NURS 242 Exam 2 - Nurse Practice Acts, BON, Laws

What term describes law that considers the nature of the action, not the resultant harm; penalties with felonies? a) Tort law b) Common law c) Constitutional law d) Criminal law e) Contract law

d) Criminal law *ex: medicare or insurance reimbursement fraud, misrepresentation of qualifications, or purposeful breaches of protected health information

What are torts that are exemplars of health care law?

-Negligence/malpractice -Standard of care -Breach of duty -Abandonment

What are the Leadership Roles & Management Functions associated with legal & legislative issues? *refer to display 5.2 p. 110-M

*Leadership Roles* -Serves as a role model by providing nursing care that meets or exceeds accepted standards of care -Practices within the scope of the Nurse Practice Act -Creates a work environment where each person understands they have some liability for their own conduct -Updates knowledge & skills in the field of practice & seeks professional certification to increase expertise in a specific field -Reports substandard nursing care to appropriate authorities following the established of command -Fosters nurse/pt relationships that are respectful, caring, and honest, thus reducing the possibility of future lawsuits -Creates an environment that encourages and supports diversity and sensitivity -Prioritizes pt rights & pt welfare in decision making -Ensures that pts receive informed consent for treatment -Demonstrates vision, risk taking, and energy in determining appropriate legal boundaries for nursing practice, thus defining what nursing is and what should be in the future. *Management Functions* -Increases knowledge regarding sources of law & legal doctrines that affect nursing practice -Ensures that organizational guidelines regarding scope of practice are consistent with the state Nurse Practice Act -Delegates to subordinates wisely, looking at the manager's scope of practice and that of the individuals they supervise -Understands & adheres to institutional policies & procedures -Minimizes the risk of product liability by assuring that all staff are appropriately oriented to the appropriate use of equipment & products -Monitors subordinates to ensure they have a valid, current, and appropriate license to practice nursing -Uses forseeability of harm in delegation & staffing decisions -Increases staff awareness of intentional torts & assists them in developing strategies to reduce their liability in these areas -Provides education for staff & pts on issues concerning treatment & end of life issues under the patient self determination act -Protects all pts rights to confidentiality under HIPAA -Ensures pts have reasonable access to information in the medical record, following established organizations processes -Secures appropriate background checks for new employees to reduce managerial liability -Provides educational and training opportunities for staff on legal issues affecting nursing practice

What are the 7 actions of BON may take against a nursing license?

1. Fine or civil penalty 2. Referral to an alternative-to-discipline program for practice monitoring and recovery support for those with drug or alcohol dependence or some other mental or physical condition 3. Public reprimand or censure for minor violation of the NPA, often with no restrictions on license 4. Imposition of requirements for monitoring, remediation, education, or other provision tailored to the particular situation 5. Limitation or restriction of one or more aspects of practice, such as probation with limits on role, setting, activities, or hours worked 6. Separation from practice for a period (suspension) or loss of license (revocation or voluntary surrender) 7. Other state specific remedies

Answer the following with either T or F regarding consent: 1. Only competent adult can legally sign 2. To be competent, pts must be capable of understanding the nature & consequences of the decision & of communicating their decision. 3. Spouses can legally sign for patient 4. a minor younger than 16-18 yrs is able to give consent if parents are not there 5. The nurse is not responsible for explaining the procedure performed 6. The nurse should be a pt advocate by determining their level of understanding & seeing that the appropriate person answers their questions 7. Physician are able to consent for the pt in terms of an emergency

1. True 2. True 3. False! They can't unless there is approved guardianship or conservatorship or unless they hold a DPOA for HC 4. False; try to contact parent/guardian to give consent 5. True 6. True 7. True; known as implied consent

T or F: if the HC professional has their license revoked, then they are able to work to get it back

False! You can if its suspended but if its revoked than you can't work in healthcare again

T or F: volunteering at clinics protects health care professionals under good samaritan laws

False, not being paid for your services will not provide good samaritan law protection

What are examples of negligence?

Failure to... -follow standards of care -use equipment in a responsible manner -communicate -document -assess and monitor -act as a client advocate

T or F: If the pt asks the nurse to see their medical record, it is the duty of the nurse to show the EHR

False! The pt must make a word written request & pay reasonable clerical costs to make such records available

T or F: good samaritan laws protects health care professions if they help pull an injured victims from the scene of a car accident without eminent danger such as fire, drowning or other harm

False! This is gross negligence

T or F: HC providers are protected from liability through good samaritan laws if they take action that does not exceed their scope of practice & in emergency situations

True

T or F: if found guilty in a criminal court then you will lose your license

True *ex:intentional administering of a life ending medication is a criminal law

T or F: A copy of an incident report should not be left in the chart. No entry should be made in the pts record about the existence of an incident report. The chart should only provide enough information about the incident or occurence so that the appropriate treatment can be given

True! It should be confidential & not disclosed to the plantiff, otherwise it can be subpoenaed in court

What term describes a collection of laws that have a direct impact on the delivery of healthy care or on the relationships among those in the business of health care or between the providers and recipients of health care.? a) Health care law b) Constitutional law c) Statutory (legislative) law d) Administrative Law & Regulation

a) Health care law

Which federal act is defined as a trust fund for the establishment of Medicaid and Medicare, a form of health insurance for those who do not have medical insurance through employment such as those retired individuals & the unemployed? a) Social Security Act b) EMTALA c) Patient Self-Determination Act d) HIPPA e) HITECH f) Patient Protection & Affordable Care Act

a) Social Security Act *ex: Medicaid & Medicare

Medicaid & Medicare are examples of which important act? a) Social Security Act b) EMTALA c) Patient Self-Determination Act d) HIPPA e) HITECH f) Patient Protection & Affordable Care Act

a) Social Security Act *trust fund for the establishment of Medicaid and Medicare, a form of health insurance for those who do not have medical insurance through employment such as those retired individuals & the unemployed

Negligence, based on the concept of fault, meaning that liability/fault attaches to an incorrect act or mistaken omission that caused harm even if the act or omission was unintentional is an example of which law? a) Tort law b) Common law c) Constitutional law d) Criminal law e) Contract law

a) Tort law *action or omission that results in harm to a person, including intentional or unintentional. It's responsible for shaping & defining many health care quality & safety standards

What term describes an action or omission that results in harm to a person. It's responsible for shaping & defining many health care quality & safety standards? This must cause injury that the law believes entitles the injured party to compensation. It includes unintentional and intentional conduct. a) Tort law b) Common law c) Constitutional law d) Criminal law e) Contract law

a) Tort law *the most common basis for liability of nurses, physicians, and other health care providers. Ex: negligence

Which of the following are torts? (select all that apply) a) abandonment b) standard of care c) good samaritan acts d) insurance fraud e) negligence f) breach of duty g) sexual assault

a) abandonment b) standard of care/duty e) negligence/malpractice f) breach of duty/failure to provide standard of care *good samaritan acts is state statutory laws; insurance fraud & sexual assault are criminal liability

What complaint category for disciplinary process by BON in nursing are maltreatment of clients that is physically, mentally, or emotionally harmful? a) abuse b) sexual misconduct c) fraud d) boundary violations

a) abuse

Which of the following are means for disciplinary process to BON in regard to complaints in nursing? (select all that apply) a) abuse b) fraud c) positive criminal background check d) practice related e) drug related f) boundary violations g) sexual misconduct

a) abuse b) fraud c) positive criminal background check d) practice related e) drug related f) boundary violations g) sexual misconduct

Which of the following are action the BON can make to take against a nursing license? (select all that apply) a) fine b) civil penalty c) suspension d) substitute e) voluntary surrender f) alternative to discipline program g) probation with limits on role, setting, & activities h) revocation

a) fine b) civil penalty c) suspension e) voluntary surrender f) alternative to discipline program g) probation with limits on role, setting, & activities h) revocation

Which of the following are elements that must be satisfied to establish liability? (select all that apply) a) injury or harm b) consent c) duty d) statutes e) breach of duty f) causation

a) injury or harm c) duty (standard of care) e) breach of duty f) causation

Statutory laws, applicable regulations, and legal precedents are analyzed in the context of the situation under review. A decision is made based on this analysis. Decisions can be limited to a specific state or area of the country. This is an examples of what type of law? a) Tort law b) Common law c) Constitutional law d) Criminal law e) Contract law

b) Common law *role of the judge or the judicial branch of government to interpret the law, but often their interpretation of the law leads to law itself

What term describes the highest law in the US, interpreted by the US Supreme court that gives authority to other three sources of the Law? a) Health care law b) Constitutional law c) Statutory (legislative) law d) Administrative Law & Regulation

b) Constitutional law *It has little direct involvement in the area of malpractice r/t the impact on nursing practice. Ex: Fourteenth Amendment was the constitutional legal principle that decided the case of Roe v. Wade, which forbid states from criminalizing or otherwise banning first trimester abortions and recognized a constitutional right to privacy inclusive of a women's right to terminate her pregnancy & Cruzan v. Missouri clarified a competent pts right to refuse treatment

The Fourteenth Amendment was used in case of Roe v. Wade, which forbid states from criminalizing/banning first trimester abortions & recognized a constitutional right to privacy inclusive of a women's right to terminate her pregnancy; Also applied to Cruzan v. Missouri which clarified a competent pts right to refuse treatment. These are both examples of which types of law? a) Health care law b) Constitutional law c) Statutory (legislative) law d) Administrative Law & Regulation

b) Constitutional law *highest law in the US, interpreted by the US Supreme court that gives authority to other three sources of the Law

What law empowers patient decision making & is defined as laws that allow physicians to write prescription for a lethal dose of medication that a mentally competent but terminally ill patient can use to end their life if the patient that has less than 6 months to live a) Tort law b) Death with dignity laws c) Good Samaritan laws d) Advance directive e) Consent for treatment

b) Death with dignity laws *Ex: Physician assisted suicide by lethal medication dose or Patient Choice & Controls at End of Life act

Which of the following are laws that empower patient descion making? (select all that apply) a) Tort law b) Death with dignity laws c) Good Samaritan laws d) Advance directive e) Consent for treatment

b) Death with dignity laws d) Advance directive e) Consent for treatment

Which of the following are criminal liability? (Select all that apply) a) death with dignity b) active euthanasia c) aid in dying d) insurance fraud e) negligence f) abandonment g) sexual assault

b) active euthanasia d) insurance fraud g) sexual assault *death with dignity & aid in dying are state statutory laws; negligence & abandonment are torts

Which of the following are the burden of proof required for a guilty verdict for civil law? a) beyond a reasonable doubt b) based on preponderance of the evidence c) clear & convincing standard

b) based on preponderance of the evidence *consequence if guilty is monetary damages

What complaint category for disciplinary process by BON in nursing are non therapeutic relationships formed between a nurse and a client in which the nurse derives a benefit at the clients expense? a) practice related b) boundary violations c) fraud d) positive criminal background checks

b) boundary violations

A nurse fails to give meds accurately, completely, or on time is an example of which of the four elements to establish liability? a) duty b) breach of duty c) causation d) injury or harm

b) breach of duty (failure to meet standard of care) *Defined as the failure to meet a standard of care. It is below the standard of care for a nursing professional to administer the wrong dose of a med to a patient. If the med error does not result in hard or injury to the pt, the nurse will not fact tort liability for his or her actions but may face termination from employment or licensure discipline depending on the circumstance.

