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Funda of nurs ch 23
Fundamentals of nursing 8e Ch 23 complete
| Question | Answer |
|---|---|
| Nursing practice acts (NPA) describe and define | legal boundaries of nursing practice within each state |
| willful acts that violate another's rights such as assault, battery, and false imprisonment | intentional torts |
| An example of a regulatory law (Administrative) is the requirement to | report incompetent or unethical nursing conduct to the State Board of Nursing |
| judicial decisions made in courts when individual legal cases are decided is considered | common law |
| Examples of common law include _A_, _B_, _C_, _D_ | A) informed consent, B) the patient's right to refuse treatment, C) negligence, D) malpractice |
| A patient burned from warm compress the action would be compared to this to answer the question, did the nurse follow proper procedure | standards of care |
| What specific order requires documentation that HC provider consulted with patient, family before attaching to med record & reviewed routinely if conditions or demand changes | DNR orders (do not resuscitate) |
| This act requires HC institutes to provide written information to patients concerning their rights under state law to make decisions, incl the right to refuse treatment & formulate advance directives | Patient Self-Determination Act (PSDA) |
| Patients have the right to be medically screened (if hospital is capable) is enacted by | Emergency Medical Treatment and Active Labor Act (EMTALA) |
| Failure to convey discharge instructions, follow policies and procedures, delegate & supervise are | acts of negligence |
| What are the two standards for the determination of death | cardiopulmonary: irreversible cessation of circulatory & respiratory function; whole-brain: irreversible cessation of all functions of the entire brain & brainstem |
| This law (2) reflects decisions made by administrative bodies such as State Boards of Nursing when they pass rules & regulations | Regulatory law, (administrative law) |
| the American disability act ADA, state board rules of IV therapy & guidelines to delegate to nurse assist (NAP) when used are all examples of | laws enacted by legislative branch of the government |
| Statutory law that Prevent harm to society as a whole and provide punishment for crimes | criminal law |
| This law reflects decisions made by administrative bodies (State Boards of Nursing passing rules and regulations) when they pass rules and regulations | regulatory (administrative ) law |
| informed consent, patients right to refuse treatment, negligence & malpractice are covered under which law? | Common Law |
| The classifications of criminal law crimes are | felony and misdemeanor |
| A crime of serious nature that has a penalty of imprisonment for greater than 1 yr or even death | felony (criminal law) |
| less serious crime than a felony; penalty is usually fine or imprisonment for less than 1 yr | misdemeanor (covered under criminal law) |
| Statutes concerned with protecting a persons rights; violation consequences are fines or public service is called | Civil laws |
| The legal guidelines for nursing practice & provide the minimum acceptable nursing care is called | standards of care |
| The ANA develops nursing practice, policy statement, & resolutions; this is described in NPA in every state, fed & state laws in hospitals & HC org & in policy & procedures where nurses work | Standards of care |
| Standards of care outline _A_ , _B_, & _C_ of nurse practice | A) scope, B) function C) role |
| This org requires accredited hospital to have internal standards (written policies & procedures) that are specific & accessible to nurses conforming to state & fed law & community standards is called | The Joint Commission (TJC) |
| The 3 best ways for nurses to keep up with the current legal issues affecting nursing practice | Maintain familiarity w/ standards of care, & policies & procedures of employing agency; Read current nursing literature in their practice area |
| federal statute protects the rights of people with disabilities in work place, education institutes & in society | American disability act |
| Malpractice suits will compare actions taken by medical staff in the care of the patient to | standards of care |
| Reflects decisions made by administrative bodies | regulatory law (administrative) |
| conduct that misuses a controlled substance is an example of | a crime under criminal law |
| Based on ADA HIV infected do | not have to disclose but a HC provider does |
| Under (EMTALA) If emergency condition exists the patient has to be | stabilized; cannot be turned away (discharged) or transferred |
| What defines the scope of nursing practice, distinguishing between nursing and medical practice & establishing education & licensure requirements for nurses | nursing practice acts (NPA) |
| Health insurance comp cannot place lifetime or annual limits on mental health coverage that are less than others benefits eg medical & surgical is covered under | Mental Health Privacy Act (MHPA) |
| Suicidal patients have to be supervised to make sure they do not attempt, if attempt occurs it is viewed as | hospital failed to provide adequate supervision & safe guard facilities; All Documentation of precautions against suicide a must! |
| What protects private patient information once it has been disclosed in health care settings | confidentiality |
