Professional Documents
Culture Documents
Legal Aspects of Nursing
Legal Aspects of Nursing
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- The legal aspects of nursing have an Respondent superior-your employer will be
impact on the manner in which care is held liable for any negligent act, if any
delivered to patients by nurses. Legal alleged negligence occur during your
concerns shape the environment in which employment.
nursing is practiced and determine how
documents are kept or shared. Ultimately, Contracts:
nurses and the nursing care they provide Nurses are responsible for carrying out all terms
and agreements in the contract (obligations,
are judged based on a legal definition for
rights, duties, institutional policies)
the standard of care for nurses.
Hospital staffing:
- Written “standards of care” and “guidelines” Nurses cannot walk out when staffing is short,
are available as resources for determining you can be charged with abandonment.
how nursing care is to be delivered and the Nurses must report short staffing to the nursing
quality of care. However, the legal definition administration.
of the standard of care for nurses is not a
“guideline” or a “policy” set by any one Floating:
individual or institution. Rather, it is the Is acceptable to solve hospital understaffing
embodiment of collective knowledge for problems.
what is required of the average nurse and Legally, a nurse cannot refuse to float, unless
sets the minimum criteria for proficiency. you contract guarantees that you can work in
- Legal accountability for all nursing actions one specific area or you can prove a lack of
knowledge of the assigned tasks.
rests with the nurse.
Nurses who float should inform the supervisor
- Nurses and student nurses are legally of any lack of experience in the new task to care
responsible for their actions. for the client on the unit.
The nurse should request and be given
Laws that Govern Nursing orientation to the new unit.
Nursing practice act:
Each state regulates the practice of nursing. Disciplinary action:
Sets educational requirements for nurses Board of nursing may deny, revoke, or suspend
and define the scope of nursing practice. license to practice as a Registered Nurse as follows:
Requirements of licensing for protection of Unprofessional conduct.
public. Breach of client confidentiality.
Failure to use sufficient knowledge, skills or
Standard of Care: nursing judgment.
Guidelines by which the nurse should Physical or verbal abuse.
practice. Delegating to unlicensed personnel nursing
Guidelines determine whether nurses have care that can place the client in risk for
performed duties appropriately, If not the injury.
nurses place themselves in jeopardy for Failure to maintain an accurate medical
legal action. records for each client.
Falsifying a client’s record.
Employee guidelines: Leaving a nursing assignment without
properly notifying appropriate personnel.
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Legal Liability Are concerned with offenses against the
public and society in general.
Types of Law: An act of violation of criminal law is called a
Contract law: crime
Agreement between private individuals. Good Samaritan Laws:
Civil law: Encourage health care professionals to
Relationship among persons and the assist in medical emergency situations
protection of person’s right and property. without fear of being sued
This law providing legal immunity for
Criminal law: helping in an emergency, providing they
give reasonable care.
Tort Law
- A civil wrong doing, other than a breach of contract, in which the law allows an injured person to seek damages
from a person who caused the injury.
Unintentional tort Intentional tort
Negligence: Assault:
Performing an act that a reasonable and Mental or physical; (without touching) forcing
prudent person would not perform. a client to take medication or treatment.
Malpractice: Battery:
It is also negligence by professional person. Touching, with or without the intend to do
Professional misconduct or unreasonable lack harm.
of skills in carrying out professional duties. Hitting or striking a client.
If a mentally competent adult is forced to have
Examples of Negligence or Malpractice a treatment he or she has refused; battery
Burning the client with hot water bottle or occurs.
heating pad. Defamation/Divulgence:
Leaving sponges or instruments in a client’s Injuring a person’s name and reputation by
body after surgery making false statements to a third party.
Failing to recognize warning signs of shock or Slander
impending MI (myocardial infarction) Making false statements orally
Ignoring signs and symptoms of bleeding
Forgetting to give medication or give the Libel
wrong medication. Making false statements in print, writing, or
pictures
Fraud:
Presenting false credentials
Describing a myth regarding treatment.
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Obligation to use due care.
Failure to care for or to protect others
against unreasonable risk. HIPPA Law
Nurse must anticipate foreseeable risk. Health Insurance Portability and Accountability
Example: wet floor, side rails –risk for Act 1996.Protect the privacy and security of a
client’s falling. person’s health information.
Patient has the right to be left alone, without
Breach of duty: any risk for injury.
Failure to perform according to established Patient has right to make personal choices
standard of care without interference such as:
Example: turn client every 2 hours to Contraception
prevent decubitus (bed sores) Abortion
Right to refuse treatment
Injury/Damages
Failure to meet standard of care that cause False Imprisonment
actual injury or damage to the client, either Confinement without authorization
physical or mental Threatening to restrain a person
Example: older client falling of the bed, Applying restrains without MD order
because side rails were not up, result of the Preventing a person from leaving a room
fracture of the hip. Leaving side rails of the bed up, preventing the
client to leave a bed.
Causation:
A connection between conduct and the
resulting injury.
