Leadership Roles and Management Functions in Nursing: Chapter 5 Exam Questions and Answers, Exams of Nursing

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functions in Nursing theory and

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Two registered nurses have disagreed about their scope of practice regarding medication administration. What resource should the nurse consult? A. The Nurse Practice Act B. The nursing standards of practice C. The attorney general's office D. The code of ethics - - - correct answer ✅A. The Nurse Practice Act Feedback: Nurse Practice Acts define and limit the practice of nursing, stating what constitutes authorized practice as well as what exceeds the scope of authority. An attorney general's office cannot supersede the provisions of a Nurse Practice Act. Ethical guidelines do not establish a nurse's scope of practice. Standards of practice describe the quality of a nurse's care but not the legal scope. A nurse is facing a malpractice suit after a client was injured in a fall. When establishing whether the nurse committed a breach of duty, the court will consult with:

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A. Medical experts from the same area of specialty B. Members of public who have been treated in similar care setting C. The administrators of health facility where the fall occurred D. Other nurses who practice in similar settings and specialties - - - correct answer ✅D. Other nurses who practice in similar settings and specialties Feedback: The testimony of other nurses in the same specialty as the defendant may be used to prove breach of duty. These people are considered a reliable and valid source of information by the court, more so than members of the public, administrators, or medical experts A health care provider prescribes a medical procedure that the staff nurse has reason to believe will harm the client. Which principle should guide the nurses choice of action? a. The staff nurse cannot be held legally liable for any harm to the client if the procedure is carried out with due care.

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b. The nurse may lose his or her license by refusing to carry out the procedure. c. The nurse can be held legally liable for any harm if the procedure is carried out without questioning it. d. Liability rests with the health-care provider, not the nurse. - - - correct answer ✅ANS: C Feedback: The rule of personal liability says that every person is liable for his or her own conduct, even if someone else prescribed the intervention. The law does not permit a wrongdoer to avoid legal liability for his or her own wrongdoing, even though someone else also may be sued and held legally liable. "Due care" does not negate the consequences of the nurse's actions or release the nurse from liability if he or she knowingly committed an unsafe act. Refusal to carry out the procedure would not be a basis for losing a nursing license.

functions in Nursing theory and

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The preoperative admitting nurse witnessed a client sign an operative consent form. The nurse then cosigned the same document as a witness. The client suffered an injury during surgery and names the nurse in the suit because the nurse witnessed the consent form. What is the most likely outcome? a. The nurse is not likely liable because the signature only specifies that the nurse witnessed the client signing the consent form. b. The nurse is likely not liable because surgery is beyond the nurse's scope of practice. c. The nurse may be liable because cosigning the consent form makes the nurse an equal member of the surgical team. d. The nurse is liable because cosigning the consent form confirms that the client fully understood the risks of surgery. - - - correct answer ✅ANS: A

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Feedback: Informed consent is obtained by a physician; therefore, in most cases, a nurse is not legally responsible for informed consent but is confirming that the client signed the consent form. If the nurse acts solely in the role of a witness, there are not likely to be legal consequences for the nurse. The nurse would not be considered to be a full member of the surgical team if his or her role was limited to admitting the client. Surgery is beyond the nurse's scope of practice, but this does not form the basis for the nurse's likely exemption from liability. A client is preparing to be discharged from the health-care facility and has told the nurse that he would like to read his medical record. What is the nurse's best initial action? a. Arrange for the medical record to be provided to the client. b. Inform the client that this request will be communicated to the facility's ethics

functions in Nursing theory and

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committee. c. Confirm the facility's policy around providing medical records to clients. d. Check whether this provision is included in the jurisdiction's Nurse Practice Act. - - - correct answer ✅ANS: C Feedback: Clients possess a right to view their medical records, but the protocols for facilitating this vary. Consequently, the nurse should check this facility's policy before acting. It would likely be premature for the nurse to provide the medical record to the client before communicating with other members of the care team or administrators to ensure policy is followed. This matter is outside the purview of ethics committees because it does not involve a dilemma. The Nurse Practice Act focuses on scope of practice and other regulatory issues, not client rights A charge nurse has discovered that a medication error was made on the previous shift. What is the nurse's best action?

functions in Nursing theory and

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a. Share that information with the charge nurse on the previous shift. b. Document the incident and follow it up as per hospital policy. c. Write a memo to the nurse who made the error requesting an incident report be written. d. Document in the client's chart that an incident report will be completed. - - - correct answer ✅ANS: B Feedback: It is the responsibility as manager to immediately document the error according to hospital policy. Because 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 client's chart. Speaking to another nurse or manager is not a sufficient response, although this may be one part of the follow-up process. What is the best reason that nurse-managers have an ongoing responsibility to be aware of

functions in Nursing theory and

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legislation affecting nursing practice? a. Laws are created by people who are not nurses. b. Laws are fluid and subject to change. c. Awareness will help ensure ethical practice. d. Awareness is included in nursing standards of practice. - - - correct answer ✅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. It is true that laws are made by people who are not nurses, but this does not necessarily create a need for managers to stay abreast of laws. Standards of practice do not explicitly guide nurses to remain aware of changes in legislation. Awareness is unlikely to have a direct effect on ethical practice, which is rooted in values and beliefs

