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99 Cards in this Set

  • Front
  • Back

What kind of law is the superior law in the US, limits the powers of the federal government and gives certain powers to the states, and all federal and state laws must comply with it?

Constitutional law

What kind of law is passed by elected legislative bodies in the state or Federal government?

Statutory law

What kind of law protects the rights of individuals and provides for fair treatment when civil wrongs occur (i.e. when a health care provider is found guilty of malpractice)?

Civil laws

What kind of law protects society as a whole and provides for punishment of crimes?

Criminal law

What is a serious crime punishable by spending at least 1 year in prison (i.e. theft, intentionally killing a patient)?

Felony

What is a less serious crime with a fine or punishment of under one year (stealing scrubs, equipment from a hospital)?

Misdemeanor

What kind of law has rules and regulations made by administrative bodies such as the WV Board of Nursing and has rules government the approval of schools of nursing in the state?

Regulatory (Administrative) law

What kind of law results from judicial decisions made in court when cases are decided (informed consent, patients right to treatment and right to refuse treatment)?

Common law (case law)

Describe the contents of most nurse Practice Acts (DBESTRPG)

Definitions (registered professional nurse, advance practicenurse, board of nursing)


Board of Nursing (its authority, composition, and power)


Educational program standards


Standards and scope of practice of nursing (minimum to be anurse)


Types of titles and licenses


Protection of titles


Requirements for license


Grounds for disciplinary action, violations, possibleremedies

What is the Nurse Practice Act as a statutory law at thestate level?

Came about to protect patients. The right to govern thepractice of professionals is a state right.

What are the legal requirements for minimum acceptablenursing care?

Standards of care

Who writes the Standards of care?

The ANA and specialty organizations

Where are the Standards of Care found?

The Nurse Practice Act or in the Regulatory law related toit.

How are the standards of care organized?

By the nursing process (Assess, Diagnosis, Plan,Intervention, and Evaluation)

What are the grounds for disciplinary actions at the statelevel?

Reprimands, fines, suspension, and revocation of license

Which disciplinary case category would be giving the wrongdrug to the wrong patient, causing death, or documentation errors?

Practice-related error

Which disciplinary case category would be mishandling,misappropriation, or misuse of a controlled substance?

Drug related

Which disciplinary case category would have inappropriaterelationships where the nurse gets a benefit?

Boundary violations

Which disciplinary case category includes maltreatment of apatient, physically, mentally, and in nursing homes?

Abuse

What are the methods of responding to substance use innursing? (IMDM)

Identify and report the issue or suspected problem


Management conducts an intervention


Diagnosed and treated


Monitor the nurse after return to practice (if this is theoption)

Which disciplinary case category includes misrepresentationof the truth for gain or profit (credentials, time, or payment)?

Fraud

What is the term for requiring Nurses to report various things to the properreporting body. i.e. impaired workers, abuse, some communicable diseases?

Mandatory reporting

What level of law is the Mandatory Reporting Law?

Statutory law at the state level

What kind of law protects nurses from liability who are giving emergency care,Can’t be sued if a nurse gave care within scope, unless patient refusestreatment?

Good Samaritan Laws

What level of law is the Good Samaritan Law?

Statutory Law at the State Level

Which federal law protects right of people with physical andmental disabilities, protects healthcare workers and patients, and ensuresemployers give employees reasonable accommodations to allow them to performtheir jobs?

The Americans with Disabilities Act (1990)

Which federal law was passed by Congress to prevent patientdumping, regardless ability to pay, insurance or citizenship status, ensures amedical assessment or baby delivery and stabilization must be made beforedischarge or transfer?

The Emergency Medical Treatment and Active Labor Act (1986)

Which law was originally about protecting employees fromlosing insurance between jobs, and is important in safeguarding the privacy andthe confidentiality of personal health information?

Health Insurance Portability and Accountability Act (1996)HIPAA

What is PHI?

Protected Health Information

What term protects health care information that is disclosedwithin the health care setting, and providers must notify patients of theconfidentiality policies, give them written notice, and attempt to get theirsignature that they have been notified of the policies?