| This reflect the knowledge & skill ordinarily possessed & used by nurses actively practicing in the profession | Standards of care |
| (PSDA) Advance directives are living wills, health care proxies, & durable powers of attorney for health care that are based on values of _A_, _B_ over the end of life decisions, _C_ & _D_ | A) informed consent, B) patient autonomy, C) truth telling, D) control of dying process |
| Advance directive, written documents that direct treatment based on patients wishes in the event of terminal illness or condition; an Instruments by which a dying person make wishes known | living will |
| A legal document by the patient that designates a person/s chosen to make HC for the patient behalf or wishes | Durable power of attorney for health care (health care proxy) |
| Right to refuse treatment if sound mind is based on religion if adult, but their children | Are an innocent 3rd party that the HC provider has the right to treat |
| negligence & malpractice are examples of | civil law |
| one speaks falsely about another eg a nurse tells people erroneously that a patient has gonorrhea & the disclosure affects the patient's business, the nurse is liable for | slander, defamation of character |
| If patient does not have DNR orders HC providers | have to try and revive |
| 18yr or older has the right to donate their organs after death all or part in writing with signature; DL has on it, is called | Uniform Anatomical Gift Act: DONOR |
| statutes enacted by legislature of any of the states or the appropriate officers of the districts or possessions that describe & define the scope of nursing practice is called | nursing practice acts (NPA) |
| Judicial decisions made in courts when individual legal cases are decided | common law |
| Most extensive law on how employers treat HC workers & patients infected with HIV & not infected with AIDS (considered disability) | American disability act |
| An exception to the act (EMTALA) is if patient requests transfer or discharge in | WRITING AFTER receiving information about the benefits & risks OR if a health care provider certifies that the benefits of transfer outweigh the risks |
| What act Prohibs purchase or sale of organs, gives civil & criminal immunity to HC providers; protects donor estate from liability | National organ transplant act NOTA |
| What company contracts w/ fed gov, set policies & guidelines for procurement of organs and has aWait list set by priority (patient w/ greatest need) | United network for organ sharing (UNOS) |
| Fed statutory, Provides rights to patients (protects people from losing health insurance when changing jobs by providing portability as long as they have had continuous group health ins) and protects employees | Health Insurance Portability and Accountability Act of 1996 (HIPAA) |
| based on the good Samaritan laws; If you leave the patient without properly transferring or handing to a capable person, you may be | liable for patient abandonment & responsible for any injury suffered after you leave him or her |
| Name The Joint Commission's three specific guidelines for the use of restraints | ensure physical safety of residents or other residents; When less restrictive interventions are unsuccessful; Written order by HC provider (TJC) which include specific start & end times |
| torts are acts in which intent is lacking but volitional action and direct causation occur such as in invasion of privacy and defamation of character | quasi intentional torte |
| Nurses who apply restraints in violation of state and federal regulations may be charged with | abuse, battery, or false imprisonment (A restraint free enviro is 1st goal, use other alternatives 1st before restraint!) |
| Restraints: Liability for improper or unlawful restraint & for patient injury from unprotected falls lies with | the nurse and the health care institution |
| Litigation from improper restraint use is a common nursing legal issue; Nurses are negligent for failure to initiate safety procedures when | the patient condition necessitates it |
| The Board of nursing license | all RN's in the state they practice in (varies) The board of nursing license can _A_ & _B_ based on _C_ that _D_ in the licensing statute based on administrative law rules that implement & enforce statute |
| No discussions in public about patients: med boards in patient room cannot reveal med condition are all example of nurse practice that enforce | Health Insurance Portability and Accountability Act of 1996 (HIPAA) |
| For licensure all states use which test for RN & practical nurse exams | NCLEX |
| This law encourage HC professionals to assist in emergencies, limit liability & offer legal immunity for nurses who help at a scene of an accident as long as it is in the scope of your practice & if acted without gross negligence | Good Samaritan laws |
| a Law concerned with acts that threaten society but may involve only an individual | criminal law |
| What three states have enacted “failure-to-act” laws that make it a crime not to provide Good Samaritan care | Louisiana, Minnesota, and Vermont |
| This law provides protection of the public's health, advocating peoples rights, regulating health care & its financing & ensuring professional accountability for the care provided | Public health laws |
