CFN Legal Principles in Nursing 4 — Questions and Answers
Question 1: A forensic nurse is asked by police to obtain a blood alcohol sample from an unconscious trauma patient without a warrant. The nurse should:
- Comply because the patient is unconscious
- Decline and advise law enforcement to obtain proper legal authorization (Correct answer)
- Obtain the sample and notify the supervisor later
- Ask the patient's family for consent
Correct answer: Decline and advise law enforcement to obtain proper legal authorization
Collecting forensic samples without proper legal authority or valid consent violates the patient's Fourth Amendment rights; a warrant or recognized exception is required.
Question 2: What is the legal significance of 'res ipsa loquitur' in nursing negligence cases?
- It requires the patient to prove all four elements of negligence
- It allows negligence to be inferred when the injury would not normally occur without negligence (Correct answer)
- It shields nurses from liability in emergency situations
- It transfers liability from the nurse to the hospital only
Correct answer: It allows negligence to be inferred when the injury would not normally occur without negligence
Res ipsa loquitur ('the thing speaks for itself') shifts the burden to the defendant when the injury is the type that ordinarily doesn't occur absent negligence.
Question 3: A forensic nurse working in a correctional facility must balance patient confidentiality with institutional security needs. Which principle guides this balance?
- Security always supersedes confidentiality
- Confidentiality applies except for legally mandated disclosures and imminent safety threats (Correct answer)
- All inmate health information is public record
- Institutional policy can override all HIPAA protections
Correct answer: Confidentiality applies except for legally mandated disclosures and imminent safety threats
Even in correctional settings, HIPAA protections apply, but exceptions exist for legally required disclosures and situations involving imminent safety threats.
Question 4: Which of the following best describes 'scope of practice' for forensic nurses?
- Defined solely by individual hospital policy
- Defined by state nurse practice acts, professional standards, and credentialing (Correct answer)
- The same in every US state regardless of local law
- Limited to what a supervising physician authorizes
Correct answer: Defined by state nurse practice acts, professional standards, and credentialing
Scope of practice is governed by state nurse practice acts, professional organization standards, and relevant certifications such as the CFN credential.
Question 5: A competent adult patient refuses to allow photographs of injuries during a forensic exam. The forensic nurse should:
- Take photographs anyway because evidence collection takes priority
- Respect the refusal and document the patient's decision (Correct answer)
- Obtain police authorization to override the refusal
- Discharge the patient for noncompliance
Correct answer: Respect the refusal and document the patient's decision
A competent adult's refusal must be respected; the nurse should document the refusal thoroughly and continue providing care the patient accepts.
Question 6: In a custody dispute involving alleged child abuse, a forensic nurse's written report may be entered into evidence as:
- Hearsay, inadmissible in all cases
- A business record exception to hearsay, potentially admissible (Correct answer)
- Privileged communication protected from disclosure
- An opinion statement with no evidentiary value
Correct answer: A business record exception to hearsay, potentially admissible
Medical records created in the ordinary course of business qualify under the business records exception to hearsay and may be admitted into evidence.
Question 7: Under the Violence Against Women Act (VAWA), sexual assault survivors seeking forensic exams must be:
- Required to report to police to receive a free exam
- Offered a forensic exam regardless of whether they report to law enforcement (Correct answer)
- Examined only after police authorization
- Charged for the exam if they decline prosecution
Correct answer: Offered a forensic exam regardless of whether they report to law enforcement
VAWA mandates that states receiving federal funding provide forensic exams to survivors at no cost, independent of whether the survivor reports to law enforcement.
CFN Legal Principles in Nursing 4
A forensic nurse is asked by police to obtain a blood alcohol sample from an unconscious trauma patient without a warrant.
The nurse should: