SYNERGY REVIEW & TRAINING CENTRE

NLE NOVEMBER 2018

NURSING JURISPRUDENCE B. accused
C. defendant
NURSING JURISPRUDENCE
D. plaintiff
department of law which comprise all legal rules
STATUTE OF LIMITATIONS
and principles affecting the practice of NURSING.
Refers to the length of time following the event
LAW
during which the plaintiff may file a suit.
a rule of civil conduct prescribed by the supreme
Example:
power in a state commanding what is right and
negligence- filed within 2-3 years from
prohibiting what is wrong.
occurrence.
Sum total of rules and regulations by which
DUE PROCESS
society is governed
A fair and orderly process which aims to protect
TYPES OF LAW
and enforce a person’s right.
PRIVATE OR CIVIL LAW
FUNDAMENTAL REQUIREMENTS OF DUE PROCESS:
body of law that deals with relationship among
1. Right to be informed
private individuals
2. Right to remain silent
PUBLIC LAW
3. Right to competent counsel
body of law for the welfare of the general public;
4. No use of violence, threat, torture
relationship between individuals and the government and
5. Right to know the witness face to face
government agencies
PHASES OF DUE PROCESS
LEGAL RIGHT
PRE-TRIAL- eliminate matters not in dispute,
a claim which can be enforced by legal means
agree on issues or settle procedural matters.
against a person whose duty is to respect it.
TRIAL- facts are presented and determined; law
COURT
applied at the end.
An agency in the government wherein the
WRITTEN ORDERS OF COURT
administration of justice is delegated.
WRIT- legal notes from court
COURT MECHANISM
SUBPOENA- an order in court
LAWSUIT- proceeding in court for a purpose.
Duces tecum (papers) bring
Purpose:
documents, objects, materials,
Enforce a right
chart to court
Redress a wrong
Ad testificandum (person) testify
QUESTION
as witness at a specified time and
If you think that a person has done something
place
seriously wrong to you, the correct action to do
SUMMON- a writ commanding an
get redress for the injury received is to:
authorized person to notify a party to
A. systematically plan on how to have a vindication for the
appear in court to answer a complaint
damage done
made against him.
B. file a lawsuit against the person for damage

C. hire someone to take revenge for you
QUESTION
D. nothing, just forget about it
A process whereby the BON only compel the
PARTIES TO A CASE
personal attendance of a witness to bring with
Complainant VS Defendant: Civil case
Plaintiff VS Accused: Criminal case SYNERGY REVIEW & TRAINING CENTRE
Witness- an individual held upon to give necessary him to the court books, papers and the like to
details either for the accused or against the elucidate the matters in issue:
accused A. Warrant
QUESTION B. Subpoena
The person who institutes legal proceeding is C. Subpoena duces tecum
called: D. Summons
A. Plaintiff LAWS THAT PROMOTE THE WELFARE AND WELLBElNG OF
B. Respondent NURSES
C. Defendant 
D. Accused LEGAL CONCEPTS AND ISSUES IN NURSING
QUESTION PROFESSIONAL NEGLIGENCE
It is promulgated for the common good by one Negligence – failure to do something which a
who has legitimate authority: reasonable & prudent person should have done.
A. Jurisprudence 2 types:
B. Dilemma 1. Commission – wrong doing
C. Law 2. Omission – total neglect of care – didn’t
D. Ethics anything do
QUESTION ELEMENTS OF NEGLIGENCE
A hospital filed a case of damages against a NURSE 4D’S
for breach of contract. Who is the NURSE in the Duty for NURSE
case? Dereliction (breach of duty)
A. complainant Damages as result
Direct result (injury, harm or

