Chapter 23:
Legal Implications in Nursing Practice
Chapter 23: Legal Implications in Nursing Practice
Potter et al.: Fundamentals of Nursing, 9th Edition
MULTIPLE CHOICE
1. A newly hired experienced nurse is preparing to change a patient’s abdominal dressing and hasn’t
done it before at this hospital. Which action by the nurse is best?
a. Have another nurse do it so the correct method can be viewed.
b. Change the dressing using the method taught in nursing school.
c. Ask the patient how the dressing change has been recently done.
d. Check the policy and procedure manual for the facility’s method.
ANS: D
The Joint Commission requires accredited hospitals to have written nursing policies and procedures.
These internal standards of care are specific and need to be accessible on all nursing units. For
example, a policy/procedure outlining the steps to follow when changing a dressing or administering
medication provides specific information about how nurses are to perform. The nurse being observed
may not be doing the procedure according to the facility’s policy or procedure. The procedure taught
in nursing school may not be consistent with the policy or procedure for this facility. The patient is
not responsible for maintaining the standards of practice. Patient input is important, but it’s not what
directs nursing practice.
DIF:Apply (application)REF:303
OBJ: List sources of standards of care for nurses. TOP: Planning
MSC:Management of Care
2. A new nurse notes that the health care unit keeps a listing of patient names in a closed bookbehind
the front desk of the nursing station so patients can be located easily. Which action
is most appropriate for the nurse to take?
, Talk with the nurse manager about the listing being a violation of the Health Insurance Portability and
a. Accountability Act (HIPAA).
b. Use the book as needed while keeping it away from individuals not involved in patient care.
c. Move the book to the upper ledge of the nursing station for easier access.
d. Ask the nurse manager to move the book to a more secluded area.
ANS: B
The book is located where only staff would have access so the nurse can use the book as needed. The
privacy section of the HIPAA provides standards regarding accountability in the health care setting.
These rules include patient rights to consent to the use and disclosure of their protected health
information, to inspect and copy their medical record, and to amend mistaken or incomplete
information. It is not the responsibility of the new nurse to move items used by others on the patient
unit. The listing is protected as long as it is used appropriately as needed to provide care. There is no
need to move the book to a more secluded area.
DIF:Apply (application)REF:306
OBJ: Describe the legal obligations and role of the nurse regarding federal and state laws that affect
health care. TOP: Implementation MSC: Management of Care
3. A 17-year-old patient, dying of heart failure, wants to have organs removed for transplantation
after death. Which action by the nurse is correct?
a. Instruct the patient to talk with parents about the desire to donate organs.
b. Notify the health care provider about the patient’s desire to donate organs.
c. Prepare the organ donation form for the patient to sign while still oriented.
d. Contact the United Network for Organ Sharing after talking with the patient.
ANS: A
, In this situation, the parents would need to sign the form because the teenager is under age 18. An
individual who is at least 18 may sign the form allowing organ donation upon death. The nurse
cannot allow the patient to sign the organ donation document because the patient is younger than age
18. The health care provider will be notified about the patient’s wishes after the parents agree to
donate the organs. The United Network for Organ Sharing (UNOS) has a contract with the federal
government and sets policies and guidelines for the procurement of organs.
DIF:Apply (application)REF:306
OBJ:Analyze legal aspects of nurse-patient, nurse-health care provider, nurse-nurse, and nurse-
employer relationships.TOP:Implementation
MSC:Management of Care
4. An obstetric nurse comes across an automobile accident. The driver seems to have a crushedupper
airway, and while waiting for emergency medical services to arrive, the nurse makes a cut in the
trachea and inserts a straw from a purse to provide an airway. The patient survives and has a
permanent problem with vocal cords, making it difficult to talk. Which statement is true regarding
the nurse’s performance?
a. The nurse acted appropriately and saved the patient’s life.
b. The nurse stayed within the guidelines of the Good Samaritan Law.
c. The nurse took actions beyond those that are standard and appropriate.
d. The nurse should have just stayed with the patient and waited for help.
ANS: C
An obstetric nurse would not have been trained in performing a tracheostomy (cut in the trachea),
and doing so would be beyond what the nurse has been trained or educated to do. If you perform a
procedure exceeding your scope of practice and for which you have no training, you are liable for
injury that may result from that act. You should only provide care that is consistent with your levelof
expertise. The nurse did not act appropriately. The nurse is not protected by the Good Samaritan Law
because the nurse acted outside the scope of practice and training. The nurse should have acted
within what was trained and educated to do in this circumstance, not just stay with the patient.
Legal Implications in Nursing Practice
Chapter 23: Legal Implications in Nursing Practice
Potter et al.: Fundamentals of Nursing, 9th Edition
MULTIPLE CHOICE
1. A newly hired experienced nurse is preparing to change a patient’s abdominal dressing and hasn’t
done it before at this hospital. Which action by the nurse is best?
a. Have another nurse do it so the correct method can be viewed.
b. Change the dressing using the method taught in nursing school.
c. Ask the patient how the dressing change has been recently done.
d. Check the policy and procedure manual for the facility’s method.
ANS: D
The Joint Commission requires accredited hospitals to have written nursing policies and procedures.
These internal standards of care are specific and need to be accessible on all nursing units. For
example, a policy/procedure outlining the steps to follow when changing a dressing or administering
medication provides specific information about how nurses are to perform. The nurse being observed
may not be doing the procedure according to the facility’s policy or procedure. The procedure taught
in nursing school may not be consistent with the policy or procedure for this facility. The patient is
not responsible for maintaining the standards of practice. Patient input is important, but it’s not what
directs nursing practice.
DIF:Apply (application)REF:303
OBJ: List sources of standards of care for nurses. TOP: Planning
MSC:Management of Care
2. A new nurse notes that the health care unit keeps a listing of patient names in a closed bookbehind
the front desk of the nursing station so patients can be located easily. Which action
is most appropriate for the nurse to take?
, Talk with the nurse manager about the listing being a violation of the Health Insurance Portability and
a. Accountability Act (HIPAA).
b. Use the book as needed while keeping it away from individuals not involved in patient care.
c. Move the book to the upper ledge of the nursing station for easier access.
d. Ask the nurse manager to move the book to a more secluded area.
ANS: B
The book is located where only staff would have access so the nurse can use the book as needed. The
privacy section of the HIPAA provides standards regarding accountability in the health care setting.
These rules include patient rights to consent to the use and disclosure of their protected health
information, to inspect and copy their medical record, and to amend mistaken or incomplete
information. It is not the responsibility of the new nurse to move items used by others on the patient
unit. The listing is protected as long as it is used appropriately as needed to provide care. There is no
need to move the book to a more secluded area.
DIF:Apply (application)REF:306
OBJ: Describe the legal obligations and role of the nurse regarding federal and state laws that affect
health care. TOP: Implementation MSC: Management of Care
3. A 17-year-old patient, dying of heart failure, wants to have organs removed for transplantation
after death. Which action by the nurse is correct?
a. Instruct the patient to talk with parents about the desire to donate organs.
b. Notify the health care provider about the patient’s desire to donate organs.
c. Prepare the organ donation form for the patient to sign while still oriented.
d. Contact the United Network for Organ Sharing after talking with the patient.
ANS: A
, In this situation, the parents would need to sign the form because the teenager is under age 18. An
individual who is at least 18 may sign the form allowing organ donation upon death. The nurse
cannot allow the patient to sign the organ donation document because the patient is younger than age
18. The health care provider will be notified about the patient’s wishes after the parents agree to
donate the organs. The United Network for Organ Sharing (UNOS) has a contract with the federal
government and sets policies and guidelines for the procurement of organs.
DIF:Apply (application)REF:306
OBJ:Analyze legal aspects of nurse-patient, nurse-health care provider, nurse-nurse, and nurse-
employer relationships.TOP:Implementation
MSC:Management of Care
4. An obstetric nurse comes across an automobile accident. The driver seems to have a crushedupper
airway, and while waiting for emergency medical services to arrive, the nurse makes a cut in the
trachea and inserts a straw from a purse to provide an airway. The patient survives and has a
permanent problem with vocal cords, making it difficult to talk. Which statement is true regarding
the nurse’s performance?
a. The nurse acted appropriately and saved the patient’s life.
b. The nurse stayed within the guidelines of the Good Samaritan Law.
c. The nurse took actions beyond those that are standard and appropriate.
d. The nurse should have just stayed with the patient and waited for help.
ANS: C
An obstetric nurse would not have been trained in performing a tracheostomy (cut in the trachea),
and doing so would be beyond what the nurse has been trained or educated to do. If you perform a
procedure exceeding your scope of practice and for which you have no training, you are liable for
injury that may result from that act. You should only provide care that is consistent with your levelof
expertise. The nurse did not act appropriately. The nurse is not protected by the Good Samaritan Law
because the nurse acted outside the scope of practice and training. The nurse should have acted
within what was trained and educated to do in this circumstance, not just stay with the patient.
