TCRN TCRN Professional and Legal Issues 3 — Questions and Answers
Question 1: Which element is NOT required to establish nursing malpractice in a court of law?
- Malicious intent by the nurse (Correct answer)
- Duty owed to the patient
- Breach of the standard of care
- Causation and damages
Correct answer: Malicious intent by the nurse
Malpractice requires duty, breach, causation, and damages — malicious intent is not a required element; negligence is sufficient.
Question 2: A trauma patient in police custody is being evaluated. Regarding release of medical information to law enforcement, the nurse should:
- Release only the minimum necessary information as required by law or court order (Correct answer)
- Provide complete records to law enforcement upon request
- Refuse all disclosure regardless of legal requirements
- Allow officers unrestricted access to the patient's chart
Correct answer: Release only the minimum necessary information as required by law or court order
HIPAA allows disclosure to law enforcement only in specific circumstances and requires release of only the minimum necessary information.
Question 3: A family member requests that the trauma team not tell the patient about a terminal diagnosis. The nurse understands that:
- The competent patient has the right to know their diagnosis unless they have waived that right (Correct answer)
- Family wishes must be followed to maintain trust
- The physician may withhold information if the family requests it
- Cultural considerations always override patient disclosure rights
Correct answer: The competent patient has the right to know their diagnosis unless they have waived that right
A competent patient has the ethical and legal right to receive truthful information about their condition; family members cannot override this unless the patient has specifically waived the right to know.
Question 4: Which action constitutes proper chain-of-custody handling for forensic evidence collected in the trauma bay?
- Documenting each person who handles the evidence and sealing it in labeled bags (Correct answer)
- Placing evidence in a common storage area accessible to all staff
- Delegating all evidence handling to law enforcement without documentation
- Cutting through bullet holes in clothing to remove garments quickly
Correct answer: Documenting each person who handles the evidence and sealing it in labeled bags
Proper chain of custody requires continuous documentation of everyone who handles evidence and maintaining sealed, labeled containers to preserve evidentiary integrity.
Question 5: The TCRN certification credential is issued by which organization?
- Board of Certification for Emergency Nursing (BCEN) (Correct answer)
- American Association of Critical-Care Nurses (AACN)
- Emergency Nurses Association (ENA)
- American Nurses Credentialing Center (ANCC)
Correct answer: Board of Certification for Emergency Nursing (BCEN)
The TCRN certification is awarded by the Board of Certification for Emergency Nursing (BCEN).
Question 6: A trauma nurse notices a pattern of preventable complications on the unit. The most appropriate professional response is to:
- Present findings through the quality improvement process to identify systemic causes (Correct answer)
- Blame individual nurses involved in each case
- Ignore isolated incidents unless a patient dies
- Report concerns only to external regulatory agencies
Correct answer: Present findings through the quality improvement process to identify systemic causes
Quality improvement processes are the appropriate mechanism to investigate recurring adverse events and implement systemic solutions.
Question 7: Under which circumstance may a trauma nurse legally restrain a patient without a physician's order?
- Immediately when the patient poses an imminent danger to self or others, with a physician order obtained promptly after (Correct answer)
- Whenever the patient is confused or agitated
- Only after two nurses agree the restraint is needed
- Never — physician order must precede any restraint
Correct answer: Immediately when the patient poses an imminent danger to self or others, with a physician order obtained promptly after
Emergency restraint is permissible when there is immediate danger, but a physician order must be obtained as soon as possible after application.
TCRN TCRN Professional and Legal Issues 3
Which element is NOT required to establish nursing malpractice in a court of law?