Chapter 01: The Evolution of Nursing
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Questions and Answers

When a nurse becomes involved in a legal action, the first step to occur is that a document is filed in an appropriate court. What is this document called?

  • Complaint (correct)
  • Summons
  • Appeal
  • Deposition

The nurse caring for a patient in the acute care setting assumes responsibility for a patient’s care. What is this legally binding situation?

  • Nurse-patient relationship (correct)
  • Accountability
  • Standard of care
  • Advocacy

What are the universal guidelines that define appropriate measures for all nursing interventions?

  • Standard of care (correct)
  • Scope of practice
  • Prudent practice
  • Advocacy

An LPN/LVN is asked by the RN to administer an IV chemotherapeutic agent to a patient in the acute care setting. What law should this nurse refer to before initiating this intervention?

<p>Nurse practice act (C)</p> Signup and view all the answers

A nurse fails to irrigate a feeding tube as ordered, resulting in harm to the patient. This nurse could be found guilty of:

<p>malpractice (B)</p> Signup and view all the answers

Patients have expectations regarding the health care services they receive. To protect these expectations, which of the following has become law?

<p>American Hospital Association’s Patient’s Bill of Rights (D)</p> Signup and view all the answers

The nurse is preparing the patient for a thoracentesis. What must be completed before the procedure may be performed?

<p>Informed consent (D)</p> Signup and view all the answers

When a nurse protects the information in a patient’s record, what ethical responsibility is the nurse fulfilling?

<p>Confidentiality (A)</p> Signup and view all the answers

An older adult is admitted to the hospital with numerous bodily bruises, and the nurse suspects elder abuse. What is the best nursing action?

<p>Report the bruises to the charge nurse. (D)</p> Signup and view all the answers

What is the best way for a nurse to avoid a lawsuit?

<p>Provide compassionate, competent care. (C)</p> Signup and view all the answers

The nurse is caring for a patient with a do-not-resuscitate (DNR) order. Although the nurse may disagree with this order, what is his or her legal obligation?

<p>To follow the order (A)</p> Signup and view all the answers

The nurse has strong moral convictions that abortions are wrong. When assigned to assist with an abortion, what is the most appropriate action for the nurse to take?

<p>Ask for another assignment. (C)</p> Signup and view all the answers

The new LPN/LVN is concerned regarding what should or should not be done for patients. What resource will best provide this information?

<p>Standards of care (D)</p> Signup and view all the answers

What role is the nurse who diligently works for the protection of patients’ interests playing?

<p>Advocate (D)</p> Signup and view all the answers

When asked to perform a procedure that the nurse has never done before, what should the nurse do to legally protect himself or herself?

<p>Discuss it with the charge nurse, asking for direction. (D)</p> Signup and view all the answers

The nurse is assisting a patient to clarify values by encouraging the expression of feelings and thoughts related to the situation. What is the most appropriate action for the nurse?

<p>Withhold an opinion. (D)</p> Signup and view all the answers

What fundamental principle must the nurse first observe when confronted with an ethical decision?

<p>Respect for people (C)</p> Signup and view all the answers

A nurse working on an acute care medical surgical unit is aware that his or her first duty is to the patient’s health, safety, and well-being. Given this knowledge, which of the following is most necessary for the nurse to report?

<p>Unethical behavior of other staff members (B)</p> Signup and view all the answers

A nurse is considering purchasing malpractice insurance. What should the nurse be aware of regarding malpractice insurance provided by the hospital?

<p>Only offers protection while on duty. (B)</p> Signup and view all the answers

Which is a nursing care error that violates the Health Insurance Portability and Accountability Act (HIPAA)?

<p>Leaving a copy of the patient’s history and physical in the photocopier (B)</p> Signup and view all the answers

Which of the following could cause a nurse to be cited for malpractice?

<p>Giving prochlorperazine (Compazine) to a patient allergic to phenothiazines (A)</p> Signup and view all the answers

A lumbar puncture was performed on a patient without a signed informed consent form. This patient might sue for:

<p>civil battery (A)</p> Signup and view all the answers

A health care provider instructs the nurse to bladder train a patient. The nurse clamps the patient’s indwelling urinary catheter but forgets to unclamp it. The patient develops a urinary tract infection. What do the nurse’s actions exemplify?

<p>Malpractice (C)</p> Signup and view all the answers

What is true about nurse practice acts?

<p>The nurse must know the nurse practice act within his or her state. (D)</p> Signup and view all the answers

What does documentation of type of care, time of care, and signature of the person prove?

<p>Interventions were implemented to meet the patient’s needs. (D)</p> Signup and view all the answers

Why is documentation especially significant in managed care?

<p>Institutions are reimbursed only for patient care that is documented. (B)</p> Signup and view all the answers

The nurse charts only additional treatments done, changes in patient condition, and new concerns. What is this system of documentation?

