Test bank for essentials of nursing leadership managementm 3rd edition by kelly

http://getbooksolutions.com Link full download:https://getbooksolutions.com/download/test-bank-foressentials-of-nursing-leadership-managementm-3rd-edition-by-kelly Test Bank for Essentials of Nursing Leadership Managementm 3rd Edition by Kelly Chapter 14: Legal Aspects of Health Care Sample MULTIPLE CHOICE Mrs J’s son has medical power of attorney for her and has arrived at her bedside to discuss care options with her Mrs J has just been dialyzed, has not received any pain medication, and is rational in her decision making Mrs J’s son decides that she should not receive any more dialysis treatments due to the acute stage of her illness, the discomfort that she has suffered, and her inability to care for herself Mrs J disagrees Whose decision should be followed? a Mrs J’s son b Mrs J c Both, and the hospital’s ethics committee should convene and decide d Neither, this is a legal decision and should be done by a court of law ANS: B http://getbooksolutions.com Even though Mrs J has given her son legal power of attorney over her health care decisions, if she is competent and disagrees with the wishes or decision of her agent (her son), her decisions are the ones that prevail PTS: OBJ: Cognitive Level: Analyzing TOP: False Imprisonment Good Samaritan laws were enacted to protect the health care professional from legal liability An example of care rendered that does not fall into this category is: a a doctor who delivers a baby during a football game b a nurse who sets a broken leg while hiking in the mountains c an EMT who, upon arrival at an accident, intubates an accident victim who stopped breathing and who was forcibly thrown from his own vehicle d a nurse who stops to help at the scene of a water skiing accident ANS: C Some of the components of care given under the Good Samaritan laws are: care that is rendered in an emergency situation (the nurse at the water skiing accident or who sets the broken leg while hiking) and the health care worker not being paid The situation of an EMT that did intubate the patient who was thrown from his vehicle indicates that the EMT arrived in response to a call, and therefore was working at the time If the EMT was just passing by and happened to see the accident and was http://getbooksolutions.com not called there to render care or was off-duty at the time, then the care would fall under the Good Samaritan laws The doctor who delivers a baby during a football game also rendered care under the Good Samaritan law PTS: Laws OBJ: Cognitive Level: Understanding TOP: Good Samaritan Providing CPR and resuscitation to a patient who has an advance directive puts the caregiver at risk for: a negligence c assault b battery d licensure ANS: B Failing to honor a patient’s advance directive (living will, medical power of attorney, or durable medical power of attorney) puts caregivers at risk for charges of malpractice via battery An example of negligence would be not honoring the wishes of a patient who does not have an advance directive and letting him die Licensure could be revoked or suspended due to certain acts (or failure to act), but this is not a guarantee and is dependent upon the circumstances and outcomes involved PTS: OBJ: Cognitive Level: Analyzing TOP: Following Orders, Including Do Not Attempt Resuscitation (DNAR) Tort law is concerned with: http://getbooksolutions.com a torts and lies, and always being correct b always being correct and failure to show up for jury duty c failure to show up for jury duty and touching people when they don’t want to be touched d touching people when they don’t want to be touched and always being correct ANS: C According to The ’Lectric Law Library’s legal lexicon on the Federal Tort Claims Act (2011), tort is defined as a negligent or intentional civil wrong that does not arise from a contract or statute, that injures someone in some way, and for which the injured party can then sue the wrongdoer for damages Examples of this include the failure to show up for jury duty (failure to comply with a public duty) and touching people when they not want to be touched (battery, which is a type of tort charge) PTS: OBJ: Cognitive Level: Analyzing TOP: Tort Law Nurse W is a new graduate who is working on a unit project regarding patient care and gastrointestinal (GI) treatments While interviewing Mr P, who has been incessantly complaining of his lack of daily bowel movements, complete with graphic details about the type and consistency, she tells him that if he is not quiet, she will give him an enema he will never forget Nurse W’s actions are an example of: http://getbooksolutions.com a invasion of privacy c assault b battery d defamation ANS: C Threatening to touch (or treat) another person without his consent is a definition of assault By threatening Mr P by giving him “an enema he will never forget” if he is not quiet, Nurse W has threatened to give him a treatment (the enema) against his will Battery is the actual act of giving the enema (treatment), and defamation is the act of giving intentionally false information, communication, or publication (such