Chapter 5

Question 1

Separate but equal branches of government

Answer 1

Executive, legislative, and judicial

Question 2

decisional. Judges’s ruling become law.

Answer 2

Common law

Question 3

established through formal legislative processes.

Answer 3

Statutory law

Question 4

delegated authority to government agencies.

Answer 4

Administrative Law

Question 5

recognized and enforces the rights of individuals in disputes over legal rights or duties of individuals in relation to one another.

Answer 5

Civil Law

Question 6

involves public concerns regarding an individual’s unlawful behavior that threatens society.

Answer 6

Criminal Law

Question 7

to protect the public health, safety, and welfare.

Answer 7

purpose of licensing

Question 8

defines and controls nursing

Answer 8

nursing practice act

Question 9

regulatory bodies

Answer 9

State Boards of Nursing

Question 10

establishes and amends laws regarding nursing practice. The legislature delegates authority to enforce the law to an executive agency: board of nursing.

Answer 10

Legislature

Question 11

enforces the laws and publicizes rules and regulations that expand the law.

Answer 11

The state board of nursing (BON)

Question 12

Executive Authority of State BON:

Answer 12

The state boards of nursing authority is limited. They can adopt rules that clarify general provisions of NPA. They do not have the authority to enlarge the law.

Has the authority to set and enforce minimum criteria for nursing education criteria.

Has the power to sanction a nurse for performing professional functions that are dangerous to the patient or general public. Probation, suspension, and revocation.

-An applicant for licensure must graduate from a state-approved nursing education program.
-Schools of nursing must have state-approval to operate.
-State-approvals are less stringent than national accreditation standards.
-Some states are undertaking rule changes to require nursing programs to have national accreditation to achieve state approval.

Question 13

Functions of state boards of nursing:

Answer 13

Executive: authority to administer the nursing practice act

Legislative: authority to adopt rules necessary to implement the act

Judicial: authority to deny, suspend, or revoke a license or to discipline a licensee or to deny an application for licensure.

Question 14

Types of Licensure Laws:

Answer 14

Mandatory law
Permissive Law

All states have a mandatory licensure law for the practice of nursing to safeguard the public. Thus, only licensed nurses, RN or LVN/LPN, can practice nursing.

Question 15

requires any person who practices the occupation or profession to be licensed.

Answer 15

mandatory law

Question 16

protects and limits the use of the title gained in the law but does not prohibit persons from practicing the occupation/profession if they do not use the title.

Answer 16

permissive law

Question 17

Most common reason for disciplining nurses:

Answer 17

Practicing while under the influence of alcohol or drugs (diverted from workplace).

Question 18

the RN may practice in different states without having to take another licensing exam.

Requirements: proof of licensure in another state and licensure fee.

Answer 18

License by Endorsement

Question 19

Legal risk in nursing Practice:

Answer 19

Malpractice occurs when a professional fails to act as a reasonably prudent professional would have acted under the same circumstances. Professional negligence (malpractice) may occur by: Commission (doing something that should not have been done) and omission (failing to do things that should have been done.)

Question 20

Four Elements of a Cause of Action for Negligence:

Answer 20

1. The professional (nurse) has assumed the duty of care (responsibility for the patient’s care).
2. The professional (nurse) breached the duty of care by failing to meet the standard of care.
3. The failure of the professional (nurse) to meet the standard of care was the proximate cause of the injury.
4. The injury is proved.

Question 21

Who can delegate?

Answer 21

Professional nurses may delegate independent nursing activities (as well as medical functions that have been delegated to them) to other nursing personnel.

State nurse practice acts do not give LPNs or LVNs the authority to delegate.

Question 22

What retains accountability for acts delegated?

Answer 22

Professional RNs retain accountability for acts delegated to another person.

-RN is responsible for determining that the delegated person (delegatee) is competent to perform the delegated act.

-The delegatee is responsible for carrying out the delegated act safely.

-The professional nurse remains legally liable, however, for the nursing acts delegated to others unless the delegatee is also a licensed professional whose scope includes the assigned act.

Question 23

5 rights of delegation:

Answer 23

1. Right Task: Is the task appropriate for delegation in a specific care situation?
2. Right circumstances: Is delegation appropriate in this case? Consider the patient’s health status, care delivery setting, complexity of the activity and delegate’s competency, and available resources, and determine any other relevant factors.
3. Right person: Can the nurse can verify that the person delegated to do the task is competent to complete this task?
4. Right direction/ communication: Has the RN given clear, specific instructions? These include identifying the patient clearly, the objective of the task, time frames, and expected results.
5. High supervision/ evaluation: Can the RN or other licensed nurse provide supervision and evaluation of the patient and the performance of the task?

Question 24

3 Major Conditions of Informed Consent

Answer 24

1. Consent must be given voluntarily
2. Consent must be given by an individual with the capacity and competence to understand
3. The patient must be given enough information.
   -RN’s may witness, but are not responsible for explaining the proposed treatment or evaluating if the risks/benefits have been explained clearly. RNs ARE responsible for determining if the elements for consent are evident.

Question 25

legal and ethical concern. Protection of private information gathered about a patient during provision of care.

Answer 25

confidentiality

Question 26

requires all health care providers, including physicians, hospitals, health plans, pharmacies, public health authorities, insurance companies, billing agencies, information systems sales and service providers, and others to ensure the privacy and confidentiality of patients.

Answer 26

HIPAA: Health Insurance Portability and Accountability Act (HIPAA)

Question 27

HIPAA regulations require several major patient protections:

Answer 27

Patients are able to see and obtain copies of their medical records, generally within 30 days of their request, and to request corrections if they detect errors. Providers may charge patients for the cost of copying and mailing the records.

Providers must give patients written notice describing the provider’s information practices and explaining patients’ rights. Patients must be asked to agree to these practices by signing or initialing the notice.

Limitations are placed on the length of time records can be retrieved, what information can be shared, where it can be shared, and who can be present when it is shared.

Question 28

is a threat or an attempt to make bodily contact with another person without the person’s consent.

Answer 28

assault

Question 29

is the assault carried out; the impermissible, unprivileged touching of one person by another.

Answer 29

battery

Question 30

1. Provide written information to all adult patients about their rights under state law.
2. Ensure institutional compliance with state laws on advance directives.
3. Provide for education of staff and the community on advance directives.
4. Document in the medical record whether the patient has an advance directive.

Answer 30

Patient Self-Determination Act (PSDA):

Question 31

Limiting possible legal action:

Answer 31

1. Practice in a safe setting
2. Communicate with other health professions, patients, and families including accurate documentation
3. Meet the standard of care
4. Carry and understand professional liability insurance
5. Promote positive interpersonal relationships.