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Silvestri Chapter 07 Ed#543

Silvestri Chapter 07 Ed#543

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Published by Linda Kuglarz

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Published by: Linda Kuglarz on Oct 14, 2008
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Silvestri, 3/e, ISBN 1-1460-0052-6Chapter 007 (edited file)—"Ethical and Legal Issues"10/14/08, Page 1 of 9, 0 Figure(s), 0 Table(s)14 Box(es)
7: Ethical and Legal Issues
PRACTICE QUESTIONS
1. A nurse enters a client’s room and finds the client lying on the floor. The nurse checks theclient and then calls the nursing supervisor and the physician to inform them of the occurrence.The nursing supervisor instructs the nurse to complete an incident report. The nurse completesthe incident report, understanding that it allows the analysis of adverse client events through:1. A method of promoting quality care and risk management2. Determining the effectiveness of interventions in relation to outcomes3. The appropriate method of reporting to local, state, and federal agencies4. Providing clients with necessary stabilizing treatmentsAnswer: 1Rationale: Proper documentation of unusual occurrences, incidents, and accidents, and thenursing actions taken as a result of the occurrence, are internal to the institution or agency.Documentation on the incident report allows the nurse and administration to review the qualityof care and determine any potential risks present. Options 2, 3, and 4 are incorrect.Test-Taking Strategy: Use the process of elimination. Eliminate options 2 and 4 becauseincident reports are not routinely filled out for interventions or treatment measures. Eliminateoption 3 because incident reports are not used to report occurrences to other agencies. Medicalrecords are used for this purpose. Review the purpose of incident reports if you had difficultywith this question.Level of Cognitive Ability: ApplicationClient Needs: Safe, Effective Care EnvironmentIntegrated Process: Nursing Process/ImplementationContent Area: Fundamental SkillsReference: Potter, P., & Perry, A. (2005).
 Fundamentals of nursing 
(6th ed.). St. Louis: Mosby, p. 419, 497.2. A nurse observes that a client received pain medication 1 hour ago from another nurse, butthat the client still has severe pain. The nurse has previously observed this same occurrence.Based on the nurse practice act, the observing nurse plans to do which of the following?1. Talk with the nurse who gave the medication2. Report the information to a nursing supervisor 3. Call the Impaired Nurse Organization4. Report the information to the policeAnswer: 2Rationale: Nurse practice acts require reporting the suspicion of impaired nurses. The Board of  Nursing has jurisdiction over the practice of nursing and may develop plans for treatment andsupervision. This suspicion needs to be reported to the nursing supervisor, who will then reportto the Board of Nursing. Option 1 may cause a conflict. Options 3 and 4 are inappropriate.Test-Taking Strategy: Use the principles related to following the channels of communication in ahealth care agency when answering this question. By reporting the information, the nurse alertsthe institution to the potential problem and sets the stage for further investigation and appropriate
 
