Professional Nursing Practice Concepts and Perspectives 7th Edition by Blais – Test Bank

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Blais/Hayes, Test Item File for Professional Nursing Practice: Concepts and Perspectives, 7e

Chapter 5: Legal Foundations of Professional Nursing

Question 1

What are the primary sources of law? (Select all that apply.)

1. Statutes

2. Contract

3. Constitutions

4. Decisions of court

5. Federal

Correct Answer: 1, 3, 4

Rationale: The three primary sources of law are statutes, constitutions, and decisions of court or common law. Contract and federal are types of law, but are not sources of law. Administrative laws are the fourth primary source of law.

Cognitive Level: Remembering

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Assessment; Nursing Process

Learning Outcome: 1. Identify primary sources of law and types of legal actions.

Page Number: p. 75

Question 2

What happens when a federal law and a state law conflict?

1. Federal law supersedes state law.

2. State law supersedes federal law.

3. Both federal and state laws are superseded by local law.

4. The two types of law carry equal weight.

Correct Answer: 1

Rationale: Laws enacted by any legislative body are called statutes or statutory laws. When federal and state laws conflict, federal law supersedes. Likewise, state laws supersede local laws.

Cognitive Level: Understanding

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Assessment; Nursing Process

Learning Outcome: 1. Identify primary sources of law and types of legal actions.

Page Number: p. 75

Question 3

Which act requires that a copy of the client’s advance health care directive be included in the client’s medical record?

1. Good Samaritan Act

2. Americans with Disabilities Act

3. Patient Self-Determination Act

4. Nurse practice Act

Correct Answer: 3

Rationale: The Patient Self-Determination Act enables clients to participate in decisions about their care, and requires that a copy of the client’s advance health care directive be included on the client’s chart. The Americans with Disabilities act supports equal access for those with disabilities. Good Samaritan laws protect healthcare professionals who volunteer services in an emergency situation. Nurse practice acts govern the practice of nursing on a state-by-state basis.

Cognitive Level: Remembering

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Assessment; Nursing Process

Learning Outcome: 1. Identify primary sources of law and types of legal actions.

Page Number: p. 75

Question 4

A nurse has been sued for malpractice after a client received a wrong medication and required two additional days in the hospital. What type of legal action is most likely in this case?

1. Contract

2. Public

3. Criminal

4. Civil

Correct Answer: 4

Rationale: There are two kinds of legal actions: civil (private) actions and criminal actions. Civil actions deal with conflicts between individuals, whereas criminal actions deal with disputes between an individual and the society as a whole. Most nursing malpractice suits are related to civil actions.

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Planning; Nursing Process

Learning Outcome: 1. Identify primary sources of law and types of legal actions.

Page Number: p. 76

Question 5

When was the first nurse practice act implemented in the United States?

1. 1900

2. 1935

3. 1949

4. 1960

Correct Answer: 3

Rationale: In 1938, New York State passed the first nurse practice act, which was implemented in 1949. By 1952, all states had nurse practice acts.

Cognitive Level: Remembering

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Assessment; Nursing Process

Learning Outcome: 2. Describe the nurse practice act as the legal boundary of nursing.

Page Number: p. 74

Question 6

Which option(s) are generally included in nurse practice acts? (Select all that apply.)

1. A definition of the authority of the board of nursing.

2. Specific guidelines for policy and procedures for nurses.

3. A definition of nursing.

4. The requirements for licensure.

5. Statements outlining clinical responsibilities of nurses.

Correct Answer: 1, 3, 4

Rationale: The nurse practice act usually defines the authority of the board of nursing, its composition, and its powers; defines nursing and the boundaries of the scope of nursing practice; identifies types of licenses and titles; states the requirements for licensure; protects titles; and identifies grounds for disciplinary action. Nurse practice acts do not generally offer specific guidelines for policies and procedures or statements of clinical responsibilities.

Cognitive Level: Understanding

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Evaluation; Nursing Process

Learning Outcome: 2. Describe the nurse practice act as the legal boundary of nursing.

Page Number: p. 77

Question 7

The advanced practice nurse is thinking of moving to another state. What information about regulation of advanced nursing practice is important for this nurse to consider?

1. Regulations are specified by each state.

2. This is a national regulation.

3. It is the same as the regulation of basic nursing practice within each state.

4. Specific, separate regulation for advanced practice is not necessary except for nurse anesthetists.

Correct Answer: 1

Rationale: The ANA’s position is that it is the function of the professional association, not the law, to establish the scope of practice for advanced nursing practice and that state boards of nursing regulate advanced nursing practice within each state. All levels of advanced practice nursing are subject to specific and separate regulations that are different from those that apply to basic level nurses.

