Deck 45: Legal Accountability

Question 1

You are caring for an alert,oriented 47-year-old patient who is recovering from abdominal surgery.The patient becomes angry and upset and says,"I'm leaving this hospital.Remove my IV and surgical drains or I will do it myself." To keep him from removing his lines and leaving the hospital,you apply bilateral wrist restraints until you can contact the physician for an order for patient restraint.This is an example of which of the following?

A) Assault and battery
B) Felony
C) False imprisonment
D) Quasi-intentional tort

Answer 1

False imprisonment

Question 2

The charge nurse uses a whiteboard located at the nurse's station to write the nurses' patient assignments and the patients' diagnoses.This is a violation of which of the following?

A) Americans with Disabilities Act (ADA)
B) Patient Self-Determination Act (PSDA)
C) Health Insurance Portability and Accountability Act (HIPAA)
D) Health Emergency Medical Treatment and Active Labor Act (EMTALA)

Answer 2

Health Insurance Portability and Accountability Act (HIPAA)

Question 3

The nurse cares for a patient who is diagnosed with a sexually transmitted infection (STI).The patient is upset and asks the nurse not to share this information with anyone.The nurse explains to the patient that this must be reported to the local Health department based on which regulation?

A) Americans with Disabilities Act (ADA)
B) Whistleblower's law
C) Good Samaritan Law
D) Mandatory reporting

Answer 3

Mandatory reporting

Question 4

A registered nurse administers the wrong medication to a patient.She does not notify anyone of the error and documents that the correct medication was administered.The nurse was reported to the state board of nursing.Which of the following actions can the state board of nursing take against the nurse in this situation?

A) Disciplinary action against the nurse's license to practice
B) Criminal misdemeanor charges against the nurse
C) Medical malpractice lawsuit against the nurse
D) Employment release from the institution

Question 5

A 4-year-old child is brought to the emergency department by his mother.He has a large bruise on his left chest and multiple contusions on his face.His mother tells you her boyfriend intentionally pushed the child down the stairs in anger.The child appears to be in a great deal of pain.Which of the following four correct items should the nurse do first?

A) Notify the nursing supervisor of the suspected physical abuse.
B) Complete a physical assessment of the child.
C) Obtain an order for pain medication.
D) Notify Child Protective Services of the suspected abuse.

Question 6

Effective delegation is a vital part of the nurse's responsibilities.What factor should guide the nurse to correctly delegate a nursing task?

A) The education and experience of the delegatee
B) The job description of the delegatee
C) The patient request for the delegatee
D) The staffing levels on a unit

Question 7

The charge nurse in a progressive care unit assigns the care of a patient receiving hemodialysis to a newly hired licensed practical nurse (LPN)without checking to see that the nurse has been determined competent to care for hemodialysis patients.The LPN is in orientation and fails to inform the charge nurse that she does not have experience with this type of patient.The actions of the charge nurse would be considered to be which of the following?

A) Malpractice
B) Incompetence
C) Negligence
D) Abandonment

Question 8

Upon initial assessment of a 75-year-old patient,you identify bruises and scratches on the patient's arms,legs,and trunk in various stages of healing.You notify your supervisor when you suspect the patient may be a victim of physical abuse.You are complying with which of the following state laws?

A) Good Samaritan Law
B) Mandatory Reporting Law
C) Nurse Practice Act
D) Nursing Standards of Practice

Question 9

A registered nurse forgot to put the siderails up for a confused patient.The patient fell out of bed and fractured his hip.The patient sues and wins a judgment (award)for $2 million.The nurse has an occurrence policy with double limit coverage of $3 million/$10 million that covered the time period when the incident occurred.The statement that best describes the nurse's situation is that her insurance policy will do which of the following?

A) Not cover her
B) Pay $4 million
C) Pay $2 million
D) Pay 75% of the $2 million

Question 10

The unit manager stops you in the hallway to discuss your inability to give safe patient care.The conversation is overheard by other nurses.The manager's comments are based on false information reported to her by a patient.This is an example of:

A) Collaboration
B) Assault and battery
C) Slander
D) Libel

Question 11

In which of the following circumstances might the nurse defer obtaining informed consent for care and treatment of a patient?

A) The patient is confused and cannot understand or sign the consent form.
B) The patient is brought to the emergency department in cardiac arrest; no family is present.
C) The surgeon requests that the patient be sent to the surgical suite before the nurse gets the consent form signed.
D) An unconscious patient is admitted to the nurse's unit; he is alone.

Question 12

The American Nurses Association (ANA)believes nurses should not participate in active euthanasia (and assisted suicide)because such acts violate ____.

A) the Patient Self-Determination Act
B) civil laws
C) the Good Samaritan laws
D) the Code of Ethics for Nurse

Question 13

Which statement describes the primary purpose of an incident report?

A) This report is used by nurse managers to discipline the nurse for her errors.
B) It is imperative that this report be kept in the patient's medical record in case of a lawsuit.
C) A copy should be provided to the patient to promote open communication.
D) This report is used by risk management to prevent the incident from reoccurring.

Question 14

Before the end of the shift,the nurse records the occurrences for each patient in the electronic medical record.Which statement below indicates that the nurse understands the main principle of accurate charting?

