Chapter 45 - Legal Issues (Week 5 Quiz)

Question 1

The _____ is a binding practice, ruler, or code of conduct that guides a community or society and is enforced by a controlling authority. Its function is to protect society by est acceptable patterns of behaviors.

Answer 1

law

Question 2

The Nursing Practice Act is an example of a ______ law. This type of law is passed by a the state legislative body to benefit society as a whole.

Answer 2

statutory law

Question 3

T or F: Protecting patient’s privacy rights is a role of the professional nurse, derived from the Bill of Rights.

Answer 3

True

Question 4

HIPAA was passed by Congress in 1996. What does HIPAA stand for? What is it’s purpose?

Answer 4

Health Insurance Portability and Accountability Act

It was put in place to:

• Protect health insurance benefits for workers who lose or change jobs.
• Protect coverage to person with preexisting medical conditions
• establish standards to protect the privacy of personal health information. (Most important for us as RNs)

hipaa training video
https://www.youtube.com/watch?v=7qme5jS5MVA

Question 5

EMTALA (emergency medical treatment and active labor act) requires healthcare facilities to provide emergency medical treatment to pts who seek healthcare in the emergency department regardless of…..

Answer 5

their ability to pay, legal status or citizenship status.

The medical facility must provide medical screening to determine if an emergency exists and to stabilize the patient before transferring him or her to another healthcare facility. p.1111

EMTALA prohibits “patient dumping”—transferring indigent or uninsured patients from a private hospital to a public hospital without appropriate screening and stabilization. When a client comes to the emergency department requesting examination or treatment for an emergency medical condition (including labor), the hospital must provide stabilizing treatment; the client cannot be transferred until he is stable. An exception is made when a hospital does not have the capability to stabilize a patient or when the patient requests a transfer. And in those circumstances, qualified personnel and equipment must be made available to transport the patient, and his medical records must be forwarded to the receiving hospital.

Question 6

Which federal law requires healthcare agencies to provide patients with information about advance directives?
s

Answer 6

Answer:
The Patient Self-Determination Act (PSDA) recognizes the patient’s right to make decisions regarding their own healthcare. It requires that patients be given information about advance directives, which provide autonomy in making healthcare decisions.

The American Nurses Association position statement on nursing functions, related to the PSDA, instructs nurses to provide patients the following assistance:
● Information necessary for informed consent regarding treatment decisions
● Opportunities to express those decisions either verbally or in writing
● Opportunities to receive or refuse desired treatment

Question 7

PSDA Box 45-1

Answer 7

pg 1111

Question 8

A _____ ____ gives direction to others about the person’s wishes regarding life-prolonging treatments if the person becomes unable to make those decisions.

Answer 8

living will

Question 9

A DPOA identifies a person who will make healthcare decisions in the even the patient is unable to do so (a surrogate decision maker). What does DPOA stand for?

Answer 9

Durable Power of Attorney

Question 10

What protections are provided to patients by the Department of Health and Human Services “privacy rule” of the HIPAA?

Answer 10

Answer:
The Health Insurance Portability and Accountability Act (HIPAA) provides patients the following protections:
● Prevent discrimination. Initially intended to keep health plans from discriminating against people on the basis of their medical condition. In most cases, HIPAA allows insurers to limit coverage for a preexisting condition for only 12 months.
● Protect privacy. The privacy regulations provide comprehensive protection for the privacy of patients’ health information. Healthcare agencies must provide reasonable safeguards to protect the confidentiality of records.
● Ensure access. Patients have the right to see and copy their medical records and to correct mistaken information.

Question 11

The ANA highlights the nursing role in PSDA. What are the nurses responsibilities?

Answer 11

1. You must facilitate informed decision making about end of life care
2. Should know laws about Adv. directives
3. You should check to make sure the adv directive is still current and still the pt’s wishes.
4. Ask the following questions about adv directive at nursing admission: a) do you have basic info about AD (including living will and dpoa)?; b) do you wish to initiate an advance care directive? If you have one already can you provide it?; c)Have you discussed your end of life choices with your family or designated surrogate and healthcare team?

Question 12

The ___ _____ ____ Act protects against discrimination of an individual based on a physical or mental impairment that substantially limits one or more major life activities.

