Chapter 04 My Nursing Test Banks

 

Kozier & Erbs Fundamentals of Nursing, 9/E
Chapter 04

Question 1

Type: MCSA

A client was given the wrong dose of medication and died. The case is being tried in court and similar cases are used by the court in comparison to arrive at a decision. What doctrine is being applied here?

1. Common law

2. Public law

3. Administrative law

4. Stare decisis

Correct Answer: 4

Rationale 1: Common lawis a type of law enacted by different entities.

Rationale 2: Public law is a type of law enacted by different entities.

Rationale 3: Administrative law is a type of law enacted by different entities.

Rationale 4: Stare decisis, to stand by things decided, is a doctrine courts adhere to when arriving at a ruling in a particular case. The courts apply the same rules and principles applied in previous, similar cases.

Global Rationale: Page Reference: 68

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 01 List sources of law and types of law.

Question 2

Type: MCSA

The student nurse is studying the various applications of law to understand the regulations surrounding nursing practice in the state. What is the type of law that implements and enforces the nurse practice act of any given state?

1. Statutory law

2. Administrative law

3. Common law

4. Public law

Correct Answer: 2

Rationale 1: Statutory laws are laws enacted by any legislative body.

Rationale 2: Administrative agencies are given authority to create rules and regulations to enforce statutory law when the state legislature passes a statute. State boards of nursing write rules and regulations to implement and enforce a nurse practice act, which was created through statutory law but is enforced by administrative law.

Rationale 3: Common law refers to laws evolved from court decisions.

Rationale 4: Public law refers to the body of law that deals with relationships between individuals and the government and governmental agencies.

Global Rationale: Page Reference: 53

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 01 List sources of law and types of law.

Question 3

Type: MCSA

The admitting nurse explains the process of signing forms to allow for the clients insurance company to be billed for services. If the insurance fails to pay for services, the client is responsible for payment. This is an example of which of the following?

1. Contract law

2. Tort law

3. Statutory law

4. Administrative law

Correct Answer: 1

Rationale 1: Contract law involves the enforcement of agreements among private individuals or the payment of compensation for failure to fulfill the agreements. Signing a form prior to receipt of health care services makes the client responsible for cost, regardless of insurance payment.

Rationale 2: Tort law defines and enforces duties and rights among private individuals that are not based on contractual agreements.

Rationale 3: Statutory laws are laws enacted by any legislative body.

Rationale 4: Administrative laws give administrative agencies the authority to create rules and regulations to enforce statutory laws.

Global Rationale: Page Reference: 54

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 01 List sources of law and types of law.

Question 4

Type: MCSA

A nurse forgets to put the call light within the clients reach and then leaves the room. The client reaches for it and falls out of bed. The nurse could be charged with which of the following?

1. Assault

2. Battery

3. Negligence

4. Criminal intent

Correct Answer: 3

Rationale 1: Assault is the threat to touch another person unjustifiably.

Rationale 2: Battery is the willful touching of a person that may cause harm.

Rationale 3: Negligence is an example of a tort law. Negligence occurs when something is accidental and harm results, as in this case. Another example of negligence would be if surgical instruments or bandages are accidentally left in a client during surgery.

Rationale 4: Criminal intent implies preplanned actions that are illegal.

Global Rationale: Page Reference: 68

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 08 Discriminate between negligence and malpractice.

09 Delineate the elements of malpractice.

10 Compare and contrast intentional torts (assault/battery, false imprisonment, invasion of privacy, defamation) and unintentional torts (negligence, malpractice).

Question 5

Type: MCSA

Before a case goes to court, the attorney will make an effort to understand and obtain all the facts surrounding a situation-for example, other staff who were working with the client, anyone who might have had access to the clients information, and the clients mental status and condition. This is referred to as which of the following?

1. Burden of proof

2. Complaint

3. Discovery

4. Civil action

Correct Answer: 3

Rationale 1: Burden of proof falls to the plaintiff and is the duty to prove wrongdoing.

Rationale 2: Complaint is a document filed by a person (plaintiff) who claims that his or her legal rights have been infringed on by one or more persons (defendants).

Rationale 3: Discovery is an effort by both parties to obtain all the facts of the situation. It occurs before the trial.

Rationale 4: Civil action is a legal action that deals with the relationships among individuals in society.

Global Rationale: Page Reference: 54

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 01 List sources of law and types of law.

