Legal And Ethical Issues in Nursing 6th Edition by Ginny Wacker Guido – Test Bank

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Legal And Ethical Issues in Nursing 6th Edition by Ginny Wacker Guido – Test Bank

 

Sample  Questions

 

Guido, Legal and Ethical Issues in Nursing, 6e
Chapter 05

Question 1

Type: MCSA

In given situations, the nature and degree of reasonable care expected of people providing care may differ depending upon which factor?

  1. The individual’s status as a professional
  2. The individual’s sense of ethical responsibility
  3. The individual’s sense of societal obligations
  4. The individual’s understanding of the law

Correct Answer: 1

Rationale 1: Individuals of a specific profession have their own unique care standards. These define the minimal requirements of an acceptable level of care that can be expected of a given profession. They are developed to see that no unnecessary harm comes to the patient and to protect and safeguard the public as a whole.

Rationale 2: Too much variation of care practices may exist if standards were only based on an individual provider’s sense of ethics.

Rationale 3: Too much variation of care practices may exist if standards were only based on societal obligations.

Rationale 4: Too much variation of care practices may exist if standards were only based on laws.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5.1 Define standards of care from a legal and a nursing perspective.

 

Question 2

Type: MCSA

What would the nurse identify as the most basic purpose of standards of care?

  1. To protect and safeguard the public as a whole
  2. To ensure that all patients receive state-of-the-art care
  3. To protect health care providers and prevent their giving less than quality care
  4. To ensure administrative agencies are protected from frivolous lawsuits

Correct Answer: 1

Rationale 1: The standards are meant to protect the public from receiving varying degrees of quality of care.

Rationale 2: State-of-the-art care changes rapidly and cannot be ensured by writing standards of care.

Rationale 3: Standards of care are not primarily written to protect health care providers.

Rationale 4: Frivolous lawsuits are not prevented by writing standards of care.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.1 Define standards of care from a legal and a nursing perspective.

 

Question 3

Type: MCMA

Hospital administration requires that the committee seeking to change nursing policy and procedures review external sources for these standards. Where should the committee look for these standards?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Current nursing literature
  2. Individual nurse’s experience and education
  3. Federal organizations
  4. The hospital’s position job descriptions.
  5. State boards of nursing

Correct Answer: 1,3,5

Rationale 1: Current nursing literature is a good source of timely information regarding standards of care.

Rationale 2: The individual nurse’s experiences and education is not likely to be sufficient documentation of the existence of a standard of care.

Rationale 3: Federal organizations, particularly those that reimburse for care, frequently set standards of care.

Rationale 4: Job descriptions are more likely to provide internal standards of care.

Rationale 5: State boards of nursing often set standards of care for nurses in their state.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5.2 Compare and contrast internal versus external standards of care.

 

Question 4

Type: MCSA

The hospital nursing group has reviewed current nursing and federal literature to establish standards of care for a newly organized patient care unit. The final report generated by this group should assure hospital administration that the standards meet which level of care?

  1. Mutually acceptable
  2. Worldwide
  3. National
  4. Locality

Correct Answer: 3

Rationale 1: Mutually acceptable is a term to describe these standards.

Rationale 2: Since many external standards are written by state and federal groups they would not necessarily be described as worldwide.

Rationale 3: External standards transcend individual practitioners and single institutions. Since they are set by state and federal organizations, they are relevant to a specific society or country and are considered national standards.

Rationale 4: External standards expand beyond locality care standards.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5.2 Compare and contrast internal versus external standards of care.

 

Question 5

Type: MCSA

Which situation supports the charge of malpractice against a professional nurse?

  1. A failure on the part of the nurse to allay a patient’s fears about an upcoming procedure
  2. A failure on the part of the nurse to ensure that patients only received care for which they could pay
  3. A failure on the part of the nurse to establish a therapeutic relationship with the patient
  4. A failure on the part of the nurse to exercise reasonable and prudent care in treating a patient

Correct Answer: 4

Rationale 1: There is no standard of care that says the nurse should allay all a patient’s fears. This may be impossible.

Rationale 2: Patients receive care regardless of payment.

Rationale 3: Development of a therapeutic relationship makes it easier to meet standards of care. However, it is not impossible to meet these standards without establishing a therapeutic relationship.

Rationale 4: Malpractice is based on the nurse breaching the standard to provide reasonable and prudent care or duty owed to the patient.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5.3 Discuss the concept of the reasonably prudent nurse in defining standards of care.

 

Question 6

Type: MCSA

What does the court consider in determining the nurse’s legal liability for standards of care?

  1. Professional conduct, but not experience or education
  2. Professional education, experience, and specific conduct
  3. Professional education, but not experience or conduct
  4. Professional experience, but not education or conduct

Correct Answer: 2

Rationale 1: Professional conduct is not the only consideration.

Rationale 2: Professional education, experience, and specific conduct all could be considered internal standards. These would be used in determining liability.

Rationale 3: Education is not the only consideration.

Rationale 4: Experience is not the only consideration.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.3 Discuss the concept of the reasonably prudent nurse in defining standards of care.

 

Question 7

Type: MCSA

What is the single most critical factor in determining whether a particular nurse acted with reasonable care in a given situation?

  1. The number of years the nurse has practiced as a professional nurse
  2. How the nurse’s conduct compares to that of nurses with similar background and experience
  3. The experience the nurse has in the particular clinical setting in which the situation occurred
  4. The ability of the nurse to perform according to his or her job description

Correct Answer: 2

Rationale 1: Amount of experience is not the most important factor.