| Community & public health nurses have the legal responsibility to enforce laws enacted to protect public health include reporting suspected | abuse & neglect (child abuse, elder abuse, or domestic violence), report communicable diseases, ensuring community have received required immunizations; & report other health-related issues enacted to protect public health |
| Based on public health law Legal immunity is provided for reporter if reports are made in good faith, if not reported | a health care professional can be liable for civil or criminal action |
| to determine death, requires irreversible cessation of _A_ & _B_ functions or that there is irreversible cessation of all functions of the _C_ including _D_ | A) circulatory & B) respiratory C) entire brain, including D) brain stem |
| False imprisonment requires that the patient be aware of the | confinement (An unconscious patient has not been falsely imprisoned) |
| The reason for the development of different definitions for the determination of death is to facilitate | recovery of organs for transplantation, some patients may be brain dead but organs are good |
| Statute that states that a competent individual with a terminal disease can make an oral & written request for medication to end life in a humane & dignified manner | Physician-assisted suicide (end of life): Oregon death with dignity act |
| Act that causes injury for which the injured party can bring civil action , are classified as intentional, quasi intentional or unintentional | Tort |
| the right of patients to keep personal information from being disclosed is called | privacy |
| a nurse to threaten to give a patient an injection or to threaten to restrain a patient for an x-ray procedure when the patient has refused consent is considered | assault (an intentional tort) |
| What is the Difference between assault and battery | the difference is the existence or nonexistence of a touching or contact |
| Unjustified restraining of a person without legal warrant is called | False imprisonment (an intentional torte) |
| this limits who is able to access a patient's record and establishes the basis for privacy and confidentiality | Health Insurance Portability and Accountability Act of 1996 (HIPAA) |
| Any intentional threat to bring about harmful or offensive contact | assault (an intentional torte) |
| when nurses restrain a patient in a confined area to keep the person from freedom it is called | false imprisonment |
| acts in which intent is lacking but volitional action & direct causation occur eg (invasion of privacy & defamation of character) is called | Quasi- intentional Torts |
| The release of a patient's medical information to an unauthorized person is considered | Invasion of privacy a violation of HIPAA |
| Any intentional touching without consent is called | battery an intention torte |
| According to HIPAA a patient has the right to be free from | unwanted intrusion into their affairs |
| Information in patient medical record is a confidential communication shared with HC providers for | medical treatment only |
| If there is public press situations ( in vitro, new discoveries etc) that is news worthy, the nurse should guide information through | the public relations department of the institution to ensure that invasion of privacy does not occur |
| A patient with a disease that is incurable & irreversible & death is within 6 mos has the right to be assisted in suicide by a health care professional under the | Physician-assisted suicide (end of life): Oregon death with dignity act |
| Civil wrong made against a person or property | tort |
| publication of false statements that result in damage to a person's reputation including slander and libel is considered | Defamation of character |
| When one person speaks falsely about another person is a quasi intentional act/tort called | slander |
| the written defamation of character such as charting false entries in a medical record is an act of | libel, defamation of character |
| Failure to notify the HC provider of problems, follow orders, follow the six rights of medication administration are all examples of | negligent acts |
| what law states that Once emergency care is administered you must stay with until handed to someone who can provide needed care such as emergency medical technicians (EMTs) or emergency department staff | Good Samaritan laws |
| negligence or malpractice is considered an | unintentional torte |
| Careless act of omission or commission that results in injury to another is an unintentional torte calledtorte called | negligence |
| Can a family member or acquaintance who speaks a patient's language be allowed to interpret health information to a patient | never, an official interpreter should be present to explain the procedures & treatment |
| Performing a procedure beyond consent is called | battery , an intentional torte |
| Written defamation of character is a quasi intentional act/tort called | libel |
| A nurse who did not carry out the duty or breached it or failure to use the degree of skill & learning ordinarily used under the same or similar circumstances by members of his or her profession is called | negligence |
| Negligence is measured by a nurses standard of care which is compared to | a degree of care a person would use under the same circumstances |
| What unintentional torts referred to as professional negligence; below the standard of care | malpractice |