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 SYNERGY REVIEW & TRAINING CENTRE
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death) Monica shared with the interviewer her most
OR… recent experiences about a restless pediatric
An injury incurred within the patient whom she puts up the side rails of the bed
Breadth of duty of the NURSE where to prevent accidental falls. Which of the following
Cause of injury is the failure to perform the attributes is shown by Monica?
Duty! A. Resourcefulness
SPECIFIC EXAMPLES B. Prudence
Burns resulting from hot water bags, heat C. Honesty
lamps, vaporizers, sitz bath D. Reliability
Objects left inside the patient’s body; DOCTRINES OF NEGLIGENCE
sponges suction tips 1. RES IPSA LOQUITOR
Falls of the elderly, confused, - “the things speak for itself”
unconscious, sedated patients - the injury is enough proof of negligence
Falls of children whose bed rails were not 2. RESPONDEAT SUPERIOR
pulled up and locked SYNERGY REVIEW & TRAINING CENTRE
Mistaken identity- drug given to the - Let the master answer for the acts of the
wrong patient subordinate
Wrong medicine, wrong concentration, - The liability is expanded to include the master as
wrong route, wrong dose well as the employee
Defects in the equipment 3. FORCE MAJEURE
QUESTION - Irresistible force; unforeseen or inevitable event
Which of the following situations would possibly - No person shall be responsible for those events
cause a NURSE to be sued due to negligence? which cannot be foreseen
A. NURSE gave a client wrong medication, and an Ex. Flood, fire, earthquake
hour later, client complained of dyspnea INCOMPETENCE: lack of ability, legal qualifications
B. While preparing a medication, the NURSE or fitness to discharge the required duty
notices that instead of 1 tablet, she put two tablets into QUESTION
the client’s medicine cup One of the important conditions that must be
C. As the NURSE was about to administer present in a negligent act to be considered as
medication, the client questioned why the medication is force majeure is:
still given when in fact the physician discontinued it. A. The NURSE is unable to predict the
D. NURSE administered 2 tablets of analgesic possible occurrence of the action hence,
instead of 1 tablet as prescribed. Patient noticed the error she cant prevent it
and complained. B. The injury is within the domain of
QUESTION NURSING practice
QUESTION C. The patient did not voluntarily participate
Which of the following statements if made by the in the action
NURSE, would you consider him/her as a prudent D. The superior is also accountable for the
NURSE? action
A. careful giving of medication in a central QUESTION
line When a staff NURSE gives the wrong medication
B. very cautiously asks supervision all the to her patient, the head NURSE and supervisor are
time also made responsible for the error. This is based
C. follows the doctor’s order even when she on what doctrine?
thinks it is wrong A. Respondent superior
D. questions wrong order of the doctor B. Good Samaritan Act
QUESTION C. Res ipsa loquitur
Which of the following actions by a NURSE would D. Force majeure
be considered negligence? QUESTION
A. Playing cards with an 8 y/o boy with diabetes When a NURSE causes an injury to the patient and
B. Instructing a 6 y/o asthmatic to blow on a pin the injury caused becomes the proof of the
wheel negligent act, the presence of the injury is said to
C. Massaging the abdomen of a 5 y/o with Wilm’s exemplify the principle of:
tumor A. Force majeure
D. Obtaining a blood test on a 6 day old infant B. Respondeat superior
QUESTION C. Res ipsa loquitur
A NURSE may be found negligent if: D. Holdover doctrine
1. a patient is injured MALPRACTICE
2. the NURSE did not follow the standard Doing acts or conducts that are not authorized or
3. failure to do the duty licensed or competent or skilled to perform,
4. the injury incurred by the pt. is foreseeable resulting to injuries or non-injurious consequences
A. 1,2,3 C. 1,2,4 Stepping beyond one’s authority
B. All of the above D. 2,3,4 Negligent act committed in the course of
QUESTION professional performance

