Chapter 08: Legal Issues in Nursing and Health Care
Cherry & Jacob: Contemporary Nursing: Issues, Trends, and Management, 7th Edition
MULTIPLE CHOICE
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1. 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?
a. Emergency Medical Treatment and Activ
ANS: A
The Emergency Medical Treatment and Active Labor Law is a federal statute that was enacted in 1986 to prohibit the transfer of unstable clients, including women in labor, from one facility to another. This law also prohibits refusal of care for ind
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:
a. neg
ANS: A
Negligence is defined as failure to act in a reasonable and prudent manner. The most frequent allegations of nursing negligence include failure to ensure client safety, improper treatment, failure to monitor the client and report significant findin
3. 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, p
ANS: D
The nurse is failing to ensure client safety after medication administration; this is defined as negligence.
DIF: Comprehension REF: p. 120|p. 132
4. A nursing student planning to apply for licensure knows that being charged with which offense would result in a minor criminal offense?
a. Solicitation of illegal drugs
b. Stealing a car
c. Failing to report elder abuse
d. Billing Medicare for services
ANS: C
Failing to report elder abuse can lead to penalty of fine or imprisonment.
DIF: Comprehension REF: p. 150
5. When differentiating between slander and libel, the nurse knows that libel:
a. results from defamation caused by subjective comments written in the nurse's notes.
b. results from negative subjective comments made to those who are not providing care.
c.
ANS: A
Libel is defined as comments that are written about a person that are defaming. Nurses may be subject to a charge of libel for subjective comments meant to denigrate the client that are placed in the medical record or in other written materials rea
6. Which statement regarding informed consent is correct? Informed consent:
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 i
ANS: B
The information that constitutes informed consent for the client includes the nature of the therapy or procedure, expected benefits and outcomes of the therapy or procedure, potential risks of the therapy or procedure, alternative therapies to the
7. A client states, "I am leaving. No one here knows what they are doing." The nurse completing the Against Medical Advice form must:
a. defer notifying the provider until the client has had ample time to leave.
b. state in medical terms the risks of leav
ANS: C
The nurse must articulate to the client the dangers associated with leaving the facility if the primary provider is not present. The nurse's notes on this form should reflect the specific advice given to the client, which should include the fact th
8. When can a nurse detain a client by using restraints?
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. Ther
ANS: D
A written physician's order that is timed and dated is required for the use of restraints. Renewal of orders must be accompanied by evidence of medical evaluation and nursing reassessment.
DIF: Comprehension REF: p. 155
9. When the client is unable to make medical decisions for himself or herself, authorization that allows another person to make these decisions is called:
a. living will.
b. durable power of attorney.
c. informed consent.
d. immunity.
ANS: B
Durable power of attorney involves preselection by the client of a person who has been authorized legally to make health care decisions once the client becomes incompetent to do so. Several states have enacted a Uniform Durable Power of Attorney Ac
10. 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:
a. Emergency Treatment and Active Labor Law.
b. Americans with Disabilities Act.
c. Uniform
ANS: C
The Uniform Health Care Decisions Act of 1993 is a federal statute that was established to support individuals in expressing their preferences about medical treatment and making decisions about end-of-life care.
DIF: Comprehension REF: p. 152
11. A nurse who functions in the role of team leader can be held negligent for matters involving:
a. inadequate training.
b. lack of development of proper policies and procedures.
c. failure to discipline unsafe workers.
d. delegation of client care tasks
ANS: D
Delegation of client care tasks falls within the role of the team leader, and inappropriate delegation of client care tasks could result in negligence. Team leaders, charge nurses, and managers are held to the standard of care of the reasonably pru
12. 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
ANS: B
Punitive damages are monetary compensation to an injured client that is greater than amount of loss.
DIF: Application REF: p. 120 |p. 135
13. A physician orders a drug for a patient with a known allergy resulting in anaphylactic shock. The nurse:
a. realizes that disclosure of the error will result in more severe ramifications for the agency than if the negligence is discovered by the patie
ANS: C
The National Quality Forum identified the process of disclosure as a key element of the national patient safety movement.
DIF: Application REF: p. 139
14. 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:
a. patient is the plain
ANS: A
The complaining person in a lawsuit is the plaintiff.
DIF: Application REF: p. 120
15. 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
ANS: A
Standard of care is the legal criteria against which the nurse's (and physician's) conduct is compared to determine whether a negligent act or malpractice occurred. Nurses are specialists in hospital care who, in the final analysis, hold the well-b
16. 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
ANS: C
In this case, criminal negligence charges would be based on "reckless and wanton" disregard for the safety, well-being, or life of an individual; behavior that demonstrates a complete disregard for another, such that death is likely in the transfus
17. 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 remai
ANS: C
Disclosure is a process in which the patient's primary provider (physician or advanced practice nurse) gives the patient, and when applicable, family members, complete information about unanticipated adverse outcomes of treatment and care.
DIF: Com
18. 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 discusse
ANS: A
HIPAA protects patient information and ensures confidentiality of data.
DIF: Analysis REF: p. 125
MULTIPLE RESPONSE
1. Which types of abuse are the nurse required to report or be subject to fines and imprisonment for not reporting? (select all that apply)
a. Animal
b. Child
c. Alcohol
d. Infant
e. Emotional
ANS: B, D
State laws have been created as a result of the 1973 Child Abuse Prevention and Treatment Act. These laws dictate that health professionals must report infant and child abuse and specified communicable diseases. Failure by the nurse to comply ca
2. A patient asks, "What is an advance directive?" The nurse explains that examples of advance directives are: (select all that apply)
a. preserving cord blood for possible future needs of a child.
b. providing instructions that life-sustaining medical pr
ANS: B, C
Advance directives document an individual's desires regarding end-of-life care. These wishes are generally stated through the execution of a formal document known as the living will. Right-to-die statutes vary from state to state; therefore, nur
3. 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)
a. The client is crying a
ANS: B, C, D, E
Nurses are legally bound to report critical incidents to their nurse managers, agency administration, and risk manager through a formal intra-agency document generally titled the "incident report." Circumstances under which an incident rep