Chapter 023

Potter & Perry: Fundamentals of Nursing, 7th Edition
Test Bank
Chapter 23: Legal Implications in Nursing Practice
MULTIPLE CHOICE
1. Which source of law best addresses a situation where nurse accidentally administers an
incorrect dosage of morphine sulfate to the client?
1. Civil law
2. Criminal law
3. Common law
4. Administrative law
ANS: 1
Civil laws protect the rights of individual persons within our society and encourage fair
and equitable treatment among people. Generally, violations of civil laws cause harm to
an individual or property and damages involve payment of money. Administering an
incorrect dosage of morphine sulfate would fall under civil law because it could cause
harm to an individual. Criminal laws prevent harm to society and provide punishment for
crimes (often imprisonment). Common law is created by judicial decisions made in
courts when individual legal cases are decided (i.e., informed consent). Administrative
law is created by administrative bodies, such as state boards of nursing when they pass
rules and regulations (i.e., the duty to report unethical nursing conduct)
DIF: A
REF: 326
OBJ: Comprehension
TOP: Nursing Process: Implementation
MSC: NCLEX test plan designation: Safe, Effective Care Environment
2. What standard of care applies to the student nurses conduct when providing care
normally performed by a registered nurse (RN)?
1. The same standard of care as an RN
2. A standard of care of an unlicensed person
3. No special standard of care because her faculty member is responsible for her
conduct
4. A standard similar to but not the same as the staff nurse with whom she is assigned
to work
ANS: 1
Student nurses are expected to perform as professional nurses (i.e., as an RN would in
providing safe client care). Students are not working in the same capacity as an
unlicensed person, and therefore are not compared to the standard of an unlicensed
person. No special standard of care because her faculty member is responsible for her
conduct is not a true statement. Staff nurses may serve as preceptors, but that does not
excuse the student from performing at the level of an RN. If a client is harmed as a direct
result of a nursing students actions or lack of action, the liability for the incorrect action
is generally shared by the student, instructor, hospital or health care facility, and
university or educational institution.
Mosby items and derived items 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.
Test Bank
23-2
DIF: A
REF: 333
OBJ: Comprehension
3. Which of the following is the most important factor in a nurse deciding whether or not to
carry malpractice insurance?
1. The nurses knowledge level of Good Samaritan laws
2. The amount of malpractice insurance provided by the nurses employer
3. The time frames and individual liability of the employers malpractice coverage
4. The evaluation of whether the nurse works in a critical area of nursing where
clients have higher morbidity and mortality rates
ANS: 3
It would be important to know the time frames of the employers malpractice coverage.
In other words, is the nurse only covered during the times he or she is working within the
institution? It would be important to know the individual liability. For example, if sued,
what financial responsibility would the nurse have? The nurse should be aware of Good
Samaritan laws, but this would not be sufficient coverage for most nursing practice.
Therefore it is not the most importance factor in determining whether to purchase private
malpractice insurance. The amount of malpractice insurance provided by the employer is
not the most important factor in deciding whether to carry private insurance. Generally,
the employers malpractice insurance coverage is much greater than private insurance
coverage. The area of nursing in which the nurse is employed is not the most important
factor in deciding whether or not to carry malpractice insurance. Lawsuits can occur
anywhere.
DIF: A
REF: 334-335
OBJ: Comprehension
4. An unconscious client with a head injury needs surgery to live. His wife only speaks
French, and the health care providers are having a difficult time explaining his condition.
Which of the following is the most correct answer regarding this situation?
1. An institutional review board needs to be contacted to give their emergency advice
on the situation.
2. The health care team should continue with the surgery after providing information
in the best manner possible.
3. A friend of the family could act as an interpreter, but the explanation could not
provide details of the clients accident, because of confidentiality laws.
4. Two licensed health care personnel should witness and sign the preoperative
consent indicating they heard an explanation of the procedure given in English.