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 SYNERGY REVIEW & TRAINING CENTRE
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RN exceeding the scope of NURSING practice &
does an MD’s job.
ELEMENTS OF MALPRACTICE
Duty of the NURSE
Dereliction or breach of duty
Direct result (injury or harm)
Damages
Exceeds the limits of the standards of care
Foreseability of harm
MEDICATIONS & PRESCRIPTIONS
1. Only registered medical, dental and veterinary
practitioners are authorized to prescribe drugs.
2. Prescription information (based on R.A. 5921 of the
Pharmacy Act)- all prescriptions must contain the
following information:
Name of MD, PTR, PRC#, location of clinic/
hospital
Name of patient, age, sex
Information about drug – frequency
duration
Generic & brand name in prescription
R.A. 6675- Generics Act of 1988
All prescribed drug must be written in
generic and brand names or generic name
but never the brand name alone
Purpose: for the pt. to choose what brand
they want
3. Know rights in giving meds
4. Proper identification of pt’s name
5. In cases of doubts and errors in medication, refer to the
physician.
6. Special training is required before a NURSE can
administer IV injection.
BON Resolution No. 8 states that who administers
IV injection without training shall be held liable whether
causing or not an injury or death to the patient)
7. Verbal or telephone order
General rule: as possible avoid T.O.
“whatever is not written is not an order”
Exception: During extreme emergency only!
What to do?
1. NURSE should read back such order to the
physician to make certain the order has been
correctly written.
2. Such order should be signed by the physician
within 24 hours.
3. The NURSE should sign the physician’s name per
her own and note the time and order was
received.
QUESTION
A telephone order is given for a client in your
ward. What is your most appropriate action?
A. Copy the order on to the chart and sign the
physician’s name as close to his original signature as
possible
SYNERGY REVIEW & TRAINING CENTRE
B. Repeat the order back to the physician, copy
onto the order sheet and indicate that it is a telephone
order
C. Write the order in the client’s chart and have
the head NURSE co-sign it
D. Tell the physician that you can not take the
order but you will call the NURSE supervisor
QUESTION
3
In an extreme situation and when no other
resident or intern is available, should a NURSE
receive telephone orders, the order has to be
correctly written and signed by the physician
within:
A. 24 hours C. 48 hours
B. 36 hours D. 12 hours
INTENTIONAL WRONGS
TORTS: A legal wrong, committed against a person
or property
TYPES:
1. Unintentional- do not require intent but do
require the element of harm.
Ex. Negligence and malpractice
2. Intentional- the act was done on purpose or with intent;
no harm, injury or damage is needed to be liable.
A. ASSAULT AND BATTERY
ASSAULT- an attempt or threat to touch another person
unjustifiably; mental or physical threat
Ex.- forcing a pt. to take his medication or
treatment
BATTERY- physical harm through willful touching of person
or clothing without consent.
Ex. – giving of injection without pt’s consent
2. FALSE IMPRISONMENT
- Unjustifiable detention of a person without a
legal warrant
- occurs when the person is not allowed to leave a
health care facility when there is no legal justification to
detain the client.
- occurs when restraining devices are used
without an appropriate clinical need.
3. INVASION OF PRIVACY
Right to privacy is the right to be left alone
Right to be free from unwarranted
publicity
Exposure to public view
Divulge information from patient’s chart
to improper sources or unauthorized
person
PRIVILEGED COMMUNICATION: Statements
uttered in good faith; not permitted to be
divulged in court of justice
Exceptions: Confidential information can be revealed!
Pt. consent, if there is
Inform HCT for precautionary measures
Crimes, child abuse, BWS
Communicable disease- R.A. 3573 (Law on Notifiable
Diseases)
Ethics
4. DEFAMATION
Character assassination
There must be a third person who hears
or read the comment before it can be
considered defamation
TYPES:
Slander-oral defamation
Libel-written words
QUESTION
The NURSE writes the following note in the client’s
chart, “the physician is incompetent because he
ordered the wrong drug dosage.” This statement
may lead to a charge of:
A. Assault
 SYNERGY REVIEW & TRAINING CENTRE
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B. Slander client or an extremity.
C. Libel TYPES:
D. Invasion of privacy Physical restraints: restrict client’s movement
QUESTION through the application of a device
Doing a NURSING procedure without the patient’s e.g. restraint jacket, straps,
informed consent may bring the health Chemical restraints: Medications given to inhibit a
professional to the court of law for what specific behavior or movement.
violation? e.g. sedation, psychotrophic drug
A. Tort C. Negligence RESTRAINTS SHOULD NOT BE USED PRN!!!
B. Assault D. Battery ALTERNATIVES TO RESTRAINTS
QUESTION Before restraints offer explanations, ask someone
Two janitors are having a heated argument as to to stay with the client, use clocks, calendars, TV &
who shall dispose the waste of a patient with radio (to decrease disorientation) or any
typhoid fever. The first one called the other relaxation techniques.
“lazybone” and “pain in the neck” within the Use LESS restrictive methods first. RESTRAINTS
hearing of the rest of the NURSEs. The case is: should always be the last.
A. Libel Assign confuse and disoriented clients to rooms
B. Slander near the NURSE’s station.
C. Invasion of privacy Maintain toileting routines & institute exercise
D. Negligence and ambulation schedules as the client condition
QUESTION allows.
Allowing a person who is in no way involved in the QUESTION
care of the patient to read the patient’s chart The NURSE noticed that restraining patients is a
constitutes which of the following violations: common practice. Which of the following should
A. Invasion of pt’s privacy she remember?
B. Breach of trust A. Restraints are necessary so that the NURSE
C. Malpractice could do more work for patients
D. Violation of pt’s dignity B. Use of restraints is an effective intervention
QUESTION C. Restraints require a physician’s order
Which of the following persons cannot have the D. Refusal to be restrained is a ground for
access to the patient record? terminating the NURSE-patient relationship
A. physical therapist CRIMES & OTHER ACTS
B. lawyer of the family CRIME: An act committed or omitted in violation
C. the patient of the law
SYNERGY REVIEW & TRAINING CENTRE Two elements:
D. speech therapist Criminal act
QUESTION Evil/criminal intent
It is unethical to tell one’s friends and family Criminal Actions
members data about the patient because doing so Acts or offenses against public welfare
is a violation of patients’ rights to: Misdemeanor- offenses or acts less than a
A. Informed consent felony
B. Confidentiality Felony- a public offense committed with
C. Least restrictive environment deceit and fault
D. Civil liberty Criminal negligence
QUESTION Reckless imprudence- person does an act
Should the accusation be written in the newsletter from which damage results immediately
of the hospital, such liability is a/an: Simple imprudence- did not use
A. Assault precaution and the damage was not
B. Libel immediate
C. Slander CLASSIFICATION
D. Battery 1. Manner of commission:
QUESTION Deceit (dolo) with criminal intent
Confidentiality of patient’s identity and condition Fault (culpa) without; negligence
is one of the NURSING responsibilities in the 2. Stages of Execution
hospital. Which of the following reasons can 3. Degree of penalty and fine
information be given without patient consent 4. Degree of participation
EXCEPT: QUESTION
A. Patient is charged with a crime A crime can be committed with the element of
B. Patient has a TB culpa if:
C. Patient is a victim of child abuse A. the person committed the crime because of
D. Patient with cancer ignorance of the law
RESTRAINTS B. the person knows the action is a crime and he
Restraints are protective devices used to limit the chooses to do it
physical activity of a client or to immobilize a C. the person committed the crime because he