Confidentiality

Term that means that there must be no way the informationdisclosed or discussed can be traced to the patient outside of a healthcarefacility, no identifiers (DOB, Name, age, etc)

Confidential

You are a student nurse and go home from clinical. When yourmom finds out that you were working on the 5th floor, she says“That’s where your cousin Sally is. How is she doing? What is your response,what guides your decision? A standard of care? A law?

“Can’t tell you anything,” confidentiality, HIPPA.

You are a student nurse and after class, you go to a bar fora late lunch before clinical and see two fellow students drinking beer. A halfhour later, you see both of them reporting to clinical What is your response?What guides your decision? A standard of care?

Report it to instructor, mandatory reporting law.

You are a student nurse and your clinical group goes tolunch at the hospital cafeteria. A fellow student asks you to describe how thecouple who just delivered a baby did with delivery. Your fellow student heard arumor that the father vomited during the delivery. What is your response? Whatlaw or standard guides your decision?

“Can’t talk about it, HIPPA.”

During post conference in a private room on the unit withthe door closed, you are asked to discuss the procedure you watched and how thepatient reacted to it. Your instructor and fellow students are present. What isyour response? What law or standard guides your decision?

Allowed to talk about it, there for education, need-to-know.

A 67-year-old man has been admitted to the hospital for a surgical procedure. During the admission process, the nurse asks whether he has a living will or a durable power of attorney. The patient asks, "What is a living will?" The best response by the nurse would be which of the following?


A) "A living will and a durable power of attorney are both advance directives."


B) "A living will states your wishes regarding future healthcare if you become unable to give instructions."


C) "A living will identifies a person who will make healthcare decisions in the event you are unable to do so."


D) "I will tell a case manager that you would like additional information."

B) "A living will states your wishes regarding future healthcare if you become unable to give instructions."

For which of the following examples of conduct by nurses would the American Nurses Association recommend disciplinary action by state boards of nursing? Select all that apply.


A) Committing a medication error


B) Taking excessive sick time or personal leave C) Restraining a patient without obtaining informed consent


D) Failing to report a person practicing nursing without a license

A) Committing a medication error


C) Restraining a patient without obtaining informed consent

The nurse's legal role in obtaining written consent from a patient for any treatment or procedure includes which of the following? Select all that apply.


A) Determining that the elements of a valid informed consent are in place


B) Explaining to the patient the treatment and potential complications before he signs the consent


C) Communicating the patient's needs for more information to the provider who will perform the procedure


D) Evaluating whether the patient's provider has adequately explained the treatment and options before the patient signs the consent

A) Determining that the elements of a valid informed consent are in place


C) Communicating the patient's needs for more information to the provider who will perform the procedure

A registered nurse administers the wrong medication to a patient. As a result, the patient suffers an injury that requires a longer hospital stay. The patient can sue the hospital under the doctrine of which of the following?


A) Battery


B) False imprisonment


C) Vicarious liability


D) Statute of limitations

C) Vicarious liability

A nurse carried her own professional liability, a claims-made policy, from May 1, 2011, until April 30, 2012. She did not renew her professional liability policy, but purchased the tail coverage because she was starting law school on July 15, 2012, and did not plan to work as a nurse. A malpractice lawsuit was filed against her on July 3, 2012, arising out of an incident that occurred in December 2011. The plaintiff won the lawsuit. The statement that best describes the nurse's situation is that her insurance policy will


A) not cover her.


B) cover her.


C) cover her only if she is working as a nurse. D) cover her if she renews her policy within 3 months.

B) cover her.

A registered nurse's primary state of residency is Utah, a compact state. She wants to practice nursing in the state of Nevada, which is a non-compact state. The nurse


A) should retake the NCLEX-RN examination for practice in Nevada.


B) must apply for licensure by compact endorsement.


C) can practice under the mutual recognition agreement.


D) must request a permissive license from the Utah Board of Nursing

B) must apply for licensure by compact endorsement.

For the patient with no healthcare coverage who is seeking medical care, the emergency department staff members decide whether to provide care or transport to a public facility based on which law, enacted by Congress in 1986 and updated in 2003?


