Critical Care Nursing: Diagnosis and Management 8th Edition Test Bank

 

UNIT SIX: KIDNEY ALTERATIONS 19. Kidney Clinical Assessment and Diagnostic Procedures 20. Kidney Disorders and Therapeutic Management

UNIT SEVEN: GASTROINTESTINAL ALTERATIONS 21. Gastrointestinal Clinical Assessment and Diagnostic Procedures 22. Gastrointestinal Disorders and Therapeutic Management

UNIT EIGHT: ENDOCRINE ALTERATIONS 23. Endocrine Clinical Assessment and Diagnostic Procedures 24. Endocrine Disorders and Therapeutic Management

UNIT NINE: MULTISYSTEM ALTERATIONS 25. Trauma 26. Shock, Sepsis, and Multiple Organ Dysfunction Syndrome 27. Hematological Disorders and Oncological Emergencies Appendix A. Nursing Management Plans of Care Appendix B. Physiologic Formulas for Critical Care

Index

Chapter 03: Legal Issues

Urden: Critical Care Nursing, 8th Edition

MULTIPLE CHOICE

1. What is the legal standard of care for a nurse’s actions?

a.	Minimal competency under the state Nurse Practice Act
b.	The ability to distinguish what is right or wrong for the patient
c.	The demonstration of satisfactory knowledge of policies and procedures
d.	The care that an ordinary prudent nurse would perform under the same circumstances

ANS: D

The legal standard of care for nurses is established by expert testimony and is generally “the care that an ordinarily prudent nurse would perform under the same circumstances.”

PTS: 1 DIF: Cognitive Level: Understanding REF: p. 27

OBJ:Nursing Process Step: N/ATOP:Legal

MSC: NCLEX: Safe and Effective Care Environment

2. A patient is admitted with chest pain, and his electrocardiogram shows elevated ST segments. The nurse bases her plan of care on the nursing diagnosis of pneumonia. What type of negligence may be present?

a.	Assessment failure
b.	Planning failure
c.	Implementation failure
d.	Evaluation failure

ANS: B

Basing nursing care on an erroneous diagnosis is a failure in planning. Standards of care include assessment, the collection of relevant data pertinent to the patient’s health or situation; diagnosis, analysis of the assessment data in determining diagnosis and care issues; implementation, coordinating care delivery and plan and using strategies to promote health and a safe environment; and evaluation, evaluation of the progress of the patient toward attaining outcomes.

PTS: 1 DIF: Cognitive Level: Analyzing REF: p. 27|p. 30|Box 3-3

OBJ:Nursing Process Step: AssessmentTOP:Legal

MSC: NCLEX: Safe and Effective Care Environment

3. What is an injury resulting from the failure to meet an ordinary duty called?

a.	Negligence
b.	Malpractice
c.	Assault
d.	Battery

ANS: A

Injury resulting from the failure to meet an ordinary duty or standard of care is negligence. Malpractice is a specialized form of negligence. Assault and battery are examples of intentional acts.

PTS: 1 DIF: Cognitive Level: Understanding REF: pp. 27-28

OBJ:Nursing Process Step: N/ATOP:Legal

MSC: NCLEX: Safe and Effective Care Environment

4. A night nurse is notified by the laboratory that the patient has a critical magnesium level of 1.1 mEq/L. The patient has a do-not-resuscitate order. The nurse does not notify the practitioner because of the patient’s code status. In doing so, the nurse is negligent for what?

a.	Failure to analyze the level of care needed by the patient
b.	Failure to respect the patient’s wishes
c.	Wrongful death
d.	Failure to take appropriate action

ANS: D

Nurses caring for acutely and critically ill patients must appropriately notify physicians of situations warranting treatment actions. Furthermore, the full no-code, do-not-resuscitate order does not exclude this patient from receiving treatment to correct the critical laboratory value. Failure to take appropriate action in cases involving acutely and critically ill patients has included not only physician-notification issues but also failure to follow physician orders, failure to properly treat, and failure to appropriately administer medication.

