions made in courts based on the judgments of individual legal cases.

3. Regulatory law reflects the decisions made by administrative bodies such as the State Boards of Nursing. Regulatory law, also known as administrative law, reflects the decisions made by administrative bodies such as the State Boards of Nursing when they set down the rules and regulations. Civil laws protect the rights of individuals within society and provide for fair treatment in case civil wrongs or violations take place. Nurse Practice Acts are responsible for describing and defining the legal boundaries of the nursing practice within each state. Common law is based on judicial decisions made in courts when individual legal cases are decided.