Question 1

Which of the following statements best describes the relationship of students to the clinical nursing instructor with respect to licensure?&#10;A) Students' nursing care activities in the clinical area are permitted under the instructor's nursing license.&#10;B) Students' nursing care activities in the clinical area are permitted under provisions of the state's nursing practice act.&#10;C) Students' nursing care activities in the clinical area are permitted under the instructor's malpractice insurance coverage.&#10;D) Students' nursing care activities in the clinical area are permitted under the hospital's malpractice insurance coverage.&#10;E) Students' nursing care activities in the clinical area are permitted under the contract between the school and the healthcare institution.

Accepted Answer

students' nursing care activities in the clinical area are permitted under provisions of the state's nursing practice act. The clinical nursing instructor's license is implicated only if she fails to assess the readiness of the student to undertake an assignment, fails to provide adequate instruction or supervision for the activity, or insists that a student performs an activity that is outside the scope of nursing practice or is too advanced for her level in the program. Malpractice insurance coverage defends claims of malpractice but is not the entity permitting students' performance of nursing acts. The contract between the school and healthcare institution provides the parameters for clinical instruction at the institution.

Question 2

Provisions of the state's nursing practice act can be used by the clinical nursing instructor to&#10;A) alert students to the types of behavior that would warrant removal of a student from the clinical area&#10;B) provide a preview of licensure examination questions that they can expect to be asked&#10;C) describe the disciplinary process that could result in sanctions being placed on the nurse's license to practice&#10;D) describe the composition of the state's board of nursing as well as its functions&#10;E) all of these

Accepted Answer

alert students to the types of behavior that would warrant removal of a student from the clinical area. The same behaviors that would result in sanction of a nurse's license are behaviors that might result in a student being removed from the clinical area. The nursing practice act does not determine the content of the licensing examination, nor does it describe the disciplinary process. While the act does address the composition and functions of the board of nursing, this is not information that the clinical nursing instructor would impart to students.

Question 3

Which of the following statements concerning legal actions involving professional standards is accurate?&#10;A) A nurse's illegal conduct outside the healthcare employment setting is unlikely to lead to a sanction against the nurse's license.&#10;B) The courts are the final arbiters of whether or not a nurse's action in carrying out nursing functions has met the professional standard of care.&#10;C) Malpractice in carrying out nursing functions may lead to a sanction against the nurse's license, but only if the patient has been injured as a direct result of the nurse's actions.&#10;D) Malpractice in carrying out nursing functions may lead to a sanction against the nurse's license, whether or not the patient has been injured as a direct result of the nurse's actions.&#10;E) A patient injury resulting from a defect in medical equipment will lead to a sanction against the nurse's license if she failed to detect the defect.

Accepted Answer

Malpractice in carrying out nursing functions may lead to a sanction against the nurse's license, whether or not the patient has been injured as a direct result of the nurse's actions. Illegal conduct outside the employment setting can be cause for a sanction against a nurse's license. Courts will review a disciplinary action by the board of nursing with respect to the nurse's due process protections but will not opine on the issue of standard of care. A civil case claiming malpractice requires that the nurse's malpractice was the direct cause of the patient's injury but this finding is not required for a sanction on a nurse's license due to malpractice. Nurses are not responsible for detecting defects in medical equipment.

Question 4

In a law suit brought by a patient, a nurse can be found guilty of malpractice only if which of the following facts is proven&#10;A) the nurse was the professional assigned to and responsible for the care of the patient&#10;B) the nurse's actions failed to meet the standard of care for actions in providing care to the patient&#10;C) the patient was injured as a direct result of the nurse's failure to meet the standard of care&#10;D) all of the above&#10;E) both a and c

Accepted Answer

all of the above. A legal action claiming a nurse's malpractice must prove that the nurse had a duty to the patient, that the nurse failed to meet the applicable standard of care in her care of the patient, and that the patient was injured as a direct result of the nurse's failure to meet the standard of care.

Question 5

The standard of care for actions provided by a professional nurse can be found in&#10;A) nursing literature&#10;B) agency policies and procedures&#10;C) experts and expert testimony&#10;D) evidence-based practice standards&#10;E) all of these

Accepted Answer

all of these. Various sources can be consulted to establish the standard of care for a particular nursing activity.

Question 6

The central purpose of due process protections is to ensure that&#10;A) the instructor has done everything possible to enable to the student to succeed&#10;B) the instructor has treated a failing student in the same way as all other students&#10;C) the student's questions and concerns about a grade are heard by a third party&#10;D) the student has met the standard of care expected for her level in the nursing program&#10;E) both a and c

Accepted Answer

both a and c. Due process protections are intended to allow the student's voice to be heard by an impartial third party in a claim concerning a failing grade and the instructor must have provided every opportunity for the student to succeed. Part of the record to be reviewed in a due process proceeding will be whether the student was treated differently than were other students, but this is not the central purpose of such protections. Whether or not the student met the standard of care for her level in the program is not determined by the third party hearing a due process claim.

Question 7

To avoid a due process claim, the clinical nursing instructor should&#10;A) give a passing grade to all students, regardless of level of performance&#10;B) plan assignments so as to enable all students to easily pass clinical&#10;C) provide students with equivalent opportunities to achieve objectives&#10;D) increase the number of anecdotal notes on the borderline student&#10;E) make allowances for a student who is repeating the course

Accepted Answer

provide students with equivalent opportunities to achieve objectives. Avoiding a potential due process claim by passing all students regardless of their level of performance or planning assignments that are easy for the level of students being taught is a dereliction of duty by the clinical nursing instructor. Treating one student differently than others, as in increased anecdotal notes or allowances for repeating a course, can support a claim of due process violations.

Question 8

A student with a physical disability is able to succeed in a nursing program if&#10;A) performance expectations are lowered to accommodate the disability&#10;B) performance expectations are increased to demonstrate her ability&#10;C) the student is provided with reasonable accommodations&#10;D) the student is provided with whatever accommodations are necessary&#10;E) the student is excused from the clinical portion of the curriculum

Accepted Answer

the student is provided with reasonable accommodations. Performance expectations for the student with a physical disability should be the same as for other students. Reasonable accommodations must be provided; extraordinary accommodations are not required.

Question 9

The contract between the healthcare institution and the nursing program details which of the following items?&#10;A) The student : instructor ratio on the clinical unit.&#10;B) The nursing theory guiding nursing care provision in the institution.&#10;C) The qualifications of clinical nursing instructors.&#10;D) The staffing adjustments to be made when students present.&#10;E) All of these

Accepted Answer

The student : instructor ratio. The contract between the healthcare institution and the nursing program does not address curricular content or learning objectives, nor does it address the qualifications of instructors. Both of these are the sole prerogative of the nursing program. The contract provides that no staffing adjustments be made when students are on the unit.

Question 10

With respect to the contractual relationship between the healthcare institution and the nursing program the clinical nursing instructor&#10;A) will be asked to sign a copy of the contract&#10;B) should request a copy of the contract from the program coordinator&#10;C) can ignore contract provisions as they don't apply to clinical instructors&#10;D) is responsible for negotiating its terms&#10;E) all but c

Accepted Answer

should request a copy of the contract from the program coordinator. The clinical nursing instructor must abide by contract provisions but she is not responsible for signing the contract nor for negotiating its terms.

Deck 18: Legal Issues in Nursing Education