mod 2 legal

Question 1

4 categories of law

Answer 1

• Administrative - executive branch (nursing regulation) - Tort - civil court system, can be criminal (against nurse) - constitutional - legislative branch (HIPAA) - federal/state health care statutory - legislative (HIPAA)

Question 2

Tort (criteria for malpractice)

Answer 2

1. damages- suffer injury? 2. causation- RN action or inaction cause injury? 3. breach of duty- rn conduct violate responsibility to pt 4. duty- rn have legal obligation?

Question 3

types unintentional malpractice

Answer 3

1. failure to properly assess pt - duty assess pt and analyze level of care 2. failure communicate pt finings in timely manner - must communicate changes 3. failure take appr. action - follow hcp and treat pt 4. failure document- must always document 5. failure use eq approp- must always learn use eq responsibly 6. failure preserve pt privacy- protect pt privacy 7. failure act pt advocate- always put pt safety and well-bring first

Question 4

types intentional malpractice

Answer 4

1. assault - intentional threat 2. invasion privacy- health info shared or obtains w/out pt consent 3. intentional infliction emotional distress - actions leads emotional distress 4. battery- intentional offensive touching w/out consent

Question 5

standard of care- tort law

Answer 5

set of guidelines based on various types evidence as what is reasonable and prudent for health care prof in same or similar circumstance

Question 6

constitutional law

Answer 6

14th amendment- right to refuse treatment

Question 7

never events

Answer 7

events subject to nonpayment/funding 1. Retained foreign object after surgery 2. Air embolism 3. Stage III and IV pressure ulcers 4. Blood incompatibility (blood transfusion error) 5. Falls 6. Poor outcomes associated with poor glycemic control 7. Catheter-associated urinary tract infections 8. Vascular catheter infections 9. Surgical site infections 10. Deep vein thrombosis or pulmonary embolism

Question 8

In the case study of Moon v St Thomas Hospital, which actions by the nurse contributed to the nursing malpractice award?

Answer 8

• Failure to notify the health care provider - Failure to request a prescription for a bite block - Failure to reposition the tube to prevent biting

Question 9

Match the type of law with the correct description

Answer 9

Governs the professional practice of nursing - Administrative Associated with civil lawsuits - Tort Laws associated with the Bill of Rights - Constitutional Patient Protection and Affordable Care Act - Federal statutory

Question 10

A registered nurse (RN) is precepting a newly graduated RN. Which statement by the new RN indicates understanding of the newly acquired nursing license?

Answer 10

“The state board of nursing has the authority to restrict me from practicing as a nurse.”

Question 11

Nurse Decision Tree

Answer 11

Question 12

safe delegation

Answer 12

1. right person- able to perform task?
2. right direction/communication- rn give clear and concise instructions?
3. right supervision/evaluation- rn supervise and evaluated tasks?
4. right task- task appropriate?
5. right circumstance- is delegation appropriate?

Question 13

Which events would require an incident report to be filed?

Answer 13

• An incident resulting in the unexpected death of a patient

• A patient who is not treated timely with antibiotics because of failure to report a positive culture
• A malfunction of medical equipment

Question 14

Which statement is correct regarding delegation?

Answer 14

When making the decision to delegate, the RN is ultimately responsible.

Question 15

Which conditions must be met for informed consent to be considered valid?

Answer 15

• Consent must be given freely.
• Alternatives to treatment must be clearly stated.
• The risks and benefits of the treatment must be clearly defined.
• Patients must be able to understand to what they are consenting.

Question 16

end of life issues

Answer 16

Euthanasia is defined as a legally competent patient making an informed and voluntary choice to have a medically assisted death. The patient explicitly asks the health care provider for assistance to die and gives informed consent for the actual procedure of euthanasia to be performed.

Assisted suicide, however, is a medically assisted death in which a qualified health care provider supplies the patient with the means of taking his or her own life but does not perform the actual actions required to cause the death (Johnstone, 2019).

Question 17

euthanasia

Answer 17

active- lethal injection

passive- medical support is withdrawn

nonvoluntary- pt unable (mentally or incapacitated) give consent, but act can justified on moral grounds

voluntary- pt gives consent

Question 18

issues to address when pt refusing care

Answer 18

1. establish mental competence
2. id pt understanding
3. involving others
4. documenting

Question 19

Which statement by the spouse of a patient who was left in a persistent vegetative state after a motorcycle accident indicates the spouse needs further education regarding end-of-life care?

