Deck 49: Legal Issues

Question 1

A client newly diagnosed with diabetes mellitus tells the nurse that the prescribed diet does not provide enough variation of choice.Which response by the nurse is most appropriate?

A) "I will bring you a different menu."
B) "I will ask my manager to talk with the dietician."
C) "Let's look at your diet and see what type of variety we can find."
D) "I will notify the dietary department to change your diet."

Answer 1

"Let's look at your diet and see what type of variety we can find."

Question 2

A client is receiving care in the hospital for life-threatening injuries sustained in a motor vehicle crash and is taken immediately to surgery.There is no family available to provide consent; however,the client's medical record is available and reviewed by the nurse.Which treatments are inappropriate in this situation? Select all that apply.

A) Emergency surgery
B) Treatment that was previously refused
C) Treatment that violates religious beliefs
D) Medications to treat the injury
E) Experimental medications for a research study

Answer 2

Treatment that was previously refused
Treatment that violates religious beliefs
Experimental medications for a research study

Question 3

A nurse educator on an oncology unit is teaching staff nurses about advance directives.Which elements will the nurse include in the teaching session? Select all that apply.

A) The surrogate decision maker has the authority to consent to any medical treatment or diagnostic procedure.
B) The surrogate decision make has the authority to consent to only life saving medical treatments.
C) The surrogate decision maker has the authority to authorize admission only to medical facilities and not long-term care facilities.
D) The surrogate decision maker has the authority to have access to all medical records.
E) The surrogate decision maker has the authority to refuse any medical treatment or diagnostic procedure.

Answer 3

The surrogate decision maker has the authority to consent to any medical treatment or diagnostic procedure.
The surrogate decision make has the authority to consent to only life saving medical treatments.
The surrogate decision maker has the authority to have access to all medical records.
The surrogate decision maker has the authority to refuse any medical treatment or diagnostic procedure.

Question 4

The nurse is asked to participate on a committee to ensure that no breaches of client confidentiality occur when providing care.Which actions help ensure client confidentiality when providing care? Select all that apply.

A) Withholding private information from other staff unless needed for care
B) Sharing the name and diagnosis of clients upon request
C) Discussing client care with nurses on other units
D) Restricting the discussion of client care to the report room
E) Reviewing the client's care needs with a designated health insurance agent

Question 5

A home healthcare case manager often receives documents that pertain to the care of clients on a shared fax machine.The case manager is aware of how important it is to protect each client's health information.Which action by the nurse ensures that the Health Insurance Portability and Accountability Act (HIPAA)requirements are met in this situation?

A) Have sending agencies call ahead before any information is sent.
B) Take relevant information over the phone.
C) Have the client sign a consent form for information to be released.
D) Do not utilize the fax machine; depend on the mail system.

Question 6

The nurse is caring for a client on a medical-surgical unit that has just implemented the electronic medical record for client documentation.The client asks the nurse about the facility's computerized system for keeping client information,especially in regard to confidentiality.Which is the best response by the nurse?

A) "I can see why you're worried, with all the computer hackers out there these days."
B) "Our system was designed with a lot of input from nursing staff."
C) "Information in the electronic medical record requires a password to retrieve."
D) "Don't worry; your information is always safe."

Question 7

The nurse working on a medical unit is admitting a client diagnosed with heart failure.During the admission process,the client states,"I do not want to be put on a ventilator because I had to watch my mother die on a ventilator.I want information on making out a will." When planning care for this client,which intervention is the most appropriate?

A) Educate the client on the process and purpose of a living will and arrange for one to be created should the client choose to do so.
B) Encourage the client to allow for mechanical ventilation.
C) Educate the client on the purpose of mechanical ventilation.
D) Refer the client to a therapist to deal with the death of her mother.

Question 8

A client who sustained a traumatic brain injury several weeks ago is in a chronic vegetative state and is no longer competent to make healthcare decisions.Who should the nurse expect to make care decisions for this client?

A) The physician
B) The client's spouse
C) Social services
D) The agent named in the durable power of attorney

Question 9

While preparing a pain medication for a client,the nurse notes that there is a discrepancy with the last removal and reports the incident.Which is an expected consequence of the nurse's action?