Rationale 2: While the characteristics of the individual nurse are relevant factors, the nurse’s practice will be compared to internal and external standards of care that are practiced by other nurses possessing similar background and experience.

Rationale 3: Clinical experience is not the most important factor.

Rationale 4: Ability to meet job description requirements is not the most important factor.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5-5 Describe the importance of standards of care to the individual nurse

 

Question 8

Type: MCSA

The state board of nursing has brought action against a nurse’s license based upon violation of a regulation. What is true about this scenario?

  1. Violation of a rule or regulation is not the same as violation of the state nursing practice act.
  2. Rules and regulations are only suggested standards of care and do not have to be followed.
  3. Rules and regulations are internal to the state board, not the nurse.
  4. These rules and regulations have the force of law.

Correct Answer: 4

Rationale 1: Rules and regulations are promulgated by the state board of nursing. Violation of a rule or regulation is a violation of the state practice act.

Rationale 2: Rules and regulations govern the practice of nursing in the state. These rules and regulations must be followed.

Rationale 3: The nurse should internalize these rules and regulations as part of their individual practice.

Rationale 4: Each state publishes acceptable standards of care as part of the nurse practice act or through the rules and regulations promulgated by the state board of nursing. These rules and regulations have the force of law and must be followed.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5.5 Describe the importance of standards of care to the individual nurse.

 

Question 9

Type: MCSA

A lawsuit is brought against a nurse in a rural hospital. The nurse replies that the standard of care for rural nurses is different from that for nurses working in large urban facilities. Is this a defensible position?

  1. No; rural nurses work in a slower paced environment, so they have more time to provide quality personal care.
  2. Yes; the rural nurse does not have access to the same quality of inservice education as the urban nurse.
  3. No; nurses in rural settings must meet the same standards as those practicing in large urban areas.
  4. Yes; it is well known that rural health care is substandard as compared to urban health care.

Correct Answer: 3

Rationale 1: Rural nurses also work in fast-paced environments.

Rationale 2: There is no evidence that rural nurses do not have access to quality inservice. Nurses, regardless of their practice areas, are responsible for staying current in their practices.

Rationale 3: Nurses are accountable for all standards of care as they pertain to their profession, no matter their practice setting.

Rationale 4: Rural health care is not known to be substandard to urban care.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5.4 Differentiate national versus local standards of care.

 

Question 10

Type: MCSA

The nurse holds national certification as a wound care specialist and works in a small, rural hospital. What standard of skill and care applies to this nurse’s practice?

  1. It should be equal to that of any other wound care specialist in the nation.
  2. It should be the same as that of any nurse who provides wound care.
  3. It should be equal to the practice of a wound care specialist working in the largest facility in the state.
  4. It should be the same as that of an average nurse who also holds national wound care certification.

Correct Answer: 4

Rationale 1: This nurse does not have to have skills equal to all other wound care specialists. There may be those that have different or better skills.

Rationale 2: The nurse should have better skills and is held to a higher standard than a nurse who does not hold certification.

Rationale 3: There is no responsibility to be as skilled as a person working in a larger, better equipped hospital.

Rationale 4: A person holding himself or herself out as a specialist should be held to the same standard of skill and care as an average member of that specialty.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5.4 Differentiate national versus local standards of care.

 

Question 11

Type: MCMA

Which scenarios reflect the “two schools of thought” doctrine?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. An honest error in judgment prevented a nurse from providing quality care.
  2. The hospital policy and procedures manual lists both local and national nursing care quality standards.
  3. Nurses on one unit vary in their choice of ways to deliver quality care.
  4. The nurse manager insists that standards are uniform and all nurses must act in the same manner.
  5. The nurse expert witness in a case describes two methods of providing the intervention in question.

Correct Answer: 3,5

Rationale 1: The court evaluates whether the care given meets the prevailing standards, not whether the judgment was correct.

Rationale 2: Two schools of thought doctrine applies to differences in interventions, not in standards.

Rationale 3: Two schools of thought is a doctrine that allows the consideration that an individual can use different approaches when rendering care as long as the standards of care are met.

Rationale 4: Insisting that all nurses provide care in exactly the same manner does not reflect the two schools of thought doctrine.

Rationale 5: There may well be more than one way to provide an intervention and still meet the standard of care. This is the basis of the two schools of thought doctrine.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5.5 Describe the importance of standards of care to the individual nurse.

 

Question 12

Type: MCSA

The hospital policy and procedure manual states that medications should be charted immediately after administration. The nurse routinely charts the medications as they are being prepared for administration. What does this practice reflect?

  1. Use of the two schools of thought doctrine
  2. Logical and appropriate variation in practice
  3. An honest error in judgment
  4. A violation of hospital policy and procedure

Correct Answer: 4

Rationale 1: The two schools of thought doctrine is used when the court evaluates the standards of care given when the nurse chooses among the alternative modes of treatment. The alternative mode still has to meet standards of care.

Rationale 2: Violating hospital policy and procedure is not logical or appropriate.

Rationale 3: The honest error in judgment rule allows the court to evaluate the standards of care given a patient even if there was an honest error in judgment. What the court evaluates is the care given and whether that care met the prevailing standards, not if the judgment was correct.

Rationale 4: This practice is a violation of the policy and procedures of the hospital and therefore is a violation of standard of care.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5.5 Describe the importance of standards of care to the individual nurse.

 

Question 13

Type: MCMA

The survivors of a patient who unexpectedly died in a hospital contact an attorney regarding a wrongful death against the hospital and two nurses. Review of the hospital’s pertinent policy and procedures found them to be current. Review of the medical record revealed that policy and procedures were followed by the nurses. Based on this information, what is the likely strength of this case?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. The survivors have a good case since hospital policy and procedures do not supersede national standards.
  2. The survivors have a good case since the death was unexpected.
  3. Since the patient is dead and cannot report variation from the standards no case is possible.
  4. The case against the nurses is weak since they followed hospital policy and procedures.
  5. The case against the hospital is weak since policies and procedures are current.