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lacked the competency to act correctly Reasonable necessity
D. all of these Lack of sufficient provocation
QUESTION Fulfillment of Duty
The NURSE out of pity unhooked the patient from Obedience to an order from superior
a respirator. The patient died after 15 minutes. Order must be lawful
This type of felony is: Superior acting within the scope of
A. Consummated practice
B. Frustrated EXEMPTING
C. Attempted Insane/imbecile
D. Murder Performance of a lawful act causes injury by mere
SYNERGY REVIEW & TRAINING CENTRE accident
 Under 9 y/o
QUESTION Under compulsion of uncontrollable force
If the penalty is death, what is the degree of the Under impulse of uncontrollable fear
felony? Failure to perform an act required by law when
A. grave prevented by some lawful cause
B. less grave MITIGATING
C. light felony Under 18y/o or over 70 y/o
D. none of the above No intention to commit so grave a wrong
SITUATION Sufficient provocation/threat preceding the act
Danaya is two-months pregnant. Her parents do Immediate vindication of a grave offense
not know this. She informed her friend Alena Voluntary surrender
about the problem. Alena then referred Danaya to Deaf & dumb/ with physical defect
Pirena, an abortionist. Danaya had an abortion. Suffer from such illness that diminishes willpower
If those involved will be charge legally, who is AGGRAVATING
considered the principal? Treachery/taking advantage of superior strength or
A. Pirena C. Alena position
B. Dayana D. None of them Price, reward, promise
If during the investigation, the pieces of evidence Use of fire, poison, explosion
were not found because Gurna, the maid of Pirena Calamities
burned it. Gurna is considered as: Craft, fraud or disguise employed
A. Accomplice Evident Premeditation
B. Accessory Cruelty
C. Principal ALTERNATIVE
D. Co-principal May increase/ decrease criminal liability
QUESTION depending on the nature and effects of the crime
A NURSE is liable as an accomplice in an abortion Relationship
if she; Intoxication
A. Assist in the escape of the offender Degree of instruction/ education
B. Refers the pregnant mother to the abortionist DRILLS
C. Conceals the evidence of the crime 1. Under compulsion of uncontrollable force
D. None of these 2. There is sufficient provocation
QUESTION 3. Act is committed with abuse of confidence
A person uses the license of another person to 4. Fulfillment of a duty
practice NURSING is liable for what? 5. Offender is over 70 years old
A. negligence 6. Voluntary surrender
B. malpractice 7. Disguise in being employed
C. misdemeanor 8. Defense of a stranger
D. invasion of privacy 9. Acts under the impulse of an uncontrollable fear
QUESTION 10. Offender is insane
The receptionist of a clinic was asked by police if a QUESTION
certain doctor charged with murder was hiding in Premeditating to commit a crime is considered as:
the premises of the clinic. She lied about it but A. justifying
unfortunately the doctor was discovered inside SYNERGY REVIEW & TRAINING CENTRE
the clinic. She could be charged with: B. mitigating
A. Principal C. aggravating
B. Accessory D. exempting
C. Accomplice QUESTION
D. Assistant All of the following are exempting circumstances
Circumstances affecting criminal liability except:
J-E-M-A-A A. Imbecile
JUSTIFYING B. 8 year old
SELF-DEFENSE C. performance of a lawful act
Unlawful aggression D. offender is deaf and dumb

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 SYNERGY REVIEW & TRAINING CENTRE
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QUESTION 2. Be familiar with the laws affecting NURSING practice
When a politician takes advantage of his power in 3. Know agency rules, regulations, policies
the performance of unlawful actions, this is 4. Upgrade skills and competence
considered as: 5. Develop good IPR with co-workers
A. justifying circumstance 6. Consult superior as needed
B. exempting circumstance 7. Verify vague/ erroneous orders
C. mitigating circumstance 8. Always keep doctor updated regarding patient
D. aggravating circumstance 9. Ensure accurate recording and reporting
QUESTION 10. Get informed consent
When the defendant kills someone accidentally: 11. Do not delegate responsibilities to others
A. justifying TIPS FOR AVOIDING LEGAL PITFALLS:
B. exempting 1. Patient Falls
C. aggravating do proper assessment
D. mitigating appropriate assistance
CRIMES CONCERNING THE NURSE use protective measures
MORAL TURPITUDE document all NURSING
Are acts contrary to the accepted and customary interventions
rule of right 2. Medication errors
ANTI- RAPE LAW (RA 8353) observe the rights of drug administration
2.MURDER- killing of another with intent Check dr’s order
3. HOMICIDE- unintentional killing of another person Understand the medication you will administer
4. PARRICIDE Consult drug handbook/ pharmacy
Killing of a person to whom you have a Not exempt from liability for following wrong dr’s
relationship order
1. father 3. Equipment injuries
2. mother refuse to use a device you do not know how to
3. brothers/sisters operate
4. ascendants report adverse events to superiors
5. descendants monitor patient regularly
6. spouse SYNERGY REVIEW & TRAINING CENTRE
5. ABORTION- termination of product of conception bring questionable orders to the attention
before the age of viability. of the doctor or superior
6. INFANTICIDE DRILLS
- the killing of an infant less than three days or 72 hours. 1. A student NURSE is overheard talking in the cafeteria
8. THEFT- -anyone who gets the personal property about a client and his suicidal tendencies.
of another without the latter’s permission. 2. A NURSE asks a client why he chose Dr. Smith for her
7. ROBBERY physician when this doctor is always rude to the staff.
- Anyone who gets the personal property of 3. A client is told he must pay the remainder of his
another with the use of force, violence or medical bill before he can leave the facility.
intimidation. 4. A NURSE told the client that she will inject her with
9. SIMULATION OF BIRTH sedatives if he does not cooperate.
1. Pretend that a woman gave birth 5. A NURSE forcibly opened the mouth of a pedia patient
2. Substitution or exchanging of babies in the NURSING and gave his medication.
3. Intentionally putting wrong information in the birth 6. A NURSE takes the wallet of the patient while the latter
registration form is sleeping.
P.D. 651 – Birth Registration Act - requires any person 7. A NURSE takes the wallet of the patient with the use of
(RN,OB, NURSE) who shall assist in giving birth to report violence and intimidation.
within 30 days without penalty any live birth at Local Civil 8. A NURSE gives a potent injection of morphine to a
Registrar’s Office. patient causing his death.
DISPENSING OF PROHIBITED DRUGS 9. A NURSE poisons his client to end his life.
R.A. 6425 (1965) – Dangerous Drugs Act 10. A patient died because of wrong medication given.
A. Prohibited – chemicals or substances that are totally NURSES AND CONTRACTS
and absolutely can’t be consumed by human being. CONTRACT
Ex. Shabu, cocaine, cannabis Meeting of minds between two persons whereby
B. Regulated – can use this drug - with appropriate one binds himself, with respect to other, to give
prescription - MD with appropriated license something or to render some service
Ex.- Valium, dormicum A promise which the law recognizes as a duty and
PENALTY FOR VIOLATING THE ACT when that duty is not performed the law provides
For licensed health care providers: a remedy (Breach)
Fines KINDS OF CONTRACT
Imprisonment Formal- refers to an agreement between parties
Automatic revocation of license and is required to be in writing.
GUIDELINES TO PREVENT CRIMINAL LIABILITY: E.g. marriage contract ..
1. Be very familiar with the Philippine NURSING law Informal- one in which the law does not require

