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.