Nursing Elites

1. Following a recent lawsuit that implicated one of their colleagues, the nursing staff at an assisted-living facility are especially aware of the need to safeguard themselves legally. Which of the following measures should the nurses take? Select one that does not apply.

• A. Investigate whether their liability insurance is sufficient
• B. Ensure that work performed by unlicensed care staff under their supervision is adequate
• C. Avoid admitting residents who have living wills or advance directives
• D. Assess the competence of employees under their supervision

Correct answer: C

Rationale: Denying admission to residents with living wills or advance directives is not a legal safeguard measure and may be considered discriminatory. Measures like investigating liability insurance adequacy, ensuring adequate work by unlicensed staff, and assessing employee competence are all valid ways for nurses to protect themselves legally. These measures help in ensuring proper care, reducing risks, and maintaining a high standard of practice.

2. In which of the following situations would the use of physical restraints most likely be justified?

• A. Mr. Y is agitated and aggressive while experiencing severe alcohol withdrawal and is not responding to chemical sedation.
• B. Mrs. U, diagnosed with dementia, was found wandering outside the hospital, and nurses have been unable to redirect her to stay on the unit.
• C. Mr. I is delirious during the acute stage of his urinary tract infection and is ringing the call bell nearly continuously.
• D. Mrs. T is frequently entering other patients' rooms and attempting to crawl into others' beds.

Correct answer: A

Rationale: Answer A is the correct choice because it describes a situation where the client poses a risk due to agitation and aggression during severe alcohol withdrawal, and chemical sedation has not been effective. In such cases, physical restraints may be justified as a last resort to ensure the safety of the client and others. Choices B, C, and D present scenarios where alternative strategies like redirection, addressing delirium, or implementing behavioral interventions should be attempted before considering physical restraints.

3. A nurse has been providing care for a 69-year-old female client who has recently had her right foot amputated as a result of a chronic diabetic foot ulcer. The nurse undertook to perform debridement of the wound despite her lack of relevant education and experience. The client experienced permanent nerve damage as a result of the nurse's misguided efforts. Which category of legal liability is most likely relevant in this case?

• A. Larceny
• B. Assault
• C. Invasion of privacy
• D. Negligence

Correct answer: D

Rationale: In this case, the most likely relevant category of legal liability is negligence. Negligence involves the commission of an improper act, as exemplified by the nurse's actions of performing a procedure without the necessary education and experience, leading to permanent nerve damage for the client. Larceny refers to theft, assault involves a deliberate threat to harm, and invasion of privacy pertains to the violation of a person's right to privacy. Therefore, in this scenario, the nurse's actions align more closely with negligence.

4. Which of the following aspects of gerontological nursing would be most likely classified under private law?

• A. The regulation of who may call himself or herself a 'nurse'
• B. The contract between an older adult resident of a care facility and the owners of the facility
• C. The legal criteria for declaring an individual mentally incompetent
• D. The criminal consequences for instances of elder abuse

Correct answer: B

Rationale: The correct answer is B because private law deals with relationships between individuals and organizations, such as the contract between an individual and the care facility. Choices A, C, and D are not classified under private law. Choice A pertains to professional regulation and is a matter of public law. Choice C involves legal criteria and decision-making related to mental competence, falling under public law. Choice D concerns criminal consequences, which are also part of public law.

5. Which of the following statements most accurately captures an aspect of contemporary family caregiving in the United States?

• A. Women typically spend more time caring for aging parents than they did for their own children.
• B. The most common pattern of care involves an older man providing in-home care for his wife.
• C. The majority of care is now provided by public and private agencies rather than family members.
• D. A residential or institutional environment is now the most common venue for caregiving.

Correct answer: A

Rationale: The correct answer is A. Today, on average, women spend more time providing care for their aging parents than they did for their own children. While some men provide care for their wives, it is not the most common pattern. Family members, rather than public or private agencies, still provide the majority of care in a non-institutional environment, making option C incorrect. Also, caregiving in a residential or institutional environment is not the most common venue, thus choice D is inaccurate.

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