TCRN TCRN Professional and Legal Issues 2 — Questions and Answers
Question 1: A trauma patient is brought in unconscious without family present. The nurse needs to perform an invasive procedure. Which legal doctrine allows treatment to proceed without consent?
- Implied consent (Correct answer)
- Expressed consent
- Informed consent
- Substitute consent
Correct answer: Implied consent
Implied consent allows emergency treatment of unconscious patients when it is reasonable to assume they would consent if able.
Question 2: Under EMTALA, a trauma center is obligated to do which of the following for any patient who presents to the emergency department?
- Provide a medical screening examination regardless of ability to pay (Correct answer)
- Transfer the patient to a facility that accepts their insurance
- Obtain insurance authorization before treatment
- Contact the patient's primary care physician before evaluation
Correct answer: Provide a medical screening examination regardless of ability to pay
EMTALA requires hospitals to provide a medical screening examination and stabilizing treatment to all patients regardless of insurance or payment status.
Question 3: A TCRN discovers a colleague charted a procedure that was never performed. The most appropriate first action is to:
- Report the finding through the facility's chain of command or risk management (Correct answer)
- Correct the chart entry yourself without notifying anyone
- Confront the colleague publicly on the unit
- Ignore it since it did not harm the patient
Correct answer: Report the finding through the facility's chain of command or risk management
Falsified documentation is fraudulent and must be reported through proper channels such as the chain of command or risk management.
Question 4: Which federal law requires healthcare workers to report suspected child abuse regardless of whether the family consents to the disclosure?
- Mandatory reporting statutes (Correct answer)
- HIPAA Privacy Rule
- EMTALA
- Stark Law
Correct answer: Mandatory reporting statutes
Mandatory reporting laws require healthcare providers to report suspected child abuse without requiring parental consent.
Question 5: A trauma nurse is subpoenaed to testify about a patient's care. The nurse's best source of information during testimony is:
- The contemporaneous medical record documented at the time of care (Correct answer)
- Memory of events recalled after reviewing social media posts
- A colleague's verbal account of the events
- A summary written the night before the deposition
Correct answer: The contemporaneous medical record documented at the time of care
The contemporaneous medical record is the most legally credible and reliable account of the care provided.
Question 6: Which nursing action best demonstrates adherence to the TCRN standard of care in a mass casualty incident?
- Implementing START triage to allocate resources based on survivability (Correct answer)
- Providing maximal care to the first patient who arrives regardless of severity
- Deferring all triage decisions to the emergency physician
- Treating patients in the order they are registered
Correct answer: Implementing START triage to allocate resources based on survivability
START (Simple Triage and Rapid Treatment) triage is the evidence-based system used in MCIs to maximize survival by allocating resources based on injury severity and survivability.
Question 7: A competent adult trauma patient refuses a blood transfusion on religious grounds. The nurse should:
- Document the refusal, notify the physician, and respect the patient's autonomous decision (Correct answer)
- Administer the blood transfusion to save the patient's life
- Obtain a court order to override the patient's wishes
- Contact the patient's family to override the refusal
Correct answer: Document the refusal, notify the physician, and respect the patient's autonomous decision
Competent adults have the legal and ethical right to refuse any medical treatment, including life-saving interventions, and this must be respected and documented.
TCRN TCRN Professional and Legal Issues 2
A trauma patient is brought in unconscious without family present.
The nurse needs to perform an invasive procedure.
Which legal doctrine allows treatment to proceed without consent?