Answer 12

Americans with Disabilities Act.

Question 13

What are some examples of things the mandatory reporting laws say we must report?

Answer 13

communicable diseases; physical/sexual/emotional abuse; neglect of children, older adults, the mentally ill (whether you suspect it or see evidence of it).

Although you are protected for reporting, you are not protected if you look the other way. Duty to report overrides pt’s right to privacy.

Question 14

What law protects those who provide emergency care to someone who has been injured from being liable?

Answer 14

good samaritan law

Question 15

To successfully use the good samaritan law, the following elements must be present:

Answer 15

1. care was provided in an emergency situation
2. person providing care did not cause the emergency.
3. Care provided in reasonable competent manner
4. care was voluntary (not paid)
5. person receiving did not object to the care.

Also, call 9-1-1, transfer care to equal competent professional (EMT etc), do not accept payment for care.

Question 16

Nursing Practice Acts are statutory laws passed by each state’s legislation to define nursing. THey are designed to….

Answer 16

1. protect pts or society
2. define the scope of nursing practice
3. Identify the minimum level of nursing care that must be provided to clients

Question 17

Student Disc - Ch 45 - Tables boxes figures

Answer 17

box 45-2 min acceptable std or care required by typical NPA

Question 18

_____ ______ refers to a lawsuit brought against a healthcare provider for damages due to the death, injury, or other loss of the person being treated.

Answer 18

medical malpractice

malpractice - failure of a professional person (nurse dr etc) to act in a reasonable and prudent manner (prudent - acting with or showing care and thought for the future).

Question 19

The ANA Code of Ethics describes standards of professional responsibility for nurses and provides insight into ethical and acceptable behavior. It describes nurses’ obligations for ….

p.1114

Answer 19

safe, compassionate, nondiscriminatory and quality care while defining commitments to self, the patient the employer and the profession.

This is not a law that can bring criminal charges but it is a good guideline to stay out of trouble with the laws! You may have to answer to the board of nursing if you violate the code of ethics…

Question 20

ANA’s code guarantees the pt the right to dignity, privacy, and safety. The ANA code also gurantees the nurse will:

Answer 20

Be accountable and competent, use informed judgment, maintain employment conditions conducive to quality pt care, protect the pt from misinformation and misrepresentation, collaborate with other healthcare prof to meet pt needs.

Question 21

The AHA pt bill of rights was replaced with the _ _ _ which states the patient should expect high quality care, a clean/safe environment, involvement in care, protection from privacy, help when leaving the hospital, help with billing claims.

Answer 21

PCP (Patient Care Partnership)

Question 22

The ANA created a bill of rights for nurses to identify the seven conditions that a nurse can expect from their workplace that are necessary for sound professional practice. It is meant to provide a guide for employers to understand what makes a safe work environment and to support nurses. What are some highlights from the nursing bill of rights?

Answer 22

1. Practice in a manner that fulfills their obligations to society and to those who receive nursing care
2. practice in environments that allow them to act in accordance with prof standards and legally auth scopes of practice (work needs to set the same standards or higher)
3. a work environment that support and facilitates ethical practice in the code of ethics for nurses
4. freely and openly advocate for themselves and their patients without fear or retribution
5. Fair compensation for their work, consistent with their knowledge, experience, and professional responsibilities
6. A work environment that is safe for themselves and their patients
7. negotiate the conditions for their employment either as individ or collectively in all practice settings.

Question 23

ANA standards of practice provides guidelines for …

Answer 23

1. Prof standards of care (includes nursing process)
2. Professional performance (identifies our role functions and expectations)
3. Practice guidelines for specialty areas

Question 24

How does each of the following protect patients: the Patient Care Partnership, nursing codes of ethics, and mandatory reporting laws?

