PREPU CHAPTER 7 Legal Dimensions of Nursing Practice

Which are areas of potential liability for the nurse? Select all that apply. The nurse administers the client's preoperative medication after the informed consent is signed. The nurse documents that the client's blood pressure has increased from 118/72 to 188/98 mm Hg and decides to retake the blood pressure in an hour. The nurse notifies the physician of the client's adverse reaction to a medication. The nurse documents that the client accurately prepared the correct amount of insulin after instruction was given. The nurse fails to document refusal by the client to ambulate following surgery.

- The nurse fails to document refusal by the client to ambulate following surgery. - The nurse documents that the client's blood pressure has increased from 118/72 to 188/98 and decides to retake the blood pressure in an hour. Areas of potential liability would include failure to document refusal by the client to participate in the treatment regimen (such as ambulation after surgery) and failure to assess the client in a timely manner. Waiting an hour to reassess a significant elevation in blood pressure does not meet the standard of care. Reporting a client's adverse reaction to a medication, administering preoperative medication after the informed consent is signed, and documenting the client's response to education are nursing behaviors that meet the standard of care.

Which is an example of an unintentional tort? Nurses discuss a client's laboratory values in the elevator. A nurse tells a client that the client cannot leave the hospital until the client pays the bill. A nurse gives the client a medication, and the client has an adverse reaction to it. A nurse threatens to restrain a client if the client does not stop talking.

A nurse gives the client a medication, and the client has an adverse reaction to it. An unintentional tort occurs when the nurse does not intend harm, but harm occurs (e.g., the nurse administers a medication and the client has an adverse reaction to it). The other three responses are intentional torts.

Nurses practicing in a critical care unit must acquire specialized skills and knowledge to provide care to the critically ill client. These nurses can validate this specialty competence through what process? Certification Litigation Accreditation Licensure

Certification Explanation: Certification validates specialty knowledge, experience, and clinical judgment. A nurse in a critical care unit having specialized skills and knowledge to provide care would be an example of certification. Licensure is a specialized form of credentialing based on laws passed by a state legislature. Licensure endorses entry-level competence. Legal accreditation is granted to educational programs by state agencies endorsing the approval of the program's design and mission to meet the needs of state requirements. Litigation is not a method for validation. Reference:

Defamation of character and invasion of privacy are two examples of unintentional torts that occur in nursing practice. Phi bang va xam pham

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Failure by a registered nurse to follow a standard of care is an example of_____ , negligence by a professional.

MALPRACTICE

______Nurse Practice Acts are an example of laws.

STATUTORY

Good Samaritan laws are designed to protect health practitioners when they give aid to people in emergency situations regardless of the outcome of care

T

Law involving medical or nursing malpractice is common law that has evolved from accumulated judiciary decisions.

t

Licensure is a form of credentialing that permits a person to practice specific skills under legal guidelines.

t

A registered nurse who has an associate degree would like to obtain a baccalaureate degree in nursing. The nurse works full time and has several family obligations and would like to find a program that fits into that lifestyle. What is the nurse's priority question about an educational program? Is the program accredited? What is the NCLEX pass rate? How much does it cost? Is it online?

Is the program accredited? Explanation: The most important consideration is whether the program is accredited. Unaccredited programs should be avoided. Cost is important and method of delivery may be very important to this student. They are not as important as whether the program is accredited. NCLEX pass rate is not important in this case as the nurse is already registered. Reference:

A client has a prescription for amoxicillin 500 mg P.O. every 8 hours. The nurse administers the medication via the intravenous route. Based on the nurse's action, the client develops complications and has an increased length of stay. The client files a lawsuit against the facility and the nurse. Which legal action has the nurse's attorney identified that meets the criteria for the client's lawsuit? Battery Assault Negligence Malpractice

Malpractice Explanation: The facility and nurse could be charged with malpractice, which is failing to perform (or performing) an act that causes harm to a client. Administering the medication intravenously instead of orally as prescribed has caused harm to a client. Negligence is failing to perform care for a client. When a person threatens to touch a client without consent, it is assault, whereas battery is carrying out the implied threat (assault).

A nurse is caring for a client following endotracheal intubation. Before applying soft wrist restraints to prevent the client from pulling out the endotracheal tube, what is the most appropriate action of the nurse? Obtain a medical order. Sedate the client. Get written consent. Notify the family.

Obtain a medical order. Nurses must obtain a medical order before each and every instance in which they use restraints. Due to the severity of the client illness requiring endotracheal intubation, the client may not be able to provide a written consent. The client does not need to be sedated unless medically necessary, and although it is appropriate to notify the family, this is not the priority.

Which are examples of a nurse appropriately protecting a client's privacy? Select all that apply. During a bed bath, the nurse exposes the client's upper torso while washing the client's face. With the client's permission, the nurse explains the client's diagnosis to the client's spouse. The nurse questions the client about the client's social life even though it does not affect care planning. The nurse moves the client from the emergency department waiting room to a private area to collect assessment data. Because the facility is a teaching facility, the nurse allows a nursing student to photograph a client for a care plan.

With the client's permission, the nurse explains the client's diagnosis to the client's spouse. The nurse moves the client from the emergency department waiting room to a private area to collect assessment data. To prevent invasion of privacy, all client information is considered confidential and private; this includes name and all identifiers (e.g., social security number, address, date of birth). With the client's permission, the nurse may share information with the client's spouse. A client should be taken to a private, soundproof area to collect data. Unnecessary exposure of a client's body, taking photos of a client, and questioning a client's social life when it does not affect care planning are examples of invasion of privacy.

Which are examples of a nurse appropriately protecting a client's privacy? Select all that apply. With the client's permission, the nurse explains the client's diagnosis to the client's spouse. During a bed bath, the nurse exposes the client's upper torso while washing the client's face. Because the facility is a teaching facility, the nurse allows a nursing student to photograph a client for a care plan. The nurse moves the client from the emergency department waiting room to a private area to collect assessment data. The nurse questions the client about the client's social life even though it does not affect care planning.

