Nursing Chapter 2: Legal and Ethical Aspects
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What is the purpose of the nurse practice act (NPA) of the state of licensure?

  • Enforce the standards of nursing care
  • Set the nurse's educational requirements
  • Define the scope of nursing practice (correct)
  • Determine the quality of nursing care

    • Which role is considered a primary duty of patient advocacy?

  • To safeguard the well-being of every patient (correct)
  • To complete all nursing responsibilities on time
  • To act as the patient's legal representative
  • To maintain the patient's right to privacy

    • What is the most likely verdict if a nurse allows a patient to walk alone despite an order to assist, resulting in a fall?

  • The nurse will be found guilty of malpractice
  • The nurse will be guilty of negligence (correct)
  • The nurse will not be found liable for any harm
  • The nurse will be charged with technical battery

    • The patient's right to refuse medication is established by which act?

    <p>The patient self-determination act</p> Signup and view all the answers

    What is one of the best defenses against a lawsuit for a nurse?

    <p>Promote a positive nurse-patient relationship</p> Signup and view all the answers

    The ethical principle that reflects treating all patients as individuals is known as:

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

    What is the purpose of a code of ethics for LPN/LVNs?

    <p>Promote trustworthy, accountable LPN/LVNs</p> Signup and view all the answers

    Which issue must be considered before answering a patient's daughter's question about whether her mother should have surgery?

    <p>Confidentiality and invasion of privacy</p> Signup and view all the answers

    Before helping families cope with terminal illnesses, what should a nurse do?

    <p>Evaluate personal mores and customs</p> Signup and view all the answers

    What is the purpose of an advance directive in a patient's medical record?

    <p>Encourage a person to determine how they will die</p> Signup and view all the answers

    The ethical principle that states all patients have the right to care regardless of demographics is known as:

    <p>Justice</p> Signup and view all the answers

    If a nurse administers an injection to an alert patient who refused it, they could be charged with:

    <p>Civil battery</p> Signup and view all the answers

    Taking a photograph of a patient without consent is considered a violation of:

    <p>The patient's right to privacy</p> Signup and view all the answers

    What legal violation occurs when a patient care notebook with specific patient information is lost?

    <p>Violated HIPAA</p> Signup and view all the answers

    What should a newly licensed nurse do if they have never performed catheterization?

    <p>Review the agency procedure and ask for help</p> Signup and view all the answers

    What statement would be appropriate regarding nursing liability?

    <p>A supervisor has some liability for staff training.</p> Signup and view all the answers

    Which positive outcome can social media provide within the nursing profession?

    <p>Networking between professionals</p> Signup and view all the answers

    What should be communicated to nurses regarding posting clinical experiences on social media?

    <p>Any identifiable information is a violation.</p> Signup and view all the answers

    Which statement characterizes criminal law?

    <p>Applies to conduct detrimental to society.</p> Signup and view all the answers

    What term describes injury to a person or property that allows for legal action?

    <p>Harm</p> Signup and view all the answers

    What resource should LPN/LVNs refer to for their scope of practice?

    <p>Nurse practice act of their licensing state</p> Signup and view all the answers

    If there's a breach in the nurse-patient relationship resulting in harm, what legal action can be taken?

    <p>Malpractice</p> Signup and view all the answers

    What must a patient sign to acknowledge understanding before surgery?

    <p>Informed consent doctrine</p> Signup and view all the answers

    What ethical principle ensures all patients have the same right to nursing interventions?

    <p>Justice</p> Signup and view all the answers

    What federal regulation affects patient privacy in healthcare?

    <p>Health Insurance Portability and Accountability Act</p> Signup and view all the answers

    What should a nurse know about the legality of advance directives?

    <p>State laws</p> Signup and view all the answers

    What factors increase the risk of abuse in older adults?

    <p>Declining mental ability</p> Signup and view all the answers

    What is the first document filed in a legal action?

    <p>Complaint</p> Signup and view all the answers

    What is formed when a nurse assumes responsibility for a patient's care?

