Chapter 23 Flashcards
As a registered nurse, you have a legal and ethical obligation to do which of the following?
a. Delegate responsibility to others
b. Show up for work on time
c. Advocate for patients
d. Respect the wishes of patients no matter what
C: The American Nurses Association Code of Ethics (2001), as well as many state Nursing Practice Acts, require nurses to serve as patient advocates. A patient’s diagnosis, extent of illness, treatments, pain, and the institutional nature of hospitals often result in patients becoming passive recipients of care instead of active participants. Nurses have the obligation to advocate for patients, especially those who are unable to do so for themselves, helping them communicate their wishes to the health care team, being vigilant in protecting their safety, and sometimes even in protecting their legal rights.
A patient’s son has medical power of attorney and has arrived at the patient’s bedside to discuss care options with her. The patient has just been dialyzed, has not received any pain medication, and is rational in her decision making. The patient’s son decides that she should not receive any more dialysis treatments due to the acute state of her illness, the discomfort that she has suffered, and her inability to care for herself. The patient disagrees. Which decision should be followed?
a. The patient’s son
b. The patient
c. Both, and the hospital ethics committee should convene and decide
d. Neither, this is a legal decision and should be done by a court of law
B: Even though the patient has given her son legal power of attorney over her health care decisions, if she is competent and disagrees with her agent’s (her son’s) wishes or decisions, her decisions are the ones that prevail.
A student nurse has learned that Good Samaritan laws were enacted to protect the health care professional from legal liability. The student nurse asks a nurse educator about when the Good Samaritan laws would not be applicable. Which of the following would a nurse educator give as an example of care rendered that does not fall under Good Samaritan laws?
a. A doctor who delivers a baby during a football game
b. A nurse who sets a broken leg while hiking in the mountains
c. An EMT who, upon their arrival at the accident, intubates an accident victim who stopped breathing and who was forcibly thrown onto their vehicle
d. A nurse who stops to help at the scene of a water-skiing accident
C: Some of the components of care given under the Good Samaritan laws are care that is rendered in an emergency situation (the nurse at the water-skiing accident or the nurse who set the broken leg while hiking) when the health care worker is not being paid. (The fact that the EMT intubated the patient who was thrown on their vehicle indicates that the EMT arrived in response to a call. If the EMT was passing by and just happened to see the accident and either had not been called or was off-duty, then the care would fall under the Good Samaritan laws.) The doctor who delivers a baby during a football game also rendered care under the Good Samaritan law.
A patient has an advance directive that indicates no CPR should be performed under any circumstance. When the nurse enters the patient’s room and finds that he has coded, the nurse immediately begins CPR. The nurse is at risk for which of the following?
a. Negligence c. Assault
b. Battery d. Licensure
B: Failing to honor a patient’s advance directive (living will, medical power of attorney, or durable medical power of attorney) puts caregivers at risk for charges of malpractice via battery. An example of negligence would be not honoring a patient’s wish to be resuscitated, and licensure may be revoked or suspended due to certain acts (or failure to act) depending on the circumstances and outcomes involved.
A student asks a nurse educator about what part of the law tort law deals with. The nurse educator responds that tort law is concerned with:
a. torts and pies, and always being correct.
b. always being correct and failure to show up for jury duty.
c. failure to show up for jury duty and touching people when they do not want to be touched.
d. touching people when they do not want to be touched and always being correct.
C: Law.com (2010) has defined tort as a civil wrong for which injury occurs to another. Examples of torts include failure to show up for jury duty (failure to comply with a public duty), touching people when they do not want to be touched (battery, which is a type of tort charge), and denial of a person’s rights.
A new nursing graduate is working on a unit project regarding patient care and GI treatments. While interviewing a patient, who has been incessantly complaining about his lack of daily bowel movements (complete with graphic details about the type and consistency), the new nursing graduate tells the patient that if he is not quiet she will give him an enema he will never forget. This is an example of:
a. invasion of privacy. c. assault.
b. battery. d. defamation.
C: Threatening to touch (or treat) another person without his consent is a definition of assault. By threatening to give the patient “an enema he will never forget” if he is not quiet, the new nursing graduate has threatened to give a treatment (enema) against his will. Battery is the actual act of giving the enema (treatment), and defamation is the act of giving intentionally false information, communication, or publication such as making a statement that could cause a patient to lose his job.
A nursing instructor asks a student to name the four elements required to provide proof of liability. Which response by the student would indicate that further teaching is needed?
a. Obligation created by law, contract, or standard practice that is owed to the professional by the complainant
b. Breach of this obligation either by omission or commission
c. Physical, emotional, or financial harm to the complainant
d. Proof that the breach of obligation caused the complainant harm
A: Providing proof of liability (or fault) in malpractice or negligence cases requires the following four factors: obligation created by law, contract, or standard practice that is owed to the complainant (patient) by the professional (not the other way around); a breach of this obligation either by omission or commission; physical, emotional, or financial harm to the complainant; and proof that the breach of obligation caused the complainant harm.