Question 6

Type: MCSA

Before the nurse can apply for re-licensure, the state board of nursing requires a specific number of hours of continuing education in nursing in-service or education. This practice best exemplifies which of the following?

1. Licensure

2. Competency

3. Credentialing

4. Certification

Correct Answer: 3

Rationale 1: Licensure is the process of granting a legal permit to practice or engage in a profession, such as nursing.

Rationale 2: Competency is a level of acceptable performance, and credentialing ensures this in licensure. Certification is also part of credentialing. It validates that an individual has met minimum standards of nursing competency in a specialty area.

Rationale 3: Credentialing is the process of determining and maintaining competence in general nursing practice. It is one way to maintain the professional standards of practice and accountability for the members educational preparation.

Rationale 4: Certification validates that an individual has met minimum standards of nursing competency in a specialty area.

Global Rationale: Page Reference: 56

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 03 Compare and contrast the state-based licensure model and the mutual recognition model for multistate licensure.

07 Recognize the nurses legal responsibilities with selected aspects of nursing practice.

Question 7

Type: MCSA

Which of the following entities must accredit or approve all nursing programs in its jurisdiction?

1. State board of nursing

2. NLNAC

3. CCNE

4. ANA

Correct Answer: 1

Rationale 1: All states require that all schools of nursing in their state are approved/accredited by the state board of nursing.

Rationale 2: Some but not all states require that programs be both state approved and accredited by a national accrediting agency such as NLNAC.

Rationale 3: Some but not all states require that programs be both state approved and accredited by a national accrediting agency such as CCNE.

Rationale 4: Voluntary accreditation is not required by all states and is a means of informing the public and prospective students that the nursing program has met certain criteria. The ANA (American Nurses Association) is nursings professional organization.

Global Rationale: Page Reference: 57

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 02 Describe ways nurse practice acts, standards of care, and agency policies and procedures affect the scope of nursing practice.

Question 8

Type: MCSA

The nurse carries out a medication order, incorrectly written by the physician and subsequently filled by the pharmacist. Who, in this situation, is legally liable for the action?

1. Physician

2. Pharmacist

3. Hospital

4. Nurse

Correct Answer: 4

Rationale 1: Even though the physician wrote the order incorrectly the primary responsibility in question is the administration of the medication and so responsibility is not the physicians.

Rationale 2: Even though the pharmacist filled an incorrect order, the primary responsibility in question is the administration of the medication and so responsibility is not the pharmacists.

Rationale 3: Assuming policies and procedures were written and accessible the hospital is not legally responsible in this case.

Rationale 4: The responsibility for the nursing activity-in this case, giving the medication-belongs to the nurse. Liability is legal responsibility for ones action. Even though the physician wrote the order incorrectly and the pharmacist filled it, it was the nurse who carried it out, making that person ultimately responsible for the action.

Global Rationale: Page Reference: 57

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 07 Recognize the nurses legal responsibilities with selected aspects of nursing practice.

08 Discriminate between negligence and malpractice.

10 Compare and contrast intentional torts (assault/battery, false imprisonment, invasion of privacy, defamation) and unintentional torts (negligence, malpractice).

Question 9

Type: MCSA

The doctrine that holds the hospital responsible as well as the nurse in cases of professional malpractice is which of the following?

1. Contractual relationship

2. Stare decisis

3. Respondeat superior

4. Res ipsa loquitur

Correct Answer: 3

Rationale 1: A contractual relationship is not a doctrine; it is what the nurse and hospital, for example, enter when the hospital hires the nurse as an employee.

Rationale 2: To stand by things decided, or stare decisis, is the same thing as following precedent, or applying the same rules to a situation as were applied in similar situations.

Rationale 3: Let the master answer, or respondeat superior, means that the master (in this case the hospital/employer) assumes responsibility for the conduct of the servant (the nurse) and can be held responsible for the nurses failure to act in a competent way.

Rationale 4: The thing speaks for itself, or res ipsa loquitur, is a doctrine in cases where harm occurs but cannot be traced to a specific health care provider or standard.

Global Rationale: Page Reference: 57

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 07 Recognize the nurses legal responsibilities with selected aspects of nursing practice.

08 Discriminate between negligence and malpractice.

09 Delineate the elements of malpractice.

Question 10

Type: MCSA

A client is to undergo an invasive procedure by a physician. The client is questioning some of the terminology in the consent form. Which of the following is the appropriate response by the nurse?