    <p>Nurse-patient relationship</p> Signup and view all the answers

    What guidelines define appropriate measures for nursing interventions?

    <p>Standard of care</p> Signup and view all the answers

    What law should a nurse check before administering IV chemotherapy?

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

    What could a nurse be found guilty of for failing to irrigate a feeding tube as ordered?

    <p>Malpractice</p> Signup and view all the answers

    What has become law to protect patient expectations regarding health care services?

    <p>American Hospital Association's Patient's Bill of Rights</p> Signup and view all the answers

    What must be completed before performing a procedure on a patient?

    <p>Informed consent</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>Absolute secrecy</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>Take photographs of the bruises</p> Signup and view all the answers

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

    <p>Carry malpractice insurance</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</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</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>Professional organization</p> Signup and view all the answers

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

    <p>Caregiver</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>Go ahead and do it</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</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</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>A worker who arrives late</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</p> Signup and view all the answers

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

    <p>Administering a stronger dose of drug than was ordered</p> Signup and view all the answers

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

    <p>Dragging an injured motorist off the highway and causing further injury</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>Assault</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</p> Signup and view all the answers

    What is true about nurse practice acts?

    <p>They informally define the scope of nursing practice</p> Signup and view all the answers

    How can the medical record be used in litigation? (Select all that apply)

    <p>Documentation of time lapses</p> Signup and view all the answers

    During lunch break, an emergency department (ED) nurse truthfully tells another nurse about the condition of a patient who came to the ED last night. What is the ED nurse guilty of? (Select all that apply)

    <p>HIPAA violation</p> Signup and view all the answers

    A nurse failed to monitor a patient's respiratory status after medicating the patient with a narcotic analgesic. The patient's respiratory status worsened, requiring intubation. The patient's family claimed the nurse committed malpractice. What must be present for the nurse to be held liable? (Select all that apply)

    <p>A nurse-patient relationship exists</p> Signup and view all the answers

    Personal beliefs about the worth of an object, idea, custom, or attitude that influence a person's behavior in a given situation are referred to as__________.

    <p>values</p> Signup and view all the answers

    Acts whose performance is required, permitted, or prohibited are defined by____________ of care.

    <p>standards</p> Signup and view all the answers

    What is the concept of do no harm?

    <p>Nonmaleficence</p> Signup and view all the answers

    What does accountability mean in nursing?

    <p>Willingness to take credit and blame for actions</p> Signup and view all the answers

    What type of civil law involves wrongs against a person or property?

    <p>Tort</p> Signup and view all the answers

    Study Notes

    • The Nurse Practice Act (NPA) defines the scope of nursing practice and sets forth educational requirements.
    • Patient advocacy involves safeguarding the well-being of patients, maintaining their rights, and ensuring privacy.
    • Allowing a patient to walk alone after an order to assist can lead to negligence and potential legal liability.
    • Patients have the right to refuse medication, established under the Patient Self-Determination Act.
    • Building a positive nurse-patient relationship is a strong defense against lawsuits.
    • The ethical principle emphasizing treating all patients as individuals is respect for people.
    • A code of ethics for nurses promotes trustworthiness and accountability.
    • Patient confidentiality is critical, especially when discussing healthcare decisions with family members.
    • Nurses should evaluate personal beliefs and customs that may affect care, especially in sensitive situations.
    • An advance directive empowers patients to determine their treatment preferences.
    • Justice in nursing means providing equal care to all patients, regardless of their background.
    • Administering treatment without consent can lead to civil battery charges.
    • Breaching patient privacy by sharing information or images can have legal consequences.
    • Nurses must adhere to the Health Insurance Portability and Accountability Act (HIPAA) to protect patient information.
    • Legal guidelines regarding what nurses can do are outlined in their state’s nurse practice act.
    • Malpractice can occur when there’s a breach of the nurse-patient relationship resulting in harm.
    • Informed consent must be obtained before medical procedures are performed.
    • Standards of care are essential for ensuring appropriate nursing interventions.
    • The Nurse Practice Act provides legal guidelines governing what nurses are permitted to do in their practice.
    • Ethical principles in nursing include justice, beneficence, and nonmaleficence.
    • Federal regulations protecting patient information include the Health Insurance Portability and Accountability Act (HIPAA).
    • State laws govern the legality of advance directives concerning patients' treatment wishes.
    • Vulnerability factors for older adults at risk of abuse include decreased strength, isolation, and declining mental ability.
    • The initiation of a legal action begins with filing a complaint in court.
    • A nurse-patient relationship forms a legally binding contract for care responsibilities.
    • Ethical responsibilities include maintaining patient confidentiality regarding health information.
    • Suspected elder abuse must be reported immediately to the charge nurse for further investigation.
    • Providing compassionate, competent care is the best strategy for avoiding legal issues.
    • Compliance with a do-not-resuscitate (DNR) order is a legal obligation, regardless of personal beliefs.
    • Nurses have the right to request reassignment if their moral convictions conflict with assigned tasks.
    • Understanding standards of care is critical for determining permissible nursing actions.### Nurse Roles and Responsibilities
    • Nurses serve as advocates for patients, ensuring their interests are protected alongside providing care.
    • For procedures not previously performed, nurses should discuss concerns with the charge nurse for guidance rather than refusing outright.

