C 20

Chapter 20: Legal Issues
MULTIPLE CHOICE
1. A nurse is giving a presentation on malpractice. Which statement indicates the nurse
understands malpractice?
a. The elements of duty, breach of duty, and patient injury must be present for a
malpractice claim.
b. Negligent nursing care and failure to follow standards must be present for a
malpractice claim.
c. Failure to report, defamation, and discrimination must be present for a malpractice
claim.
d. Error in judgment and invasion of privacy must be present for a malpractice
claim.
ANS: A
There are three elements that must be present for a malpractice claim: (1) You must have a
dutythere must be a professional nursepatient relationship. (2) You must have breached a
duty that was foreseeableyou must have fallen below the standard of care. (3) Your breach
of duty caused patient injury or damages. The other options do not indicate the nurses
understanding of malpractice.
PTS: 1
DIF: Cognitive Level: Application
REF: p. 454
OBJ: Be able to identify the elements of nursing malpractice and how they are proven in a
malpractice claim.
TOP: Malpractice MSC: NCLEX: Not applicable
2. In transcribing orders for a patient, the nurse finds a new order for aspirin, 500 mg, QID. The
patient has a long history of gastrointestinal bleeding. What is the best nursing action?
a. Give the medication.
b. Withhold the medication and chart why it was not given.
c. Call the physician and question the order in light of the patients history.
d. Ask if the patient is allergic to aspirin.
ANS: C
The nurse should call the physician and question the medication order for aspirin based on the
patients history of gastrointestinal (GI) bleeding. Claims involving medication errors are
augmented when the nurse fails to recognize side effects or contraindications or fails to know
a patients allergies. The nurse would withhold the medication until the physician is notified
and the order clarified. Giving the medication could cause the patient to start bleeding.
Although asking for allergies is an important nursing action, the important aspect in this
situation in the medical history of GI bleeding.
PTS: 1
REF: p. 456
malpractice claim.
TOP: Doctors orders
MSC: NCLEX: Physiological integritypharmacological therapies
3. The nurse enters a patients room to complete the discharge paperwork and finds the patient in
tears. The patient reports that someone from the business office stated they could not leave the
hospital until the bill was paid. What is the best nursing action?
a.
b.
c.
d.
Comfort the patient and continue the preparations for discharge.

Call the social worker for a financial evaluation.
Call the family to arrange for the payment.
Cancel the discharge plans and notify the physician of the situation.
ANS: A
The best action is to comfort the patient and continue the discharge preparations. If the
patients claim is accurate, this could be false imprisonment (wrongfully making someone
believe that they cannot leave a place). The nurses best action is to comfort the patient and
continue the discharge preparations. However, this should also be reported to the supervisor.
Calling the social worker or the contacting the family is not appropriate.
PTS:
OBJ:
risks.
MSC:
1
REF: p. 472
Incorporate an understanding of legal risks into your nursing practice and how to minimize
TOP:
False imprisonment
NCLEX: Safe and effective care environmentmanagement of care
4. What is a correct statement regarding a nurse who acts beyond the scope of practice?
a. Demonstrates what a good nurse he or she can be
b. Provides enriched services to patients who would not otherwise receive them
c. May make other nurses angry because of the increased expectations created
d. May be disciplined by the board of nursing
ANS: D
States may regulate nursing practice by controlling the scope of practice and determining the
specific activities for each level of nursing. In most states, the Nurse Practice Act provides
definitions and scope of practice for each level of nursing practice. The power of the board to
discipline can have an adverse effect on the nurses ability to practice. Practicing beyond the
scope of practice does not demonstrate what a good nurse the person is and does not provide
enriched services. Other nurses would not be angry at increased expectations but at the
foolishness of the nurse practicing beyond the scope of practice.
PTS: 1
REF: p. 454
OBJ: Understand functions of a state board of nursing.
TOP: Scope of practice
MSC: NCLEX: Safe and effective care environmentmanagement of care
5. Which error in judgment would be the most serious for the nurse defendant in a legal case?
a. Discussing the case with the plaintiff
b. Tampering with the chart
c. Hiding information from the plaintiffs attorney
d. Being discourteous on the witness stand
ANS: B
The patients chart is a legal document. Changing or tampering with the chart would be in
violation of the standards of practice, and the Nurse Practice Act and would not be considered
what a reasonable nurse would do. The nurse is expected to perform as a reasonable nurse
would. If your actions are not those of a reasonable nurse and this causes someone to be
injured, you can be sued. Being discourteous on the witness stand may not be professional. It
is also not appropriate to discuss the case with the plaintiff or hide information; however,
tampering with the chart is a more serious error in judgment.
PTS: 1
REF: p. 464
OBJ: Incorporate an understanding of legal risks into your nursing practice and how to minimize
risks. TOP:
Legal risks
6. A graduate nurse is preparing to start a first nursing job. What action would be the best legal
safeguard for the graduate nurse to take?