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Assessment; Nursing Process

Learning Outcome: 2. Describe the nurse practice act as the legal boundary of nursing.

Page Number: p. 78

Question 8

What is true about certification in nursing?

1. It is the same as registration.

2. It is the same as credentialing.

3. It is voluntary.

4. It can be obtained only in maternal-child health.

Correct Answer: 3

Rationale: Certification is the voluntary practice of validating that an individual nurse has met minimum standards of nursing competence in specialty or advanced practice areas. Registration is the listing of an individual’s name and other information on the official roster of a governmental or nongovernmental agency. Credentialing is the process of determining and maintaining competence in nursing practice. Certification can be obtained in many areas and is not limited to maternal-child health.

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Assessment; Nursing Process

Learning Outcome: 2. Describe the nurse practice act as the legal boundary of nursing.

Page Number: p. 79

Question 9

The nurse has been charged with malpractice. Which option reflects an element that must be present for this charge to be substantiated?

1. The nurse had no way of predicting that injury would result from the error.

2. The client had a duty to report what he or she was experiencing.

3. The nurse was providing care consistent with a national standard.

4. There was a causal relationship between the error and client injury.

Correct Answer: 4

Rationale: The elements of proof for nursing malpractice are: 1. a duty of the nurse to the client to provide care and follow an acceptable standard; 2. a breach of the duty on the part of the nurse; 3. foreseeability or the remembering that if the nurse fails in the duty an injury may occur; 4. an injury to the client; and 5. a causal relationship between the breach of the duty and the client’s subsequent injury.

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Assessment; Nursing Process

Learning Outcome: 3. Discuss essential legal aspects of malpractice, informed consent, adverse event reports, DNR orders, euthanasia, and death-related issues.

Page Number: p. 80

Question 10

The nurse works in a small hospital that uses narrative documentation rather than computer documentation. The nurse makes a practice of documenting care only at the end of the shift, just before giving shift report. Which aspect of documentation credibility does this most clearly violate?

1. It is contemporaneous.

2. It is accurate.

3. It is truthful.

4. It is appropriate.

Correct Answer: 1

Rationale: Documentation should be contemporaneous (documented at the time it is provided), accurate, truthful, and appropriate. In this case, the most clearly violated aspect is that of being contemporaneous. Although documenting late may impact the accuracy and truthfulness of the notes, the nurse may be very accurate and very truthful, but just late in documenting. The documentation may be appropriate for the care provided even though it is late.

Cognitive Level: Analyzing

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Assessment; Nursing Process

Learning Outcome: 3. Discuss essential legal aspects of malpractice, informed consent, adverse event reports, DNR orders, euthanasia, and death-related issues

Page Number: p. 83

Question 11

A client was admitted to the medical unit after emergency treatment of hypertensive crisis. To which staff member should the charge nurse delegate or assign measurement of this client’s vital signs?

1. A patient care technician

2. A nursing assistant

3. An LPN

4. An RN

Correct Answer: 4

Rationale: Because this client is under treatment likely to be changed based upon vital signs and blood pressure, the best person to measure and monitor vital signs is the RN. The unpredictability of the outcome of the medication and treatments being given requires the advanced nursing remembering of the RN.

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: IX.14. Demonstrate clinical judgment and accountability for patient outcomes when delegating to and supervising other members of the health care team.

NLN Competencies: Teamwork; Practice; Manage delegation effectively.

Nursing/Integrated Concepts: Planning; Nursing Process

Learning Outcome: 3. Discuss essential legal aspects of malpractice, informed consent, adverse event reports, DNR orders, euthanasia, and death-related issues.

Page Number: p. 84

Question 12

Which option is a major element of informed consent?

1. The physician, the nurse, and the client must agree on the treatment or procedure.

2. The consent must be given by family members as well as the client.

3. The client only needs to know the purpose of the treatment or procedure.

4. The consent must be given voluntarily.

Correct Answer: 4

Rationale: There are three major elements of informed consent: 1. the consent must be given voluntarily; 2. the consent must be given by an individual with the capacity and competence to understand; and 3. the client must be given enough information to be the ultimate decision maker. There is no requirement that the physician, nurse, and client agree on treatment, just that the client consents to the treatment. The consent can be given by the client alone, and family does not need to be consulted or to give consent. The client must know the purpose of the treatment or procedure, its potential benefits, its potential risks, and any alternative treatments that exist.

Cognitive Level: Understanding

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Assessment; Nursing Process

Learning Outcome: 3. Discuss essential legal aspects of malpractice, informed consent, adverse event reports, DNR orders, euthanasia, and death-related issues.

