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Urden: Thelan’s Critical Care Nursing, 5th Edition Test Bank Chapter 3: Legal Issues MULTIPLE CHOICE 1. a. b. c. d.

The legal standard of care for a nurse's actions is defined as minimal competency under the Nurse Practice Act. the ability to distinguish what is right or wrong for the patient. the demonstration of satisfactory knowledge of policies and procedures. providing reasonable, prudent care comparable to that of like practitioners.

ANS: D The nurse is legally obligated to provide reasonable and prudent care comparable to that which would be provided by practitioners facing similar situations. DIF: Cognitive Level: Comprehension REF: 22 OBJ: Nursing Process Step: N/A TOP: Legal MSC: NCLEX: Safe and Effective Care Environment 2. A patient is admitted with chest pain, and his electrocardiogram shows elevated ST segments. The nurse bases her plan of care on the nursing diagnosis of pneumonia. Which of the following would best describe the possible type of negligence present? a. Assessment failure b. Planning failure c. Implementation failure d. Evaluation failure ANS: B Basing nursing care on an erroneous diagnosis is a failure in planning. DIF: Cognitive Level: Analysis REF: 24 OBJ: Nursing Process Step: Assessment TOP: Legal MSC: NCLEX: Safe and Effective Care Environment 3. a. b. c. d.

Injury resulting from the failure to meet an ordinary duty or standard of care is termed negligence. malpractice. assault. battery.

ANS: A Copyright Š 2006 Mosby, Inc.


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Injury resulting from the failure to meet an ordinary duty or standard of care is termed negligence. Malpractice is a specialized form of negligence. DIF: Cognitive Level: Comprehension REF: 22 OBJ: Nursing Process Step: N/A TOP: Legal MSC: NCLEX: Safe and Effective Care Environment 4. Two nurses talking about a patient's condition in the cafeteria could lead to allegations of a. slander. b. libel. c. invasion of privacy. d. defamation. ANS: C Talking in an unrestricted area that reveals confidential information without authorization may support an allegation of invasion of privacy. DIF: Cognitive Level: Application REF: 26-27 OBJ: Nursing Process Step: N/A TOP: Legal MSC: NCLEX: Safe and Effective Care Environment 5. a. b. c. d.

Malpractice is a specialized form of injury. negligence. law. damages.

ANS: B Any individual who fails to meet a duty of due care resulting in injury may be alleged to have committed negligence. Only professionals commit malpractice. DIF: Cognitive Level: Comprehension REF: 31 OBJ: Nursing Process Step: N/A TOP: Legal MSC: NCLEX: Safe and Effective Care Environment 6. A nurse fails to recognize an intubated patient’s need for nasotracheal suctioning. The endotracheal tube becomes clogged and the patient has a respiratory arrest. Which of the following best describes the type if negligence the nurse may be liable for? a. Assessment failure b. Planning failure c. Implementation failure d. Evaluation failure

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ANS: A Nurses have a duty to assess and analyze the care required by each patient they care for. Failure to do so puts the nurse at risk for negligence related to failure to assess the patient’s needs. DIF: Cognitive Level: Analysis REF: 23 OBJ: Nursing Process Step: Assessment TOP: Legal MSC: NCLEX: Safe and Effective Care Environment 7. a. b. c. d.

The most effective method of risk reduction for liability is maintaining consistent standards of care. identifying litigious patients. preventing medication errors. following professional standards of care.

ANS: D The hallmark of risk reduction is knowledge of the professional standards of care, delivery and documentation of that care, and consistent demonstration that the standards are met. DIF: Cognitive Level: Analysis REF: 28 OBJ: Nursing Process Step: N/A TOP: Legal MSC: NCLEX: Safe and Effective Care Environment 8. Mr. B was receiving heparin by intravenous infusion. The nurse received an order to increase the heparin infusion rate and obtain a partial thromboplastin time in 1 hour. The partial thromboplastin time was drawn correctly and revealed a significantly elevated level. The nurse was busy with another patient and failed to report the result to the physician until Mr. B had a massive intracerebral bleed. Which of the following best describes the type of negligence the nurse is liable for? a. Assessment failure b. Planning failure c. Implementation failure d. Evaluation failure ANS: C Failure to communicate and document patient findings in a timely manner is a form of failure to implement appropriate action. DIF: Cognitive Level: Analysis REF: 24-25 OBJ: Nursing Process Step: Assessment TOP: Legal MSC: NCLEX: Safe and Effective Care Environment

