Chapter 8- Legal Issues in Critical Care Nursing My Nursing Test Banks

 

1.

A patients physician writes a medication order to administer 20 mEq of potassium chloride to a patient. The ICU nurse misreads the order as 200 mEq of potassium and administers this amount of medication to the patient. As a result, the patient dies. This situation is an example of which of the following?

A)

A questionable medical order

B)

Negligent supervision

C)

Ordinary negligence

D)

Gross negligence

2.

A family member of a patient files a complaint against an ICU nurse, claiming that the nurse improperly transferred the patient from a wheelchair to the hospital bed, resulting in a back injury to the patient. Assuming that the nurses due process rights are observed, which of the following actions would be most advisable for the nurse?

A)

Plan to appeal to a court if the State Board of Nursing rules against her.

B)

Sue the State Board of Nursing if her license is suspended before she is found guilty.

C)

Acquire legal counsel and have him or her question the boards witnesses.

D)

Continue nursing practice if her license is suspended, as such a suspension violates her constitutional rights.

3.

The ex-husband of a patient asks the ICU nurse a question about the medical history of the patient. The nurse retrieves the patients file, opens it, and relates some of the patients personal information to the ex-husband. When the ex-husband asks to see the patients file, the nurse hands it to him, although he is not authorized by the patient to see this information. What is the most accurate characterization of the nurses action?

A)

A criminal act against the patient

B)

A breaking of the rule of personal liability

C)

A violation of the HIPAA Privacy Rule

D)

A case of respondeat superior

4.

A nurse is accused of professional negligence because she improperly operated a ventilator, resulting in a patients death. The prosecution presents an expert witness to show that operating such a ventilator is within the standard of care for a reasonable nurse. Which aspect of negligence is the prosecution attempting to establish?

A)

Duty

B)

Breach of duty

C)

Causation

D)

Damages

5.

A jury involved in a malpractice suit must decide how much to compensate a patient for the emotional distress caused her by incomplete anesthesia during surgery. To which element of malpractice is this decision related?

A)

Duty

B)

Breach of duty

C)

Causation

D)

Damages

6.

A nurse is going to volunteer her nursing skills and time at a hospital other than the one in which she is employed. Which of the following is true regarding potential liability related to the nurses actions while volunteering? Select all that apply.

A)

The nurse should carry her own malpractice insurance.

B)

The hospital at which she is volunteering will protect her with its own professional liability insurance.

C)

The hospital at which she is employed will protect her with its professional liability insurance even when she is working off the job.

D)

There is no liability protection available for a nurse who is volunteering on her own time.

E)

The doctrine of respondeat superior does not apply in this situation.

F)

The captain of the ship doctrine applies in this situation.

7.

A nurse is charged with medical malpractice because she neglected to attend to a patient in the ICU whose heart stopped and whose heart monitor alarm was clearly heard by the nurse. The jury finds that the hospital was liable because of understaffing the ICU and that the nurse was liable because she should have responded to the patient whose heart stopped, regardless of the fact that she had been ordered by a physician to tend to another patient. Which types of liability did the jury uphold? Select all that apply.

A)

Captain of the ship doctrine

B)

Rule of personal liability

C)

Corporate liability

D)

Criminal liability

8.

A physician has written a medication order for a patient that includes penicillin. When the nurse receives the order, she refuses to administer the medicine because she knows that the patient is allergic to it. What is the most accurate way to describe this situation?

A)

A questionable medication order

B)

A medication error

C)

A case of respondeat superior

D)

A case of negligent supervision

9.

A patient in the ICU dies as a result of a defective defibrillator. The nurse did not become aware of the defect until after the patients death. Which of the following is true in this situation?

A)

Defibrillators are not currently regulated in the United States.

B)

The nurse is permitted but not required to report the malfunction to the FDA.

C)

The nurse is required to report the malfunction to the FDA.

D)

The nurse is likely liable in the patients death.

10.

A 10-year-old girl has been admitted to the ICU after she suffered a severe laceration on her arm. Due to heavy hemorrhaging, the child needs a blood transfusion. Her parents, however, who are Jehovahs Witnesses, do not believe in blood transfusions and refuse the treatment. What would be the best action for the nurse to take?

A)

Assist the physician in performing a blood transfusion for the girl, against her parents wishes.

B)

Refuse to assist the physician in performing a blood transfusion, to respect the parents wishes.

C)

Consult the hospitals risk management department before acting.

D)

Schedule a conference with the parents to explain why an infusion is medically necessary.

11.

While caring for patients, the nurse completely documents the care given. This nursing action is defined by what kind of law?

A)

Administrative

B)

Civil

C)

Tort

D)

Criminal

12.

Nursing practice is defined by the Nursing Practice Act, administered by the State Board of Nursing. Which nursing behavior would be least likely to be addressed by the State Board of Nursing?

A)

Qualifications for licensure

B)

Investigation of complaints

C)

Nursing excellence awards

D)

Protection of patient safety

13.

The physician has ordered a medication that is contraindicated for the patient. The nurse, after discussion with the physician and the pharmacy, refuses to administer the medication. Upon what legal principle does the nurse base this refusal?

