PrepU - Legal I Dimension of Nursing Practice

A medical surgical client is in the radiology department. The client's cousin arrives on the medical surgical unit and asks to speak with the nurse caring for his cousin. The visitor asks the nurse to provide a brief outline of the client's illness. Which response, if given by the nurse, would demonstrate application of legal safeguard in her practice?

"I cannot give you that information due to client confidentiality."

A nurse hired to work in an ambulatory setting attends new employee orientation. The nurse never worked in ambulatory before and is concerned about the Scope and Standards of Practice for Professional Ambulatory Care Nursing. Which response, given by the nurse educator, would further explain the Scope and Standards of Practice for Professional Care Nursing to the new nurse?

"The Scope and Standards of Practice for Professional Ambulatory Care Nursing deal with the professional obligations of a nurse working in the ambulatory setting."

The nurse attempts to notify a health care provider about a client's elevated temperature, but does not get a response. Which statement, if documented by the nurse, would indicate that the nurse is following proper protocol for nursing documentation?

1300: Client temperature elevated. Telephoned health care provider's service 3 times without a response. Tepid sponge bath given and nursing supervisor notified.

Which of the following is an example of certification?

A nurse who demonstrates advanced expertise in a content area of nursing through special testing.

Which of the following nursing students would most likely be held liable for negligence?

A nursing student administers medication to a resident, while working as a nursing assistant at a local nursing home.

Which process evaluates and recognizes educational programs as having met certain standards?

Accreditation

A student nurse is assisting an elderly patient to ambulate following hip replacement surgery, and the patient falls and reinjures the hip. Who is potentially responsible for the injury to this patient?

All of the above

A client informs the nurse that he wants to discontinue his treatment and go home. Later, the nurse finds the client dressed to leave. What action should the nurse take in this situation?

Let the client go after signing a document stating he is going against medical advice.

A client informs the nurse that he is leaving the health care facility because he is not satisfied with the treatment. The nurse knows that the client's treatment is incomplete and further testing and evaluations are scheduled. Which action by the nurse would be most appropriate to prevent false imprisonment?

Ask the client to sign a release without medical approval.

The charge nurse overhears a staff nurse threatening to restrain a verbally abusive client if the abuse continues. The charge nurse meets with the staff nurse to discuss this behavior. Which legal tort, if identified by the charge nurse, would alert the staff nurse to potential criminal charges?

Assault

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. When discussing the nurse's action, the charge nurse appropriately identifies which wrongdoing the nurse has violated?

Battery

A registered nurse enters a patient's room and observes the nursing assistant pushing a patient down on the bed. The patient starts crying and informs the nursing assistant that he needs to go to the bathroom. The nursing assistant holds the patient down and tells him he was just in the bathroom. The nurse observing this incident is aware that the nursing assistant's action is an example of which of the following?

Battery

The nurse fails to contact the physician regarding a client who had an open-reduction internal fixation of the tibia and has experienced increasing leg pain (unrelieved by pain medication) for the past four hours. Which element of liability has been violated?

Breach of duty

Having recently completed a specialty nursing program in neonatal care, a nurse is now preparing to leave her current position on a medical unit and begin providing care in the hospital's neonatal intensive care unit (NICU). The nurse has completed which of the following processes of credentialing?

Certification

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

Certification

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, which element of informed consent would be violated?

Competence

A nurse assesses a client with psychotic symptoms and determines that the client needs vest restraints. However, the client asks the nurse not to put on vest restraints. What would be the best nursing action?

Contact the physician and obtain necessary orders.

A client states that his recent fall was caused by the fact that his scheduled antihypertensives were mistakenly administered by two different nurses, an event that is disputed by both of the nurses identified by the client. Which of the following measures should the nurses prioritize when anticipating that legal action may follow?

Document the client's claims and the events surrounding the alleged incident.

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 of the following actions by the nurse indicates correct knowledge of handling an incident report?

Documents a complete description of the happenings in the client's records

A nurse fails to alert a physician of a change in a patient's condition for the worse. This is an example of what aspect of malpractice?

Duty

In some cases, the act of providing nursing care in unexpected situations is covered by the Good Samaritan laws. Which nursing actions would most likely be covered by these laws?

Emergency care for a choking victim in a restaurant

A nurse who obtains a license to practice nursing by misrepresenting him or herself is guilty of what tort?

Fraud

A client has a prescription for amoxicillin (Amoxil) 500 mg P.O. (by mouth) every 8 hours. The nurse administers the medication via the intravenous route. Based on the nurse's action, the client develops a pulmonary embolus, experiences respiratory distress, and is transferred to the intensive care unit. The client's family files a lawsuit against the facility and the nurse. While reviewing the case, which legal action has the nurse attorney identified that meets the criteria for the client's lawsuit?

Malpractice

While caring for an infant, the nurse hears another child screaming in the next room. She rushes to the other room to check on the screaming child, forgetting to put the side rails up on the infant's crib. She returns to the room to find the infant has fallen out of the crib and sustained a head injury. Based on the nurse's action, which tort is the nurse liable for?

