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The nurse is teaching an in-service on legal issues in nursing. Which situation is an example of battery, an intentional tort?
- A. The nurse threatens the client who is refusing to take a hypnotic medication.
- B. The nurse forcibly inserts a Foley catheter in a client who refused it.
- C. The nurse tells the client a nasogastric tube insertion is not painful.
- D. The nurse gives confidential information over the telephone.
Correct Answer: B
Rationale: Battery involves nonconsensual physical contact, like forcible catheter insertion. Threats (assault), misrepresentation (negligence), or confidentiality breaches are not battery.
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Which action by the unlicensed assistive personnel (UAP) would warrant immediate intervention by the nurse?
- A. The UAP is holding the phone to the ear of a client who is a quadriplegic.
- B. The UAP refuses to discuss the client's condition with the visitor in the room.
- C. The UAP put a vest restraint on an elderly client found wandering in the hall.
- D. The UAP is assisting the client with arthritis to open up personal mail.
Correct Answer: C
Rationale: Applying restraints without a physician’s order violates safety and legal standards, requiring intervention. Other actions are appropriate UAP tasks.
The nurse is discussing advance directives with the client. The client asks the nurse, 'Why is this so important to do?' Which statement would be the nurse's best response?
- A. The federal government mandates this form must be completed by you.
- B. This will make sure your family does what you want them to do.
- C. Don't you think it is important to let everyone know your final wishes?
- D. Because of technology, there are many options for end-of-life care.
Correct Answer: D
Rationale: ADs address varied end-of-life options due to medical technology, ensuring client wishes are followed. Federal mandates, family compliance, or rhetorical questions are less accurate.
The hospice care nurse is planning the care of an elderly client diagnosed with end-stage renal disease. Which interventions should be included in the plan of care? Select all that apply.
- A. Discuss financial concerns.
- B. Assess any comorbid conditions.
- C. Monitor increased visual or auditory abilities.
- D. Note any spiritual distress.
- E. Encourage euphoria at the time of death.
Correct Answer: A,B,D
Rationale: Financial concerns, comorbidities, and spiritual distress are relevant for holistic hospice care in end-stage renal disease. Visual/auditory increases or euphoria are not typical interventions.
The nurse is admitting a client to the medical surgical unit. Which is required to be offered to the client if the hospital accepts Medicare reimbursement?
- A. The opportunity to make an advance directive.
- B. The client must be referred to a case manager.
- C. The client must apply for a Medicare supplement insurance.
- D. The opportunity to discuss end-of-life issues.
Correct Answer: A
Rationale: The Patient Self-Determination Act mandates offering ADs on admission for Medicare-funded hospitals. Case management, insurance, or end-of-life discussions are not required.
The nurse is moving to another state which is part of the multistate licensure compact. Which information regarding ADs should the nurse be aware of when practicing nursing in other states?
- A. The laws regarding ADs are the same in all the states.
- B. Advance directives can be transferred from state to state.
- C. A significant other can sign a loved one's advance directive.
- D. Advance directives are state regulated, not federally regulated.
Correct Answer: D
Rationale: ADs are governed by state laws, varying in requirements and execution, not federal regulation. Laws differ, transferability depends on state reciprocity, and significant others cannot sign unless designated.