ANS: 2
Test Bank
23-3
In emergency situations, if it is impossible to obtain consent from the client or an

authorized person, the procedure required to benefit the client or save a life may be
undertaken without liability for failure to obtain consent. In such cases, the law assumes
that the client would wish to be treated. In an emergency, it is not necessary to contact the
institutional review board. In doing so, it would take up valuable time. A family member
or acquaintance that is able to speak a clients language should not be used to interpret
health information. An official interpreter must be available to explain the terms of
consent (except in an emergency situation). Telephone consents usually require two
witnesses. This is not the case in this situation.
DIF: A
REF: 333
OBJ: Comprehension
5. A physician asks a family nurse practitioner to prescribe a medication that the nurse
practitioner knows is incompatible with the current medication regimen. If the nurse
practitioner follows the physicians desire, which of the following is the most correct
answer?
1. Good Samaritan laws will protect the nurse.
2. The nurse practitioner will be liable for the action.
3. This type of situation is why nurse practitioners should have malpractice insurance.
4. If the nurse practitioner has developed a good relationship with the client, there will
probably not be a problem.
ANS: 2
A nurse carrying out an inaccurate or inappropriate order may be legally responsible for
any harm suffered by the client. Good Samaritan laws will not protect the nurse in this
situation. Good Samaritan laws are for providing care at the scene of an accident. The
nurse should refuse to administer the medication when he or she knows it is wrong.
Having malpractice insurance is not the answer, as it does not protect the client from
harm. The nurse practitioner should refuse administering the medication. Developing a
good relationship with the client is important, but will not protect the nurse from legal
liability for providing incompetent care.
DIF: A
REF: 327
OBJ: Comprehension
6. A registered nurse interprets a scribbled medication order by the attending physician as
25 mg. The nurse administers 25 mg of the medication to a client, and then discovers that
the dose was incorrectly interpreted and should have been 15 mg. Who would ultimately
be responsible for the error?
1. Attending physician
2. Assisting resident
3. Pharmacist
4. Nurse
Test Bank
23-4
ANS: 4
any harm suffered by the client. The nurse should clarify the order with the physician if
unable to read the order. The attending physician could be included in a lawsuit, but it
would be the nurse who is ultimately responsible for the error. The assisting resident
would not be ultimately responsible for the error. The assisting resident did not carry out
an inaccurate order. The pharmacist could be included in a lawsuit, but it would be the
nurse who is ultimately responsible for the error because the nurse was the individual
who carried out an inaccurate order.
DIF: A
REF: 327
OBJ: Comprehension
7. A nurse is being asked to move from the eye unit to a general surgery floor where she in
inexperienced in this specialty due to an influenza epidemic among the nursing staff. She
is aware of her inexperience. The nurses initial recourse is to:
1. Fill out a report noting her dissatisfaction
2. Ask to work with another general surgery nurse
3. Notify the State Board of Nursing of the problem
4. Politely refuse to move, take a leave-of-absence day, and go home
ANS: 2
Nurses who float should inform the supervisor of any lack of experience in caring for the
type of clients on the nursing unit. They should also request and be given orientation to
the unit. Asking to work with another general surgery nurse would be an appropriate
action. A nurse can make a written protest to nursing administrators, but it should not be
the nurses initial recourse. Notifying the state board of nursing should not be the nurses
initial recourse. The nurse should first notify the supervisor and request appropriate
orientation and training. If problems continue, the nurse should attempt the usual chain of
command within the institution before contacting the state board of nursing. A nurse who
refuses to accept an assignment may be considered insubordinate, and clients will not
benefit from having less staff available.
DIF: A
REF: 335-336
OBJ: Comprehension
8. There are issues concerning death and dying may influence nursing practice which the
nurse recognizes. Concerning the legalities of death and dying issues, which of the
following is true?
1. Passive euthanasia is illegal in all states.
2. Assisted suicide is a constitutional right.
3. Organ donation must be attempted if it will save the recipients life.
4. Feedings may be refused by competent individuals who are unable to self-feed.
ANS: 4
Test Bank
23-5
Competent clients have the right to refuse treatment. This includes life-saving hydration
and nutrition. This is not a true statement. Furthermore, physician-assisted suicide is legal
in the state of Oregon. In 1997 the Supreme Court ruled that there is no fundamental
constitutional right to assisted suicide. Organ donation does not have to be attempted to
save a recipients life.