Correct Answer: 4

Rationale 1: There is no evidence that the hospital’s standards did not meet national standards. The scenario indicates the policies are “current.”

Rationale 2: Unexpected deaths occasionally occur in hospitals through no fault of anyone.

Rationale 3: There is no indication that the patient being dead and unable to report variation from standards will have any impact on the guilt or innocence of the nurses or hospital.

Rationale 4: Since the nurses did follow the hospital policies and procedures some other violation would have to be found.

Rationale 5: The hospital is responsible for ensuring that policies and procedures are current. Since this is the case, the case would have to be based on some other occurrence.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5.5 Describe the importance of standards of care to the individual nurse.

 

Question 14

Type: MCMA

The administration of a health care facility takes the ethical obligation of protecting patients very seriously. Which actions would help nurses meet standards of care?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Create clearly written policy and procedure manuals.
  2. Encourage practitioners to find alternate, quicker ways to implement interventions.
  3. Refuse to tolerate those who are slow to adapt new standards of care.
  4. Emphasize protection of the hospital when developing internal standards and policies.
  5. Schedule regular reviews of policy and procedure manuals.

Correct Answer: 1,5

Rationale 1: A good way to ensure that practitioners meet current standards of care is to create policy and procedure manuals that are current and easy to understand.

Rationale 2: Taking quicker routes of implementation often results in deviation from standards of care.

Rationale 3: Intolerance of those who are ignorant of standards or slow to adopt new standards is divisive and is not helpful in encouraging these practitioners.

Rationale 4: The clear and overwhelming focus of all standards should be the patients’ safety.

Rationale 5: Regular review of policy and procedure manuals will help ensure that these documents reflect current standards of care.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 5.6 Discuss some of the ethical issues that arise concerning standards of care.

 

Question 15

Type: MCMA

Which situation creates an ethical dilemma for the nurse serving as an expert witness in a jury trial?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. The documentation in the medical record contradicts itself.
  2. There are time lapses in the documentation of the event resulting in the suit.
  3. The interventions implemented only minimally met the standards of care.
  4. Outcomes for the patient were unexpected and severe.
  5. Nurses from more than one department took care of the patient.

Correct Answer: 1,2,3

Rationale 1: Contradictions in the medical record may indicate that the record is not accurate. This creates an ethical dilemma for the expert witness.

Rationale 2: Time lapses in the medical record documentation may indicate that not all of the events that occurred were recorded. This would create an ethical dilemma for the expert witness.

Rationale 3: When the standards of care were met, but were minimal, and could have been more effective, a dilemma exists. Should the nurse report the standards as met or should the nurse explain that additional interventions could have been implemented?

Rationale 4: Just because the outcomes were unexpected does not create an ethical dilemma.

Rationale 5: The department where the nurses generally work should not create an ethical dilemma.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5.6 Discuss some of the ethical issues that arise concerning standards of care.

Guido, Legal and Ethical Issues in Nursing, 6e
Chapter 07

Question 1

Type: MCSA

The nurse has been sued for defamation after charting that the patient is a prostitute. What is the nurse’s best defense in this case?

  1. Define the contributing factors.
  2. Prove that the statement is true.
  3. No defense exists for defamation.
  4. Provide hearsay evidence.

Correct Answer: 2

Rationale 1: Contributory negligence is a defense used when there is a need to identify fault in the injury.

Rationale 2: Truth is one of the primary defenses for defamation. The nurse must prove that the statement identifying the patient as a prostitute is completely true.

Rationale 3: There are defenses against the charge of defamation.

Rationale 4: Hearsay is not a way of validating truth.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 7.1 Define the term defense and give examples of defenses that may be used against intentional, quasi-intentional, and negligence torts.

 

Question 2

Type: MCSA

A patient refused to ambulate postoperatively and subsequently developed bilateral pneumonia, causing his hospital stay to be lengthened. After discharge, the patient filed a lawsuit claiming his primary nurse was negligent in allowing him to develop pneumonia. What is the nurse’s best defense in this case?

  1. The patient was told that complications could arise when signing the informed consent form.
  2. The patient should have anticipated a longer hospital stay if complications arose.
  3. The patient was aware of the substandard care at the time it occurred.
  4. The patient’s conduct contributed to his complications.

Correct Answer: 4

Rationale 1: While the patient assumes risk with informed consent, which could be a potential defense, the patient did not follow advice or instructions.

Rationale 2: The logic that complications will result in longer hospital stays does not help support the nurse’s defense.

Rationale 3: Admitting to the knowledge that care was substandard would hinder the defense, not help it.

Rationale 4: The patient’s own negligence in this case could be argued as a contributory cause. This factor becomes the best defense in this scenario.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 7.1 Define the term defense and give examples of defenses that may be used against intentional, quasi-intentional, and negligence torts.

 

Question 3

Type: MCSA

A patient, injured at work, was seen by the factory occupational nurse. The nurse treated the wound and instructed the patient to get a tetanus antitoxin injection at the county health department. The patient failed to follow instructions, developed tetanus, and subsequently filed a suit against the nurse. What is the most likely result of the ensuing trial?

  1. The nurse is not liable, because tetanus is a reportable disease and the health department should have insisted the patient take the injection.
  2. The nurse is liable, because there was no follow-up to ensure that the patient received the injection.
  3. The nurse is liable, because tetanus is easily treatable after diagnosis.
  4. The nurse is not liable for damages, because the nurse has a right to expect that instructions will be followed.

