Legal and Ethics; Clinical Judgment

Question 1

A patient is admitted to a home health-care program for palliative care. When completing the admission interview and nursing assessment the patient empathetically states, “I want no intervention to extend my life other than keeping me comfortable.” When talking with family members, they want to continue with chemotherapy. What is the nurse’s responsibility?

Protect the patient’s right to self determination

Initiate a referral to a psychiatric nurse practitioner

Ask the patient to reconsider chemotherapy for the sake of the family

Refer family members to the primary health-care provider to resolve this issue

Answer 1

Protect the patient’s right to self determination

Rationale: The patient has right to refuse treatment & be in charge of decisions regarding treatment & care. The RN should support the decisions that are made by the patient. This is the only option that is patient-centered. ACTI’NG as ADVOCATE for the patient

Question 2

Which statements are associated with state nurse practice acts? (Select all that apply.)
_____ Nurse practice acts identify what a nurse can and cannot do.
_____ A purpose of a nurse practice act is to regulate the practice of nursing.
_____ The federal government is the regulating agency responsible for state nurse practice acts.
_____ Student nurses are not obligated to meet the same standards of care as are licensed nurses.
_____ If a student nurse is involved in a disciplinary action by the state board of nursing, the student may be prohibited from taking the National Council Licensure Examination.

Answer 2

_____ Nurse practice acts identify what a nurse can and cannot do.
Rationale: Each state has its own nurse practice act within the state; they identify what an RN can legally do or not do.

_____ A purpose of a nurse practice act is to regulate the practice of nursing.
Rationale: Although state nurse practice acts regulate the practice of nursing, the main purpose is to safeguard the health, safety, & well-being of the public.

_____ If a student nurse is involved in a disciplinary action by the state board of nursing, the student may be prohibited from taking the National Council Licensure Examination.
Rationale: Since student nurses are held accountable for ensuring that standards of care are met, they are subject to disciplinary actions by the state board of nursing. A student nurse may be prohibited from taking NCLEX if it is determined that the student nurse failed to meet standards of care identified in the state nurse practice act.

Question 3

Which term best describes the situation when a nurse says to a pediatric patient, “If you don’t be quiet, I will not let your parents visit you today?”

Battery
Assault
Negligence
Abandonment

Answer 3

Assualt—its a threat

Question 4

what is battery

Answer 4

Battery occurs when a person unlawfully touches another person without consent.

Question 5

what is assault

Answer 5

Assault occurs when a person threatens harm to an individual. The patient does not have to be touched for the nurse to be charged with assault

Question 6

what is negliglence?

Answer 6

Negligence occurs when a patient suffers from an injury when a RN fails to meet a standard of care

Question 7

abandoment

Answer 7

: Abandonment occurs when an RN leaves a patient without an appropriate nursing replacement

Question 8

Which statements accurately pertain to nursing licensure? (Select all that apply.)

_____ A state board of nursing can never revoke a nursing license.
_____ A nursing license can be refused as a result of unlawful actions.
_____ A nursing license is not necessary when practicing nursing in the home setting.
_____ A nursing license allows a nurse to practice in the state in which the license was issued.
_____ A state board of nursing is responsible for ensuring that graduates of accredited schools of nursing take the NCLEX licensure examination.

Answer 8

A nursing license can be refused as a result of unlawful actions.
Rationale: Candidates for licensure must self-report criminal convictions, chemical dependencies & functional ability deficits.

A nursing license allows a nurse to practice in the state in which the license was issued.
Rationale: Each state sets the criteria to practice nursing in that state. Nurse Licensure Compact allows RNs to have a license in 1 state & practice nursing in another state. However the RN is responsible for following the NPA in each individual state.

_____ A state board of nursing is responsible for ensuring that graduates of accredited schools of nursing take the NCLEX licensure examination.
Rationale: Each state’s BON is responsible for ensuring that only graduates of accredited schools of nursing inform state BON of the names of the individuals who have successfully completed a nursing program. The grad then completes an application for NCLEX & this is submitted to the BON

Question 9

For which tort can the nurse be legally charged when the nurse accidentally administers a medication to the wrong patient and the patient experiences a serious reaction?

Malpractice
Assault
Battery
Fraud

Answer 9

Malpractice
Rationale: Malpractice occurs when the RN does not adhere to the standards of nursing practice & it results in injury to the patient. RNs are expected to act in a way a reasonably prudent person with the same education & experience would act in a similar circumstance.