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the same to be in writing. you. What should you do first?
Express- the conditions and terms of contract are A. Tell the physician who in turn could tell the
given orally or in writing by the parties concerned. family
E.g. PDN under the doctrine of "facio ut des" B. Obtain her permission to share the information
means I do that you may give. in the family
Implied- one that is concluded as a result of acts C. Tell Imang that she has to tell her family what
of conduct of the parties into a contract. she told you
Void- one that is inexistent from the very D. Make an appointment to discuss the situation
beginning and therefore may not be enforced. with the family
Illegal- one that is expressly prohibited by law SYNERGY REVIEW & TRAINING CENTRE
Those that are made In protection of the QUESTION
law Informed consent is necessary for the treatment
Consent obtained by fraud; duress; undue for involuntary clients. When this cannot be
influence and material misrepresentation obtained, permission may be taken from the:
CONSENT A. social worker
a free and rational act that presupposes B. doctor
knowledge of the thing to which consent is being C. next of kin or guardian
given by a person who is legally capable to give D. chief NURSE
consent QUESTION
Informed Consent- a written consent should be signed to The patient has a right to information regarding
show that the procedure is the one consented to and that the operation or other invasive procedure and
the person understands the nature of the procedure potential effects. This right is achieved through:
NURSE’s responsibility regarding informed A. informed consent
consent B. preoperative visit
(1) witness the exchange between the client and the C. charting
physician D. doctor’s rounds
(2) witnessing the client affix his signature QUESTION
(3) establishing that the client really understood. A thumb mark of a comatose patient in the
Characteristics of a Valid Consent informed consent is considered:
Voluntariness; free from coercion A. a misrepresentation
Opportunities to ask questions expalined B. “nothing”
Treatment explained C. not a valid signature
Understood by the patient D. a valid signature
Maturity of parties (physically and mentally) QUESTION
CRITERIA OF GOOD CONSENT Edward elaborated on the concept of informed
Eighteen years old and above consent. He determines that the NURSEs need
Mentally capacitated more explanation if their response is one of the
Proxy consent- <18 and mentally following:
incapacitated A. the consent should provide a description of
Parent alternative treatments or procedures
Guardian (in order) B. the consent should offer a thorough
Physician explanation of the procedures to be done and the
Guardian ad litem consequences of it.
Exceptions to an Informed C. the consent should include the medical

Consent diagnosis and explanation of the patient’s condition
Married & mature minors D. the consent should describe the prognosis if the
Emancipated minors recommended care is refused.
Emergency cases QUESTION
Minors seeking birth control or pre-natal treatment A NURSE and a pregnant woman agreed that the
Over specific age (12 years old & above may give consent NURSE will do home delivery for a fee. What type
for STD, HIV testing, AIDS treatment, drugs & alcohol of contract?
treatment without parents consent. A. Implied C. Void
Sexually abused minors & adolescents B. Expressed D. Formal
QUESTION LEGAL CONSIDERATIONS IN CHARTING
The NURSE must see to it that the written consent PURPOSE OF THE PT’S. CHART
of mentally ill patients must be taken from: Communication and continuity
A. Doctor Assurance of quality care
B. Social worker Research
C. Parents or legal guardian Legal document
D. Law enforcement authorities Statistics of the disease
QUESTION *The chart is owned by the hospital
Imang is terminally ill, she speaks to you in DO’S & DONT’S IN CHARTING
confidence. You now feel that Imang’s family DO’S
could be helpful if they knew what Imang has told Full, factual and objectively accurate

