Fundamentals of Nursing Chapter 4 – Flashcards
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A primary care provider's orders indicate that a surgical consent form needs to be signed. Since the nurse was not present when the primary care provider discussed the surgical procedure, which statement best illustrates the nurse fulfilling the client advocate role? A: "The doctor has asked that you sign this consent form" B: "Do you have any questions about the procedure?" C: "What were you told about the procedure you are going to have?" D: "Remember that you can change your mind and cancel the procedure."
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C: "What were you told about the procedure you are going to have?"
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Although the client refused the procedure, the nurse insisted and inserted a nasogastric tube in the right nostril. The administrator of the hospital decides to settle the lawsuit because the nurse is most likely to be found guilt of which of the following? A: An unintentional tort B: Assault C: Invasion of privacy D: Battery
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D: Battery
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A nurse discovers that a primary care provider has prescribed an unusually large dosage of a medication. What is the most appropriate action? A: Administer the medication B: Notify the prescriber C: Call the pharmacist D: Refuse to administer the medication
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B: Notify the prescriber
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A primary care provider prescribes one tablet, but the nurse accidently administers two. After notifying the primary care provider, the nurse monitors the client carefully for untoward effects of which there are none. Is the client likely to be successful in suing the nurse for malpractice? A: No, the client was not harmed B: No, the nurse notified the primary care provider C: Yes, a breach of duty exists D: Yes, foreseeability is present
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A: No, the client was not harmed
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A nursing student is employed and working as an unlicensed assistive personnel (UAP) on a busy surgical unit. The nurses know that the UAP is enrolled in a nursing program and will be graduting soon. A nurse asks the UAP if he has performed a urinary catheterization on clients while in the nursing program. When the UAP says "Yes," the nurse asks him to help her out by doing a urinary catheterization on a postsurgical client. What is the best response by the UAP? A: "Let me get persmission from the client first" B: "Sure. Which client is it?" C: "I can't do it unless you supervise me." D: "I can't do it. Is there something else I can help you with?"
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D: "I can't do it. Is there something else I can help you with?"
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The primary care provider wrote a do-not-resuscitate (DNR) order. The nurse recognizes that which applies in the planning of nursing care for this client? A: The client may no longer make decisions regarding his or her own health care. B: The client and family know that the client will most likely die within the next 48 hours. C: The nurses will continue to implement all treatments focused on comfort and symptom management. D: A DNR order from a previous admission is valid for the current admission.
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C: The nurses will continue to implement all treatments focused on comfort and symptom management.
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The nurse's partner/spouse undergoes exploratory surgery at the hospital where the nurse is employed. Which practice is most appropriate? A: Because the nurse is an employee, access to the chart is allowed. B: The relationship with the client provides the nurse special access to the chart. C: Access to the chart requires a signed release form. D: The nurse can ask the surgeon to discuss the outcome of the surgery.
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C: Access to the chart requires a signed release form.
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Following a motor vehicle crash, a nurse stops and offers assistance. Which of the following actions is/are most appropriate? Select all that apply. A: The nurse needs to know the Good Samaritan Act for the state. B: The nurse is not held liable unless there is gross negligence. C: After assessing the situation, the nurse can leave to obtain help. D: The nurse can expect compensation for helping. E: The nurse offers to help but cannot insist on helping.
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A: The nurse needs to know the Good Samaritan Act for the state. B: The nurse is not held liable unless there is gross negligence. E: The nurse offers to help but cannot insist on helping.
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The nurse notices that a colleague's behaviors have changed during the past month. Which behaviors could indicate signs of impairment? Select all that apply. A: Is increasingly absent from the nursing unit during the shift B: Interacts well with others C: "Forgets" to sign out for administration of controlled substances D: Offers to administer prn opioids for other nurses' clients E: Is able to say "no" to requests to work more shifts
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A: Is increasingly absent from the nursing unit during the shift C: "Forgets" to sign out for administration of controlled substances D: Offers to administer prn opioids for other nurses' clients
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Which nursing actions could result in malpractice? Select all that apply. A: Learns about a new piece of equipment B: Forgets to complete the assessment of a client C: Does not follow up on client's complaints D: Charts client's drug allergies E: Questions primary care provider about an illegible order
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B: Forgets to complete the assessment of a client C: Does not follow up on client's complaints
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Do nursing students practice on their instructor's or another nurse's license?
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No, each nurse and nursing student is responsible and accountable for providing safe client care
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HIPAA Compliance: Charts should be in a ________________.
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secure, nonpublic location to prevent the public from viewing or accessing confidential health information
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HIPAA Compliance: Place clipboards _____.
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facedown
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HIPAA Compliance: Printed copies of protected health information _________________.
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should not be left unattended at a printer or fax machine
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HIPAA Compliance: Verify the number dialed before______________.
