STUDY GUIDE # 3

Legal Aspects of Nursing

Instructions:
a) Refer to the following pages for your answers: 47, 49, 52-56, 58, 62-67, & 69 of your book in a pdf file. If you’re
using an actual book, please be the one to identify from the pdf its corresponding pages in your book. b) The
number before each question is just for organization purposes because there are test items that will be merged in
iStudy, thus, only then a perfect score will be known. c) The answers will be entered into iStudy. d) Due Date:
March 10, 2022. Please be guided.
Accountable
1. Nurses are ________________for their professional judgments and actions, thus, it is important for them to know
the basics of legal concepts.
2. The legal purpose for defining the scope of nursing practice, licensing requirements, and standards of care is
Protection of the public
_______________________.
Safe
Nurses who know and follow their nurse practice act and standards of care provide (3) ________ and (4)
Competent
____________ nursing care.
Protect the client/consumer
5. The purpose of knowing and practicing nursing’s standards of care is to ______________________.
Safe Competent care
As a provider of service, the nurse is expected to provide (6) __________ and (7) __________________.
The nurse in the role of employee or contractor for service has obligations to the employer, the client, and
Limitations term
other personnel in which nursing care provided must be within the (8) ______________and (9) __________
specified.
10. Nursing practice is a service to people who are often ill or vulnerable, therefore, actions taken by nurse an
Safety of the people
affect the ___________________.
informed consent
11. Neither health care providers nor clients are well prepared for the ________________ process.

12. The more invasive a procedure or the greater the potential for risk to the client, the greater the need for
Written
_____________ permission.
express consent
13. Consent is implied in a medical emergency when an individual cannot provide _____________ because
of physical condition.
14. In obtaining an informed consent for specific medical and surgical treatments is the responsibility of the
Perform the procedure
person who is going to ________________.
Oral Written
The nurse relies on (15) ___________________or (16) ____________________for most nursing interventions.

It is imperative to remember the importance of communicating with the client by:

Explaining nursing procedure
17. ________________________________
ensuring the client understand
18. ________________________________
obtaining permission
19. ________________________________

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 The three major elements of informed consent:
Given voluntarily
20. ___________________________________________________________
given by a client/individual with the capacity and competence to understand
21. ___________________________________________________________
client/individual must be given enough information to be given the ultimate decision maker
22. ___________________________________________________________
Coercion
23. ____________________ invalidates the consent.

Cultural perspective perspective also needs to be considered when clients are asked to make decisions about a
24. ___________________
procedure or treatment.
group
25. People from other cultures may apply a _______________ perspective to decision making.
Communication
26. ________________________ is critical for client safety and quality nursing care.

A competent adult can make decisions regarding health, however, a client may not be considered
functionally competent if he or she is:
Confused
27. ______________________
disoriented
28. ______________________
sedated
29. ______________________
Three groups of people who cannot provide consent:
Minor
30. ______________________________________
Unconscious or injured
31. ______________________________________
people with mental illness
32. ______________________________________
The nurse’s signature for witnessing the client’s signature in the signed consent form confirms three
things:
client gave consent voluntarily
33. ____________________________________________________
signature is authentic
34. ____________________________________________________
client appears competent to give consent
35. ____________________________________________________
refusal
36. The right of consent also involves the right of ______________________.
documentation
37. ________________________ is an important aspect of informed consent.
full name
38. When documenting the use of an interpreter, include the interpreter’s ____________ and title.
39. Impaired nurses who voluntarily enter a diversion programs do not have their nursing license revoked if
treatment
they follow __________________ requirements.
diversion program
40. _________________________ allow for rehabilitation of the nurse while still being able to work in the profession.
Nursing medication errors include the following:

misreading or incorrectly calculating the dosage

41. ___________________________________________________
failing to read the medication label
42. ___________________________________________________
failing to correctly identify the client
43. ____________________________________________________

