Legal Aspects of Nursing Study Guide

8 | FUNDA LECTURE Study Guide # 3
STUDY GUIDE # 3
Legal Aspects of Nursing
Instructions:
a) Refer to the following pages for your answers: 47, 49, 52-56, 58, 62-67, & 69 of your book in a pdf file.
If you’re using an actual book, please be the one to identify from the pdf its corresponding pages in your
book. b) The number before each question is just for organization purposes because there are test items
that will be merged in iStudy, thus, only then a perfect score will be known. c) The answers will be
entered into iStudy. Please be guided.
1. Nurses are accountable for their professional judgments and actions, thus, it is important for them to
know the basics of legal concepts.
2. The legal purpose for defining the scope of nursing practice, licensing requirements, and standards of
care is protection of the public.
Nurses who know and follow their nurse practice act and standards of care provide (3) safe and (4)
competent nursing care.
5. The purpose of knowing and practicing nursing’s standards of care is to protect the client or
consumer.
As a provider of service, the nurse is expected to provide (6) safe and (7) competent care.
The nurse in the role of employee or contractor for service has obligations to the employer, the client,
and other personnel in which nursing care provided must be within the (8) limitations and (9) terms
specified.
10. Nursing practice is a service to people who are often ill or vulnerable, therefore, actions taken by
nurse an affect the safety of people.
11. Neither health care providers nor clients are well prepared for the informed consent process.
12. The more invasive a procedure or the greater the potential for risk to the client, the greater the need
for written permission.
13. Consent is implied in a medical emergency when an individual cannot provide express consent
because of physical condition.
14. In obtaining an informed consent for specific medical and surgical treatments is the responsibility of
the person who is going to perform the procedure.
The nurse relies on (15) orally expressed consent or (16) implied consent for most nursing
interventions.
It is imperative to remember the importance of communicating with the client by:
17. explaining nursing procedures