as making a statement that could cause an individual to lose his job) PTS: OBJ: Cognitive Level: Analyzing TOP: Assault and Battery Assault differs from battery in that it: a is the act instead of the threat of the act being done without permission b is the threat instead of the actual act itself being done without permission c concerns being offensive without permission http://getbooksolutions.com d concerns the thought without the act or threat ANS: B Assault concerns the threat to touch (or treat) another person without his permission Battery occurs through the actual act of touching (or treating) another person without his permission PTS: OBJ: Cognitive Level: Understanding TOP: Assault and Battery Three types of public laws are: a constitutional, governmental, and criminal b criminal, constitutional, and administrative c criminal, tort, and administrative d administrative, governmental, and civil ANS: B Public law defines a citizen’s relationship with the government Three examples of these types of laws are: 1) criminal (deals with the actions of individuals that intentionally harm to others), 2) constitutional (works from a constitution of http://getbooksolutions.com basic laws specifying powers of parts of the government), and 3) administrative (protection of the rights of citizens) PTS: OBJ: Cognitive Level: Understanding TOP: Sources of Law _ law is concerned with the protection of the rights of citizens a Tort b Civil c Administrative d HIPAA (The Health Insurance Portability and Accountability Act) ANS: C Administrative law deals with the protection of the rights of citizens An example of this type of law is the Civil Rights Act of 1964, which prohibits forms of discrimination in the workplace Civil law deals with how people relate to each other in everyday matters It encompasses both tort law and contract law HIPAA is a type of federal administrative law and is concerned with the protection of medical information PTS: OBJ: Cognitive Level: Understanding TOP: Administrative Law http://getbooksolutions.com The use of a whiteboard to organize nursing assignments per shift or to give patients information about their practitioners and/or diagnosis is a violation of: a civil law b tort law c HIPAA d OSHA (Occupational Safety and Health Administration) ANS: C HIPAA was enacted to safeguard medical information Some previously accepted methods for the organization of patient information have now fallen under what is considered to be HIPAA violations (such as the use of the whiteboard listed above), as they provide a means for others to access private medical information about individual patient care Examples of HIPAA violations include: the use of whiteboards to organize shift assignments and nursing organizational charts (used to organize patient treatments, diagnoses, etc.) PTS: OBJ: Cognitive Level: Analyzing TOP: Invasion of Privacy and Confidentiality 10 The Nurse Licensure Compact is: http://getbooksolutions.com a a plan for all nurses to need only one license with a large annual fee b a project of the National Council of State Boards of Nursing c a type of specialized organizational tool used in licensure and the NCLEX examinations d a spin-off of EEOC legislation ANS: B The Nurse Licensure Compact is a project of the National Council of State Boards of Nursing It is an agreement among states to allow nurses to be multistate licensed (without applying for new licenses per state) in those states that have agreed to this practice (no extra-large fee) PTS: OBJ: Cognitive Level: Understanding TOP: Multistate Licensure Compact 11 According to contract law, an agreement must contain the following in order to be considered legal: a an agreement between two people that states what the first party must http://getbooksolutions.com b an agreement between two people in which a fee was paid up front c a mutual understanding of the obligations that the contract imposes upon each party d must be a written document ANS: C Contract law regulates certain transactions between individuals, legal entities, and/or businesses For a contract to be considered legal, it must contain certain elements such as: 1) a mutual understanding of the terms and obligations that the contract imposes on each party (not only the first party) to the contract, and 2) an agreement between two or more legally competent individuals/parties stating what each must or must not It can be either oral or written PTS: OBJ: Cognitive Level: Understanding TOP: Contract Law 12 There is a going-away party for a nurse you work with who has been promoted to a managerial position in another facility that is part of the same health care organization you both currently work under Photographs have been taken of nurses around the unit as a way for the nurse to remember fellow colleagues If patients are inadvertently photographed and no consent for this has been obtained, this is an example of: a assault c invasion of privacy http://getbooksolutions.com male-female ratios according to clinical position ANS: C The reasonable person standard is used by courts of law when dealing with cases of potential negligence and malpractice to show what