Chapter 6

1. What defines the legal boundaries of nursing at the state level? A)

The states Attorney General
B) The Nurse Practice Act
C) The ANA standards of practice
D) The ANA Code for Nurses
Ans: B
Feedback:
The 51 Nurse Practice Acts representing the 50 states and the District
of Columbia are examples of statutes. These Nurse Practice Acts
define and limit the practice of nursing, stating what constitutes
authorized practice as well as what exceeds the scope of authority.
Although Nurse Practice Acts may vary among states, all must be
consistent with provisions or statutes established at the federal level.
The other options lack the comprehensiveness and focus of a states
Nurse Practice Act.
2. How is the question of whether a nurse acted with reasonable care
generally proven?
1. A) The expert testimony of nursing witnesses
2. B) The defendants explanation of what the nurse did
3. C) The trial judge, after checking the outcome of prior
similar court cases
4. D) The testimony of expert medical witnesses

Ans: A

Feedback:

The testimony of other nurses in the same specialty as the defendant may be
used to prove breach of duty. The other options are not considered qualified to
testify to this matter.

3. A doctor orders a medical procedure that the staff nurse has reason to
believe will harm the patient. Which statement accurately states the legal
consequences of carrying out, or refusing to carry out, the procedure?

1. A) The staff nurse cannot be held legally liable for any harm to the
patient if the
procedure is carried out with due care
2. B) The nurse may lose his or her license by refusing to carry out the
procedure
3. C) The nurse can be held legally liable for any harm if the procedure
is carried out
without question
4. D) The nurse can be held accountable for practicing medicine without
a license
Ans: C

Feedback:

All nurses have personal liability, which means that every person is liable for his
or her own conduct. None of the remaining options describes that liability or its
outcomes accurately.

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4. The nurse witnesses a patient sign an operative permit form. Legally, what
does the nurses signature imply?

1. A) Observed the client sign the consent form

2. B) Is certain the client understands the proposed procedure
3. C) Believe the client is capable of understanding the proposed
procedure
4. D) Assumes the client has had an adequate evaluation to agree to
the procedure

Ans: A

Feedback:

Informed consent is obtained by a physician; therefore, a nurse is not legally

responsible for informed consent but is confirming that the client signed the
consent form. The other options are the responsibilities of the professional
performing the procedure.

5. How is the legal expansion of nursing roles accomplished?

1. A) The expansion of job descriptions in an agency

2. B) Written contracts between the nurse and the client
3. C) A written agreement between the nurse and the physician
4. D) Revision of the Nurse Practice Act

Ans: D

Feedback:

RN scope of practice is always determined by the Nurse Practice Act and any
expansion of roles must occur through legislated changes in that statute. None
of the remaining options are sufficient to expand nursing roles legally.

6. What

made on the previous shift?

1. A) Share that information with the charge nurse on the previous shift
2. B) Document the incident as per hospital policy
 3. C) Write a memo to the nurse who made the error requesting
incident report be
written
4. D) Write a note in the clients chart that an incident report will be
completed

Ans: B

Feedback:

It is the responsibility as manager to immediately document the error according

to hospital policy. Since policies concerning such situations vary, it is vital to
know and follow established policies. It is not generally appropriate to make
such a note on the clients chart.

is the responsibility of a charge nurse who discovers that a medication error was

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7. What is the best reason that nurse-managers have an ongoing responsibility

to be aware of legislation affecting nursing practice?

1. A) This will prevent them from getting sued

2. B) Laws are fluid and subject to change
3. C) It will protect the agency from a lawsuit
4. D) It will ensure that correct procedure is carried out

Ans: B

Feedback:

When using doctrines as a guide for nursing practice, the nurse must remember
that all laws are fluid and subject to change. Laws are not static. It is the
responsibility of each manager to keep abreast of legislation and laws affecting
both nursing practice and management practice. While the other options are
correct, they do not describe the most encompassing reason that nurse-
managers need to keep aware of current legislature affecting nursing practice.

8. Which characteristics are required of a reasonable and prudent nurse?

1. A) Years of clinically focused nursing experience

2. B) Specialized nursing skills
3. C) Average nursing judgment and skills
4. D) Earned advanced nursing degree

Ans: C

Feedback:
Reasonable and prudent generally means the average judgment, foresight,
intelligence, and skill that would be expected of a person with similar training
and experience. The other options describe qualifications not required of a
reasonable and prudent nurse.

9. A state Nurse Practice Act is an example of which source of law?

1. A) Statutes
2. B) Constitution
3. C) Administrative
4. D) Judicial

Ans: A

Feedback:

Statutes are the only laws made by official enactment by the legislative body.

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10. A verdict of suspension or loss of licensure represents what type of law?

1. A) Criminal
2. B) Civil
3. C) Administrative
4. D) Judicial

Ans: C

Feedback:

A verdict of suspension or loss of licensure represents administrative law. This

type of law is not based on any of the other options.