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faxing personal health information
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HIPAA Compliance: Encrypt personal health information _________________.
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when transmitting by e-mail
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HIPAA Compliance: Access to protected health information is limited to __________________.
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those authorized to obtain the information
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HIPAA Compliance: Health care providers will need a password to access a client's __________.
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electronic chart
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HIPAA Compliance: A notice informing client's of their rights about privacy and their health information should be _________.
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posted or provided
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HIPAA Compliance: Voice levels should be lowered to minimize ______________________.
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disclosure of information (e.g., when discussing a client's condition over the telephone, giving a report, reading information aloud from a computer screen or chart.)
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HIPAA Compliance: Health care providers must stay current with _________.
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HIPAA regulations
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Good Samaritan Acts: Limit actions to those normally considered __________.
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first aid, if possible
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Good Samaritan Acts: Do not perform actions that ____________.
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you do not know how to do
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Good Samaritan Acts: Offer assistance, but __________.
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do not insist
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Good Samaritan Acts: Have someone call or go for ____________.
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additional help
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Good Samaritan Acts: Do not leave the scene until _________________________.
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the injured person leaves or another qualified person takes over
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Good Samaritan Acts: Do not accept ___________.
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any compensation
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Invasion of Privacy: Never discuss client situations in ______________________.
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the elevator, cafeteria, or other public areas
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Nurse's Duty: Is a nurse only responsible for her own assigned clients' call lights?
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No, it is the nurse's duty to respond to all clients' call lights, not just those of assigned clients
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Nurse's Duty: The best defense against a malpractice claim is to _______________________.
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know your nursing responsibilities and the scope of practice of members of your health team. (e.g., LPN/LVN, UAP)
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Unintentional Torts: What six elements must be present for a case of nursing malpractice to be proven?
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Duty, Breach of Duty, Foreseeability, Causation, Harm or Injury, and Damages.
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Nursing Malpractice: Define "Duty"
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The nurse must have (or should have had) a relationship with the client that involves providing care and following an acceptable standard of care.
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Nursing Malpractice: Define "Breach of Duty"
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The standard of care that is expected in the specific situation but that the nurse did not observe; this is the failure to act as a reasonable, prudent nurse under the circumstances.
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Nursing Malpractice: Define "Foreseeability"
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A link that must exist between the nurse's act and the injury suffered.
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Nursing Malpractice: Define "Causation"
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A fact that must be proven that the harm occurred as a direct result of the nurse's failure to follow the standard of care and the nurse could have (or should have) known that failure to follow the standard of care could result in such harm.
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Nursing Malpractice: Define "Harm" (or "Injury")
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The client or plaintiff must demonstrate some type of harm or injury (physical, financial, or emotional) as a result of the breach of duty owed the client; the plaintiff will be asked to document physical injury, medical costs, loss of wages, "pain and suffering," and any other damages.
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Nursing Malpractice: Define "Damages"
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If malpractice caused the injury, the nurse is held liable for damages that may be compensated.
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Nursing Malpractice: To avoid a malpractice lawsuit for an accidental fall: 1.) Assess clients for __________. 2.) Document all nursing measures ______________________.
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1.) fall potential 2.) taken to protect the client (e.g., instructed client how to use the call light
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Nursing Malpractice: To avoid a malpractice lawsuit for "failure to observe and take appropriate action," monitor both _________ and _________ status of the client. Document __________ and ______________.
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Monitor both physical and psychosocial status of the client. Document observations and interventions.
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Nursing Malpractice: To avoid a malpractice lawsuit for "medication error," you must ___________________________.
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know about the medications being administered; know why the client is receiving the medicationm, the dosage range, possible adverse effets, toxicity levels, and contraindications.
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What is an "impaired nurse?"
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A nurse who practice has deteriorated because of chemical abuse.