a “reasonable person (nurse) would do” in a given situation Reviewing the organization’s policies and procedures, evidence from the states’ Nurse Practice Act, and the use of expert witnesses to the standard of nursing practice in that community are all examples of the reasonable person standard PTS: Malpractice OBJ: Cognitive Level: Understanding TOP: Negligence and 14 Risk management programs: a help protect hospitals from bioethical problems b have an emphasis upon quality improvement and protection from financial liability c can be combined with quality management goals; hence no need for specially trained people d only investigate nurses who not practice according to evidence-based practice http://getbooksolutions.com ANS: B Risk management programs in hospitals are set up to investigate and correct system problems that may contribute to errors in patient care or to employee injury They have an emphasis upon quality improvement and the protection of the institution from financial liability Ethics departments/programs deal with bioethical problems and dilemmas While risk management personnel may reside within a quality management/improvement department, they are specially trained in risk prevention and are able to focus on identifying risk behaviors and correcting the problems PTS: Programs OBJ: Cognitive Level: Understanding TOP: Risk-Management 15 Nurse C, a nurse with 20 years of OB-GYN experience, was asked to float to the ER She refused Was she correct in this decision and why? a She was correct because if she did this once she may be expected to float on a regular basis b She was incorrect because she felt she had enough seniority to not have to float c She was incorrect because she just did not want to float d She was correct because with her lack of experience in the ER, she felt she could not safely care for her patients http://getbooksolutions.com ANS: D Sometimes, nurses may find themselves in conflict with their health care facility’s expectations and the standard of care Being asked to float to another unit, particularly a specialized one such as the ER, when one has no experience in that area can put patients at risk and can place their safety in jeopardy By refusing to float to this unit, the experienced OB-GYN nurse is advocating for the ER patient’s rights and safety When refusing to comply with a request or assignment such as this, the nurse would be wise to work through the health care facility’s chain of command and to notify her supervisor of her patient safety concerns In addition, nurses should be aware whether the individual contract they signed with the facility designates criteria for floating to another location or unit PTS: OBJ: Cognitive Level: Evaluating TOP: Other Legal Risks for the Nurse, Doctor, or Hospital 16 Nurses should be sure that their documentation includes a number of key criteria in order to be thorough and help protect them from liability Which of the following is not necessarily correct regarding thorough documentation practices? a complies with professional practice standards, such as those provided by the ANA b can use the FATE acronym to ensure good charting practices c is written evidence of what was done, the patient’s response, and any revisions made in the patient’s plan of care http://getbooksolutions.com d a method of communication among health care providers responsible for the patient’s care ANS: B Documentation serves a number of purposes in health care, but the key reasons why nurses document are professional responsibility and accountability Some of the primary criteria that thorough documentation should contain include: 1) complies with professional practice standards, such as those provided by the ANA, and with accreditation criteria, 2) is written evidence of what was done, the patient’s response, and any revisions made in the patient’s plan of care, 3) a method of communication among health care providers responsible for the patient’s care, and 4) the FLAT (not FATE) acronym can be used by nurses to help ensure accurate and thorough documentation PTS: OBJ: Cognitive Level: Analyzing TOP: Documentation 17 Which United States–based entity has the largest electronic health record system? a U.S Indian Health Services b U.S Public Health Service c U.S Department of Health Services and Resources d U.S Department of Veterans Affairs http://getbooksolutions.com ANS: D The largest electronic health record (EHR) system in the United States is located at the U.S Department of Veterans Affairs It is called the Veterans Health Information Systems and Technology Architecture (VistA) The U.S Indian Health Service has a similar type of EHR system, but it is not as large PTS: OBJ: Cognitive Level: Remembering TOP: Documentation 18 Which of the following is not one of the reasons that the implementation of the electronic medical record has been slow in the United States? a stark antidefamation law c HIPAA b federal antikickback statute d antitrust laws ANS: A Shay (2005) noted a number of reasons why the implementation of the electronic medical record has been slow in the United States Some of these factors include: the federal antiKickback