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Which of the following statements is applicable when a competent client wants to leave a hospital or long-term care facility before being discharged by the physician?
- A. Physical or chemical restraints are used to detain the client.
- B. The nurse applies restraints based on a current medical prescription.
- C. The nurse determines whether the client's safety or the safety of others is at risk.
- D. The client signs a form releasing the healthcare facility from its responsibility.
Correct Answer: D
Rationale: A nurse should not detain a competent client who wants to leave a hospital or long-term care facility before being discharged by the physician. If a client wants to leave the facility against medical advice, the client should sign a form that releases the healthcare facility from its responsibility. Mentally impaired, confused, or disoriented clients may be restrained if their safety or the safety of others is at risk; this does not apply to a competent client.
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The nursing student asks the instructor why it is important for them to know about the law and ethics when they will be taking care of client's physical and psychosocial needs and not be practicing law. What is the best response by the instructor?
- A. You will need to understand these things if you are ever sued.'
- B. This is part of the curriculum, so we have to cover this material.'
- C. You will probably never encounter any difficulty, but it is good to know just in case it happens.'
- D. You will need a basic understanding of laws and ethics because it may affect your practice.'
Correct Answer: D
Rationale: The healthcare delivery system affects and is affected by societal beliefs, values, and laws. Nurses today require a basic understanding of laws and ethics that may affect their practice. Issues related to competence, safety, and optimal care; protecting client's rights; and practicing according to professional standards of care are of most concern to nurses. Being sued is not the only issue that a nurse may face in their practice and does not cover the ethical portion of practice. The answer regarding the curriculum does not answer the question and demeans the importance of the topic.
The nurse is concerned about the potential to be sued for a possible act of malpractice. What essential element(s) of malpractice must be present for this to occur? Select all that apply.
- A. Harm to an individual
- B. Duty of a professional toward an individual
- C. Breach of duty by the professional
- D. Poor rapport built with the client
- E. Cause of harm is the breach of duty
Correct Answer: A,B,C,E
Rationale: The essential elements of malpractice must include harm to the individual, duty of a professional toward an individual, breach of duty by the professional, and cause of harm is the breach of duty. Not building a rapport can contribute to a possible malpractice suit but is not an essential element.
The LPN administered a medication to a client reporting pain. When checking the armband and the medication administration record, there were no allergies listed. The client then tells the nurse of having informed the admitting nurse of being allergic to that medication. What documentation on the incident form would be the best option?
- A. Medication is administered to client by mouth; reports having an allergy to the medication that causes hives.'
- B. The admitting nurse failed to document that the client has an allergy to the medication.'
- C. The client reports being allergic to the medication, but I really don't think so. I didn't see any hives.'
- D. I should have asked the RN if the client is allergic to any medication.'
Correct Answer: A
Rationale: Healthcare workers complete incident reports when they make or discover errors or when an event occurs that results in harm. The first option is concise and to the point without any accusation. The LPN's documentation should not accuse the admitting nurse of failure to document. The LPN's documentation should not judge the client's statement nor place blame on the client. The LPN's documentation also should not place the blame on oneself.
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.
The nurse is administering a medication to a client for the treatment of constipation. The client expresses preferring not to take the medication today. The nurse respects the client's right and says if the client needs it later, just let the nurse know. What professional value is the nurse displaying?
- A. Beneficence
- B. Nonmaleficence
- C. Autonomy
- D. Fidelity
Correct Answer: C
Rationale: Autonomy refers to a client's right to self-determination or the freedom to make choices without opposition. Nonmaleficence is the duty to do no harm to the client. If a nurse fails to check a prescription for an unusually high dose of insulin and administers it, the nurse has violated the principle of nonmaleficence. Beneficence is the duty to do good for the clients assigned to the nurse's care. The nurse has a duty to remove wrist restraints whenever possible (removing a harm) and to help the client regain independence (promoting and doing good). Fidelity is the duty to maintain commitments of professional obligations and responsibilities.