Correct Answer: 4

Rationale 1: Unless the disease is one that is a danger to the general public if not treated, the patient can refuse treatment at the health department as well.

Rationale 2: While follow-up is common, the patient still retains the right to follow or not follow instructions.

Rationale 3: Tetanus is not easily treatable, but the ease of treatment is not a factor in this case.

Rationale 4: The court recognizes that the patient’s own negligence could contribute to adverse outcomes, as in this case. The patient has a right to refuse or follow advice or instructions but must bear the results of that decision. When this occurs, the legal system applies the concept of contributory or comparative negligence.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7.1 Define the term defense and give examples of defenses that may be used against intentional, quasi-intentional, and negligence torts.

 

Question 4

Type: MCSA

When a patient became confused and dangerous to himself and others in the setting, restraints were applied, and the patient was confined to bed. What is the nurse’s best defense for applying restraints?

  1. Necessity
  2. Consent
  3. Self-defense
  4. Privilege

Correct Answer: 3

Rationale 1: Necessity is a defense that allows a nurse to interfere with a patient’s property rights to avoid a threatened injury, which does not apply to this scenario.

Rationale 2: The nurse did not get consent.

Rationale 3: Self-defense and defense of others may be justifiable to protect oneself and others in the area from harm.

Rationale 4: It is not a privilege to act in this manner.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7.1 Define the term defense and give examples of defenses that may be used against intentional, quasi-intentional, and negligence torts.

 

Question 5

Type: MCSA

A patient became confused and used a pocket knife to threaten others. The nurse confiscated the knife. What is the nurse’s best defense for this action?

  1. Privilege
  2. Self-defense
  3. Necessity
  4. Consent

Correct Answer: 3

Rationale 1: It is not a privilege to act in this manner.

Rationale 2: Self-defense is taking an action to protect oneself, but there is another option that is more specific.

Rationale 3: Necessity is a defense that allows a nurse to interfere with a patient’s property rights to avoid a threatened injury.

Rationale 4: The nurse does not need consent to act in this situation.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7.1 Define the term defense and give examples of defenses that may be used against intentional, quasi-intentional, and negligence torts.

 

Question 6

Type: MCSA

In caring for a 6-year-old who entered the emergency center for treatment of a broken arm, the nurse noted that the child had multiple bruises on his trunk and legs. When questioned, the child said his father hit him and broke his arm so that the child would remember to be good. What should the nurse do?

  1. Chart that the child is a victim of child abuse, so that there is a record of the abuse should such behavior reoccur.
  2. Report the incident immediately to the nursing supervisor or physician so that the incident will be reported to the proper authorities.
  3. Do nothing, because the nurse cannot prove the child was really abused, and saying anything could open the institution to a possible defamation lawsuit.
  4. Downplay the child’s comments, because children often exaggerate.

Correct Answer: 2

Rationale 1: It is not the nurse’s role to diagnose that child abuse exists. Charting this suspicion as fact could put the nurse at legal liability.

Rationale 2: Mandated by law, nurses and other health care professionals must report suspected abuse.

Rationale 3: Doing nothing is a violation of child abuse protection laws.

Rationale 4: The nurse must take all statements seriously regardless of the age of the patient.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7.1 Define the term defense and give examples of defenses that may be used against intentional, quasi-intentional, and negligence torts.

 

Question 7

Type: MCMA

In which scenarios would the nurse assume that apparent consent has been provided?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. The patient follows directions to swallow sips of water as the nurse inserts a nasogastric tube.
  2. The patient’s family member signed the consent to treat.
  3. The patient smiled and held out his arm when the nurse said, “I need to start an intravenous line.”
  4. The patient voluntarily signed a consent form for an invasive procedure.
  5. An unconscious patient is brought to the hospital following a motor vehicle accident.

Correct Answer: 1,3

Rationale 1: Apparent consent is given by conduct. This patient is following instructions given to help in the placement of the tube, so conduct would indicate consent.

Rationale 2: Depending upon which family member is involved, this situation may be actual consent. For example, a parent signing the consent for a minor child.

Rationale 3: Smiling and holding out the arm is an apparent consent to starting an intravenous line.

Rationale 4: This is an example of actual consent.

Rationale 5: This is a situation of implied consent. The patient is unable to give consent, but would likely give consent if able.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 7.1 Define the term defense and give examples of defenses that may be used against intentional, quasi-intentional, and negligence torts.

 

Question 8

Type: MCSA

A lawsuit is being tried in a state that recognizes pure comparative negligence. The attorney for the nurse defendant is attempting to prove the plaintiff has some responsibility for the injury that occurred. If this proof can be established, can the plaintiff recover damages?

  1. Only if the plaintiff is over 51% at fault
  2. Yes, even if the plaintiff is 99% at fault
  3. Only if the plaintiff is less than 50% at fault
  4. No; if the plaintiff has any fault, damages cannot be recovered.

Correct Answer: 2

Rationale 1: Pure comparative negligence does not set a 51% point of fault as determining recovery.

Rationale 2: Under pure comparative negligence, the plaintiff is allowed to recover the portion of the injury attributable to the defendant’s negligence, even if the plaintiff was 99% at fault.

Rationale 3: In modified comparative negligence, if the plaintiff’s negligence is found to exceed that of the defendant, the plaintiff is barred from recovery. In some states, that bar is 50%.

Rationale 4: Under pure comparative negligence, the patient can recover damages if at some amount of fault in the injury.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7.1 Define the term defense and give examples of defenses that may be used against intentional, quasi-intentional, and negligence torts.

