NU270 Week 12 PrepU: Legal Issues
The nurse is performing a rectal assessment and notices a longitudinal tear or ulceration in the lining of the anal canal. The nurse documents the finding as which condition? Anorectal abscess Anal fistula Hemorrhoid Anal fissure
Anal fissure Fissures are usually caused by the trauma of passing a large, firm stool or from persistent tightening of the anal canal secondary to stress or anxiety (leading to constipation). An anorectal abscess is an infection in the pararectal spaces. An anal fistula is a tiny, tubular, fibrous tract that extends into the anal canal from an opening located beside the anus. A hemorrhoid is a dilated portion of vein in the anal canal.
Which of the following is a true statement about a living will? It states the client's wishes regarding healthcare if terminally ill. It specifies information regarding nontreatment only. It is legal consent. It is a type of financial agreement.
It states the client's wishes regarding healthcare if terminally ill. A living will states the client's wishes regarding healthcare if terminally ill. It does not specify information regarding nontreatment only, it is not a legal consent, and it is not a type of financial agreement.
A nurse assesses a client with psychotic symptoms and determines that the client likely poses a safety threat and needs vest restraints. The client is adamantly opposed to this. What would be the best nursing action? Contact the physician and obtain necessary orders. Restrain the client with vest restraints. Ask a family member to come in to supervise the client. 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. Applying a wrist restraint instead of a vest restraint is inappropriate if a vest restraint is genuinely necessary. It would be inappropriate to delegate this aspect of care to a family member.
A client has designated her daughter as a person to make healthcare decisions for the client if he is not able to do so. What type of advance directive is this considered? Power of attorney Do-not-resuscitate order (DNR) Living will Durable power of attorney (DPOA) for healthcare
Durable power of attorney (DPOA) for healthcare A client may designate another person to be the DPOA for healthcare or healthcare proxy. This person has the authority to make healthcare decisions for the client if he or she is no longer competent or able to make these decisions. A general power of attorney does not give that designated person the ability to make healthcare decision. In DNR order, the client wishes to have no resuscitative action taken if he or she experiences a cardiac or respiratory arrest. A living will is a document that states a client's wishes regarding healthcare if he or she is terminally ill.
Which action most clearly demonstrates a nurse's commitment to social justice? Lobbying for an expansion of healthcare resources and benefits to those in poverty Ensuring that a hospital client's diet is culturally acceptable Answering a client's questions about care clearly and accurately Documenting client care in a timely, honest, and thorough manner
Lobbying for an expansion of healthcare resources and benefits to those in poverty Social justice is a professional value that encompasses efforts to promote universal access to health care, such as the expansion of publicly funded programs like Medicare. Culturally competent care is a reflection of human dignity. Answering clients' questions and documenting care accurately are expressions of the value of integrity.
What might a nurse need to do to ensure the continuation of his or her nursing license? Obtain a baccalaureate degree. Obtain a master's degree. Attend hospital in-services. Obtain continuing education credits.
Obtain continuing education credits. In many states, continuing education is required for an RN to maintain licensure. These are defined as professional development experiences designed to enrich the nurse's contribution to health. Obtainment of an ongoing degree is not necessary to maintain licensure. While hospital in-services may provide continuing education, not all in-services are designed to do so.
A client who is positive for human immunodeficiency virus (HIV) tells the nurse that the client's significant other is the only family member who knows the client's health status. What should the nurse do to keep the client's health status confidential? Select all that apply. Use the hospital code for HIV when documenting care. Ask all family members, except the client's significant other, to wait outside when she's educating the client. Discuss the case with the client's mother, who is an immediate family member. Discuss the case at lunch to educate other staff members. Keep a unit log of all clients infected with HIV for research purposes.
Use the hospital code for HIV when documenting care. Ask all family members, except the client's significant other, to wait outside when she's educating the client. Every facility uses a specific code to designate HIV-positive clients. To protect confidentiality, the nurse should speak about the diagnosis only with the client and any person the client designates. A nurse should never discuss a client with anyone who is not directly involved in that client's care. For instance, if the client does not give the nurse permission to speak with the client's mother, the nurse may not give the mother information about the client. Keeping a log of all HIV-positive clients violates client confidentiality.