Answer 24

Answer:
These standards protect patients as follows:
● Patient Care Partnership. The American Hospital Association Patient Care Partnership identifies some rights that are guaranteed to a patient while in the healthcare setting. Although not all of the rights are legally binding, some courts look to such documents as part of the overall picture of whether patient care has met the applicable standard.
Nursing codes of ethics. Although they are not laws, nursing codes of ethics specify duties of the nurse to the patient, with corresponding patient rights. The ANA Code guarantees the patient:
● The right to dignity (including the right to self-determination), privacy, and safety
● That the nurse will be accountable and competent, use informed judgment, maintain employment conditions conducive to quality patient care, protect the client from misinformation and misrepresentation, and collaborate with other healthcare professions too meet the patient’s healthcare needs
In a negligence or malpractice suit, these guarantees may be used as standards for judging the nurse’s actions. For more information on the ANA Code of Ethics,

Refer to Chapter 45 in Volume 1.

● Mandatory reporting laws. Most states have mandatory reporting laws related to abuse of children and older adults. Elder abuse laws provide protection to those persons over age 60 from actions that cause serious physical or emotional injury, caretaker neglect, and financial exploitation. The same protections are provided to children under the child abuse laws. The states vary in their requirements for mandatory reporting of abuse to the disabled, sexual assaults, and specific traumatic injuries. Laws requiring the reporting of communicable diseases help prevent spread of diseases.

Question 25

Nursing Practice Acts vary state to state, but have common components which include…

Answer 25

1. The authority of the board (composition and the power it holds)
2. A definition of nursing and nursing boundaries (the can and cannots, the do’s and the musts).
3. Standards for education programs for nurses (expectations of the school )
4. Requirement for licensure (hours, education level, etc)
5. Grounds for disciplinary action against nurse’s license

Question 26

T or F: ANy nurse who practices outside the scope of practice as defined in the NPA can be charged with violation of the Nurse Practice Act.

Answer 26

True

Even if a dr tells you to do something and “turns a blind eye” to the rules, you should not.

p.1116

Question 27

The state board of nursing can take disciplinary actions against your license for violation of the NPA. The process begins with….

Answer 27

A complaint from an individual, employer, or prof organization that the nurse has engaged in unprofessional conduct.

Next steps:

• Complaint assigned to investigator
• Investigator determines if valid.
• Case heard by Board of Nursing (you can appeal if you do not like the decision)

Question 28

Accreditation of nursing schools ensures that…

Answer 28

students receive education that meets the minimum standard for quality and that patients are cared for by safe practitioners.

Question 29

______ law deals with wrongs or offenses against society. May result in prosecution by state or federal govt.

Answer 29

criminal

Question 30

______ involve crimes punishable by more than one year in jail. A person with this type of convication loses their right to vote, hold public office, serve on a jury, and to posess firearms.

Answer 30

felony

Question 31

_____ is a minor charge. It involved less than a year in jail.

Answer 31

misdemeanor

Question 32

_____ law involves a dispute between individuals or entities.

There are two types of civil law:
_____ law involves a written or oral agreement between tow parties.

____ law deals with wrongs done to one person by another that does not involve contracts.

Answer 32

civil

contract

tort

Question 33

What is a quasi-intentional tort?

Answer 33

Involves actions that injure a person’s reputation (defamation of character).

To use this all four elements of defamation of character must be present:

1. was false
2. was made to another person or persons
3. Caused the defamed person to experience shame and ridicule and had a negative impact on the person’s reputation
4. Was made as a statement of fact rather than as an opinion

Question 34

_____ is the written or published forma of a defamation of character. _____ is the spoken or verbal form of defamation of character.

Answer 34

Libel; slander

Question 35

____ tort is an action taken by one person with the intent to harm another person.

Answer 35

intentional tort

Common intentional torts in nursing are: assault, battery, false imprisonment, and invasion of privacy.

Question 36

_____ occurs when a nurse intentionally places the pt in immediate fear of personal violence or offensive contact. It must include words and an action. Ex: the nurse raises her hand and says to the pat “I will slap you!”

Answer 36

assault

Question 37

_____ is commited when 1)offensive or harmful contact was made without pt consent; 2)there is unauthorized touching of a person’s body by another person.

Answer 37

battery

Question 38

______ _______ is the restraining of a person without proper legal authorization. It includes any type of unjustified restriction on a person’s freedom of movement.

Answer 38

False imprisonment

Question 39

T or F: You may restrain a pt who poses a threat or harm to themselves or other for safety.

Answer 39

True. However you must immediately obtain the proper authorization to continue the restraint.