With the client's permission, the nurse explains the client's diagnosis to the client's spouse. The nurse moves the client from the emergency department waiting room to a private area to collect assessment data. To prevent invasion of privacy, all client information is considered confidential and private; this includes name and all identifiers (e.g., social security number, address, date of birth). With the client's permission, the nurse may share information with the client's spouse. A client should be taken to a private, soundproof area to collect data. Unnecessary exposure of a client's body, taking photos of a client, and questioning a client's social life when it does not affect care planning are examples of invasion of privacy.

A legal document that states a client's health-related wishes — such as a preference for pain management if the client becomes terminally ill — and also allows the client's adult child to direct the client's care, is: a standard of care. an advance directive. a license. a will.

an advance directive. Explanation: Clients communicate their wishes to health care providers by verbally participating in health care decision making and by employing written documents called advance directives. A will is a legal document where one communicates wishes of how to dispose of personal effects and belongings upon one's death. The terms license and standard of care have no application in this scenario.

A nurse threatens to restrain a verbally abusive client if the abuse continues. Which legal tort has the nurse committed? Assault Negligence Defamation of character Invasion of privacy

Assault Assault is threatening to touch a person, such as by applying restraints, without consent. Sharing a client's confidential information without consent is an invasion of privacy. When a person performs an act that a reasonable person would not do under the same circumstance, it is negligence. Defamation of character occurs when one makes statements that damage another person's reputation.

A nurse is named as a defendant in a malpractice lawsuit. Which action would be recommended for this nurse? Discuss the case with the plaintiff to ensure understanding of each other's positions. Be prepared to tell your side to the press, if necessary. If a mistake was made on a chart, change it to read appropriately. Do not volunteer any information on the witness stand.

Do not volunteer any information on the witness stand. Explanation: The nurse on the witness stand should be polite, but not volunteer any information. The nurse should only answer the questions asked. The other answers are not examples of what a nurse should do in a malpractice lawsuit.

A client states that the client's recent fall was caused by his scheduled antihypertensive medications being mistakenly administered by two different nurses, an event that is disputed by both of the nurses identified by the client. Which measure should the nurses prioritizewhen anticipating that legal action may follow? Consult with practice advisors from the state board of nursing. Document the client's claims and the events surrounding the alleged incident. Consult with the hospital's legal department as soon as possible. Enlist support from nursing and non-nursing colleagues from the unit.

Document the client's claims and the events surrounding the alleged incident. It is imperative for nurses to carefully and accurately document assessment findings and the nursing care that they provide, especially when legal action is anticipated. This thorough and accurate assessment should precede consultation with the legal department, the state board of nursing, and colleagues.

A nurse is providing care to two clients who are sharing the same room. The nurse is preparing to give one of the clients a complete bed bath. Which action by the nurse would suggest liability related to invasion of the client's privacy? Removing the client's clothing with some force Documenting a belief that the client was arrested Keeping the curtain between the two clients in the room open Applying restraints to the client's arms to keep the client in bed

Keeping the curtain between the two clients in the room open Explanation: Invasion of privacy may occur with unnecessary exposure of clients while moving them through a corridor or while caring for them in rooms they share with others. Documenting a belief that the client was arrested would reflect libel. Removing a client's clothing forcibly is an example of battery. Applying restraints to contain the person in bed is an example of false imprisonment.

A nurse is called to a deposition for a malpractice charge that has resulted in the death of a client. As the chart is reviewed, the prosecuting attorney questions the nurse about several defaming comments written in the medical record about the client. What charges can be filed against the nurse due to these comments? Negligence Slander Malpractice Libel

Libel Libel is damaging statements written and read by others. Since there were defaming comments written in the chart, libel charges could be appropriate. Malpractice, slander, and negligence are not charges in this scenario

Every nurse is expected to provide patient care within defined practice limits as mandated by state Nurse _____Acts.

PRACTICE

A client newly diagnosed with congestive heart failure has a prescription for digoxin. The nurse counts the heart rate before administration of the medication and obtains a heart rate of 51 beats per minute. Which action by the nurse demonstrates adherence to the standards of nursing care? The nurse administers the medication after reviewing the client's serum potassium level. The nurse administers the medication and reassesses the client after 30 minutes. The nurse withholds the medication and notifies the health care practitioner. The nurse withholds the medication, retakes the heart rate, and gives the medication at a later time.

The nurse withholds the medication and notifies the health care practitioner. Nurses are responsible for following the standards of care for their particular work area. A reasonably prudent nurse would withhold the medication and notify the health care practitioner. All other options put the client's safety at risk and would not be done by a reasonably prudent nurse.

Professional regulations and laws that govern nursing practice are in place for which reason? To ensure that enough new nurses are always available To ensure that practicing nurses are of good moral standing To limit the number of nurses in practice To protect the safety of the public

To protect the safety of the public Governing bodies, professional regulations, and laws are in place to protect the public by ensuring that nurses are accountable for safe, competent, and ethical nursing practice. The other options do not describe accurately the role and responsibility of the governing bodies and the regulations and laws of nursing.

The nurse is assigned to various clients on a medical unit. Which statement(s) made to a client by the nurse constitutes assault? Select all that apply. "Let me help you get your shirt off, so I can listen to your lungs." "Hold still for these stitches; otherwise, I am going to have to hold you down." "I will withhold your cell phone until you pay full attention to these discharge instructions." "Give me your hand to hold, I can see you are upset by the bad news." "I am going to insert a catheter in you if you do not get up to go to the bathroom."

"I am going to insert a catheter in you, if you do not get up to go to the bathroom.""Hold still for these stitches; otherwise, I am going to have to hold you down."