Malpractice

The health care provider prescribes orders for a client with newly diagnosed uncontrolled seizure activity. When reviewing the prescriptions, the nurse correctly identifies which prescription, if followed, puts him at risk for negligence charges?

Restrain all four extremities

Injuries related to lifting or transferring patients occur in the health care setting and may be considered a work-related injury. Which law was intended to reduce work-related injuries and illnesses?

The Occupational Safety and Health Act of 1970

A registered nurse has had her license suspended after being convicted of being impaired at work. What governing body has the authority to revoke or suspend a nurse's license?

The State Board of Nurse Examiners

When making client rounds, the charge nurse observes which action by a staff nurse that would constitute battery?

The elderly client refuses the intramuscular injection, but the staff nurse administered it.

A client is brought 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 ensures that the client's family signs the consent form.

A nurse is caring for a client with vertigo. During data collection, the nurse finds multiple bruises on the client's arms and back; and suspects the client is being abused. When questioned, the client denies any abuse by the daughter she lives with. Despite the client's denial, which rationale would the nurse use for reporting the suspected abuse?

The nurse has a legal and ethical responsibility to report the suspected abuse.

A nurse comes across a screaming child in the park. The child was hit by a baseball bat, resulting in a swollen and reddened left arm. Any attempt to move the child's left arm results in the child screaming intensely. The nurse used two baseball bats to make a split, which she applied to the child's left arm. The child is transported to the hospital and later develops compartmental syndrome of the left arm. The nurse requests a meeting with the nurse attorney to discuss the possibility of being involved in a litigious suit by the child's family. After a review of the events, which important information will the attorney share with the nurse concerning the case?

The nurse is protected by the Good Samaritan Act, which states the nurse may give emergency care using good judgment.

After reporting to work for a night shift, the nurse learns that the unit will be understaffed because two RNs called out sick. As a result, each nurse on the unit will need to provide care for an additional four acute clients in addition to his or her regular client assignment. Which of the following statements is true for this nurse when working in understaffed circumstances?

The nurse will be legally held to the same standards of care as when staffing levels are normal.

A nurse enters the client's room and finds the client lying on the floor experiencing a seizure activity. After stabilizing the client, the nurse informs the physician. The physician advises the nurse to prepare an incident report. What is the purpose of an incident report?

To evaluate quality care and potential risks for injury to the client

Professional regulations and laws that govern nursing practice are primarily in place for which of the following reasons?

To protect the safety of the public

A client is received in a postoperative nursing unit after undergoing abdominal surgery. During this time, the nurse failed to recognize the significance of abdominal swelling, which significantly increased during the next 6 hours. Later, the client had to undergo emergency surgery. The lack of action on the nurse's part is liable for action. Which of the following legal terms describes the case?

Tort

A nurse is caring for a client who has undergone coronary angioplasty. The cardiac monitor is showing abnormal ECG waves, indicating arterial fibrillation. The nurse does not recognize the importance of the sign; as a result, the client's condition deteriorates and the client has to be taken up for an emergency procedure. Which of the following describes the nurse's legal liability?

Tort

Nurses are occasionally asked to witness a testator's (person who makes the will) signing of his or her will. Which of the following guidelines is true regarding a nurse's role is witnessing a testator's signature?

Witnesses to a signature do not need to read the will.

The nursing faculty is lecturing on unintentional and intentional torts. The faculty asks a nursing student to provide an example of an unintentional tort. Which example, if provided by the student, would indicate the student has a clear understanding of torts? a) Nurses are in the elevator discussing a client's laboratory values. b) A nurse gives a medication and client has an adverse reaction. c) A nurse is threatening to restrain a client if he does not stop talking. d) A nurse is telling a client he cannot leave the hospital until he pays his bill.

b) A nurse gives a medication and client has an adverse reaction.

A client admitted with Hodgkin disease has a handwritten prescription for vinblastine 3.7 mg intravenously (IV) weekly. The nurse interprets the prescription as vincristine 3.7 mg and administers the wrong medication. The client becomes neurovascularly compromised and has a fatal reaction to the medication. The client's family begins a litigious suit against the facility and the nurse's license is suspended by the board of nursing. In preparation for the lawsuit, the nurse meets with the nurse attorney to review the events. Which appropriate statement, if given by the nurse, indicates he has an understanding of the lawsuit?

"I had a duty and it was my responsibility to get clarification before administering the medication, which I did not."

A client who is scheduled for hernioplasty needs clarification regarding the procedure. The nurse calls the physician at the client's insistence. The physician, who is in a bad mood, is overheard telling the client that the nurse does not know anything. Which of the following legal torts has the physician committed?

Slander

The nurse educator is presenting a lecture on the Occupational Safety and Health Act. Which situations, if identified by the nursing staff, would indicate to the educator that the staff understands which actions about the Occupational Safety and Health Act?

