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NUR3826 Ethical and Legal Aspects of Nursing

Week 1 discussion

DQ1 Right Wrong Picture

Differentiate between the terms “Ethics”, “Morals”, and “Values”.

Discuss why ethical theories are important to nursing practice.

Discuss a situation from your clinical practice or training where one or more ethical principles was supportive of care or was in conflict of care.

DQ2 Explain the term “standard of care” from a legal and a nursing perspective.

Include support for your explanation by using references from your ANA Essentials of Nursing Package (Scope and Standards of Practice, Guide to Nursing’s Social Policy Statement, and the Guide to the Code of Ethics for Nurses).

NUR3826 Ethical and Legal Aspects of Nursing

Week 2 discussion

DQ1 Are you knowledgeable about your own state statutes and regulations regarding informed consent?

1. Discuss the law or rules of informed consent in your state or workplace organization.

2. What ethical issues should be realized by practicing nurses in regards to consent?

3. How does the process of consenting patients for genetic testing differ?

4. Many patients or family members ask nurses for further clarification regarding genetic testing and often the response is in terms of what the health care provider himself or herself would do. Discuss this phenomenon and include the concept of “paternalism” in your remarks.

DQ2 Please thoroughly review the “Effective Documentation” and Electronic Medical Record (Computerized Charting)” content from Chapter Nine of the Guido (6th ed.) textbook.

After reviewing:

1) Discuss at least two of the findings you consider most important to your practice.

2) Does your present (or past) employer use Electronic Health Records (EHR)? If so, which technology platform is utilized? In your experience, describe your biggest challenges using EHR?

3) How can privacy and confidentiality be ensured with the use of electronic health records?

4) What ethical issues might arise from the use of technology in patient care?

5) Discuss if the electronic medical record has made documentation better from a legal perspective AND from the nurses’ practice perspective.

NUR3826 Ethical and Legal Aspects of Nursing

Week 3 discussion

DQ1

Discuss issues related to corporate liability and the nurse leader’s role in prevention of legal entanglement.

What role does staffing and delegation play in corporate liability?

DQ2

There are laws that impact nursing practice including licensure, the Nurse Practice Act, the Americans with Disabilities Act (ADA) and the Civil Rights Act of 1991. As a nurse leader, legal and ethical concerns must be acknowledged and addressed to ensure care is safe, timely, effective, efficient, equitable, and patient-centered (STEEEP). Ethical decisions must adhere to both legal and ethical principles.

Consider the following scenario:

Impaired Nurse – A nurse on your unit is frequently late, occasionally looks “high”, and based on your observations, gives substandard care to patients. Upon receiving report, you realize that there is a discrepancy about medication given to one of the patients and what the patient tells you. You have suspicions based on the nurse’s behavior that the nurse might be diverting narcotics meant for patients. What do you do?

Do you have a legal obligation to address suspicions? And if so, what laws or rules would indicate a legal responsibility and what actions would you take? If the nurse is found to have a narcotic addiction, is the identifying nurse required to report this to the state board of nursing?

What is the ethical responsibility of the nurse who suspects a co-worker of substance abuse? What ethical principles apply?

NUR3826 Ethical and Legal Aspects of Nursing

Week 4 discussion

DQ1

Read the attached ethical situations. Choose one of the case study scenarios and answer the questions that follow it (Autonomy, Euthanasia, Oregon Death with Dignity Act, Assisted Reproduction, Universal Health Care, and Bioterrorism). Consider the nurses role, legal considerations, and the ethical principles involved.

DQ2

Choose the health care setting that most closely correlates with your own place of practice or one you desire to work in.

1. Acute Care Setting

2. Ambulatory and Managed Care Setting

3. Public and Community Health Setting

4. Long-Term Care Setting

5. Research

6. Education

Describe the legal and ethical issues that can arise in your chosen setting and reflect on what you have learned in this course to assist you in your practice.

NUR3826 Ethical and Legal Aspects of Nursing

Week 3 assignment

Summary: Your assignment is to write an APA formatted paper based on your readings and

literature searches exploring and answering a series of questions.

Nurses are at the forefront of patient care, and will participate fully in genetic-based and

genomic-based practice activities, such as collecting family history, obtaining informed

consent for genetic testing, and administering gene-based therapies. Nurses will have a critical

role advocating for, educating, counseling, and supporting patients and families who are

making gene-based healthcare decisions (Cassells, Jenkins, Lea, Calzone, & Johnson, 2003).

