Fundamentals Unit 6 Chapter 7
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
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
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."
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 scenario is an example of certification?
A nurse who demonstrates advanced expertise in a content area of nursing through special testing
Having recently completed a specialty nursing program in neonatal care, a nurse is now preparing to leave the medical unit and begin providing care in the hospital's neonatal intensive care unit (NICU). The nurse has completed which process of credentialing?
Certification
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.
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
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 statement about laws governing the distribution of controlled substances is true?
Nurses are responsible for adhering to specific documentation about controlled substances.
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?
Obtain a medical order
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.
A nurse and the facility have been named as defendants in a malpractice lawsuit. In addition to the nurse's attorney, whom else would be appropriate for the nurse to talk with about the case?
The agency's risk manager
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.
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.
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.
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.
Nurses complete incident reports as dictated by the agency protocol. What is the primary reason nurses fill out an incident report?
To improve quality of care
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 most appropriate, 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 nurse has been asked to serve as an expert witness in a malpractice case in which an infant died in the newborn nursery. Which questions should the nurse consider prior to accepting this job? Select all that apply. -"Have I ever worked in this hospital system?" -"How much clinical experience do I have in the newborn nursery?" -"How much education do I have about caring for newborns?" -"How would I feel if my child died due to a nurse's malpractice?" -"How would I react if I was sued?"
-"How much clinical experience do I have in the newborn nursery?" -"How much education do I have about caring for newborns?"
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 realize that I am held to the same standards as a registered nurse." -"I have also put the nursing faculty at risk with my action." -"I should have informed you that I felt unprepared for my assignment." -"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."
-"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."
Which statements made by a nurse would indicate to a nurse manager that the nurse requires further training? Select all that apply. -"If I make a mistake, I will not tell anyone." -"When I document, I make sure it is factual, accurate, complete, and timely." -"I will have the supervisor fill out the incident report when I make an error." -"I am accountable for any task that I delegate." -"The nursing plan of care must be accurate and must be followed. It is part of the client's permanent record."
-"If I make a mistake, I will not tell anyone." -"I will have the supervisor fill out the incident report when I make an error."
A nurse is preparing a presentation for a group of staff nurses about the rules affecting nursing practice and the parties involved. When describing the role of different sources for the rules, which issue would the nurse identify as being addressed specifically by state legislation? Select all that apply. -Unprofessional conduct -Scope of practice -Educational requirements of nurses -Position statements related to medication administration -Clinical procedures
-Scope of practice -Educational requirements of nurses
Which process evaluates and recognizes educational programs as having met certain standards?
Accreditation
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
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 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 prioritize when anticipating that legal action may follow?
Document the client's claims and the events surrounding the alleged incident.
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 is overheard in the hospital cafeteria making false, derogatory comments about a client. The nurse is guilty of:
Slander
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
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
A health care provider is called to see a client with angina. During the visit the health care provider advises the nurse to decrease the dosage of atenolol to 12.5 mg. However, because the health care provider is late for another visit, the health care provider requests that the nurse write down the order for the health care provider. What should be the appropriate nursing action in this situation?
The nurse should ask the health care provider to come back and write the order.
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 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
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 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 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
The client being admitted to the oncology unit conveys wishes regarding resuscitation in the event of cardiopulmonary arrest. The nurse advises the client that it would be in the client's best interest to obtain which document?
Living will
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
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
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 client falls while being transferred from the bed to the chair. -A nurse reports that a client is crying and distraught over a diagnosis of metastatic cancer. -A nurse asks an unlicensed assistive personnel (UAP) to feed a client. -A visitor slipped and fell in the hallway, but was not injured.
-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.
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 executes the health care provider's prescriptions without questioning them. -The nurse documents all client care in a timely manner. -The nurse educates the client about what to expect during the hospital stay. -The nurse confirms informed consent was give by the client to perform a procedure. -The nurse claims management is responsible for inadequate staffing leading to negligence. -The health care provider is responsible for administration of a wrongly prescribed medication.
-The nurse documents all client care in a timely manner. -The nurse educates the client about what to expect during the hospital stay. -The nurse confirms informed consent was give by the client to perform a procedure.
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 most appropriate to prevent false imprisonment?
Ask the client to sign a release without medical approval.
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