A client is transferred from the emergency department to the locked psychiatric unit after attempting suicide by taking 200 acetaminophen tablets. The client is now awake and alert but refuses to speak with the nurse. In this situation, the nurse's first priority is to: establish a rapport to foster trust. place the client in full leather restraints. try to communicate with the client in writing. ensure safety by initiating suicide precautions.
ensure safety by initiating suicide precautions. The nurse's first priority is to keep a suicidal client safe and alive. Although establishing a rapport and promoting trust are important in psychiatric nursing, neither is the highest priority. Using restraints is inappropriate and could be interpreted as punishment of the client or a convenience for the nurse. Trying to communicate in writing is also inappropriate because there is no indication that the client can't hear.
A nurse has administered 1 unit of glucose to the client as per order. What is the correct documentation of this information? 1 Unit of glucose 1 bottle of glucose One U of glucose 1U of glucose
1 Unit of glucose The nurse should write "1 Unit of glucose." The nurse cannot write "1 bottle" or "one U of glucose" because these are not the accepted standards. "1U" is an abbreviation that appears in the JCAHO "Do Not Use" list (see http://www.jcaho.com). It should be written as "1 Unit" instead of "1U" because "U" is sometimes misinterpreted as "zero" or "number 4" or "cc."
A nurse overhears another nurse say to a client, "If you do not stop spitting, I'm going to leave you outside in your wheelchair so that you miss your dinner." What is the most appropriate response by the nurse who overhears this conversation? "Your verbal threats to the client are legally considered assault." "I think you need to review therapeutic communication techniques." "Could you clarify for me whether you were joking with the client?" "I will have to report you for unprofessional behavior toward a client."
"Your verbal threats to the client are legally considered assault." Assault is conduct that makes a person fearful and produces a reasonable apprehension of harm. The nurse's behavior in legal terms is assault.
The nurse in the preoperative setting is preparing the client for surgery. During completion of the preoperative checklist the client states, "I have a question about my surgery." What is the next action by the nurse? Answer the client's question regarding the surgery. Contact the anesthesiologist and request a delay of surgery. Contact the surgeon to answer the client's question. Ask the circulating nurse to inform the surgeon of the client's question.
Contact the surgeon to answer the client's question. If a client verbalizes questions regarding a surgery, then informed consent cannot be given. To have informed consent, the surgeon performing the procedure must tell the client about the treatment, tests, alternative treatments, and the risks and benefits of each. The surgeon is responsible for ensuring that informed consent is obtained. The nurse would contact the surgeon to answer the client's questions prior to the start of the procedure, not answer the client's questions. Informed consent would be obtained prior to the client being transported to the operating room; therefore, having the circulating nurse convey the information is inappropriate. Although it may be necessary to delay the surgery, it would be most appropriate to contact the surgeon to answer the client's question.
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 Breach of duty Causation Damages
Duty Duty refers to an obligation to use due care. The nurse assessed the client and made appropriate interventions and notifications. Breach of duty is the failure to meet the standard of care. An example of breach of duty would be not performing assessments, appropriate interventions, and notifications of the health care provider. Causation is when the breach of duty caused the injury. An example of causation would be failure to perform assessment and appropriate interventions when providing client care, and this caused injury to the client. Damages are the harm or injury that occurred to the client. In this situation, it would be the death of the client.
A client informs the nurse that the client wants to discontinue treatment and go home. Later, the nurse finds the client dressed to leave. Which action should the nurse take in this situation? Let the client go after signing a document stating that the client is going against medical advice. Restrain the client until medical treatment is over. Call the physician and get the discharge paper signed. Warn the client that the client may not be able to access health care again.
Let the client go after signing a document stating that the client is going against medical advice. If a client wishes to go before the client's medical treatment is finished, the nurse should have the client sign a document indicating personal responsibility for leaving against medical advice. The nurse should not restrain the client, as it would make the nurse liable for legal action. The nurse may call the physician and get the discharge paper signed, but this is not appropriate. The nurse should not warn the client that the client will be denied health care in the future, because it is the client's right to access the health care facility whenever needed.
A toddler has been admitted to the pediatric unit with pneumonia. While assessing a toddler the nurse finds bruise marks consistent with a belt buckle on the buttocks. The nurse suspects the toddler is being abused. What action should the nurse take? Talk with the toddler about what the nurse suspects. Confront the caregiver with the nurse's suspicions. Place the toddler in a monitored room Report the case to local authorities.
Report the case to local authorities. By law, the nurse is obligated to report injuries to a child to local authorities. The nurse should notify the health care provider of the suspicion. The toddler will be assessed and the injuries will be documented. The social worker would also be notified of the suspicion. The health care provider or social worker would refer the case to local agencies, such as Child Protective Services (Canadian Centre for Child Protection) for investigation. Social workers should be consulted before approaching a toddler and discussing child abuse. Confronting the caregiver could increase the risk of harm to the toddler and to the nurse. Placing the toddler in a monitored room would only be required if it is according to hospital policy.