Question 40

_______ __ ______ violates a person’t right to be left alone.

Answer 40

invasion of privacy

A person has:

• right to have private info protected
• right to not be falsely portrayed or intentionally misrepresented in character, beliefs, or actions
• right to be free from unwanted intrusion (spying/eavesdropping)

Examples of violations: discussin pt in public, photos without permission, providing info to news media, searching pt belongings, releasing med info without patient’s consent.

Question 41

_____ is the false representation of significant facts by words or by conduct. (False statements, false documents, concealing info). It is intentionally misleading or deceiving for personal gain.

Answer 41

fraud

Question 42

What are non-intentional torts? what are the most common?

Answer 42

unintentional wrong doing

Negligence and malpractice are the most common.

Question 43

To win and recover damages, the plaintiff of a malpractice suit must provide four elements:

Answer 43

1. duty (nurse-pt relationship creates this legal obligation; it begins when pt is assigned to you or when you witness harm done to someone else’s pt)
2. breach of duty (nurse fails to meet standards of care as define by NPA, job description, hosp policies&procedures, textbooks, code of ethics etc)
3. causation (the breach of duty must be the direct and proximate cause of injury to pt. Hardest to establish.)

The plaintiff must prove that (1) the nurse’s acts (or failure to act) actually caused the plaintiff’s injury and (2) the type of injury was foreseeable or a logical consequence of the breach of the nursing standard.

4. damages - usually $$ awarded.

The plaintiff must also prove that there has been an actual injury or damage. For example, even though a nurse administers the wrong medication, if no injury occurred to the patient, then he will not be able to prove a negligence case and recover damages under civil law. However, the patient may file a complaint before the board of nurse examiners to obtain sanctions against the nurse under administrative law.

p.1120

Question 44

Distinguish negligence from malpractice.

Answer 44

Answer:
These terms differ as follows:
● Negligence is a wrong committed against an individual by one who has failed to use ordinary care.
● Malpractice is a subset of negligence: a wrong committed against an individual by a licensed professional.

Question 45

Distinguish civil law from criminal law.

Answer 45

Answer:
These laws differ as follows:
● Under civil law, the courts seek to resolve a dispute between private parties, which may result in damages or payment of money by the losing party. Tort law and contract law are types of civil law.
● Under criminal law, the federal or state government seeks to penalize the accused for an offense against society.

Question 46

Under which type of law (constitutional, statutory, administrative, or common law) does each of the following fall?

1. A defendant claiming the right not to incriminate himself under the Fifth Amendment
2. A nurse having her license revoked by the state board of nursing
3. The wording of a state nurse practice act

Answer 46

1. Constitutional, statutory, and case law
2. Administrative law
3. Statutory law

Question 47

● Define plaintiff and defendant in the context of civil law.

Answer 47

Answer:
In the context of civil law, these terms have the following definitions:
● A plaintiff is the person bringing a lawsuit seeking damages or other relief.
● The defendant is the person who is being sued or accused of wrongdoing.

Question 48

The law will assign liability to a person or entity that did not directly cause the injury but with whom you have a special kind of relationship. This type of liability is known as _____ or ______ liability.

Answer 48

vicarious or substitute

Captain of the Ship-Surgeon held responsible for actions of those on his/her team. Not recognized in some states. RN held to their own actions.

Borrowed Servant Doctrine-relieves the hiring agency of liability if the person was “borrowed” and makes a mistake while at the borrowers facility. (Agency nurses)

Respondent superior - “Let the master answer.” Hospital can be sued for a nurse making a med mistake.

Question 49

if you are served a complaint (legal doc outlining how the plaintiff has been harmed), you must do what?

Answer 49

immediately notify your supervisor, your malpractice insurer and secure an attorney.

Question 50

What happens during the discovery phase of litigation?

Answer 50

. The discovery process consists of pretrial activities designed to provide both parties with knowledge of any facts and evidence of the case.

Discovery is designed to make sure there are no “surprises” during the trial.

Discovery may be obtained through written questions, requests for documents and other evidence, and by deposition (counselors orally question parties to the suit under oath, as though the person were testifying in a courtroom).

You may be deposed as a party to the lawsuit, as a fact witness, or as an expert witness.

Prior to the deposition, you should review all pertinent medical records and other information.