1. Just sign the form, and Ill make sure your physician talks to you before he begins the procedure.

2. Ill explain whatever you dont understand.

3. You should have asked your physician when he was in here.

4. Ill call your physician back in the room to answer your questions.

Correct Answer: 4

Rationale 1: If the client has questions, he should not sign the form.These questions require the physicians attention before the consent is aigned.

Rationale 2: If the client has questions, he should not sign the form, and it is not the nurses responsibility to answer the questions.

Rationale 3: Telling the client what he should have done is demeaning and not an appropriate therapeutic response.

Rationale 4: Obtaining informed consent for specific medical treatment is the responsibility of the person who is going to perform the procedure, in this case the physician. Informed consent suggests that the client has been given complete information, including benefits, risks, and alternatives if the treatment is not given. An element of informed consent is that the client must be given enough information to be the ultimate decision maker. If not, it is the physicians responsibility to make sure the clients understanding is clear. It is important that the person obtaining the consent (the physician in this case) answer the clients questions.

Global Rationale: Page Reference: 59, 62

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 04 Describe the purpose and essential elements of informed consent.

07 Recognize the nurses legal responsibilities with selected aspects of nursing practice.

Question 11

Type: MCSA

The client presents her hand when the nurse makes this statement: I need to start an IV so you can get your antibiotics. This is an example of which of the following?

1. Informed consent

2. Express consent

3. Implied consent

4. Compliance

Correct Answer: 3

Rationale 1: Informed consent is an agreement by a client to accept a course of treatment or a procedure after being provided complete information, including the benefits and risks of treatment and generally requires the clients signature (written consent)

Rationale 2: Express consent may be either an oral or written agreement. In this case, there were neither spoken words nor a written consent form for the IV initiation.

Rationale 3: Implied consent exists when the individuals nonverbal behavior indicates agreement. In this case, presenting the hand for IV initiation would be a nonverbal behavior indicating agreement with the treatment.

Rationale 4: Compliance occurs when clients agree to follow the recommended treatment, usually by their own actions as in taking prescribed medications or following a prescribed diet.

Global Rationale: Page Reference: 59

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 04 Describe the purpose and essential elements of informed consent.

07 Recognize the nurses legal responsibilities with selected aspects of nursing practice.

Question 12

Type: MCSA

An adult client who cannot read needs surgery and is competent to make his own decisions. The best action of the nurse is to:

1. Tell the client in the nurses own words what the surgical procedure involves.

2. Read the consent form to the client and have the client state understanding.

3. Make sure the physician explains the procedure to the client.

4. Have a family member who can read sign the consent form.

Correct Answer: 2

Rationale 1: Telling the client in words other than what is on the consent form is not appropriate as some meaning and information may be lost in the transfer.

Rationale 2: If a client cannot read, the consent form must be read to the client and the client must state understanding before the form is signed.

Rationale 3: The physician should explain the procedure to the client, regardless of the clients literacy.

Rationale 4: Since the client is a competent adult, he must be the one giving consent. Illiteracy does not make one incompetent.

Global Rationale: Page Reference: 59

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 04 Describe the purpose and essential elements of informed consent.

Question 13

Type: MCSA

An elderly adult fell at home and fractured a hip, which requires surgical repair. After admittance to the emergency department, the client was given sedation for pain before a surgical permit was signed. What is the best action necessary to obtain consent?

1. The physician should have the clients wife sign the consent form.

2. The physician should wait until the effects of the medication wear off and have the client sign.

3. Since the client has been medicated, the nurse should thoroughly explain the consent form to the client.

4. This would be considered an emergency situation and consent would be implied.

Correct Answer: 1

Rationale 1: A client who is confused, disoriented, or sedated is not considered functionally competent and a legal guardian or representative can provide or refuse consent for the client. In this case, since the client was given medication that sedated him, the wife would be appropriate for giving consent for the surgical procedure.

Rationale 2: Waiting until the effects of the medication wear off would not be in the best interest of the client.

Rationale 3: Thorough explanation may or may not matter in this case since the client is considered functionally incompetent. Besides, it is the physicians responsibility to obtain informed consent.

Rationale 4: Implied consent may be used in a medical emergency, but in this case, there is an appropriate option available.

