Legal And Ethical Practice And Confidentiality - NCLEX Rn
- What four elements must be proven to establish nursing malpractice (professional negligence)?
- Duty, breach, causation, damages. These elements form the foundation of proving malpractice, requiring evidence of obligation, violation, direct cause, and resulting injury.
- Under HIPAA, what is the "minimum necessary" standard?
- Use or disclose only the least PHI needed for the purpose. This HIPAA rule limits information sharing to essential details, protecting patient privacy while allowing necessary access.
- What is the ethical principle of avoiding harm to the patient?
- Nonmaleficence. This principle obligates nurses to prevent or minimize harm, forming the basis for safe practice and risk assessment.
- What ethical principle requires truth-telling to the patient?
- Veracity. This principle mandates honest communication, building trust and enabling informed patient decisions.
- What is the key legal distinction between an advance directive and a DNR order?
- Advance directive is patient-made; DNR is a provider order. Advance directives express patient wishes directly, while DNR orders are medical directives issued by providers based on those wishes or assessments.
- What is the legal term for putting a patient in fear of harmful or offensive contact?
- Assault. This intentional tort involves creating a reasonable apprehension of imminent harmful contact, even without physical touch.
- What ethical principle requires fair and equal treatment and resource allocation?
- Justice. This principle ensures equitable distribution of care and resources, preventing discrimination in healthcare delivery.
- Identify the priority: You suspect a colleague is diverting opioids; what is the nurse's duty?
- Report through the chain of command per policy. Reporting via protocol ensures patient safety, legal compliance, and addresses potential impairment or illegal activity.
- Identify the action: A patient refuses a blood transfusion; what must the nurse do first?
- Notify the provider and document the refusal. Immediate notification and documentation protect patient rights and ensure legal safeguards against claims of abandonment or negligence.
- Which document names a surrogate to make health care decisions if the patient lacks capacity?
- Durable power of attorney for health care. This legal instrument appoints a proxy to act on behalf of an incapacitated patient, ensuring decisions align with their preferences.
- What is the ethical principle of doing good and promoting the patient's welfare?
- Beneficence. This principle guides nurses to actively promote positive outcomes and well-being in patient care decisions.
- What is the legal term for confining or restraining a competent patient without legal justification?
- False imprisonment. This tort violates patient rights by unlawfully restricting freedom of movement, often through restraints or threats.
- What is the nurse's role when a patient signs an informed consent form?
- Witness signature and assess voluntariness and capacity. Nurses verify that the patient signs willingly and has the mental capacity, ensuring legal and ethical compliance.
- Identify the priority action: A competent patient wants to leave AMA; what should the nurse do?
- Notify provider, explain risks, document, and have AMA form signed. These steps respect autonomy while ensuring informed decision-making, legal protection, and documentation of risks.
- What is implied consent in nursing care?
- Consent inferred from patient actions in noninvasive care. It assumes agreement based on voluntary participation in routine, low-risk procedures without explicit verbal or written permission.
- What is the best definition of confidentiality in nursing practice?
- Safeguarding patient information from unauthorized disclosure. Confidentiality upholds patient trust and privacy rights by preventing breaches that could lead to harm or discrimination.
- Identify the required action: You receive a subpoena for a patient record; what should you do first?
- Notify the facility legal/risk department and follow policy. Involving legal or risk management ensures compliance with laws and protects against unauthorized release of information.
- Which disclosure is allowed without patient authorization for routine care coordination?
- Disclosure for treatment, payment, and health care operations. HIPAA permits these disclosures as essential for care continuity, billing, and operational efficiency without needing explicit consent.
- What is the legal term for intentional touching of a patient without consent?
- Battery. This intentional tort occurs when physical contact is made without permission, violating patient autonomy and rights.
- What is the ethical principle supporting a competent patient's right to accept or refuse care?
- Autonomy. This principle respects the patient's right to make independent choices, central to ethical nursing practice.
- Which finding triggers mandatory reporting by the nurse in most jurisdictions?
- Suspected child abuse or neglect. Laws require reporting to protect vulnerable populations, overriding confidentiality to prevent further harm.
- What is the legal term for failing to act as a reasonably prudent nurse would in similar circumstances?
- Negligence. This term applies when a nurse's failure to meet the standard of care results in potential harm, breaching professional duty.
- What ethical principle requires keeping promises and honoring commitments to patients?
- Fidelity. This principle emphasizes reliability in maintaining therapeutic relationships and fulfilling professional obligations.
- What is the primary purpose of informed consent in health care?
- To protect the patient's right to self-determination. Informed consent ensures patients are fully aware of risks, benefits, and alternatives, upholding autonomy in decision-making.
- Which provider is primarily responsible for obtaining informed consent for a procedure?
- The provider performing the procedure. The responsible provider must explain the procedure, risks, and alternatives to ensure the patient's understanding and voluntary agreement.