 

Question 9

Type: MCSA

The cardiac telemetry unit nurses repeatedly cautioned a patient not to leave the floor because input from telemetry monitors is limited to that area. The patient went to the cafeteria and suffered a fatal dysrhythmia. What is the nurses’ best defense in the negligence lawsuit brought for the patient’s survivors?

  1. Assumption of risk
  2. Defense of the fact
  3. Immunity
  4. Exculpatory agreement

Correct Answer: 1

Rationale 1: In this case, the nurses warned the patient “repeatedly” of the danger and the patient ignored the warning. Assumption of risk states that plaintiffs (in this case the patient) are partially responsible for consequences if they understood the risks involved when they proceeded with the action.

Rationale 2: Defense of the fact is used when there is no indication that the health care provider’s actions were the cause of the patient’s outcome. In this case, it might be argued that the nurses should have noticed the patient was away from the unit.

Rationale 3: Immunity statutes serve to dismiss certain causes of action. An example is the Good Samaritan statute, which does not apply in this situation.

Rationale 4: Exculpatory contracts are signed to limit the amount of recoverable damages and are generally considered invalid.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 7.1 Define the term defense and give examples of defenses that may be used against intentional, quasi-intentional, and negligence torts.

 

Question 10

Type: MCSA

The 4-year-old child developed a seizure disorder that may be related to a medication error that occurred 3 years ago. What is true of the statute of limitations in this case?

  1. The statute of limitations in this case won’t begin to be calculated until the child reaches the age of 13.
  2. There is no statute of limitations on medication errors that occur in children prior to the age of 2.
  3. Since the incident occurred over 2 years ago, the statute of limitations has expired.
  4. Depending upon the state, the statute of limitations might not begin to be calculated until the child reaches the age of majority.

Correct Answer: 4

Rationale 1: There is no general rule that statutes of limitations do not begin to be calculated until the child reaches age 13.

Rationale 2: There is no ruling that indefinitely extends statute of limitations for children under age 2.

Rationale 3: It is not possible to say that this statement is true as statutes of limitations vary from state to state.

Rationale 4: Statutes of limitations are different for different states and different occurrences. For children, statutes of limitations may not begin to be calculated until the child reaches the age of majority. This rule is changing, but still exists at present.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 7.2 Review the concept of statute of limitations, including the importance this statute has in the health care field.

 

Question 11

Type: MCMA

While vacationing in a different state, the nurse encounters an emergency in which a person needs immediate care. What should the nurse assume about the Good Samaritan law of this state?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. A Good Samaritan law exists in the state.
  2. The nurse has a legal obligation to provide emergency care.
  3. The nurse will be protected by the Good Samaritan law in the state of licensure.
  4. The Good Samaritan law in this state may be different than the one in the state of licensure.
  5. There is a standard definition of what constitutes an emergency.

Correct Answer: 1,4

Rationale 1: All states have enacted Good Samaritan laws.

Rationale 2: There is no state that requires anyone to provide emergency care. Two states do require individuals to assist others exposed to grave physical harm, but this assistance may entail no more than calling 911.

Rationale 3: The Good Samaritan law that is in effect for this situation is the one in the state where the incident occurred.

Rationale 4: It is very likely that laws in the two states will be different.

Rationale 5: Acts may not define criteria to determine whether an emergency actually exists and what constitutes the scene of an emergency.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 7.3 Examine the Good Samaritan laws and their relevance for health care deliverers.

 

Question 12

Type: MCMA

The nurse is stopped at the scene of a motor vehicle accident with injury. What actions should the nurse take?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Start assessing the injured as is required by all registered nurses.
  2. Ask the injured person for permission to help.
  3. Move the patient only if it is necessary to prevent further harm.
  4. Instruct someone to call for additional aid.
  5. Graciously accept any payment the injured patient may offer.

Correct Answer: 2,3,4

Rationale 1: There is no common-law duty to stop and render aid. The nurse should make a quick decision about whether to stay and help.

Rationale 2: It is important to ask for permission to help. The nurse should not force services if they are refused.

Rationale 3: Care should be provided in the exact site where the patient was found, if possible. Moving the patient can result in additional injury, so the patient should not be moved unless absolutely necessary.

Rationale 4: The nurse should stay with the injured persons while someone else summons aid.

Rationale 5: The nurse should not accept any payment or gifts from the patient or their family as this may change care from a Good Samaritan act to fee-for-service which may change liability status.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 7.3 Examine the Good Samaritan laws and their relevance for health care deliverers.

 

Question 13

Type: MCSA

The plaintiff was injured by a defective intravenous catheter. In order to win a product liability case, what must the plaintiff prove first?

  1. The intravenous catheter was defective.
  2. The intravenous catheter was used incorrectly.
  3. The intravenous catheter was sold to him.
  4. The hospital purchases the poorly manufactured intravenous catheters.

Correct Answer: 3

Rationale 1: Proving the catheter was defective is not the first step that must be accomplished in a products liability case.

Rationale 2: There is a different first step than proving that the catheter was used incorrectly.

Rationale 3: The first hurdle for the plaintiff in product liability cases is to prove that there has been a sale of a product rather than the mere delivery of a service. Product liability action does not exist if there is no sale of a product.

Rationale 4: There is a different first step in a products liability case.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 7.4 Define and explain product liability and collective and alternative liability defenses.