11. A lawsuit pertaining to professional negligence must include duty, breach of

duty, injury, and a causal relationship between breach of duty and injury. What
else must be included? Which element is necessary to prove professional
negligence? Select all that apply.

1. A) Breach of duty
2. B) Presence of injury
3. C) Ability to foresee harm
4. D) Causal relationship

Ans: A, B, C, D

Feedback:
A lawsuit pertaining to professional negligence must include duty, breach of
duty, injury, a causal relationship between breach of duty and injury, and the
ability to foresee harm. Intent to cause injury is not a requirement.

12. What component of professional negligence is represented when a patient

experiences a seizure resulting from a medication error?

1. A) Duty to use due care

2. B) Failure to meet standard of care
3. C) Foreseeability of harm
4. D) A causal relationship

Ans: D Feedback:

A direct causal relationship between failure to meet the standard of care

(breach) and injury can be proved when a patient is harmed because proper
care is not given. None of the remaining options are relevant to this criterion.

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13. What component of professional negligence is represented when a nurse

fails to look up an unfamiliar medication before administering it?

A) B) C) D)

Ans:

Duty to use due care

Failure to meet standard of care

Foreseeability of harm

A direct relationship between failure to meet the standard of care (breach) and
injury can be proved

Feedback:

The nurse must have reasonable access to information about whether the
possibility of harm exists not fulfilling this responsibility may result in a
foreseeable harm to the client. None of the remaining options are relevant to
this criterion.

14. What

1. A) A timeline of when the treatment is expected to occur

2. B) Written information on what the post procedure outcomes will be
3. C) Information regarding the risks involved in the proposed
procedure
4. D) An explanation of the nature of all associated treatment provided
by the nurse
Ans: C

Feedback:

Informed consent can be given only after the patient has received a complete
explanation of the surgery, procedure, or treatment and indicates that he or she
understands the risks and benefits related to it. Timeline and nursing
responsibilities are not components that are included. Outcomes are identified
as expected or desired; no guarantees are given.

15. Which situations is a nurse-manager illegally responsible for reporting?

Select all that apply.

1. A) Suspected incidents of elder abuse

2. B) Examples of substandard medical care
3. C) Client-reported incidents of child abuse
4. D) Confirmed case of a communicable disease

Ans: A, B, C, D

Feedback:

In addition, the manager, like all professional nurses, is responsible for

reporting improper or substandard medical care, child and elder abuse, and
communicable diseases, as specified by the Centers for Disease Control and
Prevention. Disagreements are not mandated reportable situations.

element must be included in the process of securing informed consent?

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16. What is one way to promote open communication between patients

and practitioners? A) Involving health-care consumers as active
members of the health-care team
B) Promoting the creation of cultures of patient safety in health-care
organizations C) Establishing a federal leadership locus for advocacy
of patient safety and health-
care quality
D) Building an evidence-based information and technology system
that impacts
patient safety and pursue proposals to offset implementation costs
Ans: A
Feedback:
One way to promote open communication between patients and
practitioners is involving health-care consumers as active members of
the health-care team. Pursing patient safety initiatives prevent
medical injury by promoting the creation of cultures of patient safety
in health-care organizations; establishing a federal leadership locus
for advocacy of patient safety and health-care quality; and building
an evidence-based information and technology system that impacts
patient safety and pursue proposals to offset implementation costs.
 17. What document permits a registered nurse to offer special skills and
knowledge to the public in a particular jurisdiction when such practice
would otherwise be unlawful?
1. A) A state nursing license
2. B) Institutional licensure
3. C) ANA certificate
4. D) ANA practice standards

Ans: A

Feedback:

In general, a license is a legal document that permits a person to offer special

skills and knowledge to the public in a particular jurisdiction when such practice
would otherwise be unlawful. A state nursing license allows for the practice of
nursing in a specific state. Some professionals have advocated shifting the
burden of licensure, and thus accountability, from individual practitioners to an
institution or agency. Proponents for this move believe that institutional
licensure would provide more effective use of personnel and greater flexibility.
The ANA is not capable of permitting a person to practice nursing.

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18. Professional organizations generally espouse standards of care that have

what relationship to those required by law? Select all that apply.

1. A) Higher than those required by law

2. B) The same as those required by law
3. C) Are established after those required by law
4. D) Are established prior to those required by law

Ans: A, D

Feedback:

Professional organizations generally espouse standards of care that are higher

than those required by law. These voluntary controls often are forerunners of
legal controls. The standards are written by health-care professionals while laws
are written by legislatures.

19. What

1. A) Professional negligence
2. B) Assault
3. C) Battery
4. D) False imprisonment

Ans: A
Feedback:

While professional negligence is considered to be an unintentional tort, assault,

battery, false imprisonment, invasion of privacy, defamation, and slander are
intentional torts.