Which of the four elements to establish liability is defined as failure to meet a standard of care? Health care providers violate standards to patients when they fall below the standard of care or deviate from the standard in a manner that causes injury. a) duty b) breach of duty c) causation d) injury or harm

b) breach of duty (failure to meet standard of care) *Not giving the care that should be giving under the circumstances. Ex: A nurse fails to give meds accurately, completely, or on time

Which of the following are examples of negligence by the nurse? a) failure to explain surgical procedure b) failure to follow standards of care c) failure to use equipment in a responsible manner d) failure to communicate e) failure to make medical decisions for the patient f) failure to document g) failure to assess and monitor h) failure to act as a client advocate

b) failure to follow standards of care c) failure to use equipment in a responsible manner d) failure to communicate f) failure to document g) failure to assess and monitor h) failure to act as a client advocate

What is the likely consequence of guilty verdict for criminal law? a) monetary damages b) incarceration, probation, & fines c) suspension or loss of licensure

b) incarceration, probation, & fines *proof needed is beyond a reasonable doubt

What term is defined as records of unusual or unexpected incidents that occur in the course of a pts treatment? a) informed consent b) incident report c) torts d) statutes

b) incident report *considered confidential & cannot be used in lawsuits as evidence. However, if the report is disclosed to the plantiff, it is no longer confidential & can be subpoenaed in curt, so a copy should NOT be left in the chart

Which of the following are management function? (select all apply) a) ensure pts receive informed consent for treatment b) increases knowledge regrading sources of law & legal doctrines that affect nursing practice c) uses forseeability of harm in delegation & staffing decisions d) provides education for staff & pts on issues concerning treatment & end of life issues under patient self-determination act e) creates a work environment where each person understands they have some liability for their own conduct f) understands & adheres to institutional policies & procedures g) updates knowledge & skills in the field of practice & seeks professional certification to increase expertise in a specific field h) protects all pts rights to confidentiality under HIPAA

b) increases knowledge regrading sources of law & legal doctrines that affect nursing practice c) uses forseeability of harm in delegation & staffing decisions d) provides education for staff & pts on issues concerning treatment & end of life issues under patient self-determination act f) understands & adheres to institutional policies & procedures h) protects all pts rights to confidentiality under HIPAA *a, e, & g are management functions

Which of the following are state statutory laws? (select all that apply) a) negligence/malpractice b) licensing boards c) public health & safety d) standard of care e) practice acts f) good samaritan acts g) immunizations h) consent & statutory surrogates

b) licensing boards c) public health & safety e) practice acts f) good samaritan acts g) immunizations h) consent & statutory surrogates *negligence/malpractice & standard of care are torts

Which federal act promotes discourse about end of life medical treatment and to ensure the patients received appropriate education about their right to decide future care in the events of incapacitation? a) Social Security Act b) EMTALA c) Patient Self-Determination Act d) HIPPA e) HITECH f) Patient Protection & Affordable Care Act

c) Patient Self-Determination Act *Prohibits Medicare-participating health care organization from discimination against pts based on the presence or absence of an advance directive. Medicare participants are required to: Provide patients upon admission information regarding advance directives and advise patients of their rights to participate in medical decision-making Document in the medical record whether or not a patient has completed an advance directive

Medicare participants are required to provide patients upon admission information regarding advance directives and advise patients of their rights to participate in medical decision-making Document in the medical record whether or not a patient has completed an advance directive. This is an example of which federal act? a) Social Security Act b) EMTALA c) Patient Self-Determination Act d) HIPPA e) HITECH f) Patient Protection & Affordable Care Act

c) Patient Self-Determination Act *discourse about end of life medical treatment and to ensure the patients received appropriate education about their right to decide future care in the events of incapacitation

Many laws at both the federal and the state level have been enacted with the intent to directly impact the business or relationship of health care. Every state has independent legislative bodies, so laws that are enacted by the states may vary in title, but underlying authority to legislate for the general health & welfare of people is the same. This is an example of which type of law? a) Health care law b) Constitutional law c) Statutory law d) Administrative Law & Regulation

c) Statutory law *laws enacted by a legislative body

What term describes laws enacted by a legislative body? a) Health care law b) Constitutional law c) Statutory law d) Administrative Law & Regulation

c) Statutory law (legislative law) *Many laws at both the federal and the state level have been enacted with the intent to directly impact the business or relationship of health care. Every state has independent legislative bodies, so laws that are enacted by the states may vary in title, but underlying authority to legislate for the general health & welfare of people is the same

What is given authority to act by the legislative bodies and create rules and regulations that enforce statutory laws? a) constitution b) statutes c) administrative agencies d) court decisions

c) administrative agencies *Ex: state boards of nursing are administrative agencies set up to implement and enforce the state nurse practice act by writing rules and regulations and by conducting investigations and hearings to ensure the law's enforcement. Administrative laws are valid only to the extent that they are within the scope of the authority granted to them by the legislative body.

State BON are set up to implement and enforce the state nurse practice act by writing rules and regulations and by conducting investigations and hearings to ensure the law's enforcement. This is an example of which of the following? a) constitution b) statutes c) administrative agencies d) court decisions

c) administrative agencies *given authority to act by the legislative bodies and create rules and regulations that enforce statutory laws. Administrative laws are valid only to the extent that they are within the scope of the authority granted to them by the legislative body.

If nurse isn't seen as persistent enough in attempting to notify the HC provider in changes of pts conditions or the seriousness of the pts condition, the nurse can be held liable for failure to intervene bc the intervention was below what was expected of them for a pt advocate. This is an example of which element of liability? a) duty b) breach of duty c) causation d) injury or harm

c) causation *link between breach & injury; there must be provable correlation between improper care & injury to the pt

What is the impact on Nursing Practice of the Administrative Agencies? a) most malpractice laws are addressed b) little direct involvement in the area of malpractice c) some agencies like National Labor Relations Board & health & Safety boards can affect nursing practice d) before the 1970s very few state or federal laws dealt with mapractice, but since malpractice crisis many affect malpractice

c) some agencies like National Labor Relations Board & health & Safety boards can affect nursing practice *a) is court decisions; b) is the constitution; d) is statutes

Which federal act is defined as a privacy rule that protects the confidentiality of health information relating to the provision or payment of healthcare for a past present or future physical or mental health condition but does not permit the "minimum necessary" use and disclosure of protected health information without patient authorization for purposes of treatment, payment, and healthcare operations? a) Social Security Act b) EMTALA c) Patient Self-Determination Act d) HIPPA e) HITECH f) Patient Protection & Affordable Care Act

d) HIPPA *Provide individuals with pre-existing medical conditions access to health insurance specifically if they changed or lost their job Prevent healthcare fraud and abuse and medical liability form

Which federal act provides individuals with pre-existing medical conditions access to health insurance specifically if they changed or lost their job a) Social Security Act b) EMTALA c) Patient Self-Determination Act d) HIPPA e) HITECH f) Patient Protection & Affordable Care Act

d) HIPPA *prevents healthcare fraud and abuse and medical liability form

Which federal act prevents healthcare fraud and abuse and medical liability form? a) Social Security Act b) EMTALA c) Patient Self-Determination Act d) HIPPA e) HITECH f) Patient Protection & Affordable Care Act

d) HIPPA *provides individuals with pre-existing medical conditions access to health insurance specifically if they changed or lost their job

What is the impact on Nursing Practice of the Statutes? a) most malpractice laws are addressed b) little direct involvement in the area of malpractice c) some agencies like National Labor Relations Board & health & Safety boards can affect nursing practice d) before the 1970s very few state or federal laws dealt with mapractice, but since malpractice crisis many affect malpractice

d) before the 1970s very few state or federal laws dealt with mapractice, but since malpractice crisis many affect malpractice *a) is court decisions; b) is the constitution; c) isadministrative agencies

What complaint category for disciplinary process by BON in nursing is mishandling, misappropriating, or misuse of controlled substances? a) practice related b) boundary violations c) fraud d) drug related

d) drug related

What federal act was created to decrease the number of uninsured Americans, make health insurance and health care affordable, and improve health outcomes and performance of the health care system? a) Social Security Act b) EMTALA c) Patient Self-Determination Act d) HIPPA e) HITECH f) Patient Protection & Affordable Care Act

f) Patient Protection & Affordable Care Act *sometimes known as "PPACA," "ACA," or "Obamacare."

T or F: Professional negligence occurs when the actions of the nurse are judged as substandard to what is expected in "reasonable & prudent" standard of practice and that result in harm to others.

True

T or F: The Nurse Practice Acts gives authority to regulate the practice of nursing and the enforcement of law to an administrative agency for Boards of Nursing

True

Put the following stages of the health policy process in order ___policy formulation ___ policy evaluation ___ agenda setting ___ policy implementation ___ policy adoption

__2__policy formulation __5__ policy evaluation __1__ agenda setting __4__ policy implementation __3__ policy adoption

What are exemplars of health care law of: 1) Federal Statutory Laws 2) State Statutory Laws 3) Torts 4) Criminal Liability

*Federal Statutory Laws*: -Social Security Act -Social Security Amendment -Emergency Medical Treatment and Active Labor Act (EMTALA) -Patient Self-Determination Act -Health Insurance Portability and Accountability Act (HIPPA) -Patient Protection and Affordable Care Act -Americans with Disabilities Act (ADA) *State Statutory Laws*: -Licensing boards -Immunizations -Public health and safety: disease surveillance & sanitation -Consent/statutory surrogates -Advanced directives -Death with dignity or aid-in-dying -Good Samaritan acts -CMS Conditions of Participation for Hospitals -Practice acts -Scope of practice *Torts*: -Negligence/malpractice -Standard of care -Breach of duty -Abandonment *Criminal Liabilty*: -Insurance fraud -Active euthanasia -Sexual assault

What are laws that empower patient decision making?

-consent for treatment -advance directive -death with dignity laws

What are the 5 stages of the process by which health policy is made?

1. Agenda setting (Health related issue is identified) 2. Policy formulation (Different policy interventions are proposed and considered) 3. Policy adoption (Proposed intervention is selected) 4. Policy implementation (Carrying out the proposed intervention) 5. Policy evaluation (Determining if the policy achieved the desired policy goals)

What part of the Nurse Practice Acts describes that terms or phrases used in statutes must be clear and unambiguous? It is often included to avoid ambiguity about word meaning for the intent of a law to be useful to legislators and citizens 1. Definitions 2. Authority, power, & composition of a BON 3. Educational program standards 4. Standards & scope of nursing practice 5. Types of titles & licenses 6. Protection of titles 7. Requirements for licensure 8. Grounds for disciplinary action, other violations, & possible remedies

1. Definitions

What the 8 elements of all Nurse Practice Acts?

1. Definitions 2. Authority, power, & composition of a BON 3. Educational program standards 4. Standards & scope of nursing practice 5. Types of titles & licenses 6. Protection of titles 7. Requirements for licensure 8. Grounds for disciplinary action, other violations, & possible remedies

What are the 13 powers & duties of the Board of Nursing?

1. Making, adopting, amending, repealing, & enforcing rules 2. setting nursing education standards 3. setting fees for licensure 4. performing criminal background checks 5. licensing qualified applicants 6. maintaining database of licenses 7. ensuring continuing competence 8 . developing nursing standards of practice 9. collecting & analyzing data 10. implementing discipline process 11. regulating RNs 12. regulating UAPs 13. hiring BON employees

What are the 7 complaint categories in regards to disciplinary process in nursing by the BON?

1. Practice related 2. Drug related 3. Boundary violations 4. Sexual misconduct 5. Abuse 6. Fraud 7. Positive criminal background checks

What is the sequence of the BON complain process?

1. filing a complain 2. initial review of complaint 3. investigation 4. board proceedings 5. board actions 6. reporting & enforcement

T or F: Copies of incident reports should be placed in pts charts

False

T or F: Death or Dignity laws state that a nurse is allowed to prescribe a lethal dose of med that a mentally competent but terminally ill pt can use to end his or her life if the pt has less than 6 mos to live

False

T or F: The Patient Self-Determination Act requires health care facilities to provide information to patients regarding payment for services

False

What is practicing in your scope of practice, can help others in an emergency situation & not be held liable *ex: driving down the road & see car accident, you can help & not get in trouble

Good Samaritan Laws

What term describes that healthcare providers are typically protected from potential liability if they volunteer their nursing skills away from the workplace (generally limited to emergencies) provided that actions taken or not grossly negligent and does not exceed his or her training or scope of practice and performing the emergency services?