Global Rationale: Page Reference: 59

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 04 Describe the purpose and essential elements of informed consent.

Question 14

Type: MCSA

A client is brought to the emergency department after being involved in a motor vehicle crash. Although the client is conscious, her condition is critical and will require emergency surgery. The client does not speak English. What is the best action of the staff?

1. Read the consent form and have the client sign it anyway.

2. Explain as best they can using pictures and gestures.

3. Have the hospital interpreter explain the procedure.

4. Proceed with surgery as implied consent would be the case in this situation.

Correct Answer: 3

Rationale 1: Reading the consent form to someone who doesnt understand the words is pointless.

Rationale 2: There is a better option available than using pictures and gestures in the hope of explaining the procedure.

Rationale 3: If the client does not speak the same language as the health professional who is providing the information, an interpreter must be present.

Rationale 4: Implied consent indicates that the person understands what will be done.

Global Rationale: Page Reference: 60-61

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 04 Describe the purpose and essential elements of informed consent.

07 Recognize the nurses legal responsibilities with selected aspects of nursing practice.

Question 15

Type: MCSA

The nurse has delegated the task of obtaining vital signs on a new admission to a UAP (unlicensed assistive personnel). The task is completed, but the vitals were not recorded accurately. Who is fully responsible for this action?

1. The UAP

2. The nurse

3. Both the UAP and the nurse

4. The nurse manager on the unit

Correct Answer: 2

Rationale 1: While taking vital signs was an appropriate task to delegate to the UAP, the responsibility of the actionin this case, the inaction since the vitals were recorded inaccurately-is not fully assumed by the UAP.

Rationale 2: While taking vital signs was an appropriate task to delegate to the UAP, the responsibility of the action-in this case, the inaction since the vitals were recorded inaccurately-remains with the nurse.

Rationale 3: While taking vital signs was an appropriate task to delegate to the UAP, the full responsibility of the action-in this case, the inaction since the vitals were recorded inaccurately-remains is not shared by both the UAP and the nurse.

Rationale 4: Delegating this task was not the responsibility of the nurse manager and so the responsibility of the action is not his/hers.

Global Rationale: Page Reference: 62

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 07 Recognize the nurses legal responsibilities with selected aspects of nursing practice.

Question 16

Type: MCSA

A nurse is caring for a client in the emergency department who was brought in by her adult child for vague, flu-like symptoms. While helping the client to change into a gown, the nurse notices numerous bruises on the clients back and arms. When questioned, the client is distracted and ambiguous with her answers. The nurse should:

1. Report the situation to law enforcement.

2. Report the situation to social services.

3. Question the adult child who brought the client to the ED.

4. File a written report in the clients chart.

Correct Answer: 2

Rationale 1: In this case, social services should be notified. Law enforcement would be notified if the results of social services investigation warrant it.

Rationale 2: Nurses are considered mandated reporters. As a result, they must report any situation when an injury is present and appears to be the result of abuse, neglect, or exploitation. The situation described may or may not be one of abuse or neglect, but the nurse is required to report it to the proper authorities. In this case, social services should be notified.

Rationale 3: Questioning the clients adult child is appropriate, but the incident needs to be reported regardless of the questioning.

Rationale 4: Documentation in the chart is also extremely important, but this would be part of the nurses notes, not a separate written report.

Global Rationale: Page Reference: 62

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 07 Recognize the nurses legal responsibilities with selected aspects of nursing practice.

Question 17

Type: MCSA

A nurse who has been a longtime employee of a hospital, providing bedside care to clients, was seriously injured and is paralyzed from the shoulders down, with limited use of the upper arms. Through rehabilitation, the nurse is able to mobilize with a wheelchair and has no cognitive or psychological deficits. The nurse wants to return to the same position held prior to the injury. Under the guidelines of the ADA, the hospital:

1. Is required to accommodate the nurse.

2. Must find another job for the nurse.

3. Could claim undue hardship to accommodate this nurse.

4. Will have to terminate the nurses employment.

Correct Answer: 3

Rationale 1: The acts provisions states that the disabled must be able to perform the responsibilities of the job with reasonable accommodations. With limited use of upper arms, this nurse would not be able to perform the tasks required of a nurse working at the bedside.