A client in a long-term care facility has signed a form stating that he does not want to be resuscitated. He develops an upper respiratory infection that progresses to pneumonia. His health rapidly deteriorates, and he is no longer competent. The client's family states that they want everything possible done for the client. What should happen in this case? The client should be resuscitated if he experiences respiratory arrest. The client should be treated with antibiotics for pneumonia. The wishes of his family should be followed. Pharmacologic interventions should not be initiated.
The client should be treated with antibiotics for pneumonia. The client has signed a document indicating a wish not to be resuscitated. Treating the pneumonia with antibiotics is not a resuscitation measure. The other options do not respect the client's right to choice.
On admission to the hospital, each client is asked whether the client has a living will or a durable power of attorney. If not, the admitting staff person provides a sample form to the client if wanted. The purpose of this inquiry is to determine: what the client wants to have happen during the hospitalization. how the client feels about being resuscitated and maintained on life support if this is necessary. whether the client has a document describing wishes for care when the client is no longer able to make decisions. previous decisions made regarding whom to contact should the client die in the hospital.
whether the client has a document describing wishes for care when the client is no longer able to make decisions. It is important to determine whether the client has advanced directives that describe the client's wishes for care if unable to communicate or participate in health care decisions. Although these advanced directives cover the client's desires regarding whether to be resuscitated or maintained on life support should it be necessary, the inquiry is regarding whether the client has a document (an advanced directive) stating these desires, not what the client's feelings about these issues are. A copy of any advanced directives should be placed in the client's hospital record. What the client wants to have happen during hospitalization and previous decisions made regarding whom to contact should the client die in the hospital are not relevant to whether the client has an advanced directive.
A client with a history of heroin addiction is admitted to the hospital intensive care unit with a diagnosis of opioid drug overdose. While talking with a nurse, the client's parent reports a plan to have his child declared legally incompetent. Which response by the nurse is most therapeutic? "Your child is ill and can't make decisions about health care and safety right now, but this situation is temporary." "You don't have the right to declare your child incompetent. Your child has rights, too." "I'll help you contact the hospital legal representative for help with the paperwork." "If you become the guardian, you'll be responsible for your child's finances and paying for treatment."
"Your child is ill and can't make decisions about health care and safety right now, but this situation is temporary." The client is temporarily unable to make decisions about health care and safety. After receiving emergency care and treatment, the client will probably be able to safely manage daily affairs. The nurse's reference to the client's constitutional rights isn't a therapeutic response. It's antagonistic to the parent's concern and could be a barrier to further nurse-parent interactions. The nurse shouldn't offer to help the client's parent contact the hospital's legal representative; a hospital's legal resources wouldn't be used to help a parent petition a court to declare a client incompetent. A guardian is responsible for making decisions about an individual's welfare and protecting civil rights. A guardian doesn't assume financial responsibility.
A client with stage IV heart failure documents in an advance directive that no ventilatory support should be provided. What should the nurse do when the client begins experiencing severe dyspnea? Coach the client to take slow deep breaths. Administer oxygen, morphine, and a bronchodilator for comfort. Ask the client's family to consent to ventilator placement. Ask the healthcare provider to prescribe bilevel positive airway pressure (BIPAP).
Administer oxygen, morphine, and a bronchodilator for comfort. An advance directive identifies a client's wishes in the event that a life-threatening illness or injury occurs. The client's comfort should be paramount and the nurse should respect the client's wishes. Morphine, oxygen, and bronchodilators can relieve dyspnea and make the client more comfortable, which will make breathing easier. The client will need more than coaching to take slow deep breaths. It is a violation of the client's advance directive to ask the family to consent to a ventilator. BIPAP is used to treat sleep apnea and not acute shortness of breath.
A client who tested positive for human immunodeficiency virus (HIV) and has pancreatitis is admitted to the medical unit. The nurse director from another unit comes into the medical unit nurses' station and begins reading the client's chart. The staff nurse questions the director about reading the client's chart. The director states that the client is a neighbor's son. What action should the nurse take? Inform the nurse director reading the chart is a violation of the client's right to privacy and ask the nurse director to return the chart. Remind the nurse director not to share the client's medical information with anyone because of the client's HIV status. Report the incident to the medical director and document the nurse director's actions. Remind the nurse director that permission from the medical director must be provided before access can be granted.
