Deck 23: Legal Implications in Nursing Practice

Question 1

A nurse who is working with a client who has been diagnosed with AIDS reveals the client's name and diagnosis with a co-worker on the way downstairs in an elevator.Unknowingly,a friend of the client that happens to be sharing the elevator and hears the entire story.The nurse who shared the information may be held liable for:
1) Slander
2) Assault
3) Malpractice
4) Invasion of privacy

Answer 1

1
A nurse can be held liable for slander if he or she shares private client information that can be overheard by others.Assault is any intentional threat to bring about harmful or offensive contact.No actual contact is necessary.The nurse in this situation has not committed assault.Malpractice is negligence committed by a professional such as a nurse or physician.Nursing malpractice results when care falls below the standard of care.This case is not an example of malpractice.Invasion of privacy occurs when the client has unwanted intrusion into his or her private affairs.This case is not an example of invasion of privacy.This instance falls under the category of defamation of character.

Question 2

Which one of the following individuals may legally give informed consent?
1) A 16-year-old for her newborn child
2) A sedated 42-year-old preoperative client
3) The friend of an 84-year-old married client
4) A 56-year-old who does not understand the proposed treatment plan

Answer 2

1
An emancipated minor,one who is below the age of 18 but who is a parent,can legally give informed consent for the care of her newborn.An emancipated minor can also be someone below the age of 18 who is legally married.A person who has been sedated cannot legally give informed consent.Consent should be obtained before a sedative is administered.If the 84-year-old client were unable to give consent,then the client's wife would be the person legally authorized to do so on the client's behalf.In order for a friend to be legally able to give consent,he or she would have to possess power of attorney or legal guardianship of the client.If a client does not understand the proposed treatment plan,the nurse must notify the physician or nursing supervisor and must make certain that clients are informed before signing the consent.

Question 3

The nurse understands the implications of the Patient Self-Determination Act.This legislation requires that:
1) Clients designate a power of attorney
2) DNR orders for clients meet standard criteria
3) Organ donation is required upon death,if possible
4) Information be provided to the client regarding rights for refusal of care

Answer 3

4
The Patient Self-Determination Act requires health care institutions to provide written information to clients concerning the clients' rights under state law to make decisions,including the right to refuse treatment and formulate advance directives.The Patient Self-Determination Act does not require clients to designate a power of attorney.The Patient Self-Determination Act does not require that DNR orders meet standard criteria.The Patient Self-Determination Act does not require organ donation upon death.It is the client's decision whether he or she wants to participate in organ donation.

Question 4

The newly enacted Health Insurance Portability and Accountability Act (HIPAA)of 2003 requires:
1) Insurance coverage for all clients
2) Policies on how to report communicable diseases
3) Limits on information and damages awarded in court cases
4) Safeguards to protect written and verbal information about clients

Question 5

A physician asks a family nurse practitioner to prescribe a medication that the nurse practitioner knows is incompatible with the current medication regimen.If the nurse practitioner follows the physician's desire,which of the following is the most correct answer?
1) Good Samaritan laws will protect the nurse.
2) The nurse practitioner will be liable for the action.
3) This type of situation is why nurse practitioners should have malpractice insurance.
4) If the nurse practitioner has developed a good relationship with the client,there will probably not be a problem.

Question 6

Which of the following is the most important factor in a nurse deciding whether or not to carry malpractice insurance?
1) The nurse's knowledge level of Good Samaritan laws
2) The amount of malpractice insurance provided by the nurse's employer
3) The time frames and individual liability of the employer's malpractice coverage
4) The evaluation of whether the nurse works in a critical area of nursing where clients have higher morbidity and mortality rates

Question 7

When a nurse signs as a witness on an informed consent form,she is indicating that the client:
1) Fully understands the procedure
2) Agrees with the procedure to be done
3) Has voluntarily signed the consent form
4) Has authorized the physician to continue with the treatment

Question 8

The case of a nurse accused of unethical nursing conduct will be heard by the state board of nursing.This is an example of:
1) Civil law
2) Criminal law
3) Common law
4) Administrative law

Question 9

A nurse stealing narcotics from an acute care nursing unit is guilty of a:
1) Civil offense
2) Criminal offense
3) Common law offense
4) Administrative law offense

Question 10

A nurse is being asked to move from the eye unit to a general surgery floor where she in inexperienced in this specialty due to an influenza epidemic among the nursing staff.She is aware of her inexperience.The nurse's initial recourse is to:
1) Fill out a report noting her dissatisfaction
2) Ask to work with another general surgery nurse
3) Notify the State Board of Nursing of the problem
4) Politely refuse to move,take a leave-of-absence day,and go home