Keep in mind the opposing counsel can request a copy of anything you use in your preparation.

If you are deposed, do not volunteer information; answer questions factually—if they can be answered “yes” or “no,” then do so.

Take your time before answering a question; this allows your attorney to make any necessary objections.

Tell the truth, but base your answers on facts; do not speculate. Remain calm; do not get angry, argue, or be sarcastic.

Question 51

The three most common methods of alternative disputing resolution (to avoid going to trial) are:

Answer 51

1. negotiation - Negotiation takes place informally between the parties through their lawyers.
2. mediation - is the attempt to resolve the dispute through a neutral party; it is usually not binding.
3. arbitration - similar to mediation, but more formal and sometimes binding. A neutral third party with expertise in the area of contention hears the case and renders a decision.

Question 52

The most common causes of nursing malpractice claims are:

Answer 52

1. failure to assess and diagnose
   * perform an admission assessment; analyze assessment data to clearly identify problems; apply theoretical knowledge to ensure a correct diagnosis (RN DX is pt response related to etiology); conduct frequent focused assessments (til end of shift or prob is resolved).
2. failure to plan
   * plan should be consistent with standards of treatment acceptable for given diagnosis. Know the correct approach; have theoretical knowledge base to successfully plan; develop individualized plan for pt.
3. failure to implement
   * Do what you said you would do in your plan
4. failure to evaluate
   * observe for changes, recognize the significance of the change, document and report symptoms, follow up on patient responses.

Question 53

State the four requirements of the nurse’s duty to assess.

Answer 53

Answer:
The nurse’s duty to assess has these four requirements:
● The nurse must have the necessary knowledge and skills to observe the patient and interpret the symptoms in the form of a nursing diagnosis.
● The nurse must actually carry out the assessment.
● When the assessment reveals adverse symptoms, the nurse must report the symptoms to the appropriate provider and carry out the standard nursing care and ordered interventions.
● The nurse must continue to assess and monitor until the patient is stable.

Question 54

State four ways in which the nurse may fail to implement a plan of care.

Answer 54

● Failure to respond, such as not intervening to care for the patient’s specific symptoms or expressed request for care.
● Failure to educate, such as not answering questions, not teaching self-care measures, or not explaining procedures or equipment adequately on discharge.
● Failure to follow standards of care and institutional policies and procedures. This most commonly occurs in the form of medication errors and failure to follow a physician’s orders. It also frequently occurs from not using equipment responsibly. Failure to follow standards of care may also occur when the unit is understaffed or the nurse is inexperienced.
● Failure to communicate often takes the form of failing to seek medical authorization for a treatment or failing to notify a physician in a timely manner when the patient’s condition warrants.
● Failure to document the following in the patient’s record: assessment data (e.g., drug allergies), patient injuries, medication administration details, patient progress and response to treatment, physicians’ orders, and telephone conversations with physicians.
● Failure to act as an advocate. Nurses must frequently intervene to prevent harm to the patient by other healthcare providers and by relatives and significant others. The following are examples of advocacy duties:
● Medical and discharge orders. To act as an advocate, you must be knowledgeable about medical orders, and you must intervene when you believe an incorrect order has been given, for example, when a medication may cause an adverse reaction in the patient. You have a duty to question incomplete or illegible orders and discharge orders when you believe the patient is not well enough to be discharged.
● Impaired nurses. You have a duty under most state nursing practice acts to advocate for patients by reporting impaired nurse’s practice (e.g., as a result of alcoholism or mental illness) to the appropriate licensing agency. This will be discussed more in a later section.
● Family and significant others. Advocacy includes reporting neglect and intentional injuries to patients who are children, older adults, or disabled. Failure to do so may constitute negligence.

Question 55

Give one example of the duty to advocate for a patient.

.

Answer 55

Examples of patient advocacy may include the following duties:
● Duty to be knowledgeable about medical orders and to intervene in instances where an incorrect order has been given, such as a medication that may cause an adverse reaction in the patient.
● Duty to question incomplete or illegible orders and to question discharge orders when a patient’s condition warrants it.
● Duty to report the impaired nurses to the appropriate licensing agency.
● Duty to report neglect and abuse of patients by relatives and significant others

Question 56

List the four components of the nurse’s legal duty to evaluate.

