Question 1

Which of the following statements describes the nurse's duty to investigate suspected abuse of a pediatric client before reporting it?

Accepted Answer

A)Regardless of the situation, the nurse is not required to conduct any type of investigation or otherwise confirm that the suspected abuse of a pediatric client has, in fact, occurred. The nurse is required only to have a good faith suspicion based on information disclosed by a client, physical symptoms observed in a client, or the nurse's personal observations of behavior on the part of a client, colleague, or third party. The nurse is not required, therefore, to question a parent or guardian about the abuse, personally observe the client being abused, or identify witnesses who will testify to the abuse.
B)Regardless of the situation, the nurse is not required to conduct any type of investigation or otherwise confirm that the suspected abuse of a pediatric client has, in fact, occurred. The nurse is required only to have a good faith suspicion based on information disclosed by a client, physical symptoms observed in a client, or the nurse's personal observations of behavior on the part of a client, colleague, or third party. The nurse is not required, therefore, to question a parent or guardian about the abuse, personally observe the client being abused, or identify witnesses who will testify to the abuse.
C)Regardless of the situation, the nurse is not required to conduct any type of investigation or otherwise confirm that the suspected abuse of a pediatric client has, in fact, occurred. The nurse is required only to have a good faith suspicion based on information disclosed by a client, physical symptoms observed in a client, or the nurse's personal observations of behavior on the part of a client, colleague, or third party. The nurse is not required, therefore, to question a parent or guardian about the abuse, personally observe the client being abused, or identify witnesses who will testify to the abuse.
D)Regardless of the situation, the nurse is not required to conduct any type of investigation or otherwise confirm that the suspected abuse of a pediatric client has, in fact, occurred. The nurse is required only to have a good faith suspicion based on information disclosed by a client, physical symptoms observed in a client, or the nurse's personal observations of behavior on the part of a client, colleague, or third party. The nurse is not required, therefore, to question a parent or guardian about the abuse, personally observe the client being abused, or identify witnesses who will testify to the abuse.

Question 2

A medication error occurred and the nurse is preparing to complete an incident report.Which information is required to thoroughly complete this report? Select all that apply.

Accepted Answer

The incident report should include the client's name, date and time of the incident, and the medication involved. The location of where the incident report is completed and the number of hours the nurse was at work before the incident occurred are not necessary information for the incident report.

Question 3

A nurse who reports suspected child abuse,honestly believing it to have occurred,is not subject to civil or criminal liabilities when the subsequent investigation does not make a determination of abuse.This is called

Accepted Answer

Good faith immunity protects individuals who report suspected child abuse in good faith from any civil or criminal liabilities even if the subsequent investigation does not confirm child abuse.

Question 4

The nurse is concerned about the risk involved when implementing healthcare provider prescriptions for a newly admitted client.Which strategies should the nurse consider to reduce this risk? Select all that apply.

