Nursing Elites

1. Which of the following is required in order for a healthcare provider to be legally justified in not attempting to save a client's life?

• A. A 'Do Not Resuscitate' (DNR) statement on the patient's care plan
• B. A 'No-Code' sign or symbol placed at the patient's bedside
• C. A 'No-Code' order written and signed on the physician's order sheet
• D. The next of kin's request for 'Do Not Resuscitate' orally or in writing

Correct answer: C

Rationale: To legally justify not attempting to save a client's life, a healthcare provider must have a 'No-Code' order written and signed on the physician's order sheet. Unless there is a specific order stating that resuscitation should not be performed, failure to do so can be considered negligence. A 'Do Not Resuscitate' statement on the care plan or a symbol at the bedside is not legally valid without the proper medical order. Additionally, a request from the next of kin, whether oral or written, is not a substitute for a signed physician's order.

2. Which of the following is a matter of public, not private, law?

• A. Wrongful acts against another party
• B. Invasion of a patient's privacy
• C. Assault and battery on a patient
• D. Licensing of a home health agency

Correct answer: D

Rationale: The correct answer is D, 'Licensing of a home health agency.' Public law governs relationships between private parties and the government, such as licensing requirements for entities like home health agencies. Choices A, B, and C involve private law, which governs relationships between individuals and organizations. These choices pertain to wrongful acts against another party, invasion of privacy, and assault and battery, respectively.

3. To minimize liability, what action should nurses take when accepting telephone orders from physicians?

• A. Ask the physician to follow up with a faxed, written order
• B. Clearly communicate the most likely diagnosis to the physician
• C. Have another staff member talk with the physician and audiotape the conversation
• D. Accept only written orders or those communicated orally, in person

Correct answer: A

Rationale: The best action for nurses to take when accepting telephone orders from physicians to minimize liability is to ask the physician to follow up with a faxed, written order and ensure it is signed within 24 hours. This approach helps ensure clarity, accuracy, and documentation of the physician's orders, reducing the risk of misinterpretation or errors. Choices B, C, and D are incorrect. Communicating a diagnosis is outside the nurse's scope of practice and should be done by the physician. Involving another staff member to audiotape the conversation can introduce legal and practical issues. Accepting only written or orally communicated orders in person may not always be practical or feasible in urgent situations where telephone orders are necessary.

4. How does the doctrine of respondent superior affect nurses?

• A. Liable for injury resulting from advice given to a member of a patient's family
• B. Responsible for double-checking the doses of medication ordered by a physician
• C. Responsible for the actions of the staff they supervise
• D. Obligated to obtain informed consent for any diagnostic procedure

Correct answer: C

Rationale: The correct answer is C. The doctrine of respondent superior holds that supervisors are accountable not only for their own actions but also for the actions of the staff they oversee. This means that nurses, as supervisors, are responsible for ensuring that the actions of their staff comply with established protocols and standards of care. Choices A, B, and D are incorrect because they do not directly relate to the principle of respondent superior. Nurses may have other responsibilities related to giving advice, medication administration, and obtaining consent, but the doctrine of respondent superior specifically pertains to the accountability of supervisors for the actions of their subordinates.

5. Nurse R works on the geriatric medicine unit of the university hospital and provides care for numerous older adult clients nearing the end of life, many of whom have no-code orders. Which of the following situations is incompatible with the legal requirements for a no-code order?

• A. A client who is mentally competent has declared his wish to have a no-code order despite the availability of treatment options for his condition.
• B. A client has expressed her desire to have a no-code order but her daughter is adamantly opposed to it.
• C. A client clearly tells the nurse her desire to have a no-code order, which the nurse documents at the bedside.
• D. A client has been in a coma and the family has decided to put in place a no-code order.

Correct answer: C

Rationale: The correct answer is C. No-code orders require a written and signed order by a physician. Therefore, a client expressing the desire for a no-code order to a nurse, without a documented physician's order, is incompatible with legal requirements. Choices A and B are not incompatible as competent clients can make their own decisions, regardless of treatment options or family opposition. Choice D is also not incompatible as family decisions can be made on behalf of incompetent clients.

Similar Questions