The nurse attorney provides an educational session to the nursing staff on acts of negligence. Which responses by the staff would indicate to the attorney that the staff can accurately identify acts of negligence? Select all that apply. "I can be charged with negligence if I apply a heating pad to the client's skin and the client suffers a superficial or first-degree burn." "I can be charged with negligence if I follow the policy for administering insulin and the client has a reaction to it." "I can be charged with negligence if I am following the standards of care for my specialty, which is ambulatory nursing." "When I am using a new piece of equipment for the first time, I must make sure I know how to properly operate it." "I can be charged with negligence if I notify the health care practitioner about a change in a client's status but do not follow up or document.

"I can be charged with negligence if I notify the health care practitioner about a change in a client's status but do not follow up or document. "I can be charged with negligence if I apply a heating pad to the client's skin and the client suffers a superficial or first-degree burn." Negligence occurs when a nurse fails to provide care that another nurse with the same educational background would perform. Applying heat and burning the client's skin is not an act another prudent nurse would do. The nurse must act as the client's advocate by following up and documenting when a health care provider does not respond to a change in the client's condition. When a nurse follows correct policies for administering medications, follows the standards of care, and uses equipment in the correct manner, this eliminates the risk of practicing in a negligent manner.

While a client admitted to the medical-surgical unit is in the radiology department, a visitor claiming to be the client's cousin arrives on the medical-surgical unit and asks the nurse to provide a brief outline of the client's illness. Which response by the nurse would be most appropriate, both legally and professionally? "I cannot give you that information due to client confidentiality." "I will call the client and ask for permission to share this information with you." "Do you have any identification proving that you are related to the client?" "I'm busy right now but can talk later."

"I cannot give you that information due to client confidentiality." Sharing a client's information without the client's consent is an invasion of privacy. The nurse should not give out the information even if the visitor provides proof of a relationship without the client's consent. It is inappropriate to call the client to ask for permission. The nurse claiming to be busy and offering to talk later does not address the issue but only delays it, perhaps leading the visitor to assume that the nurse will disclose information then.

While a client admitted to the medical-surgical unit is in the radiology department, a visitor claiming to be the client's cousin arrives on the medical-surgical unit and asks the nurse to provide a brief outline of the client's illness. Which response by the nurse would be mostappropriate, both legally and professionally? "I will call the client and ask for permission to share this information with you." "Do you have any identification proving that you are related to the client?" "I'm busy right now but can talk later." "I cannot give you that information due to client confidentiality."

"I cannot give you that information due to client confidentiality." Explanation: Sharing a client's information without the client's consent is an invasion of privacy. The nurse should not give out the information even if the visitor provides proof of a relationship without the client's consent. It is inappropriate to call the client to ask for permission. The nurse claiming to be busy and offering to talk later does not address the issue but only delays it, perhaps leading the visitor to assume that the nurse will disclose information then. Reference:

Which statement made by the nurse providing care to a group of clients indicates that the nurse requires further education regarding negligence? "I am going to assess for collateral circulation before preforming an arterial blood gas (ABG)." "I don't need to assess distal pulses on a client after a femoral arteriography." "I am going to auscultate breath sounds every 8 hours on a client receiving enteral feedings." "Please avoid bringing fresh fruit to a client with neutropenia."

"I don't need to assess distal pulses on a client after a femoral arteriography." Distal pulses should be checked immediately after a femoral arteriography; therefore, the nurse is negligent for checking three hours after the procedure. Fresh fruit may contain bacteria and further compromise a client with neutropenia. The Allen test confirms that there is proper circulation to the hand before drawing an ABG. The nurse checks breath sounds at least every 8 hours for adventitious sounds that may indicate aspiration.

Which statements made by a nurse would indicate to a nurse manager that the nurse requires further training? Select all that apply. "If I make a mistake, I will not tell anyone." "I am accountable for any task that I delegate." "The nursing plan of care must be accurate and must be followed. It is part of the client's permanent record." "I will have the supervisor fill out the incident report when I make an error." "When I document, I make sure it is factual, accurate, complete, and timely."

"If I make a mistake, I will not tell anyone." "I will have the supervisor fill out the incident report when I make an error." Nurses should report errors and mistakes and complete incident reports themselves, not have supervisors do it. Documentation should be accurate, factual, complete, and timely. Nurses are accountable for any designated task. The nursing plan is part of the client's permanent record.

A client being discharged from the hospital asks the nurse, "When I go visit my family out of state, should I take my living will with me, or do I need a new one for that state?" Which is the most appropriate response by the nurse? "Take it with you. It is recognized universally in the United States." "We have it on file here, so any hospital can call and get a copy." "As long as your family knows your medical wishes, you will not need it." "A living will can only be used in the state in which it was created."

"Take it with you. It is recognized universally in the United States." A separate or different advance directive is not needed for each state, so it can be used in any state and does not matter where it was created. A living will is recognized in each state as valid so a client should be advised to take it with them as they travel out of state. The other responses are incorrect or inappropriate given this scenario

Which nursing student would most likely be held liable for negligence? A nursing student reports that insulin was not administered to the client by the nurse on the previous shift. A nursing student administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home. A nursing student performs a dressing change using sterile technique and documents the presence of necrotic tissue in the wound. A nursing student completes an incident report after administering a medication to a client who then experienced an adverse reaction to the medication.

A nursing student administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home. The nursing student who administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home is performing a task outside the scope of the job responsibilities of a UAP. The other options demonstrate legally defensible actions by the nursing student.

The nurse attempts to notify a health care provider about a client's elevated temperature but does not get a response. Which statement, if documented by the nurse, would indicate that the nurse is following proper protocol for nursing documentation? 1300: Client temperature elevated. Telephoned health care provider's service several times with no response. Will notify nursing supervisor during rounds. 1300: Client temperature elevated. Health care provider paged, but did not respond. Administered acetaminophen without an order because I knew this health care provider does not return calls. 1300: Client temperature elevated. Telephoned health care provider 3 times. As usual, health care provider did not respond. 1300: Client temperature elevated. Telephoned health care provider's service 3 times without a response. Tepid sponge bath given and nursing supervisor notified.