PTS: 1 DIF: Cognitive Level: Applying REF: pp. 28-29

OBJ: Nursing Process Step: Assessment | Nursing Process Step: Implementation

TOP: Legal MSC: NCLEX: Safe and Effective Care Environment

5. Two nurses are talking about a patient’s condition in the cafeteria. In doing so, these nurses could be accused of what?

a.	Failure to take appropriate action
b.	Failure to timely communicate patient findings
c.	Failure to preserve patient privacy
d.	Failure to document patient information

ANS: C

Nurses have a duty to preserve patient privacy, and failure to do so is a breach of patient confidentiality and failure to preserve patient privacy. Nurses should also refrain from having discussions about specific patients with anyone except other health care professionals involved in the care of the patient. When discussing specific patients with other health care professionals, it is imperative that patient-specific discussions occur in non-public settings. Discussions about specific patients are never appropriate in public areas such as elevators, cafeterias, gift shops, and parking lots.

PTS: 1 DIF: Cognitive Level: Applying REF: p. 31

OBJ:Nursing Process Step: AssessmentTOP:Legal

MSC: NCLEX: Safe and Effective Care Environment

6. What is negligence called when it applies to an individual who is a professional?

a.	Breach
b.	Malpractice
c.	Duty
d.	Harm

ANS: B

Whereas negligence claims may apply to anyone, malpractice requires the alleged wrongdoer to have special standing as a professional. If a nurse caring for acutely and critically ill patients is accused of failing to act in a manner consistent with the standard of care, that nurse is subject to liability for professional malpractice (negligence applied to a professional).

PTS: 1 DIF: Cognitive Level: Understanding REF: p. 28

OBJ:Nursing Process Step: N/ATOP:Legal

MSC: NCLEX: Safe and Effective Care Environment

7. A nurse fails to recognize an intubated patient’s need for suctioning. The endotracheal tube becomes clogged, and the patient has a respiratory arrest. What type of negligence may be present?

a.	Assessment failure
b.	Planning failure
c.	Implementation failure
d.	Evaluation failure

ANS: A

Nurses have a duty to assess and analyze the care required by each patient they care for. Failure to do so puts the nurse at risk for negligence related to failure to assess the patient’s needs.

PTS: 1 DIF: Cognitive Level: Analyzing REF: p. 30

OBJ:Nursing Process Step: AssessmentTOP:Legal

MSC: NCLEX: Safe and Effective Care Environment

8. What element of malpractice is based on the existence of a nurse–patient relationship?

a.	Duty
b.	Breach
c.	Damages
d.	Harm caused by the breach

ANS: A

Duty to the injured party is the first element of a malpractice case and is premised on the existence of a nurse–patient relationship. Breach is failure to act consistently within applicable standards of care. Harm caused by the breach occurs when the patient sustained injuries because of the breach of duty. Damages are derived from the harm or injury sustained by the acutely or critically ill patient and are calculated as a dollar amount.

PTS: 1 DIF: Cognitive Level: Understanding REF: p. 28

OBJ:Nursing Process Step: N/ATOP:Legal

MSC: NCLEX: Safe and Effective Care Environment

9. A patient is getting heparin by intravenous infusion. The nurse received an order to increase the heparin infusion rate and obtain a partial thromboplastin time (PTT) in 1 hour. The PTT was drawn correctly and revealed a critically elevated level. The nurse was busy with another patient and failed to report the critical result to the physician within 30 minutes according to the facility’s policy. Subsequently, the patient sustained a massive intracerebral bleed. What type of negligence may be present?

a.	Assessment failure
b.	Planning failure
c.	Implementation failure
d.	Evaluation failure

ANS: C

Failure to communicate and document patient findings in a timely manner is a form of failure to implement appropriate action.

PTS: 1 DIF: Cognitive Level: Analyzing REF: p. 30

OBJ:Nursing Process Step: AssessmentTOP:Legal

MSC: NCLEX: Safe and Effective Care Environment

10. On the way to surgery, a patient expresses doubt about proceeding with the planned procedure. The patient states that the doctor did not explain it very well and she would like to talk to her again before starting the procedure. The nurse knows the surgery schedule is very tight, reassures the patient that everything will be all right, and administers the preoperative sedation. This scenario describes what possible type of negligence?

a.	Assessment failure
b.	Planning failure
c.	Implementation failure
d.	Evaluation failure

ANS: D

The nurse has a duty to act as a patient advocate, in this case by holding the preoperative sedation until the doctor and the patient can speak and the patient is satisfied that she has the necessary information to make this decision.

PTS: 1 DIF: Cognitive Level: Analyzing REF: p. 31

OBJ:Nursing Process Step: N/ATOP:Legal

MSC: NCLEX: Safe and Effective Care Environment