LEGAL dimensions of nursing practice chapt. 7
A nursing student administers an overdose of a narcotic to a client and the client arrests. When discussing the incident with nursing faculty, which statements made by the student indicate the need for further teaching? Select all that apply.
"I am glad I am a student because nursing faculty will be blamed, not me." "I cannot be held liable because this is only my second time at this facility."
The nurse is participating in a discussion about controlled substances. Which statement by the nurse indicates she is aware of laws governing the distribution of controlled substances?
"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 use is treatable and the objective is to detect and treat the problem early. It does not matter where the nurse obtains the drugs; the nurse is still liable for personal actions
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 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.
The nursing faculty is lecturing on unintentional and intentional torts. The faculty asks a nursing student to provide an example of an unintentional tort. Which example would indicate the student has a clear understanding of torts?
A nurse gives a medication and client has an adverse reaction.
During a nursing shift, which events warrant completion of an incident report? (Select all that apply.)
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 intravenous antibiotic was administered 2 hours late because the IV site infiltrated.
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 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
The nurse is providing care to a client who had orthopedic surgery. The nurse has medicated the client for pain. However, the client reports pain is unrelieved. The nurse takes no further action regarding assessment and intervention for the client's pain. The nurse does not notify the surgeon regarding the client's pain. What element of liability has been violated?
Breach of duty Breach of duty is the failure to assess, intervene, or notify the health care provider regarding the client's condition
A nurse exits the room of a confused client without raising the side rails on the bed. The failure to raise the side rails would constitute which element of liability related to malpractice?
Breach of duty failing to meet the standard of care, and in this case, it was the failure to execute and document the use of appropriate safety measures
A nurse is named as a defendant in a malpractice lawsuit. Which action would be recommended for this nurse?
Do not volunteer any information on the witness stand. The nurse on the witness stand should be polite, but not volunteer any information. The nurse should only answer the questions asked
The nurse recognizes liability requires specific elements that must be established to prove that malpractice or negligence has occurred. Identify the specific elements. Select all that apply.
Elements of liability are duty, breach of duty, causation, and damages.
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?
Malpractice cases are generally civil litigation cases that involve nurses.
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?
Nurse withheld the medication and notified the health care practitioner. A reasonably prudent nurse would withhold the medication and notify the health care practitioner
false imprisonment.
Telling the client not to leave the hospital
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 should inform the surgeon the consent has not been signed. Obtaining informed consent is the responsibility of the person who will be performing the diagnostic or treatment procedure or the research study The nurse's roles are to confirm that a signed consent form is present in the client's chart and to answer any client questions about the consent.
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 administers amoxicillin to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest.
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?
The nurse can be charged with slander, which is a verbal attack on a person's character
A nurse enters the client's room and finds the client lying on the floor experiencing a seizure. After stabilizing the client, the nurse informs the physician. The physician advises the nurse to prepare an incident report. What is the purpose of an incident report?
To evaluate quality care and potential risks for injury to the client
Nurses are occasionally asked to witness a testator's (person who makes the will) signing of his or her will. Which guideline is true regarding a nurse's role is witnessing a testator's signature?
Witnesses to the signature on a will do not need to read it, but they should be sure the document being signed is a will and not some other document. Witnesses should watch the testator sign the will, and they should sign in the presence of each other
Libel
defamation of character in written words.
The health care institution
determines the unit and institutional policies These policies may vary from institution to institution Such policies may include clinical procedures, policies specific to the institution, and personnel and employment policies
As a student nurse, you are responsible
for your own acts, including any negligence that may result in client 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 A hospital may also be held liable for the negligence of a student nurse Nursing instructors may share responsibility for damages in the event of client injury if an assignment called for clinical skills beyond a student's competency, or the instructor failed to provide reasonable and prudent clinical supervision.
Unit and institutional based policies are not derived
from federal legislation, state legislation, or the board of nursing.
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.
Breach of confidentiality.
is a violation of HIPAA
An incident report
is a written account of an unusual, potentially injurious event involving a client, employee, or visitor.
Defamation of character in spoken words
is called slander
Causation
is the failure to use appropriate safety measures, which results in injury to the client
Accreditation
is the process by which an educational program, rather than an individual nurse, identifies that standards are being met.
Assault
is the threat of touching another person without his or her consent.
defamation had been written
it would be libel
Negligence
may be an act of omission or commission.
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.
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.
Duty
refers to an obligation to use due care and is defined by the standard of care appropriate for the nurse-client relationship
Damages
refers to the actual harm or injury that the client incurs
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 provided in specialized and high-acuity settings is safe and appropriate
Two nurses meet at their home, where one of the nurses discusses a client who had been physically abused. The next day, the client is shifted to another nursing unit after a surgical procedure and becomes the care of the second nurse who had been part of the original discussion. Nurse No. 2 asks the client about the physical abuse. The client discovers that his original nurse revealed the information and is hurt. What would be the charges if the client files a suit
The nurses could be charged for slander. The injury is considered to occur because the derogatory remarks attack a person's character and good name Even if the discussion took place at home and Nurse No. 2 was involved in the care, the revelation was without the client's consent. Even if the nurse is off-duty or may not be directly involved in the client's care, the nurse can still be charged with slander.
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 is intentional and wrongful physical contact with a person that entails an injury or offensive touching. Performing treatment without permission or receiving informed consent from the client might constitute both assault and battery. Judgments of battery suits have been based on the application of restraints to confused clients.
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 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.
the intentional confinement or restraint of another person's activities without justification
unlawful restraint or restriction of a person's freedom of movement