Rationale 2: With limited use of upper arms, this nurse would not be able to perform the tasks required of a nurse working at the bedside. However, the hospital could help find another position that utilizes the nurses experience and desire to continue in the field of nursing, but this would have to be a collaborate effort with the nurse and within a reasonable request regarding the hospitals needs and resources.

Rationale 3: According to the ADA, it is the employers responsibility to provide reasonable accommodations that would allow the person with a disability to perform the job satisfactorily. With limited use of upper arms, this nurse would not be able to perform the tasks required of a nurse working at the bedside.

Rationale 4: Terminating employment may or may not occur, but not until all other options have been explored.

Global Rationale: Page Reference: 62-63

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 02 Describe ways nurse practice acts, standards of care, and agency policies and procedures affect the scope of nursing practice.

05 Describe the purpose of the Americans with Disabilities Act.

Question 18

Type: MCSA

A nurse on the unit notices that a co-worker exhibits a pattern of behavior suggestive of drug abuse. The nurse should:

1. Report the situation to the unit charge nurse.

2. Send an anonymous letter to the director of nursing.

3. Let other co-workers know about the situation.

4. Report the situation, then let management take care of it.

Correct Answer: 1

Rationale 1: As a mandatory reporter, the nurse is required to report situations where co-workers are suspected of impairment, which includes alcohol/drug abuse as well as mental illness. The nurse should report the matter starting at the lowest possible level in the agency hierarchy. In this case, the charge nurse would be appropriate.

Rationale 2: The nurse shouldtake responsibility for the report by being open about it, not making an anonymous report to the higher level of management.

Rationale 3: The nurse should also obtain support from at least one other trustworthy person before filing the report. This doesnt mean telling the whole unit, which could be detrimental to both the nurse reporting the incident and the co-worker.

Rationale 4: After the report is made, the nurse should see the problem through, not assume that management will take care of the situation.

Global Rationale: Page Reference: 64-64

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 06 Discuss the impaired nurse and available diversion or peer assistance programs.

07 Recognize the nurses legal responsibilities with selected aspects of nursing practice.

Question 19

Type: MCSA

A nurses co-worker makes a practice of telling offensive jokes or stories with a sexual undertone during the shift. The initial action of the nurse is to:

1. Ignore the co-worker and walk away.

2. Report the incident to the nurse manager.

3. Tell the co-worker to stop the activity because the conduct is offensive.

4. Ask to be scheduled opposite this co-worker.

Correct Answer: 3

Rationale 1: Ignoring the situation is not addressing the situation in an assertive manner.

Rationale 2: Reporting the incident to the nurse manager would be an appropriate second step if the behavior doesnt stop after the nurses approach.

Rationale 3: Nurses must develop skills of assertiveness to deter sexual harassment in the workplace. Telling the co-worker to stop and why, is the first step in putting an end to the situation.

Rationale 4: Asking to be scheduled opposite this person is not addressing the situation in an assertive manner.

Global Rationale: Page Reference: 64

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 07 Recognize the nurses legal responsibilities with selected aspects of nursing practice.

Question 20

Type: MCSA

A nurse who is opposed to abortion works in a hospital where they are done. According to the Supreme Courts conscience clause, the nurse:

1. Cannot interfere with a womans constitutional right.

2. Should not be working in this particular hospital.

3. Can counsel women before they have an abortion.

4. Has the right to refuse to participate in abortions.

Correct Answer: 4

Rationale 1: The nurse cannot interfere with a womans right to privacy includes control over her own body to the extent that she can abort her fetus.

Rationale 2: The conscience clause states that nurses, as well as other health care personnel, have a right to refuse to participate in abortions.

Rationale 3: Counseling a woman prior to an abortion would not be an appropriate action since the nurse has chosen to work in a hospital where these procedures are done.

Rationale 4: In Roe v. Wade and Doe v. Bolton, the Supreme Court upheld that a womans right to privacy includes control over her own body to the extent that she can abort her fetus. Although the nurse cannot interfere with this, the conscience clause states that nurses, as well as other health care personnel, have a right to refuse to participate in abortions and hospitals have the right to deny admission to abortion clients.

Global Rationale: Page Reference: 64-65

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 07 Recognize the nurses legal responsibilities with selected aspects of nursing practice.

Question 21

Type: MCSA

A client woke in the middle of the night, confused and unaware of the surroundings. Although the call light was within reach, the client got out of bed unassisted, tripped on the bedside chair, and fell. Which of the following elements of malpractice is missing in this case?