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 preparing the wrong concentration
44. ___________________________________________________
administering a medication by the wrong route
45. ____________________________________________________

Nurses always must check medications very carefully. Even after checking, the nurse is wise to recheck the
medication order
(46)______________________________and medication
the (47)___________________before administering it if the client
states, “I did not have a green pill before.”
48. If a nurse leaves the rails down or leaves a baby unattended on a bath table, the nurse is guilty of
professional negligence
____________________________________.
49. A nurse by failing to take the blood pressure and pulse and to check the dressing of a client who had just had
assessment
abdominal surgery omits important ___________________________.
The most common causes of nursing professional negligence as identified by Painter and Dujak (2010)
include:

failure to monitor
50. _________________________________________________
failure to perform assessment and notify health care provider
51. _________________________________________________
failure to document and report a deteriorating condition
52. _________________________________________________
Situation: To avoid charges of malpractice, nurses must recognize nursing situations in which negligent actions
are most likely to occur, and take measures to prevent them. For #s 53 - 58 identify the CATEGORY OF
NEGLIGENCE if there is failure to do the following situations:

53. Failure to question an incomplete or illegible medical orders:

A. Failure to document
B. Failure to communicate
C. Failure to assess and monitor
D. Failure to act as a patient advocate

54. Failure to follow a physician’s verbal or written orders:

A. Failure to document
B. Failure to communicate
C. Failure to follow standards of care
D. Failure to act as a patient advocate

55. Failure to seek higher medical authorization for a treatment:

A. Failure to document
B. Failure to communicate
C. Failure to act as a patient advocate
D. Failure to follow standards of care

56. Failure to interpret a client’s signs and symptoms:

A. Failure to document
B. Failure to communicate
C. Failure to assess and monitor
D. Failure to act as a patient advocate

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57. Failure to note in the patient’s medical record client’s progress and response to treatment:
A. Failure to document
B. Failure to communicate
C. Failure to assess and monitor
D. Failure to act as a patient advocate

58. Failure to follow the manufacturer’s recommendations for operating the equipment:
A. Failure to document
B. Failure to assess and monitor
C. Failure to follow standards of care
D. Failure to use equipment in a responsible manner

In a little research done among 19 Registered Nurses in US analyzing professional negligence claims to
contribute in correcting deficiencies related to practice errors, identified and considered the events of
medication administration, IV therapy, and or monitoring of physiological changes to be
Preventable
59) ___________________. The actions of the nurses that contributed to the events included:

Failure to respond or set audible alarms

60. (15.7%) _____________________________________________________
failure to follow the five rights of medication administration
61. (15.7% ) _____________________________________________________
Failure to escalate communication with a nonresponsive clinical provider
62. (10.5%) ______________________________________________________
failure to perform timely assessment and intervention in a clinical situation with the majority of
63. (42%) ________________________________________________________________________________________
____________________________________________________________________________________________
these cases related to opioid administration and monitoring (

consent
64. ___________________ is required before procedures are performed.
competent
65. Another requirement for consent is that the client be ____________________ to give consent.

66. If the nurse is uncertain whether a client refusing a treatment is competent, the supervisor and primary care
consulted
provider should be __________________so that ethical treatment that does not constitute battery can be provided.
competency
67. Determination of _____________________is not a medical decision; it is one made through court hearings.
threat
68. False imprisonment accompanied by forceful restrain or _________________ of restraint is battery.

69. liability
________can result if the nurse breaches confidentiality by passing along confidential client information to others.
70. Necessary discussion about a client’s medical condition is considered appropriate, but unnecessary discussions and
gossip
______________________ are considered breaches of confidentiality.
engaged
71. Necessary discussion involves only those people ________________ in the client’s care.
Four major categories of confidential client information imposed by statutes to be reported:
vital statistics, such as births and deaths;
72. __________________________________________________________________________
infections and communicable diseases, such as diphtheria, syphilis, and typhoid fever
73. __________________________________________________________________________
child or abuse of older adults;
74. __________________________________________________________________________
violent incidents, such as gunshot wounds and knife wound
75. __________________________________________________________________________
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 Professional
76. Nurses should maintain _______________________boundaries when using electronic media.