<p>CBE (A)</p> Signup and view all the answers

What type of charting involves a chronological record of assessments, interventions, and the patient’s responses?

<p>Narrative (C)</p> Signup and view all the answers

Which charting method is an organized way to record the patient’s progress toward achieving the goals outlined in the plan of care?

<p>Focus (B)</p> Signup and view all the answers

Which charting system uses problem-oriented medical records (POMR) to document the patient’s care?

<p>SOAP (C)</p> Signup and view all the answers

The nurse discovers a discrepancy in the patient's medication record. What should the nurse do first?

<p>Notify the health care provider who prescribed the medication. (D)</p> Signup and view all the answers

Which charting format is often used for nurses working in acute care settings?

<p>SOAP (B)</p> Signup and view all the answers

What should the nurse do when documenting patient care?

<p>Document accurately, concisely, and objectively. (B)</p> Signup and view all the answers

Why is it important for the nurse to correctly document the time of an event?

<p>To ensure that the nurse is able to provide accurate information to other members of the health care team (A)</p> Signup and view all the answers

What type of charting involves documenting only the exception to the norm or the unusual occurrences?

<p>DAR (C)</p> Signup and view all the answers

When using the SOAP charting method, what does the ‘S’ represent?

<p>Subjective (A)</p> Signup and view all the answers

Which charting method uses a structured format for recording patient data and progresses based on their problems?

<p>SOAP (B)</p> Signup and view all the answers

What type of documentation, often used for nurses working in community settings, uses a problem-oriented format combined with a flow sheet that documents specific data points?

<p>PIE (A)</p> Signup and view all the answers

What type of documentation system focuses on providing a brief, specific account of the patient’s care using a checklist or a standardized form?

<p>Focus (B)</p> Signup and view all the answers

When documenting patient care the nurse should use medical terminology for all entries.

<p>False (B)</p> Signup and view all the answers

It is acceptable to document patient care at the end of the shift if a nurse is very busy.

<p>False (B)</p> Signup and view all the answers

If the nurse made an error in the patient's chart, they should erase it and make the correct entry.

<p>False (B)</p> Signup and view all the answers

The nurse is responsible for ensuring that all entries in a patient’s chart are accurate and complete.

<p>True (A)</p> Signup and view all the answers

The nursing process is a systematic approach to patient care that is not necessary when documenting patient care.

<p>False (B)</p> Signup and view all the answers

The patient’s medical record is a legal document that can be used as evidence in a court of law.

<p>True (A)</p> Signup and view all the answers

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Flashcards

What is a complaint?

A document filed in an appropriate court as the first step in litigation.

What is the nurse-patient relationship?

A legally binding situation formed when a nurse assumes responsibility for a patient's care.

What are standards of care?

Universal guidelines defining appropriate measures for nursing interventions.

What are nurse practice acts?

Laws defining and limiting the scope of nursing practice.

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What is malpractice?

A nurse's failure to meet a legal duty, causing harm to a patient.

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What is the Patient's Bill of Rights?

The American Hospital Association's document outlining patients' expectations for treatment with dignity and compassion.

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What is informed consent?

Full disclosure of facts for a patient to make an informed decision before an invasive procedure.

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What is confidentiality?

The ethical responsibility of a nurse to protect patient information.

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What is mandatory reporting?

The nurse's legal obligation to report suspicious circumstances, such as elder abuse.

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What is the best defense against a lawsuit?

Providing compassionate and competent nursing care to avoid legal issues.

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What is the legal obligation when a patient has a DNR order?

The nurse's legal and ethical obligation to follow a DNR order even if they disagree with it.

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What is the most appropriate action for a nurse when assigned to a procedure that conflicts with their personal beliefs?

Asking for another assignment when faced with a moral conflict.

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What are values?

Personal beliefs about the worth of things that influence behavior.

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What are standards of care?

Acts that are required, permitted, or prohibited as defined by standards of care.

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What does documentation of care prove?

Recording interventions to meet patient needs, proving care was given.

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Why is documentation significant in managed care?

Reimbursement for documented care, emphasizing importance of accurate records.

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What is CBE (charting by exception)?

Charting only deviations from standard care, for efficiency.

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What is autonomy?

The ethical principle of respecting people's choices and freedom to make decisions.

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What is beneficence?

The ethical principle of acting in the best interests of the patient.

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What is nonmaleficence?

The ethical principle of avoiding harm to the patient.

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What does the nurse need to report?

Reporting unethical behavior by colleagues to protect patient health and safety.

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What should the nurse know about hospital-provided malpractice insurance?

Hospital malpractice insurance only covers incidents occurring while the nurse is on duty.

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What is a violation of HIPAA related to documentation?