Nurses will need to be able to effectively translate genetic and genomic information to their

patients with an understanding of associated ethical issues. This new direction in healthcare

calls for nurses to integrate into their scope of practice the emerging field of genetics and

genomics. The increased availability of personal genetic information also challenges nurses to

understand the ethical issues associated with activities such as informed decision making,

informed consent and genetic testing, genetic and genomic research testing protection,

maintaining privacy and confidentiality of genetic information, preventing genetic

discrimination, and strengthening genetic and genomic care around the world (Lea, 2008).

Cassells, J.M., Jenkins, J., Lea D.H., Calzone K., & Johnson E., (2003). An ethical assessment framework for addressing global genetic issues

in clinical practice. Oncology Nursing Forum, 30(3), 383-90.

NUR3826 Ethical and Legal Aspects of Nursing

Quiz 1

Question 1

External sources for determining standards of care include:

Answers:

Hospital policy and procedure manuals.

Professional journals and nursing texts.

The individual nurse’s experience and education.

The individual nurse’s job description.

Question 2

The statute of limitations for a lawsuit:

Answers:

Defines events that will not be allowed to be discussed at trial.

Defines the period of time in which a lawsuit may be filed.

Is suspended for minors in all states until they become 18 years of age.

Limits the number of plaintiffs and defendants in any given lawsuit.

Question 3

The single most critical factor in determining whether a particular nurse acted with reasonable care in a given situation is:

Answers:

The number of years the nurse has practiced as a professional.

The experience the nurse has in a particular clinical setting.

The ability of the nurse to perform according to his or her job description.

How the nurse’s conduct compared to the conduct of other nurses with similar backgrounds and experience.

Question 4

Which of the following persons would best qualify as an expert in a nursing malpractice case filed because of failure of a post-anesthesia care unit nurse to recognize the early signs and symptoms of respiratory arrest?

Answers:

The director of nursing at the hospital, who holds an MSN in Nursing Administration.

The director of clinical pharmacy, who holds a doctoral degree in clinical pharmacology.

A critical care nurse, who holds a BSN in nursing and certification from the American Association of Critical Care Nurses (AACN).

A staff nurse, who works on the general medical floor and has recently earned a BSN degree.

Question 5

Match the definition to the term provided:

Question

Match

Moral Stress

Moral distress

Moral Uncertainty

Moral Dilemma

All Answer Choices

A.

Questioning the right course of action.

B.

Negative painful state of psychological imbalance which occurs when moral decisions cannot be implemented due to real or perceived constraints.

C.

Occurs when two ethical principles compete.

D.

Conflicting but morally justifiable course of action.

Question 6

The defendant in a lawsuit is the party:

Answers:

Bringing the lawsuit against another.

Who was injured by the nurse or health care provider.

Who is answering a complaint brought against him or her.

Who is the health care institution in the case.

Question 7

The health care team is involved in a situation in which there are two equally undesirable options. One of these options must be chosen and applied to the situation. What term describes this situation?

Answers:

Ethical challenge

Ethical dilemma

Ethical paradox

Ethical contradiction

Question 8

Ordering Question: There are various ethical decision-making models used by nurses when making ethical decisions. The easiest model nurses use at the bedside is the MORAL Model. Place the steps of this model in order:

Answers

Massage the dilemma

Outline the options

Resolve the dilemma

Act by applying the chosen option

Evaluate the entire process

Question 9

The plaintiff in a lawsuit is the party:

Answers:

Bringing the lawsuit against another.

Who is answering the complaint brought against him or her.

Who stands in the place of the injured party.

Who is the health care institution in the case.

Question 10

When nurses assist patients to understand their own value system and make choices consistent with those values, the approach to advocacy is said to be the

Answers:

Rights protection model.

Autonomy model.

Values-based decision model.

Patient advocate model.

Question 11

Anthony and Bob are neighbors. One day, Anthony suddenly attacks Bob with a knife, wounding him severely. Bob is hospitalized for an extended period of time and eventually loses function of his right arm. Anthony is arrested and charged with battery and assault. The classification or type of law that would determine the case against Anthony is:

Answers:

Civil law.

Constitutional law.

Criminal law.

Private law.

Question 12

Ethics as a discipline differs from law in which way?

Answers:

Ethics is external, while law is internal.

Ethics focuses on the individual, rather than society as a whole.

Ethics applies to conduct and actions rather than motive and attitude.

Ethics relies heavily on judicial enforcement.

Question 13

A nurse brings suit against the hospital after being terminated for excessive absenteeism. Who is the defendant in this lawsuit?

