Ch 23 Nclex- Legal Implications

Question 1

1. A nurse is caring for a patient who recently had coronary bypass surgery and now is on the postoperative unit. Which are legal sources of standards of care that the nurse uses to deliver safe health care? (Select all that apply.)
2. Information provided by the head nurse
3. Policies and procedures of the employing hospital
4. State Nurse Practice Act
5. Regulations identified in The Joint Commission manual
6. The American Nurses Association standards of nursing practice

Answer 1

2. Policies and procedures of the employing hospital
3. State Nurse Practice Act
4. Regulations identified in The Joint Commission manual
5. The American Nurses Association standards of nursing practice

Question 2

2. A nurse is sued for negligence due to failure to monitor a patient appropriately after a procedure. Which of the following statements are correct about this lawsuit? (Select all that apply.)
3. The nurse does not need any representation.
4. The patient must prove injury, damage, or loss occurred.
5. The person filing the lawsuit has to show a compensable damage, such as lost wages, occurred.
6. The patient must prove that a breach in the prevailing standard of care caused an injury.
7. The burden of proof is always the responsibility of the nurse.

Answer 2

2. The patient must prove injury, damage, or loss occurred.
3. The person filing the lawsuit has to show a compensable damage, such as lost wages, occurred.
4. The patient must prove that a breach in the prevailing standard of care caused an injury.

Question 3

3. A nurse stops to help in an emergency at the scene of an accident. The injured party files a suit, and the nurse’s employing institution insurance does not cover the nurse. What would probably cover the nurse in this situation?
4. The nurse’s automobile insurance
5. The nurse’s homeowner’s insurance
6. The Good Samaritan law, which grants immunity from suit if there is no gross negligence
7. The Patient Care Partnership, which may grant immunity from suit if the injured party consents

Answer 3

3. The Good Samaritan law, which grants immunity from suit if there is no gross negligence

Question 4

4. A nurse is planning care for a patient going to surgery. Who is responsible for informing the patient about the surgery along with possible risks, complications, and benefits?
5. Family member
6. Surgeon
7. Nurse
8. Nurse manager

Answer 4

2. Surgeon

Question 5

5. A woman has severe life-threatening injuries and is hemorrhaging following a car accident. The health care provider ordered 2 units of packed red blood cells to treat the woman’s anemia. The woman’s husband refuses to allow the nurse to give his wife the blood for religious reasons. What is the nurse’s responsibility?
6. Obtain a court order to give the blood
7. Coerce the husband into giving the blood
8. Call security and have the husband removed from the hospital
9. More information is needed about the wife’s preference and if the husband has her medical power of attorney

Answer 5

4. More information is needed about the wife’s preference and if the husband has her medical power of attorney

Question 6

6. A nurse notes that an advance directive is on a patient’s medical record. Which statement represents the best description of an advance directive guideline that the nurse will follow?
7. A living will allows an appointed person to make health care decisions when the patient is in an incapacitated state.
8. A living will is invoked only when the patient has a terminal condition or is in a persistent vegetative state.
9. The patient cannot make changes in the advance directive once admitted to the hospital.
10. A durable power of attorney for health care is invoked only when the patient has a terminal condition or is in a persistent vegetative state.

Answer 6

2. A living will is invoked only when the patient has a terminal condition or is in a persistent vegetative state.

Question 7

7. A nurse notes that the health care unit keeps a listing of the patient names at the front desk in easy view for health care providers to more efficiently locate the patient. The nurse talks with the nurse manager because this action is a violation of which act?
8. Patient Protection and Affordable Care Act (PPACA)
9. Patient Self-Determination Act (PSDA)
10. Health Insurance Portability and Accountability Act (HIPAA)
11. Emergency Medical Treatment and Active Labor Act

Answer 7

3. Health Insurance Portability and Accountability Act (HIPAA)

Question 8

8. Which of the following actions, if performed by a registered nurse, would result in both criminal and administrative law sanctions against the nurse? (Select all that apply.)
9. Taking or selling controlled substances
10. Refusing to provide health care information to a patient’s child
11. Reporting suspected abuse and neglect of children
12. Applying physical restraints without a written physician’s order
13. Completing an occurrence report on the unit