77. For safeguarding the client’s property, in an event that the client cannot sign a waiver, the nurse must follow the
Policies
prescribed _____________________________.
78. According to most nurse practice acts, unprofessional conduct considered one of the grounds for action against a
____________________is
nurse’s license.
79. Unethical conduct may also be addressed in nurse practice acts that includes violation of professional ethical codes,
socioeconomic or cultural
breach of confidentiality, fraud, or refusing to care for clients of specific __________________ origins.
complete
80. Accurate and _________________documentation is also a critical component of legal protection for the nurse.
81. In the event that a nurse has to make an incidental report, the report should be completed as soon as possible and filed
agency policy
according to _______________________.
82. Incident reports are often reviewed by an agency risk management committee, which decides whether to
investigate
_______________the incident further. When accident occurs, the nurse should first assess the client and
intervene
_____________________ to prevent injury.
employer
83. If a client is injured, nurses must take steps to protect the client, themselves and their ___________________.
negligent
84. It is important to follow agency policies regarding accidents and not to assume one is __________________.
precaution
85. Although negligence may be involved, accidents can and do happen when every _________________ has been taken
to prevent them.
NCLEX Questions
86. The law is essential component of nursing practice. These concepts are correct about laws, EXCEPT:
A. Laws reflect the moral values of a society
B. Laws assist in maintaining standards of practice
C. Laws are principles and processes that resolve disputes by coercion
D. Laws provide a framework for establishing which nursing actions are legal
87. The primary purpose for regulating nursing practice is to protect:
A. The public
B. Practicing nurses
C. The employing agency
D. Professional standards

88. The definition of a tort is:

A. The application of force to the person of another by a reasonable individual
B. An illegality committed by one person against the property or person of another
C. Doing something that a reasonable person under ordinary circumstances would not do
D. An illegality committed against the public and punishable by the law through the courts

89. Examples of intentional torts include:

A. Malpractice and assault
B. Malpractice and negligence
C. False imprisonment and battery
D. Negligence and invasion of privacy

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 90. When obtaining consent for surgery, initially the nurse should:
A. Explain the risks involved in the surgery
B. Explain that obtaining the signature is routine for any surgery
C. Evaluate if the client’s knowledge level is sufficient to give consent
D. Witness the signature because this is what the nurse’s signature documents

91. Nurses are protected from ALL legal action when they:
A. Offer health teaching regarding family planning
B. Offer first aid at the scene of an automobile-bus accident
C. Administer cardio-pulmonary resuscitation (CPR) measures on an unconscious chilled pulled from
swimming pool
D. Report incidents of suspected child abuse to the appropriate authorities identified in legislation and
policies

92. The physician prescribes “NPO after midnight” for a hospitalized client who is scheduled for surgery. The
morning of surgery the client eats breakfast. The surgery is cancelled and the client must stay an extra day. The
client is very disturbed and insists on not paying for the additional day because of the error. In situations such
as this:
A. The client is responsible for the hospital bill and must pay
B. A full explanation of tests or treatments is the right of the client
C. The order should have been written more clearly by the physician
D. Things go wrong, and hospital personnel are not responsible unless there is gross negligence
93. A client with rheumatoid arthritis does not want cortisone even if it is prescribed and informs the nurse of this.
Later the nurse attempts to administer cortisone that has been ordered by the physician. When the client asks
wat the medication is, the nurse givers an evasive answer. The client takes the medication and later finds that it
was cortisone. The client states an intent to sue. The decision in this suit would take into consideration the fact
that:
A. The nurse should have notified the physician
B. The nurse is required to answer the client
C. The client has insufficient knowledge to make such a decision
D. The physician’s order takes precedence over the client’s preference