Answers:

The nurse bringing the suit

The nurse’s attorney

The hospital

The hospital’s attorney

Question 14

To more fully provide ethical nursing care, nurses should:

Answers:

Explore the values and beliefs of the physicians with whom they work.

Explore their own values and beliefs.

Seek others’ input rather than relying on their own ethical determinations.

Request that all dilemmas be presented to the Hospital Ethics Committee for solution.

Question 15

Ethical dilemmas most often involve:

Answers:

Patients’ right to die.

Patients’ right to privacy.

Nurses’ violation of the Code of Ethics.

Conflicts in basic human rights.

Question 16

When a nurse manager assists an employee in deciding about the employee’s future career and possible options available to him or her, the manager is most likely following the ethical principle of:

Answers:

Justice

Fidelity

Autonomy

Paternalism

Question 17

When a professional nurse does not adhere to therapeutic jurisprudence in his or her decision making when caring for their patients and results in harm to a patient, what type of law would be enforced?

Answers:

Constitutional law.

Tort law.

Contract law.

Patent law.

Question 18

Which group or person has authority to write statutory law such as nurse practice acts?

Answers:

State legislatures

State boards of nursing

State governors

State nursing associations

Question 19

Ethical theories that derive norms and rules from the duties human beings owe to each other fall under the broad classification of:

Answers:

Teleological theories.

Deontological theories.

Utilitarian theories.

Situational ethics.

Question 20

Internal sources for determining standards of care include:

Answers:

Hospital policy and procedure manuals.

Professional journals and nursing texts.

Previous and relevant court cases.

State standards of care as defined by the state board of nursing.

NUR3826 Ethical and Legal Aspects of Nursing

Quiz 2

Question 1

Apparent consent occurs when the patient:

Answers:

Agrees to participate in a clinical trial.

Is unable due to their condition to otherwise give consent.

Allows a family member to sign the informed consent form for him or her.

Extends an arm to allow blood to be taken.

Question 2

Mr. Jones, hurt while working in a clothing factory, saw the occupational health nurse for his injury. The nurse bandaged his hand and instructed him to get a tetanus antitoxin injection at the physician’s office where the factory referred patients. He failed to follow the instructions and later developed tetanus. In the ensuing trial, the court should find that:

Answers:

The nurse is liable, because he/she did not check to see that Mr. Jones followed his/her instructions.

The nurse is liable, because Mr. Jones is an adult and able to make his own decisions about health care matters.

The nurse is not liable for damages to Mr. Jones, because she has a right to expect that her instructions would be followed.

The nurse is not liable, because tetanus is preventable.

Question 3

Consent, once validly given by a competent adult patient:

Answers:

May not be revoked.

May be revoked only in writing if the original consent was written.

May be revoked at any time prior to the procedure or treatment being implemented.

May be revoked only if a second procedure supersedes the first procedure.

Question 4

A nurse is preparing a patient for a procedure. The patient has signed a consent form, but states, “I don’t really know anything about this procedure. I wonder if there is something else I could do instead?” How should the nurse proceed?

Answers:

Continue with the preparation as consent may not be revoked.

Have the patient document the question in writing since the original consent was written.

Stop the preparation as the patient can revoke consent at any time.

Try to convince the patient to go through with the procedure.

Question 5

After shift change, a nurse calls back to the unit and speaks with the current attending nurse. The nurse reports that she forgot to document that the patient’s physician saw the patient an hour before shift change and asks the nurse to chart it for her in the medical record. What would be the best action of the attending nurse?

Answers:

Refuse to document the information in the medical record.

Call the physician to verify the visit prior to documenting it.

Notify the supervisor of the unusual conduct of the nurse.

Go ahead and chart the telephone conversation.

Question 6

A hospital’s policy states that a nurse must cosign all charts that licensed practical nurses complete. What is the effect of this policy on a nurse working on a busy medical floor?

Answers:

It places the nurse in the position of endorsing and authenticating the entries made in the charts that he or she cosigns.

It gives legal proof that the nurse was in the hospital.

It is unclear whether there is any liability for the nurse.

It has no legal effect on the nurse in this type of unit.

Question 7

A nurse is leaving the parking lot at the hospital and carelessly runs over a patient who was just discharged. Ironically, the nurse had been assigned to care for that patient that day. If the patient sues this nurse, which statement is true?

Answers:

The nurse can be held liable for both negligence and malpractice.

The nurse can be held liable for negligence but not malpractice.