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9. On the way to surgery, Mrs. D expresses doubt about proceeding with the planned procedure. She states that the doctor did not explain it very well and she would like to talk to him again before starting the procedure. The nurse knows the surgery schedule is very tight, reassures Mrs. D that everything will be all right, and administers the preoperative sedation. This scenario describes what type of possible negligence? a. Assessment failure b. Planning failure c. Implementation failure d. Evaluation failure ANS: D The nurse has a duty to act as a patient advocate, in this case by holding the preoperative sedation until the doctor and patient can speak and the patient is satisfied that she has the necessary information to make this decision. DIF: Cognitive Level: Analysis REF: 27 OBJ: Nursing Process Step: N/A TOP: Legal MSC: NCLEX: Safe and Effective Care Environment 10. Which of the following statements is true regarding a nurse’s job description? a. As long as the nurse follows the American Nurses Association Standards of Care, the job description is irrelevant in a negligence allegation. b. Job descriptions must be reflective of the accepted standard of care. c. Institution-specific job descriptions are not legally acceptable. d. Job descriptions should be vague in describing nursing functions to avoid claims of negligence. ANS: B Although job descriptions can be institution specific, they should be reflective of the national and community standards of care. DIF: Cognitive Level: Analysis REF: 29 OBJ: Nursing Process Step: N/A TOP: Legal MSC: NCLEX: Safe and Effective Care Environment 11. As a result of legal relationships that form from employment in critical care, the professional nurse owes the a. employer a willingness to work overtime when needed. b. patient the provision of reasonable and prudent care. c. physician the ability to carry out all written orders. d. state membership in a professional nursing organization. ANS: B

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The nurse has a legal obligation to provide reasonable and prudent care in any employment setting, as identified in the American Nurses Association Code for Nurses. DIF: Cognitive Level: Knowledge REF: 28 OBJ: Nursing Process Step: N/A TOP: Legal MSC: NCLEX: Safe and Effective Care Environment 12. Restraining an angry, competent patient against his or her wishes is an intentional tort because the nurse a. did not document the patient’s need for restraints in the nursing notes. b. failed to get a physician’s order for restraints. c. purposefully restrained the patient against his or her wishes. d. reassured the patient that the restraints were needed to maintain safety. ANS: C Restraining the patient involved a specific act with purposeful intent. These are the criteria for an intentional tort. DIF: Cognitive Level: Analysis REF: 33 OBJ: Nursing Process Step: Intervention TOP: Legal MSC: NCLEX: Safe and Effective Care Environment 13. a. b. c. d.

Actions nurses can take to prevent allegations of malpractice include carrying malpractice insurance. clarifying orders with the nursing supervisor. delegating care to nursing assistants. providing care according to standards of practice.

ANS: D Maintaining standards of practice is the best way to reduce risk. DIF: Cognitive Level: Comprehension REF: 37 OBJ: Nursing Process Step: N/A TOP: Legal MSC: NCLEX: Safe and Effective Care Environment 14. While participating in critical care rounds, the nurse is interrupted by the wife of a ventilated patient, who informs the nurse that her husband is having difficulty breathing. The patient is found disconnected from the ventilator and unresponsive when the nurse enters the room after rounds. This is an example of a. assault. b. battery. c. injury. d. negligence.