A nurse has heard that a fellow nurse at another hospital was charged with assault on a patient. The nurse asks the nurse manager whether assault is the same as battery. The nurse manager explains that assault differs from battery in that it:
a. is the act instead of the threat being done without permission.
b. is the threat instead of the act being done without permission.
c. concerns being offensive without permission.
d. concerns the thought without the act or the threat.
B: Assault concerns the threat to touch (or treat) another person without her permission, while battery is the actual act of touching or treating another person without her permission.Assault concerns the threat to touch (or treat) another person without her permission, while battery is the actual act of touching or treating another person without her permission.
A nurse trained in another country is seeking licensure in the United States. While becoming familiar with the American legal system, the nurse learns that there are three types of public laws that include which of the following?
a. Constitutional, governmental, and criminal
b. Criminal, constitutional, and administrative
c. Criminal, tort, and administrative
d. Administrative, governmental, and civil
B: Public laws define a citizen’s relationship with the government. Three types of these laws are criminal, constitutional, and administrative.
You are conducting an in-service and ask the participants to identify the law that is concerned with the protection of the rights of citizens. Which response by the participants would be correct?
a. Tort c. Administrative
b. Civil d. HIPAA
C: Administrative law deals with the protection of the rights of citizens. An example is the Civil Rights Act of 1964, which prohibits forms of discrimination in the workplace. Civil law deals with how people relate to each other in everyday matters; it encompasses both tort and contract law. HIPAA is a type of federal administrative law and is concerned with the protection of medical information.
Using a whiteboard to organize nursing assignments per shift or to provide patients information about their practitioner or diagnosis is a violation of which of the following?
a. Civil law c. HIPAA
b. Tort law d. OSHA
C: The Health Insurance Portability and Accountability Act (HIPAA) was enacted to safeguard medical information. Some previous methods for patient care organization fall under what is now considered to be HIPAA violations because they provide a means for others to access private information about patients’ care. Examples of HIPAA violation include the use of whiteboards to organize shift assignments and nursing organizational charts (used to organize patient treatments, diagnoses, etc.). If used, they must be destroyed when they are no longer needed.
A student nurse has heard about something called the Nurse Licensure Compact. When the student asks a nurse educator, the nurse educator explains that the Nurse Licensure Compact is a:
a. plan for all nurses to need only one license with a large annual fee.
b. project of the National Council of State Boards of Nursing.
c. type of specialized organizational tool used in licensure and NCLEX exams.
d. spinoff of EEOC legislation.
B: The Nurse Licensure Compact is a project of the National Council of State Boards of Nursing and is an agreement among states to allow nurses to be multistate licensed (without applying for a new license) in those states that have agreed to this practice (no extra large fee involved).
A nurse entrepreneur is working with an attorney to develop a contract for a health care-related business that is being started. The attorney explains to the nurse entrepreneur that, according to contract law, an agreement must contain which of the following in order to be legal?
a. Agreement between two people that states what the first party must do
b. Agreement between two people in which a fee was paid up front
c. Mutual understanding of the obligations that the contract imposes on each party
d. Must be a written document
C: Contract law regulates certain transactions between individuals, legal entities, and/or businesses. For a contract to be considered legal, it must contain certain elements such as a mutual understanding of the terms and obligations that the contract imposes on each party (not just the first party) to the contract, and an agreement between two or more legally competent individuals/parties stating what each must or must not do. It can be either oral or written.
There is a going-away party for one of the nurses, who has been promoted to a managerial position in another hospital that is part of the same health care organization. Photographs have been taken of nurses around the unit as a way for the nurse to remember fellow colleagues. If patients are inadvertently photographed and no consent for this is obtained, this is an example of:
a. assault. c. invasion of privacy.
b. battery. d. defamation.
C: Consent must always be obtained for any photographs or use of statements made by patients or to disclose confidential information about a patient. Assault deals with the threat to touch another person against their will, and battery is the actual act of touching or treating another person against their will. Defamation (including libel and slander) is concerned with intentionally giving false information that may cause the loss of a person’s reputation.
A nurse educator informs the class that the reasonable person standard is:
a. it takes a reasonable man to maintain a good relationship.
b. reasonable men tend to have reasonable children and make good partners.
c. used to demonstrate a breach of duty.
d. used by state Boards of Nursing to evaluate the male-female ratios according to clinical position.
C: The reasonable person standard is used by courts when dealing with cases of potential negligence and malpractice to show what a “reasonable nurse would do” in a given situation. Reviewing the organization’s policies and procedures, evidence from the state’s Nurse Practice Act, and the use of expert witnesses to the standard of nursing practice in that community are all examples of aspects of the reasonable person standard.