 

Question 14

Type: MCMA

In which situations would the manufacturer of a drug designated as unavoidably unsafe be held liable for injuries to a patient receiving the drug?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. The physician did not educate the patient about the risks of the medication.
  2. The physician prescribed the medication after being told that problems with the drug had been corrected.
  3. The nurse was not warned of risks by the pharmacist.
  4. The nurse did not educate the patient about the risks of the drug.
  5. The information printed in the drug information sheet accompanying the medication was wrong.

Correct Answer: 2,5

Rationale 1: In this case the physician would be at fault for not educating the patient.

Rationale 2: The manufacturer holds the responsibility to warn the health care provider who prescribes the drug about problems that may occur.

Rationale 3: The pharmacist does not hold the responsibility of educating the nurse about risks.

Rationale 4: The manufacturer is not responsible for the nurse’s actions.

Rationale 5: If erroneous information was distributed with the drug, the manufacturer has not met its obligation to provide a warning to the health care provider.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 7.4 Define and explain product liability and collective and alternative liability defenses.

 

Question 15

Type: MCMA

A representative from a drug company tells a group of nurses that one of the company’s products is unavoidably unsafe. How should the nurses interpret this information?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. The drug has risks that cannot be eliminated.
  2. The benefits of using the medication outweigh its risks.
  3. The medication has been recalled by the manufacturer.
  4. Patients who have been administered this medication are very likely to have severe side effects.
  5. There is no safer medication to use an alternative.

Correct Answer: 1,2,5

Rationale 1: One of the criteria for an “unavoidably unsafe” product is that it has risks that cannot be eliminated.

Rationale 2: One of the criteria for an “unavoidably unsafe” product is that its benefits greatly outweigh its risks.

Rationale 3: There is no indication that this medication has been recalled.

Rationale 4: There is no assurance that patients exposed to this medication will have severe side effects.

Rationale 5: One of the criteria for an “unavoidably unsafe” product is that no safer product exists as an alternative.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 7.4 Define and explain product liability and collective and alternative liability defenses.

Guido, Legal and Ethical Issues in Nursing, 6e
Chapter 11

Question 1

Type: MCSA

Changes to nursing licensure are being considered. The nurse identifies which source of the state’s power to license nurses?

  1. Police power within the state
  2. State and federal case laws
  3. Constitution of the United States
  4. Nurse practice act

Correct Answer: 1

Rationale 1: It is the states’ police power that enables them to provide a license for nurses.

Rationale 2: State and federal case laws may define actions that the state may take in certain circumstances, but they do not extend to providing licensure for nurses.

Rationale 3: The Constitution is a federal document that does not address licensing power of the states.

Rationale 4: The state practice act defines the scope of practices and the processes for licensure, not the power to issue the license.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 11.1 Define licensure, including mandatory, permissive, and institutional licensure and the advantages and disadvantages of each.

 

Question 2

Type: MCSA

A medical technician working in a physician’s office routinely refers to herself as a nurse. Which type of licensure protects that title as well as the professional actions associated with nursing?

  1. Mandatory
  2. Institutional
  3. Transitional
  4. Permissive

Correct Answer: 1

Rationale 1: Mandatory licensure requires that all persons who are compensated as a member of a licensed profession obtain licensure prior to practicing actions of the profession. It protects both the title “nurse” and the professional actions associated with the nursing.

Rationale 2: Institutional licensure is the process by which a state government regulates health institutions and is an alternative to individual licensure. It does not protect individual practice or title.

Rationale 3: Transitional is not a term used to describe licensure in this text.

Rationale 4: With permissive licensure, nurses cannot use the title RN unless duly licensed, but can perform many or all of the same actions as long as they do not call themselves RN. So, permissive licensure regulates the use of the title, not the actions.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 11.1 Define licensure, including mandatory, permissive, and institutional licensure and the advantages and disadvantages of each.

 

Question 3

Type: MCSA

A nurse appointed to the state board of nursing would expect work focused on which basic purpose of that body?

  1. Establishing a means of protecting the public at large
  2. Ensuring that all schools of nursing seek national accreditation
  3. Ensuring that all practicing nurses are competent
  4. Restricting nursing practice through regulations

Correct Answer: 1

Rationale 1: The main purpose of the state board of nursing is to protect the public.

Rationale 2: The state board of nursing may support this effort, but this is not the basic function of the board.

Rationale 3: Overseeing nurse competence is a way to support the board’s basic purpose.

Rationale 4: The state board may restrict nursing practice in order to support its basic purpose.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 11.2 Describe the process for creating state boards of nursing and their authority, including limitations on their authority.

 

Question 4

Type: MCSA

A physician reported a case of possible nursing negligence to the state board of nursing. What action will be taken by the board?

  1. The complaint will be screened and an investigation initiated if appropriate.
  2. Nothing will be done as only another professional nurse is qualified to report nursing negligence.
  3. The nurse or nurses will be placed on probation pending investigation of the complaint.
  4. The incident will be recorded as a “first strike” against the nurse or nurses involved.

Correct Answer: 1

Rationale 1: A single complaint triggers action on the part of the board. The complaint is screened and an investigation is initiated, if appropriate.

Rationale 2: Any interested person can file a complaint with the board of nursing.

Rationale 3: There is no way to know if probation is necessary until an investigation is done.

Rationale 4: No action against the nurse is indicated until an investigation is completed.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 11.2 Describe the process for creating state boards of nursing and their authority, including limitations on their authority.

 

Question 5

Type: MCSA

The hospital nurse supervisor has concerns that a staff nurse is no longer capable of competent patient care because of alcohol use. Repeated counseling sessions with the nurse have not changed the behaviors that are of concern. What action should be taken by the supervisor?

  1. Report the concerns to the state board of nursing.
  2. Terminate the nurse’s hospital employment.
  3. Transfer the nurse to a non-patient care position.
  4. Nothing as the nurse might sue the supervisor.