1. Foreseeability

2. Damages

3. Injury

4. Duty

Correct Answer: 1

Rationale 1: Foreseeability is the link between the nurses act and the injury suffered. The call light was within reach, but the client did not use it and got out of bed unassisted. Nighttime confusion occurs with some clients but unless the nurse had knowledge or awareness that this would happen, there was no link between the nurses action and the clients fall.

Rationale 2: Damages may well be present, but these probably are not due to any action or inaction on the nurses part.

Rationale 3: Injury may well be present, but these probably are not due to any action or inaction on the nurses part.

Rationale 4: Duty was addressed this case since the call light was within reach.

Global Rationale: Page Reference: 68

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 09 Delineate the elements of malpractice.

Question 22

Type: MCSA

A client is scheduled to have surgery, has signed the consent form, but refuses to have a Foley catheter placed, saying Thats not part of the surgery. The nurse should:

1. Explain that this is part of the surgical prep and continue with the procedure.

2. Explain that the client has already signed the consent, and place the catheter.

3. Respect the clients wishes and document accordingly.

4. Offer to call the physician.

Correct Answer: 3

Rationale 1: Battery exists when there is not consent, even if the client was not asked. In this case, the client has the right to refuse other treatment surrounding pre- and post-op care.

Rationale 2: Battery exists when there is not consent, even if the client was not asked. In this case, the client has the right to refuse other treatment surrounding pre- and post-op care.

Rationale 3: Consent is required before procedures are performed. Depending on the invasiveness of the procedure, a written consent may be required. The client signed a consent form for surgery, and the refusal for placement of a catheter should be respected. The nurse should document the incident and not continue with the procedure.

Rationale 4: Calling the physician is not inappropriate but there is an option that addresses the situation appropriately.

Global Rationale: Page Reference: 71

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 04 Describe the purpose and essential elements of informed consent.

Question 23

Type: MCSA

The nurse makes this entry in a clients medical record: The client is a drug addict and is always asking for more medication than what is necessary. In this situation, the nurse may be charged with which of the following?

1. Defamation

2. Slander

3. Libel

4. Incompetence

Correct Answer: 3

Rationale 1: Defamation is verbal communication that is false or made with a careless disregard for the truth and that result in injury to the reputation of a person.

Rationale 2: Slander is defamation by the spoken word.

Rationale 3: Libel is defamation of character by means of print, writing, or pictures. Putting a statement such as this in the clients medical record is, first, making a diagnosis which the nurse is not qualified to do and, second, making an assumption about the clients need for medication which is a personal attitude about how the client responds.

Rationale 4: Incompetence relates to the ineffective or improper execution of nursing tasks.

Global Rationale: Page Reference: 71

Cognitive Level: Understanding

Client Need: Safe Effective Care Environment

Client Need Sub: Safety and Infection Control

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 08 Discriminate between negligence and malpractice.

Question 24

Type: MCSA

Nurses are protected by laws such as Good Samaritan acts. Which of the following situations would apply as part of these acts?

1. A nurse gives CPR to a client brought to the emergency department; later the client is found to have a Do Not Resuscitate order.

2. A nurse gives first aid to a child injured in a sporting event.

3. A nursing student tries to insert an airway in an unconscious client.

4. A nurse leaves the scene of an emergency to call for help.

5. A nurse helps deliver the baby of a neighbor during a snowstorm.

Correct Answer: 5

Rationale 1: The Good Samaritan acts are laws designed to protect health care providers against claims of malpractice in cases of emergency, unless it can be shown that there was a gross departure from the normal standard of care. Giving CPR would be considered a level of care provided by any other reasonable person under similar circumstances. The fact that the client had a DNR order was not apparent at the time of care rendered by the nurse. A nursing student trying to insert an airway is not appropriate, since it would be above the level of care a student is able to do. A nurse should not leave the scene of an emergency until another qualified person takes over. The nurse should have someone else call or go for additional help.

Rationale 2: The Good Samaritan acts are laws designed to protect health care providers against claims of malpractice in cases of emergency, unless it can be shown that there was a gross departure from the normal standard of care. Giving CPR would be considered a level of care provided by any other reasonable person under similar circumstances. The fact that the client had a DNR order was not apparent at the time of care rendered by the nurse. A nursing student trying to insert an airway is not appropriate, since it would be above the level of care a student is able to do. A nurse should not leave the scene of an emergency until another qualified person takes over. The nurse should have someone else call or go for additional help.