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Two nursing students are riding the bus home after a stressful day of clinical. They are discussing the events of the day and laughing about the blood alcohol level of the school's basketball coach admitted after an accident. The client was never mentioned by name but common personal details about the client allowed everyone sitting near the students to know the name of their client. The students could be specifically charged with: A: Libel B: Invasion of Privacy C: Slander D: Defamation
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B: Invasion of Privacy
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A nurse responded to the alarm on the client's IV pump that sounded during the entire shift by silencing the alarm and saying "this pump is always beeping at me; if I turn the alarm off I don't have to come in here every few minutes." The client received extensive damage to her arm from the IV that was infiltrated and not infusing correctly. The nurse may be liable and charged with: A: A misdemeanor B: Failure to communicate C: Felony D: Malpractice
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D: Malpractice
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After inserting a nasogastric tube declined by the competent client, the nurse is likely to be found guilty of: A: Assault B: Invasion of Privacy C: Battery D: An unintentional tort
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C: Battery
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What is the best way for the nurse to obtain informed consent for a client who cannot read? A: Ask a relative to sign the form B: Use picture cards that explain the procedure to the client C: Assume that the client gives consent if he nods his head in agreement D: Read the consent form to the client
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D: Read the consent form to the client
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A lawsuit has been brought against a nurse for inserting a urinary catheter without using lidocaine lubricant at the beginning of the procedure and causing the client unnecessary pain. As the nurse's lawyer prepares for the case, the standard of practice for this procedure must be confirmed. An appropriate source to determine standard of practice is: (Select all that apply) A: The 10-year-old textbook the nurse used in nursing school B: The nurse practice act C: A survey of peers D: The agency's policy and procedure manual E: An expert witness
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B: The nurse practice act C: The agency's policy and procedure manual D: An expert witness
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The nurse demonstrates internal standards of practice by: (Select all that apply) A: Receiving a copy of the nurse practice act B: Reading professional journals C: Learning from continued education classes D: Helping to develop state standards of nursing care E: Reading the facility policy and procedure manual
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B: Reading professional journals C: Learning from continued education classes E: Reading the facility policy and procedure manual
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Two nurses need to discuss a client's plan of care and choose what environment to hold the discussion in order to prevent a possible HIPAA violation? A: Elevator B: Cafeteria C: Nursing unit conference room D: Nursing unit halfway
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C: Nursing unit conference room
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The nurse knows that one of the goals of the Health Insurance Portability and Accountability Act (HIPAA) is to protect a client from which of the following: A: Assault B: Battery C: Invasion of Privacy D: False Imprisonment
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C: Invasion of Privacy
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A few hours after agreeing to voluntary admission to a mental health facility, the client decides to leave. The nurse says that the client is required to stay and the nurse will not unlock the door. This nurse is guilty of: A: Libel B: Invasion of Privacy C: False Imprisonment D: Battery
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C: False Imprisonment
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A nurse documents in the client's chart that the physician is competent because he did not respond promptly to the nurse's calls regarding a client. This is an example of: A: Invasion of Privacy B: Slander C: Assault D: Libel
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D: Libel
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An off-duty nurse is in a grocery store parking lot and notices an elderly woman lying on the ground with her leg at an unnatural angle. The woman is crying in pain. What is the nurse's priority action? A: Stay with the woman, offer emotional support, and call for medical assistance B: Assist the woman into the nurse's car and take the woman to the hospital C: The nurse does not need to do anything because the woman is not an assigned client D: Observe the client from a distance until emergency responders arrive
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A: Stay with the woman, offer emotional support, and call for medical assistance
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A nurse, while transcribing the primary care provider's orders, notes that the dosage of one medication is outside the normal range. The nurse's priority of action is to: A: Notify the prescriber B: Administer the medication C: Consult the pharmacist D: Refuse to administer the medication
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A: Notify the prescriber
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A nursing student who is scheduled to graduate in 2 months is employed as a nurse aide at a local hospital. While at work, the student is asked to change the rate of an intravenous line in a client's room. What is the best response by this student? A: "Do you mind watching me this time, and then I'll do it myself next time?" B: "This will be good practice for me since I will be doing this every day in a couple of months." C: "I'm sorry, I'm not allowed to do that. I can only do tasks other nurse aides are allowed to do." D: "I'll be glad to, I have done it with my instructor a number of times."
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C: "I'm sorry, I'm not allowed to do that. I can only do tasks other nurse aides are allowed to do."
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The client tells the nurse she is considering having surgery and mentions the name of the surgeon who will perform the surgery. The nurse tells the client she should find a different doctor because this particular surgeon is not very skilled. This is an example of: A: Libel B: Invasion of privacy C: Assault D: Slander
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D: Slander
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A nurse is caring for a client who has just returned from surgery. The nurse does not assess this client's dressing. The client is later discovered to have internal bleeding and requires another surgery. What category of negligence describes this nurse's actions? A: Failure to use equipment in a responsible manner B: Failure to follow standards of care C: Failure to document D: Failure to communicate
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B: Failure to follow standards of care
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A nurse living in a nurse licensure compact state has an Internet consulting business in which she counsels clients in many different states. The nurse: A: Must have a license in his or her primary state of legal residency B: Cannot legally practice outside of the state C: Cannot utilize the Internet to practice D: Must have a license in each state
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A: Must have a license in his or her primary state of legal residency
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The client believes that his hospital-acquired infection was the result of a nurse who did not perform appropriate hand hygiene. What charges will the client bring against the nurse? A: Felony B: Malpractice C: Negligence D: Invasion of Privacy
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C: Negligence
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The nurse is driving home from work one evening, still dressed in uniform. The car traveling in front of the nurse is involved in an accident, striking a pedestrian, and the person driving that car stops to provide assistance to the injured person. The nurse does not stop and continues home. The nurse is protected from litigation because what element of malpractice is missing? A: Foreseeability B: Causation C: Harm or Injury D: Duty
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D: Duty
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The nurse, caring for a client with a progressive degenerative disease, correctly explains that the purposes of the ADA is to: (select all that apply) A: Provide a clear and comprehensive national mandate for eliminating discrimination against individuals with disabilities B: Prevent people with disabilities from being fired or discharged from their job C: Ensure that people with disabilities receive greater pay for their work because they must overcome challenges. D: Ensure that the federal government plays a central role in enforcing standards established under the act E: Provide clear, strong, consistent, and enforceable standards that address discrimination against individuals with disabilities.
