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Chapter 23 Legal Implications in Nursing Practice-Fundamentals of Nursing

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Chapter 23 Legal Implications in Nursing Practice-Fundamentals of Nursing

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Chapter 23: Legal Implications in Nursing Practice
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MULTIPLE CHOICE ra




1. A newly hired experienced nursing attendant is preparing to change a hospital client ’s a
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bdominal dressing and hasn’t done it before at this hospital. Which action by the nursin
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g attendant is best?
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a. Have another nursing attendant do it so the correct method can be viewed.
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b. Change the dressing using the method taught in nursing school. ra ra ra ra ra ra ra ra ra




c. Ask the hospital client how the dressing change has been recently done.
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d. Check the policy and procedure manual for the facility’s method. ra ra ra ra ra ra ra ra ra




ACCURATE ar



ANSWER:-D
The Joint Commission requires accredited hospitals to have written nursing policies and proc
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edures. These internal standards of care are specific and need to be accessible on all nursing u
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nits. For example, a policy/procedure outlining the steps to follow when changing a dressing
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or administering medication provides specific information about how nursing attendant s are
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to perform. The nursing attendant being observed may not be doing the procedure according
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to the facility’s policy or procedure. The procedure taught in nursing school may not be consi
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stent with the policy or procedure for this facility. The hospital client is not responsible for m
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aintaining the standards of practice. Hospital client input is important, but it’s not what direc
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ts nursing practice.
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DIF:Apply (application) ra



OBJ:Describe how standards of nursing care shape your nursing practice. ra ra ra ra ra ra ra ra ra ar



TOP:Planning MSC: Management of Care ra ra ra




2. A new nursing attendant notes that the health care unit keeps a listing of hospital client
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names in a closed book behind the front desk of the nursing station so hospital client s ca
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n be located easily. Which action is most appropriate for the nursing attendant to take?
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a. Talk with the nursing attendant manager about the listing being a violatio ra ra ra ra ra ra ra ra ra ra ra



n of the Health Insurance Portability and Accountability Act (HIPAA).
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b. Use the book as needed while keeping it away from individuals not involved in
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hospital client care. ra ra




c. Move the book to the upper ledge of the nursing station for easier access.
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d. Ask the nursing attendant manager to move the book to a more secluded area.
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ACCURATE ANSWER:-B ra



The book is located where only staff would have access so the nursing attendant can use the
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book as needed. The privacy section of the HIPAA provides standards regarding accountabil
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ity in the health care setting. These rules include hospital client rights to consent to the use a
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nd disclosure of their protected health information, to inspect and copy their medical record,
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and to amend mistaken or incomplete information. It is not the responsibility of the new nur
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sing attendant to move items used by others on the hospital client unit. The listing is protect
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ed as long as it is used
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appropriately as needed to provide care. There is no need to move the book to a more secluded ar
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ea.

, DIF:Apply (application) ra



OBJ:Discuss how federal statutes promote hospital client safety and affect nursin
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g practice. TOP:Implementation
ar MSC: Management of Care
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3. A 17- ra



yearold hospital client , dying of heart failure, wants to have organs removed for trans
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planta tion after death. Which action by the nursing attendant is correct?
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a. Instruct the hospital client to talk with parents about the desire to donate organs.
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b. Notify the health care provider about the hospital client ’s desire to donate organs.
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c. Prepare the organ donation form for the hospital client to sign while still oriented.
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d. Contact the United Network for Organ Sharing after talking with the hospital client .
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ACCURATE ANSWER:-A ra



In this situation, the parents would need to sign the form because the teenager is under age 18.
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An individual who is at least 18 may sign the form allowing organ donation upon death. The nu
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rsing attendant cannot allow the hospital client to sign the organ donation document because t
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he hospital client is younger than age 18. The health care provider will be notified about the hos
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pital client ’s wishes after the parents agree to donate the organs. The United Network for Org
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an Sharing (UNOS) has a contract with the federal government and sets policies and guideline
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s for the procurement of organs.
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DIF:Apply (application) ra



OBJ:Explain how state laws and regulations affect nursing practice. ra ra ra ra ra ra ra ra ar