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ANS: D All four elements of negligence are present: duty and standard of care, breach of duty, causation, and injury. DIF: Cognitive Level: Synthesis REF: 22, 27 OBJ: Nursing Process Step: N/A TOP: Legal MSC: NCLEX: Safe and Effective Care Environment 15. After admission to the intensive care unit, a patient shares with the nurse a concern that her adult children will not be able to reach agreement on what to do if she is no longer able to make decisions for herself. The nurse informs the patient that it is possible to grant authority to one person to make decisions by procuring a a. court-appointed guardian. b. do-not-resuscitate order. c. durable power of attorney for health care. d. living will. ANS: C This form of advance directive allows the individual to grant legal authority to another to make health care decisions if he or she is no longer competent. DIF: Cognitive Level: Application REF: 24 OBJ: Nursing Process Step: N/A TOP: Legal MSC: NCLEX: Safe and Effective Care Environment 16. In which of the following situations did the nurse disregard the patient’s right to privacy? a. Informing the physician that the patient was verbalizing suicidal thoughts b. Notifying the health department of a patient’s positive tuberculosis diagnosis c. Reporting possible dependent-adult abuse to the police d. Warning a visitor to wear gloves when giving a back rub because the patient is HIV positive ANS: D Telling the visitor of the patient's HIV status violated the patient’s right to privacy. The nurse could have ensured the visitor’s safety by providing gloves and explaining universal precautions. DIF: Cognitive Level: Analysis REF: 26-27 OBJ: Nursing Process Step: N/A TOP: Legal MSC: NCLEX: Safe and Effective Care Environment

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17. Which of the following statements best describes the definition of battery? a. An intentional act that causes the patient to believe harm may be done b. A statement that causes injury to the patient’s reputation or standing in the community c. Negligence or malpractice that results in harm to a spousal relationship d. An intentional act that brings about harm or offensive contact with the patient ANS: D Battery is defined as an intentional act that brings about harm or offensive contact with the patient. DIF: Cognitive Level: Comprehension REF: 33 OBJ: Nursing Process Step: N/A TOP: Legal MSC: NCLEX: Safe and Effective Care Environment 18. During transport to the operating room for mitral valve replacement, a patient with a signed consent form says that she does not want to go through with the surgery and asks to be returned to her room. The best response from the nurse is a. “The operating room is prepared; let’s not keep the surgeon waiting.” b. “You have the right to cancel surgery, but it could be weeks before you are rescheduled.” c. “You sound frightened, tell me what you are thinking.” d. “Your preoperative medications will have you feeling more relaxed in a minute; it will be OK.” ANS: C The patient has the right to withdraw consent at any time. The nurse must listen and then clarify if that is really what the patient desires. If it is, the surgeon should then be notified. DIF: Cognitive Level: Synthesis REF: 27 OBJ: Nursing Process Step: N/A TOP: Legal MSC: NCLEX: Safe and Effective Care Environment 19. a. b. c. d.

Which of the following would be considered a failure of proper implementation? Not identifying and analyzing symptoms appropriately Not documenting the patient’s response to pain medication Not recognizing a malfunctioning chest tube Not asking the patient about code/no code wishes

ANS: B Implementation failures include failure to document and report patient information in a timely manner, failure to take appropriate action, and failure to observe patient privacy.

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DIF: Cognitive Level: Knowledge REF: 37 OBJ: Nursing Process Step: N/A TOP: Legal MSC: NCLEX: Safe and Effective Care Environment 20. a. b. c. d.

Which of the following defines the scope of practice for nursing? Hospital policies State Nurse Practice Act State Board of Nursing State Department of Health

ANS: B State Nurse Practice Acts establish entry requirements, definitions of practice, and criteria for discipline. DIF: Cognitive Level: Knowledge REF: 22 OBJ: Nursing Process Step: N/A TOP: Nurse Practice Act MSC: NCLEX: Safe and Effective Care Environment COMPLETION 1. _________ is the failure to act consistently with applicable standards of care. ANS: Breach Rationale: For a nurse to be found negligent, the patient must establish that the nurse had a duty to provide care and that the nurse failed to do so consistent with accepted standards. DIF: Cognitive Level: Comprehension REF: 27 OBJ: Nursing Process Step: Intervention TOP: Legal Issues MSC: NCLEX: Safe and Effective Care Environment MATCHING Match the following documents with the correct definition. a. NURSE PRACTICE ACT b. STANDARD OF CARE c. STANDARD OF PROFESSIONAL PERFORMANCE d. JOB DESCRIPTION 1. How the nurse is expected to conduct himself or herself 2. Institution-specific performance requirements for the nurse