a. Competent practice
b. A legal contract
c. A valid license
d. Following management policies
ANS: A
The best legal safeguard is competent practice. Practicing within the parameters of the states
Nurse Practice Act, performing care based on established policies and procedures, and
performing as a reasonable nurse are the best ways for a nurse to safeguard against legal
action. It is important to maintain a current license and follow management policies; however,
the best safeguard is being competent. A legal contract is not necessary for all situations and is
not necessarily the best legal safeguard.
PTS:
OBJ:
TOP:
MSC:
1
REF: pp. 467-471
Relate the Nurse Practice Act to the governance of your profession.
Nursing practice
7. A nurse is providing care to a 6-year-old child with a broken arm. The nurse notices multiple
bruises. The child says, my father got mad because I was bad, and he hit and broke my arm
so that I would remember to be good. What is the best nursing action?
a. Chart that the child is a victim of abuse.
b. Do nothing because the nurse cannot prove the child was abused.
c. Report the situation to the appropriate authorities.
d. Ignore what the child said because little children often lie.
ANS: C
States have many statutes that require health care providers to report certain incidences or
occurrences. If the provider fails to report as required and a person is injured, there can be
negligence per se. It important for nurses to be aware of the reporting statutes in the state in
which they are practicing. In most states, it is the law to report evidence of child or adult
abuse. It is not appropriate to chart a decision that the child is a victim of abuse but rather to
accurately describe injuries and comments that are made. Nurses should listen to what the
patient has to saywhether the patient is a child or adult.
PTS:
OBJ:
risks.
MSC:
1
REF: p. 471
TOP:
Reportable cases
8. What would be the most effective way for a nurse to validate informed consent?
a. Check the chart for a completed and signed consent form.
b. Determine from the physician what was discussed with the patient.
c. Ask the family whether the patient understands the procedure.
d. Ask the patient what he or she understand regarding the procedure.
ANS: D
Asking the patient (not the family unless the patient is a minor child) what he or she
understands regarding the procedure is an effective way to validate informed consent.
Informed consent in the health care setting is a process whereby a patient is informed of the
risks, benefits, and alternatives of a certain procedure and then gives consent for the procedure
to be done. The piece of paper is simply evidence that the informed consent process has been
completed. Determining from the physician what was discussed does not guarantee that the
patient understands what was explained.
PTS:
OBJ:
risks.
MSC:
1
DIF: Cognitive Level: Analysis
REF: p. 472
TOP:
Informed consent
9. What action might be taken on a nurse who commits an infraction of the Nurse Practice Act?
a. The nurse is subject to discipline by a court of law.
b. The nurse is subject to discipline by the state board of nursing.
c. The nurse is subject to discipline by the local chapter of the state nurses
association.
d. The nurse is subject to discipline by the National League for Nursing.
ANS: B
The Nurse Practice Act is regulated and enforced by the state board of nursing. State Nurse
Practice Acts regulate nursing by controlling the scope of practice and determining the
specific activities for each level of nursing. Some states control who may use the titles
registered nurse (RN) and licensed practical nurse (LPN) or licensed vocational nurse (LVN).
The Nurse Practice Act is regulated and enforced by the state board of nursing. The National
League of Nursing is involved with nursing program accreditation. The local state nurses
association does not provide discipline for infarctions to the Nurse Practice Act. Only if the
infarction is of a criminal nature will the state board of nursing refer the case to the local court
of law.
PTS: 1
DIF: Cognitive Level: Synthesis
MSC: NCLEX: Not applicable
REF: p. 477
TOP: Nurse Practice Act
10. The nurse understands scope of nursing practice when making which of the following
statements?
a. The scope of nursing practice includes acts that permit some overlap between
nursing and medicine.

b. The scope of nursing practice includes activities that are legally permissible for a
nurse to perform in a particular state.

c. The scope of nursing practice are the specific duties the nurse owes to a patient.
d. The scope of nursing practice involves hose activities for which a nurse can be
held liable for malpractice.

ANS: B
Defining the scope of nursing practice is part of the responsibility of the state board of
nursing. This involves determining the specific activities for each level of nursing and who
can perform what functions. The duty that a nurse owes to a patient is part of the professional
nursepatient relationship. Any nursing activity that is outside the scope of nursing practice
can be grounds for malpractice or negligence.
PTS:
OBJ:
TOP:
MSC:
1
REF: p. 450
Scope of practice
11. A student nurse is studying assault and battery. The student interprets assault and battery to
include
a. the nurse, without consent, touched the patient in an offensive, insulting, or
injurious way.
b. the nurse threatened to put the patient in restraints if they did not stay in bed.
c. the nurse said the bill has to be paid before the patient can leave.
d. the nurse failed to perform an act expected of a reasonable nurse.
ANS: A
Assault and battery are the legal terms applied to nonconsensual threat of touch (assault) or
the actual touching (battery). Permission to do this touching is usually implied when the
patient seeks medical care. Using restraints or threatening to use them on competent patients
to make them do what you want them to do against their wishes is an example of false
imprisonment. Failure to perform an act expected of a reasonable, prudent nurse can constitute
negligence.
PTS:
OBJ:
risks.
MSC:
1
REF: p. 472
TOP:
Assault
12. A nurse understands informed consent when making which of the following statements?
a. Informed consent is a binding agreement.
b. Informed consent involves filling out an incident report.
c. Informed consent occurs when the patient receives information about a procedure
before giving consent.

d. Informed consent is a name for a written legal policy.
ANS: C
Informed consent in the health care setting is a process whereby a patient is informed of the
risks, benefits, and alternatives of a certain procedure and then gives consent for it to be done.
Informed consent is not a binding agreement, an incident report, or a written legal policy.
PTS:
OBJ:
risks.
MSC:
1
REF: p. 472
TOP:
Informed consent
13. Which definition, given by the nurse indicates understanding of malpractice?

a. Malpractice is a criminal act committed against society.
b. Malpractice means doing something a reasonable person or nurse would not do.
c. Malpractice is an intentional professional act of negligence.
d. Malpractice is a professional act or failure to act that leads to injury of a patient.
ANS: D
Malpractice may be defined as doing something outside your scope of practice or something
that is unsafe for the patient and could cause injury. A criminal act committed against society
may be a felony or a misdemeanor. Negligence is the failure to act as an ordinary prudent
person when such failure results in harm to another.
PTS: 1
REF: p. 454
malpractice claim.
TOP: Malpractice
14. A nurse tells a patient, If you dont stop getting out of that chair, Im going to put some
restraints on you. What may this nurse be accused of?