18. ensuring the client understands
19. obtaining permission
The three major elements of informed consent:
20. The consent must be given voluntarily
21. The consent must be given by a client or individual with the capacity and competence to understand
22. The client or individual must be given enough information to be the ultimate decision maker
23. Coercion invalidates the consent.
24. Cultural perspective also needs to be considered when clients are asked to make decisions about a
procedure or treatment.
25. People from other cultures may apply a group perspective to decision making.
26. Communication is critical for client safety and quality nursing care.
A competent adult can make decisions regarding health, however, a client may not be considered
functionally competent if he or she is:
27. confused
28. disoriented
29. sedated
Three groups of people who cannot provide consent:
30. minors
31. unconscious or injured individuals
32. people with mental illnesses
The nurse’s signature for witnessing the client’s signature in the signed consent form confirms three
things:
33. The client gave consent voluntarily.
34. The signature is authentic.
35. The client appears competent to give consent.
36. The right of consent also involves the right of refusal.
37. Documentation is an important aspect of informed consent.
38. When documenting the use of an interpreter, include the interpreter’s full name and title.
39. Impaired nurses who voluntarily enter a diversion programs do not have their nursing license
revoked if they follow treatment requirements.
40. Diversion program allow for rehabilitation of the nurse while still being able to work in the
profession.
Nursing medication errors include the following:
41. Failing to read the medication label.
42. Misreading or incorrectly calculating the dosage
43. Failing to correctly identify the client
44. Preparing the wrong concentration
45. Administering a medication by the wrong side
Nurses always must check medications very carefully. Even after checking, the nurse is wise to recheck
the (46) medication order and the (47) medication before administering it if the client states, “I did not
have a green pill before.”
48. If a nurse leaves the rails down or leaves a baby unattended on a bath table, the nurse is guilty of
professional negligence.
49. A nurse by failing to take the blood pressure and pulse and to check the dressing of a client who had
just had abdominal surgery omits important assessments.
The most common causes of nursing professional negligence as identified by Painter and Dujak (2010)
include:
50. failure to monitor
51. failure to perform assessment and notify health care provider
52. failure to document and report a deteriorating condition
Situation: To avoid charges of malpractice, nurses must recognize nursing situations in which negligent
actions are most likely to occur, and take measures to prevent them. For #s 53 - 58 identify the
CATEGORY OF NEGLIGENCE if there is failure to do the following situations:
53. Failure to question an incomplete or illegible medical orders:
A. Failure to document
B. Failure to communicate
C. Failure to assess and monitor
D. Failure to act as a patient advocate
54. Failure to follow a physician’s verbal or written orders:
C. Failure to follow standards of care
55. Failure to seek higher medical authorization for a treatment:
C. Failure to act as a patient advocate
D. Failure to follow standards of care
56. Failure to interpret a client’s signs and symptoms:
57. Failure to note in the patient’s medical record client’s progress and response to treatment:
58. Failure to follow the manufacturer’s recommendations for operating the equipment:
B. Failure to assess and monitor
C. Failure to follow standards of care
D. Failure to use equipment in a responsible manner
In a little research done among 19 Registered Nurses in US analyzing professional negligence claims to
contribute in correcting deficiencies related to practice errors, identified and considered the events of
medication administration, IV therapy, and or monitoring of physiological changes to be (59) considered
preventable. The actions of the nurses that contributed to the events included:
60. (15.7%) failure to respond or set audible monitor alarms
61. (15.7%) failure to follow the five rights of medication administration
62. (10.5%) failure to escalate communication with a nonresponsive clinical provider
63. (42%) failure to perform timely assessment and intervention in a clinical situation with the majority
of these cases related to opioid administration and monitoring.
64. Consent is required before procedures are performed.
65. Another requirement for consent is that the client be competent to give consent.
66. If the nurse is uncertain whether a client refusing a treatment is competent, the supervisor and
primary care provider should be consulted so that ethical treatment that does not constitute battery can
be provided.
67. Determination of competency is not a medical decision; it is one made through court hearings.
68. False imprisonment accompanied by forceful restrain or threat of restraint is battery.
69. Liability can result if the nurse breaches confidentiality by passing along confidential client
information to others.
70. Necessary discussion about a client’s medical condition is considered appropriate, but unnecessary
discussions and gossip are considered breaches of confidentiality.
71. Necessary discussion involves only those people engaged in the client’s care.
Four major categories of confidential client information imposed by statutes to be reported:
72. vital statistics
73. infections and communicable diseases
74. child or abuse of older adults
75. violent incidents
76. Nurses should maintain professional boundaries when using electronic media.
77. For safeguarding the client’s property, in an event that the client cannot sign a waiver, the nurse
must follow the prescribed policies.
78. According to most nurse practice acts, unprofessional conduct is considered one of the grounds for
action against a nurse’s license.
79. Unethical conduct may also be addressed in nurse practice acts that includes violation of
professional ethical codes, breach of confidentiality, fraud, or refusing to care for clients of specific
socioeconomic or cultural origins.
80. Accurate and complete documentation is also a critical component of legal protection for the nurse.
81. In the event that a nurse has to make an incidental report, the report should be completed as soon
as possible and filed according to agency policy.
82. Incident reports are often reviewed by an agency risk management committee, which decides
whether to investigate the incident further. When accident occurs, the nurse should first assess the
client and intervene to prevent injury.
83. If a client is injured, nurses must take steps to protect the client, themselves and their employer.
84. It is important to follow agency policies regarding accidents and not to assume one is negligent.
85. Although negligence may be involved, accidents can and do happen when every precaution has been
taken to prevent them.
NCLEX Questions
86. The law is essential component of nursing practice. These concepts are correct about laws, EXCEPT:
A. Laws reflect the moral values of a society

B. Laws assist in maintaining standards of practice
C. Laws are principles and processes that resolve disputes by coercion
D. Laws provide a framework for establishing which nursing actions are legal
87. The primary purpose for regulating nursing practice is to protect:
A. The public
B. Practicing nurses
C. The employing agency
D. Professional standards
88. The definition of a tort is:
A. The application of force to the person of another by a reasonable individual

B. An illegality committed by one person against the property or person of another
C. Doing something that a reasonable person under ordinary circumstances would not do
D. An illegality committed against the public and punishable by the law through the courts
89. Examples of intentional torts include:
A. Malpractice and assault

B. Malpractice and negligence
C. False imprisonment and battery
D. Negligence and invasion of privacy
90. When obtaining consent for surgery, initially the nurse should:
A. Explain the risks involved in the surgery

B. Explain that obtaining the signature is routine for any surgery
C. Evaluate if the client’s knowledge level is sufficient to give consent
D. Witness the signature because this is what the nurse’s signature documents
91. Nurses are protected from ALL legal action when they:
A. Offer health teaching regarding family planning