Answer 56

Answer:
The nurse’s legal duty to evaluate includes these four components:
● Observing for changes
● Recognizing the significance of the change
● Documenting or reporting symptoms to the appropriate person
● Follow-up

Question 57

How can you minimize the risk of malpractice?

Answer 57

1. perform timely assessments and document your findings for every pt interaction
2. Communicate all changes in your patient’s status to the primary healthcare provider and document those changes.
3. use proper chain of command to ensure appropriate and timely care when the primary healthcare provider is not available.

Question 58

The following is an overview of how you can minimize your malpractice risk based on NPA’s miniumum standards of care…

p.1125-1128

Answer 58

Minimum Acceptable Standards of Care Required by a Typical State Nursing Practice Act

Use the nursing process to provide prof standards of care - systematic approach to pt care; legally acceptable model of decision making. ADPIE!

Accurately administer medications and treatments -
Follow the rights of med admin; know the rationale for giving the medication, safe dosage range, side effects of the med, and relevant information to teach the patient about medication. Investigate pt concerns; question anything that doesn’t feel right. Use the correct technique.

Accurately, truthfully, and completely report and document care- “If it wasn’t documented it wasn’t done.” Always chart as if a third person will be reading your chart and need to understand it and as if you are going to be on trial.

Provide for patient safety - assess pt for fall risk; don’t forget to put the call button within reach;

Maintain patient confidentiality - only discuss the patient with those who have the need to know. Don’t assume you can tell parents about their child, if the child is grown up and married, they do not have the right to know. Get pt consent!

Educate and counsel the patient - review written materials with them, ask them to repeat back instructions or do return demonstration.

Employ, Assign, Delegate nursing care in a reasonable manner - delegation helps with timely care, but make sure you know who is allowed to do what.

Don’t accept assignments you are not qualified for. Never leave your floor without letting the charge nurse know. Ensure adequate staffing for patient coverage

Supervise nursing care in a reasonable manner

Participate in ongoing and continuing educational training

Maintain professional boundaries - do not accept gifts, do not date your pt, etc. (Violations can be physical, sexual, emotional or financial in nature)

Prevent patient abuse or injury, Report violations of the nursing practice act

Follow procedures for medication wastage

Prevent misappropriation of things of value
Follow pharmacy laws and regulations
Provide truthful information to the board of nurse examiners
Not accept fees for referral
Repay guaranteed student loans

Question 59

If standard care is breached or unusual incident occurs you should complete an _____ report

Answer 59

incident report

Do not document this in the patient’s chart. It is kept separately.

Question 60

______ _____ is the permission for any and all types of care given by the patient with full knowledge o the risks, benefits costs and alternatives.

Answer 60

informed consent

In emergency situations consent is implied/assumed.

If a patient is being pressured by family to sign, it makes the consent invalid

Question 61

List some potential violations between nurse and client…

Box 45-4 p. 1128

Answer 61

1. excessive self-disclosure (discussing personl problems or intimate details with pt)
2. Flirtation -
3. secretive behavior
4. “Super Nurse” attitude
5. Excessive attention to client
6. Unclear communication

Question 62

What is a safe harbor law?

Answer 62

protect you from being suspended, terminated, discisplined of discriminated against for refusing to do something you believe would be harmful to a patient.

Question 63

A 67-year-old man has been admitted to the hospital for a surgical procedure. During the admission process, the nurse asks if he has a living will or a durable power of attorney. The patient asks, “What is a living will?” The best response by the nurse would be which of the following?

1) “A living will and a durable power of attorney are both advance directives.”
2) “A living will states a patient’s wishes regarding future healthcare if he becomes unable to give instructions.”
3) “A living will identifies a person who will make healthcare decisions in the event the patient is unable to do so.”
4) “I will tell a case manager that you would like additional information.”

Answer 63

Answer:
2) “A living will states a patient’s wishes regarding future healthcare if he becomes unable to give instructions.”

Rationale:
Generally, there are two types of advance directives: a living will and a durable power of attorney. A living will is a directive that declares the patient’s wishes should the patient become unable to give instruction. A durable power of attorney identifies a person who will make healthcare decisions in the event the patient is unable to do so. Simply saying a living will and durable power of attorney are both advance directives is broadly stated and does not give as much information to the patient.