A) "Charting communicates to members of the healthcare team the patient's care and responses during my shift."
B) "Charting is important so that I may share with the healthcare team my opinions of what happened with the patient."
C) "Charting allows the other nurses to understand the patient care provided during my shift."
D) "Charting is important to comply with practice guidelines and institutional policies."

Question 15

Nursing codes of ethics support which of the following?

A) Patients can receive emergency treatment regardless of their ability to pay.
B) Nurses will educate patients about advance directives.
C) Nurses with HIV must disclose their condition to their employer.
D) Patients have the right to dignity, privacy, and safety.

Question 16

A pregnant 15-year-old girl presents to the emergency department (ED)of the local private hospital.She has been transported by her mother and appears to be in active labor.The girl is crying uncontrollably and says she is scared and experiencing painful contractions.Her mother states,"We don't have any money or insurance,but this hospital is closer than the public hospital,and she needs help now." What is the first step that the ED staff should take?

A) Arrange for an ambulance to transport her to the nearest public hospital.
B) Explain to the girl and her mother that the hospital only accepts patients who can pay the hospital bill.
C) Examine her to determine whether her condition is stable or whether she requires immediate medical attention.
D) Inform her mother that she will need to transport her daughter to the nearest public hospital.

Question 17

The nurse on night shift is caring for a patient who is confused and gets out of bed frequently.The nurse pushes him into a chair and states,"Do not get out of this chair or I will tie you up and leave you alone for hours." The nurse's action is an example of:

A) Assault and battery
B) Libel
C) False imprisonment
D) Safe nursing practice

Question 18

Which of the following are examples of invasion of privacy by nurses? Select all that apply.

A) Searching a patient's belongings without permission
B) Reviewing the plan for patient care in the lunchroom
C) Discussing healthcare issues for an unconscious patient with the person who holds his power of attorney
D) Releasing patient health information to local newspaper reporters

Question 19

The nurse enters a patient's room with a portable computer station to assess the patient.The nurse does not log out while assisting a patient to the bathroom.A visitor reads the patient's chart and begins to question the nurse about the patient information.This is an example of:

A) Failure to educate the patient
B) Failure to maintain patient confidentiality
C) Negligence regarding the patient's care
D) Failure to educate the visitor

Question 20

An 87-year-old patient has just been diagnosed with cancer.Her durable power of attorney names her son as her surrogate decision maker.He arrives at the patient's bedside to discuss treatment options with her.The patient is alert and oriented.Her son tells you that he does not want her to receive any treatment (chemotherapy)because of the side effects and her age.The patient tells you that she wants to try the treatment.Which decision should be followed by the nurse?

A) The patient's son's
B) The patient's
C) Both-initially the patient's; then the son's when the medication's side effects become severe
D) Neither; this is a legal decision and should be made by a court of law

Question 21

While you are admitting an adult patient,he asks you whether he should create an advance directive.To provide him adequate information to make an informed decision,you should tell the patient which of the following? Select all that apply.

A) If he is unable to communicate, his family may make changes to his advance directive.
B) Once he signs an advance directive, no further care will be provided to him.
C) He may change his advance directive by telling his physician or by making changes in writing.
D) An advance directive will ensure he gets as much or as little care as he wishes.

Question 22

Under the American Nurses Association (ANA)Code of Ethics,the nurse has the professional responsibility to uphold ethical behavior.Choose the statements below that are accurate about the Code of Ethics.Select all that apply.

A) ANA Code of Ethics is a law.
B) Nurse actions are to be at the level expected by the profession.
C) Nurses are not held accountable for their actions.
D) Nurses are professionally bound to give correct information to the patient.
E) Nurses do not need to collaborate to meet a patient's healthcare needs.
F) ANA Code of Ethics will protect the nurse even if the law is broken.

Question 23

The nurse is caring for a patient diagnosed with a brain tumor who is about to undergo surgery to have the tumor removed.Before the surgery,the patient signs a document giving instructions to his family regarding the level and extent of life-prolonging treatments he desires.Which of the choices below describe this legal directive? Select all that apply.

A) The document is a durable power of attorney for healthcare.
B) The document is a living will.
C) The family can make decisions that are consistent with the document if the patient is incompetent.
D) The family is able to decide to prolong the patient's life, even if he does not want it.
E) The family has guidance on the treatments the patient wants.

Question 24

What do negligence and malpractice have in common? Select all that apply.

A) Negligence and malpractice are unintentional torts.
B) Negligence and malpractice are felonies.
C) Malpractice is the professional form of negligence.
D) Negligence and malpractice involve the intent to do harm to a patient.

Question 25

You are caring for a patient with renal failure.His morning laboratory results reveal an abnormal potassium level of 6.8.This value is higher than it was on the previous day,when the level was within normal limits.You page the patient's provider,but he does not return your call right away.You become busy with another patient and forget to notify the provider again and fail to mention the critical laboratory value to the oncoming nurse during shift report.Which of the following does this scenario illustrate? Select all that apply.

A) Failure to implement a plan of care
B) Failure to evaluate
C) Malpractice
D) Failure to assess and diagnose

Question 26

What are the elements that the plaintiff must establish in a malpractice lawsuit? Select all that apply.

A) Duty
B) Breach of duty
C) Intent to harm
D) Assault
E) Causation
F) Injury