DIF: A
REF: 330
OBJ: Comprehension
9. The Joint Commission (TJC) sets standards of care, in which an institution is required to
have:
1. Limits of professional liability
2. Educational standards for nurses
3. A delineated scope of practice for health professionals
4. Written nursing policies and procedures for client care
ANS: 4
The TJC requires that accredited hospitals have written nursing policies and procedures.
Standards of care help define the limits of professional liability. The TJC does not require
an institution to have limits of professional liability. Nurse practice acts establish
educational requirements for nurses. Nurse practice acts define the scope of nursing
practice. The rules and regulations enacted by the state board of nursing define the
practice of nursing more specifically. The American Nurses Association has developed
standards for nursing practice that delineate the scope, function, and role of the nurse and
establish clinical practice standards.
DIF: A
REF: 326
OBJ: Comprehension
10. In the event that a nursing license is revoked, which of the following is correct?
1. The hearings are usually held in court.
2. Due process rights are waived by the nurse.
3. Appeals may be made regarding the decisions.
4. The federal government becomes involved in the procedures.
ANS: 3
Because a license is viewed as a property right, due process must be followed before a
license can be suspended or revoked. Due process means that nurses must be notified of
the charges brought against them, and that the nurses have an opportunity to defend
against the charges in a hearing. Hearings for suspension or revocation of a license do not
occur in court but are usually conducted by a hearing panel of professionals. Due process
must be followed. They do not have to be waived by the nurse. Some states, not the
federal government, provide administrative and judicial review of such cases after nurses
have exhausted all other forms of appeal.
Test Bank
23-6
DIF: A
REF: 330
OBJ: Comprehension
11. Which one of the following actions is an example of an unintentional tort?
1. Restraining a client who refuses care
2. Taking photos of a clients surgical wounds
3. Leaving the side rails down and the client falls and is injured
4. Talking about a clients history of sexually transmitted diseases
ANS: 3
An unintentional tort is an unintended wrongful act against another person that produces
injury or harm. An example of an unintentional tort would be leaving the side rails down
and the client falls and is injured. Restraining a client who refuses care would be an
example of assault and battery. Taking photos of a clients surgical wounds without the
clients permission is an example of invasion of privacy. Talking about a clients history
of sexually transmitted diseases would fall under the category of invasion of privacy.
Personal information should be kept confidential.
DIF: A
REF: 332
OBJ: Comprehension
12. Which one of the following individuals may legally give informed consent?
1. A 16-year-old for her newborn child
2. A sedated 42-year-old preoperative client
3. The friend of an 84-year-old married client
4. A 56-year-old who does not understand the proposed treatment plan
ANS: 1
An emancipated minor, one who is below the age of 18 but who is a parent, can legally
give informed consent for the care of her newborn. An emancipated minor can also be
someone below the age of 18 who is legally married. A person who has been sedated
cannot legally give informed consent. Consent should be obtained before a sedative is
administered. If the 84-year-old client were unable to give consent, then the clients wife
would be the person legally authorized to do so on the clients behalf. In order for a friend
to be legally able to give consent, he or she would have to possess power of attorney or
legal guardianship of the client. If a client does not understand the proposed treatment
plan, the nurse must notify the physician or nursing supervisor and must make certain
that clients are informed before signing the consent.
DIF: A
REF: 332-333
OBJ: Comprehension
13. When a nurse signs as a witness on an informed consent form, she is indicating that the
client:
Test Bank
1.
2.
3.
4.
23-7
Fully understands the procedure

Agrees with the procedure to be done
Has voluntarily signed the consent form
Has authorized the physician to continue with the treatment
ANS: 3
The nurses signature witnessing the consent means that the client voluntarily gave
consent, that the clients signature is authentic, and that the client appears to be competent
to give consent. It is the physicians responsibility to make sure the client fully
understands the procedure. If the nurse suspects the client does not understand, the nurse
should notify the physician. The nurses signature does not indicate that the client agrees
with the procedure, but that the client has voluntarily given consent and is competent to
do so. Clients also have the right to refuse treatment, which is also signed and witnessed.