Good samaritan laws

Place the following in order for the sequence of BON complaint process ____ initial review of complaint ____ filing a complaint ____ reporting and enforcement ____ board proceedings ____ investigation ____ board actions

__2__ initial review of complaint __1__ filing a complaint __6__ reporting and enforcement __4__ board proceedings __3__ investigation __5__ board actions

Place the steps of the policy process in the correct order. ____Policy formation ____Policy adoption ____Policy implementation ____Agenda setting ____Policy evaluation

__2__Policy formation __3__Policy adoption __4__Policy implementation __1__Agenda setting __5__Policy evaluation

Match the following exemplars of health care law to either: a) Federal Statutory Laws, b) State Staturoy Laws, c) Torts, d) Criminal liability 1. Negligence/malpractice 2. Insurance fraud 3. Practice acts 4. Patient Protection & Affordable Care Act 5. Licensing boards 6. Public health & safety; disease surveillance & sanitation 7. Patient Self-Determination Act 8. Standard of care 9. scope of practice 10. Americans with Disabilities Act (ADA) 11. CMS Conditions of Participation for Hospitals 12. Emergency Medical Treatment & Active Labor Act 13. Consent/statutory surrogates 14. Breach of duty 15. Advanced directive 16. Health Insurance Portability & Accoutability Act (HIPPA) 17. Americans with Disabilities Act (ADA) 18. Immunizations 19. Abandonment 20. Sexual assault 21. Social Security Act 22. Social Security Amendment 23. Death with dignity or aid-in-dying 24. active euthanasia 25. Good Samaritan Act

*Federal Statutory Laws*: 4. Patient Protection & Affordable Care Act 7. Patient Self-Determination Act 10. Americans with Disabilities Act (ADA) 12. Emergency Medical Treatment & Active Labor Act (EMTALA) 16. Health Insurance Portability & Accoutability Act (HIPPA) 17. Americans with Disabilities Act (ADA) 21. Social Security Act 22. Social Security Amendment *State Statutory Laws*: 3. Practice acts 5. Licensing boards 6. Public health & safety; disease surveillance & sanitation 9. scope of practice 11. CMS Conditions of Participation for Hospitals 13. Consent/statutory surrogates 15. Advanced directive 18. Immunizations 23. Death with dignity or aid-in-dying 25. Good Samaritan Act *Torts*: 1. Negligence/malpractice 8. Standard of care 14. Breach of duty 19. Abandonment *Criminal Liabilty*: 2. Insurance fraud 20. Sexual assault 24. active euthanasia

What are the federal, state, and local governmental agency right acts, laws, & policies? *must know

*Federal*: -Americans with Disabilities Act (ADA) -Emergency Medical Treatment and Labor Act (EMTLA) -Health information technology for economic and clinical health care act (HITECH) -Health Insurance Portability and Accountability Act (HIPPA) -Patient protection and affordable care act -Patient safety and quality improvement act -Patient Self Determination Act (PSDA) -Promoting health/preventing disease: objectives for the nation, healthy people -Social security (Medicare and Medicaid) -The mental health parity and addiction equity act -US preventive services task force -Mandated health coverage and Medicaid expansion *State*: -Scope of practice -Licensing boards -Good Samaritan acts -Death with Dignity or aid-in death -State professional practice acts -State public health programs & policies related to infectious diseases -State public health regulations that govern healthcare facilities -State statutes and case law related to professional negligence and malpractice *Local*: -City and county fire codes that govern safe occupancy limits in healthcare facilities -City and county ordinances that govern facility maintenance, signs, utilities, parking and traffic around hospitals and other healthcare facilities -City and county tax districts for publicly supported facilities

Match the following with either a) federal, b) state, or c) local a) scope of practice b) ADA c) licensing boards d) fire codes e) EMTLA f) HITECH g) HIPPA h) PSDA i) Death with Dignity j) licensing boards k) patient protection & affordable care act l) professional practice acts m) social security (medicare/medicaid) n) ordinances that govern facility maintenance, signs, utilities, parking and traffic around hospitals & other HC facilities o) good Samaritan acts p) mental health parity & addiction equity act q) public health programs & policies r/t infectious disease r) US preventative services task force s) tax districts for publicly supported facilities t) patient safety & quality improvement act u) objectives for the nation v) health people w) professional negligence/malpractice x) mandated health coverage & medicaid expansion y) public health regulations that govern HC facilities

*Federal*: b) ADA e) EMTLA f) HITECH g) HIPPA h) PSDA k) patient protection & affordable care act m) social security (medicare/medicaid) p) mental health parity & addiction equity act r) US preventative services task force t) patient safety & quality improvement act u) objectives for the nation v) health people x) mandated health coverage & medicaid expansion *State*: a) scope of practice i) Death with Dignity j) licensing boards l) professional practice acts o) good Samaritan acts q) public health programs & policies r/t infectious disease w) professional negligence/malpractice y) public health regulations that govern HC facilities *Local*: d) fire codes n) ordinances that govern facility maintenance, signs, utilities, parking and traffic around hospitals & other HC facilities s) tax districts for publicly supported facilities

Match the following to either a) Leadership Roles, or b) Management Functions 1) Increases knowledge regarding sources of law & legal doctrines that affect nursing practice 2) Ensures that organizational guidelines regarding scope of practice are consistent with the state Nurse Practice Act 3) Serves as a role model by providing nursing care that meets or exceeds accepted standards of care 4) Practices within the scope of the Nurse Practice Act 5) Creates a work environment where each person understands they have some liability for their own conduct 6) Delegates to subordinates wisely, looking at the manager's scope of practice and that of the individuals they supervise 7) Updates knowledge & skills in the field of practice & seeks professional certification to increase expertise in a specific field 8) Reports substandard nursing care to appropriate authorities following the established of command 9) Fosters nurse/pt relationships that are respectful, caring, and honest, thus reducing the possibility of future lawsuits 10) Understands & adheres to institutional policies & procedures 11) Creates an environment that encourages and supports diversity and sensitivity 12) Minimizes the risk of product liability by assuring that all staff are appropriately oriented to the appropriate use of equipment & products 13) Monitors subordinates to ensure they have a valid, current, and appropriate license to practice nursing 14) Prioritizes pt rights & pt welfare in decision making 15) Uses forseeability of harm in delegation & staffing decisions 16) Increases staff awareness of intentional torts & assists them in developing strategies to reduce their liability in these areas 17) Ensures that pts receive informed consent for treatment 18) Provides education for staff & pts on issues concerning treatment & end of life issues under the patient self determination act 19) Protects all pts rights to confidentiality under HIPAA 20) Ensures pts have reasonable access to information in the medical record, following established organizations processes 21) Demonstrates vision, risk taking, and energy in determining appropriate legal boundaries for nursing practice, thus defining what nursing is and what should be in the future. 22) Secures appropriate background checks for new employees to reduce managerial liability 23) Provides educational and training opportunities for staff on legal issues affecting nursing practice

*Leadership Roles* 3) Serves as a role model by providing nursing care that meets or exceeds accepted standards of care 4) Practices within the scope of the Nurse Practice Act 5) Creates a work environment where each person understands they have some liability for their own conduct 7) Updates knowledge & skills in the field of practice & seeks professional certification to increase expertise in a specific field 8) Reports substandard nursing care to appropriate authorities following the established of command 9) Fosters nurse/pt relationships that are respectful, caring, and honest, thus reducing the possibility of future lawsuits 11) Creates an environment that encourages and supports diversity and sensitivity 14) Prioritizes pt rights & pt welfare in decision making 17) Ensures that pts receive informed consent for treatment 21) Demonstrates vision, risk taking, and energy in determining appropriate legal boundaries for nursing practice, thus defining what nursing is and what should be in the future. *Management Functions* 1) Increases knowledge regarding sources of law & legal doctrines that affect nursing practice 2) Ensures that organizational guidelines regarding scope of practice are consistent with the state Nurse Practice Act 6) Delegates to subordinates wisely, looking at the manager's scope of practice and that of the individuals they supervise 10) Understands & adheres to institutional policies & procedures 12) Minimizes the risk of product liability by assuring that all staff are appropriately oriented to the appropriate use of equipment & products 13) Monitors subordinates to ensure they have a valid, current, and appropriate license to practice nursing 15) Uses forseeability of harm in delegation & staffing decisions 16) Increases staff awareness of intentional torts & assists them in developing strategies to reduce their liability in these areas 18) Provides education for staff & pts on issues concerning treatment & end of life issues under the patient self determination act 19) Protects all pts rights to confidentiality under HIPAA 20) Ensures pts have reasonable access to information in the medical record, following established organizations processes 22) Secures appropriate background checks for new employees to reduce managerial liability 23) Provides educational and training opportunities for staff on legal issues affecting nursing practice

What are the guidelines for informed consent? *refer to Display 5.3 P. 121-M

*The person(s) giving consent must fully comprehend*: -The procedure to be performed -The risks involved -Expected or desired outcomes -Expected complications or side effects that may occur as a result of treatment -Alternative treatments that are available *Consent may be given by*: -A competent adult -A legal guardian or individual holding durable power of attorney -An emancipated or married minor -Mature minor (varies by state) -Parent of a minor child -Court order

Which of the following best describes failure to notify the physician in timely manner when conditions warrant, to listen to a client's complaint and act on it, to communicate effectively with a client, to seek higher medical authorization for treatment a) abuse b) abandonment c) negligence d) fraud e) sexual misconduct

*an example of Failure to communicate

What are the elements that must be satisfied to establish liability?

-Duty -Breach of duty -Causation -Injury or harm

What are criminal liability exemplars of health care law?

-Insurance fraud -Active euthanasia -Sexual assault

What are State Statutory Laws that are exemplars of health care law?

-Licensing boards -Immunizations -Public health and safety: disease surveillance & sanitation -Consent/statutory surrogates -Advanced directives -Death with dignity or aid-in-dying -Good Samaritan acts -CMS Conditions of Participation for Hospitals -Practice acts -Scope of practice

What are Federal Statutory Laws that are exemplars of health care law?

-Social Security Act -Social Security Amendment -Emergency Medical Treatment and Active Labor Act (EMTALA) -Patient Self-Determination Act -Health Insurance Portability and Accountability Act (HIPPA) -Patient Protection and Affordable Care Act -Americans with Disabilities Act (ADA)

Identify common causes of professional nursing license suspension or revocation?