TOP:Implementation MSC: Management of Care ra ra




4. An obstetric nursing attendant comes across an automobile accident. The driver seems to ha
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ve a crushed upper airway, and while waiting for emergency medical services to arrive, the n
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u
rsing attendant makes a cut in the trachea and inserts a straw from a purse to provide an air
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way. The hospital client survives and has a permanent problem with vocal cords, making it
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difficult to talk. Which statement is true regarding the nursing attendant ’s performance? a.
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The nursing attendant acted appropriately and saved the hospital client ’s life.
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b. The nursing attendant stayed within the guidelines of the Good Samaritan Law.
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c. The nursing attendant took actions beyond those that are standard and appropriate.
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d. The nursing attendant should have just stayed with the hospital client and waited for help.
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ACCURATE ANSWER:-C ra



An obstetric nursing attendant would not have been trained in performing a tracheostomy (c
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ut in the trachea) and doing so would be beyond what the nursing attendant has been trained
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or educated to do. If you perform a procedure exceeding your scope of practice and for which
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you have no training, you are liable for injury that may result from that act. You should only p
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rovide care that is consistent with your level of expertise. The nursing attendant did not act a
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ppropriately. The nursing attendant is not protected by the Good Samaritan Law because the
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nursing attendant acted outside the scope of practice and training. The nursing attendant sho
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uld have acted within what was trained and educated to do in this circumstance, not just stay
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with the hospital client .
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DIF:Apply (application) ra



OBJ:Describe how standards of nursing care shape your nursing practice. ra ra ra ra ra ra ra ra ra ar



TOP:Evaluation MSC: Management of Care ra ra ra

, 5. A nursing attendant performs cardiopulmonary resuscitation (CPR) on a 92- ra ra ra ra ra ra ra ra ra



yearold with brittle bones and breaks a rib during the procedure, which then punctures a
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alung
. The hospital client recovers completely without any residual problems and sues the nur
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sing attendant for pain and suffering and for malpractice. Which key point will the prose
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c ution attempt to prove against the nursing attendant ? a. ar ra ra ra ra ra ra ra



The CPR procedure was done incorrectly.
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b. The hospital client would have died if nothing was done.
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c. The hospital client was resuscitated according to the policy.
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d. The older hospital client with brittle bones might sustain fractur
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es when chest compressions are done.
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ACCURATE ANSWER:-A ra



Certain criteria are necessary to establish nursing malpractice. The prosecution would try to
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prove that a breach of duty had occurred (CPR done incorrectly), which had caused injury. T
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he defense team, not the prosecution, would explain the correlation between brittle bones an
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d rib fractures during CPR and that the hospital client was resuscitated according to policy. I
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n this situation, although harm was caused, it was not because of failure of the nursing attend
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ant to perform a duty according to standards, the way other nursing attendant s would have p
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erformed in the same situation. The fact that the hospital client sustained injury, as a result of
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age and physical status, does not mean the nursing attendant breached any duty to the hospita
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l client . The nursing attendant would need to make sure the defense attorney knew that the
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cardiopulmonary resuscitation (CPR) was done correctly. Without intervention, the hospital ra ra ra ra ra ra ra ra ra ra



client most likely would not have survived.
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DIF:Understand (comprehension) ra



OBJ:Define the standard of proof required to establish a nursing attendant ’s
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negligence. TOP:Evaluation MSC: Management of Care ra ra ra ra




6. A recent immigrant who does not speak English is alert but requires hospitalization. What i
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s the initial action that the nursing attendant must take to enable informed consent to be ob
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tained?
a. Ask a family member to translate what the nursing attendant is saying.
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b. Request an official interpreter to explain the terms of consent. ra ra ra ra ra ra ra ra ra




c. Notify the nursing manager that the hospital client doesn’t speak English.
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d. Use hand gestures and medical equipment while explaining in English.
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ACCURATE ANSWER:-B ra



An official interpreter must be present to explain the terms of consent if a hospital client spea
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ks only a foreign language. A family member or acquaintance who speaks a hospital client ’s la
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nguage should not interpret health information. Family members can tell those caring for the
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hospital client what the hospital client is saying, but privacy regarding the hospital client ’s c
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ondition, assessment, etc., must be protected. A nursing attendant can take care of requesting
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an interpreter, and the nursing attendant manager is not needed. Using hand gestures and me
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dical equipment is inappropriate when communicating with a hospital client who does not u
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nderstand the language spoken. Certain hand gestures may be acceptable in one culture and n
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ot appropriate in another. The medical equipment may be unknown and frightening to the ho
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spital client , and the hospital client still doesn’t understand what is being said.
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DIF:Apply (application) ra



OBJ:Discuss how federal statutes promote hospital client safety and affect nursin
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g practice. TOP:Implementation
ar MSC: Management of Care
ra ra ra

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