The nurses signature does not verify that the client has authorized the physician to
continue with treatment. It only verifies that the consent was given voluntarily, the client
is competent to give consent, and the signature is authentic.
DIF: A
REF: 332
OBJ: Comprehension
14. A nurse who is working with clients who have DNR (do not resuscitate) orders knows
that these orders:
1. Are legally required for terminally ill clients
2. May be written by the physician without client consent if resuscitation is futile
3. Are maintained throughout the clients stay in either an acute care or a long-term
care facility
4. Follow nationally consistent standards for implementation of client interventions
ANS: 2
If the client is unable, and there is no surrogate available to give consent, the DNR order
can be written but only if the physician is reasonably medically certain that the
resuscitation would be futile. A DNR order is not legally required for terminally ill
patients.. DNR orders are not necessarily maintained throughout the clients stay because
a clients condition may warrant a change in DNR status. The attending physician must
review the DNR orders every 3 days for hospitalized clients or every 60 days for clients
in residential health facilities. There is no nationally consistent standard for DNR
implementation. States have their own statutes regarding DNR orders.
DIF: A
REF: 328-329
OBJ: Comprehension
15. The nurse understands the implications of the Patient Self-Determination Act. This
legislation requires that:
1. Clients designate a power of attorney
2. DNR orders for clients meet standard criteria
Test Bank
23-8
3. Organ donation is required upon death, if possible

4. Information be provided to the client regarding rights for refusal of care
ANS: 4
The Patient Self-Determination Act requires health care institutions to provide written
information to clients concerning the clients rights under state law to make decisions,
including the right to refuse treatment and formulate advance directives. The Patient SelfDetermination Act does not require clients to designate a power of attorney. The Patient
Self-Determination Act does not require that DNR orders meet standard criteria. The
Patient Self-Determination Act does not require organ donation upon death. It is the
clients decision whether he or she wants to participate in organ donation.
DIF: A
REF: 328
OBJ: Comprehension
16. The newly enacted Health Insurance Portability and Accountability Act (HIPAA) of 2003
requires:
1. Insurance coverage for all clients
2. Policies on how to report communicable diseases
3. Limits on information and damages awarded in court cases
4. Safeguards to protect written and verbal information about clients
ANS: 4
The Health Insurance Portability and Accountability Act (HIPAA) requires all hospitals
and health agencies to have specific policies and procedures in place to ensure that there
are reasonable safeguards to protect written and verbal communications about clients.
HIPAA does not require insurance coverage for all clients. It limits the extent to which
health plans may impose preexisting condition limitations and prohibits discrimination in
health plans against individual participants and beneficiaries based on health status.
HIPAA does not require policies on how to report communicable diseases. It does require
safeguards to protect written and verbal information about clients. HIPAA does not
require limits on information and damages awarded in court cases.
DIF: A
REF: 329
OBJ: Comprehension
17. A client is told by his nurse that he has to take the medications, including an injection.
The client refuses the medications, but continues to have them administered by the nurse.
This action is an example of the intentional tort of:
1. Assault
2. Battery
3. Malpractice
4. Invasion of privacy
ANS: 2
Test Bank
23-9
Battery is any intentional touching without consent. An example of battery is a nurse who
gives a medication after the client has refused. Assault is any intentional threat to bring
about harmful or offensive contact. No actual contact is necessary. Malpractice is
negligence committed by a professional such as a nurse or physician. This case is not an
example of malpractice. Invasion of privacy is where the client has unwanted intrusion
into his or her private affairs. This case is not an example of invasion of privacy.
DIF: A
REF: 331
OBJ: Comprehension
18. A nurse who is working with a client who has been diagnosed with AIDS reveals the
clients name and diagnosis with a co-worker on the way downstairs in an elevator.
