Chapter 23 Legal Implications In Nursing Practice

Question 1

Which source of law best addresses a situation where nurse accidentally administers an incorrect dosage of morphine sulfate to the client?

a. Civil law
b. Criminal law
c. Common law
d. Administrative law

Answer 1

a. Civil law

Question 2

What standard of care applies to the student nurses conduct when providing care normally performed by a registered nurse (RN)?

a. The same standard of care as an RN
b. A standard of care of an unlicensed person
c. No special standard of care because her faculty member is responsible for her conduct
d. A standard similar to but not the same as the staff nurse with whom she is assigned to work

Answer 2

a. The same standard of care as an RN

Question 3

Which of the following is the most important factor in a nurse deciding whether or not to carry malpractice insurance?

a. The nurse’s knowledge level of Good Samaritan laws
b. The amount of malpractice insurance provided by the nurse’s employer
c. The time frames and individual liability of the employer’s malpractice coverage
d. The evaluation of whether the nurse works in a critical area of nursing where
clients have higher morbidity and mortality rates

Answer 3

c. The time frames and individual liability of the employer’s malpractice coverage

Question 4

An unconscious client with a head injury needs surgery to live. His wife only speaks French, and the health care providers are having a difficult time explaining his condition. Which of the following is the most correct answer regarding this situation?

a. An institutional review board needs to be contacted to give their emergency advice
on the situation.
b. The health care team should continue with the surgery after providing information
in the best manner possible.
c. A friend of the family could act as an interpreter, but the explanation could not provide details of the client’s accident, because of confidentiality laws.
d. Two licensed health care personnel should witness and sign the preoperative
consent indicating they heard an explanation of the procedure given in English.

Answer 4

b. The health care team should continue with the surgery after providing information

Question 5

A physician asks a family nurse practitioner to prescribe a medication that the nurse practitioner knows is incompatible with the current medication regimen. If the nurse practitioner follows the physicians desire, which of the following is the most correct answer?

a. Good Samaritan laws will protect the nurse.
b. The nurse practitioner will be liable for the action.
c. This type of situation is why nurse practitioners should have malpractice
insurance.
d. If the nurse practitioner has developed a good relationship with the client, there
will probably not be a problem.

Answer 5

b. The nurse practitioner will be liable for the action.

Question 6

A registered nurse interprets a scribbled medication order by the attending physician as 25 mg. The nurse administers 25 mg of the medication to a client, and then discovers that the dose was incorrectly interpreted and should have been 1 5 mg. Who would ultimately be responsible for the error?

a. Attending
b. physician Assisting resident
c. Pharmacist
d. Nurse

Answer 6

d. Nurse

Question 7

A nurse is being asked to move from the eye unit to a general surgery floor where she in inexperienced in this specialty due to an influenza epidemic among the nursing staff. She is aware of her inexperience. The nurse’s initial recourse is to:

a. Fill out a report noting her dissatisfaction
b. Ask to work with another general surgery nurse
c. Notify the State Board of Nursing of the problem
d. Politely refuse to move, take a leave-of-absence day, and go home

Answer 7

b. Ask to work with another general surgery nurse

Question 8

There are issues concerning death and dying may influence nursing practice which the nurse recognizes. Concerning the legalities of death and dying issues, which of the following is true?
a. Passive euthanasia is illegal in all states.
b. Assisted suicide is a constitutional right.
c. Organ donation must be attempted if it will save the recipients life.
d. Feedings may be refused by competent individuals who are unable to self-feed.

Answer 8

d. Feedings may be refused by competent individuals who are unable to self-feed.

Question 9

The Joint Commission (TJC) sets standards of care, in which an institution is required to have:

a. Limits of professional liability
b. Educational standards for nurses
c. A delineated scope of practice for health professionals
d. Written nursing policies and procedures for client care

Answer 9

d. Written nursing policies and procedures for client care

Question 10

In the event that a nursing license is revoked, which of the following is correct?

a. The hearings are usually held in court.
b. Due process rights are waived by the nurse.
c. Appeals may be made regarding the decisions.
d. The federal government becomes involved in the procedures.

Answer 10

c. Appeals may be made regarding the decisions.

