Ethical and Legal Issues IN NURSING PRACTICE

A nurse is caring for a patient who refuses a life-saving blood transfusion due to religious beliefs. The nurse understands that this decision aligns with which ethical principle?
A. Beneficence
B. Nonmaleficence
C. Autonomy
D. Fidelity

Answer: C. Autonomy
Rationale: Autonomy refers to the patient's right to make personal choices regarding their care, even if it goes against medical advice.

A nurse fails to secure bed rails for a confused patient, leading to a fall and injury. The patient’s family files a lawsuit. Which element must be proven for this to be considered malpractice?
A. The nurse had a duty to the patient.
B. The patient experienced financial hardship.
C. The patient signed an informed consent.
D. The patient was dissatisfied with the care provided.

Answer: A. The nurse had a duty to the patient.
Rationale: Malpractice requires proving four elements: duty, breach of duty, causation, and injury. The nurse’s failure to uphold a duty resulted in patient harm.

Which of the following is an example of a criminal law violation in nursing?
A. Administering the wrong medication to a patient.
B. Charting care that was never provided.
C. Forgetting to document a patient’s vital signs.
D. Failing to provide patient discharge instructions.

Answer: B. Charting care that was never provided.
Rationale: Falsifying documentation can be considered fraud, which is a criminal offense.

A nurse is caring for a patient who states, “If you don’t give me more pain medication, I’ll report you for neglect.” The nurse replies, “If you keep threatening me, I won’t come back in here.” Which type of legal issue does this situation represent?
A. Assault
B. Battery
C. Negligence
D. Malpractice

Answer: A. Assault
Rationale: Assault is a deliberate act that threatens harm, even if no physical contact occurs.

Which of the following is a responsibility of the Ohio Board of Nursing under the Nurse Practice Act?
A. Establishing hospital policies and procedures.
B. Approving nursing education programs.
C. Enforcing workplace safety guidelines.
D. Providing legal defense for nurses.

Answer: B. Approving nursing education programs.
Rationale: The Nurse Practice Act gives the Ohio Board of Nursing authority to regulate nursing education, licensing, and disciplinary actions.

A nurse must adhere to the ANA Code of Ethics. Which of the following are provisions outlined in the code? (Select all that apply.)
A. The nurse promotes, advocates for, and protects patient rights.
B. The nurse's primary commitment is to the hospital organization.
C. The nurse establishes, maintains, and improves ethical work environments.
D. The nurse is only accountable for direct patient care, not policy development.
E. The nurse collaborates with other health professionals to reduce health disparities.

Answer: A, C, E
Rationale: The ANA Code of Ethics includes advocacy for patients, fostering ethical work environments, and collaborating to reduce health disparities.

Which of the following situations require mandatory reporting by the nurse? (Select all that apply.)
A. A nurse suspects a child is being physically abused.
B. A patient confesses to having committed a crime.
C. A nurse notices unexplained bruises on an elderly patient in a nursing home.
D. A coworker frequently appears intoxicated while on duty.
E. A patient refuses care against medical advice.

Answer: A, C, D
Rationale: Mandatory reporting laws require reporting suspected child abuse, elder abuse, and impaired healthcare workers.

A nurse providing care under the Good Samaritan Law must ensure which of the following? (Select all that apply.)
A. They act within their scope of practice.
B. They provide care only in emergency situations.
C. They ensure the patient signs a consent form.
D. They charge for their services if necessary.
E. They do not deviate from the standard of care expected of a nurse.

Answer: A, B, E
Rationale: The Good Samaritan Law protects healthcare providers who provide emergency care within their scope of practice and adhere to nursing standards.

IdIdentify Major Categories of the ANA Code of Ethics for Nurses Question 1:

Which statement best describes the primary purpose of the ANA Code of Ethics?
A. It serves as a legal framework for nursing practice.
B. It provides specific disciplinary actions for nurses who violate ethical principles.
C. It guides nurses in ethical decision-making and professional behavior.
D. It only applies to nurses working in hospitals and acute care settings.

Answer: C. It guides nurses in ethical decision-making and professional behavior.
Rationale: The ANA Code of Ethics serves as a professional guideline to ensure ethical nursing care, rather than a legal framework or disciplinary document.

Discuss Self-Awareness of Beliefs and Values as They Relate to Professional Nursing Practice Question 2:

A nurse is providing care to a patient whose beliefs conflict with the nurse’s personal values. What is the best action for the nurse to take?
A. Explain to the patient why their decision is incorrect.
B. Reflect on their own biases and provide nonjudgmental care.
C. Refer the patient to another healthcare provider.
D. Avoid discussing any ethical issues with the patient.

Answer: B. Reflect on their own biases and provide nonjudgmental care.
Rationale: Nurses must engage in self-reflection to ensure they provide ethical, patient-centered care without imposing their own beliefs.

Discuss the Rights of Patients to Refuse Care Question 3:

A patient with stage IV cancer decides to stop all treatment. The nurse strongly believes that continuing treatment would improve the patient's condition. What is the nurse’s ethical responsibility?
A. Contact the patient's family to persuade the patient to reconsider.
B. Continue treatment despite the patient’s decision.
C. Respect the patient’s decision and ensure they receive appropriate care.
D. Seek legal intervention to continue treatment.

Answer: C. Respect the patient’s decision and ensure they receive appropriate care.
Rationale: Autonomy allows patients to make their own healthcare decisions, including refusing treatment.