Rationale 3: The Good Samaritan acts are laws designed to protect health care providers against claims of malpractice in cases of emergency, unless it can be shown that there was a gross departure from the normal standard of care. Giving CPR would be considered a level of care provided by any other reasonable person under similar circumstances. The fact that the client had a DNR order was not apparent at the time of care rendered by the nurse. A nursing student trying to insert an airway is not appropriate, since it would be above the level of care a student is able to do. A nurse should not leave the scene of an emergency until another qualified person takes over. The nurse should have someone else call or go for additional help.

Rationale 4: The Good Samaritan acts are laws designed to protect health care providers against claims of malpractice in cases of emergency, unless it can be shown that there was a gross departure from the normal standard of care. Giving CPR would be considered a level of care provided by any other reasonable person under similar circumstances. The fact that the client had a DNR order was not apparent at the time of care rendered by the nurse. A nursing student trying to insert an airway is not appropriate, since it would be above the level of care a student is able to do. A nurse should not leave the scene of an emergency until another qualified person takes over. The nurse should have someone else call or go for additional help.

Rationale 5: The Good Samaritan acts are laws designed to protect health care providers against claims of malpractice in cases of emergency, unless it can be shown that there was a gross departure from the normal standard of care. Giving CPR would be considered a level of care provided by any other reasonable person under similar circumstances. The fact that the client had a DNR order was not apparent at the time of care rendered by the nurse. A nursing student trying to insert an airway is not appropriate, since it would be above the level of care a student is able to do. A nurse should not leave the scene of an emergency until another qualified person takes over. The nurse should have someone else call or go for additional help.

Global Rationale: Page Reference: 73

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 12 Describe the laws and strategies that protect the nurse from litigation.

Question 25

Type: MCMA

A nurse shows an understanding of practices that are designed to provide legal protections regarding liability for client care when:

Standard Text: Select all that apply.

1. Checking the clients name band prior to the administration of a preoperative medication.

2. Asking for help when moving a comatose client because the client can not be safely handled by one nurse.

3. Attending an in-service on the appropriate use of a new piece of equipment used in the facility.

4. Delegating only those tasks that he/she cant personally perform.

5. Reviewing the five rights of medication administration when the client states, This doesnt look like my usual pill.

Correct Answer: 1,2,3,5

Rationale 1: Legal Protection for Nurses is best assured by always checking the identity of the client to make sure it is the right client.

Rationale 2: Legal Protection for Nurses is best assured by asking for assistance and/or supervision in situations for which you feel inadequately prepared.

Rationale 3: Legal Protection for Nurses is best assured by maintaining clinical competence.

Rationale 4: Delegation is a nursing responsibility that is designed to help provide quality and timely nursing care but that is not its sole focus.

Rationale 5: Legal Protection for Nurses is best assured by checking any order that a client questions.

Global Rationale: Page Reference: 73-74

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 12 Describe the laws and strategies that protect the nurse from litigation.

Question 26

Type: MCMA

A clinical nursing instructor recognizes that a nursing student understands the legal responsibilities she/he has to their clients when the student:

Standard Text: Select all that apply.

1. is prepared to discuss their clients medical diagnosis in pre-conference.

2. is overheard stating, My care is held to the same standards as that of the unit nurses.

3. offers to stay with the client who is about to experience a painful diagnostic procedure.

4. addresses the staff and clients respectfully and by their full names.

5. asks for help with a dressing change involving techniques he/she has not yet performed alone.

Correct Answer: 1,2,5

Rationale 1:

Rationale 2: Nursing students are held to the same standards as licenses nurses, and therefore need to make sure that they are prepared to provide the necessary care to assigned clients.

Rationale 3: While offering to stay with a client during a painful procedure shows compassion, it is not a behavior representative of legal responsibility.

Rationale 4: While showing respect for staff and clients shows professionalism, it is not a behavior that is representative of legal responsibility.

Rationale 5: It is important that nursing students ask for help or supervision in situations for which they feel inadequately prepared.

Global Rationale: Page Reference: 73-74

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 12 Describe the laws and strategies that protect the nurse from litigation.

Kozier & Erbs Fundamentals of Nursing, 9/E Test Bank

Copyright 2012 by Pearson Education, Inc.

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