Correct Answer: 1

Rationale 1: Of the options provided, the one most protective of public safety is to report concerns to the state board of nursing.

Rationale 2: Simply terminating employment does not address the problem at the nurse’s level and does not guarantee that the nurse will not have similar issues at the next place of employment.

Rationale 3: Transfer of the nurse to a non-patient care position is only a temporary solution and does not address the safety issues. Nurses can make errors that impact the public, even in non-patient care roles.

Rationale 4: Ignoring the problem for fear of suit will not make the problem go away.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 11.2 Describe the process for creating state boards of nursing and their authority, including limitations on their authority.

 

Question 6

Type: MCSA

The nurse is searching for the legal guide to the practice of registered nurse. Which document should the nurse review?

  1. ANA Code of Ethics
  2. State Nurse Practice Act
  3. Nurse’s Bill of Rights
  4. Nightingale Pledge

Correct Answer: 2

Rationale 1: The ANA Code of Ethics is the document that defines ethical principles for nurses.

Rationale 2: The state nurse practice act is the legal guide to define the scope of practice for nurses.

Rationale 3: The Nurse’s Bill of Rights are references to nurses’ rights, not specific legal aspects of nursing practice.

Rationale 4: The Nightingale Pledge is the nurses’ pledge or commitment to serving their patients derived from the writings of Florence Nightingale.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 11.3 Describe the process of how state nursing acts define the professional scope of practice.

 

Question 7

Type: MCSA

A nursing student reports that her grandmother served as a nurse in World War II. At the end of the war, her grandmother was licensed as a nurse, even though she never graduated from nursing school. Which type of exemption from licensure does this reflect?

  1. Grandfather clause
  2. Reciprocity
  3. Endorsement
  4. Licensure by waiver

Correct Answer: 1

Rationale 1: The grandfather clause is a form of exemption that allows certain persons working within a given profession prior to a given deadline to apply for licensure without meeting all the requirements for that licensure. It was used to allow World War II nurses with on-the-job training and expertise licensure as a nurse.

Rationale 2: Reciprocity allows a person who has a license in one state to practice in another state if the states have an agreement to do so.

Rationale 3: Endorsement is similar to reciprocity but there is no prior agreement among the states.

Rationale 4: Licensure by waiver is similar to licensure by exam. If the person meets the exam requirements without taking the test, the exam is waived and a license is issued.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 11.4 Describe entry into practice in relationship to state nursing practice acts.

 

Question 8

Type: MCMA

In which situations would the state board of nursing have probable grounds for disciplining a nurse?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. The nurse can no longer lift 30 pounds.
  2. The nurse fails to report a co-worker who is working outside his scope of practice.
  3. The nurse questioned a direct physician order.
  4. The nurse made a false statement on the licensure application.
  5. The nurse told a co-worker that she is taking antidepressant medications.

Correct Answer: 2,4

Rationale 1: Inability to lift 30 pounds may change where a nurse can safely work, but is not grounds for action against the license.

Rationale 2: Failure to report another person for fraudulent, incompetent, unprofessional, or unethical conduct is grounds for action against the non-reporter’s license.

Rationale 3: Questioning an order is not grounds for action against the nurse unless the questioning is done in an unethical or unprofessional manner.

Rationale 4: Making a false statement on the licensure application is grounds for action against the nurse’s license.

Rationale 5: If the nurse is seeking treatment for depression and the depression does not interfere with safe, competent nursing care there is no reason for disciplinary action.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 11.4 Describe entry into practice in relationship to state nurse practice acts.

 

Question 9

Type: MCMA

A nurse executive has requested that additional budgetary funds be allocated to support staff seeking a baccalaureate degree in nursing or specialty certification. Which information should this executive provide during discussions of this funding?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “Research shows no correlation between an increased number of BSN prepared nurses and increased nursing salaries.”
  2. “Nurse specialty certification has been shown to lower patient mortality.”
  3. “If our nursing staff is educated at a higher level and are certified we will see fewer lawsuits for negligence and malpractice.”
  4. Higher failure-to-rescue rates
  5. “Education at the BSN level, when coupled with specialty certification, has been shown to reduce adverse patient outcomes.”

Correct Answer: 2,4,5

Rationale 1: Typically nurses do receive salary increases as educational level increases.

Rationale 2: Kendall-Gallagher and colleagues (2011) concluded that hospitals’ nurse specialty certification lowers patient mortality.

Rationale 3: There is no evidence that this is the case.

Rationale 4: Higher rates of nurse specialty certification have been correlated with reduction of failure-to-rescue rates in hospital settings.

Rationale 5: Researchers have noted a reduction of adverse patient outcomes when specialty certification exists along with education at the BSN level.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 11.5 Analyze the impact of education on nursing practice issues.

 

Question 10

Type: MCSA

The patient tells the nurse that the physician mentioned deep tissue massage as treatment for rheumatoid arthritis. As a part of the subsequent conversation, the nurse demonstrates techniques and encourages the patient to begin a regimen immediately. What is true regarding this situation?

  1. Since back massage is a standard skill taught in nursing school, the nurse has no liability for these actions.
  2. The nurse’s liability centers on the recommendation to begin a massage regime.
  3. Since the physician initiated the discussion, the nurse has no liability.
  4. This nurse may be guilty of practicing massage without a license.

Correct Answer: 4

Rationale 1: The nurse is responsible for all nursing actions.

Rationale 2: The recommendation itself would probably not be a liability issue if the nurse was educated to make such a recommendation.

Rationale 3: The nurse is responsible for all nursing actions.