Inform the nurse director reading the chart is a violation of the client's right to privacy and ask the nurse director to return the chart. Personal health information may not be used for purposes not related to health care. The nurse director found reading the chart is not providing health care to the client and therefore does not require access to the chart. The nurse should confront the nurse director and request the return of the client's chart. The director should not have access to this client's health care information regardless of the client's HIV status. If the nurse director does not comply with the nurse's request, the nurse should report the incident to the nurse manager, so the infraction can be reported through the proper channels. The staff nurse should not report the incident to the medical director. Asking the nurse director about permission from a medical director to read the chart does not protect client confidentiality.
A nurse uses the Nurse Practice Act to guide professional standards. Which actions are within the scope of the registered nurse? Select all that apply. Administer conscious sedation. Initiate a plan of care for a client with vertigo. Administer an intravenous medication to decrease blood pressure. Delegate basic hygiene to an unlicensed assistive personnel. Provide insulin injection teaching to a new diabetic client.
Initiate a plan of care for a client with vertigo. Administer an intravenous medication to decrease blood pressure. Delegate basic hygiene to an unlicensed assistive personnel. Provide insulin injection teaching to a new diabetic client. The registered nurse's scope of practice allows for administering intravenous medication to decrease blood pressure, initiating a plan of care for a client with vertigo, delegating basic hygiene to unlicensed personnel, and providing insulin injection teaching to a new diabetic client. The registered nurse needs special certification to administer conscious sedation.
The nurse is caring for a confused older adult client who requires surgery for a broken hip. What steps does the nurse take to determine if the client has a durable power of attorney for health care and how to contact that person? Review the medical chart for a copy of a durable power of attorney for health care or permission for disclosure contact. Explain the client's need for hip surgery to visitors and ask them for information about a durable power of attorney for health care. Look on the chart for a living will if a durable power of attorney for health care cannot be located. Allow the surgeon to handle the issue as part of his or her legal responsibility for explaining the surgical procedure and obtaining the appropriate signature on the consent form.
Review the medical chart for a copy of a durable power of attorney for health care or permission for disclosure contact. The client cannot give consent due to confusion. In most cases, the durable power of attorney for health care document is discussed and obtained during the admission process. The nurse should act as a client advocate by seeking someone with durable power of attorney to sign the informed consent form. It is the surgeon's responsibility to explain the surgical procedure and obtain the appropriate signature on the consent form; however, the nurse still acts as the client advocate to locate the designated person. A living will specifies the types of medical treatment the client wants should the client become unable to speak in a terminal or permanently unconscious medical condition, but it does not address matters related to client confusion. Telling visitors about the need for surgery may violate client confidentiality. If the nurse identifies who they have permission to disclose medical information to, they can ask that person about a durable power of attorney for health care.
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. The Good Samaritan law will not protect the nurse because the nurse 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 in this scenario; moreover, Good Samaritan laws apply to those who do not accept any compensation for services 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 lay people. In cases of gross negligence, health care workers may be charged with a criminal offense.
The nurse is discussing deinstitutionalization of mentally ill persons at a community forum. What is a consequence of the trend towards deinstitutionalization? The number of persons with mental illness in prison has increased. The justice and correctional systems work together to improve care. One million people in correctional facilities have mental illness. Male offenders receive more treatment than do female offenders.
The number of persons with mental illness in prison has increased. As the number of state hospitals was dramatically reduced beginning in the 1960s, the number of persons with mental illness incarcerated in jails and prisons increased. Based on the total number of inmates, this means that there are approximately 356,000 inmates with serious mental illness in jails and state prisons. A large number of persons with mental illness are confined to U.S. prisons and jails. Individuals with mental illnesses are at higher risk for arrest than the general population. They are more likely to have encounters with the criminal justice system and be convicted of a crime than those without a mental illness. After they enter the corrections system, female offenders are more likely than male offenders to receive mental health services, and black offenders receive significantly less mental health treatment than similar non-black Americans.
Which example may illustrate a breach of confidentiality and security of client information? The nurse provides information over the phone to the client's family member who lives in a neighboring state. The nurse provides information to a professional caregiver involved in the care of the client. The nurse informs a colleague that the colleague should not be discussing client information in the hospital cafeteria. The nurse accesses client information on the computer at the nurse's station then logs off before answering a client's call bell.
The nurse provides information over the phone to the client's family member who lives in a neighboring state. Providing information over the phone to a family member without knowing whether the client wants the family member to know the information is a breach of confidentiality and security of client information. Providing information to a caregiver involved in the care of a client is not a breach in confidentiality, while providing information to a professional not involved in the care of the client is a breach in confidentiality. Client information should not be discussed in public areas such as elevators or the cafeteria. Logging off a computer that displays client data is an appropriate method of protecting client confidentiality and information.
A nurse is seeing a client for a weekly therapeutic session in an outpatient psychiatric clinic. The client discloses to the nurse that the client often has thoughts about killing a neighbor. What should be the nurse's first response? Warn the client's neighbor and report to the authorities. Document the session thoroughly and meet with the client again the next day. Review the client's history to determine presence of past of violent behavior. Review coping strategies for anxiety and set new therapeutic goals.
Warn the client's neighbor and report to the authorities. When the client makes specific threats or has a plan to harm another person, health care providers are legally obligated to warn the target of the threats. Legally this is called duty to warn. Although the nurse must document the session thoroughly and can meet with the client again the next day, this should not be the nurse's first action. The nurse should eventually review coping strategies for anxiety and set new therapeutic goals; however, duty to warn is the priority.
A nurse confides in a nurse friend, "I never report minor incidents. The charge nurse always wants a variance report filled out and they take so much time." Which responses by the friend are indicated? Select all that apply. "As long as no one is hurt, I don't see a problem with not reporting minor incidences." "I don't blame you, I think the charge nurse is just trying to get us in trouble." "Having documentation might keep you out of trouble someday." "Reporting helps us fix problems that result in danger to clients." "I usually document the problem in the chart, but don't fill out a report."
"Having documentation might keep you out of trouble someday." "Reporting helps us fix problems that result in danger to clients." Incident or variance reports serve as a tool for trending to identify risk and avoid it in the future. Having correct documentation is very beneficial if error or injuries lead to litigation. Simply documenting problems in a client chart is not enough, as they may apply to more than just that client and may be overlooked. Injury is not always immediately obvious. Variance reports should not be used punitively.
Friends come to visit a client admitted with new-onset ischemic stroke. The stroke has caused aphasia and right-sided weakness. The client has an advance directive and an identified healthcare power of attorney. The friends ask the nurse about the client's condition. How should the nurse respond? "I'm not at liberty to discuss their condition with you. You'll have to speak to the client's power of attorney if you'd like information." "I can't tell you anything about the client's condition." "You'll have to ask the client how they're feeling." "The client is unable to communicate as a result of a stroke, so I'll tell you what I think they'd want you to know."
"I'm not at liberty to discuss their condition with you. You'll have to speak to the client's power of attorney if you'd like information." To maintain client privacy, the nurse may not divulge information about the client to the friends. The nurse may, however, explain that nurses must maintain client privacy and refer the visitors to the power of attorney who may wish to update them about the client's condition. Option 2 doesn't provide a reason as to why the nurse can't provide the visitors with client information. Option 3 is incorrect because client is aphasic and can't provide the friends with information about the client's condition. Option 4 requires the client to give permission to divulge information about their condition and because the client is aphasic, the client is unable to give permission.
The nurse is gathering supplies in the medication room when another nurse asks to borrow the nurse's security code for the computerized automated dispensing cabinet (ADC) to obtain a dose of hydrocodone for a client. What is the best response by the nurse? "It is important to use your own security code because the law requires accurate documentation of all controlled substances." "I'm really not comfortable sharing my security code with you." "If I share my security code with you, I need you to make certain you don't allow anyone else to use it." "I will remove the dose of medication from the ADC and you can administer the medication to the client."
"It is important to use your own security code because the law requires accurate documentation of all controlled substances." Hydrocodone is a controlled substance. Federal law requires a record for each controlled substance administered. Computerized ADCs maintain the administration records and a secure access code is equivalent to the nurse's signature. Therefore, it is important that the nurse who obtains the medication from the ADC is the nurse who administers the controlled substance. Explaining to the nurse why it is important for each nurse to have their own access code provides education and promotes compliance. Because the secure access code is equivalent to the nurse's signature, a nurse should never share their code with others.
A nurse is admitting a client to the palliative unit and discussing advanced directives. Which statement made by the client leads the nurse to believe the client requires clarification around advanced directives? "This will allow me to identify who my power of attorney will be." "This will stop my daughter-in-law from putting me in a home." "It is good to do this now before I am unable to make the decisions." "I can let my family know what treatment I want in the future."