statute, HIPAA, antitrust laws, stark antireferral (not antidefamation) rules, and concerns about malpractice exposure PTS: OBJ: Cognitive Level: Analyzing TOP: Documentation http://getbooksolutions.com 19 A state board of nursing that develops rules specifying the duties of registered nurses is displaying a type of law under which specific branch of the government at the state level? a tort c administrative b legislative d judicial ANS: C When a state board of nursing develops rules that specify the duties of registered nurses in that state, that board is demonstrating administrative branch law at the state level An example at the state level of legislative branch law would be the Nurse Practice Act An example of judicial branch law at the state level would be courts and juries deciding whether a nurse’s actions and behaviors comply with the law governing the practice of nurses in the state PTS: OBJ: Cognitive Level: Understanding TOP: Sources of Law 20 A patient is requesting a priest to come and visit Which type of law is the nurse following when the nurse calls for a clergy to visit the patient? a administrative c federal b constitutional d state http://getbooksolutions.com ANS: B Several categories of public law affect the practice of nursing The nurse accommodates patients’ constitutional right to practice their religion every time the nurse calls a patient’s clergy as requested, follows a specific religious custom for the preparation of meals, or prepares a deceased person’s remains for burial PTS: OBJ: Cognitive Level: Applying TOP: Constitutional Law 21 A health care organization can two things to comply with criminal law to protect the public These are: a background checks and drug screens b drug screens and vaccination requirements c vaccination and OSHA requirements d background checks and vaccination requirements ANS: A One aspect of criminal law affecting nursing practice is the state and federal requirement that criminal background checks be performed This is an attempt to protect the most vulnerable citizens Another area of criminal law which affects nursing practice is the prohibition against substance abuse Both federal and state laws require health care organizations to keep a strict accounting of the use and distribution of regulated drugs Health care facilities can perform random drug screens on nurses and all employees as well as drug screens for a condition of employment http://getbooksolutions.com PTS: OBJ: Cognitive Level: Understanding TOP: Criminal Law 22 Other than having a legal record of patient care, documentation is important as: a evidence of physician orders b evidence of professional standard compliance c evidence of staffing patterns d evidence of consent for treatment ANS: B Professional responsibility and accountability are two primary reasons why nurses document Thorough documentation provides a method of communication among health care team members, written evidence of what was done for the patient and evidence of compliance with professional practice standards Evidence of physician orders is not seen in documentation nor is the evidence of staffing patterns or consent for treatments PTS: OBJ: Cognitive Level: Understanding TOP: Documentation 23 One way to avoid or decrease professional liability is to: http://getbooksolutions.com a have every employee take a flu shot b have a risk management department c avoid taking telephone or verbal orders d deliver care in teams ANS: C There are many ways nurses can use to decrease the risk for liability One way to this is to avoid taking verbal or telephone orders from a health care practitioner If it is necessary for the nurse to take a verbal or telephone order, always repeat the order back to the provider and document on the physician’s order sheet that the order was “read back” and “verified.” PTS: OBJ: Cognitive Level: Applying TOP: Nursing Actions to Decrease Liability 24 The respondent superior law states: a nurses may be sued individually b employers must cover liability insurance for the nurse http://getbooksolutions.com c nurses must carry liability insurance d the hospital is responsible for nurses damage ANS: D It is a well-established law throughout the United States that a “master is subject to liability for the torts of the servants committed while acting in the scope of employment.” The law is called the respondent superior In other words, a hospital, nursing home, clinic, and so on are legally responsible for the damages caused by the negligence of their nurses PTS: OBJ: Cognitive Level: Understanding TOP: Nurses Involved in Litigation 25 State laws are interpreted as administrative rules when they: a specify licensing requirements b specify payment for federal funds c protect employees from violence d mandate the requirements for nursing education http://getbooksolutions.com ANS: A Both the federal government and state government have administrative laws that affect nursing The Code of Federal Regulations has rules that health care organizations must adhere to if they are to qualify for federal funding Likewise, state laws are interpreted in administrative rules that specify licensing requirements