1300: Client temperature elevated. Telephoned health care provider's service 3 times without a response. Tepid sponge bath given and nursing supervisor notified. Explanation: Documentation must have the correct, factual, and timely information. The nurse must document when the health care provider was called and response or lack of response; what nursing action was done, if any, and notification of appropriate personnel. The nurse cannot administer medication without an order. The nurse should be careful to not make incriminating statements, such as, "as usual, health care provider did not respond." The nurse should not wait until rounds are made to inform the supervisor.

While teaching about advance care planning, which fact is important for the nurse to share with a client who has been diagnosed with a terminal illness? Living wills provide specific instructions related to the client's personal property upon death. A durable power of attorney for health care appoints an agent the person trusts to make decisions. Advance directives must be completed 30 days prior to hospitalization in order to be valid. The Patient Self-Determination Act of 1990 requires hospital clients to have an advance directive.

A durable power of attorney for health care appoints an agent the person trusts to make decisions. Advance directives can minimize difficulties by allowing people to state in advance what their choices would be for health care if certain circumstances arise. A durable power of attorney for health care appoints an agent the person trusts to make decisions in the event of subsequent incapacity. Living wills provide specific instructions about the kinds of health care that should be provided or foregone in particular situations. In the United States, the Patient Self-Determination Act of 1990 requires all hospitals to inform clients about advance directives. Advance directives do not have to be completed prior to hospitalization in order to be valid. Reference:

The client being admitted to the oncology unit conveys wishes regarding resuscitation in the event of cardiopulmonary arrest. The nurse advises the client that it would be in the client's best interest to obtain which document? A proxy directive Proof of health care power of attorney A living will A will

A living will Explanation: A living will is an advance directive that specifies the type of medical treatment clients do or do not want to receive should they be unable to speak for themselves in a terminal or otherwise unconscious condition. A will is a legal document detailing how to dispose of one's assets and belongings upon death. Proof of health care power of attorney and a proxy directive are documents identifying another person to legally make health care decisions for the client. In this case the client is stating the client's own decisions in advance of potential incapacitation. Refe

Which scenario is an example of certification? A nurse who demonstrates advanced expertise in a content area of nursing through special testing A hospital that meets the standards of the Joint Commission An education program that meets standards of the National League for Nursing A graduate of a nursing education program who passes NCLEX-RN

A nurse who demonstrates advanced expertise in a content area of nursing through special testing Explanation: Certification is a voluntary process whereby a person who has met criteria established by a nongovernmental association is granted special recognition in a specified practice area. Licensure is granted by the state to a graduate of a nursing education program who passes NCLEX-RN. Accreditation is a voluntary process by which a nursing education program is recognized as having met certain standards by the NLN Commission for Nursing Education Accreditation and/or the American Association of Colleges of Nursing. The Joint Commission can also accredit health care agencies.

Which scenario is an example of certification? An education program that meets standards of the National League for Nursing A hospital that meets the standards of the Joint Commission A graduate of a nursing education program who passes NCLEX-RN A nurse who demonstrates advanced expertise in a content area of nursing through special testing

A nurse who demonstrates advanced expertise in a content area of nursing through special testing Explanation: Certification is a voluntary process whereby a person who has met criteria established by a nongovernmental association is granted special recognition in a specified practice area. Licensure is granted by the state to a graduate of a nursing education program who passes NCLEX-RN. Accreditation is a voluntary process by which a nursing education program is recognized as having met certain standards by the NLN Commission for Nursing Education Accreditation and/or the American Association of Colleges of Nursing. The Joint Commission can also accredit health care agencies.

Which nursing student would most likely be held liable for negligence? A nursing student administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home. A nursing student performs a dressing change using sterile technique and documents the presence of necrotic tissue in the wound. A nursing student completes an incident report after administering a medication to a client who then experienced an adverse reaction to the medication. A nursing student reports that insulin was not administered to the client by the nurse on the previous shift.

A nursing student administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home. Explanation: The nursing student who administers medication to a resident while working as an unlicensed assistive personnel (UAP) at a local nursing home is performing a task outside the scope of the job responsibilities of a UAP. The other options demonstrate legally defensible actions by the nursing student.

Which process evaluates and recognizes educational programs as having met certain standards? Licensure Credentialing Accreditation Certification

Accreditation Accreditation is the process by which an educational program is evaluated and recognized as having met certain standards. Credentialing refers to ways in which professional competence is ensured and maintained. Licensure is the process by which a state determines that a candidate meets certain minimum requirements to practice in the profession—and grants that person the license to do so. Certification is the process by which a person who has met certain criteria established by a nongovernmental association is granted recognition in a specified practice area. Reference:

During a nursing shift, which events warrant completion of an incident report? Select all that apply. A client falls while being transferred from the bed to the chair. A visitor slipped and fell in the hallway, but was not injured. A nurse asks an unlicensed assistive personnel (UAP) to feed a client. An intravenous antibiotic was administered 2 hours late because the IV site infiltrated. A nurse reports that a client is crying and distraught over a diagnosis of metastatic cancer.

An intravenous antibiotic was administered 2 hours late because the IV site infiltrated. A visitor slipped and fell in the hallway, but was not injured. A client falls while being transferred from the bed to the chair. n incident report is a written account of an unusual, potentially injurious event involving a client, employee, or visitor. Late administration of medication is considered a medication error and is potentially injurious to the client. A visitor fall and a client fall are both reportable situations. A client crying following a diagnosis of cancer could be expected, and a nurse delegating appropriate care to a UAP is not reportable. Therefore, these actions do not require an incident report to be filed.

A client informs the nurse about leaving the health care facility because the client is not satisfied with the treatment. The nurse knows that the client's treatment is incomplete and further testing and evaluations are scheduled. Which action by the nurse would be most appropriate to prevent false imprisonment? Tell the client that the client will not be able to get access again. Call the health care provider to speed up the discharge process. Ask the client to sign a release without medical approval. Restrain the client to prevent from leaving.