Accepted Answer

A) Nurses can minimize risk by analyzing procedures and medications ordered by the physician. It is the nurse's responsibility to seek clarification of ambiguous or seemingly erroneous orders from the prescribing physician. To protect them legally, nurses should question any order a client questions, any order if the client's condition has changed, and any order that is incomplete. All orders written for postoperative clients do not need to be questioned. Verbal orders should be recorded accurately to avoid miscommunication but they do not all need to be questioned.
B) Nurses can minimize risk by analyzing procedures and medications ordered by the physician. It is the nurse's responsibility to seek clarification of ambiguous or seemingly erroneous orders from the prescribing physician. To protect them legally, nurses should question any order a client questions, any order if the client's condition has changed, and any order that is incomplete. All orders written for postoperative clients do not need to be questioned. Verbal orders should be recorded accurately to avoid miscommunication but they do not all need to be questioned.
C) Nurses can minimize risk by analyzing procedures and medications ordered by the physician. It is the nurse's responsibility to seek clarification of ambiguous or seemingly erroneous orders from the prescribing physician. To protect them legally, nurses should question any order a client questions, any order if the client's condition has changed, and any order that is incomplete. All orders written for postoperative clients do not need to be questioned. Verbal orders should be recorded accurately to avoid miscommunication but they do not all need to be questioned.
D) Nurses can minimize risk by analyzing procedures and medications ordered by the physician. It is the nurse's responsibility to seek clarification of ambiguous or seemingly erroneous orders from the prescribing physician. To protect them legally, nurses should question any order a client questions, any order if the client's condition has changed, and any order that is incomplete. All orders written for postoperative clients do not need to be questioned. Verbal orders should be recorded accurately to avoid miscommunication but they do not all need to be questioned.
E) Nurses can minimize risk by analyzing procedures and medications ordered by the physician. It is the nurse's responsibility to seek clarification of ambiguous or seemingly erroneous orders from the prescribing physician. To protect them legally, nurses should question any order a client questions, any order if the client's condition has changed, and any order that is incomplete. All orders written for postoperative clients do not need to be questioned. Verbal orders should be recorded accurately to avoid miscommunication but they do not all need to be questioned.

Question 5

While making rounds on the night shift,a nursing supervisor notes that a 73-year-old client under observation following a myocardial infarction has multiple visible bruises on the arms and legs.The supervisor suspects abuse because nothing in the client's chart suggests this client should have sustained these injuries.This state's good faith immunity applies in cases of suspected abuse not only of children but also of older adults or adults with disabilities.Which action has the highest priority for the nursing supervisor in this situation?

Accepted Answer

Suspected abuse of older adults or adults with disabilities must be reported, and notifying the authorities is the best course of action to protect the client from further harm. Doing nothing or notifying the security department would not address the client's safety and well-being. Asking a shift nurse about the injuries might lead to clarifying the circumstances, but it does not guarantee addressing the suspected abuse.

Question 6

A novice nurse attends a lecture regarding risk management.Which action should the nurse implement to reduce risks in practice?

Accepted Answer

A)Healthcare organizations can use several strategies to minimize risk. One of the most basic strategies is protecting against financial risk by purchasing insurance or by self-insuring. Risk management also entails analyzing errors to determine causes and changing policy to reduce more errors. Nurses should report all errors in an effort to assist in the campaign to reduce medical errors. Storing unused equipment in the hall serves to eliminate risk of contamination but could increase the risk of injury. The nurse does not need to question every order that a physician writes; the nurse is responsible only for questioning orders that may injure clients.
B)Healthcare organizations can use several strategies to minimize risk. One of the most basic strategies is protecting against financial risk by purchasing insurance or by self-insuring. Risk management also entails analyzing errors to determine causes and changing policy to reduce more errors. Nurses should report all errors in an effort to assist in the campaign to reduce medical errors. Storing unused equipment in the hall serves to eliminate risk of contamination but could increase the risk due to injury. The nurse does not need to question every order that a physician writes; the nurse is responsible only for questioning orders that may injure clients.
C)Healthcare organizations can use several strategies to minimize risk. One of the most basic strategies is protecting against financial risk by purchasing insurance or by self-insuring. Risk management also entails analyzing errors to determine causes and changing policy to reduce more errors. Nurses should report all errors in an effort to assist in the campaign to reduce medical errors. Storing unused equipment in the hall serves to eliminate risk of contamination but could increase the risk due to injury. The nurse does not need to question every order that a physician writes; the nurse is responsible only for questioning orders that may injure clients.
D)Healthcare organizations can use several strategies to minimize risk. One of the most basic strategies is protecting against financial risk by purchasing insurance or by self-insuring. Risk management also entails analyzing errors to determine causes and changing policy to reduce more errors. Nurses should report all errors in an effort to assist in the campaign to reduce medical errors. Storing unused equipment in the hall serves to eliminate risk of contamination but could increase the risk due to injury. The nurse does not need to question every order that a physician writes; the nurse is responsible only for questioning orders that may injure clients.