Silvestri, 3/e, ISBN 1-1460-0052-6Chapter 007 (edited file)—"Ethical and Legal Issues"10/14/08, Page 2 of 9, 0 Figure(s), 0 Table(s)14 Box(es)
action. Review the actions to take regarding reporting the suspicion of an impaired nurse if youhad difficulty with this question.Level of Cognitive Ability: ApplicationClient Needs: Safe, Effective Care EnvironmentIntegrated Process: Nursing Process/PlanningContent Area: Fundamental SkillsReference: Potter, P., & Perry, A. (2005).
 Fundamentals of nursing 
(6th ed.). St. Louis: Mosby, p. 407.3. A client has died and a nurse asks a family member about the funeral arrangements. Thefamily member refuses to discuss the issue. The nurse’s appropriate action is to:1. Provide information needed for decision making2. Suggest a referral to a mental health professional3. Show acceptance of liability of feelings4. Remain with the family member without discussing funeral arrangementsAnswer: 4Rationale: The family member is exhibiting the first stage of grief–denial. Option 1 may be anappropriate intervention for the bargaining stage. Option 2 may be an appropriate interventionfor depression. Option 3 is an appropriate intervention for the acceptance or reorganization andrestitution stage.Test-Taking Strategy: Use therapeutic communication techniques to direct you to option 4.Remember to address client and family feelings first. Review the grieving process andtherapeutic communication techniques if you had difficulty with this question.Level of Cognitive Ability: ApplicationClient Needs: Psychosocial IntegrityIntegrated Process: CaringContent Area: Fundamental SkillsReference: Potter, P., & Perry, A. (2005).
 Fundamentals of nursing 
(6th ed.). St. Louis: Mosby, pp. 570-571.4. A client arrives in the emergency room and is staggering, confused, and verbally abusive. Theclient complains of a headache from drinking alcohol and is asking for medication. The nurseexplains to the client that the physician will need to perform an assessment before theadministration of medication. When the client becomes verbally abusive, the nurse threatens to place the client in restraints. Which of the following can the client legally charge the nurse as aresult of the nursing action?1. Assault2. Battery3. Negligence4. Invasion of privacyAnswer: 1Rationale: An assault occurs when a person puts another person in fear of a harmful or offensivecontact. For this intentional tort to be actionable, the victim must be aware of the threat of harmful or offensive contact. Battery is the actual contact with one’s body. Negligence involvesactions below the standards of care. Invasion of privacy occurs when the individual’s privateaffairs are unreasonably intruded into.
 
Silvestri, 3/e, ISBN 1-1460-0052-6Chapter 007 (edited file)—"Ethical and Legal Issues"10/14/08, Page 3 of 9, 0 Figure(s), 0 Table(s)14 Box(es)
Test-Taking Strategy: Use the process of elimination. Note the key word,
threatens
, in thequestion. This will direct you to option 1. Review the descriptions associated with each term inthe options if you had difficulty with this question.Level of Cognitive Ability: ComprehensionClient Needs: Safe, Effective Care EnvironmentIntegrated Process: Nursing Process/ImplementationContent Area: Fundamental SkillsReference: Potter, P., & Perry, A. (2005),
 Fundamentals of nursing 
(6th ed.). St. Louis: Mosby, p. 413.5. A nurse lawyer provides an education session to the nursing staff regarding client rights. Anurse asks the lawyer to describe an example that might relate to invasion of client privacy. Anursing action that indicates a violation of this right is:1. Taking photographs of the client without consent2. Telling the client that he or she cannot leave the hospital3. Threatening to place a client in restraints4. Performing a surgical procedure without consentAnswer: 1Rationale: Invasion of privacy takes place when an individual’s private affairs are intruded onunreasonably. Not allowing a client to leave the hospital constitutes false imprisonment.Threatening to place a client in restraints constitutes assault. Performing a surgical procedurewithout consent is an example of battery.Test-Taking Strategy: Use the process of elimination. Note the key words,
invasion of client  privacy
. These words should direct you to option 1. Review those situations that includeinvasion of client privacy if you had difficulty with this question.Level of Cognitive Ability: ComprehensionClient Needs: Safe, Effective Care EnvironmentIntegrated Process: Nursing Process/ImplementationContent Area: Fundamental SkillsReference: Potter, P., & Perry, A. (2005).
 Fundamentals of nursing 
(6th ed.). St. Louis: Mosby, p. 413.6. A nurse calls the physician of a client scheduled for a cardiac catheterization because theclient has numerous questions regarding the procedure and has requested to speak to the physician. The physician is very upset, and arrives at the unit to visit the client after prompting by the nurse. The nurse is outside the client’s room and hears the physician tell the client in aderogatory manner that the nurse “doesn’t know anything.” The nurse plans to address the physician’s remark, understanding that the physician has violated which legal tort?1. Libel2. Slander 3. Assault4. NegligenceAnswer: 2Rationale: Defamation is a false communication or careless disregard for the truth that causesdamage to someone’s reputation, either in writing (libel) or verbally (slander). An assault occurswhen a person puts another person in fear of a harmful or an offensive contact. Negligence

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