Legal considerations in nursing practice sherpath – NSG 521 Fundamental Concepts & Health Assessment
Question 1 of 9 – Which statements are correct regarding state nurse practice acts?
State nurse practice acts delineate what a nurse can and cannot do.
State nurse practice acts establish the scope of practice for the RN.
Nurse practice acts identify who can use the title of RN.
State nurse practice acts define who can use the title of RN legally and the minimum requirement of schooling.
They are consistent throughout the United States.
State nurse practice acts vary from state to state in specific content, scope of practice, and licensure requirements; therefore they are not consistent throughout the United States.
Nurse practice acts are revised periodically to reflect a changing society.
State nurse practice acts are revised periodically to reflect an always-changing environment affecting society and health care.
They define behaviors that are considered misconduct.
State nurse practice acts clearly define behaviors that are unacceptable for an RN
.
Question 2 of 9 – The nurse is caring for a patient for whom the health care provider has prescribed an injection to treat a sexually transmitted infection. The patient has requested oral antibiotics instead of an intramuscular injection. The nurse believes that the patient is acting childishly and is threatening to give the injection without the patient’s consent. This action could lead to which type of lawsuit in nursing?
Medication error
A medication error would occur if the nurse gave the patient a different medication or a different dosage of medication than what was originally prescribed by the health care provider.
Negligence
Even though the nurse is failing to act as a reasonable person would do in a similar circumstance, this example more clearly illustrates assault, which is an intentional threat toward another person.
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Battery
Battery is intentional offensive touching without consent, so actually giving the injection without patient consent would be considered battery.
. Assault
Threatening to give the patient an injection without his or her consent is an example of verbal assault as it would be considered an intentional threat toward another person.
Question 3 of 9 – Which incidents are examples of never events and subject to nonreimbursement from the Centers for Medicare and Medicaid Services?
A patient falling out of bed
A patient fall would be considered a never event because it is seen as a preventable injury occurring during a hospital stay.
An
E. coli
bacterial central venous line infection
A central venous line infection would be considered a never event because it is seen as a preventable injury occurring during a hospital stay.
A candida urinary tract infection
A never event is a preventable injury occurring during a hospital stay. A candida urinary tract infection without an associated urinary catheter would not be considered a never event as it is not seen as a preventable event.
A retained surgical object after a surgery
A retained foreign object after a surgery would be considered a never event because it is seen as a preventable injury occurring during a hospital stay.
A staphylococcal surgical site infection
A surgical site infection would be considered a never event because it is seen as a preventable injury occurring during a hospital stay.
Question 4 of 9 – Which information should be included in patient documentation?
The specific treatment provided to the patient
The specific treatment administered to the patient should be clearly documented in the patient chart.
The patient’s response to the treatment
The patient’s response to the treatment with facts such as vital signs should be clearly documented in the patient’s chart.
The nurse’s opinion about the patient’s mood/affect after the treatment
Personal opinions should not be documented in the patient’s chart.
The time the treatment was administered
The specific time the treatment was given should be clearly documented in the patient’s chart.
Documentation of the previous nurse failing to administer treatment
The nurse should not document what others did or did not do and would only document what he or she did during the current shift. Charting should reflect only the nurse’s own actions and the patient’s response.
Question 5 of 9 – Which aspects of nursing care is the registered nurse (RN) responsible for when delegating actions to someone on his or her behalf?
Ensuring that the task is appropriate to delegate
Right task is one of the five rights of safe delegation as it involves ensuring that the task is appropriate to delegate.
Ensuring that the delegatee is able to correctly perform the task
Right person is one of the five rights of safe delegation as it involves ensuring that the person to whom the task is delegated is competent to carry out the assigned task.
Performing follow-up and evaluation after completing the task
Right supervision is one of the five rights of safe delegation as it involves ensuring that the appropriate follow-up and evaluation are performed after completing the task.