Question 7

Which of the following should the nurse understand to be health information not protected under the HIPAA Privacy Rule?

Accepted Answer

A)Protected health information includes information that identifies the individual (e.g., name, address, birth date, and Social Security number)or for which a reasonable basis exists to believe the information can be used to identify the individual as it relates to the individual's past, present, or future physical or mental health or condition; the provision of healthcare to the individual; or the past, present, or future payment for the provision of healthcare to the individual. A mere description of the symptoms for an illness that does not reference the client in any way is not protected health information.
B)Protected health information includes information that identifies the individual (e.g., name, address, birth date, and Social Security number)or for which a reasonable basis exists to believe the information can be used to identify the individual as it relates to the individual's past, present, or future physical or mental health or condition; the provision of healthcare to the individual; or the past, present, or future payment for the provision of healthcare to the individual. A mere description of the symptoms for an illness that does not reference the client in any way is not protected health information.
C)Protected health information includes information that identifies the individual (e.g., name, address, birth date, and Social Security number)or for which a reasonable basis exists to believe the information can be used to identify the individual as it relates to the individual's past, present, or future physical or mental health or condition; the provision of healthcare to the individual; or the past, present, or future payment for the provision of healthcare to the individual. A mere description of the symptoms for an illness that does not reference the client in any way is not protected health information.
D)Protected health information includes information that identifies the individual (e.g., name, address, birth date, and Social Security number)or for which a reasonable basis exists to believe the information can be used to identify the individual as it relates to the individual's past, present, or future physical or mental health or condition; the provision of healthcare to the individual; or the past, present, or future payment for the provision of healthcare to the individual. A mere description of the symptoms for an illness that does not reference the client in any way is not protected health information.

Question 8

An adolescent client with a sexually transmitted infection (STI)says to the nurse,"Promise you won't tell my parents about my condition." The agency policy is that all STIs must be reported in accordance with federal and state law.Which action by the nurse is appropriate?

Accepted Answer

The nurse has a legal and ethical obligation to report the STI in accordance with federal and state law. Protecting the client's privacy and confidentiality is also important, but it cannot override the legal requirements for reporting contagious diseases. Disclosing information to the parents without the client's consent would also be a violation of the client's privacy. Respecting the client's privacy and confidentiality while also fulfilling the legal requirement to report the STI can be achieved by explaining the reporting process to the client and seeking their consent to involve their parents or guardians in their care. Telling other nurses in the clinic about the client's STI would also be a violation of the client's privacy and confidentiality.

Question 9

The nurse is in the midst of a complicated client care situation and is not sure what needs to be done with some information.Which healthcare issues must the nurse report to the state? Select all that apply.

Accepted Answer

A) The term "mandatory reporting" refers to a legal requirement to report an act, event, or situation that is designated by state or local law as a reportable event. All states mandate the reporting of certain vital statistics, including deaths. Many states also require healthcare providers to report neonatal deaths. Federal and state laws mandate the reporting of communicable diseases such as tuberculosis. Limb amputations and transplants do not need to comply with mandatory reportable events.
B) The term "mandatory reporting" refers to a legal requirement to report an act, event, or situation that is designated by state or local law as a reportable event. All states mandate the reporting of certain vital statistics, including deaths. Many states also require healthcare providers to report neonatal deaths. Federal and state laws mandate the reporting of communicable diseases such as tuberculosis. Limb amputations and transplants do not need to comply with mandatory reportable events.
C) The term "mandatory reporting" refers to a legal requirement to report an act, event, or situation that is designated by state or local law as a reportable event. All states mandate the reporting of certain vital statistics, including deaths. Many states also require healthcare providers to report neonatal deaths. Federal and state laws mandate the reporting of communicable diseases such as tuberculosis. Limb amputations and transplants do not need to comply with mandatory reportable events.
D) The term "mandatory reporting" refers to a legal requirement to report an act, event, or situation that is designated by state or local law as a reportable event. All states mandate the reporting of certain vital statistics, including deaths. Many states also require healthcare providers to report neonatal deaths. Federal and state laws mandate the reporting of communicable diseases such as tuberculosis. Limb amputations and transplants do not need to comply with mandatory reportable events.
E) The term "mandatory reporting" refers to a legal requirement to report an act, event, or situation that is designated by state or local law as a reportable event. All states mandate the reporting of certain vital statistics, including deaths. Many states also require healthcare providers to report neonatal deaths. Federal and state laws mandate the reporting of communicable diseases such as tuberculosis. Limb amputations and transplants do not need to comply with mandatory reportable events.