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about what is good The novice nurse can reduce the likelihood of being sued for malpractice by: a. beginning his or her career in a lower acuity setting. b. avoiding performing interventions without a witness present. c. establishing positive, therapeutic relationships with clients and families. d. engaging in lifelong learning. - - - correct answer ✅ANS: C Feedback: It has been shown that despite technical competence, nurses who have difficulty establishing positive interpersonal relationships with patients and their families are at greater risk for being sued. Relationship building is a skill that consequently has the potential to reduce a nurse's risk of a lawsuit. Many malpractice suits originate in lower acuity settings, such as long-term care, so practicing in such an environment may not

functions in Nursing theory and

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necessarily reduce the nurse's risk of a lawsuit. It is unrealistic and unnecessary to perform all interventions with a witness, and there is no evidence that this would reduce the risk of a lawsuit. Lifelong learning is beneficial but is not noted to reduce the nurse's risk of a lawsuit A state Nurse Practice Act is an example of which source of law? a. Statutes b. Constitution c. Administrative d. Judicial - - - correct answer ✅ANS: A Feedback: Statutes are the only laws made by official enactment by the legislative body. A

functions in Nursing theory and

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Nurse Practice Act is an example of a "law that governs." As a statute, a Nurse Practice Act is not a form of constitutional, administrative, or judicial law. A nurse failed to supervise a confused client, and the client fell while transferring to the bathroom. The client was unharmed, but the client's family has launched a malpractice suit, citing the nurse's breach of duty. What is the most likely outcome of this case? a. The outcome will depend on the extent to which the client was responsible for the incident. b. It will likely be successful, provided the family can prove the event was reasonably foreseeable. c. It will likely be unsuccessful because the client was not injured.

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d. The outcome will depend on how the nurse's actions compare to the established standard of care. - - - correct answer ✅ANS: C Feedback: A malpractice suit requires evidence of actual injury to the offended party. The fact that this client was unharmed would likely jeopardize the suit, regardless of the client's role or the standard of care. Even if the event was foreseeable, the absence of injury removes a key criterion of malpractice A nurse is facing a malpractice suit after an incident where a client received the wrong dose of medication. Which elements must be present to prove malpractice? Select all that apply. a. Breach of duty b. Presence of injury

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c. Ability to foresee harm d. Causal relationship between inadequate care and injury e. Intent to cause harm - - - correct answer ✅ANS: A, B, C, D Feedback: A lawsuit pertaining to malpractice must include a standard of care, breach of duty, injury, a causal relationship between breach of duty and injury, and a foreseeability of harm. Malicious intent does not need to be present or proven. The presence of malice would be more suggestive of a criminal act than professional malpractice. A nurse is being sued for malpractice after a client completed suicide on the medical-surgical unit. The nurse's attorney has pointed out that the client had no history of suicide attempts, had no history of mental illness, and denied suicidality on the standard

functions in Nursing theory and

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intake assessment. This argument calls into question what component of a malpractice suit? a. Breach of duty b. Failure to meet standard of care c. Foreseeability of harm d. A causal relationship - - - correct answer ✅ANS: C Feedback: This argument suggests that there is no obvious reason why the nurse should have predicted a suicide attempt. This may negate the criterion of foreseeability. There is no evidence that the attorney is addressing the nurse's standards of care or the nurse's ability to perform his or her duties. The attorney is not questioning the relationship between the nurse's actions and the outcomes

functions in Nursing theory and

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The nurse made a medication error that injured a hospital client. The nurse's attorney has cited the concept of respondeat superior during the trial. This argument would focus on: a. the resources that were available to the nurse. b. the intent of the nurse's actions. c. the hospital's responsibility for the injury. d. the provisions of the nurse's malpractice insurance. - - - correct answer ✅ANS: C Feedback: The legal concept of respondeat superior states that an employer should be held legally liable for the conduct of employees whose actions he or she has a right to direct or control. Consequently, there is no direct reference to the nurse's resources, intent, or insurance coverage.

