Nurse Practice Acts and Tort Law

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Questions and Answers

What is the primary purpose of advanced directives in healthcare?

To allow patients to dictate treatment options at any stage of care

To provide patients more control over health care decisions at the end of life (correct)

To ensure that healthcare providers do not perform unnecessary procedures

To limit the responsibilities of healthcare providers

Which of the following statements is true regarding unintentional torts?

Negligence is a form of unintentional tort (correct)

They always involve the intent to harm another individual

They can only occur within a hospital setting

They are a result of intentional misconduct or negligence

What is indicated by an incident report in a healthcare setting?

It is used to identify patterns of potential liability or risk (correct)

It serves as a formal medical record for the patient

It must be noted in the patient's chart for legal reasons

It documents the care given to the patient during an emergency

What are the two primary forms of intentional torts that can occur in a healthcare setting?

Assault and defamation Signup and view all the answers

Under what circumstances must a nurse report suspected child abuse?

When there is reasonable suspicion of abuse Signup and view all the answers

Which of the following is an example of malpractice in nursing?

Failing to record a patient's vital signs Signup and view all the answers

What is the role of the healthcare provider when a patient refuses care?

To inform the patient about the risks of refusing care Signup and view all the answers

What does battery refer to in a legal context?

Unlawfully touching another person or threatening physical harm Signup and view all the answers

Which of the following is NOT a requirement for informed consent?

The process must involve coercion Signup and view all the answers

What is the legal classification for assaults and battery within healthcare?

Intentional torts Signup and view all the answers

In what situation is informed consent NOT required?

In emergency situations Signup and view all the answers

What should a nurse do if they observe ambiguous doctor orders?

Consult with a peer for clarification Signup and view all the answers

Which of the following actions is essential for protecting nursing licensure?

Notifying the board of nursing about address changes Signup and view all the answers

Which of these conditions must be reported to authorities?

Child and elder abuse Signup and view all the answers

How should a nurse approach understanding a client’s culturally based behavior?

Assess the client’s interaction with their family and friends Signup and view all the answers

What should a nurse do if they lose their nursing license?

Immediately report the loss and seek a duplicate Signup and view all the answers

What is required for the use of physical restraints on a patient?

An informed consent from the patient or proxy Signup and view all the answers

Under which circumstance can restraints be applied without a physician's order?

In an emergency situation for a very limited time Signup and view all the answers

Which of the following describes false imprisonment in a healthcare setting?

Unlawfully detaining a patient against their will Signup and view all the answers

What type of discharge requires a contract with the hospital until final discharge?

Conditional discharge Signup and view all the answers

What must be checked every 10-15 minutes for a restrained patient?

The neuromuscular status of the extremities Signup and view all the answers

When can psychotropic drugs be used as chemical restraints?

Only for diagnoses-related conditions Signup and view all the answers

What is a common time duration for restraint orders in psychiatric patients?

One hour Signup and view all the answers

Involuntary admissions can occur in which of the following instances?

When a patient poses a danger to themselves or others Signup and view all the answers

What does the nurse’s signature as a witness on a consent form indicate?

The client voluntarily signed the consent form. Signup and view all the answers

Which element is NOT part of the Good Samaritan Laws?

Care should be provided for compensation. Signup and view all the answers

What type of liability holds individuals accountable for their personal actions?

Individual liability Signup and view all the answers

Which of the following is considered a form of criminal law?

Manslaughter Signup and view all the answers

What distinguishes torts from other types of legal wrongs?

They involve compensation for the victim. Signup and view all the answers

Which scenario would NOT typically be covered under Good Samaritan Laws?

Conducting emergency care in an emergency room. Signup and view all the answers

What is a potential consequence of malpractice?

Civil penalties including compensation for damages. Signup and view all the answers

Which statement about vicarious liability is true?

It can involve shared liability with healthcare facilities. Signup and view all the answers

What must be established for a professional to owe a duty in a malpractice suit?