Question 10

A nurse educator is planning a class for a group of nursing students regarding risk management.Which information should the educator include in this presentation? Select all that apply.

Accepted Answer

A) Risk management seeks to prevent harm, which is a key component of nursing practice and patient safety. 
D) Risk management involves examining past mistakes and identifying potential hazards in order to proactively prevent harm in the future. 
B, C, and E are not directly related to risk management in the context of nursing practice.

Question 11

The nursing instructor is evaluating the success of training provided to staff nurses on ways to reduce the incidence of pediatric medication errors.Which observations indicate that training has been effective? Select all that apply.

Accepted Answer

A)Children are at a higher risk for medical error than other clients and also may be more vulnerable to harm from errors due to their immature physiology. Reasons for increased medical error among children include miscalculation of doses and amounts and incorrect placement of the decimal point in calculations. Nurses who double-check medication calculations, use liquid preparations, and ask another nurse to validate the placement of the decimal point are demonstrating that the training was effective. The nurses should not be refusing to dilute medications because many preparations require dilution to achieve the small dosages required by infants, and they should not expect the pharmacy to prepare the medications in exact doses.
B)Children are at a higher risk for medical error than other clients and also may be more vulnerable to harm from errors due to their immature physiology. Reasons for increased medical error among children include miscalculation of doses and amounts and incorrect placement of the decimal point in calculations. Nurses who double-check medication calculations, use liquid preparations, and ask another nurse to validate the placement of the decimal point are demonstrating that the training was effective. The nurses should not be refusing to dilute medications because many preparations require dilution to achieve the small dosages required by infants, and they should not expect the pharmacy to prepare the medications in exact doses.
C)Children are at a higher risk for medical error than other clients and also may be more vulnerable to harm from errors due to their immature physiology. Reasons for increased medical error among children include miscalculation of doses and amounts and incorrect placement of the decimal point in calculations. Nurses who double-check medication calculations, use liquid preparations, and ask another nurse to validate the placement of the decimal point are demonstrating that the training was effective. The nurses should not be refusing to dilute medications because many preparations require dilution to achieve the small dosages required by infants, and they should not expect the pharmacy to prepare the medications in exact doses.
D)Children are at a higher risk for medical error than other clients and also may be more vulnerable to harm from errors due to their immature physiology. Reasons for increased medical error among children include miscalculation of doses and amounts, and incorrect placement of the decimal point in calculations. Nurses who double-check medication calculations, use liquid preparations, and ask another nurse to validate the placement of the decimal point are demonstrating that the training was effective. The nurses should not be refusing to dilute medications because many preparations require dilution to achieve the small dosages required by infants, and they should not expect the pharmacy to prepare the medications in exact doses.
E)Children are at a higher risk for medical error than other clients and also may be more vulnerable to harm from errors due to their immature physiology. Reasons for increased medical error among children include miscalculation of doses and amounts and incorrect placement of the decimal point in calculations. Nurses who double-check medication calculations, use liquid preparations, and ask another nurse to validate the placement of the decimal point are demonstrating that the training was effective. The nurses should not be refusing to dilute medications because many preparations require dilution to achieve the small dosages required by infants, and they should not expect the pharmacy to prepare the medications in exact doses.