"This will stop my daughter-in-law from putting me in a home." Advanced directives or a "living will" allow clients to convey their wishes for treatment, alternative decision makers, and end of life treatment, but do not specifically address issues of placement in a long-term care facility.
A client in a long-term care facility signed a form requesting not to be resuscitated. The client develops pneumonia, and the client's health rapidly deteriorates. The client is no longer competent, but the family wants everything possible done for the client. When the family asks the nurse what will be done, what is the best response by the nurse? "We will resuscitate the client only if there is a respiratory arrest." "We will continue to use antibiotics to treat the pneumonia." "We will honor the family's wishes because the client cannot make decisions." "We will not provide any pharmacologic intervention at this time."
"We will continue to use antibiotics to treat the pneumonia." The client has signed a document indicating a wish not to be resuscitated. Treating the client's pneumonia with antibiotics would not be considered a resuscitation measure. The other options do not respect the client's choice.
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 that person 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 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. 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, especially when legal action is anticipated. This thorough and accurate assessment should precede consultation with the legal department, the state board of nursing, and colleagues.
Which herbs has been removed from most weight-loss medications due to potential legal liability? Gingko Ginseng Ephedra Rose hips
Ephedra Ephedra has serious adverse reactions, such as hypertension and irregular heart beat. These side effects have been associated with stroke and heart attacks. The Food and Drug Administration has warnings against taking weight-loss pills that have ephedra in them. Gingko, ginseng, and rose hips have not had these serious side effects.
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? Unintentional tort Invasion of privacy Defamation of character Negligence of duty
Invasion of privacy The nurse has committed the tort of invasion of privacy. Personal names and identities should be concealed or obliterated in case studies or research work. Invasion of privacy is a type of intentional tort. Defamation is an act in which untrue information harms a person's reputation and is therefore not applicable here. Negligence is the harm that results because a person did not act reasonably.
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. The employing health care institution may have submitted the paperwork regarding the allegation of the issue but does not suspend or revoke the nurse's license. The National League for Nursing is a national organization for faculty nurses and leaders in nurse education. The Supreme Court is the highest judicial court in a country or state. The Supreme Court does not rule on a nurse's license.
A nurse becomes concerned that a coworker may have a substance use disorder. Which behaviors by the coworker would increase this concern? Select all that apply. The last two times the nurse has needed help turning a client, the coworker could not be found. The coworker has needed to leave early "to pick up my kids" several times in the last 2 months. The coworker mentioned going to the primary care provider's office twice in the last month. The coworker has stopped eating lunch in the breakroom with other nurses. The coworker made a medication error last week.
The last two times the nurse has needed help turning a client, the coworker could not be found. The coworker has needed to leave early "to pick up my kids" several times in the last 2 months. The coworker has stopped eating lunch in the breakroom with other nurses. Frequent absences from the unit, leaving early or being late, and isolation from others may be signs associated with a substance use disorder. Having primary care provider appointments and an isolated medication error would not be particular concerns related to potential substance use.
A client with a psychiatric illness has become extremely aggressive and the nurse decides that the client needs to be restrained. Which action would be considered human restraint? The nurse asks the client to calm down. The nurse sedates the client with morphine. The nurse ties the client's wrist using wrist restraints. The nurse and a group of paramedics hold the client.
The nurse and a group of paramedics hold the client. Restraint is the direct application of physical force to restrict the client's freedom of movement. The nurse and a group of paramedics holding the client is an example of human restraint. The nurse does not apply force while telling the client to calm down. Sedating the client is an example of chemical restraint. Applying a wrist cuff to control the aggression of the client indicates the use of mechanical restraints.
A client is brought to the operating room for an elective surgery. What is the priority action by the circulating nurse? Verify consent. Document the start of surgery. Acquire ordered blood products. Count sponges and syringes.
Verify consent. Surgery cannot be performed without consent. Documentation of the start of surgery can only happen once the surgery has started. Blood products must be administered within an allotted time frame and therefore should not be acquired unless needed. The sponge and syringe count is a safety issue that should be completed before surgery and while the wound is being sutured, but if the client has not consented, the surgery should not take place.
A client informs the nurse that he is leaving the healthcare facility because he is not satisfied with the treatment. The nurse knows that the client's treatment is incomplete and few investigations are scheduled. Which is the most appropriate action by the nurse to prevent false imprisonment? restrain the client to prevent him from going call the physician and speed up the discharge process ask the client to sign release without medical approval tell the client that he will not be able to get access again
ask the client to sign release without medical approval If a client wants to leave the healthcare facility, the nurse should ask him to sign a release stating that he or she left without medical approval. The nurse cannot restrain the client because doing so amounts to false imprisonment. Calling the physician is not an appropriate measure. Telling the client that he may not be able to access the healthcare facility again is an inappropriate response because healthcare is a right and the client can access it whenever necessary.