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client privacy. Which of the following, if identify by On physical assessment the nurse notes old and
the student, indicates an understanding of a new ecchymotic areas on the client’s chest and legs.
violation of this client right? The nurse asks the client how the bruises were
1) Performing a procedure without consent. sustained. The client, although reluctant, tells the
2) Telling the client that he or she cannot leave the nurse in confidence that her son frequently hits her
hospital. if supper is not prepared on time when he arrives
3) Threatening to give a client a medication. home from work. Which of the following is the
4) Observing care provided to the client without the most appropriate nursing response?
client’s permission. 1) “Oh really, I will discuss this situation with your son.”
2) “Do you have any friends that can help you out until
10. The nursing staff is sitting in the lounge taking their you resolve these important issues with your son?”
morning break. A nursing assistant tells the group 3) “Let’s talk about the ways you can manage your time
that she thinks that the unit secretary has acquired to prevent this from happening.”
immunodeficiency syndrome. The nursing assistant 4) “This is a legal issue, and I need to let you know that
proceeds to tell the nursing staff that the secretary I will need to report it.”
probably contracted the disease from her husband,
who is supposedly a drug addict. Which legal tort 14. The nurse is working in a long-term care facility and
has a nursing assistant violated? administering medication to assigned clients. A
1) Slander client refuses to take the prescribed medication,
2) Libel and the nurse threatened the client and tells the
3) Assault client that if the medication is not taken orally, then
4) Negligence restrains will be applied and the medication will be
given by injection. The statement by the nurse
11. The nurse hears a client calling out for help. The constitutes which legal tort?
nurse hurries down the hallway to the client’s room 1) Invasion of privacy.
and finds a client lying on the floor. The nurse 2) Negligence.
performs a thorough assessment and assists the 3) Assault.
client back to bed. The nurse notifies the physician 4) Battery.
of the incident and completes an incident report.
Which of the following would the nurse document 15. While preparing medications, the nurse notes an
on the incident report? unusually large dose of medication for a client.
1) The client was found lying on the floor. Which action would be most appropriate?
2) The client claimed over the side rails. 1) Asking another nurse to give the medication
3) The client fell out of bed. 2) Giving the medication as ordered
4) The client became restless and tried to get out of 3) Notifying the nursing supervisor
bed. 4) Calling the prescribing physician
16. Albeit the responsibility to explain procedures,
12. A client is brought to the emergency room by the their risks and benefits to the client is that of the
emergency medical services after being hit by a car. physician's, in some cases, this could be witnessed
The name of the client is not known. The client has by the nurse. Which client is legally allowed to give
sustained a severe head injury, multiple fractures, informed consent?
and is unconscious. An emergency craniotomy is 1) An unconscious client
required. Regarding informed consent for the 2) A client who cannot read
surgical procedure, which of the following is the 3) A sedated client
best action? 4) A 14-year-old with a broken arm
1) Call the police to identify the client and locate the
family.
2) Obtain a court order for the surgical procedure. 17. In which situation would the nurse understand that
3) Ask the emergency medical services team to sign the implied consent is given?
informed consent. 1) The nurse prepares to insert a nasogastric tube into a
4) Transport the victim to the operating room for client.
surgery. 2) The client will have anesthesia by a nurse anesthetist
for a surgical procedure.
13. The 87 year-old women is brought to the 3) A client is nearing delivery, attended by a nurse
emergency room for treatment of a fractured arm. midwife.
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4) An emergency room Emergency Department client 21. When giving a report to the oncoming shift, which
with a laceration requiring sutures action by the nurse could be considered an invasion
of the client's privacy?
1) Asking the client if a nursing student can participate
18. A nurse has been in the peer assistance program in their care
voluntarily after being charged with drug abuse on 2) Allowing a photographer to take a sleeping client's
the nursing unit. Which statement is true about this photograph
nurse's ability to practice? 3) Telling the oncoming nurse that the client has active
1) The nurse may work in a critical care area if closely herpes
supervised. 4) Telling a visitor the client's room number
2) There are no restrictions on work if the nurse agrees
to random drug screening.
3) The nurse may only work day shift, with no overtime. 22. A nurse is interviewing for a position at a major
4) The nurse may no longer practice nursing under state hospital. Which information regarding liability
law. insurance should the nurse keep in mind when
asking questions about hospital versus private
liability insurance?
19. Which situation is an example of an unintentional 1) Private liability insurance is not recommended,
tort? because the hospital has an umbrella policy covering
1) Forcibly restraining a client for a procedure all nurses.
2) Telling another nurse that the client is gay 2) Hospitals must carry complete liability insurance for
3) Administering a medication that causes client harm all nurses employed.
4) Documenting in the chart that the client is 3) Private liability insurance covers the nurse in all
incompetent situations, inside and outside the hospital.
4) Nurses can be countersued by the hospital if they are
found negligent and the hospital has to pay.
20. The client responds when the nurse calls the client
by name. After giving the client a medication, the 23. A client climbs over the side rails and falls after the
nurse realizes that it is the wrong client. The nurse has instructed the client to remain in bed.
physician is notified, and the nurse documents no What information should the nurse leave out of an
adverse reactions to the medication. What should incident report?
the nurse understand about the possibility of being 1) Names of witnesses
sued for malpractice? 2) That the nurse was called to another unit to assist
1) There is no validity to a lawsuit for malpractice, with a procedure
because the client did not sustain harm or injury 3) That the client received a sedative one hour prior to
from the action. the incident
2) If the nurse notifies the physician, the nurse is no 4) That the client disregarded the nurse's instructions
longer liable for the action. on not getting out of bed
3) The nurse can be sued, because the action was
below the standard of practice.
4) There would be no lawsuit, because the client 24. A nurse has been convicted of theft after the head
identified himself by answering when the nurse nurse discovered the narcotics count inaccurate on
called his name. a number of occasions. The hospital must report
the nurse's conviction to which data base:
1) Healthcare Integrity and Protection Data Bank
2) Nursing Reference Data Bank
3) Health Professionals Data Collection Bank
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4) Incompetent Registered Nurses Data bank 2) Health Insurance Portability Act
3) Good Samaritan Act
4) American with Disabilities Act
25. A majority of disciplinary actions by the state
boards of nursing pertain to:
1) Malpractice claims 29. A client refuses to follow the physician’s orders and
2) Impaired nurses leaves the hospital against medical advice (AMA).
3) Negligence What risk is the client assuming?
4) Practicing without a license 1) Acting irresponsibly.
2) Violating the physicians orders
3) Contributing to negligence
26. A consulting surgeon explained the risks and 4) Assuming the risk for his health state
benefits of an experimental surgery. The client signs
the consent form with a witness that attests to the
signature. The client dies during the surgery. The 30. The physician has declared a client to be “brain
family despondent after the death wants to litigate dead." The nurse understands this means that the
the hospital, physician and nursing staff. The nurse client has:
knows: 1) No reflexes and no breathing.
1) The family has a case and should contact a lawyer. 2) Slow reflexes and shallow breathing.
2) Nurse's notes should have documented the 3) No cortical functioning with some reflex breathing,
procedure of the informed consent and if the form 4) Deep tendon reflexes only and no independent
was signed voluntarily. breathing.
3) The family does not have a case since the consent
form was signed and witnessed.
4) The family does have a case since the client died.
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1) Oxygen had not been ordered and therefore should 41. Which act would the nurse consider passive
not be administered euthanasia?
2) The nurse's observations were sufficient to begin 1) Removing a "no code" client from a ventilator
administration of oxygen 2) Refusing to assist a client wishing to commit suicide
3) The symptoms were too vague for the nurse to 3) Administering a lethal dose of medication to a client
diagnose a need for oxygen with terminal cancer
4) The physician should have been called for an order 4) Providing pills to a client wishing to commit suicide
before oxygen was begun
42. A mentally competent client with end-stage liver
39. A 15-year-old is taken to the emergency room of disease continues to consume alcohol after being
the local hospital after stepping on a nail. The informed of the consequences of this action. What
puncture wound is cleansed and a sterile dressing action best illustrates the nurse's role as a client
applied. The nurse asks if the adolescent has been advocate?
immunized against tetanus. The reply is 1) Asking the spouse to take all the alcohol out of the
affirmative. Penicillin is administered, and the house
adolescent is sent home with instructions to return 2) Accepting the client's choice and not intervening
if there is any change in the wound area. A few days 3) Reminding the client that the action may be an end-
later, the adolescent is admitted to the hospital of-life decision
with a diagnosis of tetanus. Legally: 4) Refusing to care for the client because of the client's
1) Hospital protocol should govern treatment in noncompliance
emergency care .
2) The nurse's judgment was adequate in view of the 43. A client is admitted to a psychiatric–mental health
client's symptoms unit on an emergency involuntary status. What is
3) Assessment by the nurse was incomplete and the the minimum length of time the client will remain
treatment was inadequate hospitalized?
4) The possibility of tetanus could not have been 1) 60 days
foreseen, because the adolescent had been 2) 48 hours
immunized 3) 12 hours
4) 3 to 5 days
40. A fully alert and competent 89-year-old client is in
end-stage liver disease. The client says, "I'm ready
to die," and refuses to take food or fluids. The
family urges the client to allow the nurse to insert a
feeding tube. What is the nurse's moral
responsibility?
1) The nurse should obtain an order for a feeding tube.
2) The nurse should encourage the client to reconsider
the decision.
3) The nurse should honor the client's decision.
4) The nurse must consider that the hospital can be
sued if she honors the client's request.
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6 4 29 4
7 3 30 3
8 3 31 2
9 4 32 4
10 1 33 1,2,4
11 1 34 1,3,6
12 4 35 1,2,3
12 4 36 2
13 4 37 2
14 3 38 2
15 4 39 3
16 2 40 3
17 1 41 1
18 3 42 2
19 3 43 4
20 1
21 2
22 4
23 4
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