A) Being sued by the nurse who made the error
B) Being ostracized by the staff
C) Being protected by the law
D) Being summoned to testify

Question 10

The nurse is concerned about being sued for negligence when providing care.Which nursing actions may be grounds for negligence? Select all that apply.

A) Client fell getting out of bed because the call light was not used.
B) Client name band was checked prior to providing all medications.
C) Client's morning medications were administered in the early afternoon.
D) Client states not understanding activity restrictions and wound eviscerated.
E) Client documentation did not include appearance of infiltrated IV site.

Question 11

The nurse on the medical unit is admitting a client.When the nurse asks the client about advance directives,the client states,"I have a living will." Which is the purpose of a living will?

A) Provides specific instructions about type of medications the client requires to sustain life
B) Provides specific instructions about what medical treatment the client chooses to omit or refuse in the event they can no longer make decisions for themselves
C) Provides specific instructions about who will make healthcare decisions if the client cannot
D) Provides specific instructions about how decisions are to be made if the client is unable to make the decisions

Question 12

The nurse receives a notice that the state board of nursing has become a member of the Nurse Licensure Compact.How would this change in the state board of nursing structure influence the nurse's ability to practice nursing? Select all that apply.

A) The nurse can only practice nursing in the residing state.
B) The nurse can practice nursing in other states within the compact.
C) The nurse is accountable to the state in which the nurse and clients reside.
D) The nursing license will become similar to having a driver's license.
E) The nurse has to obtain an additional license.

Question 13

A nurse working on a medical-surgical unit wants to ensure care is provided within the standard of nursing care.Which actions by the nurse are appropriate? Select all that apply.

A) Analyze the position description.
B) Review and become familiar with the policy and procedure manual.
C) Question the value of collaborating with other disciplines.
D) Ensure the nursing process steps are practiced.
E) Adhere to national standards of practice and care.

Question 14

After discussing advance directives during a home visit,an older adult client decides to prepare documents for future care needs.Which actions by the nurse are appropriate in this situation? Select all that apply.

A) Telling the client that changes to the advance directive can be made at any time
B) Telling the client it is not necessary to make decisions about health care needs in the future
C) Giving a copy of the advance directives to the client's adult children
D) Educating the client about the purpose and types of life-sustaining measures
E) Having the client name an individual to be responsible for care decisions

Question 15

A client with terminal cancer has signed an advance directive indicating that no parenteral nutrition or hydration will be implemented.For several days the client has refused food and fluids,pushing the caregiver's hands away when attempts are made to feed the client or offer any kind of fluid.The family is considering placing a gastrostomy tube because they feel the client is "starving to death." Which actions by the nurse are appropriate? Select all that apply.

A) Take the case to the hospital's ethics committee.
B) Honor the client's refusal of parenteral nutrition and hydration.
C) Talk to the healthcare provider so the family's wishes can be acted upon.
D) Help the family come to terms with the situation.
E) Honor the family's wishes and have them sign a consent form.

Question 16

A client on a medical-surgical unit experiences a code blue situation unexpectedly.The emergency situation has ended and the client survived.The nurses are breaking for lunch and plan to process their feelings about the emergency.Which action by the nurses will facilitate this?

A) Discussing the event outside the hospital.
B) Asking management for the use of a private room to debrief.
C) Talking while riding in the staff elevator.
D) Debriefing about the situation at home.

Question 17

The nurse observes a healthcare provider discuss an operative procedure with a client and determines informed consent was achieved.Which information was included in the informed consent process? Select all that apply.

A) The provider's disapproval if the surgery is not performed
B) The health problem that requires surgery
C) The purpose of the surgery
D) The expectations of the surgery
E) Outcome if surgery is not performed

Question 18

A nurse educator is teaching a group of nursing students about the function of the state board of nursing.Which information will the educator include in the teaching session? Select all that apply.

A) Creating the NCLEX-RN examination
B) Defining professional standards
C) Investigating violations of the nurse practice act
D) Suspending or revoking licenses
E) Finding drug treatment centers for impaired nurses

Question 19

The staff development trainer is preparing a seminar to review the concepts of a just culture,which is being implemented in the organization.Which elements are integral when training on this content? Select all that apply.