Unknowingly, a friend of the client that happens to be sharing the elevator and hears the
entire story. The nurse who shared the information may be held liable for:
1. Slander
2. Assault
3. Malpractice
ANS: 1
A nurse can be held liable for slander if he or she shares private client information that
can be overheard by others. Assault is any intentional threat to bring about harmful or
offensive contact. No actual contact is necessary. The nurse in this situation has not
committed assault. Malpractice is negligence committed by a professional such as a nurse
or physician. Nursing malpractice results when care falls below the standard of care. This
case is not an example of malpractice. Invasion of privacy occurs when the client has
unwanted intrusion into his or her private affairs. This case is not an example of invasion
of privacy. This instance falls under the category of defamation of character.
DIF: A
REF: 331
OBJ: Comprehension
19. A nurse stealing narcotics from an acute care nursing unit is guilty of a:
1. Civil offense
2. Criminal offense
3. Common law offense
4. Administrative law offense
ANS: 2
Test Bank
23-10
Criminal laws prevent harm to society and provide punishment for crimes (often
imprisonment). A felony is a crime of a serious nature that has a penalty of imprisonment
for greater than 1 year or even death. A misdemeanor is a less serious crime that has a
penalty of a fine or imprisonment for less than 1 year. An example of criminal conduct
for nurses is misuse of a controlled substance. Civil laws protect the rights of individual
persons within our society and encourage fair and equitable treatment among people.
Common law is created by judicial decisions made in courts when individual legal cases
are decided (i.e., informed consent). Administrative law is created by administrative
bodies, such as state boards of nursing, when they pass rules and regulations.
DIF: A
REF: 326
OBJ: Comprehension
20. The case of a nurse accused of unethical nursing conduct will be heard by the state board
of nursing. This is an example of:
1. Civil law
2. Criminal law
3. Common law
4. Administrative law
ANS: 4
Administrative law is created by administrative bodies, such as state boards of nursing
when they pass rules and regulations such as unethical nursing conduct. Civil laws
protect the rights of individual persons within our society and encourage fair and
equitable treatment among people. Criminal laws prevent harm to society and provide
punishment for crimes (often imprisonment). Common law is created by judicial
decisions made in courts when individual legal cases are decided.
DIF: A
REF: 330
OBJ: Comprehension
21. Which of the following statements made by a nursing student regarding responsibility for
provided care requires immediate follow-up by the nursing instructor?
1. Im not held to the same standards as a licensed RN.
2. I am required to provide the safest, appropriate care I am capable of.
3. My clinical instructor is ultimately responsible for the care I provide.
4. No one expects nursing students to provide care on the level as an experienced
RN.
ANS: 3
Student nurses are expected to perform as professional nurses, that is, as an RN would in
providing safe, appropriate client care. The clinical instructor is responsible for proper
instruction, supervision, and guidance but the student is responsible for their own acts.
The remaining options do reflect misconceptions, but the issue of responsibility has
priority.
Test Bank
23-11
DIF: C
REF: 333
OBJ: Analysis
22. The nurse is having difficulty reading the prescribed dosage on a handwritten order for a
pain medication. The most appropriate action to ensure the clients safety and to
minimize legal issues is for the nurse to:
1. Ask another RN to confirm the order
2. Request the pharmacist to interpret the order
3. Call the health care provider to clarify the order
4. Consult a current drug book to determine the normal dosage range
ANS: 3
any harm suffered by the client. The nurse should clarify the order with the prescriber if
unable to read the order. Although asking others to interpret the order may appear
prudent, it is ultimately the nurses responsibility if a medication error is made. Although
the drug book may provide a normal range it does not aid in determining definitively
what the order intended.
DIF: A
REF: 336
OBJ: Comprehension
23. The legal basis for a nurse to provide emergency treatment without consent to a client
incapable of informed consent is:
1. Such care is clearly a nursing responsibility
2. To fail to provide such care is nursing negligence
3. It is presumed that the client would want the emergency treatment
4. Health care providers have an obligation to provide emergency treatment
ANS: 3
In emergency situations, if it is impossible to obtain consent from the client or an
authorized person, the law assumes that the client would wish to be treated. Providing
appropriate nursing care is a nursing responsibility, and failure to do so is negligence.
