Chapter 38 Legal Accountability

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Chapter 38 Legal Accountability of the Test Bank for Davis Advantage Basic Nursing Thinking, Doing, and Caring 4th Edition by Treas, Leslie S. Barnett, Karen L. Smith, Mable H.

1. A pregnant 15-year-old girl presents to the emergency department (ED) of the local private hospital. She has been transported by her mother and appears to be in active labor. The girl is crying uncontrollably and says she is scared and experiencing painful contractions. Her mother states, “We don’t have any money or insurance, but this hospital is closer than the public hospital, and she needs help now.” What is the first step that the ED staff should take?

a. Arrange for an ambulance to transport her to the nearest public hospital.
b. Explain to the girl and her mother that the hospital only accepts patients who can pay the hospital bill.
c. Examine her to determine whether her condition is stable or whether she requires immediate medical attention.
d. Inform her mother that she will need to transport her daughter to the nearest public hospital.

ANS: C

When a client comes to the ED requesting examination or treatment for an emergency medical condition (including labor), the hospital must provide stabilizing treatment; the client cannot be transferred until she is stable.

2. An 87-year-old patient has just been diagnosed with cancer. Her durable power of attorney names her son as her surrogate decision maker. He arrives at the patient’s bedside to discuss treatment options with her. The patient is alert and oriented. Her son tells you that he does not want her to receive any treatment (chemotherapy) because of the side effects and her age. The patient tells you that she wants to try the treatment. Which decision should be followed by the nurse?

a. The patient’s son’s
b. The patient’s
c. Both—initially the patient’s; then the son’s when the medication’s side effects become severe
d. Neither; this is a legal decision and should be made by a court of law

ANS: B

The patient is alert and oriented and can make her own healthcare decisions. The son only has the authority to make healthcare decisions once his mother becomes incompetent and unable to process information to make decisions. This is not an issue for the court. The patient will decide if and when to discontinue treatment.

3. The charge nurse uses a whiteboard located at the nurse’s station to write the nurses’ patient assignments and the patients’ diagnoses. This is a violation of which of the following?

a. Americans with Disabilities Act (ADA)
b. Patient Self-Determination Act (PSDA)
c. Health Insurance Portability and Accountability Act (HIPAA)
d. Health Emergency Medical Treatment and Active Labor Act (EMTALA)

ANS: C

The Health Insurance Portability and Accountability Act (HIPAA) provides comprehensive protection for the privacy of protected health information (confidentiality of patient records). Writing the nurses’ assignments with the corresponding patients and their diagnoses in a location where others may view it is a violation of HIPAA. Assignments should be kept in the nurses’ conference room or a location that is not accessible to patients, their family members, or visitors.

4. Upon initial assessment of a 75-year-old patient, you identify bruises and scratches on the patient’s arms, legs, and trunk in various stages of healing. You notify your supervisor when you suspect the patient may be a victim of physical abuse. You are complying with which of the following state laws?

a. Good Samaritan Law
b. Mandatory Reporting Law
c. Nurse Practice Act
d. Nursing Standards of Practice

ANS: B

Under state mandatory reporting laws, nurses must report to designated authorities (e.g., Adult Protective Services) suspected physical, sexual, emotional, or verbal abuse or neglect by healthcare workers or family members. In general, nurses who fail to report suspected abuse or neglect may be held criminally or civilly liable.

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