Page Number: p. 87

Question 13

In which case can the physician and nurse initiate care without consent?

1. A 15-year-old female who requests treatment for acne.

2. An 80-year-old client presenting with the flu who seems to be confused.

3. A 35-year-old male who is unconscious and in shock following an auto accident.

4. A 6-year-old child with a possible broken arm brought to the emergency room by a teacher.

Correct Answer: 3

Rationale: If a person is unconscious or injured in such a way that he or she is unable to give consent, physicians and nurses can provide care. Minors cannot be treated without parental consent unless the situation is life-threatening. The 80-year-old must give consent for treatment unless confusion is so profound as to make the person’s decision-making capacity suspect.

Cognitive Level: Analyzing

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Implementation; Nursing Process

Learning Outcome: 3. Discuss essential legal aspects of malpractice, informed consent, adverse event reports, DNR orders, euthanasia, and death-related issues.

Page Number: p. 88

Question 14

For which nurse would the concern about chemical abuse be most appropriate?

1. A nurse who avoids colleagues and friends and has frequent mood swings.

2. A nurse who requests night shifts because of increasing financial responsibilities.

3. A nurse who always comes to work 15 minutes early by bus.

4. A nurse who arrives late for work with the excuse of a flat tire.

Correct Answer: 1

Rationale: Increasing isolation from colleagues, friends and family, mood swings, irritability, and depression are behavioral indicators of chemical abuse. The request for night shifts may also be a behavioral indicator, but in this case there is an apparent reason for the request. Arriving early or staying late for no reason may be a behavioral indicator, but this nurse is likely early because of the bus schedule. Arriving late with an excuse of a flat tire may be a behavioral indicator if lateness is chronic and excuses become redundant. In this question, the most suspicious behavior is that of isolation and mood swings.

Cognitive Level: Analyzing

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Assessment; Nursing Process

Learning Outcome: 4. Examine the nurse’s role in identifying and assisting the impaired nurse.

Page Number: p. 93

Question 15

When an impaired nurse provides care, the primary concern should be for which victim?

1. The client

2. The nurse’s colleagues

3. The impaired nurse

4. The healthcare facility where the nurse works

Correct Answer: 1

Rationale: All of the options reflect groups that are in danger or are harmed when the nurse is impaired. The primary concern is for the client, as the client is the most vulnerable of the groups listed.

Cognitive Level: Understanding

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Planning; Nursing Process

Learning Outcome: 4. Examine the nurse’s role in identifying and assisting the impaired nurse.

Page Number: p. 92

Question 16

The nurse suspects that a coworker is impaired at work. What is this nurse’s priority action?

1. Closely observe the coworker to gain evidence of impairment.

2. Plan to work with the person as a team to provide care.

3. Report the suspicion to the appropriate supervisor.

4. Confront the coworker with the suspicion.

Correct Answer: 3

Rationale: In this case, the priority is to report the suspicion to the supervisor so that appropriate action can be taken. Confronting the coworker is the responsibility of the supervisor, not the nurse. Just observing the coworker or planning to provide care as a team may allow injury to a client or involve the nurse in unsafe actions.

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Implementation; Nursing Process

Learning Outcome: 4. Examine the nurse’s role in identifying and assisting the impaired nurse.

Page Number: p. 93

Question 17

A nurse who has been taking antihistamines for a head cold says these medications always make her “sleepy.” Is this nurse impaired?

1. No; impairment means under the influence of alcohol.

2. Yes; any situation that clouds the nurse’s professional vigilance can be thought of as impairment.

3. No; impairment from drug ingestion occurs only if the drugs are illegal.

4. The nurse is impaired only if he or she has taken more medication than is recommended by the medication literature.

Correct Answer: 2

Rationale: Impairment is anything that clouds the nurse’s professional vigilance. This impairment can come from legal drugs at recommended dosages, as well as from illegal drugs, alcohol, depression, sleeplessness, and other situations that change vigilance.

Cognitive Level: Analyzing

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Assessment; Nursing Process

Learning Outcome: 4. Examine the nurse’s role in identifying and assisting the impaired nurse.

Page Number: p. 92

Question 18

The nurse educator is developing materials to educate hospital employees about sexual harassment. Which information should be included in these materials?

1. Victims of sexual harassment are always female.

2. Any sexual conduct, even if it is desired by both parties, is considered sexual harassment.

3. It includes unwanted verbal or physical conduct of a sexual nature.

4. Sexual harassment occurs only in the workplace.

Correct Answer: 3

Rationale: Sexual harassment includes unwanted verbal or physical conduct of a sexual nature. It can occur at the workplace or outside the workplace and occurs to both genders. If both parties desire the sexual conduct, it is not considered sexual harassment.