    Patient Care and Ethical Principles

    • During values clarification, nurses must withhold personal opinions to encourage patient expression.
    • The fundamental ethical principle in decision-making is respect for people, emphasizing dignity and individual rights.

    Reporting and Accountability

    • Nurses must report unethical behavior of colleagues to uphold professional standards and patient safety.
    • Institutional malpractice insurance typically only covers actions performed during official duty hours.
    • Violations of HIPAA can occur through improper handling of patient information, such as leaving documents unattended at the photocopier.
    • Malpractice can occur if a nurse administers medications to patients with known allergies or health complications.
    • Performing procedures without informed consent may lead to civil battery claims against healthcare providers.
    • Patient care negligence, like failing to monitor vital signs after medication, demonstrates malpractice due to breach of duty.

    Nurse Practice Acts and Standards

    • Nurse practice acts define legal scopes of nursing and are essential for nurses to understand within their jurisdiction.
    • Care standards delineate required, permitted, or prohibited actions necessary for quality patient care.
    • Negligence refers to carelessness and can involve medication errors or inadequate monitoring.
    • Key malpractice elements include established duty, breach of that duty, and resultant harm to the patient.

    Ethical Principles and Metrics

    • Core ethical principles in nursing encompass autonomy, beneficence, nonmaleficence, justice, and respect for persons.
    • The Patient Self-Determination Act (PSDA) ensures patients can make informed choices about their medical care and treatment options.
    • Patients are entitled to dignity, privacy, safety**, and complete information about their health conditions.
    • Nurses must ensure competent and compassionate care to avoid potential lawsuits and foster trust in the nurse-patient relationship.

    Documentation and Litigation

    • Medical records serve crucial purposes in litigation, including proof of adherence to standards and evidence of any omissions.
    • Violations such as discussing a patient’s condition with unauthorized parties can lead to HIPAA violations and legal repercussions.

    Professional Ethics and Standards

    • The Code of Ethics for Nurses provides guidelines to ensure the moral integrity of nursing practices.
    • Effective communication and thorough documentation reduce the risk of malpractice claims against nurses.
    • Various forms of defamation exist: libel (written) and slander (spoken), both can impact a nurse’s professional standing.
    • In the context of torts, nurses must be vigilant about actions that could be construed as wrongful against patients.
    • To minimize malpractice risks, nurses should focus on trust-building, open communication, and thorough patient assessment.

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    Test your knowledge on the legal and ethical aspects of nursing as outlined in Chapter 2. This quiz includes flashcards that cover important concepts such as the nurse practice act and standards of nursing care. Perfect for newly licensed nurses to understand their professional scope.

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