Question 12

The nurse is asked to participate on a committee to ensure that no breaches of client confidentiality occur when providing care.Which actions help ensure client confidentiality when providing care? Select all that apply.

Accepted Answer

A) The nurse has the responsibility to keep client information private and confidential. Actions that ensure client confidentiality include only sharing information with staff who are directly involved in care and restricting discussion regarding client care to the report room or other areas that are secure. Client names and diagnoses should only be shared with those who are directly providing care. The nurse is able to review the client's care needs with the designated health insurance agent.
B) The nurse has the responsibility to keep client information private and confidential. Actions that ensure client confidentiality include only sharing information with staff who are directly involved in care and restricting discussion regarding client care to the report room or other areas that are secure. Client names and diagnoses should only be shared with those who are directly providing care. The nurse is able to review the client's care needs with the designated health insurance agent.
C) The nurse has the responsibility to keep client information private and confidential. Actions that ensure client confidentiality include only sharing information with staff who are directly involved in care and restricting discussion regarding client care to the report room or other areas that are secure. Client names and diagnoses should only be shared with those who are directly providing care. The nurse is able to review the client's care needs with the designated health insurance agent.
D) The nurse has the responsibility to keep client information private and confidential. Actions that ensure client confidentiality include only sharing information with staff who are directly involved in care and restricting discussion regarding client care to the report room or other areas that are secure. Client names and diagnoses should only be shared with those who are directly providing care. The nurse is able to review the client's care needs with the designated health insurance agent.
E) The nurse has the responsibility to keep client information private and confidential. Actions that ensure client confidentiality include only sharing information with staff who are directly involved in care and restricting discussion regarding client care to the report room or other areas that are secure. Client names and diagnoses should only be shared with those who are directly providing care. The nurse is able to review the client's care needs with the designated health insurance agent.

Question 13

The nurse is caring for a client on a medical-surgical unit that has just implemented the electronic medical record for client documentation.The client asks the nurse about the facility's computerized system for keeping client information,especially in regard to confidentiality.Which is the best response by the nurse?

Accepted Answer

The HIPAA Privacy Rule outlines standards for the confidentiality, security, and privacy of individual's protected health information. It is important for the nurse to reassure the client that the electronic medical record system complies with these regulations to maintain confidentiality and privacy of their information. Options A and D may increase the client's anxiety and do not provide accurate information, while option B may not directly address the client's concerns about confidentiality.

Question 14

During an assessment of a child in the urgent care clinic,the nurse notes that the child has a swollen and split lip.When asking the parent how the child's lip injury occurred,the parent responds,"We are here for my child's ear not my child's lip." Which is the rationale for reporting this incident?

Accepted Answer

Suspected abuse must be reported, regardless of whether the parent acknowledges the injury or if it seems unrelated to the reason for the urgent care visit. It is the nurse's legal and ethical responsibility to report any suspected abuse or neglect.

Question 15

The Health Insurance Portability and Accountability Act (HIPAA)was created in part to

Accepted Answer

HIPAA was created to provide special rights for individuals who lose other health coverage, ensuring they will not be denied coverage due to preexisting conditions. It also includes privacy rules that protect individuals' personal health information. Medical underwriting is not promoted under HIPAA, and the rules for disclosing protected health information are actually more strict under HIPAA regulations.

Question 16

Which action protects the client's confidentiality?

Accepted Answer

Protecting a client's confidentiality is the nurse's ethical and legal responsibility. Not revealing that he was involved with the treatment of a famous client is an example of maintaining client confidentiality. The nurse should not discuss details of a client's case with individuals who have no legitimate need to know, or whom the client has not authorized as a recipient of information about their case. Moreover, HIPAA procedures need to be strictly adhered to since they provide the necessary framework for ensuring that client's confidentiality is maintained. Lastly, the nurse should only discuss clients with other employees of the healthcare facility where they work as disclosure to others may jeopardize the client's confidentiality.

Quiz 49: Legal Issues