c. Invasion of privacy
d. Malpractice
a. False imprisonment
b. Defamation
ANS: A
Assault and battery are the legal terms applied to nonconsensual threat of touch (assault) or
the actual touching (battery). Use of restraints may also be interpreted as false imprisonment.
False imprisonment means making someone wrongfully believe that they cannot leave a
place. It is often associated with assault and battery claims. Assault and battery are the legal
terms applied to nonconsensual threat of touch (assault) or the actual touching (battery).
Malpractice is the improper performance of professional duties, a failure to meet the standards
of care that results in harm to another person. Defamation (libel and slander) refers to causing
damage to someone elses reputation. If the means of transmitting the damaging information
is written, it is called libel; if it is oral or spoken, it is called slander. Invasion of privacy
applies to several behaviors, such as photographing a procedure and showing it without the
patients consent, going through a patients belongings without consent, or talking about a
patients private life publicly.
PTS:
OBJ:
risks.
MSC:
1
REF: p. 472
TOP:
Assault
15. During a malpractice suit, how can the standard of what the wise and prudent nurse would
do best be established?
From the testimony of an expert nurse
By consulting with nursing faculty regarding standards of care
Conferring with a lawyer regarding malpractice parameters
By consulting the standards of The Joint Commissions
a.
b.
c.
d.
ANS: A
The most common way to establish the duty owed by a nurse is by the testimony of a
registered nurseusually, but not always, with training and background similar to the nurse
being sued. This expert witness will then testify as to what a reasonable nurse in the same or
similar circumstances would be expected to do. The Joint Commission standards may reflect
on hospital policies and procedures, not the nurses practice. A lawyer provides legal advice
but cannot attest to the standards of nursing practice that a nurse can. Faculty can be
knowledgeable about standards of care, but the testimony of a nurse with similar training and
background can determine what the wise and prudent nurse would have done.
PTS: 1
REF: p. 481
OBJ: Participate as a professional when dealing with nurses who are impaired or functioning
dangerously in a work setting.
TOP: Expert testimony
16. During a life-threatening emergency, a nurse hurriedly gives the patient a medication by IV
push. There is extravasation of medication. Later, necrosis and tissue sloughing take place.
The nurses behavior may be the basis for what action?
a. Felony charge
c. Tort suit
b. Misdemeanor charge
d. Defamation suit
ANS: C
Unintentional torts are those that usually involve an inadvertent, unreasonable act that causes
harm to someone. Civil, as opposed to criminal, actions are also called torts. Remember that
civil actions occur when a plaintiff files a lawsuit to receive compensation for damages he or
she suffered as a result of a perceived wrong. Unintentional torts are those that usually involve
an inadvertent, unreasonable act that causes harm to someone. Defamation (libel and slander)
refers to causing damage to someone elses reputation. If the means of transmitting the
damaging information is written, it is called libel; if it is oral or spoken, it is called slander.
PTS: 1
REF: p. 472
risks. TOP:
Torts MSC:
NCLEX: Not applicable
17. At the time of admission, a patient gave a history of allergy to penicillin that was duly noted
in all critical areas of the patients record. While giving medications, a nurse accidentally
administered penicillin to this patient. The patient had a severe reaction but recovered. What is
the implication of the nurses action?
a. The nurse cannot be sued for malpractice because the patient did not directly the
nurse of the allergy.
b. The nurse failed to act in a reasonable and prudent fashion and thus is liable for
malpractice.
c. The nurse who gave the medication can bring a countersuit against the nurse who
took the history.
d. There is no cause for concern because the action did not result in the patients
death.
ANS: B
The nurse failed to act in a reasonable and prudent fashion and thus is liable for malpractice.
The most common errors include failure to administer the right drug to the right patient, in the
right amount, by the right route, at the right time, and with the right documentation. Claims
involving medication errors are augmented when the nurse fails to record the medication
administration properly, fails to recognize side effects or contraindications, or fails to know a
patients allergies. There is no justification for the nurse to bring about a countersuit for the
nurse who took the medication history because it was clearly noted in all critical areas of the
chart.
PTS:
OBJ:
risks.
MSC:
1
REF: p. 467
TOP:
Medication errors
NCLEX: Physiological integritypharmacological therapies
18. In a legal suit, what element is necessary to prove a tort has been committed?
a. Intent
c. Injury
b. Assault
d. Malpractice
ANS: C
There are four elements that need to be present in a malpractice case, one of which is patient
injury. The patient will have to prove that the specific nursing action caused injury or harm.
The nurse, as a defendant, does not have a burden of proof.
PTS: 1
DIF: Cognitive Level: Knowledge
REF: p. 472
malpractice claim.
TOP: Malpractice, tort
19. What action must occur to prove a breach of duty?
a. Liability testimony of physician
b. Testimony from state board of nurses
c. Expert testimony
d. Testimony of coworkers
ANS: C
The duty of a nurse is to act as a reasonable nurse would under the same or similar
circumstances. An expert witness may testify as to what a reasonable nurse in the same or
similar circumstances would be expected to do. Testimony from a physician, the state board of
nursing, or coworkers does not establish a breach of duty. The state board of nursing provides
the statues and laws that govern nursing practice.
PTS: 1
REF: p. 455
malpractice claim.
TOP: Breach of duty
20. What is a significant action a nurse can take to prevent being named in malpractice suits?
a. Refuse to care for suit-prone patients.
b. Carry professional liability insurance.
c. Maintain updated professional knowledge and skills.
d. Check with a nursing supervisor before undertaking care.
ANS: C
When you become a registered nurse, you will have a license to practice nursing. This license
sets certain standards, which you must follow as a nurse in the state. Should you not live up to
these standards, your state can take away your ability to practice as a nurse. The best way to
maintain those standards to practice professionally is to stay updated on skills and knowledge.
Refusing to care for patients does not prevent you from being named in other malpractice
suits. Carrying professional liability insurance does not prevent a malpractice suit but may
provide assistance and monies in paying out claims. Although it is important to check with a
supervisor about questions concerning nursing care, it may not prevent you from being named
if you perform a procedure or intervention incorrectly.
PTS:
OBJ:
risks.
MSC:
1
REF: pp. 466-471
TOP:
Malpractice
21. A nurse places a heating pad on the lower leg of a patient with peripheral vascular disease.
When the heating pad is removed, it is apparent that the patient has sustained partial-thickness
burns to the area covered by the pad, and the nurse is sued for malpractice. Which statement is
true?
a. All elements are present to find the nurse liable for damages.
b. Proximate cause cannot be established, so the nurse will not be found liable.
c. The standard of care in such a situation cannot be established, so the nurse will not
be found liable.
d. No duty to the patient exists, so the nurse will not be held liable.
ANS: A
The nurse had a duty, that duty was breached, the injury was foreseeable, and the patient
suffered harm (partial-thickness burn). All four elements for a malpractice suit are present.
The other options do not show that all elements are present and are therefore incorrect.
PTS: 1
REF: p. 470
risks. TOP:
Malpractice
22. A nurse has relocated to another state and wants to find a full-time nursing job. What action
should be taken first in order to provide care as a nurse?