Ask the client to sign a release without medical approval. If a client wants to leave the health care facility, the nurse should ask the client to sign a release stating that the client left without medical approval. The nurse cannot restrain the client because it amounts to false imprisonment. Calling the health care provider may be seen by the client as a delay tactic, although the nurse should follow facility protocol. Additional options would include having the client meet with the health care provider or client advocate if the client was willing to remain for care while those actions were initiated. Telling the client that the client may not be able to access the health care facility again is an inappropriate response because health care is a right and the client can access it whenever necessary.

An RN is working on a medical-surgical unit with a licensed practical/vocational nurse (LPN/LVN). Which action by the RN is considered negligent if injury results from this action? Delegating oral medication administration to the LPN/LVN Asking the LPN/LVN to teach a new diabetic client how to administer insulin Calling the health care provider about abnormal lab results Obtaining vital signs on a newly admitted client

Asking the LPN/LVN to teach a new diabetic client how to administer insulin Negligence is harm that results because a person did not act reasonably. As nurses perform the role of delegators, they must know which tasks are legal and appropriate for particular health care providers to perform (scope of practice), as well as the policy for the facility at which they are employed. Teaching is not in the current scope of practice for a LPN/LVN, and thus the RN's delegation of this task to the LPN/LVN could be considered negligence. The other actions are within the scope of practice for a LPN/LVN.

While walking down the hall, a nurse manager overhears a staff member telling a client, "If you don't stay in this chair and stop wandering, I'm going to tie you to it." The nurse manager pulls the staff member aside and discusses what was said. The nurse manager intervenes because the staff member's statement is which type of tort? Battery False imprisonment Assault Invasion of privacy

Assault Explanation: The staff member's statement reflects a threat of contact with another person without the person's consent. This is considered assault. Battery is an assault that is carried out and includes willful, angry, and violent or negligent touching of another's body or clothes (or anything attached to or held by that person). False imprisonment is the unjustified retention or prevention of the movement of another person without proper consent. This would apply if the staff member did in fact tie the client to the chair. Invasion of privacy involves the disclosure of information without the person's consent.

Which are torts rather than crimes? Select all that apply. Assault Defamation of character Manslaughter ke ngo sat Robbery Negligence

Assault Defamation of character Negligence orts are intentional or unintentional acts of wrongdoing. Some of the intentional torts for which nurses may be held liable include assault and battery, defamation of character, negligence, invasion of privacy, false imprisonment, and fraud. Manslaughter and robbery are crimes.

A nurse working in a coronary care unit resuscitates a client who had expressed wishes not to be resuscitated. Which tort has the nurse committed? Assault Libel Slander Battery

Battery The nurse has committed battery by unlawfully carrying out a procedure that the client had refused. Battery is an assault and includes negligent touching of another person's body or clothes or anything attached to or held by that other person. Assault is the threat of touching another person without the person's consent. Defamation of character in spoken words is called slander. Libel is defamation of character in written words.

An RN enters a client's room and observes the unlicensed assistive personnel (UAP) forcefully pushing a client down on the bed. The client starts crying and informs the UAP of the need to go to the bathroom. What action is the RN witnessing that should be immediately reported to the supervisor? Battery Defamation of character Fraud Assault

Battery Explanation: The UAP is engaging in battery, which is an assault that is carried out and includes willful, angry, and violent or negligent touching of another person's body or clothes or anything attached to (or held by) that other person. Assault is a threat or an attempt to make bodily contact with another person without that person's consent. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property. Defamation of character is an intentional tort in which one party makes derogatory remarks about another that harm the other party's reputation.

A client with end-stage renal disease decides against further treatment and requests a "Do Not Resuscitate" (DNR) order. The DNR status is part of the change-of-shift report. The client stops breathing and a nurse begins cardiopulmonary resuscitation. The family is upset and makes a complaint to the charge nurse. The charge nurse appropriately identifies that nurse has committed: assault. defamation. fraud. battery.

Battery. The nurse has committed battery by performing CPR against the client's wishes. Assault occurs when a person threatens to touch a client without consent. Fraud is a willful and purposeful misrepresentation, whereas defamation occurs when a derogatory remark is made about another person.

The nurse is providing care to a client who had orthopedic surgery. The nurse has medicated the client for pain. However, the client reports that the pain is unrelieved. The nurse takes no further action regarding assessment and intervention for the client's pain. The nurse does not notify the surgeon regarding the client's pain. The nurse's failure to take further action represents which element of liability in this case? Damages Duty Breach of duty Causation

Breach of duty Breach of duty is the failure to assess, intervene, or notify the health care provider regarding the client's condition. It does not meet the expected standard of care. Duty refers to an obligation to use due care and is defined by the standard of care appropriate for the nurse-client relationship. Causation is when the failure to meet the standard of care caused injury. Damages are the harm or injury to the client.

Having recently completed a specialty nursing program in neonatal care, a nurse is now preparing to leave the medical unit and begin providing care in the hospital's neonatal intensive care unit (NICU). The nurse has completed which process of credentialing? Certification Accreditation Licensure Validation

Certification The process of certification involves the attainment and validation of specialized nursing knowledge and skills. Certification is often necessary to ensure that the nursing care provided in specialized and high-acuity settings is safe and appropriate. Accreditation is the process by which an educational program, rather than an individual nurse, is identified as meeting standards. The process of licensure involves the determination that a nurse meets minimum requirements to practice but not necessarily that the nurse has the specialized knowledge that is necessary for some care settings. Validation is not a specific aspect of the process of credentialing.

A client states that the client's recent fall was caused by his scheduled antihypertensive medications being mistakenly administered by two different nurses, an event that is disputed by both of the nurses identified by the client. Which measure should the nurses prioritize when anticipating that legal action may follow? Document the client's claims and the events surrounding the alleged incident. Enlist support from nursing and non-nursing colleagues from the unit. Consult with the hospital's legal department as soon as possible. Consult with practice advisors from the state board of nursing.

Document the client's claims and the events surrounding the alleged incident. It is imperative for nurses to carefully and accurately document assessment findings and the nursing care that they provide, especially when legal action is anticipated. This thorough and accurate assessment should precede consultation with the legal department, the state board of nursing, and colleagues.