A) Health Insurance Portability and Accountability Act (HIPAA)


B) Patient Self-Determination Act (PSDA)


C) Newborns' and Mothers' Health Protection Act (NMHPA)


D) Emergency Medical Treatment and Active Labor Act (EMTALA)

D) Emergency Medical Treatment and Active Labor Act (EMTALA)

A patient tells you that chart entries made by the nurse from the previous day indicate he was uncooperative when asked to ambulate. He says this is not true and asks that his record be corrected. You understand that if what he says is accurate, he has the right to have the documentation error corrected based on which of the following regulations?


A) Americans with Disabilities Act (ADA)


B) Patient Self-Determination Act (PSDA)


C) Health Insurance Portability and Accountability Act (HIPAA)


D) Health Care Quality Improvement Act (HCQIA)

C) Health Insurance Portability and Accountability Act (HIPAA)

A registered nurse on active duty in the army is licensed in the state of Texas. She is assigned to work as a nurse in the military hospital located in Nevada. The nurse will:


A) need to obtain a license through the endorsement process.


B) need to obtain a license through the mutual recognition process.


C) not need to obtain a new license in the state of Nevada.


D) not need a license for Nevada if she gets a guest license from the state of Texas.

C) not need to obtain a new license in the state of Nevada.

A nurse may be convicted of false imprisonment for which behavior?


A) Putting the patient in fear of being harmed B) Touching the patient without his/her consent C) Putting a patient in restraints to prevent him from leaving


D) Yelling and screaming at the patient for trying to get out of bed without assistance

C) Putting a patient in restraints to prevent him from leaving

The legal criterion against which the nurse's conduct is compared to determine whether a negligent act occurred is called:


A) standard of care.


B) intentional tort.


C) vicarious liability.


D) an advance directive.

A) standard of care.

Mutual recognition in nursing benefits which of the following individuals?


A) A registered nurse whose primary state of residency is in a compact state and wants to work in a different compact state


B) A registered nurse who lives is in a compact state and wants to work in another compact state


C) A registered nurse whose primary state of residency is in a non-compact state, but who works in a compact state


D) A nursing student who wants to work in a hospital and is attending a university to obtain a bachelor's degree in nursing

A) A registered nurse whose primary state of residency is in a compact state and wants to work in a different compact state

Two student nurses in the elevator are discussing the HIV-positive status of a client. One of the clients' family members is in the elevator and overhears the conversation between the student nurses. Which of the following statements is true?


A) The state board of nursing can discipline the students' license.


B) The client can sue the student nurses for slander and libel.


C) The students have violated the Health Insurance Portability and Accountability Act.


D) The students have violated the Emergency Medical Treatment and Active Labor Act.

C) The students have violated the Health Insurance Portability and Accountability Act.

Glenn is a homeless man who is admitted to General Hospital's emergency room for chest pain. He could be having a myocardial infarction (heart attack), but the emergency room is busy and a resident suggests sending Glen to County Hospital. If he is transferred without being stabilized, the hospital is violating which of the following?


A. Health Insurance Portability and Accountability Act (HIPAA)


B. Americans with Disabilities Act (ADA)


C. Emergency Medical Treatment and Active Labor Act (EMTALA)


D. Patient Self-Determination Act (PSDA)

C. Emergency Medical Treatment and Active Labor Act (EMTALA)

A new charge nurse is advocating changing the shift report, which currently is the oral communication of patient information between nurses at the nurses' station. What would be the most important reason to make this change?


A. Giving the report at the nurse's station causes too much noise.


B. Discussing patient information at the desk may violate HIPAA laws.


C. If the patient being discussed hears the nurses, he or she may sue the hospital.


D. Sharing information about patients at the desk is an invasion of privacy.

B. Discussing patient information at the desk may violate HIPAA laws.

An 82-year-old patient with terminal metastatic breast cancer is confused and not eating well. However, she has in her chart documentation that instructs healthcare providers not to insert a feeding tube. This documentation would be which of the following?


A. Do not attempt resuscitation order


B. Durable power of attorney


C. Patient Care Partnership


D. Living will

D. Living will

A registered nurse is giving an end-of-shift report on her patient with hepatitis B, which he acquired through IV drug use. She tells the nurse coming on to the shift that the patient is nasty and uncooperative and that she's not surprised he has hepatitis, given his lifestyle. The nurse's behavior is consistent with which of the following?