Question 11

Which one of the following actions is an example of an unintentional tort?

a. Restraining a client who refuses care
b. Taking photos of a client’s surgical wounds
c. Leaving the side rails down and the client falls and is injured
d. Talking about a client’s history of sexually transmitted diseases

Answer 11

c. Leaving the side rails down and the client falls and is injured

Question 12

Which one of the following individuals may legally give informed consent?

a. A 16-year -old for her newborn child
b. A sedated 42-year-old preoperative client
c. The friend of an 84-year-old married client
d. A 56-year -old who does not understand the proposed treatment pla

Answer 12

a. A 16-year -old for her newborn child

Question 13

When a nurse signs as a witness on an informed consent form, she is indicating that the client:

a. Fully understands the procedure
b. Agrees with the procedure to be done
c. Has voluntarily signed the consent form
d. Has authorized the physician to continue with the treatment

Answer 13

c. Has voluntarily signed the consent form

Question 14

A nurse who is working with clients who have DNR (do not resuscitate) orders knows that these orders:

a. Are legally required for terminally ill clients
b. May be written by the physician without client consent if resuscitation is futile
c. Are maintained throughout the clients stay in either an acute care or a long-term
care facility
d. Follow nationally consistent standards for implementation of client interventions

Answer 14

b. May be written by the physician without client consent if resuscitation is futile

Question 15

The nurse understands the implications of the Patient Self-Determination Act. This legislation requires that:

a. Clients designate a power of attorney
b. DNR orders for clients meet standard criteria
c. Organ donation is required upon death, if possible
d. Information be provided to the client regarding rights for refusal of care

Answer 15

d. Information be provided to the client regarding rights for refusal of care

Question 16

The newly enacted Health Insurance Portability and Accountability Act (HIPAA) of 2003 requires:

a. Insurance coverage for all clients
b. Policies on how to report communicable diseases
c. Limits on information and damages awarded in court cases
d. Safeguards to protect written and verbal information about clients

Answer 16

d. Safeguards to protect written and verbal information about clients

Question 17

A client is told by his nurse that he has to take the medications, including an injection. The client refuses the medications, but continues to have them administered by the nurse. This action is an example of the intentional tort of:

a. Assault
b. Battery
c. Malpractice
d. Invasion of privacy

Answer 17

b. Battery

Question 18

A nurse who is working with a client who has been diagnosed with AIDS reveals the clients name and diagnosis with a co -worker on the way downstairs in an elevator. Unknowingly, a friend of the client that happens to be sharing the elevator and hears the entire story. The nurse who shared the information may be held liable for:

a. Slander
b. Assault
c. Malpractice
d. Invasion of privacy

Answer 18

a. Slander

Question 19

A nurse stealing narcotics from an acute care nursing unit is guilty of a:

a. Civil offense
b. Criminal offense
c. Common law offense
d. Administrative law offense

Answer 19

b. Criminal offense

Question 20

The case of a nurse accused of unethical nursing conduct will be heard by the state board of nursing. This is an example of:

a. Civil law
b. Criminal law
c. Common law
d. Administrative law

Answer 20

d. Administrative law

Question 21

Which of the following statements made by a nursing student regarding responsibility for provided care requires immediate follow -up by the nursing instructor?

a. I’m not held to the same standards as a licensed RN.
b. I am required to provide the safest, appropriate care I am capable of.
c. My clinical instructor is ultimately responsible for the care I provide.
d. No one expects nursing students to provide ca re on the level as an experienced
RN.

Answer 21

c. My clinical instructor is ultimately responsible for the care I provide.

Question 22

The nurse is having difficulty reading the prescribed dosage on a handwritten order for a pain medication. The most appropriate action to ensure the clients safety and to minimize legal issues is for the nurse to:

a. Ask another RN to confirm the order
b. Request the pharmacist to interpret the order
c. Call the health care provider to clarify the order
d. Consult a current drug book to determine the normal dosage range

Answer 22

c. Call the health care provider to clarify the order

Question 23

The legal basis for a nurse to provide emergency treatment without consent to a client incapable of informed consent is:

a. Such care is clearly a nursing responsibility
b. To fail to provide such care is nursing negligence
c. It is presumed that the client would want the emergency treatment
d. Health care providers have an obligation to provide emergency treatment

Answer 23

c. It is presumed that the client would want the emergency treatment

Question 24

An experienced pediatric nurse is reassigned to an adult oncology floor because of staffing issues and immediately recognizes a lack of experience in this specialty. Which of the following nursing actions shows a lack of professionalism?

a. Politely declining the assignment
b. Filling out a report noting her dissatisfaction
c. Asking to work with another oncology nurse
d. Notifying the state board of nursing of the problem

Answer 24

a. Politely declining the assignment

Question 25

Although a nurse may not agree, the nurse recognizes that a terminally ill client has the legal right to

a. Seek passive euthanasia in some states
b. Sign an organ donor pledge statement
c. Refuse DNR (do not resuscitate) status
d. Refuse treatment in the form of food and water

Answer 25

d. Refuse treatment in the form of food and water

Question 26

Which of the following statements best reflects a nurse’s understanding of the proper critical thinking process regarding the need for personal malpractice insurance?

a. The states Good Samaritan laws protect me outside of the hospital.
b. I work in a very low risk area of nursing, so I don’t really have a need.
c. The hospital carries its own malpractice insurance, so I don’t need extra.
d. Lawsuits can occur years after the event, so I carry my own liability insurance.