-professional negligence -practicing medicine or nursing without a license -obtaining a license by fraud -allowing others to use your license -felony conviction -participating professionally in criminal abortion -not reporting substandard medical or nursing care -providing pt care while under the influence of drugs or alcohol -giving narcotics without an order -falsely holding oneself out to the public or any health care practitioner as a nurse practitioner (remember you are an RN not an NP)

What are common causes of professional Nursing License Suspension or Revocation? *refer to Display 5.4 P.128-M

-professional negligence -practicing medicine or nursing without a license -obtaining a nursing license by fraud or allowing others to use your license -felony conviction for any offense substantially r/t the function or duties of RN -participating professionally in criminal abortions -not reporting substandard medical nursing care -providing pt care while under the influence of drugs or alcohol -giving narcotic drugs without an order -falsely holding oneself out to the public or to any HC practitioner as a "nurse practitioner"

What part of the Nurse Practice Acts grants authority to regulate practice of nursing & enforcement of law to an administrative agency/BON, which is charged with maintaining the balance between the rights of the nurse to practice nursing & responsibility to protect the public health, safety, and welfare of its citizens? 1. Definitions 2. Authority, power, & composition of a BON 3. Educational program standards 4. Standards & scope of nursing practice 5. Types of titles & licenses 6. Protection of titles 7. Requirements for licensure 8. Grounds for disciplinary action, other violations, & possible remedies

2. Authority, power, & composition of a BON

What part of the Nurse Practice Acts sets standards for prelicensure nursing educational programs and clinical learning experiences and approve such programs that meet requirements of the NPA? 1. Definitions 2. Authority, power, & composition of a BON 3. Educational program standards 4. Standards & scope of nursing practice 5. Types of titles & licenses 6. Protection of titles 7. Requirements for licensure 8. Grounds for disciplinary action, other violations, & possible remedies

3. Educational program standards

What part of the Nurse Practice Acts is aligned with the nursing process: comprehensive nursing assessment, collab with HC team, pt centered HC plans, decision making, & critical thinking 1. Definitions 2. Authority, power, & composition of a BON 3. Educational program standards 4. Standards & scope of nursing practice 5. Types of titles & licenses 6. Protection of titles 7. Requirements for licensure 8. Grounds for disciplinary action, other violations, & possible remedies

4. Standards & scope of nursing practice

What part of the Nurse Practice Acts provides statements regarding title of RN & LPN that protects these titles from being used by unauthorized persons and thereby protects the public? 1. Definitions 2. Authority, power, & composition of a BON 3. Educational program standards 4. Standards & scope of nursing practice 5. Types of titles & licenses 6. Protection of titles 7. Requirements for licensure 8. Grounds for disciplinary action, other violations, & possible remedies

5. Types of titles & licenses

What part of the Nurse Practice Acts must a complaint be filed with the BON when a nurse deviates from the standard or care or commits an error, which can take formal action only if it finds sufficient basis that the nurse violated the NPA regulations 1. Definitions 2. Authority, power, & composition of a BON 3. Educational program standards 4. Standards & scope of nursing practice 5. Types of titles & licenses 6. Protection of titles 7. Requirements for licensure 8. Grounds for disciplinary action, other violations, & possible remedies

8. Grounds for disciplinary action, other violations, & possible remedies

Which of the following client statements about advance directives most concerns the nurse on the med surg unit? A) my living will is all made out and secure in my safe deposit box B) I can change my durable power of attorney at any time C) my friends think I am tempting fate by having advance directives, but I don't care D) I find the thought of my own death or incapacitation to be quite scary

A) my living will is all made out and secure in my safe deposit box *Nurse needs to assess whether this is the only copy of the living will and whether client is the only one who has access to the safe deposit box. Such storage is not advised and is unlikely to be available if client is incapacitated. It's advised that the client gives copies of the living will to their physician and to chosen family members

Nursing staff members are sitting in the lounge taking the morning break. A UAP tells the group that she thinks that the unit secretary has AIDS and proceeds to tell the nursing staff that the secretary probably contracted The disease from her husband who is supposedly a drug attic. The RN should inform the UAP that making this accusation has violated which legal tort? A) libel B) slander C) assault D) negligence

B) slander *defamation is a false communication or careless disregard for the truth that causes damage to someone's reputation in either writing (libel) or verbally (slander). An assault occurs when a person puts another person in fear of a harmful or offensive contact. Negligence involves the actions of professionals that fall below the standard of care for a specific professional group

Who is charged with maintaining the balance between the rights of the nurse to practice nursing & the responsibility to protect the public health, safety, & welfare of its citizens? *granted authority by the nurse practice acts

Board of Nursing (BON)

Who has authority, granted by the nurse practice acts, to regulate the practice of nursing?

Board of Nursing (BON) *charged with maintaining the balance between the rights of the nurse to practice nursing & the responsibility to protect the public health, safety, & welfare of its citizens

Who is charged with maintaining the balance between the rights of the nurse to practice nursing & responsibility to protect the public health, safety, and welfare of its citizens?

Board of Nursing under the Nurse Practice Acts

The nurse hears a client calling out for help, hurries down the hallway to the clients room, and finds the client lying on the floor. The nurse performs an assessment, assist the client back to bed, notifies the healthcare provider of the incident, and completes an incident report. Which statement should the nurse document on the incident report? A) The client fell out of bed B) The client climbed over the side rail C) The client was found lying on the floor D) The client became restless and tried to get out of bed

C) The client was found lying on the floor *incident reports should include factual descriptions of the incident, any injuries experienced by those involved, and outcomes of the situation

The nurse who works on the night shift enters the medication room and finds a coworker with a tourniquet wrapped around the upper arm. The coworker is about to insert a needle, attached to a syringe containing a clear liquid, into the antecubital area. Which is the most appropriate action by the nurse? A) call security B) call the police C) call the nursing supervisor D) lock the coworker in the medication room until help is obtained

C) call the nursing supervisor *Nurse Practice Acts requires reporting impaired Nurses. The BON has jurisdiction over the practice of nursing and may develop plans for treatment and supervision of the impaired nurse. The incident needs to be reported to the nursing supervisor, who will then report to the BON and other authorities such as the police as required.

The nurse employed in a hospital is waiting to receive a report from the lab via fax machine. The fax machine activated and the nurse expects the report, but instead received a sexually oriented photo. Which is the most appropriate initial nursing action? A) call the police B) cut up the photo and throw it away C) call the nursing supervisor and report the incident D) call the lab and ask for the name of the individual who sent the photo

C) call the nursing supervisor and report the incident *Sexual harassment in the workplace is prohibited by state and federal laws. Sexually suggestive jokes, touching, pressuring coworkers for a date, and open displays of a transmitting sexually oriented photograph or posters are examples of conduct that could be considered sexual harassment. If the nurse believes that they are being subjected to unwelcome sexual contact, these concerns should be reported to the nursing supervisor immediately.

Which document does the nurse know the force of law backs up? A) standards of nursing care B) code of ethics C) nursing practice acts D) nursing organization bylaws

C) nursing practice acts *Nurse practice act are a legal code and have the force of law fully behind them with specific statutes and are passed by the state legislature, which define and regulate nursing practice within each state; the acts address licensure in entry into practice requirements, define the scope of nursing practice, and establish a BON for oversight and enforcement of the act

A client is brought to the ED by EMS after being hit by a car. The name of the client is unknown, and the client has sustained a severe head injury, multiple fractures, and is unconscious. An emergency craniotomy is required. Regarding informed consent for the surgical procedure, which is the best action? A) obtain a court order for the surgical procedure B) ask the EMS team to sign the informed consent C) transport the victim to the operating room for surgery D) call the police to identify the client and locate the family

C) transport the victim to the operating room for surgery * there are two situations where informed consent of an adult is not needed: 1) when the emergency is present and delaying treatment for the purpose of obtaining consent would result in injury or death to the client., 2) when the client waives the right to give informed consent

A hospitalized client tells the nurse that an instructional directive is being prepared and that the lawyer will be bringing the document to the hospital today for witness signatures. The client asks the nurse for assistance in obtaining a witness to the will. Which is the most appropriate response to the client? A) I will sign as a witness to your signature B) you will need to find a witness on your own C) whoever is available at the time will sign as a witness for you D) I will call the nursing supervisor to seek assistance regarding your request

D) I will call the nursing supervisor to seek assistance regarding your request *instructional directives (living wills) are required to be in writing and signed by the client. The client signature must be witnessed by specified individuals or notarized. Many states prohibit any employee, including the nurse of a facility from being a witness.

The nurse observes the student nurse give a presentation about incident reports. The nurse intervenes if the nursing student states which situation requires an incident report? A) The client has a prescription for citalopram to be administered. The nurse administers clonazepam B) At 1000 the nurse notes the clients BP is 80/50 and pulse is 110. Health care provider notified at 1300 C) The client falls while ambulating to the bathroom and reports right hip pain D) The healthcare provider orders a medication to be administered at 0900. The nurse administers the medication at 0930

D) The healthcare provider orders a medication to be administered at 0900. The nurse administers the medication at 0930

The student nurse discusses causes of malpractice suits with the instructor. The instructor intervenes if the student includes which occurrence as an example of malpractice? A) failure to warn a potential employer of an RNs incompetence B) failure to staff a unit adequately C) failure to ensure that nurses are practicing in a competent manner D) failure to document within 30 mins after a change in the client condition

D) failure to document within 30 mins after a change in the client condition *Failure to report and failure to document can lead to malpractice suits. Nurse is required to document in a timely fashion, but not required document within 30 minutes

What is the process for a pt to access their own medical record?

Must make a word written request & pay reasonable clerical costs to make such records available *may take several days to receive

T or F: The purpose of the Emergency Medical Treatment & Labor Act of 1986 was enacted to prevent the denial of emergency services to patients because they are uninsured & unable to pay for care

True

T or F: Consent must be voluntarily given & pt must have capacity to consent r/t meds or current/underlying condition, otherwise pt may designate person who can give consent on their behalf

True! Performing a procedure without pt consent could constitute as battery, even if procedure was done competently & with good outcomes

T or F: Performing a procedure without pt consent could constitute as battery, even if procedure was done competently & with good outcomes

True! Unless its an emergency situation where consent is implied

Match the following complaint categories of disciplinary process in nursing by BON ____ Practice related ____ Drug related ____ Boundary violations ____ Sexual misconduct ____ Abuse ____ Fraud ____ Positive criminal background checks 1. maltreatment of clients that is physically, mentally, or emotionally harmful 2. detection of reportable criminal conduct as defined by statute 3. breakdowns or errors during aspects of the nursing process 4. inappropriate physical or sexual contact with a client 5. non therapeutic relationships formed between a nurse & a client in which the nurse derives a benefit at the clients expense 6. mishandling, misappropriating, or misuse of controlled substances 7. misrepresentations of the truth for gain or profit; usually r/t credentials, time, or payment

__3__ Practice related __6__ Drug related __5__ Boundary violations __4__ Sexual misconduct __1__ Abuse __7__ Fraud __2__ Positive criminal background checks

Match the following definitions to the following stages of the process of how health policy is made 1) ____Agenda setting 2) ____Policy formulation 3) ____Policy adoption 4) ____Policy implementation 5) ____Policy evaluation a) carrying out the proposed intervention b) health related issue is identified c) different policy interventions are proposed & considered d) determining if the policy achieved the desired policy goals e) proposed intervention is selected

__b__Agenda setting __c__Policy formulation __e__Policy adoption __a__Policy implementation __d__Policy evaluation

Match the following components of professional negligence to each example ____duty to use due care (standard of care) ___ failure to meet standard of care (breach of duty) ____ causation ____ injury a) convulsion or other serious complication occur from giving wrong medication b) nurse fails to give medication accurately, completely, or on time c) nurse should give medication accurately, completely, & on time d) drug handbook specifies that the wrong dosage or route may cause injury

__c__ duty to use due care (standard of care) __b__ failure to meet standard of care (breach of duty) __d__ causation __a__ injury

When proving negligence, there are 4 elements that must be satisfied to establish liabilty. Match each element with the correct definition/example. ____Duty ____Breach of Duty ____Causation ____Injury of Harm a) can often be difficult to prove in negligence cases; is the link between breach of duty & injury/harm b) may be physical or a combination of physical, mental, emotional, or financial c) providing a reasonable, standard of care to pts; standard of care can depend upon where one works, whether a rural or urban setting or ICU vs Surgery d) falling below the reasonable, standard of care owed to pts

__c__Duty __d__Breach of Duty __a__Causation __b__Injury of Harm

The physician's order reads: Give Furosemide (Lasix) 200 mg IVP over 30 minutes prior to the infusion of PRBCs. Kendra, RN, administers the Furosemide (Lasix) as ordered on the MAR. The patient has a cardiac arrest & dies at the end of Kendra's shift. During the nurse manager's review of the chart, he notes the dose of Furosemide (Lasix) administered & asks Kendra to explain. The patient's family is suing Kendra & the hospital. Which of the following statements by Kendra will not stand up in court under Tort Law? a) "I just followed the physician's order" b) "I should have telephoned the physician" c) "I should have called the pharmacy to help me" d) "I should not have given the Furosemide (Lasix) as ordered bc the dose was incorrect"

a) "I just followed the physician's order"

The novice nurse asked his preceptor why he needed to be aware of the rights & duties of legal matters. What is the preceptor's best response? a) "To be able to better protect yourself" b) "To be able to better protect your patients" c) "To be able to better protect your peers" d) "To be able to better protect your superiors"

a) "To be able to better protect yourself"

Which of the following fall under criminal liability? (select all that apply) a) Insurance fraud b) Breach of duty c) Active euthanasia d) Abandonment e) Sexual assault f) Negligence/malpractice

a) Insurance fraud c) Active euthanasia e) Sexual assault *breach of duty, abandonment, & negligence/malpractice are all torts; refer to Box 58-2 p. 538-G

A new nurse needs further teaching when stating a valid consent involves which action? a) It must be presented to the patient by a nurse. b) The consent includes information about the risks and benefits of the procedure. c) The patient must have the capacity to give consent. d) The patient must voluntarily give consent.

a) It must be presented to the patient by a nurse. *The person presenting the informed consent document must be the provider performing the procedure. To be valid, information for consent must be given by the provider who will be performing the procedure and includes information about the risks and benefits of the procedure. The patient must voluntarily give consent.