The nurse can be held liable for malpractice but not negligence.

The nurse cannot be held liable for either malpractice or negligence based upon this set of facts.

Question 8

Circumstances that may be exceptions to obtaining informed consent include:

Answers:

Emergency situation, therapeutic privilege, patient waiver, and prior patient knowledge.

Emergency situation, qualified privilege, patient waiver, and prior patient knowledge.

Emergency situation, therapeutic privilege, waiver by the patient or the staff, and prior patient knowledge.

Emergency situation, prior patient knowledge, therapeutic privilege, and patient inability to sign the form.

Question 9

An angry patient had a pocket knife that he was using to keep others away from him and the nurse confiscated the pocket knife. The nurse’s best defense for the confiscation of the pocket knife would be:

Answers:

Consent.

Self-defense.

Necessity.

Privilege.

Question 10

Nursing students are frequently required to show proof of malpractice insurance before beginning their clinical experience. The reason for requiring malpractice insurance coverage for students in clinical settings is:

Answers:

The law requires all students to have individual policies.

Nursing students are just as liable as registered nurses for acts of malpractice.

The cost of coverage is minimal and is fully tax deductible.

Students are more likely to give substandard care than registered nurses are.

Question 11

The main purpose of documentation is to:

Answers:

Communicate the patient’s condition to all members of the health care team.

Record patient information for future research studies.

Verify dates of patients’ admissions to health care institutions.

Ensure that all charges are validly documented and assessed to the patient for collection from third-party payers.

Question 12

A patient on the medical-surgical unit became confused and dangerous to himself and others in the setting, restraints were applied, and the patient was confined to bed. The nurse’s best defense for applying the restraints would be:

Answers:

Consent

Self-defense

Necessity

Privilege

Question 13

If an adult patient is given treatment for which he or she has not previously consented, the health care provider administering the treatment may be held liable for:

Answers:

Battery

Assault.

Malpractice.

False imprisonment.

Question 14

Under a claims-made insurance policy, for which claim is the nurse protected?

Answers:

Claims that were filed before the insurance coverage became active

Claims that are filed for incidents during the active period of the policy

Claims filed within a 30-day grace period before or after policy times

Claims for all future events, whether the policy is active at that time or not

Question 15

If a nurse is named in a lawsuit and he or she has no professional malpractice insurance coverage, the nurse:

Answers:

Is considered judgment-proof and will not be required to pay damages.

Can be held personally responsible for all damages assessed.

Can rely upon the hospital’s insurance policy as protection from personal financial responsibility.

Will be nonsuited from the filed lawsuit once this fact is known.

Question 16

One of the more convincing arguments for having malpractice insurance is:

Answers:

Having insurance assures that the nurse will not be named in lawsuits.

Having insurance makes it more costly for the plaintiff to file suit against the nurse.

Defending against a lawsuit is costly in today’s society.

Filing a lawsuit is costly in today’s society.

Question 17

Which of the following situations would support a charge of malpractice against a professional nurse?

Answers:

A failure on the part of the nurse to allay a patient’s fears.

A failure on the part of the nurse to exercise reasonable and prudent care in treating a patient.

A failure on the part of the nurse to establish a therapeutic relationship with the patient.

A failure on the part of the nurse to ensure that patients only received care for which they could pay.

Question 18

An elderly patient is taken to CT scan and has a seizure violently hitting his head requiring sutures above the eyebrow. The next day, while the patient’s wife is visiting she is informed about the mishap and asks to see the incident report. Your first action should be to:

Answers:

Show her the incident report immediately since she has power of attorney for the patient.

Tell her the incident report is only discoverable in some states and Florida is not one of them.

Notify the nurse manager and risk management immediately of the request.

Call the physician to go over the report with the patient and his family.

Question 19

A nurse has decided to purchase individual professional liability insurance. The purchased policy states that coverage is only valid for suits filed while the policy is in effect. Which type of policy is reflected by this statement?

Answers:

Claims-made

Certificate -based

Occurrence-based

Employer-sponsored

Question 20

In caring for the suit-prone patient, one of the interventions that nurses should remember and use is:

Answers:

Give the same compassionate, competent care that all patients receive.

Treat the patient in the same rude and hostile manner as the patient.

Avoid the patient if possible so that there will be less chance of saying the wrong thing or performing in an incompetent manner.

Assign the patient to a different nurse each shift, so that no one nurse will become the target of a lawsuit.

NUR3826 Ethical and Legal Aspects of Nursing

Quiz 3

Question 1

Delegation has been a concept used in nursing:

Answers:

Since the 1990s.