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3. What the patient can expect to receive from the nurse 4. Provides statutory authority for the practice of nursing 1. ANS: C DIF: Cognitive Level: Analysis REF: 28-29 OBJ: Nursing Process Step: N/A TOP: Legal Issues MSC: NCLEX: Safe and Effective Care Environment 2. ANS: D DIF: Cognitive Level: Analysis REF: 28-29 OBJ: Nursing Process Step: N/A TOP: Legal Issues MSC: NCLEX: Safe and Effective Care Environment 3. ANS: B DIF: Cognitive Level: Analysis REF: 28-29 OBJ: Nursing Process Step: N/A TOP: Legal Issues MSC: NCLEX: Safe and Effective Care Environment 4. ANS: A DIF: Cognitive Level: Analysis REF: 28-29 OBJ: Nursing Process Step: N/A TOP: Legal Issues MSC: NCLEX: Safe and Effective Care Environment Match each of the following situations with the correct term. a. SEXUAL MISCONDUCT b. THREATENING TO PUNCH SOMEONE c. PERFORMING CARDIOPULMONARY RESUSCITATION ON A PATIENT WITH A DO-NOT-RESUSCITATE ORDER d. A NOTICE PUBLISHED IN THE PAPER WRONGFULLY ACCUSING THE HOSPITAL ADMINISTRATOR OF DRUG ABUSE e. VERBALLY ACCUSING A COLLEAGUE OF THEFT IN PUBLIC 5. Assault 6. Slander 7. Battery 8. Battery 9. Libel 5. ANS: B

DIF:

Cognitive Level: Application

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REF: 33


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OBJ: Nursing Process Step: N/A TOP: Legal Issues MSC: NCLEX: Safe and Effective Care Environment 6. ANS: E DIF: Cognitive Level: Application REF: 33 OBJ: Nursing Process Step: N/A TOP: Legal Issues MSC: NCLEX: Safe and Effective Care Environment 7. ANS: A DIF: Cognitive Level: Application REF: 33 OBJ: Nursing Process Step: N/A TOP: Legal Issues MSC: NCLEX: Safe and Effective Care Environment 8. ANS: C DIF: Cognitive Level: Application REF: 33 OBJ: Nursing Process Step: N/A TOP: Legal Issues MSC: NCLEX: Safe and Effective Care Environment 9. ANS: D DIF: Cognitive Level: Application REF: 33 OBJ: Nursing Process Step: N/A TOP: Legal Issues MSC: NCLEX: Safe and Effective Care Environment SHORT ANSWER 1. To establish that the nurse has a duty to provide care for a patient, it must first be proven that the nurse was __________ on the day the negligence occurred and was __________ to the patient who suffered damages. ANS: working, assigned Rationale: Unless it can be shown that the nurse was indeed present at the time of injury to the patient and was responsible for providing care for that patient, a sense of duty has not been established. DIF: Cognitive Level: Analysis REF: 22 OBJ: Nursing Process Step: N/A TOP: Legal Issues MSC: NCLEX: Safe and Effective Care Environment OTHER 1. Which of the following statements about defamation are true? Select all that apply. a. Defamation refers only to the spoken word. b. It is a communication that damages a person's reputation.

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c. It must be heard by at least one other person. d. The plaintiff is not required to prove damages. e. The communication must be proven false and made with malice. ANS: b, c, e Rationale: Defamation can occur verbally or in writing. The plaintiff must prove that the communication was made specifically to damage the individual's character or reputation and that the damage actually occurred. DIF: Cognitive Level: Application REF: 33 OBJ: Nursing Process Step: N/A TOP: Legal Issues MSC: NCLEX: Safe and Effective Care Environment

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Test bank thelans critical care nursing 5th edition urden