A)

Respondeat superior

B)

Captain of the ship

C)

Corporate liability

D)

Rule of personal liability

14.

The nurse caring for a sedated patient leaves the side rails down when leaving the room and the patient falls, breaking her hip. Why is this considered to be malpractice by negligence?

A)

The patient had requested the side rails be left down.

B)

The nurse assumed that the family would watch the patient.

C)

This is breach of duty resulting in patient harm.

D)

There will probably be a suit brought by the family.

15.

A nurse has been called before the State Board of Nursing for accusations of malpractice. As part of his defense, the nurse states that he was unaware of several provisions of the Nursing Practice Act. Why is this defense statement valid or invalid?

A)

Invalid: The nurse has a legal duty to know the contents of the Nursing Practice Act.

B)

Invalid: Nursing Practice Acts vary widely in content from version to version and state to state.

C)

Valid: The nurse did not know he was violating the Nursing Practice Act at the time of his actions.

D)

Valid: The nurse was under the supervision of his charge nurse at the time of his actions

16.

The nurse is caring for a critically ill patient. Which action by the nurse could most likely be considered malpractice?

A)

Assessing for allergies before administering medications

B)

Consistent failure to complete adequate hand hygiene

C)

Strict adherence to the visiting hours policies of the unit

D)

Encouraging the patient to ask questions of the physician

17.

The nurse has been accused of negligence resulting in patient harm. She was not informed about the complaint, and her employment was terminated before a hearing before the State Board of Nursing. What best legal recourse does the nurse have?

A)

Safe harbor provision in state law

B)

Fifth Amendment of the U.S. Constitution

C)

Civil and tort law allows the nurse to sue the accuser.

D)

Automatic dismissal of case by the State Board of Nursing

18.

A nurse who commonly works on a general medical-surgical floor is asked to work briefly in a critical care unit. The charge nurse, based on the legal principle of vicarious liability, should give this nurse which patient assignment?

A)

Admit day-of-surgery patient after open heart surgery

B)

Three stable patients awaiting transfer to medical units

C)

Patient with hemodynamic monitoring and unstable vital signs

D)

Patient whose care requires frequent titration of vasoactive medications

19.

After receiving an injury as a result of negligent care by a physician, the patient brings suit against the hospital, the physician, and all of the members of the health care team who participated in his care. Based on the principle of respondeat superior, the hospital is liable for the actions of whom?

A)

Nurse working in her usual assignment at hospital

B)

Non-employee physician practicing in the hospital

C)

Nurse on temporary assignment from an agency

D)

Nurse doing volunteer work at another agency

20.

A patient in CCU is critically and terminally ill. The family has made a written request that no cardiopulmonary resuscitation (CPR) take place. The patient is well known to the physician, who does not agree with the familys assessment of the situation. While the physician is discussing the situation with the family and before agreement, the patient experiences a cardiopulmonary arrest. Legally, what is the most appropriate nursing action?

A)

Proceed as though a DNR order has been written, since such an order is anticipated.

B)

Take no action and page the patients physician to ask for an immediate decision over the telephone.

C)

Initiate CPR and page the patients physician to come to the care unit.

D)

Take no action and page the patients family to return to the care unit immediately.

21.

A patient has been critically ill for several weeks and a Do Not Resuscitate (DNR) order was written several days ago. The patients status has improved, and he is now eligible for transfer to a general nursing unit and is awake and alert. What is the most appropriate nursing action?

A)

Initiate risk-reduction teaching to prevent recurrence of instability.

B)

Ask the patient, family, and physician to review the DNR order.

C)

Increase the frequency of monitoring of vital signs to ensure safety.

D)

Encourage the patient to get more rest in preparation for transfer.

22.

A terminally ill patient is admitted to the CCU for stabilization and palliative procedures. The nurse encourages this awake and alert patient to complete paperwork for advance directives. What is the best rationale for this nursing action?

A)

Required by the admission protocol for the hospital and the unit

B)

Allows the patient to express his or her choices for some treatment decisions

C)

Prevents estranged family from interfering with competent patient decisions

D)

Allows the physician to apply his or her best judgment for care decisions

23.

A critical care nurse has administered an intravenous sedative in an excessive dose to a patient. The patient experiences a cardiopulmonary arrest, and the family complains to the State Board of Nursing. After investigation and a hearing, the Board finds that the nurse was guilty of malpractice and disciplines the nurse. This situation is an example of what?

A)

Medication errors are the most common reason for State Board of Nursing action.

B)

An unusual and rare incidence of lack of judgment by a nurse in a stressful situation

C)

Absence of the application of due process for the nurse by the State Board of Nursing

D)

A family looking for an opportunity for litigation

Answer Key

1.

C

2.

C

3.

C

4.

A

5.

D

6.

A, E

7.

B, C

8.

A

9.

C

10.

C

11.

A

12.

C

13.

D

14.

C

15.

A

16.

B

17.

B

18.

B

19.

A

20.

C

21.

B

22.

B

23.

A

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