Since the early 1970s.

Since the mid-1950s.

Throughout all of nursing’s history.

Question 2

Collective bargaining is defined and protected by the:

Answers:

Civil Rights Act of 1991.

National Labor Relations Act and its amendments.

Equal Pay Act of 1963.

National Practitioner Data Bank.

Question 3

Risk management is a process that attempts to identify potential hazards and:

Answers:

Compensate previous injuries.

Eliminate them before anyone is harmed.

Discipline staff who have been involved in previous incidents.

Supercede the need to file incident reports.

Question 4

When the nurse manager transfers full responsibility for the performance of a task without transferring the accountability for the ultimate outcome, the task has been:

Answers:

Regulated.

Supervised.

Delegated.

Retained.

Question 5

The doctrine of respondeat superior:

Answers:

Makes the hospital liable for independent contractor.

Prevents the hospital from being liable for actions of its employees.

Makes it more likely that the hospital will be liable for actions of its employees.

Makes the hospital responsible for liability against invited guests.

Question 6

When a nurse is employed as a private-duty nurse, which of the following legal doctrines cannot apply to the nurse’s conduct?

Answers:

The doctrine of respondeat superior.

Personal liability.

Res ipsa loquitur.

Negligent cause of action.

Question 7

Persons who are qualified under the Americans with Disabilities Act include:

Answers:

Persons who have gender identity disorders and sexual behavior disorders.

Persons who are bisexual and homosexual.

Persons who are currently using illegal drugs.

Persons who are recovering or rehabilitated alcoholics.

Question 8

When nursing students perform skills customarily performed by RNs, the standard of care that applies to their actions is:

Answers:

A diminished standard of care, because the nursing student has not yet passed the state board examination.

A student’s standard of care, specially carved out for student nurses.

A higher standard of care, because the student is more completely supervised than are practicing RNs.

The same standard as for the RN.

Question 9

In passing the Americans with Disabilities Act of 1990, Congress attempted to combine the two legal concepts of:

Answers:

Disability and the right to work.

Disability and equality.

Disability and autonomy.

Disability and fairness.

Question 10

Reasonable accommodation means that the employer must provide the qualified employee with:

Answers:

Employment regardless of the disability.

Needed and reasonable modifications in the workplace.

A part-time schedule if the qualified worker is unable to work on a full-time basis.

Employment opportunities not given to persons without disabilities.

Question 11

One of the means used today to ensure that nurses floated to other areas of the hospital are qualified to work in those units is:

Answers:

Cross-training staff to various units.

Employing extra staff for all units.

Orienting staff to only one unit and then keeping them on that unit.

Transferring patients to units with better staffing patterns.

Question 12

Since unlicensed personnel are not licensed by the state in their own right, they may perform delegated tasks because:

Answers:

They practice on the license of the professional delegating the task.

They are sanctioned by the American Hospital Association as an exception to the requirement for licensure.

They work under the auspices and licensure of the institution, not the professional nurse.

They are sanctioned by the state nurse practice act as an exception to the requirement for licensure.

Question 13

A nurse, while under a general employment contract with a hospital, is subject to the right to direct and control the details of his or her work by a second entity. Such a nurse would be said to be acting as a (an):

Answers:

Dual servant.

Borrowed servant.

Independent contractor.

Agent of the principal.

Question 14

The nurse’s responsibility and accountability for appropriate delegation of tasks is found in the:

Answers:

ANA Code for Nurses.

ANA Nursing Scope and Standards of Practice.

State nurse practice acts and rules and regulations as promulgated by the state boards of nursing.

All of the above.

Question 15

When one delegates tasks to another, accountability for that task:

Answers:

Is transferred to the person performing the task.

Is retained by the person who transfers the task.

Is held jointly by the person transferring the task and the person performing the task.

Can be imputed to either the person performing the task or the person transferring performance of the task.

Question 16

Advanced Practice Nurses (APNs) in hospital settings are more likely to be sued for malpractice than staff nurses because:

Answers:

They work with more seriously ill patients, who may develop more complications during the course of treatment.

They enjoy higher salaries and thus are better litigation targets.

They assume greater legal liability by virtue of their specialty credentials.

They are perceived as having greater autonomy in the work setting.

Question 17

A nurse practicing in a long term care facility, delegates the task of ambulating Mr. Gonzales, to two aides. Mr. Gonzales is an elderly gentleman who has a history of transient ischemic attacks (TIAs). While he appears to be able to ambulate without assistance, two aides are to walk with him to ensure that he does not experience another TIA and falls. One of the most important aspects when delegating this task, given Mr. Gonzales’ history, is to ensure that:

Answers:

Mr. Gonzales is comfortable with having aides walk with him.

Mr. Gonzales understands the need for assistance.

The aides understand the importance of walking with Mr. Gonzales.

The aides ambulate Mr. Gonzalez at least once during the day.

Question 18

The legal guide to the practice of registered nursing is:

Answers:

ANA Code of Ethics

Nightingale Pledge

State Nurse Practice Act

Nurse’s Bill of Rights

Question 19

The doctrine of personal liability is a rule that:

Answers:

Protects nurses against liability for malpractice.

Holds everyone responsible for his or her own negligent conduct.

Makes some persons responsible for the actions of others.

Ensures that no one has liability in certain legal actions.

Question 20

The Americans with Disabilities Act covers:

Answers:

Only physical impairment.

Only mental impairment.

Either physical or mental impairment.

Neither physical or mental impairment.

FINAL EXAM

Question 1

A nurse who has an obvious physical disability applies for a staff nurse position. Which question, asked by the nurse recruiter, is legal?

“How long have you been disabled?”

“How does your disability affect your life?”

“Are you able to fulfill the requirements of this job?”

“Has your condition stabilized, or do you foresee it getting worse with time?”

Question 2

What is the basic purpose of the state board of nursing?

To ensure that all practicing nurses are competent

To restrict nursing practice through regulations

To ensure that all schools of nursing seek national accreditation

To establish a means of protecting the public at large

Question 3

A nurse brings suit against the hospital after being terminated for excessive absenteeism. Who is the defendant in this lawsuit?

The nurse bringing the suit

The nurse’s attorney

The hospital

The hospital’s attorney

Question 4

Which of the following principles underlies the actions of all health care providers and assures that those actions will meet or exceed standards of care?

Veracity

Maleficence

Beneficence

Autonomy

Question 5

What is the nurse’s legal duty with regard to implementing a physician’s order?

The nurse should follow the order unless the nurse believes some other course of action would be better.

The nurse should follow the order unless the nurse has reason to believe that the patient could come to harm if the order is followed.

The nurse should review each order with the physician and then follow the order.

The nurse should question every order with the physician, since physicians are only human.

Question 6

Which patient incident should be addressed because it is the primary cause of action in lawsuits against long-term care facilities?

Inadequate resident nutrition

Resident falls

Medication errors

Abuse of residents

Question 7

Ethical theories that derive norms and rules from the duties human beings owe to each other fall under the broad classification of:

Teleological theories.

Deontological theories.

Utilitarian theories.

Situational ethics.

Question 8

Which of the following actions is a requirement of the standard of care when it comes to technology and equipment in nursing practice?

Select and properly use equipment within health care settings.

Clean and repair equipment so that it can be readily used.

Modify equipment or improvise as needed in clinical settings.

Notify the FDA is equipment is not working properly.

Question 9

Students do not need to be licensed to practice nursing actions because:

They practice on their instructors’ licenses.

They practice as an exception to the licensure requirement.

They have a lower standard of care than do licensed nurses.

Clinical contracts preclude the need for licenses.

Question 10

A nurse’s neighbor routinely calls and asks for advice regarding health issues. What should the nurse do about these calls?

Tell the neighbor that the nurse is not legally able to give health advice outside the work environment.

Be certain that any advice given reflects both nursing and community standards.

Charge the neighbor a flat fee of $25 for each call.

Tell the neighbor that nurses are not educationally prepared to give health advice.

Question 11

When one delegates tasks to another, accountability for that task:

Is transferred to the person performing the task.

Is retained by the person who transfers the task.

Is held jointly by the person transferring the task and the person performing the task.

Can be imputed to either the person performing the task or the person transferring performance of the task.

Question 12

When giving health-related advice, the nurse can avoid liability if the advice reflects:

A solid medical diagnosis.

Nursing and community standards.

A quick assessment and treatment recommendations.

There is no way to avoid liability when giving advice.

Question 13

The overall goal of American antitrust laws is to:

Prevent competition while creating efficient markets.

Promote competition while creating efficient markets.

Promote competition without affecting market practices.

Prevent competition without affecting market practices.

Question 14

The single most critical factor in determining whether a particular nurse acted with reasonable care in a given situation is:

The number of years the nurse has practiced as a professional.

The experience the nurse has in a particular clinical setting.