functions in Nursing theory and

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A client has provided informed consent for surgery and is being assessed by the nurse. What statement by the client should prompt the nurse to contact the surgeon? a. "Why am I not allowed to eat and drink before the surgery?" b. "How long do you think I'll stay in the recovery room?" c. "Do you think this surgery is actually safe and necessary?" d. "What is the difference between the surgeon and the anesthesiologist?" - - - correct answer ✅ANS: C Feedback: Nurses are obligated to provide teaching and to clarify information given to patients by their physicians. This could include such topics as the different roles of the OR team, typical recovery times, and the rationale for fasting. However, nurses must be careful

functions in Nursing theory and

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not to give new information or to go outside the scope of practice. Addressing the safety and relative risks of a surgery, or the necessity for surgery, would be beyond the nurse's scope In which situations does the nurse-manager have a legal responsibility for reporting? Select all that apply. a. A nurse had to work 2 hours of overtime because another nurse failed to report for a shift. b. A nursing assistant has reported a suspected incident of elder abuse. c. A nurse is suspected of providing substandard medical care. d. A pediatric client reports physical abuse in the home. e.

functions in Nursing theory and

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There is a confirmed case of a reportable infectious disease - - - correct answer ✅ANS: B, C, D, E Feedback: 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. Staffing issues are not mandated reportable situations What initiative is most likely to promote open communication between clients and practitioners? a. Involving health-care consumers as active members of the health- care team b. Promoting the creation of cultures of client safety in health-care organizations c.

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Establishing a federal leadership locus for advocacy of client safety and health-care quality d. Building an evidence-based information and technology system that impacts client safety - - - correct answer ✅ANS: A Feedback: One way to promote open communication between clients and practitioners is involving health-care consumers as active members of the health- care team. Pursuing client safety initiatives prevent medical injury by promoting the creation of cultures of client safety in health-care organizations, establishing a federal leadership locus for advocacy of client safety and health-care quality, and building an evidence- based information and technology system impacts client safety.

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A registered nurse has admitted to the manager that she obtained her license on false pretenses and that she never actually graduated from a nursing education program. What is most likely to take place next? a. An investigation by the board of nursing b. A civil lawsuit by the health-care facility c. Criminal charges d. A fine levied by the jurisdiction where the event took place - - - correct answer ✅ANS: A Feedback: Following a complaint, the board of nursing completes an investigation. The facility may or may not pursue a lawsuit and is more likely to focus solely on dismissal. This would be more likely to be handled administratively by the board of nursing than

functions in Nursing theory and

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criminally, by the court system. A ban from the profession would be more likely than a fine. The nurse-manager is working with colleagues to update the policies and procedures at a health-care facility. To ensure that the policies align with the provisions of Title VII, the team should focus on what aspect of care? a. Falls prevention b. Timely and accurate documentation c. Relationships between practical and registered nurses d. Avoiding discrimination against clients - - - correct answer ✅ANS: D Feedback: Title VII is the Civil Rights Act which covers many different manifestations of diversity. The major focus of Title VII is civil rights and the avoidance of discrimination.

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Topics such as injury prevention, documentation, and interprofessional relationships are not normally within the scope of civil rights. Which nurse could face discipline for committing an intentional tort? Select all that apply. a. A nurse who slapped a client when the client became verbally abusive b. A nurse who applied restraints to a client as a punitive measure c. A nurse who increased a client's analgesia dosage without a prescription d. A nurse who neglected to supervise a client, leading to a fall e. A nurse who threatened an elderly client when the client did not participate in care - - - correct answer ✅ANS: A, B, E

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Feedback: Whereas professional negligence is considered to be an unintentional tort, assault, battery, false imprisonment, invasion of privacy, defamation, and slander are intentional torts. Failing to supervise a client or practicing outside the scope of practice (changing a medication dose) would be classified as unintentional torts. Slapping a client is battery. Threatening a client is assault, and applying restraints inappropriately is a form of false imprisonment The nurse at a long-term care facility became frustrated with a client who has dementia and is unable to be redirected from wandering. The nurse applied restraints to keep the client in bed during a night shift despite there being no order to do so. How should this nurse's actions be best interpreted? a.

functions in Nursing theory and

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The nurse is guilty of malpractice. b. The nurse's action is permissible if it was in the client's best interest. c. The nurse could face charges of false imprisonment. d. The nurse's action may be grounds for an assault charge - - - correct answer ✅ANS: C Feedback: Inappropriate use of restraints constitutes false imprisonment. Assault, however, is characterized by a verbal threat of harm. Malpractice is an unintentional tort, but this nurse's action is an intentional tort. Even if the nurse's felt that he or she was acting in the client's best interests, there are still grounds for false imprisonment charges Which statement is true regarding criminal law cases in the context of nursing? Select all

functions in Nursing theory and

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that apply. a. Incarceration is a likely consequence of being found guilty of a criminal offense. b. Intentionally giving an overdose of a potent narcotic is a criminal offense. c. A guilty verdict requires evidence beyond a reasonable doubt. d. Most malpractice cases are tried in criminal court. e. A serious, inadvertent drug error is likely to bring criminal charges. -

• • correct answer ✅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