20. Malpractice or professional negligence is the failure of a person with

professional training to act in a reasonable and prudent manner. How many
components must be present for an individual to be found guilty of malpractice?

1. A) Three
2. B) Four
3. C) Five
4. D) Six

Ans: C

Feedback:

Five components must be present for a professional to be held liable for

malpractice: duty to use care, failure to meet standard of care, foreseeability of
harm, direct relationship between failure to meet the standard of care and
injury can be proved, and injury.

is an example of an unintentional tort?

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21. Which statement is true regarding criminal law cases? Select all that apply.

1. A) Incarceration is a likely consequence of being found guilty of a

criminal offense
2. B) Intentionally giving an overdose of a potent narcotic is a criminal
offense
3. C) A guilty verdict requires evidence beyond a reasonable doubt
4. D) Most malpractice cases are tried in criminal court

Ans: A, B, C

Feedback:

In criminal cases, the individual faces charges generally filed by the state or
federal attorney general for crimes committed against an individual or society.
In criminal cases, the individual is always presumed to be innocent unless the
state can prove his or her guilt beyond a reasonable doubt. Incarceration and
even death are possible consequences for being found guilty in criminal
matters. Nurses found guilty of intentionally administering fatal doses of drugs
to patients would be charged in a criminal court. Most malpractice cases are
tried in civil court.

22. Which behavior will best minimize a nurses risk for a malpractice claim?
 1. A) Always carry a personal liability insurance policy
2. B) Always function with the states nursing practice act
3. C) Ask for assistance when engaged in complicated procedures
4. D) Devote time to establishing an effective nursenpatient relationship

Ans: B

Feedback:

Nurses can reduce the risk of malpractice claims by practicing within the scope
of the Nurse Practice Act. Nurses should purchase their own liability insurance
and understand the limits of their policies. Although this will not prevent a
malpractice suit, it should help to protect a nurse from financial ruin should
there be a malpractice claim. While the other options present reasonable advice,
they will not necessarily help in the avoidance of a malpractice claim.

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23. Which statement is true regarding the implications of a Good Samaritan law
for a registered nurse? Select all that apply.

1. A) A nurse has a legal responsibility to provide emergency services

2. B) Such laws are universally worded so as to minimize state-to-state
differences
3. C) In order for protection to apply, the nursing care cannot be
considered negligent
4. D) A nurse who provided out-of-scope care is not protected by the
Good Samaritan
law

Ans: C, D Feedback:

Nurses are not required to stop and provide emergency services as a matter of
law, although most health-care workers feel ethically compelled to stop if they
believe they can help. Good Samaritan laws suggest that health-care providers
are typically protected from potential liability if they volunteer their nursing
skills away from the workplace (generally limited to emergencies), provided that
actions taken are not grossly negligent and if the health-care worker does not
exceed his or her training or scope of practice in performing the emergency
services. However, not being paid for your services alone will not provide Good
Samaritan law protection. Good Samaritan laws apply only if the health-care
worker does not exceed his or her training or scope of practice in performing
the emergency services. Protection under Good Samaritan laws varies
tremendously from state to state. In some states, the law grants immunity to
RNs but does not protect LVNs or LPNs. Other states offer protection to anyone
who offers assistance, even if they do not have a health-care background.
Nurses should be familiar with the Good Samaritan laws in their state.
24. Which action demonstrates appropriate management regarding legal issues?
Select all that apply.

1. A) Remains current on all institutional policies and procedures

2. B) Delegates with consideration to appropriate scopes of practice
3. C) Requires physical proof of appropriate professional licensure each
year
4. D) Provides yearly in-services on the operation of newly acquired
equipment

Ans: A, B, C

Feedback:

Sound management functions regarding legal issues include understanding and

adhering to institutional policies and procedures delegating to subordinates
wisely, looking at the managers scope of practice and that of the individuals he
or she supervises, and monitoring subordinates to ensure they have a valid,
current, and appropriate license to practice nursing. In-services should be held
frequently especially when related to issues that affect care delivery. The
reliance on peers for advice in such matters is not prudent; the institutions legal
advisor is much better prepared for this task.

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25. Which statement best describes the impact that the concept of respondeat
superior has on the issue of nursing liability?

1. A) It allows for joint liability among physicians, nurses, and health-

care
organizations
2. B) It supports the sharing of blame among all involved sources of
health-care
services
3. C) It encourages legal intervention when health care is thought to be
substandard
4. D) It implies that the institution is responsible for the acts of its
employees

Ans: B

Feedback:

Nurses must remember that the purpose of respondeat superior is not to shift
the burden of blame from the employee to the organization but rather to share
the blame, increasing the possibility of larger financial compensation to the
injured party. While the other options may be true statements, the correct
option describes the more nurse-related implication of the concept.

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