Ethical and Legal Standards Flashcards

A nurse manager discovers that a staff nurse has been documenting medication administration before actually giving the medications. What is the most appropriate first action?

Answer: Conduct a thorough investigation and review patient records for harm

A thorough investigation must occur first to determine if patient harm resulted and to gather facts before any disciplinary action.

Which legal doctrine holds hospitals liable for the negligent acts of their employed nurses?

Answer: Respondeat superior

Respondeat superior ('let the master answer') holds employers vicariously liable for employees' negligent acts committed within the scope of employment.

A competent adult patient refuses a blood transfusion on religious grounds despite a life-threatening hemorrhage. The nurse manager should ensure staff:

Answer: Respect the refusal, document it, and explore alternative treatments

Competent adults have the legal and ethical right to refuse any treatment, including life-saving interventions, and staff must respect this decision.

Under HIPAA, which situation represents a permitted disclosure of protected health information (PHI) without patient authorization?

Answer: Reporting a gunshot wound to law enforcement as required by state law

HIPAA permits disclosure of PHI without authorization when required by law, such as mandatory reporting of gunshot wounds to law enforcement.

An ANM notices a pattern of near-miss medication errors on the unit but no actual patient harm has occurred. Ethically, the ANM is obligated to:

Answer: Investigate and address the system issues causing near-misses proactively

The ethical principle of nonmaleficence requires proactive identification and correction of hazardous conditions before harm occurs.

A nurse asks the ANM for guidance on a patient who has a Do Not Resuscitate (DNR) order but whose family is demanding resuscitation. The ANM should advise:

Answer: Honor the DNR order as it reflects the competent patient's documented wishes

A valid DNR order reflects the patient's autonomous decision and must be honored; family preferences do not override a competent patient's documented directives.

Which element is NOT required to prove nursing negligence in a malpractice lawsuit?

Answer: The nurse intended to cause harm to the patient

Negligence does not require intent to harm; the four elements are duty, breach, causation, and damages — intent is an element of intentional torts, not negligence.