for health care providers in the state Protecting employees from violence is covered under federal law and mandating requirements for nursing education is covered under state law PTS: OBJ: Cognitive Level: Analyzing TOP: Administrative Law MULTIPLE RESPONSE Identify the reasons nurses may need to carry their own malpractice insurance Select all that apply a their institution’s insurance may not cover them if they fail to comply with its policies and procedures b nurses are being named individually in lawsuits c their institution may fail to cover them if they acted outside the scope of their employment d nurses are being considered easy targets for lawsuits http://getbooksolutions.com ANS: A, B, C Some reasons why nurses may consider carrying their own malpractice insurance pertain to an employer’s liability coverage that might not protect them if it is found that they acted outside their scope of employment (e.g., NAP who started an IV) or failed to comply with facility policies and procedures In addition, nurses are being named individually as defendants more frequently, and it would be advantageous for a nurse to be assured of a sound defense independent of the nurse’s employer PTS: OBJ: Cognitive Level: Applying TOP: Professional Liability Insurance Following are suggestions for consulting and collaborating with attorneys Which are not correct? Select all that apply a Look them straight in the eye and try not to worry about costs b Be attentive and don’t set your own course c Retain a specialist and not notify your carrier of a possible liability until you are sure d Weed through the writing and set your own course ANS: A, B, C In the event that you as a nurse are named as a defendant in a malpractice case, it is important to understand some criteria and guidelines when working with attorneys http://getbooksolutions.com LaDuke (2002) noted a number of helpful suggestions: 1) keep costs sensible (expenses should be explained up front and sometimes a retaining fee is paid), 2) be attentive (read the documents your attorney provides), 3) set your own course (insist on a collaborative relationship with your attorney for the duration of your case), 4) retain a specialist (professional malpractice, professional disciplinary proceedings, and employment disputes require the expertise of a specialist in those areas), 5) DO notify your insurance carrier as soon as you are aware of a real or potential liability issue, and 6) weed through the writing (your attorney needs to explain all facts and opinions) PTS: OBJ: Cognitive Level: Applying TOP: Nurse | Attorney Relationship A number of issues that impact nursing practice are covered by criminal law Which of the following are some of these issues? Select all that apply a criminal background checks c Medicare requirements b prohibition against substance abuse d reportability of physical abuse ANS: A, B, D Criminal law concentrates on the actions of individuals that intentionally harm to others Some areas of criminal law that affect nurses and nursing practice include: 1) criminal background checks, 2) prohibition against substance abuse, and 3) reportability of physical abuse Medicare requirements and eligibility fall under the administrative law category http://getbooksolutions.com PTS: OBJ: Cognitive Level: Understanding TOP: Criminal Law Which are terms that relate to the tort law on intentionally false communication or publication? Select all that apply a libel c defamation b slander d DNAR ANS: A, B, C Defamation is an intentionally false communication or publication (Black’s Law Dictionary, 2005) Other terms that relate to defamation are: slander (verbal communication) and libel (written communication) DNAR refers to a not attempt resuscitation order on a patient, but is not a term specific to defamation PTS: OBJ: Cognitive Level: Understanding TOP: Defamation A nursing checklist of actions to decrease liability notes a number of different ways to help prevent liability Which of the following are suggestions from this list? Select all that apply a communicate with your patients and keep them informed b maintain ongoing monitoring of the process and outcome of patient care through incident reports, http://getbooksolutions.com sentinel events, etc c develop physical, mental, and verbal “no abuse” policies d frequently use verbal orders and the telephone to promote rapid transmission of information to help ensure good patient outcomes ANS: A, B, C The nursing checklist of actions to decrease liability provided a number of suggestions that can be adopted from a risk management standpoint Some of these actions include: 1) communicate with your patients and keep them informed, 2) maintain ongoing monitoring of the process and outcome of patient care through incident reports, sentinel events, etc., 3) develop physical, mental, and verbal “no abuse” policies to be followed by all professional and nonprofessional staff, and 4) avoid the use of telephone and verbal orders and if used be sure to repeat the order back to the practitioner to maintain clarity and promote patient safety PTS: Programs OBJ: Cognitive Level: Applying TOP: Risk-Management