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Planning; Nursing Process

Learning Outcome: 5. Examine the problem of sexual harassment in nursing.

Page Number: pp. 93–94

Question 19

The nurse has made a claim of sexual harassment against a coworker. What evidence must this nurse present?

1. The sexual advances occurred over a period of at least 6 weeks.

2. The conduct was explicit and was a condition of employment.

3. There was psychological damage from the conduct.

4. The actions created a hostile or abusive environment.

Correct Answer: 4

Rationale: The nurse must prove that the actions created a hostile or abusive environment. There is no need for the advances to occur over a specific period of time. If the conduct is explicit and was a condition of employment, it is sexual harassment; but the conduct does not have to meet those requirements to be considered sexual harassment. There does not have to be psychological damage to be sexual harassment.

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Implementation; Nursing Process

Learning Outcome: 5. Examine the problem of sexual harassment in nursing.

Page Number: p. 94

Question 20

A staff nurse continually tells sexually explicit jokes during shift report and frequently focuses those jokes on a newly hired nursing assistant. Who can make the charge of sexual harassment against this staff nurse?

1. Only the nursing assistant.

2. Only the staff nurse’s supervisor.

3. Anyone affected by the offensive material.

4. Any person who hears the jokes.

Correct Answer: 3

Rationale: The victim of sexual harassment does not have to be the person who is being harassed. Anyone who is affected by the offensive conduct may make the charge of sexual harassment.

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Assessment; Nursing Process

Learning Outcome: 5. Examine the problem of sexual harassment in nursing.

Page Number: p. 94

Question 21

What is the first action the victim of sexual harassment should take?

1. Ignore the behavior, hoping it will decrease.

2. Confront the harasser and ask that the behavior stop.

3. Report the sexual harassment to the appropriate supervisor.

4. Report the sexual harassment to the Equal Employment Opportunity Commission.

Correct Answer: 2

Rationale: When sexual harassment begins, the victim should confront the harasser, name the behavior as sexual harassment, and ask that the behavior stop. In some cases, the harasser may not be aware that behaviors are inappropriate and are offensive. Ignoring the behavior will not make it stop. Naming the behavior to the harasser may be sufficient to increase understanding and the behavior may stop. Reporting should follow chain of command if the behavior does not stop after the initial request.

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Implementation; Nursing Process

Learning Outcome: 5. Examine the problem of sexual harassment in nursing.

Page Number: p. 94

Question 22

Which organization was established by the American Nurses Association as the first labor union for registered nurses in the United States?

1. United American Nurses

2. National Labor for Nurses

3. United States Nurses United

4. American Federal Union of Nurses

Correct Answer: 1

Rationale: In 1999 the ANA established the United American Nurses as the labor union for registered nurses in the United States. The remaining options are not recognized labor unions.

Cognitive Level: Remembering

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Assessment; Nursing Process

Learning Outcome: 6. Consider how the collective bargaining process is used to improve nursing practice.

Page Number: p. 95

Question 23

The nurse educator asks the student whether the American Nurses Association supports striking as a strategy when collective bargaining breaks down. Which response, made by the student, reflects the best understanding of the ANA’s position?

1. “No, the organization holds that striking is not professional.”

2. “Only when no direct client care is delivered in the area affected by work stoppage.”

3. “Only when the daily operation of the healthcare facility is not compromised.”

4. “Yes, as a means of achieving economic and general welfare.”

Correct Answer: 4

Rationale: The ANA supports striking as a means of achieving economic and general welfare. Striking is used when collective bargaining breaks down, and is not effective unless the daily operations of the facility are compromised. There is nothing in the ANA support that indicates it is limited to non-client care areas.

Cognitive Level: Analyzing

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Evaluation; Nursing Process

Learning Outcome: 6. Consider how the collective bargaining process is used to improve nursing practice.

Page Number: p. 95

Question 24

Are nurses who work as team leaders, overseeing the nursing care provided by other nurses, considered supervisors by the National Labor Relations Act?

1. Yes; these nurses are supervising others.

2. They are considered supervisors only if they supervise more than three other nurses.

3. There is still debate over this issue.

4. No; there is too much variation in a team leader’s day-to-day responsibilities.

Correct Answer: 3

Rationale: Nurses who are supervisors are not covered by the National Labor Relations Act. There is still debate regarding whether all nurses who oversee the nursing care provided by other nurses, such as team leaders, are supervisors as defined by the NLRA. Some of the questions are related to the numbers of persons supervised and the level of supervision provided.