Question 10

A client enters the emergency department with shortness of breath, pedal edema, and reports sleeping in a recliner chair for the past 2 nights. Which would the nurse do first?
A. Obtain a blood sample for BNP
B. Elevate the head of the stretcher
C. Prepare for a 12 lead EKG
D. Auscultate heart sounds

Answer 10

Elevate the head of the bed

Question 11

A client enters the emergency department with shortness of breath, pedal edema and a productive cough. In triage the client is assesses and blood for lab studies are drawn. The client’s BNP levels are elevated and there are crackles throughout the lung fields. Which would the nurse anticipate administering first to the client?
A normal saline fluid bolus
Morphine intravenously
A stat dose of furosemide
A digitalizing dose of digoxin

Answer 11

furosemide

Question 12

touching without consent is considered?

Answer 12

battery

also defined as:

Any intentional offensive touching without consent or lawful justification. The contact can harmful to the pt and can cause an injury or it merely can be offensive to the pts person dignity

Question 13

describes the process to report unethical or incompetent conduct to the State BON

Answer 13

administrative law

Question 14

what is it considered when you consent to one surgery and they perform another?

Answer 14

battery

Failure to obtain consent in situations other than emergencies can result in a claim of battery.

Question 15

• Describes decisions made in legal cases that were resolved in courts. After a case is presented to a judge or jury, there is a report of the issue, facts, findings, that was made to resolve

Answer 15

case law

Question 16

what law is derived from federal and state constitutions

Answer 16

constitutional law

Question 17

what is an example of constitutional law?

Answer 17

can deny medications, abortion, and right to use contraception

Question 18

The ANA code of ethics is

Answer 18

The Code establishes and reiterates the fundamental commitments and values of nurses. It identifies the boundaries of professional nursing practice and loyalties and outlines the duties of nurses extending beyond individual patient encounters. According to the American Nurses Association, the Code of Ethics for Nurses is the “Social contract that nurses have with the United States public. It exemplifies our profession’s promise to provide and advocate for safe, quality care for all patients and communities. It binds nurses to support each other so all nurses can fulfill their ethical and professional obligations.”

Question 19

The 7 ethical principles the Nursing Code of Ethics is based upon include beneficence, nonmaleficence, justice, accountability, autonomy, fidelity, and veracity.

Question 20

Answer 20

Question 21

Answer 21

Question 22

Answer 22

Question 23

Answer 23

Question 24

Answer 24

Question 25

Answer 25

Question 26

what is associated with common law?

Answer 26

HIPPAA

Question 27

under constitutional law (derived from federal and state) a pt can

Answer 27

refuse meds and care

Question 28

Question 29

ex of administrative law or regulatory law

Answer 29

A nurse who does not report unethical or incompetent conduct violates regulatory law.

Question 30

an example of common law

Answer 30

Thus patient confidentiality originated as common law.

Question 31

Nurses witness consent; they do not obtain consent for procedures performed by others

Answer 31

A nurse’s signature as a witness to the consent means that the patient appeared to voluntarily give consent, that the patient appeared capable to give consent, and that the patient signed the consent form in the nurse’s presence. If you suspect that a patient does not understand or did not voluntarily and/or knowingly give consent, notify the health care provider and nursing supervisor.

Nursing students cannot and should not under any circumstances be responsible for or be asked to witness the signing of consent forms because of the legal nature of the document.

Question 32

libel

Answer 32

Libel is the written defamation of character (e.g., charting false defamatory entries in a medical record)

Question 33

slander

Answer 33

Slander occurs when one speaks falsely about another. For example, if a nurse tells people erroneously that a patient has gonorrhea and the disclosure affects the patient’s business, the nurse is liable for slander.

Question 34

Question 35

ask yourself this when looking at negligence

Answer 35

A reasonably prudent nurse under similar circumstances would have provided care differently.

Question 36

Malpractice is a type of negligence. A person being held liable for malpractice must be a professional. Certain criteria are necessary to establish nursing malpractice: (1) the nurse (defendant) owed a duty of care to the patient (plaintiff), (2) the nurse did not carry out or breached that duty, (3) the patient was injured as a result of the breach in duty, and (4) damages or remedies are allowed under state law to “make the person whole” in the eyes of the court. Even though nurses do not intend to injure patients, some patients file claims of malpractice if nurses give care that does not meet the appropriate standards.

Question 37

Common causes of malpractice against nurses include failure to follow the standard of care (e.g., not implementing a pressure injury or fall prevention protocol), failure to communicate important information to another health care provider, failure to document appropriately, failure to assess and monitor a patient, and inappropriate delegation of nursing tasks.

Malpractice sometimes involves failing to check a patient’s identification correctly before administering blood and then giving the blood to the wrong patient. It also involves administering a medication to a patient even though the medical record contains documentation that the patient has an allergy to that medication

Question 38

The standard of proof is typically what a reasonably prudent nurse would do under similar circumstances in the geographical area in which the alleged breach occurred. M

Question 39