DIF: C
REF: 332
OBJ: Analysis
24. An experienced pediatric nurse is reassigned to an adult oncology floor because of
staffing issues and immediately recognizes a lack of experience in this specialty. Which
of the following nursing actions shows a lack of professionalism?
1. Politely declining the assignment
2. Filling out a report noting her dissatisfaction
3. Asking to work with another oncology nurse
Test Bank
23-12
4. Notifying the state board of nursing of the problem

ANS: 1
A nurse who refuses to accept an assignment may be considered insubordinate, and
clients will not benefit from having less staff available. This is an unprofessional attempt
to resolve the problem. Asking to work with another oncology nurse, sending a written
protest, and notifying the state nursing board would be appropriates action, and so are not
examples of unprofessional behavior.
DIF: C
REF: 335
OBJ: Analysis
25. Although a nurse may not agree, the nurse recognizes that a terminally ill client has the
legal right to:
1. Seek passive euthanasia in some states
2. Sign an organ donor pledge statement
3. Refuse DNR (do not resuscitate) status
4. Refuse treatment in the form of food and water
ANS: 4
Competent clients have the right to refuse treatment. This includes life-saving hydration
and nutrition. Physician-assisted suicide is legal in the state of Oregon, and it is legally a
clients decision to declare a DNR status or to sign an organ donor card.
DIF: A
REF: 328
OBJ: Comprehension
26. Which of the following statements best reflects a nurses understanding of the proper
critical thinking process regarding the need for personal malpractice insurance?
1. The states Good Samaritan laws protect me outside of the hospital.
2. I work in a very low risk area of nursing, so I dont really have a need.
3. The hospital carries its own malpractice insurance, so I dont need extra.
4. Lawsuits can occur years after the event, so I carry my own liability insurance.
ANS: 4
The employing institutions insurance only covers nurses while they are working within
the scope of their employment. Because nurses are professionals and it is often difficult to
separate their private lives from their professional skills, nurses need to consider
purchasing individual professional liability insurance, even if the employing institution
has coverage. It would be important to know the time frames of the employers
malpractice coverage. The nurse may be only covered during the times he or she is
working within the institution. Good Samaritan laws have a narrow scope and would not
cover many nursing activities. Although it is true that some areas of nursing have a higher
potential for liability claims, all areas have risk. The hospitals insurance may not cover
all potential expenses and may not be applicable in all liability situations.
Test Bank
23-13
DIF: C
REF: 334-335
OBJ: Analysis
27. Which of the following statements made by a nurse puts the nurse at risk for assault of
the client?
1. You will be sorry if you dont agree to take this medication.
2. You cant refuse this medication if you really want to feel better.
3. Ill be so disappointed in you if you dont take your medication.
4. Ill tell your son you arent cooperating if you dont take your medication.
ANS: 1
Assault is any intentional threat to bring about harmful or offensive contact. No actual
contact is necessary. Threatening to tell a family member may be a breech of
confidentiality; the remaining options are examples of unnecessary pressuring of the
client.
This case is not an example of invasion of privacy.
DIF: C
REF: 331
OBJ: Analysis
28. Which of the following statements made by a nurse shows the best understanding
regarding the requirements of the Health Insurance Portability and Accountability Act
(HIPAA) of 2003?
1. Im always careful to close the door when taping or listening to the units shift
report.
2. The nursing assistants know to hand me the vital signs sheet and not just put it on
the medication cart.
3. I called the radiology department to tell them I would be faxing the client
information they requested.
4. The clients niece called to see how she slept last night, but I told her I couldnt
share that with her over the phone.
ANS: 3
The Health Insurance Portability and Accountability Act (HIPAA) requires all hospitals
and health care agencies to have specific policies and procedures in place to ensure that
there are reasonable safeguards to protect written and verbal communications about
clients. By notifying the receiver of an impending client-oriented fax, the nurse has taken
a reasonable measures to ensure it is seen by only the appropriate individuals. Although
the remaining options deal with safeguards, the potential for a breech in client
confidentiality is not as great in those scenarios.
DIF: C
REF: 331
OBJ: Analysis
Test Bank
23-14
29. Which of the following statements made by a nurse reflects the best understanding of the
legal safeguards of a DNR (do not resuscitate) order?