A. Battery


B. An appropriate shift report


C. Slander


D. Malpractice

C. Slander

An older patient has a known history of peripheral vascular disease. The nurse places a heating pad directly on the patient's lower leg to relieve muscle spasms. The heating pad causes a burn, the area becomes infected, and the patient eventually must have a skin graft. This is an example of which of the following?


A. Malpractice


B. Assault


C. Vicarious liability


D. A felony

A. Malpractice

T/F Nurse practice acts are voluntary professional standards that are used often for peer review.

False, Nurse practice acts are mandatory standards.

T/F Telling an agitated patient that an oral sedative is a medication for his headache would be considered fraud.

True

If a patient falls while a nurse aide is assisting the patient to ambulate, the registered nurse should make it clear on the incident report that it was the aide's fault.

False, No blame should be placed when writing an incident report.

The state board of nursing is the entity that establishes accreditation requirements for schools of nursing.

False, Accreditation requirements are established by the Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE).

Identify whether the following examples violate state or federal law.


The emergency room nurse fails to report a case in which an older patient, who lives with a young nephew, has suspicious bruises.

State


Rationale: This violates the mandatory reporting law.

Identify whether the following examples violate state or federal law.


A hospital terminates a registered nurse because she has mild cerebral palsy and a weakened left arm.

Federal


Rationale: Termination on these grounds violates the Americans with Disabilities Act.

Identify whether the following examples violate state or federal law.


A graduate nurse (GN) continues to work in a GN position even though she has not passed the state board examination (NCLEX-RN).Answer: State

This violates the nurse practice act regulation on licensing.

Identify whether the following examples violate state or federal law.


A nursing instructor copies a patient's lab results to use in class for teaching purposes.

Federal


Rationale: This violates HIPAA.

A pregnant 15-year-old girl presents to the emergency department (ED) of the local private hospital. She has been transported by her mother and appears to be in active labor. The girl is crying uncontrollably and says she is scared and experiencing painful contractions. Her mother states, We dont have any money or insurance, but this hospital is closer than the public hospital, and she needs help now. What is the first step that the ED staff should take?


1)Arrange for an ambulance to transport her to the nearest public hospital.


2)Explain to the girl and her mother that the hospital only accepts patients who can pay the hospital bill.


3)Examine her to determine if her condition is stable or if she requires immediate medical attention.


4)Inform her mother that she will need to transport her daughter to the nearest public hospital.

3)Examine her to determine if her condition is stable or if she requires immediate medical attention.

For the patient with no healthcare coverage who is seeking medical care, the emergency department staff members decide whether to provide care or transport to a public facility based on which law, enacted by Congress in 1986 and updated in 2003?


1)Health Care Quality Improvement Act (HCQIA)2)Patient Self-Determination Act (PSDA)


3)Newborns and Mothers Health Protection Act (NMHPA)


4)Emergency Medical Treatment and Active Labor Act (EMTALA)

4)Emergency Medical Treatment and Active Labor Act (EMTALA)

A patient tells you that chart entries made by the nurse from the previous day indicate he was uncooperative when asked to ambulate. He says this is not true and asks his record be corrected. You understand that, if what he says is accurate, he has the right to have the documentation error corrected based on which of the following regulations?


1)Americans with Disabilities Act (ADA)


2)Patient Self-Determination Act (PSDA)


3)Health Insurance Portability and Accountability Act (HIPAA)


4)Health Care Quality Improvement Act (HCQIA)

3)Health Insurance Portability and Accountability Act (HIPAA)

pon initial assessment of a 75-year-old patient, you identify bruises and scratches on the patients arms, legs, and trunk in various stages of healing. You notify your supervisor when you suspect the patient may be a victim of physical abuse. You are complying with which of the following state laws?


1)Good Samaritan Law


2)Mandatory Reporting Law


3)Nurse Practice Act


4)Nursing Standards of Practice

2)Mandatory Reporting Law

Nursing codes of ethics support which of the following?