It is the responsibility of the registered nurse to obtain informed consent for a diagnostic or treatment procedure.

F

A nurse who obtains a license to practice nursing through self-misrepresentation is guilty of what tort? Slander Libel Assault Fraud

Fraud Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property. A nurse obtaining a license to practice through misrepresentation is committing fraud. Assault is a threat or an attempt to make bodily contact with another person without that person's consent. Slander is one form of defamation of character. Defamation of character is an intentional tort in which one party makes derogatory remarks about another, remarks that harm the other party's reputation. Slander is spoken defamation of character; libel is written defamation.

A nurse working on a busy medical-surgical unit does not take the vital signs of client who is preparing for discharge but instead documents the same vital signs obtained for this client earlier in the morning. For which tort would the nurse be potentially liable? False imprisonment Battery Assault Fraud

Fraud Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property. Nurses who report vital signs or other assessment data that were not obtained are acting fraudulently. Unjustified retention or prevention of the movement of another person without proper consent can constitute false imprisonment. Assault is a threat or an attempt to make bodily contact with another person without that person's consent. Battery is an assault that is carried out and includes willful, angry, and violent or negligent touching of another person's body or clothes (or anything attached to or held by that other person).

A nurse suspects that a client is a prostitute. The nurse documents this suspicion in the medical record and includes it in report to the oncoming shift. The nurse also mentions the suspicion to the nurse's sister saying, "I had a client named Susan in room 126 today who I think is a prostitute." Which violations has this nurse committed? Select all that apply. HIPAA Assault Battery Libel Slander

HIPAA Libel Slander Slander is the spoken defamation of character (e.g., including in the change-of-shift report); libel is written defamation (e.g., including in the client record). HIPAA rules are violated when a client's personal information is disclosed (e.g., informing one's sister). The use of the client's room number and name make the client's presence in the facility discoverable. The nurse did not threaten the client (assault) or physically touch the client (battery). Referenc

An HIV-positive client discovers that the client's name is published in a research report on HIV care prepared by the client's nurse. The client is hurt and files a lawsuit against the nurse. Which offense has the nurse committed? Defamation of character Unintentional tort Invasion of privacy Negligence of duty

Invasion of privacy The nurse has committed the tort of invasion of privacy. Personal names and identities should be concealed or obliterated in case studies or research work. Invasion of privacy is a type of intentional tort. Defamation is an act in which untrue information harms a person's reputation and is therefore not applicable here. Negligence is the harm that results because a person did not act reasonably.

When talking with family over dinner, the nurse shares about a client with infertility at the hospital, identifying the person by name. Which tort has the nurse committed? Slander Invasion of privacy Assault Fraud

Invasion of privacy Explanation: Invasion of privacy involves a breach in keeping client information confidential. Slander is oral defamation of character. Assault is a threat or attempt to make bodily contact with another person without that person's consent. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property. Reference:

A nurse talks with family members about an AIDS client from the clinic where the nurse works. Which tort has the nurse committed? Slander Assault Fraud Invasion of privacy

Invasion of privacy Explanation: Invasion of privacy involves a breach of keeping client information confidential. Fraud is willful and purposeful misrepresentation that could cause, or has caused, loss or harm to a person or property. Slander is oral defamation of character. Assault is a threat or attempt to make bodily contact with another person without that person's consent. Reference:

Which statement about laws governing the distribution of controlled substances is true? The nurse is only at risk if diverting medication from the client; a nurse using the nurse's own personal drugs is not at risk. When a nurse misuses controlled substances in the workplace and gets help, the nurse will not be charged with a criminal act. Substance use is not treatable. Nurses are responsible for adhering to specific documentation about controlled substances.

Nurses are responsible for adhering to specific documentation about controlled substances. Nurses have specific responsibilities regarding controlled substances, including specific documentation. Violation of controlled substances laws at the workplace is serious and a criminal act. Substance use is treatable, and the objective is to detect and treat the problem early. It does not matter where the nurse obtains the drugs; the nurse is still liable for personal actions. Reference:

A nurse, while off-duty, tells the physiotherapist that a client who was admitted to the nursing unit contracted AIDS due to exposure to sex workers at the age of 18. The client discovers that the nurse has revealed the information to the physiotherapist. With what legal action could the nurse be charged? Negligence Libel Slander Malpractice

Slander Explanation: The nurse can be charged with slander, which is a verbal attack on a person's character. Libel pertains to damaging written statements read by others. Both libel and slander are considered defamation of character-an intentional tort in which one party makes derogatory remarks about another that diminish the other party's reputation. To be found guilty of slander or libel, the statement must be proved false. Negligence and malpractice pertain to actions which are committed or omitted, thereby causing physical harm to a client.

Nurse practice acts are examples of which type of laws? Constitutional laws Common laws Administrative laws Statutory laws

Statutory laws Nurse practice acts are statutory laws. Statutory laws must be in keeping with both the federal constitution and the state constitution. Constitutional law refers to rights carved out in the federal and state constitutions. The majority of this body of law has developed from state and federal supreme court rulings, which interpret their respective constitutions and ensure that the laws passed by the legislature do not violate constitutional limits. Administrative law is the body of law that governs the activities of administrative agencies of government. Common law is the body of English law as adopted and modified separately by the different states of the U.S. and by the federal government and is in contrast with statutory law.

A nurse witnesses a traffic accident and dresses the open wounds sustained by a child. Later, in the hospital, the child develops complications from an infection in the wound. The family holds the nurse responsible for the complications and attempts to file a lawsuit. Which statement is true regarding how the Good Samaritan law applies to this case? The Good Samaritan law is not applicable to health care workers. The Good Samaritan law will provide legal immunity to the nurse. The Good Samaritan law will provide absolute exemption from prosecution. The Good Samaritan law will not protect the nurse because the nurse did not accept compensation.