Correctly following hospital protocol
When delegating a task, the RN is responsible for the right task, right person, right circumstance, right communication, and right supervision/evaluation. The nurse is not responsible for the delegate (LVN/LPN or another RN) following hospital protocol (e.g., if the delegate did not use the appropriate personal protective gear when entering the room).
Ensuring that the circumstance is appropriate to delegate the task
Right circumstance is one of the five rights of safe delegation as it involves ensuring that the circumstance or scenario is appropriate to delegate the task.
Question 6 of 9 – The nurse is filling out an incident report after finding an older adult patient on the floor beside the bed. Which guidelines would the nurse follow when completing the report?
Describe objectively how the nurse found the patient.
The event must be described objectively and only describe events that the nurse personally witnessed.
Notify management that a critical event occurred.
Every critical event must be reported to upper management.
Document in the medical record that an incident report was filed.
The nurse would not document in the chart that an incident report was filed as it can bring the existence of an incident report to a plaintiff’s attorney.
Document in the medical record that the patient fell getting out of bed.
The nurse would not make assumptions. If the nurse did not see the patient fall out of the bed, he or she should not assume that the patient fell getting out of the bed.
Make a photocopy of the incident report to keep for personal records.
The nurse should never photocopy an incident report for his or her own records.
Question 7 of 9 – A patient diagnosed with terminal cancer has obtained a prescription for medications that will end his life. This is an example of which type of end-of-life treatment?
Nonvoluntary euthanasia
Nonvoluntary euthanasia is defined as when a family member or an advance directive allows an incapacitated patient to have a medically assisted death with the goal of ending patient suffering.
Suicide
Suicide is the act of intentionally causing one’s death without the assistance of a health care provider.
assisted suicide
Assisted suicide is a medically assisted death in which a qualified health care provider supplies the patient with the means of taking his or her own life but does not perform the actual actions required to cause death.
Voluntary euthanasia
Voluntary euthanasia is defined as when a legally competent patient makes an informed and voluntary choice to have a medically assisted death.
Question 8 of 9 – When a patient is refusing medical treatment, which information should be included in the documentation?
Presence of hospital chaplain
When documenting a patient’s refusal of medical treatment, included in the documentation should be the patient’s signature, patient’s acknowledgement of being of sound mind, the presence of family/friends (support system), and clearly stated risks associated with refusal of medical care. The presence (or absence) of a hospital chaplain is not required as it does not necessarily affect the decision.
Patient being of sound mind
When documenting a patient’s refusal of medical treatment, included in the documentation should be the patient’s acknowledgment of understanding the implications of his or her decision.
Support system present for the patient
When documenting a patient’s refusal of medical treatment, included in the documentation should be the presence of family/friends available to support the patient’s decision.
Risks associated with refusal of care
When documenting a patient’s refusal of medical treatment, included in the documentation should be clearly stated information associated with refusal of medical care that could affect the decision.
Patient signature on the document with all presented information
When documenting a patient’s refusal of medical treatment, included in the documentation should be the patient’s signature to acknowledge receipt of relevant information.
Question 9 of 9 – How did the 2010 Patient Protection and Affordable Care Act affect the ability for individuals to receive health care?
It required insurance coverage for all US citizens and undocumented residents.
US citizens and legal residents, not undocumented citizens, were required to maintain health insurance or be financially penalized. This expanded the pool of insured Americans, lowering the overall cost of care.
It stipulated that there would be no out-of-pocket expenses for preventive services.
The act removed copays for preventive services, making it easier to receive this type of care.
It allowed insurance companies to screen for preexisting conditions.
The act eliminated preexisting condition barriers by not allowing insurance companies to deny coverage based on conditions the patient already had when acquiring the coverage.
It allowed dependents to remain on a parent’s insurance until 22 years of age.
The act allowed dependents to remain on parental coverage until 26 years of age, not 22 years of age. This expanded coverage for a segment of the population that often was uninsured because of a lack of job benefits or the high cost of premiums.
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