A nurse observes another nurse place an unused dose of an opioid in the nurse's pocket. If caught, the nurse could be charged with which type of crime? negligence misdemeanor felony tort
felony A felony is a serious criminal offense, and includes actions such as stealing opioids, murder, falsifying medical records, and insurance fraud. A misdemeanor is a minor criminal offense; a tort is a lawsuit in which a plaintiff charges that a defendant committed a deliberately aggressive act. Negligence is harm that results because a person did not act reasonably.
An HIV-positive client discovers that their name is published in a report on HIV care prepared by the nurse. The client strongly opposes this and files a lawsuit against the nurse. Which offense has this nurse committed? unintentional tort invasion of privacy defamation negligence of duty
invasion of privacy The nurse has committed the tort of invasion of privacy. Personal names and identities are concealed or obliterated in case studies or research work. Invasion of privacy is a type of intentional tort. Defamation is an act in which untrue information harms a person's reputation, and is therefore not applicable here. Negligence is the harm that results because a person did not act reasonably.
A nurse sends a group text message to coworkers describing a coworker dating a former client. The message includes sexual behaviors, times, and places that the two people were seen together. The nurse is at risk of what act of wrongdoing? Select all that apply. libel intentional tort unintentional tort false imprisonment slander of the client
libel intentional tort The texting nurse is at risk of libel and the texting is considered an intentional tort. Slander is the spoken word of defamation of character so the texting is not spoken. An unintentional tort is negligence or malpractice and the nurse is texting information willingly. False imprisonment is restricting movement without proper consent so this does not describe texting.
The children of a male client with late-stage Alzheimer disease have informed the nurse on the unit that their father possesses a living will. The nurse should recognize that this document is most likely to: specify the treatment measures that the client wants and does not want. dictate how the client wants his estate handled after his death, and by whom. make legal provisions for active euthanasia. give permission for organ donation.
specify the treatment measures that the client wants and does not want. Living wills provide instructions about the kinds of health care that should be used or rejected under specific circumstances. The management of an individual's estate is specified in a will, not a living will. It is not legal for a living will to make provisions for active euthanasia. A living will may or may not include reference to organ donation, but normally this is addressed in a separate, specific consent card or document.
A nurse saw a coworker steal drugs from a locked cabinet. The supervisor notices the missing drugs and has a good idea who is responsible for the theft. The supervisor asks if the nurse saw anything out of the ordinary. Which professional value reflects a nurse's duty to tell the truth? veracity autonomy beneficence nonmaleficence
veracity Veracity is the nurse's duty to tell the truth in all professional situations. Autonomy refers to a client's right to self-determination. Beneficence is the duty to do good for the clients assigned to the nurse's care. Nonmaleficence is the duty to do no harm to the client.
In which circumstance may the nurse legally and ethically disclose confidential information about a client? A single client's human immunodeficiency virus (HIV) status to the family members A diagnosis of pancreatic cancer to a client's significant other A taxi driver's diagnosis of an uncontrolled seizure disorder to a state agency The fact that a woman is 32 weeks pregnant with twins to the partner from whom she is legally separated
A taxi driver's diagnosis of an uncontrolled seizure disorder to a state agency A nurse may lawfully disclose confidential information about a client when the welfare of a person or group of people is at stake. A healthcare provider must inform the Department of Motor Vehicles that the taxi driver has an uncontrolled seizure disorder; disclosing the condition is in the best interest of public safety and the client's well-being. Confidentiality of HIV testing is required, but the client, who's HIV positive, should be encouraged to share the information with family. Many state legislatures require maintaining confidentiality of HIV testing. The nurse may not disclose a diagnosis of pancreatic cancer or a pregnancy because these situations don't affect the welfare of a group of people.
The nurse is to administer a potassium supplement to the client. The nurse does not check the potassium level prior to administering the medication and later finds that the potassium level was at a critical high. What principle has this nurse violated? Beneficence Nonmaleficence Autonomy Fidelity
Nonmaleficence Nonmaleficence is the duty to do no harm to the client. For instance, if a nurse fails to check an order for an unusually high dose of insulin and administers it, he or she has violated the principle of nonmaleficence. Beneficence is the duty to do good for the clients assigned to the nurse's care. The nurse has a duty to remove wrist restraints whenever possible (removing a harm) and to help the client regain independence (promoting and doing good). Fidelity is the duty to maintain commitments of professional obligations and responsibilities. Autonomy refers to a client's right to self-determination or the freedom to make choices without opposition.