Answer 19

“If the health care provider withdraws medical support to relieve his suffering, it is nonvoluntary.”

Question 20

The Death with Dignity Act allows health care providers to prescribe life-ending medication to anyone who is mentally competent and diagnosed with an illness giving them less than how many months to live? Record your answer as a whole number.

Answer 20

6 months

Question 21

Which ethical principle supports the patient’s right to refuse treatment or medical care?

Answer 21

Autonomy

• Autonomy is the ethical principle of an individual’s right to determine his or her own actions. The right to refuse treatment is based on the ethical principal of autonomy and is supported by legislation in the US Constitution.

Question 22

The nurse is caring for a patient for whom the health care provider has prescribed an injection to treat a sexually transmitted infection. The patient has requested oral antibiotics instead of an intramuscular injection. The nurse believes that the patient is acting childishly and is threatening to give the injection without the patient’s consent. This action could lead to which type of lawsuit in nursing?

Answer 22

assault

Question 23

Which incidents are examples of never events and subject to nonreimbursement from the Centers for Medicare and Medicaid Services?

Answer 23

• pt falling out of bed
• e.coli bacterial central venous line infection
• retained surgical obj after surgery
• staphylococcal surgical site infection

Question 24

The nurse is filling out an incident report after finding an older adult patient on the floor beside the bed. Which guidelines would the nurse follow when completing the report?

Answer 24

• describe objectively how nurse found pt
• notify management critical event occurred

Question 25

When a patient is refusing medical treatment, which information should be included in the documentation?

Answer 25

• pt being sound mind
• support system present for pt
• risk assoc. w/refusal of care
• pt signature on doc w/all presented info

Question 26

How did the 2010 Patient Protection and Affordable Care Act affect the ability for individuals to receive health care?

Answer 26

stipulated there would be no out-of-pocket expenses for preventative services

Question 27

Which statements are correct regarding state nurse practice acts?

Answer 27

• state nurse practice act delineate what nurse can and cant do
• nurse practice acts id who can use title of rn
• NPA revised periodically reflect changing society
• define bx considered misconduct

Question 28

Which information should be included in patient documentation?

Answer 28

• specific tx provided to pt
• pt response to tx
• time tx admin

Question 29

Which aspects of nursing care is the registered nurse (RN) responsible for when delegating actions to someone on his or her behalf?

Answer 29

• ensuring task is approp to delegate
• delagatee able to correctly perform task
• performing follow-up and eval after completing task
• circumstances approp to delegate task

Question 30

A patient diagnosed with terminal cancer has obtained a prescription for medications that will end his life. This is an example of which type of end-of-life treatment?

Answer 30

assisted suicide

Question 31

fall risk assessment

Answer 31

1. hendrich II fall risk model (8 factors)

**score 5 or higher is high risk

• confusion/disorientation/impulsivity
• symptomatic depression
• altered elimination
• dizziness/vertigo
• male gender
• any admin antiepileptics
• any admin benzodiazepines
• get up and go test (rising from chair)
  2. Morse fall scale - based on yes/no response and score
• history falls
• existence secondary diagnosis
• use ambulatory aids
• received IV therapy or heparin lock
• gait/transferring
• mental status

Total Score‡: Tally the patient score and record.
<25: Low risk
25–45: Moderate risk
>45: High risk

3. johns hopkins fall risk assessment (7 factors)

** 0-5 low risk, 6-13 moderate, 13 and more high

• age (increase age increase risk)
• fall history (last 6 months increase)
• elimination, bowel, bladder concerns
• medications
• pt care eq tethers
• mobility
• cognition

Question 32

Morse fall risk scale

Answer 32

Question 33

hendrick II fall risk model

Answer 33

Question 34

Which cues would the nurse use to determine a patient’s safety needs?

Answer 34

• Subjective data related to the patient’s symptoms
• Subjective information about the patient’s chief complaint
• Patient’s history of exposures to environmental hazards
• Objective assessment focused on the affected body systems

Question 35

To specifically assess the patient’s safety risks related to health issues, which question would the nurse ask?