1. All family members need to agree before a DNR order can be written.
2. All terminally ill clients are ultimately required to be declared a DNR status.
3. The DNR order on the terminally ill client in Room 45 needs reviewed today.
4. If the clients family cant be located, the physician will write the DNR order.
ANS: 3
DNR orders are not necessarily maintained throughout the clients stay because a clients
condition may warrant a change in DNR status. To ensure client safety, the attending
physician must review the DNR orders every 3 days for hospitalized clients or every 60
days for clients in residential health facilities. If there is no living will or durable power
of attorney appointed, members of the family will be consulted regarding a DNR order.
Although not all family members need to agree, an order will usually not be written if
some family members express strong opposition to the status change. If no family can be
located, the attending physician has the legal right to write the order. There is no legal
requirement for a terminally ill client to be required to assume DNR status.
DIF: C
REF: 328-329
OBJ: Analysis
30. Which of the following statements made by a nurse reflects a lack of understanding
regarding a DNR (do not resuscitate) order?
1. All family members need to agree before a DNR order can be written.
2. All terminally ill clients are ultimately required to be declared a DNR status.
3. The DNR order on the terminally ill client in Room 45 needs reviewed today.
4. If the clients family cant be located the physician will write the DNR order.
ANS: 1
If there is no living will or durable power of attorney appointed, members of the family
will be consulted regarding a DNR order. Although not all family members need to agree,
an order will usually not be written if some family members express strong opposition to
the status change. DNR orders are not necessarily maintained throughout the clients stay
because a clients condition may warrant a change in DNR status. To ensure client safety,
the attending physician must review the DNR orders every 3 days for hospitalized clients
or every 60 days for clients in residential health facilities. If no family can be located, the
attending physician has the legal right to write the order. There is no legal requirement for
a terminally ill client to be required to assume DNR status.
DIF: C
REF: 328-329
OBJ: Analysis
31. Which of the following statements made by a nurse shows a lack of understanding
regarding the Uniform Anatomical Gift Act?
1. A client must be 21 to give consent to be an organ donor.
Test Bank
23-15
2. All clients admitted to the hospital are asked about becoming an organ donor.
3. We have a form here on the unit that must be signed to show a clients informed
consent to be an organ donor.
4. In our state, you can check the back of a clients drivers license to verify whether
they are an organ donor.
ANS: 1
An individual who is at least 18 years of age has the right to make an organ donation
(defined as a donation of all or part of a human body to take effect upon or after death).
Donors need to make the gift in writing with their signature. In many states, adults sign
the back of their drivers license, indicating consent to organ donation. In most states,
required request laws mandate that at the time of admission to a hospital, a qualified
health care provider has to ask each client older than 18 whether he or she is an organ or
tissue donor.
DIF: C
REF: 329
OBJ: Analysis
32. The nurse is heard stating to another staff member that, the client in Room 54 is such a
whiner; you would think she was dying. This nurse is liable of:
1. Libel
2. Slander
3. Malpractice
ANS: 2
Defamation of character is the publication of false statements either verbally or in writing
that result in damage to a persons reputation. Slander occurs when one verbalizes the
false statement. Libel is the written defamation of character, whereas invasion of privacy
occurs when the client has unwanted intrusion into his or her private affairs. Malpractice
is negligence committed by a professional such as a nurse or physician. Nursing
malpractice results when care falls below the standard of care.
DIF: A
REF: 332
OBJ: Comprehension
33. Which of the following nursing statements reflects the best understanding of the
importance of appropriate nursing documentation regarding risk management?
1. If the client isnt compliant, Im sure to put that in my notes.
2. Im always careful to document any changes in the clients condition.
3. My notes are the proof that I provided the client with effective, appropriate care.
4. When there is a lawsuit, the nursing notes are the first thing the attorney looks at.
ANS: 3
Test Bank
23-16
The nurses documentation is often the evidence of care received by a client and serves as
proof that the nurse acted reasonably and safely. The remaining options are not incorrect
but do not identify the primary importance to the nurse.
