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324 > mod 2 legal > Flashcards

mod 2 legal Flashcards

1
Q

4 categories of law

A
  • 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)
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2
Q

Tort (criteria for malpractice)

A
  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?
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3
Q

types unintentional malpractice

A
  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
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4
Q

types intentional malpractice

A
  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
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5
Q

standard of care- tort law

A

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

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6
Q

constitutional law

A

14th amendment- right to refuse treatment

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7
Q

never events

A

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

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8
Q

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

A
  • Failure to notify the health care provider - Failure to request a prescription for a bite block - Failure to reposition the tube to prevent biting
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9
Q

Match the type of law with the correct description

A

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

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10
Q

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

A

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

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11
Q

Nurse Decision Tree

A
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12
Q

safe delegation

A
  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?
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13
Q

Which events would require an incident report to be filed?

A
  • 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
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14
Q

Which statement is correct regarding delegation?

A

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

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15
Q

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

A
  • 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.
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16
Q

end of life issues

A

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).

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17
Q

euthanasia

A

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

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18
Q

issues to address when pt refusing care

A
  1. establish mental competence
  2. id pt understanding
  3. involving others
  4. documenting
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19
Q

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?

A

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

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20
Q

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.

A

6 months

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21
Q

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

A

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.
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22
Q

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?

A

assault

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23
Q

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

A
  • pt falling out of bed
  • e.coli bacterial central venous line infection
  • retained surgical obj after surgery
  • staphylococcal surgical site infection
24
Q

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?

A
  • describe objectively how nurse found pt
  • notify management critical event occurred
25
Q

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

A
  • pt being sound mind
  • support system present for pt
  • risk assoc. w/refusal of care
  • pt signature on doc w/all presented info
26
Q

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

A

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

27
Q

Which statements are correct regarding state nurse practice acts?

A
  • 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
28
Q

Which information should be included in patient documentation?

A
  • specific tx provided to pt
  • pt response to tx
  • time tx admin
29
Q

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

A
  • 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
30
Q

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?

A

assisted suicide

31
Q

fall risk assessment

A
  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

  1. 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
32
Q

Morse fall risk scale

A
33
Q

hendrick II fall risk model

A
34
Q

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

A
  • 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
35
Q

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

A

have you ever had a seizure?

36
Q

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

A

Where do you store your household cleaners?

37
Q

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

A

fire

38
Q

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

A

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

39
Q

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

A

occupational therapist

40
Q

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

A

physical therapist

41
Q

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?

A

social worker

42
Q

health-care associated infections

A

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

43
Q

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

A

6 months

44
Q

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

A

Rescue, Alarm, Contain, Extinguish

45
Q

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

A

Remove the patient from the room.

46
Q

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?

A

fall prevention

47
Q

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?

A

pharmacist

physical therapist

occupational therapist

48
Q

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? __

A

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.

49
Q

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?

A

“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

50
Q

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?

A
  • 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?
51
Q

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?

A
  • do you have a plan to exit the home in case of emergency?
52
Q

Which factor is a patient-related fall risk hazard?

A

incontinence

53
Q

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?

A

pt will dress self within 1 month

54
Q

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

A

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

55
Q

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

A

room nearest the nurse’s station

56
Q

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

A

i checked my floorboards to make sure they are even

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