1)Patients can receive emergency treatment regardless of their ability to pay.


2)Nurses will educate patients about advance directives.


3)Nurses with HIV must disclose their condition to their employer.


4)Patients have the right to dignity, privacy, and safety.

4)Patients have the right to dignity, privacy, and safety.

The charge nurse in a progressive care unit assigns the care of a patient receiving hemodialysis to a newly hired licensed practical nurse (LPN) without checking to see that the nurse has been determined competent to care for hemodialysis patients. The LPN is in orientation and fails to inform the charge nurse that she does not have experience with this type of patient. The actions of the charge nurse would be considered to be which of the following?


1)Malpractice


2)Incompetence


3)Negligence


4)Abandonment

3)Negligence

In which of the following circumstances might the nurse defer obtaining informed consent for care and treatment of a patient?


)The patient is confused and cannot understand or sign the consent form.


2)The patient is brought to the emergency department in cardiac arrest; no family is present.3)The surgeon requests that the patient be sent to the surgical suite before you get the consent form signed.


4)An unconscious patient is admitted to your unit; he is alone.

2)The patient is brought to the emergency department in cardiac arrest; no family is present.

A 4-year-old child is brought to the emergency department by his mother. He has a large bruise in his left chest and multiple contusions on his face. His mother tells you her boyfriend intentionally pushed the child down the stairs in anger. The child appears to be in a great deal of pain. Which of the following four items should the nurse do first?


1)Notify the nursing supervisor of the suspected physical abuse.


2)Complete a physical assessment of the child.


3)Obtain an order for pain medication.


4)Notify Child Protective Services of the suspected abuse.

2)Complete a physical assessment of the child.

You are caring for an alert, oriented 47-year-old patient who is recovering from abdominal surgery. The patient becomes angry and upset and says, Im leaving this hospital. Remove my IV and surgical drains or I will do it myself. In order to keep him from removing his lines and leaving the hospital, you apply bilateral wrist restraints until you can contact the physician for an order for patient restraint. This is an example of which of the following?


1)Assault and battery


2)Felony


3)False imprisonment


4)Quasi-intentional tort

3)False imprisonment

A registered nurse forgot to put the side rails up for a confused patient. The patient fell out of bed and fractured his hip. The patient sues and wins a judgment (award) for $2 million. The nurse has an occurrence policy with double limit coverage of $3 million/$10 million that covered the time period when the incident occurred. The statement that best describes the nurses situation is that her insurance policy will:


1)Not cover her.


2)Pay $4 million.


3)Pay $2 million.


4)Pay 75% of the $2 million



3)Pay $2 million.

A registered nurse administers the wrong medication to a patient. She does not notify anyone of the error and documents that the correct medication was administered. The nurse was reported to the state board of nursing. Which of the following actions can the state board of nursing take against the nurse in this situation?


1)Disciplinary action against the nurses license to practice


2)Criminal misdemeanor charges against the nurse


3)Medical malpractice lawsuit against the nurse4)Employment release from the institution

1)Disciplinary action against the nurses license to practice

Which of the following are examples of invasion of privacy by nurses? Choose all that apply.


1)Searching a patients belongings without permission


2)Reviewing the plan for patient care in the lunchroom


3)Discussing healthcare issues for an unconscious patient with his power of attorney


4)Releasing patient health information to local newspaper reporters

1, 2, 4

While you are admitting an adult patient, he asks you whether he should create an advance directive. To provide him adequate information to make an informed decision, you should tell the patient which of the following? Choose all that apply.


1)If he is unable to communicate, his family may make changes to his advance directive.


2)Once he signs an advance directive, no further care will be provided to him.


3)He may change his advance directive by telling his physician or by making changes in writing.


4)An advance directive will ensure he gets as much or as little care as he wishes.



3, 4

What do negligence and malpractice have in common? Choose all that apply.


1)Negligence and malpractice are non-intentional torts.


2)Negligence and malpractice are felonies.


3)Malpractice is the professional form of negligence.


4)Negligence and malpractice involve the intent to do harm to a patient.