Which of the following fall under State Statutory Laws? (select all that apply) a) Licensing boards b) Scope of practice c) Americans with Disabilities Act of 1990 d) Good Samaritan Acts e) Death with Dignity or aid-in dying

a) Licensing boards b) Scope of practice d) Good Samaritan Acts e) Death with Dignity or aid-in dying *ADA is federal

Advance directives, patient's wishes, are covered by the guidelines of which federal law? a) Patient Self-Determination Act (PSDA) b) Emergency Medical Treatment and Labor Act of 1986 (EMTLA) c) Patient Protection & Affordable Care Act d) Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH)

a) Patient Self-Determination Act (PSDA) *facilities provide pts with information related to their end of life care; is federal law

Some patients will choose to except all lifesaving measures should their condition deteriorate while hospitalized and given the choice is an example of which federal law? a) Patient Self-Determination Act (PSDA) b) Emergency Medical Treatment and Labor Act of 1986 (EMTLA) c) Patient Protection & Affordable Care Act d) Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH)

a) Patient Self-Determination Act (PSDA) *facilities provide pts with information related to their end of life care; is federal law

Which federal law requires HC facilities such as hospitals & nursing homes to provide pts with information related to their preferences & the right to make their own decisions about their end-of-life care and the facilities policies respecting those decisions. a) Patient Self-Determination Act (PSDA) b) Emergency Medical Treatment and Labor Act of 1986 (EMTLA) c) Patient Protection & Affordable Care Act d) Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH)

a) Patient Self-Determination Act (PSDA) is federal law *ex: Some patients will choose to except all lifesaving measures should their condition deteriorate while hospitalized and given the choice

Several high school students are attending a job fair hosted by a local hospital. One student asks, "Who determines what type of care a nurse can give to patients?" Which of the following is the nurse's best response? a) Practice is determined by state regulatory boards. b) Practice is determined by institutional policies and procedures. c) Practice is determined by federal health organizations. d) Practice is determined by the Institute of Medicine.

a) Practice is determined by state regulatory boards. *States create laws that establish professional practice acts that regulate nursing practice. Institutional policies govern actions in the workplace but must comply with state regulations. Federal health organizations set overall health policies but not specific nursing practice standards. The Institute of Medicine is an advisory board that makes recommendations about the delivery of health care and where resources might be focused to improve overall health.

Which of the following are federal statutory laws? (select all that apply) a) Social Security Act b) Good Samaritan Act c) Patient protection & Affordable Care Act d) Practice Acts e) Americans with Disabilities Act f) Patient Self-Determination Act g) CMS Conditions of Participation for Hospitals h) Public health & safety

a) Social Security Act c) Patient protection & Affordable Care Act e) Americans with Disabilities Act f) Patient Self-Determination Act *Good Samaritan Act, Practice Acts, CMS Conditions of Participation for Hospitals, & Public health & safety--disease surveillance & sanitation are ALL examples of State Statutory Laws

Which of the following would be a violation of the Consolidated Omnibus Budget Reconciliation Act and Emergency Medical Treatment and Active Labor Act (EMTALA) of 1986? a) The hospital ER physician suspects that a pt is not competent in making decisions for his post-care treatment. The physician does not complete a competency evaluation prior to transfer for a non-emergent treatment and allows the pt with suspected incompetence to sign the consent for transfer. b) After providing a medical screening examination, the pt's attending physician determines that transfer for a psychiatric service is necessary and not provided by the hospital. The attending seeks consent from the competent surrogate decision maker for the patient prior to transfer. c) The pt's attending physician determines the pt to be in stable condition after completing the medical screening examination & stabilizing the pt. The pt's condition would deteriorate without a life-saving procedure not available at the hospital. The physician explains the risks of staying at the hospital & the risks of the transfer to the pt's power of attorney. Informed consent is received from the pt's power of attorney for the transfer. d) The hospital does not contract with the pt's insurance company. The ER physician completes a medical screening examination & stabilizes the pt for discharge. The pt financial services department informs the pt of insurance status after discharge and arranges for payment options.

a) The hospital ER physician suspects that a pt is not competent in making decisions for his post-care treatment. The physician does not complete a competency evaluation prior to transfer for a non-emergent treatment and allows the pt with suspected incompetence to sign the consent for transfer. *EMTALA was created so ERs have a duty to care for pts requiring emergency medical services irrespective of patient's ability to pay. EMTALA required that any hospital that operated an ED & received Medicare funds provide an appropriate screening examination to anyone who presented and stabilize any emergency medical condition prior to transfer to another facility. The physician who allows the pt with suspected incompetence to sign the consent for transfer did not complete the medical screening examination.

The standards & scope of nursing practice within a Nurse Practice Act are aligned with: a) The nursing process b) State laws & statutes c) Educational program standards d) Job descriptions

a) The nursing process

When referring to informed consent, which of the following must be fully comprehended by the pt? (select all that apply) a) The risks involved b) Expected or desired outcomes c) The procedure to be performed d) Alternative treatments that are available e) Expected complications or side effects

a) The risks involved b) Expected or desired outcomes c) The procedure to be performed d) Alternative treatments that are available e) Expected complications or side effects

Which of the following are the burden of proof required for a guilty verdict for criminal law? a) beyond a reasonable doubt b) based on preponderance of the evidence c) clear & convincing standard

a) beyond a reasonable doubt *consequence if guilty is either incarceration, probation, & fines

Which of the following are able to give consent? (Select all that apply) a) competent adult b) legal guardian or individual holding DPOA c) emancipated or married minor d) dementia pt e) court order f) mature minor g) parent of a minor child

a) competent adult b) legal guardian or individual holding DPOA c) emancipated or married minor e) court order f) mature minor (varies by state) g) parent of a minor child

What is a system of fundamental laws of principles that govern a nation, society, corporation, or other aggregate of individuals Purpose is to establish the basis of a governing system for the future and the present. a) constitution b) statutes c) administrative agencies d) court decisions

a) constitution *has little direct involvement in the area of malpractice

What is the highest law in the US interpreted by the US supreme court that gives authority to other three sources of the law? a) constitution b) statutes c) administrative agencies d) court decisions

a) constitution *has little direct involvement in the area of malpractice

A nurse should give meds accurately, completely and on time is an example of which of the four elements to establish liability? a) duty b) breach of duty c) causation d) injury or harm

a) duty (standards of care) *Duty to use due care; the care that should be given under the circumstances of what the reasonably prudent nurse would have done. Exercise ordinary care to avoid harming another person, place, or thing.

Which of the four elements to establish liability is defined the standard of care which represent the skills & learning commonly possessed by members of the profession & generally are the minimal requirement that define an acceptable level of care? a) duty b) breach of duty c) causation d) injury or harm

a) duty (standards of care) *Duty to use due care; the care that should be given under the circumstances of what the reasonably prudent nurse would have done. Exercise ordinary care to avoid harming another person, place, or thing. Ex: A nurse should give meds accurately, completely and on time

Which of the following can only be given after the pt has received a complete explanation about the procedure & indicates that they understand the risks & benefit related to it? a) informed consent b) implied consent c) express consent d) invalid consent

a) informed consent *Must be in a language the pt can understand & conveyed by an individual performing the procedure. The pt must be invited to ask qs & have clear understandings of the options. Only competent adult can legally sign; to be competent, pts must be capable of understanding the nature & consequences of the decision & of communicating their decision. Spouses can't legally sign unless there is approved guardianship or conservatorship or unless they hold a durable power of attorney for HC.

Which of the following are means for disciplinary process to BON in regard to complaints in nursing? (select all that apply) a) maltreatment of clients that is emotionally harmful b) detection of reportable criminal conduct as defined by statute c) breakdowns or errors during aspects of the nursing process d) delaying charting for several hours e) inappropriate physical contact with a client f) non therapeutic relationships formed between a nurse & a client in which the nurse derives a benefit at the clients expense g) mishandling, misappropriating, or misuse of controlled substances h) misrepresentations of the truth for gain or profit; usually r/t credentials, time, or payment

a) maltreatment of clients that is emotionally harmful b) detection of reportable criminal conduct as defined by statute c) breakdowns or errors during aspects of the nursing process e) inappropriate physical contact with a client f) non therapeutic relationships formed between a nurse & a client in which the nurse derives a benefit at the clients expense g) mishandling, misappropriating, or misuse of controlled substances h) misrepresentations of the truth for gain or profit; usually r/t credentials, time, or payment -a) *abuse*: physically, mentally, or emotionally harmful; b) *positive criminal background checks*; c) *practice related*; e) *physical or sexual contact*; f) *boundary violations*; g) *drug related*; h) *fraud*

What is the likely consequence of guilty verdict for civil law? a) monetary damages b) incarceration, probation, & fines c) suspension or loss of licensure

a) monetary damages *proof needed is based on preponderance of the evidence

What is the impact on Nursing Practice of the Court Decisions? a) most malpractice laws are addressed b) little direct involvement in the area of malpractice c) some agencies like National Labor Relations Board & health & Safety boards can affect nursing practice d) before the 1970s very few state or federal laws dealt with mapractice, but since malpractice crisis many affect malpractice

a) most malpractice laws are addressed *b) is constitution; c) is administrative agencies; d) is statutes

What part of the health policy process are different policy interventions are proposed and considered? a) policy formulation b) policy evaluation c) policy adoption d) agenda setting

a) policy formulation

Which of the following are apart of the health policy process? (select all that apply) a) policy formulation b) policy evaluation c) policy generation d) agenda setting e) policy implementation f) policy adoption g) policy collection

a) policy formulation (2nd stage) b) policy evaluation (5th stage) d) agenda setting (1st stage) e) policy implementation (4th stage) f) policy adoption (3rd stage)

What complaint category for disciplinary process by BON in nursing are breakdowns or errors during aspects of the nursing process? a) practice related b) boundary violations c) fraud d) positive criminal background checks

a) practice related

Which of the following are leadership roles? (select all that apply) a) practice withing the scope of Nurse Practice Acts b) Understands & adheres to institutional policies & procedures c) updates knowledge & skills in the field of practice & seeks professional certification to increase expertise in a specific field d) reports substandard nursing care to appropriate authorities following the established of command e) prioritizes pts rights & pt welfare in decision making f) increases staff awareness of intentional torts & assists them in developing strategies to reduce their liability in these areas g) ensures pts receive informed consent for treatment h) provides educational & training opportunities for staff on legal issues affecting nursing practice

a) practice withing the scope of Nurse Practice Acts c) updates knowledge & skills in the field of practice & seeks professional certification to increase expertise in a specific field d) reports substandard nursing care to appropriate authorities following the established of command e) prioritizes pts rights & pt welfare in decision making g) ensures pts receive informed consent for treatment *b, f, & h are all management functions

Which of the following must the pt comprehend to obtain valid consent? (select all that apply) a) procedure being performed b) risks involved c) expected or desired outcomes d) expected complications or side effects e) alternative treatment

a) procedure being performed b) risks involved c) expected or desired outcomes d) expected complications or side effects e) alternative treatment

Which of the following are common causes of professional nursing license suspension or revocation? (select all that apply) a) professional negligence b) practicing medicine or nursing without a license c) obtaining a nursing license by fraud or allowing others to use your license d) felony conviction for any offense substantially r/t the function or duties of RN e) participating professionally in criminal abortions f) not reporting substandard medical nursing care g) providing pt care while under the influence of drugs or alcohol h) giving narcotic drugs without an order

a) professional negligence b) practicing medicine or nursing without a license c) obtaining a nursing license by fraud or allowing others to use your license d) felony conviction for any offense substantially r/t the function or duties of RN e) participating professionally in criminal abortions f) not reporting substandard medical nursing care g) providing pt care while under the influence of drugs or alcohol h) giving narcotic drugs without an order *also falsely holding oneself out to the public or to any HC practitioner as a "nurse practitioner"

Which of the following are powers/duties of the BON? (Select all that apply) a) setting nursing education standards & developing standards of practice b) regulating RNs & UAPs c) setting fees for licensure d) collecting & analyzing data e) performing criminal background check f) licensing qualified applicants g) implementing discipline process h) hiring BON employees

a) setting nursing education standards & developing standards of practice b) regulating RNs & UAPs c) setting fees for licensure d) collecting & analyzing data e) performing criminal background check f) licensing qualified applicants g) implementing discipline process h) hiring BON employees *also making, adopting, amending, repealing, & enforcing rules; maintaining database of licenses; & ensuring continuing competence

What health care policy relates to decisions that promote welfare to the public. It can be directed at a wide variety of social concerns & issues in which the primary policy goal is not necessarily health but the policy still has an impact on health. a) social policy b) institutional policy c) negligence d) policy process

a) social policy *ex: A state or federal law might govern WIC payments for health foods at farmers market's.