Question 64

For which of the following examples of conduct by nurses would the American Nurses Association recommend disciplinary action by state boards of nursing? Choose all that apply.

1) Committing medication error
2) Taking excessive sick time or personal leave
3) Restraining a patient without obtaining informed consent
4) Failing to report a person practicing nursing without a license

Answer 64

Answer:

3) Restraining a patient without obtaining informed consent
4) Failing to report a person practicing nursing without a license

Rationale:
The American Nurses Association (ANA) recommends the following unprofessional conduct result in disciplinary action: violation of the nursing practice act or rules, fraud, deceit, criminal activity, negligence, risk to clients, physical or mental incapacity, disciplinary action by another jurisdiction, incompetence, and unethical conduct.

State boards of nursing enforce the requirements of nursing practice by establishing disciplinary actions for unprofessional conduct, including negligence. Restraining a patient without informed consent is considered false imprisonment, which is an intentional tort.

Medication administered in error might be the grounds for liability in a nursing lawsuit. However, the error when unintentional is not necessarily the basis for disciplinary action. Nurses must report the unauthorized practice of nursing. Excessive use of sick time and personal leave may result in disciplinary action by the manager but would not warrant action by the state board.

Question 65

The nurse’s legal role in obtaining written consent from a patient for any treatment or procedure includes which of the following? Choose all that apply.

1) Determining that the elements of a valid informed consent are in place
2) Explaining to the patient the treatment and potential complications before he signs the consent
3) Communicating the patient’s needs for more information to the provider who will perform the procedure
4) Evaluating whether the patient’s provider has adequately explained the treatment and options before the patient signs the consent

Answer 65

Answer:

1) Determining that the elements of a valid informed consent are in place
3) Communicating the patient’s needs for more information to the provider who will perform the procedure

Rationale:
As a nurse, your legal role regarding written consent is to collaborate with the provider who will perform the procedure. You may witness a patient’s signature on the consent form, but

…. you are not legally responsible for explaining the treatments and options nor for evaluating whether the physician has adequately explained them…..

You must, however, determine that the elements of a valid informed consent are in place, communicate the patient’s need for more information to the physician, and provide feedback to the physician if the patient wishes to change her consent.

Question 66

A registered nurse administers the wrong medication to a patient. As a result, the patient suffers an injury that requires a longer hospital stay. The patient can sue the hospital under the doctrine of which of the following?

1) Battery
2) False imprisonment
3) Vicarious liability
4) Statute of limitations

Answer 66

Answer:
3) Vicarious liability

Rationale:
Vicarious liability is also known as substituted liability, where another party is responsible for the negligence or malpractice of another person.

Sue THE HOSPITAL for NURSE mistake….

Question 67

A nurse carried her own professional liability, a claims-made policy, from May 1, 2010, until April 30, 2011. She did not renew her professional liability policy, but purchased the tail coverage because she was starting law school on July 15, 2011, and did not plan to work as a nurse. A malpractice lawsuit was filed against her on July 3, 2011, arising out of an incident that occurred in December, 2010. The plaintiff won the lawsuit. The statement that best describes the nurse’s situation is that her insurance policy will

1) not cover her.
2) cover her.
3) cover her only if she is working as a nurse.
4) cover her if she renews her policy within 3 months.

Answer 67

Answer:
2) cover her.

Rationale:
A claims-made policy covers claims that were made and reported during the policy period. The purchase of the tail insurance extended the coverage of the policy. If the nurse had not purchased the tail insurance, she would not have been covered.

Question 68

A registered nurse’s primary state of residency is Utah, a compact state. She wants to practice nursing in the state of Nevada, which is a non-compact state. The nurse

1) should retake the NCLEX-RN examination for practice in Nevada.
2) must apply for licensure by compact endorsement.
3) can practice under the mutual recognition agreement.
4) must request a permissive license from the Utah Board of Nursing

Answer 68

Answer:
2) must apply for licensure by compact endorsement.

Rationale:
The mutual recognition model of nursing applies to states that have entered into the compact agreement. The agreement does not extend to those states that have not entered into the compact agreement (Nevada).