TCRN TCRN Professional and Legal Issues 4 — Questions and Answers
Question 1: A trauma nurse administers the wrong medication dose to a patient. The nurse's immediate priority after addressing the patient's safety is to:
- Complete an incident/variance report and notify the treating physician (Correct answer)
- Tell the patient nothing to avoid causing anxiety
- Document the correct dose in the medical record to avoid liability
- Inform only the charge nurse verbally and take no further action
Correct answer: Complete an incident/variance report and notify the treating physician
After ensuring patient safety, the nurse must notify the physician and complete an incident report to facilitate investigation and prevent recurrence.
Question 2: Which document designates a person to make healthcare decisions on behalf of a patient who becomes incapacitated?
- Durable power of attorney for healthcare (Correct answer)
- Living will
- Do-not-resuscitate order
- POLST form
Correct answer: Durable power of attorney for healthcare
A durable power of attorney for healthcare designates a specific person (healthcare proxy) to make medical decisions if the patient cannot do so.
Question 3: A trauma patient is a registered organ donor. The patient is declared brain dead. The nurse's role includes:
- Notifying the organ procurement organization (OPO) and maintaining physiologic stability of the donor (Correct answer)
- Immediately withdrawing all supportive care
- Obtaining family consent before notifying the OPO
- Documenting the donor status but taking no further action until the family decides
Correct answer: Notifying the organ procurement organization (OPO) and maintaining physiologic stability of the donor
Federal law requires hospitals to notify the OPO of all potential donors, and physiologic support must be maintained to preserve organ viability.
Question 4: Which behavior by a trauma nurse best exemplifies the principle of justice in clinical practice?
- Providing equitable care to all patients regardless of race, socioeconomic status, or insurance (Correct answer)
- Giving preference to patients who are pleasant and cooperative
- Treating uninsured patients less urgently to prioritize paying patients
- Allocating extra resources to patients whose families are most insistent
Correct answer: Providing equitable care to all patients regardless of race, socioeconomic status, or insurance
Justice requires fair, equitable distribution of care and resources without discrimination based on personal characteristics or financial status.
Question 5: A trauma nurse who acts as a patient advocate is primarily responsible for:
- Ensuring the patient's rights, preferences, and needs are communicated and protected (Correct answer)
- Agreeing with all physician decisions to support the medical team
- Minimizing family involvement to streamline care
- Documenting all care without questioning orders
Correct answer: Ensuring the patient's rights, preferences, and needs are communicated and protected
Patient advocacy means actively protecting and promoting the patient's rights, preferences, and best interests within the healthcare system.
Question 6: A nurse is floated to the trauma unit without adequate orientation. Which action best protects the nurse legally and ethically?
- Communicate limitations to the charge nurse and request assignment of only patients within competency (Correct answer)
- Accept all assignments without comment to appear cooperative
- Refuse to work the shift entirely
- Perform unfamiliar procedures to avoid slowing the team down
Correct answer: Communicate limitations to the charge nurse and request assignment of only patients within competency
Nurses must practice within their scope of competence; communicating limitations allows supervisors to make safe assignments and protects both the patient and the nurse.
Question 7: Which statement about the Health Insurance Portability and Accountability Act (HIPAA) is correct?
- HIPAA permits sharing patient information among the treatment team without additional authorization (Correct answer)
- HIPAA prohibits all sharing of patient information within the care team
- HIPAA requires patient consent before emergency treatment can begin
- HIPAA applies only to electronic health records
Correct answer: HIPAA permits sharing patient information among the treatment team without additional authorization
HIPAA's treatment exception allows providers directly involved in care to share information necessary for treatment without additional patient authorization.
TCRN TCRN Professional and Legal Issues 4
A trauma nurse administers the wrong medication dose to a patient.
The nurse's immediate priority after addressing the patient's safety is to: