A nurse forgets to administer a client's diuretic and the client experiences an episode of
pulmonary edema. The charge nurse would consider the medication error to constitute
negligence because the situation contains which element?
1. Purposeful failure to perform a health care procedure
2. Unintentional failure to perform a health care procedure
3. Act of substituting a different medication for the one ordered
4. Failure to follow a direct order by a physician - ANSWER Answer: 2
Rationale: Negligence is the unintentional failure of an individual to perform or not perform
an act that a reasonable person would or would not do in the same or similar circumstances.
A purposeful failure to perform a procedure would be the opposite of negligence, which is
unintentional. Substituting a different medication does not fit the description of the
situation in the question. Failure to follow a direct order does not fit the description in the
situation in the question.
Cognitive Level: Applying
Client Need: Management of Care
Integrated Process: Nursing Process: Assessment
Content Area: Fundamentals
Strategy: Two options are opposites, 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.
A client asks why a diagnostic test has been ordered and the nurse replies, "I'm unsure but
will find out for you." When the nurse later returns and provides an explanation, the nurse is
acting under which principle?
1
,1. Nonmaleficence
2. Veracity
3. Beneficence
4. Fidelity - ANSWER Answer: 4
Rationale: Fidelity means being faithful to agreements and promises. This nurse is acting on
the client's behalf to obtain needed information and report it back to the client.
Nonmaleficence is the duty to do no harm. Veracity refers to telling the truth for example,
not lying to a client about a serious prognosis. Beneficence means doing good, such as by
implementing actions (e.g. keeping a salt shaker out of sight) that benefit a client (heart
condition requiring sodium-restricted diet).
Cognitive Level: Understanding
Client Need: Management of Care
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals
Strategy: Use the process of elimination. The correct answer is the one that matches the
description in the stem; that is, the nurse made a promise to a client and kept it, which
constitutes fidelity.
An individual has a seizure while walking down the street. During the seizure, a nurse from a
physician's office is noticed driving past without stopping to assist. The individual sues the
nurse for negligence but fails to win a judgement for which reason?
1. The nurse had no duty to the individual.
2. The nurse did what most nurses would do in the same circumstance.
3. The nurse did not cause the client's injuries.
4. The nurse was off-duty at the time. - ANSWER 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 of employment. The
nurse did not necessarily do what others would do in this situation. Although the nurse did
not cause the client's injuries, it does not prevent the nurse from assisting in this situation.
Although the nurse was off-duty, the nurse could have assisted if motivated to do so.
2
, Cognitive Level: Understanding
Client Need: Management of Care
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals
Strategy: Use the process of elimination and nursing knowledge. The correct answer is the
one that recognizes that the nurse was not in the role of employee at the time of the
incident, removing the requirement 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 subsequently has a bleeding
episode because of a drug interaction. The legal nurse consultant interprets that which
necessary elements of malpractice are missing from this case? Select all that apply.
1. Breech of duty
2. Duty owed
3. Injury experienced
4. Causation between nurse's action and injury
5. Intent to cause harm or injury - ANSWER Answer: 2, 5
Rationale: There was no nurse-client relationship because the nurse was acting as a
neighbor and not in an employment capacity. Thus, there can be no duty owed. Intent is not
a necessary element of malpractice, because malpractice can occur because of unintended
actions as well. There was no breach of duty because there was no official nurse-client
relationship, which accompanies an employment situation. There was injury experiences
because of this event. The bleeding was caused by the interaction of the aspirin with the
anticoagulant.
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
3
pulmonary edema. The charge nurse would consider the medication error to constitute
negligence because the situation contains which element?
1. Purposeful failure to perform a health care procedure
2. Unintentional failure to perform a health care procedure
3. Act of substituting a different medication for the one ordered
4. Failure to follow a direct order by a physician - ANSWER Answer: 2
Rationale: Negligence is the unintentional failure of an individual to perform or not perform
an act that a reasonable person would or would not do in the same or similar circumstances.
A purposeful failure to perform a procedure would be the opposite of negligence, which is
unintentional. Substituting a different medication does not fit the description of the
situation in the question. Failure to follow a direct order does not fit the description in the
situation in the question.
Cognitive Level: Applying
Client Need: Management of Care
Integrated Process: Nursing Process: Assessment
Content Area: Fundamentals
Strategy: Two options are opposites, 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.
A client asks why a diagnostic test has been ordered and the nurse replies, "I'm unsure but
will find out for you." When the nurse later returns and provides an explanation, the nurse is
acting under which principle?
1
,1. Nonmaleficence
2. Veracity
3. Beneficence
4. Fidelity - ANSWER Answer: 4
Rationale: Fidelity means being faithful to agreements and promises. This nurse is acting on
the client's behalf to obtain needed information and report it back to the client.
Nonmaleficence is the duty to do no harm. Veracity refers to telling the truth for example,
not lying to a client about a serious prognosis. Beneficence means doing good, such as by
implementing actions (e.g. keeping a salt shaker out of sight) that benefit a client (heart
condition requiring sodium-restricted diet).
Cognitive Level: Understanding
Client Need: Management of Care
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals
Strategy: Use the process of elimination. The correct answer is the one that matches the
description in the stem; that is, the nurse made a promise to a client and kept it, which
constitutes fidelity.
An individual has a seizure while walking down the street. During the seizure, a nurse from a
physician's office is noticed driving past without stopping to assist. The individual sues the
nurse for negligence but fails to win a judgement for which reason?
1. The nurse had no duty to the individual.
2. The nurse did what most nurses would do in the same circumstance.
3. The nurse did not cause the client's injuries.
4. The nurse was off-duty at the time. - ANSWER 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 of employment. The
nurse did not necessarily do what others would do in this situation. Although the nurse did
not cause the client's injuries, it does not prevent the nurse from assisting in this situation.
Although the nurse was off-duty, the nurse could have assisted if motivated to do so.
2
, Cognitive Level: Understanding
Client Need: Management of Care
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals
Strategy: Use the process of elimination and nursing knowledge. The correct answer is the
one that recognizes that the nurse was not in the role of employee at the time of the
incident, removing the requirement 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 subsequently has a bleeding
episode because of a drug interaction. The legal nurse consultant interprets that which
necessary elements of malpractice are missing from this case? Select all that apply.
1. Breech of duty
2. Duty owed
3. Injury experienced
4. Causation between nurse's action and injury
5. Intent to cause harm or injury - ANSWER Answer: 2, 5
Rationale: There was no nurse-client relationship because the nurse was acting as a
neighbor and not in an employment capacity. Thus, there can be no duty owed. Intent is not
a necessary element of malpractice, because malpractice can occur because of unintended
actions as well. There was no breach of duty because there was no official nurse-client
relationship, which accompanies an employment situation. There was injury experiences
because of this event. The bleeding was caused by the interaction of the aspirin with the
anticoagulant.
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
3
