Question 1

The nurse is caring for a patient who has a do-not-resuscitate order from the physician in the chart.The patient stops breathing and his skin turns blue.What is the best action of the nurse to avoid a lawsuit for malpractice or wrongful death?

Accepted Answer

The nurse should follow the do-not-resuscitate order and allow the patient to die without lifesaving intervention.The nurse should stay with the patient and offer support to the family members in the room.The Rapid Response Team should not be called.The nurse should validate the do-not-resuscitate order before the patient stops breathing.The nurse should review the nursing policy and procedure manual for resuscitation guidelines before starting the shift.

Question 2

Which situation will enable a nurse to use restraints?

Accepted Answer

Regulations set the standard that all patients have the right to be free from seclusion and physical or chemical restraints except to ensure the patient's safety in emergency situations.The standards specifically prohibit restraining patients for staff convenience,punishment,or retaliation.

Question 3

When is the nurse covered by the health care agency's malpractice insurance?

Accepted Answer

If a nurse works for a health care institution,generally the institution's insurance will cover the nurse during employment.The nurse is not covered by the agency's malpractice insurance when volunteering at a scout camp.The nurse will need to carry additional insurance for this situation.Providing assistance on a flight or at the scene of a car accident may be covered by the state's Good Samaritan law.

Question 4

The nurse is caring for a patient who climbed out of bed and fell to the floor.What will the nurse do in regard to the incident report?

Accepted Answer

The nurse will document how the patient was found and a description of the injuries.The nurse will also document fall prevention steps that were in place before the patient fell in order to aid the investigation into the event.The nurse will not suggest that the nurse assistant was not paying attention,chart that an incident report was completed,or make recommendations for fall precautions.

Question 5

Which information must be obtained from the patient upon admission to the hospital?

Accepted Answer

The Patient Self-Determination Act (1991)requires health care institutions to inquire whether a patient has created an advance directive,give patients information on advance directives,and document whether a patient states that he or she has an advance directive.Asking how payment will be made is not required by law and is not the responsibility of the nurse.

Question 6

The home care nurse suspects that the patient's bedsores are due to neglect from family caregivers.Which is the appropriate action of the nurse?

Accepted Answer

Health care providers are required to report incidents such as child,spousal,or elder abuse; rape; gunshot wounds; attempted suicide; and certain communicable diseases.Health care providers are provided legal immunity if the report is made in good faith.Not reporting suspected abuse or neglect can cause a nurse to be liable in civil or criminal legal actions.It is not the nurse's responsibility to inform the caregivers of illegal activity or to prevent the caregivers from seeing the patient.The nurse is responsible for reporting the suspected abuse,not call security to handle the problem.

Question 7

The nurse is caring for a patient who will have surgery.The nurse witnesses the patient sign the informed consent document,and then the nurse adds her signature as a witness.What does the nurse's signature on the document mean?

Accepted Answer

The nurse's signature on the consent form indicates only that the patient signed the form,not someone else.The nurse's signature on the consent form does not indicate that the patient accepts the potential risks of the procedure,fully understands the procedure to be performed or agrees with the surgeon's planned treatment approach.

Question 8

The nurse has received an order to administer warfarin 100 mg PO today to the patient.This amount seems high to the nurse.Which are the appropriate actions of the nurse?

Accepted Answer

Nurses are responsible for carrying out medical treatment unless the physician's or health care provider's order is in error,violates hospital policy,or is harmful to the patient.Therefore it is imperative to assess all orders and,if they appear to be erroneous or harmful to the patient,to obtain further clarification from the physician or health care provider.100 mg is not an appropriate dosage of warfarin so it should not be administered to the patient.Do not carry out the order if there is a risk that harm will come to your patient; therefore do not administer the medication.The nursing supervisor should be notified.The pharmacist should be contacted about the order.Inform the nurse manager or the nursing supervisor.The nurse does not document suspicions or opinions,just objective,factual information.

Question 9

The nurse is caring for a patient who attempted to get out of bed and fell to the floor,causing a fractured hip.The nursing supervisor asks the nurse to rewrite her entry into the patient's chart to show that the patient's bed was lowered to the floor even though it was not.What is the best action of the nurse?

Accepted Answer

It is against the standards of nursing care to alter or falsify information in the patient's chart.The nurse should not ask the nursing assistant to chart that the patient's bed was lowered either.

Question 10

Which actions by the nurse violate the American Nurses Association's Social Media Policy?

Accepted Answer

The American Nurses Association has developed a Social Media Policy (2011),which recommends that when using social media sites,a nurse should never name or describe a patient,never post an image of a patient,and never disparage a fellow employee or employer.The nurse is allowed to write a blog about staffing ratios and post a professional profile on LinkedIn.

Question 11

Which patient scenario allows the physician to perform needed procedures without the need to obtain informed consent first?

Accepted Answer

Informed consent may not be obtained from an unconscious trauma patient.Informed consent must be obtained with a translator for patients who do not speak English.Deaf patients require sign language translators.Lack of health insurance does not eliminate the need for informed consent.

Quiz 5: Legal Principles in Nursing