94. A client is placed on a stretcher and restrained with Velcro straps while being transported to the x-ray
department. A Velcro strap breaks, and the client falls to the floor, sustaining a fractured arm. Later the client
states, “The Velcro strap was worn just at the very sport where the strap snapped.” The nurse is:
A. Exempt from any lawsuit because of the doctrine of respondeat superior
B. Totally and singly responsible for the obvious negligence because of failure to report defective equipment
C. Liable, along with the employer, for misapplication of equipment or use of defective equipment that
harms the client
D. Completely exonerated, because only the hospital, as principal employer, is primarily responsible for the
quality and maintenance of equipment

95. The nurse insists that a medication for sleep be taken at 9 pm even though the client states, “ I never went to
sleep this early and I would like the medication later.” Later the client awakens and is confused. The client tries
to get out of bed and in so doing falls, fracturing a hip. LEGALLY:
A. The time the medication was given has nothing to do with the confusion
B. Client’s rights have precedence (priority) over hospital policy or physician’s orders
C. Hospital policy requires that sleep medications be given at 9 PM and respondeat superior applies
D. When the physician orders a medication, it must be given at the scheduled time unless the nursing supervisor
authorizes differently

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 96. A client is voluntarily admitted to the psychiatric unit. Later the client develops severe pain in the right lower
quadrant and is diagnosed as having acute appendicitis. When preparing the client for an appendectomy the
nurse should:
A. Have two nurses witness the operative consent as the client signs it
B. Have the surgeon and the psychiatrist sign for the surgery, because it is an emergency procedure
C. Phone the client’s next of kin to come in to sign the consent form because the client is on the psychiatric unit
D. Ask the client to sign the preoperative consent form after being informed of the procedure and required care
Self -Assessment Questions
97. Individuals have a right to withhold themselves and their lives from public scrutiny. The intentional tort that
results from not respecting this right is termed:
A. Slander
B. Battery
C. Invasion of privacy
D. False imprisonment

98. An attempt or threat to touch another person unjustifiably describes the intentional tort of:
A. Libel
B. Assault
C. Slander
D. False imprisonment

99. An unusual occurrences report used to make all the facts available to agency personnel to in a way help health
personnel prevent further incidents or accidents:
A. Charting
B. Documentation
C. Incident report
D. Medical reports
100. A primary purpose of an incident report is to:
A. Provide evidence for trial
B. Identify ways to prevent future incidents
C. Identify the person(s) responsible for the incident
D. Assure that necessary follow-up procedures were followed
101. The most common situation for which nurses are charged with malpractice is:
A. Loss of client property
B. Making a medication error
C. Not following a physician’s order
D. Failure to obtain informed consent

102. The most common problem areas for nurses are the failure to properly document the care provided. The main
rule of thumb is:
A. ‘If it is not documented, it is not done’
B. ‘If it is not reported properly, it is not legal’
C. ‘If it is not in the policy, it will be covered by the employer’
D. ‘If it is not appropriate for the patient, it should not be given’
103. Good Samaritan acts protect nurses from liability for acts performed in an emergency situation:
A. No matter what they do
B. If they have the client’s consent
C. If they are not grossly negligent in their actions
D. If the client has a good outcome from their actions

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 104. Failure to behave in a reasonably prudent manner whether engaged in simplest or most complex type of
activity will mean:
A. Incompetence
B. Gross negligence
C. Negligence
D. Malpractice

105. While assisting during an operation, you noticed that the procedure is unusual and illegal. The most
appropriate approach of the nurse is:
A. Leave the OR right away and make a report
B. Call the attention of the doctor and leave immediately
C. Show that you were so much disturbed about what is happening
D. Call the attention of the doctor, remain with the patient, then make a report afterward

Reference:
th
Berman, A. & Synder, S. (2016) Kozier & Erb’s Fundamentals of Nursing. 10 ed. Pearson Education, Inc.

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