Fundamentals Nursing Prep U Chapter 7 Legal Dimensions of Nursing Practice
An RN enters a client's room and observes the unlicensed assistive personnel (UAP) forcefully pushing a client down on the bed. The client starts crying and informs the UAP of the need to go to the bathroom. What action is the RN witnessing that should be immediately reported to the supervisor?
battery
An HIV-positive client discovers that his name is published in a research report on HIV care prepared by his nurse. He is hurt and files a lawsuit against her. Which offense has the nurse committed?
Invasion of privacy
When the nurse reports for duty, she finds out her neighbor is admitted to one of units in her facility. The nurse asks a coworker about the neighbor's condition. The coworker is uncomfortable with the nurse's request and confers with the charge nurse. The charge nurse informs the coworker of which potential tort violation she could be charged with if she honors the nurse's request for client information?
Invasion of privacy
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.
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
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?
"Nurses are responsible for adhering to specific documentation about controlled substances."
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.
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 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
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?
Begin CPR
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 client newly diagnosed with congestive heart failure has a prescription for digoxin (Lanoxin). 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?
Nurse withheld the medication and notified the health care practitioner
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
A client is brought 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 ensures that the client's family signs the consent form.
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?
Tort
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
In some cases, the act of providing nursing care in unexpected situations is covered by the Good Samaritan laws. Which nursing actions would most likely be covered by these laws?
emergency care for a choking victim in a restaurant
The nurse manager is using voluntary standards as a guideline for developing policies on the unit. What voluntary standards are available for the nurse to use? (Select all that apply.)
• American Nurses Association Standards of Practice • Professional standards for certification of individual nurses in general practice • Process of certification
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.
The nurse is preparing to administer a medication ordered by the surgeon in a dose much higher than is recommended. Which action should the nurse take?
Call the surgeon to clarify the order.
A nurse has applied soft wrist restraints to a client following endotracheal intubation. Which documentation is essential while using restraints? (Select all that apply.)
• patient assessment findings every 2 hours • foley catheter draining clear yellow urine • .9NS IV infusing at 100 ml/hr
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?
"Take it with you. It is recognized universally in the United States."
The nurse fails to contact the physician regarding a client who had an open-reduction internal fixation of the tibia and has experienced increasing leg pain (unrelieved by pain medication) for the past 4 hours. Which element of liability has been violated?
Breach of duty
A nurse caring for an older adult client following a total abdominal hysterectomy documents administration of morphine 4 mg intravenously for pain of 8 on 1-10 scale, bed in the lowest position, bed alarm on, side rails up times two, and call light in reach. After the nurse leaves the room, the client gets out of bed and falls. In which order should the nurse proceed?
• Assess the client for injury. • Assist the client back into bed. • Notify the physician. • Document the incident. • Complete an incident report.
Which of the following is an area 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 and decides to retake the blood pressure in an hour.
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 heath care practitioner about a change in a client's status, but do not follow up or document.
The nurse is concerned about a potential malpractice or negligence lawsuit regarding a client that 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 new graduate wants to be knowledgeable about state-mandated rules to better practice within the scope of nursing. What are the best resources for this nurse to research? (Select all that apply.)
• Nurse practice acts • Nursing educational requirements • Composition and disciplinary authority of board of nursing
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 had a duty and it was my responsibility to get clarification before administering the medication, which I did not."
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 deal with the professional obligations of a nurse working in the ambulatory setting."
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?
Ask the client to sign a release without medical approval.
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 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 nurse has a legal and ethical responsibility to report the suspected abuse.
In comparison with licensure, which measures entry-level competence, what does certification validate?
specialty knowledge and clinical judgment
A client admitted to a mental health unit has exhibited physical behaviors that put him and others at risk. The nurse applies four-point restraints on the client without obtaining a physician's order or the client's consent. The nurse is at risk of being accused of which of the following?
Battery
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.
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?
Helps reduce workforce injuries and illness in the workplace
Injuries related to lifting or transferring patients occur in the health care setting and may be considered a work-related injury. Which law was intended to reduce work-related injuries and illnesses?
The Occupational Safety and Health Act of 1970
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?
Tort