TCRN Professional and Legal Issues Questions and Answers

Question 1

An adult patient arrives unresponsive after a motor vehicle collision and requires an immediate exploratory laparotomy for suspected internal hemorrhage.
No family is present, and the patient has no identification.
Which legal principle allows the trauma team to proceed with the life-saving surgery?

Accepted Answer

Implied Consent

Answer

Informed Consent

Answer

Substituted Judgment

Answer

EMTALA Mandate

Question 2

A trauma patient is brought in after being assaulted. During the primary survey, the nurse must remove the patient's blood-soaked shirt to assess for chest injuries. Which action demonstrates proper preservation of forensic evidence?

Accepted Answer

Cutting along the shirt's seams and placing it in a paper bag.

Answer

Cutting directly through a large tear in the shirt to speed up removal.

Answer

Placing the wet shirt in a sealed plastic bag to prevent contamination.

Answer

Giving the shirt directly to a police officer before documenting its removal.

Question 3

An 84-year-old patient is admitted after a fall, presenting with a fractured hip. The nurse notes several large bruises on the patient's back in various stages of healing and that the patient appears fearful when their caregiver is in the room. What is the nurse's primary legal responsibility in this situation?

Accepted Answer

Report the suspicion of elder abuse to Adult Protective Services.

Answer

Ask the caregiver to explain the origin of the bruises.

Answer

Document the findings and monitor for further signs of abuse.

Answer

Ask the patient if they feel safe at home with the caregiver present.

Question 4

A patient arrives at a rural community hospital with a severe, unstable pelvic fracture after a farming accident and is in hemorrhagic shock. The hospital lacks an interventional radiologist and trauma surgeon. According to the Emergency Medical Treatment and Active Labor Act (EMTALA), what is the hospital's primary obligation before transferring the patient to a Level I trauma center?

Accepted Answer

Provide stabilizing treatment to the best of its ability and resources.

Answer

Obtain written consent for transfer from the patient or family.

Answer

Immediately transfer the patient to the higher level of care.

Answer

Contact the hospital's administrator to authorize the transfer costs.

Question 5

A trauma patient with a catastrophic, non-survivable brain injury has been declared brain dead. The patient is a registered organ donor. According to federal regulations and best practices, what is the most appropriate next step regarding organ donation?

Accepted Answer

Notify the designated Organ Procurement Organization (OPO) of the patient's status.

Answer

The trauma nurse should immediately begin discussing the donation process with the family.

Answer

Wait for the family to bring up the topic of organ donation first.

Answer

Discontinue all supportive measures as the patient is legally deceased.

Question 6

A well-known public figure is admitted to the trauma center, and a person claiming to be their sibling calls the unit asking for a detailed medical update. The patient is intubated and cannot give permission. To comply with HIPAA, what is the nurse's most appropriate action?

Accepted Answer

Use professional judgment to verify the caller's identity before providing limited, relevant information.

Answer

Provide a detailed update to the caller to ensure the family is informed.

Answer

State that no information can be given over the phone due to HIPAA.

Answer

Refer the caller to the hospital's public relations department for an official statement.

An adult patient arrives unresponsive after a motor vehicle collision and requires an immediate exploratory laparotomy for suspected internal hemorrhage.No family is present, and the patient has no identification.Which legal principle allows the trauma team to proceed with the life-saving surgery?