a. Begin applying for jobs at the local hospital.
b. Contact the board of nursing in the nurses new state to obtain licensure to practice.
c. Begin practicing immediately, as the nurse is still licensed in the formerly lived in
state.
d. Begin practice on a part-time basis so that a new license is not needed.
ANS: B
The nurse should contact the board of nursing in the state the nurse just moved to in order to
determine what needs to be done to obtain licensure to practice in that state. The nurse should
not begin practicing without an updated license even on a part-time basis. Each state may
require a new license, and the nurse will not be covered by a license issued in another state
unless the state is part of the nurse licensure compact. Either way, the nurse will need to
contact the board of nursing first.
PTS:
OBJ:
TOP:
MSC:
1
REF: p. 451
Describe your responsibilities for obtaining and maintaining your license.
Legal control over nursing practice
NCLEX: Safe and effective care environment
23. The nurse has an adequate understanding of nurse practice acts when stating which of the
following?
Nurse practice acts do not help guide nurses.
Nurse practice acts describe how to prepare for the NCLEX exam.
Nurse practice acts describe how and when to renew a nursing license.
Nurse practice acts provide a list of job openings.
a.
b.
c.
d.
ANS: C
Nurse practice acts are great resources that provide information to nurses, including how and
when to renew a nursing license. The nurse practice acts do not describe how to prepare for
the NCLEX exam or provide a list of job openings.
PTS:
OBJ:
TOP:
MSC:
1
REF: p. 451
24. A nurse wants to avoid malpractice claims. What action can be taken to greatly reduce the risk
of a lawsuit?
Reduce work status to part time.
Implement fall precautions on an older adult patient.
Leave clutter on the floor in patient rooms.
Leave the patients bed in the highest position.
a.
b.
c.
d.
ANS: B
To protect themself from a malpractice claim, the nurse can implement fall precautions on an
older adult patient. These include supervising the patient when getting out of bed, keeping the
floor clear, and placing the bed in the lowest position. Reducing work status to part time
would not guarantee that the nurse wouldnt be named in a lawsuit.
PTS:
OBJ:
risks.
MSC:
1
REF: p. 454
TOP:
Preventing malpractice claims
25. A nurse has just administered a medication when suddenly realizing that more medication was
given than was ordered. Which action should the nurse take?
Call the patients physician and report the error.
Say nothing about the medication error and continue to monitor the patient.
Document the dose that was supposed to be given in the medical record.
Document the amount given in the medical record but keep the error quiet.
a.
b.
c.
d.
ANS: A
The nurse should call the physician and report the error after assessing the patients condition.
The nurse should never falsify a document in the medical record or keep the error to themself.
PTS:
OBJ:
risks.
MSC:
1
REF: p. 467
TOP:
Preventing malpractice claims
26. Which of the following would be considered a criminal action?

a. A nurse who steals narcotics from the hospital
b. A nurse who gets into a verbal disagreement with a visitor
c. A nurse who restrains a patient who is considered a threat to himself
d. A nurse who refuses to allow a visitor onto the unit who appears intoxicated
ANS: A
An example of a criminal action is the nurse who steals narcotics from the hospital. Verbal
disagreements, restraining a patient who has the potential to harm themselves, and refusing
visitors who appear intoxicated are not examples of a criminal action.
PTS:
OBJ:
TOP:
MSC:
1
Discuss various sources and types of law.
Court actions based on legal principles
REF: p. 477
27. Which of the following can result in a civil action against the nurse?
a. Failure to monitor
b. Enforcing strict compliance with contact precautions against the familys wishes
c. Refusing to discuss the patients medical history with the family per patient request
d. Assisting the physician in a bedside procedure after obtaining informed consent
ANS: A
Failure to monitor can result in a civil action against the nurse. Enforcing strict compliance
with contact precautions against the familys wishes, refusing to discuss the patients medical
history with family per the patients request, and assisting the physician in a bedside
procedure after obtaining informed consent are not examples that could lead to civil action.
PTS:
OBJ:
TOP:
MSC:
1
REF: p. 450
28. Which of the following statements by the nurse indicates understanding of legal actions?
a. A misdemeanor is a less serious crime resulting in a fine.
b. A felony is a less serious crime that can result in a fine.
c. Civil actions are serious and often result in prison time.
d. The defendant is the victim.
ANS: A
A misdemeanor is a less serious crime resulting in a fine. A felony is a serious crime that often
results in prison time. In court cases, the victim is the plaintiff.
PTS:
OBJ:
TOP:
MSC:
1
REF: p. 450
29. Which statement by the nurse indicates understanding of the nurse practice act?
a. The nurse practice act defends any action the nurse may take.
b. The nurse practice act defines the scope of practice for each level of licensure.
c. The nurse practice act details pay raises for each year of service to an
organization.
d. The nurse practice act has language that grants nurses vacation time.
ANS: B
The nurse practice act defines the scope of practice for each level of licensure. It is a type of
state statutory law and can be obtained from the state board of nursing or online. It does not
defend any action the nurse may take, detail pay raises, or discuss vacation time.
PTS:
OBJ:
TOP:
MSC:
1
REF: p. 450
MULTIPLE RESPONSE
1. Which actions take place in organizations to monitor quality improvement? (Select all that
apply.)
Evaluation of what nurses are doing for patients
Development of policies and procedures
Employee evaluations
Intermittent monitoring
Continuing education
a.
b.
c.
d.
e.
ANS: A, B, C, E
There are many actions that take place in organizations to monitor quality improvement.
These include evaluation of what nurses are doing for patients, development of policies and
procedures, employee evaluations, ongoing monitoring, and continuing education.
PTS:
OBJ:
TOP:
MSC:
1
REF: p. 453
Take an active role in improving the quality of health care as required by legal standards.
Risk management and quality improvement
2. A nurse is completing an incident report. The nurse demonstrates an adequate understanding
of the report when refraining from putting which of the following on the form
(Select all that apply.)
a. Conclusions about the incident
b. The name of the patient
c. Blame of others
d. Judgment
e. The nurses opinion about what happened
ANS: A, C, D, E
The nurse should avoid putting conclusions, blame, judgment, and opinions on the incident
report. The nurse should only relay facts. It would be appropriate for the nurse to list the
patients name.
PTS:
OBJ:
TOP:
MSC:
1
REF: p. 479
3. The nurse has an adequate understanding of risk management when stating which of the
following? (Select all that apply.)

Risk management becomes involved when incidents occur.
Risk management becomes involved when untoward events occur.
Risk management becomes involved to discipline the nurse.
Risk managers gather evidence surrounding the event.
a.
b.
c.
d.
e. Risk managers will interview those involved in an event.