B. Offer first aid at the scene of an automobile-bus accident
C. Administer cardio-pulmonary resuscitation (CPR) measures on an unconscious chilled pulled
from swimming pool
D. Report incidents of suspected child abuse to the appropriate authorities identified in legislation
and policies
92. The physician prescribes “NPO after midnight” for a hospitalized client who is scheduled for surgery.
The morning of surgery the client eats breakfast. The surgery is cancelled and the client must stay an
extra day. The client is very disturbed and insists on not paying for the additional day because of the
error. In situations such as this:
A. The client is responsible for the hospital bill and must pay
B. A full explanation of tests or treatments is the right of the client
C. The order should have been written more clearly by the physician
D. Things go wrong, and hospital personnel are not responsible unless there is gross negligence
93. A client with rheumatoid arthritis does not want cortisone even if it is prescribed and informs the
nurse of this. Later the nurse attempts to administer cortisone that has been ordered by the physician.
When the client asks wat the medication is, the nurse givers an evasive answer. The client takes the
medication and later finds that it was cortisone. The client states an intent to sue. The decision in this
suit would take into consideration the fact that:
A. The nurse should have notified the physician

B. The nurse is required to answer the client
C. The client has insufficient knowledge to make such a decision
D. The physician’s order takes precedence over the client’s preference
94. A client is placed on a stretcher and restrained with Velcro straps while being transported to the x-
ray department. A Velcro strap breaks, and the client falls to the floor, sustaining a fractured arm. Later
the client states, “The Velcro strap was worn just at the very sport where the strap snapped.” The nurse
is:
A. Exempt from any lawsuit because of the doctrine of respondeat superior

B. Totally and singly responsible for the obvious negligence because of failure to report defective
equipment
C. Liable, along with the employer, for misapplication of equipment or use of defective equipment
that harms the client
D. Completely exonerated, because only the hospital, as principal employer, is primarily
responsible for the quality and maintenance of equipment
95. The nurse insists that a medication for sleep be taken at 9 pm even though the client states, “ I never
went to sleep this early and I would like the medication later.” Later the client awakens and is confused.
The client tries to get out of bed and in so doing falls, fracturing a hip. LEGALLY:
A. The time the medication was given has nothing to do with the confusion
B. Client’s rights have precedence (priority) over hospital policy or physician’s orders
C. Hospital policy requires that sleep medications be given at 9 PM and respondeat superior
applies
D. When the physician orders a medication, it must be given at the scheduled time unless the
nursing supervisor authorizes differently

96. A client is voluntarily admitted to the psychiatric unit. Later the client develops severe pain in the
right lower quadrant and is diagnosed as having acute appendicitis. When preparing the client for an
appendectomy the nurse should:
A. Have two nurses witness the operative consent as the client signs it
B. Have the surgeon and the psychiatrist sign for the surgery, because it is an emergency
procedure
C. Phone the client’s next of kin to come in to sign the consent form because the client is on the
psychiatric unit
D. Ask the client to sign the preoperative consent form after being informed of the procedure and
required care Self -Assessment Questions
97. Individuals have a right to withhold themselves and their lives from public scrutiny. The intentional
tort that results from not respecting this right is termed:
A. Slander
B. Battery
C. Invasion of privacy
D. False imprisonment
98. An attempt or threat to touch another person unjustifiably describes the intentional tort of:
A. Libel
B. Assault
C. Slander
D. False imprisonment
99. An unusual occurrences report used to make all the facts available to agency personnel to in a way
help health personnel prevent further incidents or accidents:
A. Charting
B. Documentation
C. Incident report
D. Medical reports
100. A primary purpose of an incident report is to:
A. Provide evidence for trial

B. Identify ways to prevent future incidents
C. Identify the person(s) responsible for the incident
D. Assure that necessary follow-up procedures were followed
101. The most common situation for which nurses are charged with malpractice is:
A. Loss of client property

B. Making a medication error
C. Not following a physician’s order
D. Failure to obtain informed consent
102. The most common problem areas for nurses are the failure to properly document the care
provided. The main rule of thumb is:
A. ‘If it is not documented, it is not done’

B. ‘If it is not reported properly, it is not legal’
C. ‘If it is not in the policy, it will be covered by the employer’
D. ‘If it is not appropriate for the patient, it should not be given’
103. Good Samaritan acts protect nurses from liability for acts performed in an emergency situation:
A. No matter what they do

B. If they have the client’s consent
C. If they are not grossly negligent in their actions
D. If the client has a good outcome from their actions
104. Failure to behave in a reasonably prudent manner whether engaged in simplest or most complex
type of activity will mean:
A. Incompetence
B. Gross negligence
C. Negligence
D. Malpractice
105. While assisting during an operation, you noticed that the procedure is unusual and illegal. The most
appropriate approach of the nurse is:
A. Leave the OR right away and make a report

B. Call the attention of the doctor and leave immediately
C. Show that you were so much disturbed about what is happening
D. Call the attention of the doctor, remain with the patient, then make a report afterward
Reference:
Berman, A. & Synder, S. (2016) Kozier & Erb’s Fundamentals of Nursing. 10th ed. Pearson Education, Inc.

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8 | FUNDA LECTURE Study Guide # 3