DIF: C
REF: 336
OBJ: Analysis
34. Which of the following statements reflects a nurses need for further instructions
regarding an incident report?
1. I hope this incident report will help determine a way to help prevent falls.
2. Risk management will want to review the incident report on the clients fall.
3. I put the incident report on the clients fall in his chart as soon as I was finished.
4. I need to review the guidelines before I fill out this incident report regarding the
clients fall.
ANS: 3
The report is confidential and separate from the medical record. The remaining options
reflect an understanding about incident reports.
DIF: C
REF: 336
OBJ: Analysis
35. Regarding hours worked and frequency of errors, recent research has shown that nurses
working more than 12.5 hours per shift and more than a 40-hour week are:
1. Reporting more physical illnesses than those working only 40 hours per week
2. Three times more likely to commit an error in nursing judgment related to client
care
3. Experiencing more physical injuries than those working only 40 hours per week
4. Experiencing signs of emotional burn out more frequently than those working
only 40 hours per week
ANS: 2
Results showed that nurses who worked shifts lasting 12.5 hours or more had a three
times greater likelihood of making an error. Overtime increased the odds of making at
least one error regardless of length of original shift scheduled. The remaining options are
not supported by research data.
DIF: C
REF: 335
OBJ: Analysis
36. While working as a nursing assistant, a nursing student is asked to reinsert a Foley
catheter by the RN. Which of the following reflects the most appropriate initial student
response to the request?
1. Notify the nursing supervisor of the inappropriate request.
Test Bank
23-17
2. Tell the RN that she can only perform as a nursing assistant.

3. Agree to perform the task but with the supervision of the RN.
4. Jointly read the nursing assistant job description with the RN.
ANS: 2
When students work as nursing assistants or nurses aides, they should not perform tasks
that do not appear in a job description for a nurses aide or assistant. The remaining
options do not appropriately address the immediate situation.
DIF: C
REF: 333-334
OBJ: Analysis
MULTIPLE RESPONSE
1. Which of the following statements is true regarding the implications of the nurses
signature as a witness for a clients consent? (Select all that apply.)
1. Client signed voluntarily.
2. The signature is authentic.
3. Client appears to be competent.
4. Client appears knowledgeable about the procedure.
5. The nurse has discussed the possible risks of the procedure.
6. The nurse has discussed possible post procedure nursing care.
ANS: 1, 2, 3, 4
The nurses signature witnessing the consent means that the client voluntarily gave
consent, that the clients signature is authentic, and that the client appears to be competent
to give consent. When nurses provide consent forms for clients to sign, nurses must ask
the clients if they understand the procedure for which they are giving consent. If clients
deny understanding or you suspect they do not understand, notify the physician or
nursing supervisor. Nursing care post procedure should be discussed but is not inferred by
a nurses signature as a witness. Discussing possible risk factors is the physicians
responsibility.
DIF: C
REF: 332-333
OBJ: Analysis
2. When documenting notification of the primary health care provider concerning a client
whose condition is deteriorating, the nurse must be sure to include which of the
following? (Select all that apply.)
1. Clients wife at bedside.
2. Client rating pain at 3 out of 10 at 0920.
3. Client asking to have wife called to come to hospital.
4. Dr. Smith notified of clients pain rating of 8 out of 10 at 0900.
5. Client administered 2 mg morphine sulfate IV every 5 minutes for two doses.
6. Client ordered morphine sulfate 2 mg IV every 5 minutes until pain relief is
Test Bank
23-18
achieved.
ANS: 2, 4, 5, 6
The nurse must be certain to document that the physician was notified and his or her
response, nursing action in follow-up of orders, and the clients response. The remaining
options are not relevant to the proper documentation of the situation.
DIF: C
REF: 336
OBJ: Analysis

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Potter & Perry: Fundamentals of Nursing, 7th Edition

In emergency situations, if it is impossible to obtain consent from the client or an

Fully understands the procedure

3. Organ donation is required upon death, if possible

4. Notifying the state board of nursing of the problem

2. Tell the RN that she can only perform as a nursing assistant.

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