Question 1

A patient asks, "What is an advance directive?" The nurse explains that examples of advance directives are: (Select all that apply.)

Accepted Answer

A)  preserving cord blood for possible future needs of a child.
B)  providing instructions that life-sustaining medical procedures should be withheld in the event of a terminal situation.
C)  giving someone the legal right to act on one's behalf when one becomes incapacitated.
D)  completing hospital admission paperwork before being admitted to the hospital. B,C

Question 2

A nurse is caring for a client with malignant hypertension whose blood pressure has increased by 40 mm Hg during the past hour. The nurse goes to lunch and fails to report the change to the physician. The nurse is at risk for being charged with:

Accepted Answer

A)   negligence.
B)   assault.
C)   defamation of character.
D)   tort. A

Question 3

A physician orders a drug for a patient with a known allergy resulting in anaphylactic shock. The nurse:

Accepted Answer

A)   realizes that disclosure of the error will result in more severe ramifications for the agency than if the negligence is discovered by the patient or family.
B)   should disclose the occurrence before speaking with the physician who ordered the drug or with hospital management.
C)   recognizes disclosure as an essential component of the national patient safety movement.
D)   should report the occurrence to the patient's insurance company to decrease patient costs. C

Question 4

A nurse who functions in the role of team leader can be held negligent for matters involving:

Accepted Answer

A)   inadequate training.
B)   lack of development of proper policies and procedures.
C)   failure to discipline unsafe workers.
D)   delegation of client care tasks.

Question 5

Which types of abuse are the nurse required to report or be subject to fines and imprisonment for not reporting? (Select all that apply.)

Accepted Answer

A)   Animal
B)   Child
C)   Alcohol
D)   Infant
E)   Emotional

Question 6

Although a hospital reversed all charges when a client was the victim of wrong site surgery, the court awarded the client $1.5 million. The client was able to return to work in 6 weeks and had no permanent damages. This monetary compensation is termed:

Accepted Answer

A)   res ipsa loquitur.
B)   punitive damages.
C)   vicarious liability.
D)   immunity.

Question 7

A physician shares with the patient's family that, while a central line was being inserted, the patient's lungs were inadvertently punctured, which required oxygen administration. The physician also explains that a chest x-ray indicated the lung remained intact and no additional treatment was required. The physician's role in this instance is based on the legal principle of:

Accepted Answer

A)   comparative negligence.
B)   gross negligence.
C)   disclosure.
D)   the Emergency Medical Treatment and Active Labor Act (EMTAL
A)  .

Question 8

When can a nurse detain a client by using restraints?

Accepted Answer

A)   Staffing resources are insufficient to monitor a patient with hemiplegia.
B)   The client is confused.
C)   The family requests the restraints to prevent the client from leaving the facility.
D)   There are current physician orders following a medical evaluation.

Question 9

A nursing student planning to apply for licensure knows that being charged with which offense would result in a minor criminal offense?

Accepted Answer

A)   Solicitation of illegal drugs
B)   Stealing a car
C)   Failing to report elder abuse
D)   Billing Medicare for services not rendered

Question 10

A nurse is charged with battery after helping an invalid patient back to bed and not calling for help due to a reduced staffing level. The patient sustained excessive bruising, sore joints, and extended stay. In this case, the:

Accepted Answer

A)   patient is the plaintiff.
B)   nurse can be charged with forcefully restraining the patient without orders.
C)   nurse is accountable due to the decreased level of staffing.
D)   charge of invasion of privacy may be withheld.

Question 11

A nurse working in a privately owned hospital is charged with a negligent act after failing to check laboratory reports prior to giving a dose of digoxin (Lanoxin) resulting in the patient's condition becoming critical due to decreased cardiac output and falling leading to a broken hip and concussion. A nurse is brought in who testifies that a professional with the knowledge and skill of an RN should understand that, before administering this drug, potassium level and pulse level is always checked to prevent such an occurrence. The nurse's testimony as to what constitutes reasonable care is based on:

Accepted Answer

A)   the legal definition of standard of care.
B)   the legal definition of the informed consent process.
C)   the doctrine of res ipsa loquitur.
D)   governmental immunity.

