Question 1

A nurse is giving a presentation on malpractice.Which statement indicates the nurse understands malpractice?

Accepted Answer

There are four elements that must be present for a malpractice claim: (1)You must have a duty-there must be a professional nurse-patient relationship.(2)You must have breached a duty that was foreseeable-you must have fallen below the standard of care.(3)Your breach of duty caused patient (4)injury or damages.The other options do not indicate the nurse's understanding of malpractice.

Question 2

The nurse understands "scope of nursing practice" when making which of the following statements?

Accepted Answer

Defining the scope of nursing practice is part of the responsibility of the state board of nursing.This involves determining the specific activities for each level of nursing and who can perform what functions.The duty that a nurse owes to a patient is part of the professional nurse-patient relationship.Any nursing activity that is outside the scope of nursing practice can be grounds for malpractice or negligence.

Question 3

During a malpractice suit,how can the standard of "what the wise and prudent nurse would do" best be established?

Accepted Answer

The most common way to establish the duty owed by a nurse is by the testimony of a registered nurse-usually,but not always,with training and background similar to the nurse being sued.This expert witness will then testify as to what a reasonable nurse in the same or similar circumstances would be expected to do.The Joint Commission standards may reflect on hospital policies and procedures,not the nurse's practice.A lawyer provides legal advice but cannot attest to the standards of nursing practice that a nurse can.Faculty can be knowledgeable about standards of care,but the testimony of a nurse with similar training and background can determine what the wise and prudent nurse would have done.

Question 4

Which error in judgment would be the most serious for the nurse defendant in a legal case?

Accepted Answer

The patient's chart is a legal document.Changing or tampering with the chart would be in violation of the standards of practice and the Nurse Practice Act and would not be considered "what a reasonable nurse would do." The nurse is expected to perform as a reasonable nurse would.If your actions are not those of a reasonable nurse and this causes someone to be injured,you can be sued.Being discourteous on the witness stand may not be professional.It is also not appropriate to discuss the case with the plaintiff or hide information;however,tampering with the chart is a more serious error in judgment.

Question 5

A nurse understands informed consent when making which of the following statements?

Accepted Answer

Informed consent in the health care setting is a process whereby a patient is informed of the risks,benefits,and alternatives of a certain procedure and then gives consent for it to be done.Informed consent is not a binding agreement or a written legal policy and is more than just a consent form.

Question 6

A graduate nurse is preparing to start a first nursing job.What action would be the best legal safeguard for the graduate nurse to take?

Accepted Answer

The best legal safeguard is competent practice.Practicing within the parameters of the state's Nurse Practice Act,performing care based on established policies and procedures,and performing as a reasonable nurse are the best ways for a nurse to safeguard against legal action.It is important to maintain a current license and follow management policies;however,the best safeguard is being competent.A legal contract is not necessary for all situations and is not necessarily the best legal safeguard.

Question 7

A nurse tells a patient,"If you don't stop getting out of that chair,I'm going to put some restraints on you." What may this nurse be accused of?

Accepted Answer

Assault and battery are the legal terms applied to nonconsensual threat of touch (assault)or the actual touching (battery).Use of restraints may also be interpreted as false imprisonment.False imprisonment means making someone wrongfully believe that he/she cannot leave a place.It is often associated with assault and battery claims.Assault and battery are the legal terms applied to nonconsensual threat of touch (assault)or the actual touching (battery).Malpractice is the improper performance of professional duties,a failure to meet the standards of care that results in harm to another person.Defamation (libel and slander)refers to causing damage to someone else's reputation.If the means of transmitting the damaging information is written,it is called libel;if it is oral or spoken,it is called slander.Invasion of privacy applies to several behaviors,such as photographing a procedure and showing it without the patient's consent,going through a patient's belongings without consent,or talking about a patient's private life publicly.

Question 8

Which definition given by the nurse indicates understanding of malpractice?

Accepted Answer

Malpractice may be defined as doing something outside your scope of practice or something that is unsafe for the patient and could cause injury.A criminal act committed against society may be a felony or a misdemeanor.Negligence is the failure to act as an ordinary prudent person when such failure results in harm to another.

Question 9

What action might be taken on a nurse who commits an infraction of the Nurse Practice Act?

Accepted Answer

The Nurse Practice Act is regulated and enforced by the state board of nursing.State Nurse Practice Acts regulate nursing by controlling the scope of practice and determining the specific activities for each level of nursing.The National League of Nursing is involved with nursing program accreditation.The local state nurses association does not provide discipline for infractions of the Nurse Practice Act.Only if the infraction is of a criminal nature will the state board of nursing refer the case to the local court of law.

Question 10

What would be the most effective way for a nurse to validate informed consent?

Accepted Answer

Asking the patient (not the family unless the patient is a minor child)what he/she understands about the procedure is an effective way to validate informed consent.Informed consent in the health care setting is a process whereby a patient is informed of the risks,benefits,and alternatives of a certain procedure and then gives consent for the procedure to be done.The piece of paper is simply evidence that the informed consent process has been completed.Determining from the physician what was discussed does not guarantee that the patient understands what was explained.

Question 11

What is a correct statement regarding a nurse who acts beyond the scope of practice?