A linked health policy goal would be directed at ensuring Medicare or Medicaid payments for exercise and weight loss programs is an example of which health care policy? a) social policy b) institutional policy c) negligence d) policy process

a) social policy *relates to decisions that promote welfare to the public

A state or federal law might govern WIC payments for health foods at farmers market's is an example of which health care policy? a) social policy b) institutional policy c) negligence d) policy process

a) social policy *relates to decisions that promote welfare to the public

Government policies related to a social policy goal that addresses obesity may result in legislation or regulation that governs the sale of high fat or high sugar content foods available in public schools is an example of which health care policy? a) social policy b) institutional policy c) negligence d) policy process

a) social policy *relates to decisions that promote welfare to the public

What is the purpose of the National Practitioner Data Bank? a) Hold the states accountable for nursing practice b) Free service for the general public c) Workforce tool to prevent practitioners from moving state to state without disclosure or discovery of previous damaging performance d) Promote regulatory compliance

c) Workforce tool to prevent practitioners from moving state to state without disclosure or discovery of previous damaging performance

A nurse is answering questions about health care at a community health fair. An elderly visitor asks why health care is so expensive. Which of the following is the best response by the nurse? a) "There are a decreasing number of patients needing long-term health care, so there are fewer health care providers." b) "Patients without health care coverage use emergency departments, where it is more expensive to provide care." c) "We are not developing equipment and technology fast enough to keep medical costs down." d) "Many patients are only using nonprescription medications, so the cost of other cares has gone up."

b) "Patients without health care coverage use emergency departments, where it is more expensive to provide care." *Uninsured patients often go to emergency departments for primary medical care, which adds to the cost of the health care system. As the population ages, there is an increase in patients needing long-term health care because of increased chronic illnesses. Technology development tends to decrease the cost of health care because it increases efficiency and decreases labor needs. Patients use nonprescription medications but also use complementary and alternative treatments that are frequently not covered by payment plans and do not raise health costs by themselves.

What is the duty of all nurses with respect to the Nurse Practice Act & regulations? a) The individual nurse has no involvement with the Nurse Practice Act & regulations b) All nurses have a duty to understand their Nurse Practice Act & regulations & to keep up with ongoing changes as the document evolves & scope of practice expands c) All nurses should educate the public on the requirements of the NPA & regulations d) All nurses should rely on their employer to inform them of any changes to practice requirements

b) All nurses have a duty to understand their Nurse Practice Act & regulations & to keep up with ongoing changes as the document evolves & scope of practice expands

What term describes the role of the judge or the judicial branch of government to interpret the law, but often their interpretation of the law leads to law itself? Statutory laws, applicable regulations, and legal precedents are analyzed in the context of the situation under review. A decision is made based on this analysis. Decisions can be limited to a specific state or area of the country. a) Tort law b) Common law c) Constitutional law d) Criminal law e) Contract law

b) Common law (case) *One area of the country may not have addressed a question that another area has already answered in the courts and it may adopt the ruling of another area without going through the process of litigating the question in courts

A nurse is charged with administrating a fatal dose of Potassium 80 meg IVP to a patient on hospice that asked the nurse "to help her die today." In which court would the nurse be charged? a) Civil b) Criminal c) Administrative d) None of the above

b) Criminal

Physician assisted suicide by lethal medication dose and Patient Choice & Controls at End of Life act are examples of which law that empowers patient decision making? a) Tort law b) Death with dignity laws c) Good Samaritan laws d) Advance directive e) Consent for treatment

b) Death with dignity laws *laws that allow physicians to write prescription for a lethal dose of medication that a mentally competent but terminally ill patient can use to end their life if the patient that has less than 6 months to live

Which federal act is defined as any Medicare participating hospital that offers emergency services must provide an appropriate medical screening exam to persons who present for treatment of an emergency medical condition and must stabilize any emergency medical condition before transfer to another facility irrespective of patient's ability to pay. At patient's request, or if the hospital is unable to stabilize the patient's condition, the hospital can arrange for transfer to appropriate level of care a) Social Security Act b) EMTALA c) Patient Self-Determination Act d) HIPPA e) HITECH f) Patient Protection & Affordable Care Act

b) EMTALA *Ex: If a patient is unstable due to an aortic dissection and your hospital has the resources to repair that dissection, you are obligated to keep the patient.

If a patient is unstable due to an aortic dissection and your hospital has the resources to repair that dissection, you are obligated to keep the patient. This is an example of which federal act? a) Social Security Act b) EMTALA c) Patient Self-Determination Act d) HIPPA e) HITECH f) Patient Protection & Affordable Care Act

b) EMTALA *any Medicare participating hospital that offers emergency services must provide an appropriate medical screening exam to persons who present for treatment of an emergency medical condition and must stabilize any emergency medical condition before transfer to another facility irrespective of patient's ability to pay. At patient's request, or if the hospital is unable to stabilize the patient's condition, the hospital can arrange for transfer to appropriate level of care

Which federal law was enacted to prevent the denial of emergency services to patients chiefly because they are uninsured and unable to pay for their care? a) Patient Self-Determination Act (PSDA) b) Emergency Medical Treatment and Labor Act of 1986 (EMTLA) c) Patient Protection & Affordable Care Act d) Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH)

b) Emergency Medical Treatment and Labor Act of 1986 (EMTLA) *Before this law, pts were transferred to "safety net" hospitals, usually tax supported public hospitals

Before this federal law, pts were transferred to "safety net" hospitals, usually tax supported public hospitals? It was meant to stop private hospital facilities from "patient dumping" to public hospitals at the taxpayers expense. a) Patient Self-Determination Act (PSDA) b) Emergency Medical Treatment and Labor Act of 1986 (EMTLA) c) Patient Protection & Affordable Care Act d) Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH)

b) Emergency Medical Treatment and Labor Act of 1986 (EMTLA) *prevent denial of emergency services to pts bc they are uninsures & unabl to pay for their care

What is the basis for Board of Nursing action related to complaints about nursing care? a) Precedence with similar cases b) Findings of an investigation & results of board proceedings c) Consensus of board members d) The nurse's ability to practice nursing in the state taking action

b) Findings of an investigation & results of board proceedings

The ED nurse is scheduling the 16 yr old pt for an emergency appendectomy. Which intervention should the nurse implement when obtaining permission for the surgery? a) Withhold the narcotic pain med until the pt signs the permit b) Have the pts parent or legal guardian sign the permit c) Explain the procedure to the pt & the parents in simple terms d) Get a visitor from the ED waiting area to witness the parent's signature

b) Have the pts parent or legal guardian sign the permit

A nurse manager recognizes that an individual can affect health policy. Which of the following actions by the nurse indicates the step of agenda setting in affecting health policy? a) Planning a fund-raising campaign to raise money for a nutrition program b) Identifying increased malnutrition in preschool children c) Evaluating daycare meal plans d) Implementing a home meal plan for preschool children

b) Identifying increased malnutrition in preschool children -In *Agenda setting*, a health-related issue is identified. This is the 1st stage of the process on how Health policy is made. -*Policy formulation* is 2nd stage -Planning a fund raising program is the 3rd stage *Policy adoption*. -*Policy implementation* is the 4th stage when an intervention such as a meal plan is put into place. -Evaluation of a program is the 5th stage of *Policy evaluation*. *refer to Figure 57-1 on page 527 in the Giddens

How can the public access information about licensure status & Board of Nursing actions? (select all that apply) a) Through the National Practitioner Data Bank b) Newsletters c) Databases d) Websites e)) Nursys QuickConfirm Licence Verification

b) Newsletters c) Databases d) Websites e)) Nursys QuickConfirm Licence Verification

A home health agency's patient filed a complaint with the BON that Nurse Joan appeared as though she was under the influence of drugs or alcohol. The BONs investigation of Nurse Joan revealed that a substance use disorder was suspected. What type of action may the BON choose in this situation? a) Incarceration b) Nondisciplinary alternative-to-discipline program c) Treatment programs d) Notice to the public

b) Nondisciplinary alternative-to-discipline program

The nurse has been named in a lawsuit concerning the care provided. Which action should the nurse take first? a) Consult with the hospital's attorney b) Review the pts chart c) Purchase personal liability insurance d) Discuss the case with the supervisor

b) Review the pts chart *The nurse should refresh their memory (not a HIPPA violation). The hospital attorney & supervisor is going to protect the hospital; the nurse should have already purchased insurance

How did the states gain regulatory authority over the practice of nursing? a) Governmental policy b) Under a state's policy powers c) As specified in the United States Constitution d) None of the above

b) Under a state's policy powers

What is the likely consequence of guilty verdict for administrative law? a) monetary damages b) incarceration, probation, & fines c) suspension or loss of licensure

c) suspension or loss of licensure *proof needed is clear & convincing standard

A nurse protecting a patient's right to consent to a procedure is represented in which of the following answers? a) Finding that the informed consent document is not with the chart, the nurse gives the patient another consent document to sign before the procedure. b) When the nurse finds that the informed consent document is not yet complete, she holds the patient's pre-procedure narcotics until the physician can obtain patient consent. c) The nurse finds that the consent form is unsigned in the chart and waits until after the procedure to get the document signed. d) Knowing the patient is not competent to sign a consent form, the nurse asks the friend who came with the patient to sign it.

b) When the nurse finds that the informed consent document is not yet complete, she holds the patient's pre-procedure narcotics until the physician can obtain patient consent. *To be valid, info for consent must be given prior to the procedure by the provider who will be performing the procedure and the info given must include a description of the procedure, a description of the risks & benefits of the procedure, & a discussion of any alternatives to the proposed procedure. Consent by the patient must be voluntarily given, & the person who consents must have the capacity to consent. Capacity can be determined by the HC provider & may be affected by drugs or the current or underlying medical condition. If the patient is unable to give consent directly, they may designate a person who can give consent on their behalf. If such a person is not designated by the pt, most states provide a statutory solution or a law that lists "statutory surrogates."