A) Managers providing feedback to staff regarding actions
B) Proactive environment that supports employee involvement in decision making
C) Supports learning
D) Examines system failures when an adverse event occurs
E) Nurse accountability for actions

Question 20

A student nurse administers a medication to the wrong client while the instructor is with another student.Which statement by the instructor is most appropriate in this situation?

A) "You have placed the nursing student program in danger."
B) "You may be sued by the hospital for the extra care cost to the client."
C) "You are expected to practice like a licensed nurse."
D) "You have set a bad example for the other students."

Question 21

The nurse is concerned about the risk involved when implementing healthcare provider prescriptions for a newly admitted client.Which strategies should the nurse consider to reduce this risk? Select all that apply.

A) Question any order written for a postoperative client.
B) Question any order a client questions.
C) Question any order if the client's condition changes.
D) Question any verbal order.
E) Question any order that is incomplete.

Question 22

During an assessment of a child in the urgent care clinic,the nurse notes that the child has a swollen and split lip.When asking the parent how the child's lip injury occurred,the parent responds,"We are here for my child's ear not my child's lip." Which is the rationale for reporting this incident?

A) The child reports that a parent caused the injury.
B) The lip injury is unrelated to the ear infection.
C) The nurse can be sued if there is no abuse.
D) Suspected abuse must be reported.

Question 23

A medication error occurred and the nurse is preparing to complete an incident report.Which information is required to thoroughly complete this report? Select all that apply.

A) Name of client involved in the incident
B) Location where completion of an incident report is located in the medical record
C) Date and time of the incident
D) Medication involved in the incident
E) Number of hours the nurse was at work before the incident occurred

Question 24

A nurse educator is planning a class for a group of nursing students regarding risk management.Which information should the educator include in this presentation? Select all that apply.

A) Risk management seeks to prevent harm.
B) Risk management empowers clients.
C) Risk management controls the cost of supplies.
D) Risk management examines past mistakes and identifies potential hazards.
E) Risk management assures that nurses are truthful.

Question 25

The nurse is in the midst of a complicated client care situation and is not sure what needs to be done with some information.Which healthcare issues must the nurse report to the state? Select all that apply.

A) Amputation of a limb
B) Death of a client
C) Death of a neonate
D) Diagnosis of tuberculosis
E) Kidney transplant

Question 26

A novice nurse attends a lecture regarding risk management.Which action should the nurse implement to reduce risks in practice?

A) Not discussing errors made
B) Questioning every order that the physician writes
C) Purchasing liability insurance
D) Storing unused equipment in the halls of the unit

Question 27

The nursing instructor is evaluating the success of training provided to staff nurses on ways to reduce the incidence of pediatric medication errors.Which observations indicate that training has been effective? Select all that apply.

A) Staff nurses are double checking medication calculations.
B) Staff nurses are refusing to administer medications.
C) Staff nurses are using liquid preparations.
D) Staff nurses are asking the pharmacy to prepare the exact doses.
E) Staff nurses are asking each other to validate placement of decimal points.

Question 28

The nurse manager is evaluating the success of staff training on just culture.Which observations indicate that training has been successful? Select all that apply.

A) Staff members are reporting safety errors.
B) Staff members are taking responsibility for actions.
C) Staff members are naming others responsible for errors.
D) Staff members are neglecting client safety initiatives.
E) Staff members are reporting unsafe staffing conditions to the media.

Question 29

An adolescent client with a sexually transmitted infection (STI)says to the nurse,"Promise you won't tell my parents about my condition." Which action by the nurse is appropriate?

A) Disclosing information to the parents
B) Communicating only necessary information
C) Respecting the client's privacy and confidentiality
D) Honoring the client's wishes

Question 30

While making rounds on the night shift,a nursing supervisor notes that one of the nurses has multiple visible bruises.Which action is appropriate by the nursing supervisor in this situation?

A) Ask the nurse about the source of the injuries.
B) Do nothing about the situation.
C) Notify the security department.
D) Notify authorities regarding the abuse.