An established nurse-client relationship Signup and view all the answers

Which of the following is NOT a necessary element for a claim of malpractice?

Client must demonstrate understanding of the procedure Signup and view all the answers

During a procedure, nursing actions should prioritize which of the following?

Respecting the patient's dignity and privacy Signup and view all the answers

What constitutes defamation in a healthcare context?

Injuring an individual’s reputation through communication Signup and view all the answers

Which of the following best describes involuntary admission?

Admission resulting from an external decision on behalf of the patient Signup and view all the answers

What is the legal implication of breach of duty in a malpractice case?

The professional's actions must directly lead to the injury Signup and view all the answers

In terms of client property, what is required prior to searching belongings?

Specific authorization from the client Signup and view all the answers

What action qualifies as assault in a nursing context?

Threatening a procedure without consent Signup and view all the answers

What is the initial step in the nursing process?

Assessment Signup and view all the answers

Why is it important to verify data before implementation of a nursing action?

To clarify any doubts and ensure patient safety Signup and view all the answers

During suctioning, what risk is associated with stimulating the vagus nerve?

Hypoxia and potential cardiac arrest Signup and view all the answers

What type of data can only be perceived by the patient?

Subjective Data Signup and view all the answers

When assessing a patient’s pain, what action should a nurse take if the patient rates their pain as 0-4?

Use diversional therapy Signup and view all the answers

Which of the following is NOT a phase of the nursing process?

Interpretation Signup and view all the answers

What is a crucial consideration before administering potassium to a patient?

Assess the patient’s potassium levels Signup and view all the answers

Which principle should a nurse remember regarding suctioning children versus adults?

Suctioning duration for children is shorter than for adults Signup and view all the answers

Study Notes

Hospital Policy and Nurse Practice Acts

Hospital policies and state Nurse Practice Acts dictate the conditions of licensed nursing practice.
Nurses are legally obligated to report suspected child abuse.
Incident reports should not be documented in a patient's chart; instead, the filing of an incident report should be noted separately.
Healthcare providers must inform clients of potential risks associated with their care decisions, including decisions to leave against medical advice (AMA).
Advanced directives allow patients to control end-of-life healthcare decisions.

Tort Law

Civil wrongs are known as torts.
Intentional torts include assault, battery, defamation, false imprisonment, outrage, invasion of privacy, and wrongful disclosure of confidential information.
Negligence is an unintentional tort, involving a failure to act as a reasonable person would in similar circumstances.

Negligence

Intentional torts involve intentionally causing harm to another.
Malpractice comprises professional misconduct involving a lack of skill or care in professional duties.
Examples of malpractice include improper procedures (e.g., inserting a Foley catheter), failure to monitor a patient's condition, and failure to prevent falls.
Other examples include failure to report worsening conditions to a physician or failure to prevent falls.
Libel refers to written statements harming a person's reputation.
Slander refers to oral statements harming a person's reputation.
Assault is an attempt to injure someone physically or verbally.
Battery is unlawful physical contact with another person.

Durable Power of Attorney

A durable power of attorney enables a person to transfer healthcare decision-making authority to a designated agent.

Confidentiality

Patient information should only be accessed by those directly involved in client care.
Faxing or emailing patient information is permissible with written patient consent.
Informed consent is not required in emergency situations.
Specific situations for questioning orders include ambiguous orders, orders concerning client condition changes, orders inconsistent with the clinician's experience or licensure, and verbal physician orders requiring co-signing.

Legal Aspects of Nursing

State regulations govern nursing practice and establish regulatory agencies for licensing.

Reporting Obligations

Specific conditions, such as child or elder abuse, require reporting to the appropriate authorities. These conditions vary by state.

Capacity (e.g., age, competence) is crucial for valid consent.
Voluntariness (absence of force, fraud, deceit, coercion) must be demonstrated.
A healthcare professional witnesses consent, thereby validating voluntary consent, but it doesn't mean they explained the entire procedure.
Health care providers need not inform patients about the procedure if asked.