Question 11

The Joint Commission (TJC)sets standards of care,in which an institution is required to have:
1) Limits of professional liability
2) Educational standards for nurses
3) A delineated scope of practice for health professionals
4) Written nursing policies and procedures for client care

Question 12

An unconscious client with a head injury needs surgery to live.His wife only speaks French,and the health care providers are having a difficult time explaining his condition.Which of the following is the most correct answer regarding this situation?
1) An institutional review board needs to be contacted to give their emergency advice on the situation.
2) The health care team should continue with the surgery after providing information in the best manner possible.
3) A friend of the family could act as an interpreter,but the explanation could not provide details of the client's accident,because of confidentiality laws.
4) Two licensed health care personnel should witness and sign the preoperative consent indicating they heard an explanation of the procedure given in English.

Question 13

There are issues concerning death and dying may influence nursing practice which the nurse recognizes.Concerning the legalities of death and dying issues,which of the following is true?
1) Passive euthanasia is illegal in all states.
2) Assisted suicide is a constitutional right.
3) Organ donation must be attempted if it will save the recipient's life.
4) Feedings may be refused by competent individuals who are unable to self-feed.

Question 14

Which one of the following actions is an example of an unintentional tort?
1) Restraining a client who refuses care
2) Taking photos of a client's surgical wounds
3) Leaving the side rails down and the client falls and is injured
4) Talking about a client's history of sexually transmitted diseases

Question 15

In the event that a nursing license is revoked,which of the following is correct?
1) The hearings are usually held in court.
2) Due process rights are waived by the nurse.
3) Appeals may be made regarding the decisions.
4) The federal government becomes involved in the procedures.

Question 16

A client is told by his nurse that he has to take the medications,including an injection.The client refuses the medications,but continues to have them administered by the nurse.This action is an example of the intentional tort of:
1) Assault
2) Battery
3) Malpractice
4) Invasion of privacy

Question 17

What standard of care applies to the student nurse's conduct when providing care normally performed by a registered nurse (RN)?
1) The same standard of care as an RN
2) A standard of care of an unlicensed person
3) No special standard of care because her faculty member is responsible for her conduct
4) A standard similar to but not the same as the staff nurse with whom she is assigned to work

Question 18

Which source of law best addresses a situation where nurse accidentally administers an incorrect dosage of morphine sulfate to the client?
1) Civil law
2) Criminal law
3) Common law
4) Administrative law

Question 19

A nurse who is working with clients who have DNR (do not resuscitate)orders knows that these orders:
1) Are legally required for terminally ill clients
2) May be written by the physician without client consent if resuscitation is futile
3) Are maintained throughout the client's stay in either an acute care or a long-term care facility
4) Follow nationally consistent standards for implementation of client interventions

Question 20

A registered nurse interprets a scribbled medication order by the attending physician as 25 mg.The nurse administers 25 mg of the medication to a client,and then discovers that the dose was incorrectly interpreted and should have been 15 mg.Who would ultimately be responsible for the error?
1) Attending physician
2) Assisting resident
3) Pharmacist
4) Nurse

Question 21

The nurse is having difficulty reading the prescribed dosage on a handwritten order for a pain medication.The most appropriate action to ensure the client's safety and to minimize legal issues is for the nurse to:
1) Ask another RN to confirm the order
2) Request the pharmacist to interpret the order
3) Call the health care provider to clarify the order
4) Consult a current drug book to determine the normal dosage range

Question 22

Which of the following statements made by a nurse reflects a lack of understanding regarding a DNR (do not resuscitate)order?
1) "All family members need to agree before a DNR order can be written."
2) "All terminally ill clients are ultimately required to be declared a DNR status."
3) "The DNR order on the terminally ill client in Room 45 needs reviewed today."
4) "If the client's family can't be located the physician will write the DNR order."

Question 23

The legal basis for a nurse to provide emergency treatment without consent to a client incapable of informed consent is:
1) Such care is clearly a nursing responsibility
2) To fail to provide such care is nursing negligence
3) It is presumed that the client would want the emergency treatment
4) Health care providers have an obligation to provide emergency treatment

Question 24

Which of the following statements best reflects a nurse's understanding of the proper critical thinking process regarding the need for personal malpractice insurance?
1) "The state's Good Samaritan laws protect me outside of the hospital."
2) "I work in a very low risk area of nursing,so I don't really have a need."
3) "The hospital carries its own malpractice insurance,so I don't need extra."
4) "Lawsuits can occur years after the event,so I carry my own liability insurance."