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 SYNERGY REVIEW & TRAINING CENTRE
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Legible A. When the record is voluminous
Immediate B. When a medical record is subpoenaed in
Personal court
DON’T’S C. When it is missing
Language or unacceptable words D. When the medical record is inaccurate,
Improper corrections incomplete, and inadequate
Spaces & skips QUESTION
Abbreviation, not standard Disposal of medical records in government
Don’t tamper the medical record by: hospitals/institutions must be done in close
Adding coordination with what agency?
Rewriting A. Department of Interior and Local
Destroying original record Government (DILG)
Observe agency’s standards on documentation B.
Metro Manila Development Authority
Complete & Concise (MMDA)
Specific & Standard abbreviations C. Records Management Archives Office
Writing an Incident Report (RMAO)
A tool used as a means of identifying and D. Department of Health (DOH)
improving client care. They are usually made QUESTION
immediately after its occurrence and validated In the hospital, when you need the medical record
immediately by co-workers. of a discharged patient for research you will
Purpose: to provide accurate documentation of request permission through:
occurrences affecting the client as to have basis A. Doctor in charge
for its intervention. B. Hospital director
The following are common situations that require C. The NURSING service
an incident report: D. Medical records section
MOST OF THEM ARE NEGLIGENT ACTS QUESTION
Falls , burns & medication error Legally, patient’s chart is:
Break in the aseptic technique A. Owned by the hospital
Incorrect sponge count during surgery B. Owned by the doctor
Failure to report the clients condition C. Owned by the gov’t. cause it’s
Rules in Incident Report a legal
document
Don’t use the word error or include lawful D. Owned by the patient
judgment or inflammatory words QUESTION
QUESTION As a NURSE, you can help improve the
A main function of the patient’s records is to: effectiveness of communication among healthcare
A. prepare the NURSE for the shift worked givers by:
B. serve as a record of financial charges A. Use of reminders of ‘what to do’
C. serve as a vehicle for communication B. Using standardized list of
D. ensure that the message is received abbreviations, acronyms, and symbols
QUESTION C. One-on-one oral endorsement
When the NURSE writes in the chart and discovers D. Text messaging and e-mail
an error has been made, which is the BEST QUESTION
approach? Charting should be legible and include only
A. erase the erroneous material standard abbreviations. Which of the following is
B. carefully ink out the erroneous material NOT a standard abbreviation?
C. place an asterisk next to the statement, then A. PRN C. NNO
footnote it B. OD D. NPO
D. draw a straight line through the error & NURSES AND WILLS, GIFTS, ADVANCE DIRECTIVES
initial it. WILLS- legal declaration of a person’s intentions
QUESTION upon death.
Which of the following qualities are relevant in Called a testamentary document
documenting patients care? because it takes effect after the
SYNERGY REVIEW & TRAINING CENTRE death of its maker
1. accuracy and consciousness An act whereby a person is
2. thoroughness and currentness permitted with the formalities
3. systematic and orderly prescribed by law, to control a
4. legibly, properly dated and signed certain degree the deposition of
5. use of locally accepted abbreviation his estate, to take effect after
A. 1,3,4 & 5 C. 1,2,3 & 5 death.
B. 2,3,4 & 5 D. 1,2,3,& 4 Decedent – a person whose property is
QUESTION transmitted through succession whether or not he
The patient’s medical record can work as a double left a will
edged sword. When can the medical record Testator – a person who left a will.
become the doctor’s/ NURSE’s worst enemy? Testatrix – a woman who is making a will

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 SYNERGY REVIEW & TRAINING CENTRE
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Heir – a person called to succession either by the
provision of a will or by operation of law
Testate – a person who dies leaving a will
Intestate – a person who died without leaving a
will
Probate – validation of a will in court
Administrator – one who administers the
provision of the will
Estate – the interest a person has in lands or in
any other subject to property
Attestation Clause- means the clause wherein the
witness certifies that the instrument has been
executed before them, and the manner of the
same.
TYPES OF WILLS
Holographic will – a will is written, dated and
signed by the testator
Nuncupative will or Nuncupation- an oral will
WHO CAN MAKE A WILL?
Sound mind
Eighteen years old & above
Not prohibited by law
WHO CAN WITNESS?
Sound mind
Eighteen years old & above
Able to read and write
Not blind, deaf or dumb
The midwives obligation in the Execution of a will
Note the soundness of the Pt’s mind
Ensure there was freedom from fraud or under
influence
SYNERGY REVIEW & TRAINING CENTRE
The Pt should be above 18 years of age
Note the will was signed by the testator and that
the witnesses signed the will in the presence of
the testator
For protection, the NURSE must make a notation
on the Pt’s chart
Gifts
Another way of disposing property
Four legal requirements for a gift:
gift must consist of personal property
Intention to make the gift
Indication of transfer of control over such
property
acceptance by the recipient
 the agony of the
Gifts Causa Mortis or Donation Causa Mortis
 cultural & religious
– client against
Gifts made by a person because of anticipation of death or
beliefs in approaching death.
ADVANCE CARE
DIRECTIVE
a document written or completed by the client
and used by a facility or hospital to provide care at
a time when client cannot make his own decision
SUBJ ECTS:
1. Show risk for early dementia
2. Show risk for stroke
3. Activities- severe head injuries
4. Severe and recurring psychiatric illness
5. Terminally ill
Characteristics of Advance Directives
a. Allows clients to participate in choosing health
care providers
9
b. Allows also in choosing the type of medical
treatment the client desires.
c. Allows clients to consent or refuse treatments
TYPES:
1. INSTRUCTIVE DIRECTIVE- specifies life- sustaining
treatment to be withheld or withdrawn.
n LIVING WILL-legal document stating person does
not wish to have extra-ordinary life saving measures when
not able to make decisions about his own care.
-applicable for life saving treatment only.
Example: DNR
2. PROXY OR DURABLE POWER OF ATTORNEY
legal document giving designated person
authority to make health care decisions on the
client’s behalf when the client is unable to do so.
QUESTION
Mr. Martin felt better after 5 days but recognizing
the severity of his illness, he executes a document
authorizing the wife to transact any form of
business in his behalf in addition to all decisions
relative to his confinement his document is
referred to as:
A. durable power of attorney
B. living will
C. informed consent
D. medical records
QUESTION
While in the ICU, a pt. executes the document that
list the medical treatment he chooses to refuse in
case his condition becomes severe to a point that
he will be unable to make decisions for himself.
This document is:
A. living will
B. informed consent
C. last will and testament
D. power of attorney
Do not Resuscitate (DNR)
Factors in giving order of resuscitation:
1. Client’s will and advance directives
2. Disease prognosis such as cancer or HIV
3. Client’s ability to cope
4. Whether CPR will be given or not
Reasons for refusing to perform resuscitation
Epidemic or widespread disease or debilitating
condition & that CPR is not beneficial
CPR will aggravate or prolong
suffering
Advance directives & Will
QUESTION
In medical and NURSING practice, code means a
call for:
A. DNR state
B. call to order
C. clinical case
D. cardiopulmonary resuscitation
Organ Donation
REQUIREMENTS:
Any person 18 years of age or older may become
an organ donor by written consent.
Informed choice to donate an organ can take
place with the use of a written document signed
by the client prior to death, a will, or a donor card
 SYNERGY REVIEW & TRAINING CENTRE
NLE NOVEMBER 2018
or an advance directive. that one has made to oneself and others
In the absence of appropriate documentation, a VERACITY
family member or legal guardian may authorize Truthfulness or honesty
donation on the descendant’s organs. RESPECT
In case of newborns, they must be full term treat all individuals as persons with rights with or
already (more than 200 grams) without abnormality.
TYPES: INVIOLABILITY/ SANCTITY OF LIFE
1. Autotransplantation- donor and recipient are one and No one can violate or destroy life
the same SHARING OR ALLOCATION OF
Ex: skin and bones RESOURCES
2. Heterologous- donor and recipient are two different applies when resources are scanty or very limited
individuals. Standards of Care
SYNERGY REVIEW & TRAINING CENTRE Guidelines for determining whether NURSEs have
a. animal to human performed duties in an appropriate manner &
b. human to human guidelines in which the NURSE should practice
c. cadaver donor QUESTION
d. living donor Bioethics in caring for children capitalizes on some
Types of organs used : important principles. You are expected to know
1. Those that regenerate these by heart because NURSEs care for children
- bone marrow, skin as well as adults.
2. Those that come in pair What is the principle to hold on when caring for
- kidneys, eyes children who have been abandoned and abused?
Religions that have different views regarding a. consistent assurance
organ donations b. respect
Russian Orthodox: permits all donations EXCEPT c. allocation of resources
THE HEART. d. autonomy
Jehovah’s Witness: DOES NOT ALLOW organ QUESTION
donation and all organ to be transplanted must be The principle that tells children are to be treated
drained of blood first. accordingly as persons is
Judaism: They permit organ donation as long as a. beneficence
with RABBINICAL CONSULTATION. b. autonomy
Islam: will NOT USE ORGAN STORED IN ORGAN c. non-maleficence
BANKS. d. respect
NURSING ETHICS QUESTION
ETHICS When a NURSE is providing care to her/his
Came from the Greek word ETHOS ‘moral duty’ patient, s/he must remember that she is duty
Studies how people make judgment in regard to bound not to do any action that will cause the
right or wrong patient harm. This is the meaning of the bioethical
MORALITY principle:
It is the right or wrong; good or evil; proper or A. Non-maleficence
improper, cruel or benevolent acts B. Beneficence
Health Care ethics C. Justice
Division of ethics that relates to human health D. Solidarity
Bioethics QUESTION
Focuses on moral issues in the field of health care When the NURSE triage patients to render care
NURSING ETHICS accordingly, you are using this particular
The examination of all ethical and bio-ethical principle
issues from the prospective of NURSING theory a. respect
and practice b. allocation of resources
PRINCIPLES IN c. beneficence
BIOETHICS d. autonomy
BENEFICENCE QUESTION
means to do only what’s good In choosing sharp intramuscular needles for
NON- MALEFICENCE injection, you are practicing this principle
Principle of “do no harm” SYNERGY REVIEW & TRAINING CENTRE
AUTONOMY a. beneficence
the right to make one’s own decision; selfdetermination b. respect
STEWARDSHIP c. justice
not harm our body because it is God’s not ours d. non-maleficence
JUSTICE QUESTION
The right to be treated fairly, justly and equally In rendering care to a handicapped child, the
FIDELITY NURSE has many responsibilities, most of all the
refers to the obligation to be faithful to the NURSE should be ethical.
agreements, commitments and responsibilities What principle should a NURSE carry when caring