ANS: A, B, D, E
Risk management becomes involved when incidents and untoward events occur. Risk
managers gather evidence surrounding the event and interview those involved. Risk
management does not become involved to discipline the nurse.
PTS:
OBJ:
TOP:
MSC:
1
REF: p. 479
Zerwekh: Nursing Today, 7th Edition

Test Bank
MULTIPLE CHOICE
1. What elements must be present for a malpractice claim?
a. Duty, breach of duty, patient injury
b. Negligent nursing care, failure to follow standards
c. Failure to report, defamation, discrimination
d. Error in judgment, invasion of privacy
ANS: A
(1) You must have a dutythere must be a professional nurse/patient
relationship. (2) You must have breached a duty that was foreseeableyou
must have fallen below the standard of care. (3) Your breach of duty
caused patient injury or damages.
DIF: Cognitive Level: Comprehension
REF:
p. 427
OBJ: Be able to identify the elements of nursing malpractice and how they
are proven in a malpractice claim. TOP: MalpracticeMSC: NCLEX: Not
applicable
2. In transcribing orders for a patient, the nurse finds a new order for aspirin,
500 mg, qid. The patient has a long history of gastrointestinal bleeding.
What is the best nursing action?
c. Call the physician and question the order in light of the patients
history.
d. Ask the patient whether he is allergic to aspirin.
ANS: C
Claims involving medication errors are augmented when the nurse fails to
recognize side effects or contraindications or fails to know a patients
allergies. She should also follow up with the physician.
DIF: Cognitive Level: Application REF: pp. 434, 440

are proven in a malpractice claim. TOP: Doctors orders
3. The nurse enters a patients room to complete the discharge paperwork
and finds the patient in tears. The patient reports that someone from the
business office told her she could not leave the hospital until the bill was
paid. What is the best nursing action?
a. Comfort the patient and continue the preparations for discharge.
b. Call the social worker for a financial evaluation.
c. Call the family to arrange for the payment.
d. Cancel the discharge plans and notify the physician of the
situation.
ANS: A
If the patients claim is accurate, this could be false imprisonment
(wrongfully making someone feel that she cannot leave a place). Your best
action is to comfort the patient and continue the discharge preparations.
However, this should also be reported to the supervisor.
DIF: Cognitive Level: Application REF: p. 446
OBJ: Incorporate an understanding of legal risks into your nursing practice
and how to minimize risks.
TOP: False imprisonment
MSC: NCLEX: Safe, effective care environmentmanagement of care
4. What is a correct statement regarding a nurse who acts beyond the scope
of practice?
a. Demonstrates what a good nurse she or he can be
b. Provides enriched services to patients who would not otherwise
receive them
c. May make other nurses angry because of the increased
expectations created
ANS: D
States may regulate nursing practice by controlling the scope of practice
and determining the specific activities for each level of nursing. In most
states, the Nurse Practice Act provides definitions and scope of practice for
each level of nursing practice. The power of the board to discipline can
have an adverse affect on the nurses ability to practice.
REF:
p. 452
TOP: Scope of
practice
5. Which error in judgment would be the most serious for the nurse
defendant in a legal case?
ANS: B
You are expected to perform as a reasonable nurse would. If your actions
are not those of a reasonable nurse and this causes someone to be injured,
you can be sued. The patients chart is a legal document. Changing or
tampering with the chart would be in violation of the standards of practice
and the Nurse Practice Act and would not be considered what a
reasonable nurse would do.
TOP: Legal risks
6. What is the best legal safeguard for a nurse?
b. A legal contract
c. A valid license
ANS: A
Practicing within the parameters of the states Nurse Practice Act,
performing care based on established policies and procedures, and
performing as a reasonable nurse are the best ways for a nurse to
safeguard against legal action.
DIF:
OBJ:
TOP:
MSC:
Cognitive Level: Knowledge REF: pp. 419, 439

Nursing practice
NCLEX: Safe, effective care environmentmanagement of care
7. A nurse is providing care to a 6-year-old boy with a broken arm. She

notices multiple bruises. The boy says that his father got mad because he
was bad and that he hit him and broke his arm so that he would remember
to be good. What is the best nursing action?
b. Do nothing because you cannot prove he was abused.
d. Ignore what the child said because little boys often lie.
ANS: C
States have many statutes that require health care providers to report
certain incidences or occurrences. If the provider fails to report as required
and a person is injured, there can be negligence per se. It important for
nurses to be aware of the reporting statutes in the state in which they are
practicing. In most states, it is the law to report evidence of child or adult
abuse.
TOP: Reportable cases
8. What would be the most effective way for a nurse to validate informed
consent?
b. Determine from the physician what was discussed with the
patient.
c. Ask the family whether the patient understands the procedure.
d. Ask the patient what he understands regarding the procedure.
ANS: D
Informed consent in the health care setting is a process whereby a patient
is informed of the risks, benefits, and alternatives of a certain procedure
and then gives consent for the procedure to be done. The piece of paper is
simply evidence that the informed consent process has been completed.
REF: p. 449
TOP: Informed consent
9. A nurse who commits an infraction of the Nurse Practice Act is always
subject to discipline by what group?
a. A court of law
b. The state board of nursing
c. The local chapter of the state nurses association
d. The National League for Nursing
ANS: B
State Nurse Practice Acts regulate nursing by controlling the scope of
practice and determining the specific activities for each level of nursing.
Some states control who may use the titles registered nurse (RN) and
licensed practical nurse (LPN) or licensed vocational nurse (LVN). The
Nurse Practice Act is regulated and enforced by the state board of nursing.
REF:
p. 452
MSC:
NCLEX: Not
applicable
10. What does the scope of nursing practice refer to?

a. Acts that permit some overlap between nursing and medicine
b. The activities legally permissible for a nurse to perform in a
particular state
c. The specific duty the nurse owes to a patient
d. Those activities for which a nurse can be held liable for
malpractice
ANS: B
Defining the scope of nursing practice is part of the responsibility of the
state board of nursing. This involves determining the specific activities for
each level of nursing and who can perform what functions.
DIF:
OBJ:
TOP:
MSC:
Cognitive Level: Comprehension