| A patient consented for appendectomy and HC provider also performed a tonsillectomy (without consent) is an example of | battery (intentional torte) |
| An unintentional tort that is injurious or unprofessional actions that harm another and is also care falling below standard of care | nursing malpractice |
| State the four criteria that establish nursing malpractice | 1) the nurse (defendant) owed a duty to the patient (plaintiff), 2) did not carry out that duty, 3) the patient was injured, 4) failure to carry out the duty caused the injury |
| This form a patient signs & is required by facility for all routine treatment, hazardous procedures ( surgery), some treatment programs (chemotherapy), & research involving patients | consent form (not a general consent) |
| Even if no intent to injure, failing to verify ID correctly & admin wrong blood, admin med that patient is allergic to (not checking chart & asking ), claims of | malpractice can be filed |
| Name the three best ways to avoid malpractice | 1) follow standards of care, 2) give competent care, 3) communicate with other HC providers |
| The law establishes standard of care to protect others against unreasonable risk or harm; Running a stop sign is considered | negligence |
| touching another body without consent; contact can be harmful (injury) or offensive to personal dignity | battery |
| this law is Defined by municipal, state & federal legislation | criminal law |
| communicate with the patient by | explaining tests & treatments & document that you provided specific explanations to them |
| To avoid claims of malpractice, nurses should develop caring rapport with patient and document | assessments, interventions, and evaluations completely |
| Conduct that falls below the standard of care is an unintentional torte called | negligence |
| These rules create patient rights to consent to the use & disclosure of their protected health information, to inspect & copy one's medical record, & to amend mistaken or incomplete information | Insurance Portability and Accountability Act of 1996 (HIPAA) |
| what is any action that places a person in apprehension of a harmful or offensive contact without consent; No actual contact is necessary | assault (an intentional torte) |
| A nurse is accountable for reporting any _A_ to the health care provider and documenting _B_ | A) significant changes in the patient's condition , B) these changes in the chart |
| All documentation in a patient's chart the nurse is obligated to report | in a timely manner, it is legible, signed and dated |
| Nursing notes that are incomplete or illegible causes | HC professionals to be less credible the act of releasing medical info to unauthorized person eg press, employer, family is |
| Failure to assess and/or monitor, including making a nursing diagnosis is a | negligent act |
| students are liable if they cause patient harm or lack of action liability is shared among | student, instructor, hospital, HC facility, university |
| a person seeking abortion in the 3rd trimester the fetus is viable and | the state protects fetus, prohibits abortion if over 28 weeks unless it is to save mothers life |
| If a staff nurse overseeing the nursing assistant or aide knowingly assigns work without regard for the person's ability to safely conduct the task defined in the job description | the student and the staff nurse is liable |
| failure to ensure patient safety, especially patients who have a history of falling, are heavily sedated, have disequilibrium problems, are frail, are mentally impaired, get up in the night, & are uncooperative are considered | an act of negligence |
| when a patient is admitted to the hospital they initially sign a | general consent for that does not consent to a specific procedure |
| Patient or representative needs to sign separate form for treatment before the performance of a specialized procedure is called | an informed consent form |
| If a patient is deaf or illiterate or speaks a foreign language when consent is needed, the nurse should get a/an | an official interpreter must be present to explain the terms of consent |
| a blood count is an example of a | “simple and common” procedure that does not need an informed consent and uses a general consent |
| process of obtaining permission from a patient to perform a specific test or procedure after describing all risks, side effects, and benefits is called | informed consent |
| informed consent is not required for the performance of | “simple and common” procedures when the related risks are commonly understood |
| This act establishes patient privacy and confidentiality | Insurance Portability and Accountability Act of 1996 (HIPAA) |
| procedures that are complex, invasive, and/or involve the risk of serious injury, eg chemotherapy require | an informed consent signed by patient |
| Person's agreement to allow something to happen based on disclosure of risks, benefits, and alternatives is called | informed consent |
| This source of law is created by judicial decisions made in court when legal cases are decided and not legislative bodies (statutory law) | common law |
| hanging the wrong IV solution for patient or allowing a Nursing Assistant to give meds is an example of _A__, which leads to _B_ | A) negligence, B) disciplinary actions by state board of nursing |
| who determines if a procedure is complex and an informed consent is needed | the physician |
| a person's agreement to allow something to happen such as surgery or an invasive diagnostic procedure, based on a full disclosure of risks, benefits, alternatives, and consequences of refusal is called | an informed consent |
| Informed consent creates a legal duty for the health care provider to | disclose material facts in terms the patient is able to understand to make an informed choice |
| patient's informed consent does not fall within the nursing duty, it is responsibility of | the person performing the procedure |
| When nurse provides consent form to patient they have to ask if | the patient understands the procedure they are consenting to |
| It is important to note that nursing students cannot and should not be responsible for or asked to | witness consent forms because of the legal nature of the document |
| A child of divorced parents being treated at the hospital consent has to be signed by | the parent with legal custody |
| Nurses need to assess all orders if it is erroneous or harmful they should first | clarify order with HC provider |
| The 2nd trimester a person can have abortion but the state protects | maternal health & enforces regulation on the procedure and facility |
| Briefly explain the process that a nurse needs to follow when a staffing assignment is unreasonable | Inform supervisor and make written protest to nursing administrators (Keep a copy) |
| a student has learned to administer intramuscular medications in class, the student now working as a nurse's aide can they perform this task | NO, they may not perform this task |
| If someone requests students employed as nurse's aides to perform tasks that they are not prepared to complete safely, the student needs to | bring this information to the supervisor's attention so they are able to obtain the needed help |
| What federal statute protects the rights of individuals who are disabled in the workplace, in educational institutions, and throughout our society | American with disabilities act (ADA) |
| A person wanting abortion has the right in the | 1st trimester has right to abort (< than normal child birth) |
| If nurses have to accept unreasonable assignments, they need to | make written protests to nursing administrators and keep a copy |
| Identify what the nurse's responsibility is when he or she "floats" to another nursing unit | inform their supervisor of any lack of experience in caring for the type of patients on the unit & request an orientation to the unit |
| failure to use skill or learning that would be used under same or similar circumstances by members of the nursing profession defines | malpractice |
| If a patient states they do not understand the procedure they are consenting to the nurse should | notify HC provider or nursing supervisor |
| If a patient refuses to consent to procedure, the patient has to refuse consent | in writing, signed and witnessed |
| moving from area a nurse is accustomed to, to other nursing unit is called | floating |
| What is the nurse's responsibility with physicians' orders? | Nurses must follow physicians orders unless they believe the orders are in error or will harm the patient |
| If there is a controversy about a physicians/APN order the nurse needs to also inform | the supervising nurse or follow the established chain of command |
| a preoperative verification that ensures all relevant documents and studies are available before the start of the procedure and are consistent with the patient's expectations is | 1 of 3 guiding principles as protocol for procedures to reduce errors set by the joint commission (TJC) |
| If HC provider confirms their orders and you believe it is still inappropriate you should | inform supervising nurse or follow chain of command |
| If you carry out inaccurate or inappropriate order legally you are | responsible for patient suffering because the nurse is obligated to keep the HC provider informed of patient condition |
| To inform provider properly a nurse should | perform a competent nursing assessment that determine significant signs & symptoms to help the provider diagnosis & treat |
| Do not walk out when staffing is inadequate because you may be | charged with patient abandonment |
| When students work as nursing assistants or nurse's aides when not attending classes, they should not | perform tasks that do not appear in a job description for a nurse's aide or assistant |
| After your assessment and notifying the HC provider a nurse should always | Document that you notified provider, their response, your follow up and patient response |
| If nurses are assigned to care for more patients than is reasonable, they need to | bring this information to the attention of the nursing supervisor |
| Failure to monitor in timely fashion, use proper equipment to monitor, & document the monitoring is an example of | negligent acts |
| a “time out” just before starting a surgical procedure for final verification of the correct patient, procedure, site, and any implants is | the 3rd guiding principle to reduce errors as a protocol set by the TJC |
| facility admin that ID's/analyzes, evaluates steps taken & act to reduce/correction threats that could lead to injury of patients, staff members, or visitors and result in property loss or damage is | risk management |