A violation of HIPAA, exposing patient information to the public.

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What could cause a nurse to be cited for malpractice related to medication administration?

Providing inappropriate medications or dosages, potentially leading to malpractice.

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What could a patient sue for if a procedure is performed without informed consent?

A lawsuit for civil battery, claiming unlawful physical contact without consent.

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What do a nurse's actions exemplify when they fail to perform a necessary intervention resulting in harm?

A nurse's actions leading to harm due to negligence or omission, potentially leading to malpractice.

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What is true about nurse practice acts?

Knowing the nurse practice act within their state, a responsibility for safe practice.

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How can the medical record be used in litigation?

The medical record can be used as evidence in a lawsuit.

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What is the ED nurse guilty of when sharing patient information with another nurse during their lunch break?

Violating HIPAA and invading a patient's privacy.

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What must be present for a nurse to be held liable for malpractice?

The nurse must demonstrate a duty of care, a breach of duty, and harm to the patient for the nurse to be held liable for malpractice.

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Study Notes

Chapter 01: The Evolution of Nursing

  • Nursing program approval is certification by a state agency, meeting minimum standards
  • Nursing program accreditation is by the NLN, meeting more complex standards
  • Health care delivery systems aim for optimal health care levels
  • Emphasis on wellness in healthcare stems from education on preventive medicine, including issues like smoking, heart disease, and weight control
  • Individualized care plans are used by all healthcare team members, outlining patient-specific care
  • Effective care plan evaluation relies on communication amongst the healthcare team
  • Interdisciplinary approaches to patient care prevent fragmentation
  • LPN/LVNs practice under supervision of a healthcare provider or RN
  • Florence Nightingale championed sanitary conditions and improved patient environments
  • Understanding the Nurse Practice Act is crucial for LPN/LVNs
  • Cost-effective care delivery, like case management, lets LPN/LVNs work with RNs
  • Patient's Bill of Rights is the AHA document outlining patient expectations
  • Nursing models are theories related to nursing, patients, health, and environment
  • Cross-training reduces staffing while maintaining care quality
  • Nurse licensing laws protect the public from unqualified providers
  • Maslow's Hierarchy of Needs prioritizes basic needs before higher-level needs
  • Environmental factors (physical and social) mutually affect health and illness
  • Cadet Nurse Corps provided nursing education and training during WWII
  • Articulation programs advance LPN/LVN education to RN standing
  • Florence Nightingale trained at Kaiserswerth School
  • Holistic health care considers physical, emotional, social, and spiritual needs
  • National Federation of Licensed Practical Nurses (NFLPN) is the LPN/LVN membership organization
  • A "pass" score on a computerized exam allows licensed vocational nurses to be licensed
  • The 1965 ANA position paper defined registered and technical nurses
  • Legal action begins with a complaint filed in court
  • The nurse-patient relationship is a legally binding responsibility assumed by the nurse
  • Universal nursing intervention guidelines are called standards of care
  • Before administering IV chemotherapeutic agents, LPN/LVNs must refer to the nurse practice act
  • Malpractice arises from failing to meet a legal duty and causing harm
  • The American Hospital Association's Patient's Bill of Rights protects patient expectations
  • Informed consent is needed before invasive procedures
  • Confidentiality in patient records is an ethical responsibility
  • Reporting suspected elder abuse is a legal obligation
  • Providing compassionate and competent care avoids potential lawsuits
  • Following a DNR order is a legal obligation for the nurse
  • It's appropriate for a nurse to request reassignment if morally conflicted with a procedure
  • Knowing the standards of care guides nursing decisions
  • A nurse functions as an advocate to protect patient interests
  • Discussing procedures with the charge nurse is appropriate when unsure
  • A nurse can assist in values clarification without offering personal opinions
  • Respect for people is the first principle to consider in ethical decisions
  • Nurses are expected to report unethical behaviors by other staff
  • Hospital malpractice insurance generally only covers on-duty liability
  • HIPAA violations occur when patient information is improperly disclosed
  • Malpractice arises from administering an inappropriate medication or procedure
  • Performing an invasive procedure without informed consent leads to potential civil battery charges
  • Nurses are liable for actions taken while fulfilling their professional duties
  • Nurse practice acts define the scope of nursing practice and are adopted by all US/Canadian states.

Chapter 03: Documentation

  • Documentation of care (type, time, signature) demonstrates care provision
  • Documentation is crucial in managed care because reimbursement depends on it
  • Charting by exception (CBE) details only changes, not usual care

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Description

This quiz explores the foundational concepts presented in Chapter 01 of nursing education. Key topics include nursing program accreditation, health care delivery systems, individualized care plans, and the historical contributions of Florence Nightingale. Understanding these principles is essential for nursing students and professionals.

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