REF:
p. 424
Scope of practice
NCLEX: Safe, effective care environmentmanagement of care
11. A nurse is being sued for assault and battery. What does this mean?
a. The nurse, without consent, touched the patient in an offensive,
insulting, or injurious way.
b. The nurse threatened to put the patient in restraints if he did not
stay in bed.
c. The nurse told the patient he could not leave until his bill was
paid.
d. The nurse failed to perform an act expected of a reasonable
nurse.
ANS: A
Assault and battery are the legal terms applied to nonconsensual threat of
touch (assault) or the actual touching (battery).
REF:
p. 446
TOP: Assault
12. What is the term used to describe a situation in which a patient agrees to
have an invasive procedure performed after having the procedure and its
consequences explained?
a. Contract
b. Incident report
c. Informed consent
d. Statute
ANS: C
Informed consent in the health care setting is a process whereby a patient
is informed of the risks, benefits, and alternatives of a certain procedure
and then gives consent for it to be done.
DIF: Cognitive Level: Knowledge REF: p. 446

13. What is the best definition of malpractice?
a. A criminal act committed against society
b. Doing something a reasonable person or nurse would not do
c. An intentional professional act of negligence
d. A professional act or failure to act that leads to injury of a patient
ANS: D
Malpractice may be defined as doing something outside your scope of
practice or something that is unsafe for the patient and could cause injury.
DIF: Cognitive Level: Knowledge REF: p. 421
are proven in a malpractice claim. TOP: Malpractice
14. A nurse tells a patient, If you dont stop getting out of that chair, Im
going to put some restraints on you. What may this nurse be accused of?
a. Assault
b. Defamation
d. Malpractice
ANS: A
Assault and battery are the legal terms applied to nonconsensual threat of
touch (assault) or the actual touching (battery). Use of restraints may also
be interpreted as false imprisonment.
REF: p. 446
TOP: Assault
15. During a malpractice suit, how can the standard of what the wise and
prudent nurse would do best be established?
a. From the testimony of an expert nurse
b. By consulting with nursing faculty regarding standards of care
c. Conferring with a lawyer regarding malpractice parameters
d. By consulting the standards of The Joint Commissions
ANS: A
The most common way to establish the duty owed by a nurse is by the
testimony of a registered nurseusually, but not always, with training and
background similar to the nurse being sued. This expert witness will then
testify as to what a reasonable nurse in the same or similar circumstances

would be expected to do.
OBJ: Participate as a professional when dealing with nurses who are
impaired or functioning dangerously in a work setting.
TOP: Expert
testimony
16. During a life-threatening emergency, a nurse hurriedly gives the patient a
medication by IV push. There is extravasation of medication. Later,
necrosis and tissue sloughing take place. The nurses behavior may be the
basis for what action?
a. Felony charge
b. Misdemeanor charge
c. Tort suit
d. Defamation suit
ANS: C
Civil, as opposed to criminal, actions are also called torts. Remember that
civil actions occur when a plaintiff files a lawsuit to receive compensation
for damages he or she suffered as a result of a perceived wrong.
Unintentional torts are those that usually involve an inadvertent,
unreasonable act that causes harm to someone.
REF: p. 426
TOP: Torts
MSC: NCLEX: Not
applicable
17. At the time of admission, a patient gave a history of allergy to penicillin
that was duly noted in all critical areas of the patients record. While giving
medications, a nurse accidentally administered penicillin to this patient.
The patient had a severe reaction but recovered. What is the implication of
the nurses action?
a. The nurse cannot be sued for malpractice because the patient did
not tell him or her directly of the allergy.
b. The nurse failed to act in a reasonable and prudent fashion and
thus is liable for malpractice.
c. The nurse who gave the medication can bring a countersuit
against the nurse who took the history.
d. There is no cause for concern because the action did not result in
the patients death.
ANS: B
The most common errors include failure to administer the right drug to the
right patient, in the right amount, by the right route, at the right time, and
with the right documentation. Claims involving medication errors are
augmented when the nurse fails to record the medication administration

properly, fails to recognize side effects or contraindications, or fails to
know a patients allergies.
TOP: Medication errors
18. In a legal suit, what element is necessary to prove a tort has been
committed?
a. Intent
b. Assault
c. Injury
d. Malpractice
ANS: C
There are four elements that need to be present in a malpractice case, one
of which is patient injury. The patient will have to prove that the specific
nursing action caused injury or harm. The nurse, as a defendant, does not
have a burden of proof.
DIF: Cognitive Level: Knowledge REF: pp. 427, 428
are proven in a malpractice claim. TOP: Malpractice, tort
19. In a malpractice suit, how may a breach of duty be established?
c. Expert testimony
ANS: C
The duty of a nurse is to act as a reasonable nurse would under the same
or similar circumstances. An expert witness may testify as to what a
reasonable nurse in the same or similar circumstances would be expected
to do.
REF:
p. 429
are proven in a malpractice claim. TOP: Breach of duty
20. What is a significant action a nurse can take to prevent being named in
malpractice suits?
a. Refuse to care for suit-prone patients.

ANS: C
When you become a registered nurse, you will have a license to practice
nursing. This license sets certain standards, which you must follow as a
nurse in the state. Should you not live up to these standards, your state
can take away your ability to practice as a nurse. The best way to maintain
those standards to practice professionally is to stay updated on skills and
knowledge.
REF:
p. 429
TOP: Malpractice
21. A nurse places a heating pad on the lower leg of a patient with peripheral
vascular disease. When the heating pad is removed, it is apparent that the
patient has sustained third-degree burns to the area covered by the pad.
The nurse is sued for malpractice. Which statement is true?
b. Proximate cause cannot be established, so the nurse will not be
found liable.
c. The standard of care in such a situation cannot be established, so
the nurse will not be found liable.
d. No duty to the patient exists, so the nurse will not be held liable.
ANS: A
The nurse had a duty, that duty was breached, the injury was foreseeable,
and the patient suffered harm. All four elements for a malpractice suit are
present.
TOP: MalpracticeMSC: NCLEX: Not
applicable
Zerwekh: Nursing Today, 6th Edition
Test Bank
MULTIPLE CHOICE
1. What elements must be present for a malpractice claim?