The Good Samaritan law will provide legal immunity to the nurse. Explanation: The Good Samaritan laws provide legal immunity to passersby who provide emergency first aid to victims of accidents. Therefore, the law is applicable to the nurse in this scenario; moreover, Good Samaritan laws apply to those who do not accept any compensation for services provided. The law is equally applicable to everyone but does not provide absolute exemption from prosecution in cases of negligence. Paramedics, ambulance personnel, physicians, and nurses who stop to provide assistance are still held to a higher standard of care because they have training above and beyond that of average lay people. In cases of gross negligence, health care workers may be charged with a criminal offense.

A nurse and the facility have been named as defendants in a malpractice lawsuit. In addition to the nurse's attorney, whom else would be appropriate for the nurse to talk with about the case? The plaintiff's lawyer The local press A colleague The agency's risk manager

The agency's risk manager Explanation: A nurse who is named a defendant should work closely with an attorney while preparing the defense. With the exception of the nurse's attorney and the agency's risk manager, the nurse should not discuss the case with anyone, including anyone at the agency, the plaintiff, the plaintiff's lawyer, anyone testifying for the plaintiff, or reporters. Reference:

Which statements made by a nurse would indicate to a nurse manager that the nurse requires further training? Select all that apply. "If I make a mistake, I will not tell anyone." "I will have the supervisor fill out the incident report when I make an error." "I am accountable for any task that I delegate." "When I document, I make sure it is factual, accurate, complete, and timely." "The nursing plan of care must be accurate and must be followed. It is part of the client's permanent record."

The first nurse could be charged with slander. Slander is a character attack uttered orally in the presence of others. Injury is considered to occur because the derogatory remarks attack a person's character and good name. In this case, the first nurse (and possibly the second, depending on context) could be charged with slander. If the defamation had been written, it would be libel. Even though the discussion took place offsite and during off-duty hours and both nurses are involved in the client's care, the defamatory remarks could constitute slander.

A client is unhappy with the health care provided and informs the nurse that the client is leaving the facility. The client has not been discharged by the physician. The nurse finds that the client has dressed and is ready to go. What should the nurse's action be in this situation? The nurse should call and inform the nursing supervisor of the situation. The nurse should let the client go because the nurse cannot do anything. The nurse should have the client restrained and call the physician. The nurse should warn the client that the client cannot come to the hospital again.

The nurse administers amoxicillin to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest. Explanation: All elements of liability are in place for the scenario involving a nurse administering amoxicillin to a client with documented allergies to penicillin: the nurse had a duty and breached it by giving the medication (amoxicillin), which caused the client harm (seizures and respiratory arrest). The nurse is negligent when applying an ice pack without an order. The nurse assisting the client into bed used proper body mechanics, so the client fall is an accident even though harm occurred. Giving the wrong medication could be cause for malpractice, but in this case, the client was not harmed.

Which best exemplifies malpractice? The nurse, using proper body mechanics, assists a client into a locked bed. The client slips and breaks a femur. The nurse applies an ice pack to a client's lower back without an order and the client feels better. The nurse administers the wrong medication to a client, who then has one episode of vomiting 5 minutes later but no further adverse reactions. The nurse administers amoxicillin to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest.

The nurse administers amoxicillin to a client with known allergies to penicillin. The client has a seizure with resulting respiratory arrest. Explanation: All elements of liability are in place for the scenario involving a nurse administering amoxicillin to a client with documented allergies to penicillin: the nurse had a duty and breached it by giving the medication (amoxicillin), which caused the client harm (seizures and respiratory arrest). The nurse is negligent when applying an ice pack without an order. The nurse assisting the client into bed used proper body mechanics, so the client fall is an accident even though harm occurred. Giving the wrong medication could be cause for malpractice, but in this case, the client was not harmed.

A family brings the client to the emergency department in an unconscious state with a head injury. The client requires surgery to remove a blood clot. What would be the appropriate nursing intervention in keeping with the policy of informed consent prior to a surgical procedure? The nurse informs the family about the living will. The nurse confirms that the client's family has signed the consent form. The nurse informs the family about advance directives. The nurse confirms that the client has signed the consent form.

The nurse confirms that the client's family has signed the consent form. Explanation: The nurse should confirm that the client's family has signed the consent form. However, the health care provider is responsible for having the client, or in this case, the client's family sign consent. This client cannot sign the consent form because the client is not in an alert state and is unable to communicate. If the client is not in a condition to sign the consent form, a family member may sign the consent form on the client's behalf. Advance directives are written statements identifying a competent person's wishes concerning terminal care and are not applicable here. A living will is an instructive form of advance directive; that is, it is a written document that identifies a person's preferences regarding medical interventions to use in a terminal condition, irreversible coma, or persistent vegetative state with no hope of recovery.

A nurse enters a client's room and finds that the client is lying on the floor. The nurse makes the client comfortable on the bed and completes an examination. She informs the physician and the nursing supervisor about this incident and also completes an incident report. Which action by the nurse indicates correct knowledge of handling an incident report? The nurse makes a copy of the incident report to give to the physician. The nurse mentions in the client's report that an incident report was completed. The nurse documents a complete description of the happenings in the client's records. The nurse makes a copy of the incident report and places it in the client's records.

The nurse documents a complete description of the happenings in the client's records. Explanation: An incident report is a written account of an unusual, potentially injurious event involving a client, employee, or visitor. It is kept separate from the medical record. The incident report is a legal document and making a copy of it is not advisable. It should not be placed in the client's records; however, the nurse can mention the incident in the client's records without mentioning the incident report.

After reporting to work for a night shift, the nurse learns that the unit is understaffed because two RNs called out sick. As a result, each nurse on the unit must provide care for four acute clients in addition to the nurse's regular clients. Which statement is true for this nurse when working in understaffed circumstances? The nurse is legally held to the same standards of care as when staffing levels are normal. The nurse must document that float staff, nurses on overtime, and part-time staff were contacted in an effort to fill the gaps in care. The nurse is legally obliged to refuse to provide care when understaffing creates the potential for unsafe conditions. Understaffing constitutes an extenuating circumstance that creates a temporarily lower expectation for care for the nurse.

