Chapter 23 Legal Implications in Nursing Practice Fundamentals of Nursing 11th Edition (Potter & Perry) 50 NCLEX-Style Exam Questions with Detailed Rationales

1. What is the primary purpose of the Nurse Practice Act (NPA)? A) To provide ethical guidelines for nursing practice B) To define the scope and standards of nursing practice within each state C) To regulate hospital policy on patient safety D) To ensure physicians delegate appropriate tasks Answer: B Rationale: The NPA is a state-specific law that governs nursing practice, defining the scope, responsibilities, and legal limits of nurses. It ensures that nurses practice safely and competently. A is incorrect because ethics is covered by codes of ethics, not law. C and D relate to institutional policies and medical practice, not nurse legislation. ________________________________________ 2. A nurse who restrains a patient without a physician’s order or emergency justification may be charged with: A) Battery B) Negligence C) False imprisonment D) Malpractice Answer: C Rationale: False imprisonment is the unlawful restraint or restriction of a person’s freedom of movement. Using restraints without proper authorization or justification falls under this legal violation. Battery is intentional physical contact, negligence is failure to act responsibly, and malpractice relates to professional misconduct causing harm. ________________________________________ 3. Which of the following situations most clearly represents negligence by a nurse? A) Administering medication without a physician’s order B) Failing to raise side rails for a confused patient who later falls C) Documenting care at the end of the shift D) Explaining a procedure in detail before performing it Answer: B Rationale: Negligence occurs when a nurse fails to act as a reasonably prudent nurse would, such as omitting safety measures. A is beyond the scope of negligence and may constitute malpractice. C is acceptable if care is accurately documented. D is appropriate and shows informed consent practice. ________________________________________ 4. A nurse gives the wrong medication, causing harm. This is an example of: A) Invasion of privacy B) Assault C) Malpractice D) Battery Answer: C Rationale: Malpractice refers to professional negligence. In this case, a medication error that causes harm meets this legal definition. Assault is a threat of harm, battery is physical contact without consent, and invasion of privacy involves unauthorized access to personal information. 5. A patient refuses treatment. The nurse continues to administer it. This is an example of: A) Negligence B) False imprisonment C) Battery D) Defamation Answer: C Rationale: Continuing a treatment after refusal constitutes battery, as it is intentional touching without consent. Defamation is harming reputation, false imprisonment is restraint, and negligence involves unintentional errors or omissions. ________________________________________ 6. The nurse’s legal responsibility regarding informed consent includes: A) Explaining the surgical procedure B) Witnessing the client’s signature C) Obtaining verbal consent D) Ordering the procedure Answer: B Rationale: Nurses do not explain procedures—that’s the provider’s duty—but they witness the patient’s voluntary signing. A and D are beyond nursing scope. C is not a substitute for formal, written informed consent in most cases. ________________________________________ 7. A patient tells the nurse, “I don’t want the surgery.” What should the nurse do first? A) Tell the surgeon to cancel it B) Document the refusal and walk away C) Inform the charge nurse D) Clarify the patient’s concerns and notify the physician Answer: D Rationale: The nurse must first assess why the patient refuses. After understanding and supporting patient autonomy, the nurse then informs the provider. A and C may be premature. B is insufficient care. ________________________________________ 8. What is the purpose of incident reports in nursing practice? A) To report patient complaints to administration B) To assign blame for errors C) To document events that could or did lead to patient harm D) To explain medical diagnoses Answer: C Rationale: Incident reports help facilities track and investigate errors or near misses to improve safety. They are not for blame (B), grievances (A), or clinical diagnoses (D). ________________________________________ 9. What should the nurse do when making an entry in a patient’s record? A) Use white-out to fix errors B) Document facts, not opinions C) Leave space between entries D) Record only abnormal findings Answer: B Rationale: Legal documentation must be objective and factual. A and C violate documentation standards. D is incorrect—all relevant data, normal or abnormal, must be recorded. ________________________________________ 10. Which of the following is true regarding Good Samaritan laws? A) They require nurses to stop and assist in emergencies B) They protect nurses from liability only in hospitals C) They encourage healthcare providers to offer help in emergencies without fear of legal repercussion D) They apply only to physicians Answer: C Rationale: Good Samaritan laws exist to protect people providing emergency care outside of healthcare settings from liability, provided they act within scope and without gross negligence. ________________________________________ 11. Which term refers to a legal wrong committed against a person or property? A) Tort B) Crime C) Consent D) Law Answer: A Rationale: A tort is a civil wrong (e.g., negligence, malpractice). Crimes are prosecuted by the state, while consent and law are legal concepts rather than violations. ________________________________________ 12. A patient’s health information is disclosed without consent. This is a violation of: A) Battery B) HIPAA C) Autonomy D) Consent Answer: B Rationale: The Health Insurance Portability and Accountability Act (HIPAA) protects patients’ personal health information. Disclosing without consent breaches this federal law. ________________________________________ 13. Which documentation best protects the nurse legally? A) “Patient seemed upset.” B) “Patient was acting strange.” C) “Patient cried when asked about pain, stated pain level was 9/10.” D) “Patient might be faking symptoms.” Answer: C Rationale: This statement is objective, uses measurable data (pain scale), and includes observable behavior (crying). Others are vague, opinionated, or speculative. ________________________________________ 14. Which action by a nurse can reduce legal liability? A) Delegating tasks based on convenience B) Keeping quiet about a mistake C) Following evidence-based nursing standards D) Relying on memory for documentation Answer: C Rationale: Following accepted standards of care protects nurses legally. A, B, and D increase legal risk due to unsafe or unethical practices. ________________________________________ 15. What is the best definition of informed consent? A) Permission granted under duress B) Agreement to treatment with limited knowledge C) Voluntary agreement to treatment after full disclosure of risks, benefits, and alternatives D) Consent granted by the nurse Answer: C Rationale: Informed consent means the patient is fully informed and gives voluntary permission. A and B lack autonomy or adequate info, and D is outside the nurse’s scope. ________________________________________