The ability of the nurse to perform according to his or her job description.

How the nurse’s conduct compared to the conduct of other nurses with similar backgrounds and experience.

Question 15

Persons who are qualified under the Americans with Disabilities Act include:

Persons who have gender identity disorders and sexual behavior disorders.

Persons who are bisexual and homosexual.

Persons who are currently using illegal drugs.

Persons who are recovering or rehabilitated alcoholics.

Question 16

When the nurse manager transfers full responsibility for the performance of a task without transferring the accountability for the ultimate outcome, the task has been:

Regulated.

Supervised

Delegated.

Retained.

Question 17

Consent, once validly given by a competent adult patient:

May not be revoked.

May be revoked only in writing if the original consent was written.

May be revoked at any time prior to the procedure or treatment being implemented.

May be revoked only if a second procedure supersedes the first procedure.

Question 18

Nurses in which health care settings are required to comply with the Patient Self-Determination Act of 1990?

Solely in formal institutional settings, such as hospitals.

In all health care settings except home health care settings.

In all health care settings, including home health care settings, if federal funds are received.

In home health care settings only if they have a validly executed advanced directive when care is first rendered.

Question 19

A nurse is caring for a 45-year-old patient who reveals that recent injuries are a result of domestic violence. The patient begs the nurse not to “tell anyone.” What action, taken by the nurse, is correct?

Tell the patient that the law requires reporting this incident.

Promise the patient the information will not be shared.

Talk with the patient about the reason for secrecy.

Report the revelation to the charge nurse immediately.

Question 20

The number of states that now have elder abuse laws is:

40

45

48

50

Question 21

Which of the following best describes the term “Telehealth”?

Transmission of information from one site to another.

Delivery of health care through a telecommunications system.

Transmission of sounds and images between two or more sites.

Combination of robotics and virtual reality to allow treatment modalities in distant sites.

Question 22

Apparent consent occurs when the patient:

Voluntarily signs a consent form for an invasive procedure.

Orally agrees to have an invasive procedure performed.

Allows a family member to sign the informed consent form for him or her.

Shows by his or her conduct that he or she agrees to the treatment.

Question 23

In passing the Americans with Disabilities Act of 1990, Congress attempted to combine the two legal concepts of:

Disability and the right to work.

Disability and equality.

Disability and autonomy.

Disability and fairness.

Question 24

A nurse, while under a general employment contract with a hospital, is subject to the right to direct and control the details of his or her work by a second entity. Such a nurse would be said to be acting as a (an):

Dual servant.

Borrowed servant.

Independent contractor.

Agent of the principal.

Question 25

Internal sources for determining standards of care include:

Hospital policy and procedure manuals.

Professional journals and nursing texts.

Previous and relevant court cases.

State standards of care as defined by the state board of nursing.

Question 26

The defendant in a lawsuit is the party:

Bringing the lawsuit against another.

Who was injured by the nurse or health care provider.

Who is answering a complaint brought against him or her.

Who is the health care institution in the case.

Question 27

One of the most important state legislative acts in the area of community health nursing is the:

State nurse practice act.

State Medicaid law.

State family consent doctrine.

State reporting statute.

Question 28

Which advanced nurse practitioner role is authorized by nurse practice acts, medical practice acts, and allied health laws?

Nurse anesthetist

Nurse midwife

Family nurse practitioner

Clinical nurse specialist

Question 29

Since unlicensed personnel are not licensed by the state in their own right, they may perform delegated tasks because:

They practice on the license of the professional delegating the task.

They are sanctioned by the American Hospital Association as an exception to the requirement for licensure.

They work under the auspices and licensure of the institution, not the professional nurse.

They are sanctioned by the state nurse practice act as an exception to the requirement for licensure.

Question 30

When nurses assist patients to understand their own value system and make choices consistent with those values, the approach to advocacy is said to be the:

Rights protection model.

Autonomy model.

Values-based decision model.

Patient advocate model.

Question 31

The main purpose of documentation is to:

Communicate the patient’s condition to all members of the health care team.

Record patient information for future research studies.

Verify dates of patients’ admissions to health care institutions.

Ensure that all charges are validly documented and assessed to the patient for collection from third-party payers.

Question 32

What is the most significant professional qualification necessary for a nurse who practices as a school nurse?

The nurse’s ability to work closely with school officials.

The nurse’s ability to properly counsel students about medical concerns.

The nurse’s ability to exercise independent judgment in emergency situations.

The nurse’s ability to effectively teach students about their health and wellness.