The nurse is legally held to the same standards of care as when staffing levels are normal. The claim of being overworked does not constitute a legal defense, and both the potential for liability and standards of care remain unchanged despite an increased client assignment. Although it is prudent to make all realistic attempts to fill the gaps in staffing, documenting these efforts does not change the nurse's legal position. A nurse has the right to refuse an unsafe client assignment but the nurse is not legally obliged to withhold care.

Which situation violates an element of informed consent? The client says, "I wish there was a guarantee this procedure will be successful." The nurse says, "You have to sign this before we can do the surgery." The nurse signs the consent as a witness to the client's signature. The client asks a question about the surgery prior to signing the consent form.

The nurse says, "You have to sign this before we can do the surgery." Explanation: The elements of informed consent are disclosure, comprehension, competence, and voluntariness. Telling the client that the surgery cannot be done until the form has been signed could be interpreted as coercion. The nurse's signature on the form indicates witness that the client or surrogate signed the paper. The nurse can answer questions about the surgery (within scope of practice) prior to the client signing the form. The client who is aware that there are no guarantees is informed.

A client is unhappy with the health care provided and informs the nurse that the client is leaving the facility. The client has not been discharged by the physician. The nurse finds that the client has dressed and is ready to go. What should the nurse's action be in this situation? The nurse should have the client restrained and call the physician. The nurse should call and inform the nursing supervisor of the situation. The nurse should warn the client that the client cannot come to the hospital again. The nurse should let the client go because the nurse cannot do anything.

The nurse should call and inform the nursing supervisor of the situation. Explanation: The nurse should call and inform the nursing supervisor of the situation. The client should be made to sign the document stating that the client is responsible for the client's own actions. The nurse cannot restrain the client because that would be false imprisonment. Likewise, the nurse cannot overlook the incident because there is a responsibility for client care. Additionally, the nurse cannot warn the client that the client will not be allowed to come back to the hospital because it is the client's right to access health care whenever required.

A nurse enters the client's room and finds the client lying on the floor experiencing a seizure. After stabilizing the client, the nurse informs the physician. The physician advises the nurse to prepare an incident report. What is the purpose of an incident report? To evaluate the quality of care provided and assess the potential risks for injury to the client To evaluate the immediate care provided by the nurse to the client To provide information to local, state, and federal agencies To determine the nurse's fault in the incident

To evaluate the quality of care provided and assess the potential risks for injury to the client Explanation: An incident report is a written account of an unusual, potentially injurious event involving a client, employee, or visitor. Incident reports determine how to prevent hazardous situations and serve as a reference in case of future litigation. Accurate and detailed documentation often helps to prove that the nurse acted reasonably or appropriately in the circumstances. It may not always serve as a method of determining the nurse's fault in the incident. The document does not evaluate the immediate care provided to the client but states the actions taken. Reference:

Professional regulations and laws that govern nursing practice are in place for which reason? To limit the number of nurses in practice To protect the safety of the public To ensure that practicing nurses are of good moral standing To ensure that enough new nurses are always available

To protect the safety of the public Governing bodies, professional regulations, and laws are in place to protect the public by ensuring that nurses are accountable for safe, competent, and ethical nursing practice. The other options do not describe accurately the role and responsibility of the governing bodies and the regulations and laws of nursing.

Nurses are occasionally asked to witness a testator's (person who makes the will) signing of a will. Which guideline is true regarding a nurse's role in witnessing a testator's signature? Witnesses do not need to observe the signing of the will and can sign it at a later time. A beneficiary to a will is allowed to act as a witness. A single witness is sufficient for a will. Witnesses to a signature do not need to read the will.

Witnesses to a signature do not need to read the will. Explanation: Witnesses to the signature on a will do not need to read it, but they should be sure the document being signed is a will and not some other document. Witnesses should watch the testator sign the will, and they should sign it in the presence of each other. A beneficiary to a will is not allowed to act as a witness in most states. Two or three witnesses are most commonly required on a will. Reference:

Discharging an infant to the wrong person or performing surgery on the wrong patient are examples of _________events, extremely rare medical errors.

never

A client is scheduled for a colonoscopy. The nurse realizes immediately after administering medications to induce conscious sedation that the client has not signed the informed consent. If the nurse has the client sign the informed consent at this point, which element of informed consent would be violated? Voluntariness Competence Comprehension Disclosure

ompetence The client under conscious sedation would not be considered competent to make a decision to undergo an invasive procedure such as a colonoscopy. Disclosure ensures that the following information has been given to the client: the nature of the treatment, possible alternative treatments, and potential risks and benefits of the treatment. Comprehension is met when the client demonstrates understanding by describing in the client's own words to what he is consenting. The client's consent must be given voluntarily.

An unexpected occurrence involving death or a serious physical injury (e.g., wrong side surgery) is called a ------event.

sentinel /se'n to*` no^/

A nurse is overheard in the hospital cafeteria making false, derogatory comments about a client. The nurse is guilty of: invasion of privacy. assault. slander. libel.

slander. Slander is oral defamation of character. Libel is written defamation of character. Assault is a threat or attempt to make bodily contact with another person without that person's consent. Invasion of privacy involves a breach in keeping client information confidential.

A new graduate wants to be knowledgeable about state-mandated rules to better practice within the scope of nursing. What are the best resources for this nurse to research? Select all that apply. Medication administration Nursing educational requirements Medicare and Medicaid provisions for reimbursement of nursing services Composition and disciplinary authority of board of nursing Delegation trees Nurse practice acts

• Nurse practice acts • Nursing educational requirements • Composition and disciplinary authority of board of nursing Examples of state-mandated rules would include nurse practice acts, nursing educational requirements, and composition and disciplinary authority of boards of nursing. Delegation trees, medication administration, and Medicare and Medicaid provision for reimbursement of nursing services are not examples of state-mandated rules.