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for a handicapped child? when to divulge information:
a. respect 1. patient placed in serious danger
b. beneficence 2. public welfare
c. non-maleficence 3. legal proceeding
d. justice 7. Right to go over records
QUESTION 8. Right to services and to transfer
Ensuring that there is an informed consent on the Referral
part of the patient before a surgery is done, 9. Right to know relationship with other health care and
illustrates the bioethical principle of: educational institutions
A. Beneficence 10. Right not to be subjects of research or
B. Autonomy experimentation
C. Veracity 11. Right to expect reasonable continuity of care
D. Non-maleficence follow up consultations
QUESTION 12. Right to know what hospital rules and regulations
In apportioning candies and other nice goodies apply to his conduct as a patient
among children, what bioethical principle should a MORAL PRINCIPLES
NURSE observe? The golden rule
a. respect Do unto others what you would
b. beneficence like others do unto you
c. non-maleficence The two fold effect
d. justice May have bad and good effect
QUESTION Must be morally good
This principle states that a person has Good effect must be willed and
unconditional worth and has the capacity to the bad effect merely allowed
determine his own destiny: Good effect must not come from
A. Bioethics C. Fidelity an evil action
B. Justice Good effect must be greater than
D. Autonomy
QUESTION the bad effect
A handicapped child like any other child should be The Principle of Totality
loaded with The whole is greater than any of
a. care its parts
b. food Epikia
c. toys SYNERGY REVIEW & TRAINING CENTRE
d. love Exception to the general rule
QUESTION One who acts through an agent is himself
What ethical consideration is violated in human responsible
transplantation? Ex. NURSE recommends patient to
a. Principle of totality another clinic for abortion but
b. Stewardship does not want to perform
c. Autonomy No one is obliged to betray
d. Respect himself/herself
PATIENT’S BILL OF No one can force any person to
RIGHTS answer a question if such will
1. Right to considerate and respectful care incriminate him/her
NURSE avoids discriminating acts that tends to The end does not justify the means
bring the appearance of favoritism Giving sleeping tablets to
a “ tender loving care attitude” someone who has chronic illness
2. Right to information about diagnosis, Defects of nature may be corrected
treatment and prognosis Corrected by plastic surgery
3. Right to informed consent If one is willing to cooperate in the act,
refers to the capacity of the patient to accept or no injustice is done to him/her
refuse treatment options offered by the health With patient’s consent
care provider. A little more or less does not change the
Elements: substance of an act
n Voluntariness Stealing
n Informed The greatest good for the greatest
n Competent parties number
n Knowledgeable info. provided Have more good effects for more
n Signed prior to pre-op meds people than a smaller group
4. Right to an advance care directive No one is held to the impossible
5. Right to Privacy Do not promise impossible things
6. Right to confidentiality The morality of cooperation
all records and communications held in Formal cooperation is an evil act
confidence and never allowed