Answer 35

have you ever had a seizure?

Question 36

Which question would the nurse ask to assess a patient’s understanding of the risks of chemicals?

Answer 36

Where do you store your household cleaners?

Question 37

Educating patients about electrical cord safety is important in preventing which specific home safety hazard?

Answer 37

fire

Question 38

To assess the patient’s risk for exposure to biohazards in the home, which question would the nurse ask?

Answer 38

Do you or does anyone in the home use hypodermic needles?

Question 39

Which member of the interprofessional team would the nurse consult to evaluate a patient for safe performance of activities of daily living (ADLs)?

Answer 39

occupational therapist

Question 40

Which member of the interprofessional team would the nurse consult to evaluate a patient who is a fall risk?

Answer 40

physical therapist

Question 41

During an assessment, the nurse learns that a patient and child are living in a car. Which member of the interprofessional team would the nurse consult with to evaluate these individuals?

Answer 41

social worker

Question 42

health-care associated infections

Answer 42

nosocomial infections - acquired during hospital stay when pt admitted for another illness

Question 43

A fire prevention plan must include changing batteries in smoke alarms (detectors) at least every

Answer 43

6 months

Question 44

Many hospitals use the acronym RACE to describe emergency fire response. Which terms stand for the letters in RACE?

Answer 44

Rescue, Alarm, Contain, Extinguish

Question 45

Which action would the nurse take first when discovering a fire in a patient’s room?

Answer 45

Remove the patient from the room.

Question 46

The nurse is planning care for a patient who is 70 years old, lives at home with her healthy 50-year-old daughter, and swims and walks daily. When the patient says she wants to learn more about staying safe at home, which need would the nurse identify as the priority?

Answer 46

fall prevention

Question 47

A 90-year-old patient taking multiple medications is being discharged to home. Which members of the interprofessional team would the nurse consult with to evaluate fall risk?

Answer 47

pharmacist

physical therapist

occupational therapist

Question 48

The nurse is caring for a 72-year-old patient who is on bed rest after hip surgery for an injury sustained from a fall at home. The patient has a history of diabetes and ongoing dementia. Upon assessment, the nurse notes an intravenous (IV) infusion, a nasogastric tube, and a urinary drainage catheter. According to the Morse Fall Scale, what is the patient’s total score? __

Answer 48

75

The patient is a high risk for falls: History of falling—25; Secondary diagnosis—15; Ambulatory aid—0; IV/heparin lock—20; Gait/transferring—0; Mental status—15 = 75 points.

Question 49

The nurse is asking the patient a series of questions about the patient’s activities of daily living. The patient asks the nurse why that information is important. Which nursing response is appropriate?

Answer 49

“The answers to these questions will help us determine if you need any assistance at home.”

The purpose of the questions is to assess the patient’s need for assistance at home and ensure the patient’s safety

Question 50

A patient is on a large number of medications, and the nurse is concerned about the patient’s personal ability to manage taking all the medications at home. Which questions would the nurse ask to assess the patient’s potential safety risk?

Answer 50

• do you take your medications consistently
• do you know how to take these prescriptions?
• do you know when to take your drugs?
• do you know why HCP has prescribed these meds?

Question 51

A patient with paraplegia is being prepared for discharge from a spinal cord rehabilitation unit. Which question is most important for the nurse to ask when performing a home safety assessment?

Answer 51

• do you have a plan to exit the home in case of emergency?

Question 52

Which factor is a patient-related fall risk hazard?

Answer 52

incontinence

Question 53

The nurse identifies that a patient has difficulty putting on shoes and buttoning a shirt after the examination. Which goal would the nurse create as part of the plan of care?

Answer 53

pt will dress self within 1 month

Question 54

The nurse is educating a patient about home safety. Which patient response indicates that further nursing teaching is required?

Answer 54

i shave with my electric razor when I’m in the tub for convenience

Question 55

The nurse is admitting a patient who is a fall risk. Which room will the nurse assign?

Answer 55

room nearest the nurse’s station

Question 56

The nurse is evaluating a patient’s understanding of home safety measures. Which patient response indicates that teaching has been effective?

Answer 56

i checked my floorboards to make sure they are even