Accepted Answer

States may regulate nursing practice by controlling the scope of practice and determining the specific activities for each level of nursing.In most states,the Nurse Practice Act provides definitions and scope of practice for each level of nursing practice.The power of the board to discipline can have an adverse effect on the nurse's ability to practice.Practicing beyond the scope of practice does not demonstrate what a good nurse the person is and does not provide enriched services.Other nurses would not be angry at increased expectations but at the foolishness of the nurse practicing beyond the scope of practice.

Question 12

What is a significant action a nurse can take to prevent being named in malpractice suits?

Accepted Answer

When you become a registered nurse,you will have a license to practice nursing.This license sets certain standards,which you must follow as a nurse in the state.Should you not live up to these standards,your state can take away your ability to practice as a nurse.The best way to maintain those standards to practice professionally is to stay updated on skills and knowledge.Refusing to care for patients does not prevent you from being named in other malpractice suits.Carrying professional liability insurance does not prevent a malpractice suit but may provide assistance and monies in paying out claims.Although it is important to check with a supervisor about questions concerning nursing care,it may not prevent you from being named if you perform a procedure or intervention incorrectly.

Question 13

During a life-threatening emergency,a nurse hurriedly gives the patient a medication by IV push.There is extravasation of medication.Later,necrosis and tissue sloughing take place.The nurse's behavior may be the basis for what action?

Accepted Answer

Unintentional torts are those that usually involve an inadvertent,unreasonable act that causes harm to someone.Civil,as opposed to criminal,actions are also called torts.Remember that civil actions occur when a plaintiff files a lawsuit to receive compensation for damages he/she suffered as a result of a perceived wrong.Unintentional torts are those that usually involve an inadvertent,unreasonable act that causes harm to someone.Defamation (libel and slander)refers to causing damage to someone else's reputation.If the means of transmitting the damaging information is written,it is called libel;if it is oral or spoken,it is called slander.

Question 14

The nurse enters a patient's room to complete the discharge paperwork and finds the patient in tears.The patient reports that someone from the business office stated the patient could not leave the hospital until the bill was paid.What is the best nursing action?

Accepted Answer

The best action is to comfort the patient and continue the discharge preparations.If the patient's claim is accurate,this could be false imprisonment (wrongfully making someone believe that he/she cannot leave a place).The nurse's best action is to comfort the patient and continue the discharge preparations.However,this should also be reported to the supervisor.Calling the social worker may be needed if the patient does not have the resources to pay the bill so the social worker can help explore options.Contacting the family is not appropriate.

Question 15

A nurse is providing care to a 6-year-old child with a broken arm.The nurse notices multiple bruises.The child says,"My father got mad because I was bad,and he hit me and broke my arm so that I would remember to be good." What is the best nursing action?

Accepted Answer

States have many statutes that require health care providers to report certain incidences or occurrences.If the provider fails to report as required and a person is injured,there can be negligence per se.It important for nurses to be aware of the reporting statutes in the state in which they are practicing.In most states,it is the law to report evidence of child or adult abuse.It is not appropriate to chart a decision that the child is a victim of abuse but rather to accurately describe injuries and comments that are made.Nurses should listen to what the patient has to say-whether the patient is a child or adult.

Question 16

At the time of admission,a patient gave a history of allergy to penicillin that was duly noted in all critical areas of the patient's record.While giving medications,a nurse accidentally administered penicillin to this patient.The patient had a severe reaction but recovered.What is the implication of the nurse's action?

Accepted Answer

The nurse failed to act in a reasonable and prudent fashion and thus is liable for malpractice.The allergy was clearly documented,so the patient did not have to tell this particular nurse about it;the nurse was responsible for knowing it.There is no justification for the nurse to bring about a countersuit for the nurse who took the medication history because it was clearly noted in all critical areas of the chart.Injury or harm,not death,is the standard for malpractice.

Question 17

What action must occur to prove a breach of duty?

Accepted Answer

The duty of a nurse is to act as a reasonable nurse would under the same or similar circumstances.An expert witness may testify as to what a reasonable nurse in the same or similar circumstances would be expected to do.Testimony from a physician,the state board of nursing,or coworkers does not establish a breach of duty.The state board of nursing provides the statutes and laws that govern nursing practice.

Question 18

A student nurse is studying assault and battery.The student interprets assault and battery to include

Accepted Answer

Assault and battery are the legal terms applied to nonconsensual threat of touch (assault)or the actual touching (battery).Permission to do this touching is usually implied when the patient seeks medical care.Using restraints or threatening to use them on competent patients to make them do what you want them to do against their wishes is an example of false imprisonment.Failure to perform an act expected of a reasonable,prudent nurse can constitute negligence.

Question 19

In a legal suit,what element is necessary to prove that malpractice has been committed?

Accepted Answer

There are four elements that need to be present in a malpractice case,one of which is patient injury.The patient will have to prove that the specific nursing action caused injury or harm.Intent,assault,and expenses are not included in the elements of malpractice.

Question 20

In transcribing orders for a patient,the nurse finds a new order for aspirin,500 mg,QID.The patient has a long history of gastrointestinal bleeding.What is the best nursing action?

Accepted Answer

The nurse should call the provider and question the medication order for aspirin based on the patient's history of gastrointestinal (GI)bleeding.Claims involving medication errors are augmented when the nurse fails to recognize side effects or contraindications or fails to know a patient's allergies.The nurse would withhold the medication until the provider is notified and the order clarified.Giving the medication could cause the patient to start bleeding.Although asking for allergies is an important nursing action,the important aspect in this situation in the medical history of GI bleeding.

Quiz 20: Legal Issues