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Principle relating to the origin and Values, customs and spiritual beliefs
destruction of life respected
shall be
Thou shall not kill Individual freedom to make decisions
PATIENT’S Personal information acquired must
RESPONSIBILITIES be held in
Providing information confidence
Complying with instructions Guidelines to be observed:
Informing the physician of refusal to treatment a. individuality and totality of patients
Paying hospital charges b. respect
Following hospital rules and regulations c. uphold the rights of individuals
Showing respect and consideration d. take into consideration culture and values
NURSES’ BILL OF RIGHTS in the event of conflict, welfare and safety take
Registered NURSEs promote and restore health precedence
Prevent illness SYNERGY REVIEW & TRAINING CENTRE
Protect the people entrusted to their care
REGISTERED NURSES AND
Alleviate suffering
PRACTICE
Provide services that maintain respect for human
Ethical Principles
dignity
a.Human life is inviolable
QUESTION
b.Quality and excellence in the care of patients
The Patient’s Bill of rights helps practitioners
c.Accurate documentation- NURSING accountability
provide more effective patient care. Which of the
Guidelines to be observed:
following should NOT be included in the list?
a. know the definition and scope of NURSING practice
A. be informed of administrative and policies and
b. be aware of duties and responsibilities
practices
c. acquire and develop competence in knowledge, skills
B. considerate and respectful care
and attitude
C. confidentiality of communications and records
d. optimum standard of safe NURSING practice
D. relevant current and understandable
e. be morally and legally responsible
information concerning diagnosis, treatment diagnosis,
f. patient’s records considered confidential
specific procedures treatment and risks involved.
RN’S are aware that their actions have
QUESTION
professional, ethical, moral and legal dimensions
You inform the patient about his rights which
Guidelines to be observed:
include the following EXCEPT:
1. Duties in conformity with law
A. Right to expect reasonable continuity of
2. Not allow to be used in advertisements that demean
care
image of the profession
B. Right to consent to or decline to
3. Decline any gift, favor or hospitality from
participate in research studies or experiments
patient
C. Right to obtain information about another
4. Not demand and receive any commission,
patient
fee for recommendations made
D. Right to expect that the records about his
5. Avoid any abuse of relationship
care will be treated as confidential
REGISTERED NURSES AND THE PROFESSION
QUESTION
Ethical Principles:
Which document addresses the patient’s right to
1. Maintain loyalty
information, informed consent and treatment
2. Compliance with by laws of accredited professional
refusal?
organizations
A. Code for NURSEs
3. Commitment to continual learning
B. NURSING Practice Act
4. Contribute to the improvement of the socio-economic
C. Patient’s Bill of Rights
conditions and welfare of NURSEs
D. Standard of NURSING Practice
Guidelines to be observed:
Board Resolution #
a. Be a member of accredited prof organization (PNA)
220
b. Strictly adhere to NURSING standards
CODE OF ETHICS
c. Strive to secure equitable working conditions through
FOR REGISTERED NURSES
appropriate legislation and other means
Four basic ethical
d. Assert for the implementation of labor and work
principles:
standards
1. Fundamental responsibility of the NURSE is four-fold
QUESTION
2. NURSE renders service regardless of race, creed,
Based on the Code of Ethics for Filipino NURSEs,
nationality or political belief.
what is regarded as the hallmark of NURSING
3. NURSE protects life and respects the dignity of man.
responsibility and accountability?
4. NURSE works in collaboration with members of the
A. Human rights of clients, regardless of
health team
creed and gender
REGISTERED NURSES AND
B. The privilege of being a registered
PEOPLE
professional NURSEs
Ethical Principles:

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 SYNERGY REVIEW & TRAINING CENTRE
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C.
Health, being a fundamental right of every
individual

D.
Accurate documentation of actions and
outcomes
QUESTION
A basic structure against which competent care is
objectively measured is which of the following?
a. principles
b. standards
c. laws
d. codes
QUESTION
Which of the following NURSE’s behavior is
regarded as a violation of the Code of Ethics of
Filipino NURSEs?
A. A NURSE withholding harmful information to
the family members of a patient
B. A NURSE declining commission sent by a doctor
for her referral
C. A NURSE endorsing a person running for
congress.
D. NURSE Reviewers and/or NURSE review center
managers who pays a considerable amount of cash for
reviewees who would memorize items from the licensure
exams and submit these to them after the examination.
QUESTION
The purpose of having a NURSEs’ code of ethics is:
A. Delineate the scope and areas of
NURSING practice
B. Identify NURSING action recommended
for specific health care situations
C. To help the public understand
professional conduct expected of NURSEs
D. To define the roles and functions of the
health care givers, NURSEs, clients

13