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A: Provide a clear and comprehensive national mandate for eliminating discrimination against individuals with disabilities D: Ensure that the federal government plays a central role in enforcing standards established under the act E: Provide clear, strong, consistent, and enforceable standards that address discrimination against individuals with disabilities
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Most statutes include conscience clauses that are designed to protect hospitals and nurses in matters dealing with abortion services. These clauses allow the nurse to be protected from: A: Prejudicial statements B: Discrimination or retaliation C: Defamation or injust prejudice D: Legal liability
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B: Discrimination or retaliation
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A nurse knows that the main purpose of an advance care directive is to: A: Outline a client's wishes about treatment B: Provide a form on which a family member gives permission for a client's treatment C: Require a "do-not-resuscitate" (DNR) order from one institution to be implemented in another D: Serve as a substitute for a "do-not-resuscitate" (DNR) order by a doctor
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A: Outline a client's wishes about treatment
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A physician orders a medicine that the nurse believes to be contraindicated for the client. The nurse's legal obligation is to: A: Call the physician to question the order B: Report the order to the supervisor C: Administer the medication as ordered D: Disregard the order as an error
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A: Call the physician to question the order
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After disclosing a substance addiction problem to the nursing supervisor, what can the nurse anticipate will occur? A: The nurse will enter a supervised treatment program for 6 weeks B: The nurse will continue to work as before but must submit to regular, random drug screening C: The nurse will be encouraged to enter a diversion program D: The nurse's license will be revoked
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C: The nurse will be encouraged to enter a diversion program
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A nurse recently disagreed with a physician concerning a client's plan of care. The nurse then tells everyone that this particular physician is completely incompetent and should not be trusted. This is an example of: A: Slander B: Negligence C: Assault D: Libel
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A: Slander
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The client confides in the nurse that she had unprotected sexual intercourse while on vacation and is afraid that she has a sexually transmitted infection. With whom may the nurse share this information without violating HIPAA? A: The unit secretary B: The client's physician C: The laboratory technician D: The pharmacist
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B: The client's physician
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A rationale for defining the nursing scope of practice, standards of care, and licensing is: A: For convenience in litigation B: The explain specialty practice C: For public protection D: To ensure accountability
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C: For public protection
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In order to reduce the risk of legal action, the nurse's priority action is to: A: Clarify all physician's orders B: Deliver competent care following the nursing process C: Obtain written informed consent before performing any procedures D: Document care provided at the end of the shift
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B: Deliver competent care following the nursing process
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When signing an informed consent after witnessing the client's signature, the nurse is confirming that: A: The signature on the form came from the client B: The client appears competent to give consent C: The client fully understands the procedure to be performed D: The nurse has sufficiently explained the surgery
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A: The signature on the form came from the client
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A nurse tells a loud, disruptive client that he must quiet down or a sedative will be administered to quiet the client. When the client continues the behavior, the nurse administers the sedative without the client's permission. Which of the following describes the torts that the nurse has committed, in the order they were committed? A: False imprisonment, then assault B: Assault, then invasion of privacy C: Battery, then invasion of privacy D: Assault, then battery
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D: Assault, then battery
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A nursing student incorrectly administered an intramuscular injection that resulted in nerve damage to the client. The nursing student told the nursing instructor, "Well, I'm just a student so I can't get in any trouble." What is the nursing instructor's best response? A: "Even though you are a student, you are held to the same standard as a professional nurse when you perform a task." B: "I hope you have learned from your mistake so you won't harm someone else when you graduate." C: "You are correct that you are not liable, but you should write a letter of apology to the client." D: "Because of this mistake, you will not be able to be licensed."
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A: "Even though you are a student, you are held to the same standard as a professional nurse when you perform a task."
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When a nurse moves to another state in the country, he or she will: A: Use his or her existing license if the home state is part of the multistate nurse compact B: Practice for up to 60 days using his or her license from the original state of licensure C: Obtain a new license in the new state D: Work with the license from the original state of licensure
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C: Obtain a new license in the new state