| Provides data investigation in an attempt to determine deviations from standards of care; corrective measures are needed to prevent recurrence & alert risk mgnt to potential claim situation is the purpose of | an occurrence (incident) report |
| A nurse is sued for failure to monitor a patient appropriately after a procedure; Which of the following statements are correct about this lawsuit | Person filing has burden of proof; has to prove that a breach in standard of care has caused the injury |
| confidential document that describes any patient accident while the person is on the premises of a health care agency is called | an occurrence (incident) report |
| marking of the operative site with indelible ink to mark left and right distinction, multiple structures (fingers), and levels of the spine is | 2 of 2 guiding principles as protocol for procedures to reduce errors set by the TJC |
| The scope of nursing practice is legally defined by | state nursing practice act |
| A student nurse who is employed as a nursing assistant may perform any functions that | Are identified in the position's job description |
| A confused patient who fell out of bed because side rails were not used is an example of which type of liability? | negligence because nurse could have prevented; It is conduct that falls below the standard of care |
| The nurse puts restraints on a patient without the patient's permission and without a physician's order; The nurse may be guilty of | battery because unintentional touching without consent; assault there is no touching, battery there is touching |
| An occurrence report is confidential and separate from | a patients the medical record |
| In a situation in which there is insufficient staff to implement competent care, a nurse should | Accept the assignment but make a protest in writing to the administration |
| A nurse is caring for a patient who recently had coronary bypass surgery; Which are legal sources of standards of care the nurse uses to deliver safe health care? | P&P of facility employed at; NPA for state; regulation in TJC manual;& ANA standards of nursing practice |
| A nurse stops to help in an emergency accident scene; injured party files a suit, & the nurse's employing institution insurance does not cover the nurse; What would probably cover the nurse in this situation? | The Good Samaritan laws, which grant immunity from suit if there is no gross negligence |
| A nurse is planning care for a patient going to surgery; Who is responsible for informing the patient about the surgery along with possible risks, complications, and benefits? | Surgeon |
| A woman has severe life-threatening injuries; HC provider ordered 2 units of blood to treat anemia; husband refuses to allow the nurse to give his wife the blood; What is the nurse's responsibility | Abide by the husband's wishes and inform the health care provider |
| The legal guidelines that nurses follow come from _A_, _B_, _C_ | A) statutory law, B) regulatory law, C) common law |
| The nurse notes that an advance directive is on a patient's medical record; Which statement represents the best description of an advance directive guideline the nurse will follow? | A living will is invoked only when the patient has a terminal condition or is in a persistent vegetative state |
| A nurse notes that the HC unit keeps a listing of the patient names at the front desk in easy view for HC providers to more efficiently locate the patient; this action is a violation of which act? | Health Insurance Portability and Accountability Act (HIPAA) |
| Taking or selling controlled substances & Applying physical restraints without a written physician's order are violations that result in | both criminal and administrative law sanctions against the nurse |
| A system of ensuring appropriate nursing care that attempts to identify potential hazards and eliminate them before harm occurs is called | risk management |
| homeless man enters the ER seeking health care; The HC provider indicates that the patient needs to be transferred to the City Hospital for care; This action is most likely a violation of which of the following laws? | Emergency Medical Treatment and Active Labor Act (EMTALA) |
| you are the night shift nurse & caring for a newly admitted patient who appears to be confused; The family asks to see the patient's medical record: What is the first nursing action to take? | Discuss the issues that concern the family with them |
| A nurse notices bruising on a 2-year-old patient's head, arms, abdomen, & legs; Mother describes the patient's frequent falls; What is the best nursing action for the nurse to take? | Contact a child abuse hotline |
| You are floated to work on a nursing unit where you are given an assignment that is beyond your capability; What is the best nursing action to take first? | Call the nursing supervisor to discuss the situation |
| What is the statutory law Nurses are required to know for the state they work in | Nursing Practice Acts (NPA) |
| The ADA is a broad civil statute protecting rights of people w/ physical & mental disabilities & prohibits discrimination & ensures equal opportunity in | state & local gov services, public accommodation, commercial facilities & transportation |
| Most states adopted uniform determination of death act; Name the two standards for the determination of death | health care providers can use the cardiopulmonary & Whole brain standard to determine death |
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