The nurse is providing care to several clients. In which situation would the nurse be able to accept a verbal order from the healthcare provider? The client is hemorrhaging from a surgical wound. The client has just been admitted to the unit from the emergency department. The client reports new onset headache and has a blood pressure of 90/50 mm Hg. The client is being transported to the cardiac catheterization department.
The client is hemorrhaging from a surgical wound. In most facilities, the only circumstance in which an attending healthcare provider may issue orders verbally is in a medical emergency, when the healthcare provider is present but finds it impossible to write the order. The postoperative hemorrhage is the only scenario that could be considered an emergency. Although the one client's blood pressure is low, there is no evidence there this is a potentially life-threatening situation. When clients are transferred between facilities or departments, there is time to write prescriptions, so the healthcare provider should enter these directly into the medical record as the safest form of documentation.
A physician is called to see a client with angina. During the visit the physician advises the nurse to decrease the dosage of atenolol to 12.5 mg. However, because the physician is late for another visit, the physician requests that the nurse write down the order for the physician. 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.
A nurse has been asked to obtain a client's signature on an operative consent form. When the nurse approaches the client, who is scheduled for a cholecystectomy later in the day, the client asks the nurse why the procedure is needed. Which response by the nurse is appropriate? "You have stones in your gallbladder and the treatment is to remove the gallbladder." "This is a common procedure performed using a scope and will relieve your symptoms." "The surgeon feels this is the best option for you at this time based on your symptoms." "I will ask the surgeon to come speak to you about the procedure."
"I will ask the surgeon to come speak to you about the procedure." It is the surgeon's responsibility to explain the procedure to the client and to answer questions so the client can provide an informed consent. The nurse can reinforce the information after the consent is obtained and clarify the information, but the surgeon must explain the procedure initially.
Which are appropriate actions for protecting clients' identities? Select all that apply. Orient computer screens toward the public view. Ensure that clients' names on charts are visible to the public. Document all personnel who have accessed a client's record. Place light boxes for examining X-rays with the client's name in private areas. Have conversations about clients in private places where they cannot be overheard.
Document all personnel who have accessed a client's record. Place light boxes for examining X-rays with the client's name in private areas. Have conversations about clients in private places where they cannot be overheard. Documenting all personnel who have accessed a client's record, placing light boxes for examining X-rays with the client's name in private areas, and having conversations about clients take place in private where they cannot be overheard are useful strategies to limit casual access to the identity of clients and health informatics. Orienting computer screens toward the public view and visibly displaying clients' names on charts are incorrect, as these are breaches of patient confidentiality.
A nurse is working in a clinic where a family member's spouse is treated for a sexually transmitted disease. The nurse is concerned about the risk to family members. What is the most appropriate action for the nurse to take? Anonymously inform the family member of the spouse's diagnosis so that they may seek necessary treatment. As legally required, inform the family member of the client's diagnosis. Encourage the client to speak with the family member about the diagnosis if the client has not already done so. Provide the local Board of Health with the family member's name so they can contact them with information about the client's diagnosis.
Encourage the client to speak with the family member about the diagnosis if the client has not already done so. Encouraging the client to talk with their spouse is the nurse's only option. According to the Privacy Acts, a client's diagnosis is confidential information that shouldn't be shared with anyone, including a spouse, without the client's permission. Telling a family member about the diagnosis is a violation of the client's confidentiality. The nurse isn't legally obligated to report the diagnosis to family members. It isn't appropriate for the nurse to provide information that would allow other agencies to contact the client's spouse.
An 18-year-old client is being treated for a sexually transmitted infection. The parent of the client comes to the clinic demanding information regarding the care provided since the child is covered on the parent's insurance. Which response by the nurse is most appropriate? Explain the reason why information cannot be disclosed. Verify the insurance coverage before giving information. Refer the parent to the physician providing care. Mediate a meeting between the parent and client.
Explain the reason why information cannot be disclosed. The nurse needs to explain the reason why information cannot be released to the parents. Providing insurance coverage does not negate the privacy laws. Referring the parent to the physician is inappropriate since the physician cannot release the information either. Mediating a meeting between the parent and client would only be appropriate if the client requested the meeting.