Question 12

A client states, "I am leaving. No one here knows what they are doing." The nurse completing the Against Medical Advice form must:

Accepted Answer

A)   defer notifying the provider until the client has had ample time to leave.
B)   state in medical terms the risks of leaving.
C)   inform the client that leaving could result in complications and impairment.
D)   detain the person with the use of soft restraints until security arrives.

Question 13

When the client is unable to make medical decisions for himself or herself, authorization that allows another person to make these decisions is called:

Accepted Answer

A)   living will.
B)   durable power of attorney.
C)   informed consent.
D)   immunity.

Question 14

All hospitals receiving Medicare and Medicaid funds must ask clients whether they have a living will or a durable power of attorney. This act is known as the:

Accepted Answer

A)   Emergency Treatment and Active Labor Law.
B)   Americans With Disabilities Act.
C)   Patient Self-Determination Act.
D)   doctrine of res ipsa loquitur.

Question 15

A nurse learns in orientation that an incident report does not "blame" anyone but concisely documents the events leading up to an occurrence. Which events would warrant completion of an incident report? (Select all that apply.)

Accepted Answer

A)  The client is crying and distraught when he learns of a diagnosis of cancer.
B)  An intravenous antibiotic given preoperatively does not infuse because of a faulty pump.
C)  The nurse is unable to carry out orders written by the specialist because of illegibility.
D)  A client falls while in the shower, although she was told not to get up alone.
E)  The registered nurse is not available to complete the preoperative checklist.

Question 16

A client arrives in active labor and exhibits toxemia with irregular fetal heart tones. The client is an immigrant and is uninsured. Which act would prevent the client from being transferred to another facility?

Accepted Answer

A)   Emergency Medical Treatment and Active Labor Law
B)   Health Insurance Portability and Accountability Act
C)   Patient Self-Determination Act
D)   The Patient Safety and Quality Improvement Act

Question 17

A nurse is caring for a client who just suffered a stroke and is medicated for pain. The nurse completes the following interventions: places the client on the examining table, completes a thorough history and physical, covers the client with a sheet, places the call button within reach, and goes out in the hall to speak with the client's physician. The client tries to get up to speak with his family and falls, sustaining a hematoma on the head and a broken hip. The nurse's actions reflect:

Accepted Answer

A)   invasion of privacy.
B)   libel.
C)   slander.
D)   negligence.

Question 18

On a nursing unit all assigned breaks including lunch/dinner breaks are assigned at the beginning of the shift. A nurse caring for a patient with anemia and heart failure prepares to hang a unit of packed red blood cells and realizes her break is in 5 minutes. She decides it is not necessary to have another nurse check the blood against the patient's information since the patient's blood type is O+ which she incorrectly remembered to be the universal donor. She hangs the blood, noting the patient is "reading and vital signs normal." She leaves the floor for her break and does not report leaving or ask anyone to perform required vital signs. Upon returning she meets a family friend who is visiting and time "just flies." She returns to the patient's room after admitting a new patient. The patient is hypotensive and color is cyanotic and anxious. She reports the findings to the charge nurse, who then contacts the physician. A blood reaction occurrence is noted. The nurse providing care is charged:

Accepted Answer

A)   with comparative negligence.
B)   with a preventable adverse event.
C)   with criminal negligence.
D)   under the doctrine of res ipsa loquitur.

Question 19

A nurse is assigned to a unit other than the one she is normally assigned due to increased census on the alternate unit. She is assigned to care for seven patients and participates in walking rounds where the patient's condition and needs are discussed between oncoming and off-going shifts of the interdisciplinary team. The nurse carefully makes notes of all pending orders and prioritizes needs. The nurse enters the cafeteria later and the notes accidentally fall from her pocket, which contain the above information that contains patient sensitive data. The liabilities arising from this incident would be covered under:

Accepted Answer

A)   the Health Insurance Portability and Accountability Act.
B)   the ANA Scope and Practice Act.
C)   affirmative duty failing to question order.
D)   personal liability with floating and cross-training.

Question 20

Which statement regarding informed consent is correct? Informed consent:

Accepted Answer

A)   is mandated by federal but not state law.
B)   must reveal expected benefits.
C)   requires concealing any known risks.
D)   allows the RN to communicate information needed so that informed consent can be provided.

Exam 8: Legal Issues in Nursing and Health Care