Rationale 4: Deep tissue massage goes beyond the bedtime “backrub” type of massage taught in nursing school and is used for a specific disease therapy, so the nurse may be guilty of practicing massage without a license. States differ on this licensure.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 11.6 Describe the legal ramifications of complementary and alternative medicine, including the medical use of cannabis (marijuana).

 

Question 11

Type: MCMA

The home health nurse discovers that a homebound cancer patient is using marijuana to control nausea from chemotherapy. What advice should the nurse give this patient?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. The effect of marijuana on decreasing nausea is fleeting and not worth the health problems caused by using it.
  2. Since the patient is homebound, it is likely the use of marijuana will not be discovered by anyone else.
  3. Possession of marijuana is illegal under federal law.
  4. Some states have current legislative guidelines for legal possession of medical marijuana.
  5. As long as it is documented that an illness exists that can be treated with marijuana, no risk of prosecution is present.

Correct Answer: 3,4

Rationale 1: Some patients report that marijuana does decrease nausea from chemotherapy.

Rationale 2: The nurse cannot legally advise the patient that it is permissible to break a law.

Rationale 3: Any possession of marijuana remains illegal under federal law.

Rationale 4: Some states do have such guidelines and if these are in place and followed, it is unlikely that federal charges would be pursued.

Rationale 5: The mere presence of an illness that can be treated with marijuana is not sufficient to avoid prosecution for the patient and those providing the substance.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 11.6 Describe the legal ramifications of complementary and alternative medicine, including the medical use of cannabis (marijuana).

 

Question 12

Type: MCSA

Which information would the nurse provide as rationale for supporting the nurse licensure and mutual recognition movements?

  1. Advancing technologies, especially telehealth and telephone triage makes single state licensure problematic.
  2. Some areas have an oversupply of nurses while others are still experiencing a nursing shortage.
  3. Multistate licensure will protect the safety of consumers who use call-in phone lines for health advice.
  4. The number of practicing nurses holding more than one state license is increasing.

Correct Answer: 1

Rationale 1: Advancing technologies such as telehealth and telephone triage have expanded practice beyond geographic boundaries.

Rationale 2: Multistate licensure is not a logical means of correcting this situation.

Rationale 3: There is no guarantee that changes in licensure will protect these patients.

Rationale 4: While this situation has some relation to mutual recognition and nurse licensure compacts it is not the most important force to consider.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 11.7 Discuss the status and future of nurse licensure compacts.

 

Question 13

Type: MCMA

The nurse holds original licensure in a compact state and has practice privileges in two remote states. Should practice concerns arise with this nurse in a remote state, what is the status of the nurse’s license?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. Only the state in which the nurse demonstrated poor practice can act to suspend or revoke the nurse’s license.
  2. License suspension or revocation can only occur if all three states agree to the action.
  3. Only the state in which the nurse holds licensure can act to suspend or revoke that license.
  4. The remote state can place the nurse’s license on probation.
  5. The remote state can limit or stop the nurse from practicing in that state.

Correct Answer: 3,5

Rationale 1: Action may be taken by the home state and the remote state where poor practice was demonstrated.

Rationale 2: All three states do not have to be in accordance with the action against this nurse’s license.

Rationale 3: Only the state that issued the license can suspend or revoke it.

Rationale 4: Only the home state can act against the license by using probation.

Rationale 5: The remote state would act against the practice privilege by limiting or stopping practice with a cease-and-desist order.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 11.7 Discuss the status and future of nurse licensure compacts.

 

Question 14

Type: MCMA

The patient decides to discontinue standard medical treatment for diabetes mellitus and to rely on diet and herbal medications for blood sugar control. Which statements, made by the nurse, are appropriate?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

  1. “You are an adult and can do anything you want to do.”
  2. “We need to talk about how medications work to control diabetes mellitus.”
  3. “Tell me more about why you decided to make this change.”
  4. “Don’t you know that you are gambling with your health?”
  5. “I think that would be a mistake.”

Correct Answer: 2,3

Rationale 1: This statement closes the conversation before additional assessment can be completed.

Rationale 2: This statement could be helpful in setting the stage for additional patient education.

Rationale 3: Before the nurse makes any other comments, more assessment must be done. Asking the patient to describe why this decision was made will help gather data for this assessment.

Rationale 4: This statement is not therapeutic and could be evaluated as belittling to the patient.

Rationale 5: The nurse should not offer this opinion, but should seek to continue talking with the patient about this choice.

Global Rationale:

 

Cognitive Level: Analyzing

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 11.8 Analyze some of the ethical issues surrounding licensure, certification, and scope of practice.

 

Question 15

Type: MCSA

The nurse has a strong religious conviction against elective sterilization procedures. When seeking employment, how should the nurse handle this belief?

  1. Request placement on a unit where care of these patients is unlikely.
  2. Be up front and discuss the issue during the employment interview.
  3. Say nothing about this belief as it is personal, private information.
  4. Be certain that this information is documented in the employment contract.

Correct Answer: 2

Rationale 1: While many units would be unlikely to receive such patients, it cannot be guaranteed that the nurse would never come into contact with them.

Rationale 2: The best strategy is to be up front about these beliefs and to discuss them at the time of the employment interview.

Rationale 3: While it is true that these are personal beliefs, they may impact the way the nurse is assigned or able to practice in given environments.

Rationale 4: There is no need to document the information in the contract.

Global Rationale:

 

Cognitive Level: Applying

Client Need: Safe Effective Care Environment

Client Need Sub: Management of Care

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 11.8 Analyze some of the ethical issues surrounding licensure, certification, and scope of practice.