Which of the following does the physician states in the progress notes of the medical record in an emergency that the patient is unable to sign but the treatment is immediately needed and is in the patient's best interest? a) informed consent b) implied consent c) express consent d) invalid consent

b) implied consent *usually needs to be validated by another physician

Which health care policies govern the workplace? a) social policy b) institutional policy c) negligence d) policy process

b) institutional policy *Ex: Nurses work with policies and procedure manuals of specific units, clinics, or home health agencies

An organization might have specific institutional policies developed for their workforce that relate to prevention of obesity, such as providing exercise facilities onsite is an example of which health care policy? a) social policy b) institutional policy c) negligence d) policy process

b) institutional policy *policies govern the workplace

Nurses work with institutional policies that govern nursing practices, such as professional job descriptions is an example of which health care policy? a) social policy b) institutional policy c) negligence d) policy process

b) institutional policy *policies govern the workplace

Student Nurses Association might adopt a resolution supporting exercise classes for student nurses is an example of which health care policy? a) social policy b) institutional policy c) negligence d) policy process

b) institutional policy *policies govern the workplace

What is the impact on Nursing Practice of the Constitution? a) most malpractice laws are addressed b) little direct involvement in the area of malpractice c) some agencies like National Labor Relations Board & health & Safety boards can affect nursing practice d) before the 1970s very few state or federal laws dealt with mapractice, but since malpractice crisis many affect malpractice

b) little direct involvement in the area of malpractice *a) is court decisions; c) is administrative agencies; d) is statutes

What part of the health policy process is carrying out the proposed intervention? a) policy adoption b) policy implementation c) policy evaluation d) agenda setting

b) policy implementation

What complaint category for disciplinary process by BON in nursing are inappropriate physical or sexual contact with a client? a) abuse b) sexual misconduct c) fraud d) boundary violations

b) sexual misconduct

What are laws that govern & legislative bodies, such as the U.S. Congress, state legislatures, and city councils make these laws? a) constitution b) statutes c) administrative agencies d) court decisions

b) statutes *Statutes are officially enacted (voted on and passed) by the legislative body and are compiled into codes, collections of statutes, and ordinances. Before the 1970s, very few state or federal laws dealt with malpractice. Since the malpractice crisis, many statutes affect malpractice

What is officially enacted, voted on, & passed by the legislative body & are compiled into codes & ordinances? a) constitution b) statutes c) administrative agencies d) court decisions

b) statutes *laws that govern & legislative bodies, such as the U.S. Congress, state legislatures, and city councils make these laws. Before the 1970s, very few state or federal laws dealt with malpractice. Since the malpractice crisis, many statutes affect malpractice

What is also called legislative law which are laws that are passed by the state or federal legislators and that must be signed by the president or governor? a) constitution b) statutes c) administrative agencies d) court decisions

b) statutes *laws that govern. Before the 1970s, very few state or federal laws dealt with malpractice. Since the malpractice crisis, many statutes affect malpractice

What are the consequences for nurses who violate the Nurse Practice Act or regulations, or commit an error? a) Law enforcement handles all of these cases b) There are no consequences c) A complaint may be filed with the Board of Nursing d) Formal action is always taken, regardless of findings of sufficient basis for violation of the Nurse Practice Act or regulations

c) A complaint may be filed with the Board of Nursing

Which of the following is an example of a medical malpractice tort liability? a) A patient is informed of all known side effects of a medication and voluntarily takes the medication. The patient experiences an adverse effect from a medication prescribed by a physician. b) A nurse follows the standard of care for initiating an intravenous line, but the patient's vein bursts, causing a hematoma and the need for minor surgery to evacuate the fluid. c) A surgeon does not complete the postprocedure count process, and a sponge is retained in the patient's abdominal cavity. d) The Department of Justice fines an organization for releasing protected health information to a pharmaceutical company without individual patient consent.

c) A surgeon does not complete the postprocedure count process, and a sponge is retained in the patient's abdominal cavity. *For tort liability to attach, four elements must be satisfied: duty, breach, causation, and injury. An adverse effect experienced by a patient who was informed of all known side effects of a medication, is prescribed the medication, and voluntarily takes the medication is an adverse event, not a tort liability. When a nurse follows the standard of care for initiating an IV line, but the pts vein bursts, this is an adverse event and not a tort liability. Releasing protected health information to a pharmaceutical company without individual patient consent is regulated by federal law enforcement; it is considered employer liability and may be considered to be criminal if proven to be purposeful and egregious.

The nurse is reviewing current health care policies for newly hired employees. Which of the following topics will the nurse include in the presentation? a) Hospital infection control measures b) Hospital dress code expectations c) Hospital HIPAA (Health Information Portability and Accountability Act) protections d) Hospital annual evaluation processes

c) Hospital HIPAA (Health Information Portability and Accountability Act) protections *HIPAA is a federal health policy instituted to protect health information access. Infection control, dress codes, performance reviews, staffing, and professional development policies are institutional policies, not health policies created by governmental authority.

Nurse James works at Kansas City Memorial Hospital. At Kansas City Memorial Hospital it is a smoke-free workplace. This policy of a smoke-free workplace at Kansas City Memorial is an example of a... a) Social policy b) Market c) Institutional policy d) Dynamic tension

c) Institutional policy

Sandy, RN, is a 78 yr old full time RN on a busy medical-surgical unit. Her manager has reported her to the Board of Nursing due to many "near-miss" medication errors & errors in clinical judgment/patient safety. The Board of Nursing investigates the complaint & makes what decision for Sandy? a) The BON will ignore the allegation bc she has many years of experience b) The BON will punish Sandy for all of the "near miss" errors c) The BON will revoke Sandy's license due to physical/mental impairment related to age d) The BON will take Sandy's nursing license away bc after many years of nursing she shouldn't be making mistakes

c) The BON will revoke Sandy's license due to physical/mental impairment related to age

What is the purpose for state involvement in the regulation of nursing practice? a) To report any issues to the federal government b) To identify offenders of the Nurse Practice Act c) To protect those who receive nursing care d) To provide treatment & remedial skills to nurses as needed

c) To protect those who receive nursing care

What are rules and regulations established by appointed agencies of the executive branch of the government (governor or president) a) constitution b) statutes c) administrative agencies d) court decisions

c) administrative agencies *Some of these agencies, such as the National Labor Relations Board and health and safety boards, can affect nursing practice. Some of these agencies, such as the National Labor Relations Board and health and safety boards, can affect nursing practice.

Which of the four elements to establish liability is defined as the link between breach and injury? There must be provable correlation between improper care & injury to the pt a) duty b) breach of duty c) causation d) injury or harm

c) causation *Would the injury have not occurred "but for" the defendant's actions? Causation answers this question and establishes that the breach of duty legally caused injury to the patient. Ex: The drug handbook specifies that the wrong dosage or route may cause injury & the wrong dosage causes the pt to have a convulsion

The charge nurse makes pt assignments. The RN makes a med error for the assigned pt that injures the pt & the charge nurse had reason to believe that the RN was incapable of adequately caring for the pt or failed to provide adequate supervision, foreseeability of harm is apparent & the charge nurse could also be held liable. This is an example of which element of liability? a) duty b) breach of duty c) causation d) injury or harm

c) causation *link between breach & injury; there must be provable correlation between improper care & injury to the pt

The drug handbook specifies that the wrong dosage or route may cause injury & the wrong dosage causes the pt to have a convulsion is an example of which element to establish liability? a) duty b) breach of duty c) causation d) injury or harm

c) causation *link between breach & injury; there must be provable correlation between improper care & injury to the pt

Which of the following are the burden of proof required for a guilty verdict for administrative law? a) beyond a reasonable doubt b) based on preponderance of the evidence c) clear & convincing standard

c) clear & convincing standard *consequences if guilt is suspension or loss of licensure

Which of the following does the nurse seek this from pts by witnessing patients sign a standard consent form but also ensures that the patient has received informed consent and seek remedy if they have not? a) informed consent b) implied consent c) express consent d) invalid consent

c) express consent

What complaint category for disciplinary process by BON in nursing are misrepresentation of the truth for gain or profit; usually related to credentials, time, or payment? a) practice related b) boundary violations c) fraud d) positive criminal background checks

c) fraud

Which of the following best describes failure to question discharge orders then the client's condition warrants, incomplete or illegible medical orders; or to provide a safe environment for the client a) abuse b) abandonment c) negligence d) fraud e) sexual misconduct

c) negligence *an example of Failure to act as a client advocate

Which of the following best describes failure to complete a shift assessment, implement plan of care, observe the client's ongoing progress, interpret the client's sign and symptoms a) abuse b) abandonment c) negligence d) fraud e) sexual misconduct

c) negligence *an example of Failure to assess and monitor

Which of the following best describes failure to record a client's progress and response to treatment, client's injuries, important nursing assessment information, physican's medical orders; failure to document information or telephone conversations with physicians, including time, content of communication between nurse and physician and actions taken? a) abuse b) abandonment c) negligence d) fraud e) sexual misconduct

c) negligence *an example of Failure to document

What health care policy occurs when the actions of the nurses are judged as substandard to what is expected in "reasonable and prudent" standards of practice that results in harm to others. a) social policy b) institutional policy c) negligence d) policy process

c) negligence *ex: Not following 5 Rights and causing harm to patient

Harmful objects left near a patient who has suicidal is an example of which health care policy? a) social policy b) institutional policy c) negligence d) policy process

c) negligence *occurs when the actions of the nurses are judged as substandard to what is expected in "reasonable and prudent" standards of practice that results in harm to others

Not following 5 Rights and causing harm to patient is an example of which health care policy? a) social policy b) institutional policy c) negligence d) policy process

c) negligence *occurs when the actions of the nurses are judged as substandard to what is expected in "reasonable and prudent" standards of practice that results in harm to others

What term is the failure to use reasonable prudent care in the same or similar circumstances? It is the most common tort holding nurses, physicians, and other health care providers liable to patients for damages. a) abuse b) abandonment c) negligence d) fraud e) sexual misconduct

c) negligence or malpractice

Which of the following best describes what the nurse is doing when they fail to perform a complete admission assessment of design the plan of care, pass the admission assessment off to next shift, then something is not completed? a) abuse b) abandonment c) negligence d) fraud e) sexual misconduct

c) negligence/malpractice *an example of Failure to follow standards of care

Which of the following best describes failure to follow manufacturer's recommendations for operating equipment, failure to check equipment for safety prior to use, failure to place/position equipment properly during treatment, & failure to learn how equipment functions a) abuse b) abandonment c) negligence d) fraud e) sexual misconduct

c) negligence/malpractice *an examples of Failure to use equipment in a responsible manner

What part of the health policy process were a proposed intervention is selected? a) policy formulation b) policy evaluation c) policy adoption d) agenda setting

c) policy adoption

What part of the health policy process is determining if the policy achieved the desired policy goals? a) policy adoption b) policy implementation c) policy evaluation d) agenda setting

c) policy evaluation

Two nurses are having lunch in the hospital cafeteria when one of the nurses begins talking about a difficult patient. What response by the second nurse indicates the best understanding of the Health Insurance Portability and Accountability Act? a) "I am worried the family may be near, tell me when we're walking back to the unit" b) "You need to speak quieter so people can't over hear" c) "Be careful not to mention any name or room numbers" d) "It's not appropriate for us to discuss patients in the lunch room"

d) "It's not appropriate for us to discuss patients in the lunch room"

Protecting the public's health by preventing and controlling communicable disease & protecting the public against bioterrorism; promote quality of healthcare services; reduce health care costs & promote access sto care; protect consumers in the market for health insurance & other types of coverages are all examples of which type of law? a) Health care law b) Constitutional law c) Statutory law d) Administrative Law & Regulation

d) Administrative Law & Regulation * laws that protect a public interest and act as agents for the executive branches of the federal and state government

U.S. Dept of Health & Human Services and State licensing boards are examples of which type of law? a) Health care law b) Constitutional law c) Statutory law d) Administrative Law & Regulation

d) Administrative Law & Regulation * laws that protect a public interest and act as agents for the executive branches of the federal and state government

