CANS Exam 2 Study Guide – Comprehensive Review Notes, Practice Questions & Key Concepts

CANS Exam 2 Study Guide


Chapter 6: Nursing as a regulated practice
- American Legal System
o 3 separate but equal branches
 Executive branch- charged to implement the law (president is highest power)
 Legislative branch- charged to create the law (US congress)
 Judicial branch- charged to interpret the law (Supreme court)
o Types of laws
 Common Law- decisional, meaning the judges’ ruling becomes law
 Statutory laws (statues)- are those established through formal legislative processes
 Administrative laws- result when the legislative branch of the government delegates
authority to governmental agencies to create laws that meet the intent of a statue. Federal
and state administrate laws have the force and effect of statutory law.
 Nursing- administrative cases would happen when a nurse practices without a
valid license or beyond the scope of nursing practice.
 These cases are reviewed by the state board of nursing.
o Civil vs criminal
 Civil law- recognizes and enforces the rights of individuals in disputes over legal rights
or duties of individuals in relation to one another.
 Criminal law- involves public concerns regarding an individuals unlawful behavior that
threatens society, such as murder, robbery, kidnapping, or domestic violence
- State Boards of Nursing, Nursing Practice Acts, and Licensure
o State Boards of Nursing- regulatory bodies by which nursing practice acts are administered and
enforced. They regulate nursing to protect the public from harm by unprepared or incompetent
practitioners
o Statutory authority of state nurse practice acts
 Nursing practice acts in each state accomplish at least 4 objectives
 Defines the practice of professional nursing
 Sets the minimum educational qualifications and other requirements for licensure
 Determines the legal titles and abbreviations nurses may use
 Provides for disciplinary actions of licensees for certain causes.
 Once the law regarding nursing practice is established or amended by the legislature, the
legislative branch delegates authority to enforce the law to an executive agency, usually
the SBN. SBNs are responsible for enforcing the nursing practice acts in the various
states.
 ANA’s Model practice Act- guide to state nurses associations seeking revisions in their
nursing practice acts. (clear differentiation between advanced and general nursing
practice, authority of boards of nursing to regulate advanced nursing practice, including
authority for prescriptive writing and to oversee unlicensed assistive personnel,
clarification of nurses responsibilities for delegation, support for mandatory licensure)
o Executive authority of state boards of nursing
 The executive branch (both federal and state) administered and implements the law
(governor is the highest state office—they generally delegate the responsibility for
administering the nursing practice act to the SBN)
 SBN- agency charged with executing laws—usually consists of RNs, LPNs---- CANNOT
enlarge the law, but can clarify general provisions of the nursing practice act

,  SBN functions
 Executive- authority to administer the nursing practice act
 Legislative- authority to adopt rules necessary to implement the act
 Judicial- authority to deny, suspend, or revoke a license or to otherwise discipline
a licensee or to deny application for licensure
o Licensing powers
 Mandatory vs permissive laws
 The practice act stipulates that an applicant for licensure must graduate from a state-
approved nursing education program as a prerequisite to being admitted to the licensure
exam.
 Schools always have to have state approval, but can voluntarily seek national
accreditation
 SBN- can grant license or sanction a nurse (probation, suspension, revocation)
 Most common reason for discipline is due to practicing under the influence of alcohol or
other substances
o Licensure examinations
 NCLEX-RN- national council licensure examination for registered nurses
 Computerized adaptive testing- 75-265 questions
o Mobility of nurses: licensure by endorsement
 Licensure by endorsement- All states recognize the licensure awarded in other states. Can
practice in any state without having to take another licensing exam.
o Nurse Licensure Compact
 The compact allows nurses to have one license yet practice in another compact state
without additional licensure in the state of employment
- Legal Risks in Professional Nursing Practice
o Malpractice
 Negligence is the failure to act as a reasonably prudent personal would have acted in the
same circumstances
 Malpractice is negligence applied to the acts of a professional
 Nurses is the defendant, patient/family is the plaintiff--- Civil cases
 2 requirements
 Nurse has specialized knowledge and skills
 Practice of that specialized knowledge of the nurse causes the patient injury
 Elements
 Nurses assumed care of patient
 Nurse breached duty of care by failing to meet standard of care
 Failure of nurse to meet standard of care was cause of injury.
 Injury is proven.
o Delegation
 Giving someone authority to act for anther-
 RNs have power, LPNs do not
 RN retain accountability for acts delegated to another person
 5 rights to ensure safe delegation
 Right task
 Right circumstance
 Right person
 Right direction-communication
 Right supervision/evaluation