Answer 26

d. Lawsuits can occur years after the event, so I carry my own liability insurance.

Question 27

Which of the following statements made by a nurse puts the nurse at risk for assault of the client?

a. You will be sorry if you don’t agree to take this medication.
b. You can’t refuse this medication if you really want to feel better.
c. I’ll be so disappointed in you if you don’t take your medication.
d. I’ll tell your son you aren’t cooperating if you don’t take your medication.

Answer 27

a. You will be sorry if you don’t agree to take this medication.

Question 28

Which of the following statements made by a nurse shows the best understanding regarding the requirements of the Health Insurance Portability and Accountability Act (HIPAA) of 2003?

a. I’m always careful to close the door when taping or listening to the units shift
report.
b. The nursing assistants know to hand me the vital signs sheet and not just put it on
the medication cart.
c. I called the radiology department to tell them I would be faxing the client
information they requested.
d. The client’s niece called to see how she slept last night, but I told her I couldn’t
share that with her over the phone.

Answer 28

c. I called the radiology department to tell them I would be faxing the client

Question 29

Which of the following statements made by a nurse reflects the best understanding of the legal safeguards of a DNR (do not resuscitate) order?

a. All family members need to agree before a DNR order can be written.
b. All terminally ill clients are ultimately required to be declared a DNR status.
c. The DNR order on the terminally ill client in Room 45 needs reviewed today.
d. If the client’s family can’t be located, the physician will write the DNR order

Answer 29

c. The DNR order on the terminally ill client in Room 45 needs reviewed today.

Question 30

Which of the following statements made by a nurse reflects a lack of understanding regarding a DNR (do not resuscitate) order?

a. All family members need to agree before a DNR order can be written.
b. All terminally ill clients are ultimately required to be declared a DNR status.
c. The DNR order on the terminally ill client in Room 45 needs reviewed today.
d. If the client’s family can’t be located the physician will write the DNR order.

Answer 30

a. All family members need to agree before a DNR order can be written.

Question 31

Which of the following statements made by a nurse shows a lack of understanding regarding the Uniform Anatomical Gift Act?

a. A client must be 21 to give consent to be an organ donor.
b. All clients admitted to the hospital are asked about becoming an organ donor.
c. We have a form here on the unit that must be signed to show a clients informed consent to be an organ donor.
d. In our state, you can check the back of a client’s driver’s license to verify whether they are an organ donor.

Answer 31

a. A client must be 21 to give consent to be an organ donor.

Question 32

The nurse is heard stating to another staff member that, the client in Room 54 is such a whiner; you would think she was dying. This nurse is liable of

a. Libel
b. Slander
c. Malpractice
d. Invasion of privacy

Answer 32

b. Slander

Question 33

Which of the following nursing statements reflects the best understanding of the importance of appropriate nursing documentation regarding risk management?

a. If the client isn’t compliant, I’m sure to put that in my notes.
b. I’m always careful to document any changes in the client’s condition.
c. My notes are the proof that I provided the client with effective, appropriate care.
d. When there is a lawsuit, the nursing notes are the first thing the attorney looks at.

Answer 33

c. My notes are the proof that I provided the client with effective, appropriate care.

Question 34

Which of the following statements reflects a nurses need for further instructions regarding an incident report?

a. I hope this incident report will help determine a way to help prevent falls.
b. Risk management will want to review the incident report on the clients fall.
c. I put the incident report on the clients fall in his chart as soon as I was finished.
d. I need to review the guidelines before I fill out this incident report regarding the
clients fall.

Answer 34

c. I put the incident report on the clients fall in his chart as soon as I was finished.

Question 35

Regarding hours worked and frequency of errors, recent research has shown that nurses
working more than 12.5 hours per shift and more than a 40-hour week are:

a. Reporting more physical illnesses than those working only 40 hours per week
b. Three times more likely to commit an error in nursing judgment related to client care
c. Experiencing more physical injuries than those working only 40 hours per week
d. Experiencing signs of emotional burn out more frequently than those working only
40 hours per week

Answer 35

b. Three times more likely to commit an error in nursing judgment related to client care

Question 36

While working as a nursing assistant, a nursing student is asked to reinsert a Foley catheter by the RN. Which of the following reflects the most appropriate initial student response to the request?

a. Notify the nursing supervisor of the inappropriate request.
b. Tell the RN that she can only perform as a nursing assistant.
c. Agree to perform the task but with the supervision of the RN.
d. Jointly read the nursing assistant job description with the RN.

Answer 36

b. Tell the RN that she can only perform as a nursing assistant.