Answer 8

1. Taking or selling controlled substances

4. Applying physical restraints without a written physician’s order

Question 9

9. The nurse received a hand-off report at the change of shift in the conference room from the night shift nurse. The nursing student assigned to the nurse asks to review the medical records of the 314patients assigned to them. The nurse begins assessing the assigned patients and lists the nursing care information for each patient on each individual patient’s message board in the patient rooms. The nurse also lists the patients’ medical diagnoses on the message board. Later in the day the nurse discusses the plan of care for a patient who is dying with the patient’s family. Which of these actions describes a violation of the Health Insurance Portability and Accountability Act (HIPAA)?
10. Discussing patient conditions in the nursing report room at the change of shift
11. Allowing nursing students to review patient charts before caring for patients to whom they are assigned
12. Posting medical information about the patient on a message board in the patient’s room
13. Releasing patient information regarding terminal illness to family when the patient has given permission for information to be shared

Answer 9

3. Posting medical information about the patient on a message board in the patient’s room

Question 10

10. A patient has a fractured femur that is placed in skeletal traction with a fresh plaster cast applied. The patient experiences decreased sensation and a cold feeling in the toes of the affected leg. The nurse observes that the patient’s toes have become pale and cold but forgets to document this because one of the nurse’s other patients experienced cardiac arrest at the same time. Two days later the patient in skeletal traction has an elevated temperature, and he is prepared for surgery to amputate the leg below the knee. Which of the following statements regarding a breach of duty apply to this situation? (Select all that apply.)
11. Failure to document a change in assessment data
12. Failure to provide discharge instructions
13. Failure to follow the six rights of medication administration
14. Failure to use proper medical equipment ordered for patient monitoring
15. Failure to notify a health care provider about a change in the patient’s condition

Answer 10

1. Failure to document a change in assessment data

5. Failure to notify a health care provider about a change in the patient’s condition

Question 11

11. A homeless man enters the emergency department seeking health care. The health care provider indicates that the patient needs to be transferred to the City Hospital for care. This action is most likely a violation of which of the following laws?
12. Health Insurance Portability and Accountability Act (HIPAA)
13. Americans with Disabilities Act (ADA)
14. Patient Self-Determination Act (PSDA)
15. Emergency Medical Treatment and Active Labor Act (EMTALA) without triage completed

Answer 11

4. Emergency Medical Treatment and Active Labor Act (EMTALA) without triage completed

Question 12

12. You are the night shift nurse caring for a newly admitted patient who appears to be confused. The family asks to see the patient’s medical record. What is the priority nursing action?
13. Give the family the record
14. Discuss the issues that concern the family with them
15. Call the nursing supervisor
16. Determine from the medical record if the family has been granted permission by the patient to access his or her medical information

Answer 12

4. Determine from the medical record if the family has been granted permission by the patient to access his or her medical information

Question 13

13. A home health nurse notices significant bruising on a 2-year-old patient’s head, arms, abdomen, and legs. The patient’s mother describes the patient’s frequent falls. What is the best nursing action for the home health nurse to take?
14. Document her findings and treat the patient
15. Instruct the mother on safe handling of a 2-year-old child
16. Contact a child abuse hotline
17. Discuss this story with a colleague

Answer 13

3. Contact a child abuse hotline

Question 14

14. Which of the following statements indicate that the new nursing graduate understands ways to remain involved professionally? (Select all that apply.)
15. “I am thinking about joining the health committee at my church.”
16. “I need to read newspapers, watch news broadcasts, and search the Internet for information related to health.”
17. “I will join nursing committees at the hospital after I have completed orientation and better understand the issues affecting nursing.”
18. “Nurses do not have very much voice in legislation in Washington, DC, because of the nursing shortage.”
19. “I will go back to school as soon as I finish orientation.”

Answer 14

1. “I am thinking about joining the health committee at my church.”
2. “I need to read newspapers, watch news broadcasts, and search the Internet for information related to health.”
3. “I will join nursing committees at the hospital after I have completed orientation and better understand the issues affecting nursing.”

Question 15

15. You are floated to work on a nursing unit where you are given an assignment that is beyond your capability. Which is the best nursing action to take first?
16. Call the nursing supervisor to discuss the situation
17. Discuss the problem with a colleague
18. Leave the nursing unit and go home
19. Say nothing and begin your work

Answer 15

1. Call the nursing supervisor to discuss the situation