Question 33

The functions of risk management include all of the following except:

Defining situations that place the entity at some financial risk.

Intervening in and investigating potential risks that exist in the health care setting.

Identifying opportunities for improving patient care.

Identifying opportunities and funding for patient research.

Question 34

The legal guide to the practice of registered nursing is:

ANA Code of Ethics.

Nightingale Pledge.

State Nurse Practice Act.

Nurse’s Bill of Rights.

Question 35

When a nurse manager assists an employee in deciding about the employee’s future career and possible options available to him or her, the manager is most likely following the ethical principle of:

Justice

Fidelity

Autonomy

Paternalism

Question 36

The standard of care under Good Samaritan laws is usually the:

Standard of the reasonably prudent patient.

Emergency care standard.

Disaster care standard.

Standard of the prudent hospital-based staff nurse.

Question 37

The court found a nurse manager liable for failure to warn. Which option reflects a failure to warn scenario?

The nurse manager did not adequately supervise a newly hired nurse who had not practiced nursing in five years.

The nurse manager did not tell a potential employer that a former employee was asked to resign for incompetence.

The nurse manager did not advise a newly hired nurse that continuing education was an annual requirement for promotion.

The nurse manager did not notify the physician regarding worsening of a patient’s respiratory status.

Question 38

One of the earliest needs for the EMTALA was seen as the need to prevent:

Patients being turned away from clinics because of inability to pay for services.

Health maintenance organizations from making a profit by providing substandard care.

Patients being turned away from emergency centers based on inability to pay for services.

Illegal aliens from receiving free services in the United States.

Question 39

Which group or person has authority to write statutory law such as nurse practice acts?

State legislatures

State boards of nursing

State governors

State nursing associations

Question 40

The doctrine of personal liability is a rule that:

Protects nurses against liability for malpractice.

Holds everyone responsible for his or her own negligent conduct.

Makes some persons responsible for the actions of others.

Ensures that no one has liability in certain legal actions.

Question 41

The statute of limitations for a lawsuit:

Defines events that will not be allowed to be discussed at trial.

Defines the period of time in which a lawsuit may be filed.

Is suspended for minors in all states until they become 18 years of age.

Limits the number of plaintiffs and defendants in any given lawsuit.

Question 42

By passing the Emergency Medical Treatment and Labor Act, Congress:

Established the right of all Americans to have health insurance.

Established the right of access to medical care, regardless of ability to pay.

Established the right of access to medical care, dependent upon the ability to pay.

Set into motion a socialized medical plan for all Americans.

Question 43

Delegation has been a concept used in nursing:

Since the 1990s.

Since the early 1970s.

Since the mid-1950s.

Throughout all of nursing’s history.

Question 44

A confused patient frequently calls out for “help” throughout the shift. When nursing staff respond to the call, the patient is unable to explain what is needed. What action should be taken by the nurse?

Continue to respond and attempt to reorient the patient.

Move the call bell out of the patient’s reach to deter erroneous calls.

Restrain the patient in soft wrist restraints until the physician can be reached.

Chemically restrain the patient with a mild sedative so he/she will sleep.

Question 45

A nurse has decided to obtain individual professional liability insurance. In general, which type of insurance is best for most nurses?

Claims-made

Certificate-based

Occurrence-based

Employer-sponsored

Question 46

A patient on the medical/surgical unit became confused and dangerous to himself and others in the setting, restraints were applied, and the patient was confined to bed. The nurse’s best defense for applying the restraints would be:

Consent.

Self-defense.

Necessity.

Privilege.

Question 47

The standard of care of the nursing student is:

Greater than that of the RN.

Less than that of the RN.

The same as that of the RN.

Not comparable to the standard of the RN.

Question 48

A school nurse negligently administered an overdose of medication to a student, causing the student to suffer a severe reaction that necessitated hospitalization. Should a lawsuit result from this case, the nurse would be held to what standard?

The reasonably prudent school nurse

The reasonably prudent pediatric nurse

The reasonably prudent general duty hospital nurse

The reasonably prudent advanced nurse practitioner

Question 49

Discrimination against which group of persons necessitated the Americans with Disabilities Act?

The increasing population of older Americans

Those returning from war with orthopedic injuries

The increasing numbers of people injured in motor vehicle accidents

Those living with HIV/AIDS

Question 50

External sources for determining standards of care include:

Hospital policy and procedure manuals.

Professional journals and nursing texts.

The individual nurse’s experience and education.

The individual nurse’s job description.

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