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The LPN is working in a perioperative setting, and formalin is being used in an unvented room that could result in a health hazard to the other staff as well as clients. The nurse is aware that the Occupational Safety and Health Administration (OSHA) is an agency that will fine the hospital for this type of infraction. What type of law does the LPN understand empowers OSHA to regulate for the health, welfare, and safety of federal and state citizens?
- A. Common law
- B. Civil law
- C. Criminal law
- D. Administrative law
Correct Answer: D
Rationale: Statutory law empowers regulatory agencies to create and carry out the laws. These federal and regulatory agencies practice administrative law, the rules and regulations that concern the health, welfare, and safety of federal and state citizens. For example, OSHA is the federal agency that develops the rules and regulations governing workplace safety. Common law is based on earlier court decisions, judgments, and decrees. Civil law applies to disputes that arise between individual citizens. Criminal law concerns offenses that violate the public's welfare.
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Which of the following is a component of the nurse practice acts of various states?
- A. Breaches of duty owed by one person to another
- B. Determining the grounds for disciplinary action
- C. Expected action based on moral or legal obligations
- D. Injury due to the failure to act
Correct Answer: B
Rationale: Nurse practice acts define nursing practice and set standards for nurses in each state. Each state has its own nurse practice act, but one of the common components is the grounds for disciplinary action. Tort law is the body of law that governs breaches of duty owed by one person to another. A duty is an expected action that is based on moral or legal obligations. A tort is an injury that occurred because of another person's intentional or unintentional actions or failure to act.
A client jumped out of a window on the second floor of the hospital and sustained a spinal cord injury that resulted in the inability to have upper and lower extremity sensation. What type of documentation by the nurse would be appropriate in this situation?
- A. The client must have been depressed and wanted to commit suicide.'
- B. I saw the client get ready to jump and was unable to get to them fast enough.'
- C. Client observed standing on the window ledge; asked client to come down and proceeded to enter the room, and client jumped through the glass.'
- D. The previous shift should have notified the physician that the client was suicidal.'
Correct Answer: C
Rationale: The documentation in which the nurse describes observing the client on the window ledge, asking the client to come down and entering the room, and the client jumping through the class is objective, accurate, and concise. The other choices were judgmental, subjective, and vague.
The nurse is assigned to a group of clients on the medical floor. A client at the hospital has a neighbor visit who asks the nurse what is wrong with the client. The nurse checks the client's electronic medical record (EMR) and proceeds to inform the visitor about the client's diagnosis. What federal guideline has the nurse violated?
- A. HIPAA
- B. Nurse Practice Act
- C. Hospital policy
- D. Agency standards of practice
Correct Answer: A
Rationale: The client has the right to request restrictions and confidential communications concerning protected health information, which is an overview of the major client protections provided by HIPAA. The nurse may also have violated the hospital's policy and/or an agency's standards of practice, depending on their verbiage, and the Nurse Practice Act, but the federal guideline violated is HIPAA.
The nurse is caring for a terminally ill client in the intensive care unit that is on life support measures. The family members are opposed in their decision to take the client off of life support. What option does the nurse discuss with the nurse manager?
- A. Ask the family to go out of the unit and make a decision that is final.
- B. Contact the ethics committee for their input.
- C. Have the health care provider inform the family that they are not responsible for the decision.
- D. Take the client off of life support when the family is not present.
Correct Answer: B
Rationale: The ethics committee may be called on to act as an advocate for clients who no longer are mentally capable of making their own decisions. Ethics committees are a valuable resource for reviewing difficult cases and helping ensure a careful and unbiased decision. The nurse is not practicing within the scope of practice by taking the client off of life support. The nurse does not mandate to the health care provider decisions that should be made. It is nontherapeutic for the nurse to ask the family to go out and make a decision.
A client who has been diagnosed with terminal cancer states wanting no further treatment and also informs the physician of not wanting any resuscitative action taken if the client experiences a cardiac or respiratory arrest. What type of order does the nurse anticipate the physician will write?
- A. A do-not-resuscitate order
- B. Intubation and mechanical ventilation only if respiratory arrest occurs
- C. Emergency medications only
- D. Do everything except resuscitate
Correct Answer: A
Rationale: DNR orders are written when clients wish to have no resuscitative action taken if they experience cardiac or respiratory arrest. Intubation, mechanical ventilation, emergency medications, and do everything but resuscitate are measures that are against the client's wishes.