Good Samaritan Laws

Good Samaritan Laws encourage healthcare providers to help in emergencies.
They generally ensure that care is provided in good faith.
Care is usually gratuitous (no payment expected).
Professional expertise is expected at the level of an ordinary nurse in similar situations, but a higher level of care may be expected due to the professional's expertise or experience.

Liability

Healthcare professionals can be held liable individually or vicariously.
Individual liability arises from their own actions.
Vicarious liability can occur when a professional is held responsible for the actions of another individual or group.
This group could include fellow doctors, fellow nurses or institution such as a hospital.

Criminal Law

Criminal law involves wrongdoings against society.
Examples include violation of the nursing practice act, murder, manslaughter, false imprisonment, and narcotic violations.

Civil Law

Civil law involves wrongdoings against individuals or groups.
Torts (e.g., negligence, malpractice) are common examples.

Nursing Implications

Nurses are responsible for intervening if a patient's dignity or privacy is compromised.
Nurses must be careful to ensure the client's belongings and medical records are protected and handled appropriately.
Defamation involves harming a person's reputation through false statements, either written or spoken.
Assault involves threatening or attempting to harm someone.
Battery involves physically harming another.

Client Admission and Discharge

Voluntary admission occurs when a patient chooses to seek admission.
Involuntary admission occurs when admission is mandated by another person or authority.
Hospital discharges can be final, absolute, conditional, or incomplete.
Conditional or incomplete discharges may involve placement in a halfway house, nursing home, or other rehabilitation/monitoring facility.

Restraints

Using restraints without proper justification can lead to false imprisonment.
Restraints should be applied only when medically necessary and appropriate in response to a patient's harmful behaviors, and according to proper procedures and physician order.
Restraints should be documented on a regular basis, noting the presence and duration of restraints and any client reaction.

Nursing Process

Nurses use the nursing process (Assessment, Diagnosis, Planning, Implementation, and Evaluation) to systematically provide patient care.
Assessment includes gathering data (both subjective and objective) on the patient's condition.
Specific lab values are crucial to analyze the patient's condition (e.g., RBC, WBC, Hemoglobin, and Hematocrit)

Confidentiality in Nursing Care

Patient confidentiality is vital.
The right to confidentiality can only be violated in specific, necessary circumstances, such as potential suicide or harm.
Nurses must protect patient information from unnecessary disclosure and unauthorized access.
Specific conditions, like communication of communicable diseases, gunshot/knife wounds, elder or child abuse, psychiatric situations (e.g., suicidal tendencies) may necessitate disclosure of certain information.

Patient Rights in Nursing

Nurses must actively protect patients' rights.
Nurses should take appropriate steps to protect patients from harm, including preventing falls, avoiding inappropriate touching, and clearing and maintaining a safe environment.

Maslow's Hierarchy of Needs

Maslow's hierarchy of needs is a framework that organizes human needs into a pyramid, starting from basic physiological needs to more complex needs such as self-actualization.

Nursing Procedures

Standard precautions and hand hygiene are essential to prevent the transmission of infectious diseases.
Nurses must follow evidence-based guidelines to perform specific procedures like blood transfusions, wound care, and administering medications.

Advance Care Directives

Advance care directives such as living wills and durable power of attorney for healthcare are crucial legal documents that outline patient preferences regarding medical treatment.
These documents outline the patient's desires regarding life-sustaining treatments, end-of-life care, and the appointment of someone to make healthcare decisions if they lose the capacity.

Euthanasia and Assisted Suicide

Euthanasia involves actively ending a patient's life, while assisted suicide involves providing the means for a patient to end their own life.
The legality and ethics of these practices vary by jurisdiction. Nurses must adhere to their professional code of conduct and relevant laws.

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Description

This quiz covers important aspects of nurse practice acts and tort law, including the legal obligations of nurses and the types of torts such as negligence and intentional torts. Understand how hospital policies guide nursing practices and the implications of healthcare decisions. Test your knowledge on legal responsibilities in nursing.