a. Duty, breach of duty, client injury
b. Negligent nursing care, failure to follow standards
c. Failure to report, defamation, discrimination
d. Error in judgment, invasion of privacy
ANS: A
(1) You must have a dutythere must be a professional nurse/client relationship.
(2) You must have breached a duty that was foreseeableyou must have fallen
below the standard of care. (3) Your breach of duty caused client injury or
damages.
OBJ: Be able to identify the elements of nursing malpractice and how they are
proven in a malpractice claim
2. In transcribing orders for a client, the nurse finds a new order for aspirin, 500 mg,
qid. The client has a long history of gastrointestinal bleeding. What is the best
nursing action?
c. Call the physician and question the order in light of the clients history.
d. Ask the client whether he is allergic to aspirin.
ANS: C
Claims involving medication errors are augmented when the nurse fails to
recognize side effects or contraindications or fails to know a clients allergies. She
should also follow up with the physician.
TOP: Doctors orders
3. The nurse enters a clients room to complete the discharge paperwork and finds
the client in tears. The client reports that someone from the business office told
her she could not leave the hospital until the bill was paid. What is the best
nursing action?
a. Comfort the client and continue the preparations for discharge.
b. Call the social worker for a financial evaluation.
c. Call the family to arrange for the payment.
d. Cancel the discharge plans and notify the physician of the situation.
ANS: A
If the clients claim is accurate, this could be false imprisonment (wrongfully
making someone feel that she cannot leave a place). Your best action is to
comfort the client and continue the discharge preparations. However, this should
also be reported to the supervisor.
OBJ: Incorporate an understanding of legal risks into your nursing practice and
how to minimize risks
TOP: False imprisonment
4. What is a correct statement regarding a nurse who acts beyond the scope of
practice?
a. Demonstrates what a good nurse she or he can be
b. Provides enriched services to clients who would not otherwise receive
them
c. May make other nurses angry because of the increased expectations
created
ANS: D
States may regulate nursing practice by controlling the scope of practice and
determining the specific activities for each level of nursing. In most states, the
Nurse Practice Act provides definitions and scope of practice for each level of
nursing practice. The power of the board to discipline can have an adverse affect
on the nurses ability to practice.
state board of nursing
OBJ:
Understand functions of a

5. Which error in judgment would be the most serious for the nurse defendant in a
legal case?
ANS: B
You are expected to perform as a reasonable nurse would. If your actions are not
those of a reasonable nurse and this causes someone to be injured, you can be
sued. The clients chart is a legal document. Changing or tampering with the
chart would be in violation of the standards of practice and the Nurse Practice Act
and would not be considered what a reasonable nurse would do.
TOP: Legal risks MSC: NCLEX: Safe, effective care environmentmanagement of
care
6. What is the best legal safeguard for a nurse?

b. A legal contract
c. A valid license
ANS: A
Practicing within the parameters of the states Nurse Practice Act, performing
care based on established policies and procedures, and performing as a
reasonable nurse are the best ways for a nurse to safeguard against legal action.
OBJ: Relate the Nurse Practice Act to the governance of your profession
TOP: Nursing practice
7. A nurse is providing care to a 6-year-old boy with a broken arm. She notices
multiple bruises. The boy says that his father got mad because he was bad and
that he hit him and broke his arm so that he would remember to be good. What is
the best nursing action?
b. Do nothing because you cannot prove he was abused.
d. Ignore what the child said because little boys often lie.
ANS: C
States have many statutes that require health care providers to report certain
incidences or occurrences. If the provider fails to report as required and a person
is injured, there can be negligence per se. It important for nurses to be aware of
the reporting statutes in the state in which they are practicing. In most states, it
is the law to report evidence of child or adult abuse.
TOP: Reportable cases
8. What would be the most effective way for a nurse to validate informed
consent?
b. Determine from the physician what was discussed with the client.
c. Ask the family whether the client understands the procedure.
d. Ask the client what he understands regarding the procedure.
ANS: D
Informed consent in the health care setting is a process whereby a client is
informed of the risks, benefits, and alternatives of a certain procedure and then
gives consent for the procedure to be done. The piece of paper is simply evidence
that the informed consent process has been completed.
9. A nurse who commits an infraction of the Nurse Practice Act is always subject to
discipline by what group?
a. A court of law
b. The state board of nursing
c. The local chapter of the state nurses association
d. The National League for Nursing
ANS: B
State Nurse Practice Acts regulate nursing by controlling the scope of practice
and determining the specific activities for each level of nursing. Some states
control who may use the titles registered nurse (RN) and licensed practical nurse
(LPN) or licensed vocational nurse (LVN). The Nurse Practice Act is regulated and
enforced by the state board of nursing.
state board of nursing
OBJ:
Understand functions of a
MSC:
NCLEX: Not applicable
10. What does the scope of nursing practice refer to?

a. Acts that permit some overlap between nursing and medicine
b. The activities legally permissible for a nurse to perform in a particular
state
c. The specific duty the nurse owes to a client
d. Those activities for which a nurse can be held liable for malpractice
ANS: B
Defining the scope of nursing practice is part of the responsibility of the state
board of nursing. This involves determining the specific activities for each level of
nursing and who can perform what functions.
OBJ: Relate the Nurse Practice Act to the governance of your profession
11. A nurse is being sued for assault and battery. What does this mean?
a. The nurse, without consent, touched the client in an offensive, insulting,
or injurious way.
b. The nurse threatened to put the client in restraints if he did not stay in
bed.
c. The nurse told the client he could not leave until his bill was paid.
d. The nurse failed to perform an act expected of a reasonable nurse.
ANS: A
Assault and battery are the legal terms applied to nonconsensual threat of touch
(assault) or the actual touching (battery).
TOP: Assault
care
MSC: NCLEX: Safe, effective care environmentmanagement of
12. What is the term used to describe a situation in which a client agrees to have an
invasive procedure performed after having the procedure and its consequences
explained?
a. Contract
b. Incident report
c. Informed consent
d. Statute
ANS: C
Informed consent in the health care setting is a process whereby a client is
informed of the risks, benefits, and alternatives of a certain procedure and then
gives consent for it to be done.
13. What is the best definition of malpractice?

