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Answer: 2
Rationale: Negligence is the unintention-
al failure of an individual to perform or not
perform an act that a reasonable person
A nurse forgets to administer a client's would or would not do in the same or sim-
diuretic and the client experiences ilar circumstances. A purposeful failure to
an episode of pulmonary edema. The perform a procedure would be the oppo-
charge nurse would consider the med- site of negligence, which is unintentional.
ication error to constitute negligence be- Substituting a different medication does
cause the situation contains which ele- not fit the description of the situation in
ment? the question. Failure to follow a direct
order does not fit the description in the
1. Purposeful failure to perform a health situation in the question.
care procedure Cognitive Level: Applying
2. Unintentional failure to perform a Client Need: Management of Care
health care procedure Integrated Process: Nursing Process:
3. Act of substituting a different medica- Assessment
tion for the one ordered Content Area: Fundamentals
4. Failure to follow a direct order by a Strategy: Two options are opposites,
physician which is a clue that one of them may
be correct. Choose unintentional failure
to carry out a procedure over purposeful
failure because it matches the definition
of negligence.
Answer: 4
Rationale: Fidelity means being faithful
to agreements and promises. This nurse
is acting on the client's behalf to ob-
A client asks why a diagnostic test has
tain needed information and report it
been ordered and the nurse replies, "I'm
back to the client. Nonmaleficence is the
unsure but will find out for you." When
duty to do no harm. Veracity refers to
the nurse later returns and provides an
telling the truth for example, not lying
explanation, the nurse is acting under
to a client about a serious prognosis.
which principle?
Beneficence means doing good, such
as by implementing actions (e.g. keeping
1. Nonmaleficence
a salt shaker out of sight) that benefit
a client (heart condition requiring sodi-
um-restricted diet).
Cognitive Level: Understanding
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Client Need: Management of Care
Integrated Process: Nursing Process:
Implementation
2. Veracity Content Area: Fundamentals
3. Beneficence Strategy: Use the process of elimination.
4. Fidelity The correct answer is the one that match-
es the description in the stem; that is,
the nurse made a promise to a client and
kept it, which constitutes fidelity.
Answer: 1
Rationale: To be guilty of negligence, the
nurse must have a relationship with the
client that involves a duty to provide care.
The relationship is usually a component
An individual has a seizure while walking
of employment. The nurse did not neces-
down the street. During the seizure, a
sarily do what others would do in this sit-
nurse from a physician's office is noticed
uation. Although the nurse did not cause
driving past without stopping to assist.
the client's injuries, it does not prevent
The individual sues the nurse for neg-
the nurse from assisting in this situa-
ligence but fails to win a judgement for
tion. Although the nurse was off-duty, the
which reason?
nurse could have assisted if motivated to
do so.
1. The nurse had no duty to the individ-
Cognitive Level: Understanding
ual.
Client Need: Management of Care
2. The nurse did what most nurses would
Integrated Process: Nursing Process:
do in the same circumstance.
Implementation
3. The nurse did not cause the client's
Content Area: Fundamentals
injuries.
Strategy: Use the process of elimination
4. The nurse was off-duty at the time.
and nursing knowledge. The correct an-
swer is the one that recognizes that the
nurse was not in the role of employee at
the time of the incident, removing the re-
quirement of acting on the client's behalf.
An adult female ambulatory care client
receiving an oral anticoagulant is given
aspirin for a headache while visiting a
neighbor, who is a nurse. The client sub-
sequently has a bleeding episode be-
cause of a drug interaction. The legal
nurse consultant interprets that which
necessary elements of malpractice are
missing from this case? Select all that
apply.
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Answer: 2, 5
Rationale: There was no nurse-client re-
lationship because the nurse was act-
ing as a neighbor and not in an em-
ployment capacity. Thus, there can be no
duty owed. Intent is not a necessary el-
ement of malpractice, because malprac-
tice can occur because of unintended
actions as well. There was no breach
of duty because there was no official
nurse-client relationship, which accom-
panies an employment situation. There
was injury experiences because of this
event. The bleeding was caused by the
interaction of the aspirin with the antico-
agulant.
Cognitive Level: Analyzing
Client Need: Management of Care
Integrated Process: Nursing Process:
Evaluation
Content Area: Fundamentals
Strategy: Use the process of elimination.
The wording of the question indicates
more than one option is correct, and
the focus is on necessary elements that
must be present. First eliminate the intent
to cause harm or injury, since this is not
necessary to a charge of malpractice.
Next note that there is no duty owed, and
because of this, there can be no breach
of duty, to choose these two options as
the necessary missing elements.
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