Helps reduce workforce injuries and illness in the workplace

A nurse is overheard in the hospital cafeteria making false comments about a client. The nurse is guilty of:

Slander

A nurse who comments to her coworkers at lunch that her patient with a sexually transmitted disease has been sexually active in the community may be guilty of what tort?

Slander

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?

Slander

An HIV-positive client discovers that his name is published in a research report on HIV care prepared by his nurse. He is hurt and files a lawsuit against her. Which of the following offenses has the nurse committed?

Invasion of privacy

The nursing student talks with the student's family about an AIDS client from the clinical experience. Which tort has the student committed?

Invasion of privacy

The student nurse tells her family about a client with AIDS cared for in clinical yesterday. Which tort has the student committed?

Invasion of privacy

When the nurse informs a client's employer of his autoimmune deficiency disease, the nurse is committing the tort of:

Invasion of privacy

When the nurse reports for duty, she finds out her neighbor is admitted to one of units in her facility. The nurse asks a coworker about the neighbor's condition. The coworker is uncomfortable with the nurse's request and confers with the charge nurse. The charge nurse informs the coworker of which potential tort violation she could be charged with if she honors the nurse's request for client information?

Invasion of privacy

During the admission assessment of a female client age 40 years with a suspected mandibular fracture, the client discloses to the nurse that her injury came as a result of her husband hitting her. Which of the following actions should the nurse prioritize when responding to this disclosure? a) Reporting the abuse to the appropriate authorities b) Informing the client of her right to keep this information private c) Ensuring the client's statement is confirmed by another nurse d) Performing an assessment to confirm the client's statement

Reporting the abuse to the appropriate authorities Explanation: Nurses have a legal and ethical obligation to report cases of abuse. It would be inappropriate and likely unethical to require a third party witness to the statement or to withhold action pending assessment results. The nurse's obligation to report abuse legally supersedes the client's right to privacy.

A client on a surgical unit asks for the nurse's opinion of the surgeon. The nurse replies, "He is rude. His clients always end up with infections." The nurse is at risk of being accused of which of the following?

Slander/defamation

A physician is called to see a client with angina. During the visit the physician advises the nurse to decrease the atenolol to 12.5 mg. However, since the physician is late for another visit, she requests that the nurse write down the order for her. What should be the appropriate nursing action in this situation?

The nurse should ask the physician to come back and write the order.

The nurse educator is presenting an in-service on nursing and malpractice. Which statements, made by the nursing staff, would indicate to the educator that further teaching is required? Select all that apply. a) "I am accountable for any task that I delegate." b) "If I make a mistake, I will not tell anyone" c) "I will have the supervisor fill out the incident report when I make an error." d) "The nursing plan of care must be accurate and be followed. It is part of the client's permanent record." e) "When I document, I make sure it is factual, accurate, complete, and timely."

b) "If I make a mistake, I will not tell anyone" c) "I will have the supervisor fill out the incident report when I make an error."

Nurses practice within the legal and mandatory standards of the nursing profession. What are examples of voluntary standards in nursing? (Select all that apply.) a) State nurse practice acts b) Process of certification c) American Nurses Association Standards of Practice d) Professional standards for certification of individual nurses in general practice e) Rules and regulations of nursing

b) Process of certification c) American Nurses Association Standards of Practice d) Professional standards for certification of individual nurses in general practice

Which situation is an example of battery that the nurse may experience while performing her duties at the health care facility? a) taking the client's photographs without consent b) telling the client that he cannot leave the hospital c) performing a surgical procedure without getting consent d) witnessing a procedure done on a client without his consent

c) performing a surgical procedure without getting consent

While riding in the elevator, a nurse discusses the HIV-positive status of a client with other colleagues. The nurse's action reflects:

invasion of privacy.

In comparison with licensure, which measures entry-level competence, what does certification validate?

specialty knowledge and clinical judgment

A nurse is being sued for malpractice in a court of law. What elements must be established to prove that malpractice or negligence has occurred? (Select all that apply.)

• Duty • Breach of duty • Causation

Nurses follow nursing practice rules when working within the profession. What are examples of state-mandated rules? (Select all that apply.)

• Nurse practice acts • Nursing educational requirements • Composition and disciplinary authority of board of nursing

A nurse is writing a letter to a U.S. Congressman to support the promotion of health care issues. Which guidelines would ensure a properly written letter? (Select all that apply.)

• The nurse should state the purpose of the letter briefly and clearly in the first paragraph. • The nurse should name the city and state where he or she lives and votes. • The nurse should restate exactly what the legislator should do at the end of the letter.

The nurse educator provides an educational session to the nursing staff on protection of a client's privacy. Which circumstances, identified by the staff, would indicate to the educator that the teaching was effective? Select all that apply.

• With the client's permission, the nurse explained the client's diagnosis to the client's spouse. • The nurse removed the client from the emergency department waiting room into a private area to collect assessment data.