Cognitive Level: Understanding

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Evaluation; Nursing Process

Learning Outcome: 6. Consider how the collective bargaining process is used to improve nursing practice.

Page Number: p. 95

Question 25

The nursing instructor is preparing material for an introduction to nursing class. In which order should the instructor present events that affected nursing practice?

1. Nurse registration laws present in all states.

2. ANA published the Nursing Practice Act.

3. ANA published the Nursing Disciplinary Diversion Act.

4. Nursing licensure module legislation developed.

5. Model Nursing Practice Act revised for background checks.

6. Uniform licensure requirements published.

Correct Answer: 3, 1, 5, 4, 6, 2

Rationale: By 1923, all states had nurse registration laws. In 1981, the American Nurses Association (ANA) published a document titled The Nursing Practice Act: Suggested State Legislation, to serve as a guide for states in developing their nurse practice acts. In 1990, the ANA published Suggested State Legislation: Nursing Practice Act, Nursing Disciplinary Diversion Act, and Prescriptive Authority Act, to help state nurses’ associations revise their nurse practice acts to incorporate issues related to impaired nurses and advanced nursing practice. In 1998 the NCSBN developed Nurse Licensure Compact Model Legislation. In 2006, the National Council of State Boards of Nursing revised the Model Nursing Practice Act to include new sections that require criminal background checks on all applicants for licensure and current licensees as determined by the state board. The 2011 Uniform Licensure Requirements published by the NCSBN, an applicant for initial licensure must graduate or be eligible to graduate from an approved RN prelicensure program; successfully complete the NCLEX-RN; self-disclose all misdemeanors, felonies, and plea agreements up to the time of application; submit to state and federal fingerprint checks; and self-disclose any substance use disorder in the previous 5 years.

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Implementation; Teaching/Learning

Learning Outcome: 2. Describe the nurse practice act as the legal boundary of nursing.

Page Number: pp. 76–78

Question 26

The nurse manager is concerned that a staff nurse will be sued for malpractice. In which order should the manager analyze information to make this determination?

1. The client was injured.

2. The nurse did not follow standards of care.

3. Nurse had a duty to follow standards of care.

4. The client’s injury was caused by not following standards of care.

5. The nurse was aware that an injury could occur if standards not followed.

Correct Answer: 3, 2, 5, 1, 4

Rationale: The elements of proof for nursing malpractice are: 1. a duty of the nurse to the client to provide care and follow an acceptable standard; 2. a breach, or failure of the nurse to perform the duty; 3. foreseeability, or the knowledge that if the nurse fails in the duty an injury may occur; 4. an injury to the client; and 5. a causal relationship between the breach of the duty and the client’s subsequent injury.

Cognitive Level: Analyzing

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: VIII.12. Act to prevent unsafe, illegal, or unethical care practices.

NLN Competencies: Context and Environment; Ethical Comportment; Act in accordance with legal and regulatory requirements, including HIPAA, for faculty, students, patients, and families.

Nursing/Integrated Concepts: Assessment; Nursing Process

Learning Outcome: 3. Discuss essential legal aspects of malpractice, informed consent, adverse event reports, DNR orders, euthanasia, and death-related issues.

Page Number: p. 80

Question 27

A new graduate is planning to delegate aspects of client care to unlicensed assistive personnel (UAP). Before completing this delegation, in which order should the graduate review the rights of delegation?

1. Task

2. Person

3. Circumstance

4. Supervision and evaluation

5. Direction and communication

Correct Answer: 1, 3, 2, 5, 4

Rationale: To delegate tasks safely, nurses must delegate appropriately and supervise adequately. The five rights of delegation include the right task being performed, in the right circumstances, by the right person (delegate), who has received the right directions and communication, and who has the right supervision and evaluation.

Cognitive Level: Applying

Client Need: Safe and Effective Care Environment

Client Need Sub: Management of Care

QSEN Competencies: I.A.7. Explore ethical and legal implications of patient-centered care.

AACN Essential Competencies: IX.14. Demonstrate clinical judgment and accountability for patient outcomes when delegating to and supervising other members of the health care team.

NLN Competencies: Teamwork; Practice; Manage delegation effectively.

Nursing/Integrated Concepts: Planning; Nursing Process

Learning Outcome: 3. Discuss essential legal aspects of malpractice, informed consent, adverse event reports, DNR orders, euthanasia, and death-related issues.

Page Number: pp. 83–84

©2016 by Pearson Education, Inc. Blais/Hayes, Test Item File for Professional Nursing Practice: Concepts and Perspectives, 7th Edition