1, 3

You are caring for a patient with renal failure. His morning laboratory results reveal an abnormal potassium level of 6.8. This value is more elevated than on the previous day, when the level was within normal limits. You page the patients physician, but he does not return your call right away. You become busy with another patient and forget to notify the physician again and fail to mention the critical laboratory value to the oncoming nurse during shift report. Which of the following does this scenario illustrate? Choose all that apply.


1)Failure to implement a plan of care


2)Failure to evaluate


3)Malpractice


4)Failure to assess and diagnose

1, 2, 4

The American Nurses Association (ANA) believes nurses should not participate in active euthanasia (and assisted suicide) because such acts violate..


1) the Patient Self-Determination Act


2) civil laws


3) the Good Samaritan laws


4) the Code of Ethics for Nurses

4) the Code of Ethics for Nurses

Prioritize the following guidelines for nursing practice in order of specificity (1-4, with 4 being the most specific).


State laws


Institutional policies and procedures


Federal laws


State nurse practice acts

Federal laws


State laws


Institutional policies and procedures


State nurse practice acts

(class 2)


This federal law requires hospital and other health care agencies to provide written information to patients about their right to accept or refuse treatment and to make decisions related to advance directives. Each state has a law requiring what makes an advance directive a legal document.

The Patient Self Determination Act of 1991

(class 2)


One's wishes related to health care choices if one becomes unable to make such decisions. To be enforced, the patient must be legally incompetend (as determined by a judge) or lack decisional capacity

advance directives

(class 2)


A document that directs whether or not a person wants certain procedures to be done if one becomes terminally ill or in a persistent vegetative state or is otherwise unable to make decisions. It is written when the person is competent.

Living will

(class 2)


The person chooses a designee to make the health care decisions that the person would want when no longer able to make decisions

Medical power of attorney/health care proxy/durable power of attorney for health care

(class 2)


What are the two options for the standard of informed consent?

Physician based disclosure,


Patient based disclosure

(class 2)


West Virginia uses which disclosure standard

Patient based



(class 2)


Consent is usually obtained by ______

the person performing the procedure, usually the physician

(class 2)


An explanation of the procedure/treatment/surgery


The names of the people performing procedure


A description of the serious harm that is possible, including death, pain and discomfort,


An explanation of alternative treatments and their descriptions/risks of doing nothing


The right to refuse treatment without discontinuing other supportive care


The patient may refuse the procedure at any time, even after it has begun




Are key elements of what?

Informed consent

(class 2)
Can a patient give consent under the influence of medications?

no

(class 2)


Is it the nurse's legal responsibility to determine the treatment options or extent of information given?

no

(class 2)


What is a civil wrong made against a person or property (not involving a contract dispute, not usually breaking the law)?

tort

(class 2)


What kind of tort is a willful act that violates another's acts, assault, battery or false imprisonment?

intentional tort

(class 2)


What kind of tort threatens a patient?

assault

(class 2)


What kind of tort performs a procedure that a patient refuses?

battery

(class 2)


What kind of tort is restraining a patient inappropriately?

false imprisonment

(class 2)


What kind of tort lacks intent, but violates rights, injures a person's character, defamation of character (i.e. you're dumb)?

quasi-intentional tort

(class 2)


Term for falling below a standard, usually failure to do what a reasonable and prudent person would do in that circumstance

negligence

(class 2)


professional negligence

malpractice

(class 2)


What 4 elements are necessary for a malpractice case to prevail?

Duty ( the nurse has as duty to the patient)


Breach of Duty (the nurse fails to uphold standard)


Causation(the break of duty causes a problem)


Damages(the patient has been damaged in some way)

(class 2)
Failure to assess and/or monior the patient
Failure to notify the health care provider of problems
Failure to follow orders, or follow improper orders
Failure to follow the 6 rights of medication administration
Failure to convey discharge instructions
Failure to ensure patient safety, especially patients who have a history of falling, are heavily sedated, have disequilibrium problems, are frail, are mentall impaired, and are uncooperative, or get up in the night
Failure to follow policies, procedures
Failure to properly delegate and supervice

Are all common what?

Common negligent acts in nursing

(class 2)


Can a nurse be held liable for not following an order or for following an incorrect order?

yes