Violation of Nurse practice act results in suspension or loss of licensure is an example of what type of law? a) Health care law b) Constitutional law c) Statutory law d) Administrative Law & Regulation

d) Administrative Law & Regulation * laws that protect a public interest and act as agents for the executive branches of the federal and state government

What term describes laws that protect a public interest and act as agents for the executive branches of the federal and state government; many government agencies have the power to make laws in the form of rules and regulations to promote public health? a) Health care law b) Constitutional law c) Statutory law d) Administrative Law & Regulation

d) Administrative Law & Regulation *ex: U.S. Dept of Health & Human Services and State licensing boards; Violation of Nurse practice act results in suspension or loss of licensure

What law empowers patient decision making & is defined as identifying how a pt wishes to be treated in the event of certain medical conditions & also identifies who the pt wants to make decisions on their behalf in the event that the pt is unable to do so? a) Tort law b) Death with dignity laws c) Good Samaritan laws d) Advance directive e) Consent for treatment

d) Advance directive *Ex: Living wills, medical power of attorney for health care decisions, & pre-hospital DNR orders

Living wills, medical power of attorney for health care decisions, & pre-hospital DNR orders are all examples of which law that empowers patient decision making? a) Tort law b) Death with dignity laws c) Good Samaritan laws d) Advance directive e) Consent for treatment

d) Advance directive *identifies how a pt wishes to be treated in the event of certain medical conditions & also identifies who the pt wants to make decisions on their behalf in the event that the pt is unable to do so

Typically, the powers & duties of Boards of Nursing include, but are not limited to: a) Hiring Board of Nursing employees b) Setting fees for licensure c) Ensuring continuing competence d) All of the above

d) All of the above

For what purpose did state governemtns establish Boards of Nursing? a) To protect the public's health & welfare b) To oversee & ensure the safe practice of nursing c) To avoid public notoriety of discipline d) Both a & b

d) Both a & b

Where can the state's Nurse Practice Act and regulations be found? a) They are not publicly available b) Most state Boards of Nursing websites c) NCSBN Find Your Nurse Practice Act tool d) Both b & c

d) Both b & c

Which item is NOT a component of all Nurse Practice Acts? a) Definitions b) Educational program standards c) Types of titles & licences d) Complete guidance for the nursing profession

d) Complete guidance for the nursing profession

HC providers found guilty of neglect or abuse when they have shown extreme indifference to the needs of their patients, like restraining pts then ignoring their cries for help, need for repositioning, or toileting. These are examples of which law? a) Tort law b) Common law c) Constitutional law d) Criminal law e) Contract law

d) Criminal law *considers the nature of the action, not the resultant harm; penalties with felonies

Medicare or insurance reimbursement fraud, misrepresentation of qualifications, or purposeful breaches of protected health information are examples of which law? a) Tort law b) Common law c) Constitutional law d) Criminal law e) Contract law

d) Criminal law *considers the nature of the action, not the resultant harm; penalties with felonies

Physician found guilty of manslaughter for refusing to return to attend to a pt after she developed complications from elective procedure is an example of which law? a) Tort law b) Common law c) Constitutional law d) Criminal law e) Contract law

d) Criminal law *considers the nature of the action, not the resultant harm; penalties with felonies

Intentional administrating of life ending medication is an example of which law? a) Tort law b) Common law c) Constitutional law d) Criminal law e) Contract law

d) Criminal law *considers the nature of the action, not the resultant harm; penalties with felonies; if found guilty in criminal court then you lose your license

Which of the following addresses privacy & security concerns associated with the electronic transmission of health information? a) Patient Self-Determination Act b) Emergency Medical Treatment & Labor Act c) Nurse Practice Act d) Health Information Technology for Economic & Clinical Health Act

d) Health Information Technology for Economic & Clinical Health Act

Privacy and security concerns associated with electronic transmission of health information through several provisions that strengthen the civil and criminal enforcement of the HIPPA rules is an example of which federal law? a) Patient Self-Determination Act (PSDA) b) Emergency Medical Treatment and Labor Act of 1986 (EMTLA) c) Patient Protection & Affordable Care Act d) Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH)

d) Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH) *established a nationwide health information technology (EHR) & reinforce HIPPA

Which federal law established a nationwide health information technology infrastructure (EHR), including the development of health IT standards, interoperability and certification, reports on quality, & reimbursement incentives to improve healthcare quality. a) Patient Self-Determination Act (PSDA) b) Emergency Medical Treatment and Labor Act of 1986 (EMTLA) c) Patient Protection & Affordable Care Act d) Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH)

d) Health Information Technology for Economic and Clinical Health Act of 2009 (HITECH) *ex: addresses privacy and security concerns associated with electronic transmission of health information through several provisions that strengthen the civil and criminal enforcement of the HIPPA rules.

What are laws and regulations designed to protect the public & provide guidance in nursing practice a) Patient Self-Determination Act b) Patient Protection and Affordable Care Act c) Objections for the Nation d) Nurse Practice Acts

d) Nurse Practice Acts *The state is required to protect its citizens from harm, that protection comes in form of reasonable laws to regulate nursing. These laws include standards for education, scope of practice, and discipline of professionals

State legislature enacts this to regulate nursing and delegates authority to state boards of nursing, which its mission/purpose is to protect the public a) Patient Self-Determination Act b) Patient Protection and Affordable Care Act c) Objections for the Nation d) Nurse Practice Acts

d) Nurse Practice Acts *laws & regulations designed to protect the public & provide guidance in nursing practice

The state is required to protect its citizens from harm. That protection comes in form of reasonable laws to regulate nursing. These laws include standards for education, scope of practice, and discipline of professionals. This is described under which law: a) Patient Self-Determination Act b) Patient Protection and Affordable Care Act c) Objections for the Nation d) Nurse Practice Acts

d) Nurse Practice Acts *laws & regulations designed to protect the public & provide guidance in nursing practice

Which of the following statements is true regarding The Joint Commission's authority relating to health care organizations? a) The Joint Commission standards have the same effect as law, and organizations can be fined by The Joint Commission for noncompliance. b) The Joint Commission regulations have no effect on the legal process in health care. c) The Joint Commission serves as an advisor to the federal government in establishing fines related to noncompliance. d) The Joint Commission regulations may be seen as having the effect of law because they accredit organizations to bill Medicare and the standards are frequently used in malpractice cases.

d) The Joint Commission regulations may be seen as having the effect of law because they accredit organizations to bill Medicare and the standards are frequently used in malpractice cases. *The Joint Commission standards do not have the same effect as law; however, they are often utilized as best practice standards in a malpractice case against which negligence is measured. The Joint Commission does not establish fines for noncompliance.

What part of the health policy process is a health related issue is identified, usually as a problem. Nurses are effective in this stage by helping to frame the issue, which means creating a particular perspective for the issue a) policy formulation b) policy evaluation c) policy adoption d) agenda setting

d) agenda setting *ex: assisted suicide is ethically justified bc pts have a right to make their own health care decisions

Which of the following are judicial or decisional laws made by the courts to interpret legal issues that are in dispute. Depending on the type of court involved, judicial or decisional law may be made by a single justice, with or without a jury, or by a panel of justices? a) constitution b) statutes c) administrative agencies d) court decisions

d) court decisions *also called tort law where courts interpret statutes (laws passed by state or federal legislators) & sets precedents

Which of the following are also called tort laws where courts interpret statutes & set precedents? a) constitution b) statutes c) administrative agencies d) court decisions

d) court decisions *in the US there are two levels of court: trail court & appellate court. Most malpractice laws are addressed by the courts.

Which of the four elements to establish liability is defined as resultant of physical or a combination of physical, mental, emotional, or financial harm?The plantiff must show that the action of the defendant directly caused injury & that the injury would not have occurred without the defendant's actions. a) duty b) breach of duty c) causation d) injury or harm

d) injury or harm *not taking an action is an action. Ex: Convulsion or other serious complication occurs due to med dosage error

Convulsion or other serious complication occurs due to med dosage error is an example of which element of liability? a) duty b) breach of duty c) causation d) injury or harm

d) injury or harm *resultant of physical or a combination of physical, mental, emotional, or financial harm.The plantiff must show that the action of the defendant directly caused injury & that the injury would not have occurred without the defendant's actions.

What complaint category for disciplinary process by BON in nursing is detection of reportable criminal conduct as defined by statute? a) practice related b) boundary violations c) fraud d) positive criminal background checks

d) positive criminal background checks

The provider provides pt with description of the procedure, an explanation of the risks & benefits, & discussion of alternative to treatment. From there the pt will either agree to the procedure, which involves them in the decision of their care. This is an example of which law that empowers pt decision making? a) Tort law b) Death with dignity laws c) Good Samaritan laws d) Advance directive e) Consent for treatment

e) Consent for treatment *It arises from the ethical principle of autonomy & fundamentally accepted tent that pts have a right to be involved in decisions about their care.

What law empowers patient decision making & is defined as laws that designate who can agree or make decisions for an incapacitated patient if the pt has not already designated someone? It arises from the ethical principle of autonomy & fundamentally accepted tent that pts have a right to be involved in decisions about their care. a) Tort law b) Death with dignity laws c) Good Samaritan laws d) Advance directive e) Consent for treatment

e) Consent for treatment *The provider must provide pt with description of the procedure, an explanation of the risks & benefits, & discussion of alternative to obtain valid consent

An employment contract between a nurse and a healthcare organization is an example of which law? a) Tort law b) Common law c) Constitutional law d) Criminal law e) Contract law

e) Contract law

What term describes a legally binding agreement that recognizes and governs the rights and duties of the parties to the agreement? It's used to define the work agreements of those who provide services of health care. a) Tort law b) Common law c) Constitutional law d) Criminal law e) Contract law

e) Contract law *Ex: Routine conditions of admission and consent forms represent a contract between the patient and the health care facility or the health care provider. Also an employment contract between a nurse and a healthcare organization

Routine conditions of admission and consent forms between the patient and the health care facility or the health care provider is an example of which law? a) Tort law b) Common law c) Constitutional law d) Criminal law e) Contract law

e) Contract law *legally binding agreement that recognizes and governs the rights and duties of the parties to the agreement

Which federal act broadens the scope of HIPAA's privacy rule and provided for more enforcement of noncompliance by establishing increased levels of culpability and raising penalty amounts for compliance violations? a) Social Security Act b) EMTALA c) Patient Self-Determination Act d) HIPPA e) HITECH f) Patient Protection & Affordable Care Act

e) HITECH *Include specific requirements for notifying individuals when they're protected health information has been breached or improperly used or disclosed without authorization

Which federal act includes specific requirements for notifying individuals when they're protected health information has been breached or improperly used or disclosed without authorization? a) Social Security Act b) EMTALA c) Patient Self-Determination Act d) HIPPA e) HITECH f) Patient Protection & Affordable Care Act

e) HITECH *broadens the scope of HIPAA's privacy rule and provided for more enforcement of noncompliance by establishing increased levels of culpability and raising penalty amounts for compliance violations

Which federal act enables Americans with pre-existing conditions to more easily afford insurance, the creation of health insurance exchanges to make insurance coverage more accessible and affordable for some individuals and small businesses, and the elimination of insurance co-pays for preventive care? a) Social Security Act b) EMTALA c) Patient Self-Determination Act d) HIPPA e) HITECH f) Patient Protection & Affordable Care Act

f) Patient Protection & Affordable Care Act *sometimes known as "PPACA," "ACA," or "Obamacare." Created to (1) decrease the number of uninsured Americans, (2) make health insurance and health care affordable, and (3) improve health outcomes and performance of the health care system.

Which federal act law also requires that every American have a minimum essential health insurance? a) Social Security Act b) EMTALA c) Patient Self-Determination Act d) HIPPA e) HITECH f) Patient Protection & Affordable Care Act

f) Patient Protection & Affordable Care Act *sometimes known as "PPACA," "ACA," or "Obamacare." Created to (1) decrease the number of uninsured Americans, (2) make health insurance and health care affordable, and (3) improve health outcomes and performance of the health care system.