a. A criminal act committed against society
b. Doing something a reasonable person or nurse would not do

c. An intentional professional act of negligence
d. A professional act or failure to act that leads to injury of a client
ANS: D
Malpractice may be defined as doing something outside your scope of practice or
something that is unsafe for the client and could cause injury.
TOP: Malpractice
14. A nurse tells a client, If you dont stop getting out of that chair, Im going to put
some restraints on you. What may this nurse be accused of?
a. Assault
b. Defamation
d. Malpractice
ANS: A
Assault and battery are the legal terms applied to nonconsensual threat of touch
(assault) or the actual touching (battery). Use of restraints may also be
interpreted as false imprisonment.
TOP: Assault
care
MSC: NCLEX: Safe, effective care environmentmanagement of
15. During a malpractice suit, how can the standard of what the wise and prudent
nurse would do best be established?
a. From the testimony of an expert nurse
b. By consulting with nursing faculty regarding standards of care
c. Conferring with a lawyer regarding malpractice parameters
d. By consulting the standards of The Joint Commissions
ANS: A
The most common way to establish the duty owed by a nurse is by the testimony
of a registered nurseusually, but not always, with training and background
similar to the nurse being sued. This expert witness will then testify as to what a
reasonable nurse in the same or similar circumstances would be expected to do.
OBJ: Participate as a professional when dealing with nurses who are impaired or
functioning dangerously in a work setting
TOP: Expert
testimony
16. During a life-threatening emergency, a nurse hurriedly gives the client a

medication by IV push. There is extravasation of medication. Later, necrosis and
tissue sloughing take place. The nurses behavior may be the basis for what
action?
a. A felony charge
b. A misdemeanor charge
c. A tort suit
d. A defamation suit
ANS: C
Civil, as opposed to criminal, actions are also called torts. Remember that civil
actions occur when a plaintiff files a lawsuit to receive compensation for damages
he or she suffered as a result of a perceived wrong. Unintentional torts are those
that usually involve an inadvertent, unreasonable act that causes harm to
someone.

TOP: Torts
17. At the time of admission, a client gave a history of allergy to penicillin that was
duly noted in all critical areas of the clients record. While giving medications, a
nurse accidentally administered penicillin to this client. The client had a severe
reaction but recovered. What is the implication of the nurses action?
a. The nurse cannot be sued for malpractice because the client did not tell
him or her directly of the allergy.
b. The nurse failed to act in a reasonable and prudent fashion and thus is
liable for malpractice.
c. The nurse who gave the medication can bring a countersuit against the
nurse who took the history.
d. There is no cause for concern because the action did not result in the
clients death.
ANS: B
The most common errors include failure to administer the right drug to the right
client, in the right amount, by the right route, at the right time, and with the right
documentation. Claims involving medication errors are augmented when the
nurse fails to record the medication administration properly, fails to recognize
side effects or contraindications, or fails to know a clients allergies.
TOP: Medication errors
18. In a legal suit, what element is necessary to prove a tort has been committed?
a. Intent
b. Assault
c. Injury
d. Malpractice
ANS: C
There are four elements that need to be present in a malpractice case, one of
which is client injury. The client will have to prove that the specific nursing action
caused injury or harm. The nurse, as a defendant, does not have a burden of
proof.
TOP: Malpractice, tort MSC: NCLEX: Not
applicable
19. In a malpractice suit, how may a breach of duty be established?

c. Expert testimony
ANS: C
The duty of a nurse is to act as a reasonable nurse would under the same or
similar circumstances. An expert witness may testify as to what a reasonable
nurse in the same or similar circumstances would be expected to do.
TOP: Breach of duty
MSC: NCLEX: Not
applicable
20. What is a significant action a nurse can take to prevent being named in
malpractice suits?
a. Refuse to care for suit-prone clients.

ANS: C
When you become a registered nurse, you will have a license to practice nursing.
This license sets certain standards, which you must follow as a nurse in the state.
Should you not live up to these standards, your state can take away your ability
to practice as a nurse. The best way to maintain those standards to practice
professionally is to stay updated on skills and knowledge.
TOP: Malpractice MSC: NCLEX: Safe, effective care environmentmanagement of
care
21. A nurse places a heating pad on the lower leg of a client with peripheral vascular
disease. When the heating pad is removed, it is apparent that the client has
sustained third-degree burns to the area covered by the pad. The nurse is sued
for malpractice. Which statement is true?
b. Proximate cause cannot be established, so the nurse will not be found
liable.
c. The standard of care in such a situation cannot be established, so the
nurse will not be found liable.
d. No duty to the client exists, so the nurse will not be held liable.
ANS: A
The nurse had a duty, that duty was breached, the injury was foreseeable, and
the client suffered harm. All four elements for a malpractice suit are present.

C 20

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Chapter 20: Legal Issues

Comfort the patient and continue the preparations for discharge.

DIF: Cognitive Level: Application

safeguard for the graduate nurse to take?

nursing and medicine.

nurse to perform in a particular state.

held liable for malpractice.

before giving consent.

13. Which definition, given by the nurse indicates understanding of malpractice?

restraints on you. What may this nurse be accused of?

should be taken first in order to provide care as a nurse?

26. Which of the following would be considered a criminal action?

2. A nurse is completing an incident report. The nurse demonstrates an adequate understanding

following? (Select all that apply.)

e. Risk managers will interview those involved in an event.

Zerwekh: Nursing Today, 7th Edition

DIF: Cognitive Level: Application REF: pp. 434, 440

Cognitive Level: Knowledge REF: pp. 419, 439

7. A nurse is providing care to a 6-year-old boy with a broken arm. She

10. What does the scope of nursing practice refer to?

Cognitive Level: Comprehension

DIF: Cognitive Level: Knowledge REF: p. 446

testify as to what a reasonable nurse in the same or similar circumstances

augmented when the nurse fails to record the medication administration

c. Maintain updated professional knowledge and skills.

Zerwekh: Nursing Today, 6th Edition

Chapter 20: Legal Issues

1. What elements must be present for a malpractice claim?

MSC: NCLEX: Physiological integritypharmacological therapies

TOP: Scope of practice

6. What is the best legal safeguard for a nurse?

MSC: NCLEX: Safe, effective care environmentmanagement of care

TOP: Nurse Practice Act

NCLEX: Not applicable

10. What does the scope of nursing practice refer to?

d. The nurse failed to perform an act expected of a reasonable nurse.

MSC: NCLEX: Safe, effective care environmentmanagement of

13. What is the best definition of malpractice?

b. Doing something a reasonable person or nurse would not do

MSC: NCLEX: Safe, effective care environmentmanagement of

16. During a life-threatening emergency, a nurse hurriedly gives the client a

DIF: Cognitive Level: Application

MSC: NCLEX: Not applicable

19. In a malpractice suit, how may a breach of duty be established?

a. Refuse to care for suit-prone clients.

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