Question 25

Which of the following statements made by a nurse reflects the best understanding of the legal safeguards of a DNR (do not resuscitate)order?
1) "All family members need to agree before a DNR order can be written."
2) "All terminally ill clients are ultimately required to be declared a DNR status."
3) "The DNR order on the terminally ill client in Room 45 needs reviewed today."
4) "If the client's family can't be located,the physician will write the DNR order."

Question 26

Which of the following statements reflects a nurse's need for further instructions regarding an incident report?
1) "I hope this incident report will help determine a way to help prevent falls."
2) "Risk management will want to review the incident report on the client's fall."
3) "I put the incident report on the client's fall in his chart as soon as I was finished."
4) "I need to review the guidelines before I fill out this incident report regarding the client's fall."

Question 27

While working as a nursing assistant,a nursing student is asked to reinsert a Foley catheter by the RN.Which of the following reflects the most appropriate initial student response to the request?
1) Notify the nursing supervisor of the inappropriate request.
2) Tell the RN that she can only perform as a nursing assistant.
3) Agree to perform the task but with the supervision of the RN.
4) Jointly read the nursing assistant job description with the RN.

Question 28

Which of the following statements made by a nurse puts the nurse at risk for assault of the client?
1) "You will be sorry if you don't agree to take this medication."
2) "You can't refuse this medication if you really want to feel better."
3) "I'll be so disappointed in you if you don't take your medication."
4) "I'll tell your son you aren't cooperating if you don't take your medication."

Question 29

Regarding hours worked and frequency of errors,recent research has shown that nurses working more than 12.5 hours per shift and more than a 40-hour week are:
1) Reporting more physical illnesses than those working only 40 hours per week
2) Three times more likely to commit an error in nursing judgment related to client care
3) Experiencing more physical injuries than those working only 40 hours per week
4) Experiencing signs of emotional 'burn out' more frequently than those working only 40 hours per week

Question 30

Which of the following statements made by a nursing student regarding responsibility for provided care requires immediate follow-up by the nursing instructor?
1) "I'm not held to the same standards as a licensed RN."
2) "I am required to provide the safest,appropriate care I am capable of."
3) "My clinical instructor is ultimately responsible for the care I provide."
4) "No one expects nursing students to provide care on the level as an experienced RN."

Question 31

Which of the following statements made by a nurse shows the best understanding regarding the requirements of the Health Insurance Portability and Accountability Act (HIPAA)of 2003?
1) "I'm always careful to close the door when taping or listening to the unit's shift report."
2) "The nursing assistants know to hand me the vital signs sheet and not just put it on the medication cart."
3) "I called the radiology department to tell them I would be faxing the client information they requested."
4) "The client's niece called to see how she slept last night,but I told her I couldn't share that with her over the phone."

Question 32

Although a nurse may not agree,the nurse recognizes that a terminally ill client has the legal right to:
1) Seek passive euthanasia in some states
2) Sign an organ donor pledge statement
3) Refuse DNR (do not resuscitate)status
4) Refuse treatment in the form of food and water

Question 33

Which of the following nursing statements reflects the best understanding of the importance of appropriate nursing documentation regarding risk management?
1) "If the client isn't compliant,I'm sure to put that in my notes."
2) "I'm always careful to document any changes in the client's condition."
3) "My notes are the proof that I provided the client with effective,appropriate care."
4) "When there is a lawsuit,the nursing notes are the first thing the attorney looks at."

Question 34

The nurse is heard stating to another staff member that,"the client in Room 54 is such a whiner;you would think she was dying." This nurse is liable of:
1) Libel
2) Slander
3) Malpractice
4) Invasion of privacy

Question 35

Which of the following statements made by a nurse shows a lack of understanding regarding the Uniform Anatomical Gift Act?
1) "A client must be 21 to give consent to be an organ donor."
2) "All clients admitted to the hospital are asked about becoming an organ donor."
3) "We have a form here on the unit that must be signed to show a client's informed consent to be an organ donor."
4) "In our state,you can check the back of a client's driver's license to verify whether they are an organ donor."

Question 36

An experienced pediatric nurse is reassigned to an adult oncology floor because of staffing issues and immediately recognizes a lack of experience in this specialty.Which of the following nursing actions shows a lack of professionalism?
1) Politely declining the assignment
2) Filling out a report noting her dissatisfaction
3) Asking to work with another oncology nurse
4) Notifying the state board of nursing of the problem