Discuss Standards of Nursing Practice Question 4:

Which sources define nursing standards of practice? (Select all that apply.)
A. The Nurse Practice Act
B. Organizational policies and procedures
C. American Nurses Association (ANA)
D. Professional nursing organizations
E. Federal regulations

Answer: A, B, C, D
Rationale: Standards of nursing practice are defined by the Nurse Practice Act, ANA, healthcare facility policies, and professional organizations. Federal regulations do not specifically define nursing standards.

Discuss the Ohio Nurse Practice Act Regarding Practice as a Student Nurse Question 5:

A nursing instructor explains that student nurses are held to the same standards as registered nurses (RNs). Which statement is true regarding student nurses in Ohio?
A. They are legally responsible for their actions during clinical rotations.
B. They may perform procedures without supervision if they feel confident.
C. They have a different standard of practice than licensed nurses.
D. They are protected from liability under the Ohio Nurse Practice Act.

Answer: A. They are legally responsible for their actions during clinical rotations.
Rationale: Student nurses must adhere to the same standards of care as licensed nurses and are legally responsible for their actions.

Discuss the Major Role of the State Board of Nursing Question 6:

Which of the following are responsibilities of the Ohio Board of Nursing? (Select all that apply.)
A. Licensing and credentialing nurses
B. Enforcing the Nurse Practice Act
C. Developing hospital policies and procedures
D. Disciplinary actions for violations of nursing standards
E. Conducting hospital inspections

Answer: A, B, D
Rationale: The Ohio Board of Nursing is responsible for licensing, enforcement of the Nurse Practice Act, and disciplinary actions, but does not create hospital policies or conduct inspections.

Define Common Law and Criminal Law Question 7:

Which scenario represents criminal law rather than common law?
A. A nurse documents a false statement about a patient.
B. A nurse administers a lethal dose of medication intentionally.
C. A nurse forgets to chart a patient's wound assessment.
D. A nurse violates an employer’s workplace policy.

Answer: B. A nurse administers a lethal dose of medication intentionally.
Rationale: Criminal law deals with intentional harm, while common law is based on court decisions and precedents.

Identify Implications of Civil Law in Nursing Practice Question 8:

Which civil law violations could result in legal action against a nurse? (Select all that apply.)
A. Breach of contract with an employer
B. Administering medication without patient consent
C. Negligence resulting in patient harm
D. Theft of hospital property
E. Failing to report suspected abuse

Answer: A, B, C
Rationale: Civil law covers contract breaches, negligence, and unauthorized treatments, whereas theft and failure to report abuse can have criminal law implications.

Discuss the Basic Requirements for Negligence or Malpractice Question 9:

Which of the following must be proven for malpractice to be established? (Select all that apply.)
A. The nurse had a duty to the patient.
B. The nurse breached that duty.
C. The breach of duty directly caused harm.
D. The patient was dissatisfied with care.
E. The patient experienced injury.

Answer: A, B, C, E
Rationale: Malpractice requires duty, breach of duty, causation, and injury.

Introduce Mandatory Reporting Laws Question 10:

A nurse suspects elder abuse but has no proof. What is the nurse’s legal responsibility?
A. Report the suspicion to the appropriate agency.
B. Wait for concrete evidence before reporting.
C. Discuss concerns with the patient’s family first.
D. Inform the employer but take no further action.

Answer: A. Report the suspicion to the appropriate agency.
Rationale: Mandatory reporting laws require nurses to report suspected abuse regardless of proof.

Discuss the Patient’s Bill of Rights Question 11:

A patient refuses a prescribed treatment. What should the nurse do?
A. Persuade the patient to comply with the treatment.
B. Educate the patient about the risks of refusal and document their decision.
C. Proceed with the treatment to prevent harm.
D. Report the patient’s decision to legal authorities.

Answer: B. Educate the patient about the risks of refusal and document their decision.
Rationale: Patients have the right to refuse care, and nurses must respect autonomy while ensuring informed decision-making.

Identify Major Categories of the ANA Code of Ethics for Nurses Question 12:

A nurse who maintains patient confidentiality, provides safe and competent care, and upholds ethical behavior is following which aspect of the ANA Code of Ethics?
A. Social Justice
B. Accountability
C. Veracity
D. Nonmaleficence

Answer: B. Accountability
Rationale: The ANA Code of Ethics requires nurses to be accountable for their actions, ensure patient safety, and adhere to ethical principles.

Discuss Self-Awareness of Beliefs and Values as They Relate to Professional Nursing Practice Question 13:

Which action by the nurse demonstrates ethical self-awareness?
A. Refusing to care for a patient with different religious beliefs.
B. Reflecting on personal biases to provide nonjudgmental care.
C. Encouraging patients to adopt the nurse’s personal beliefs.
D. Avoiding ethical dilemmas by delegating them to colleagues.

Answer: B. Reflecting on personal biases to provide nonjudgmental care.
Rationale: Nurses must identify and manage their personal beliefs and biases to provide fair, patient-centered care.

Discuss the Rights of Patients to Refuse Care Question 14:

A nurse is caring for a patient who refuses life-saving surgery. What is the nurse’s best course of action?
A. Respect the patient’s decision and document the refusal.
B. Continue preparing the patient for surgery to prevent legal consequences.
C. Ask the patient’s family to convince them to proceed with surgery.
D. Seek an ethics committee review before proceeding with care.

Answer: A. Respect the patient’s decision and document the refusal.
Rationale: The ethical principle of autonomy allows patients to refuse treatment, even if it may result in harm.

Discuss Standards of Nursing Practice Question 15:

Which statement about standards of nursing practice is correct?
A. They vary significantly from state to state.
B. They are legally enforceable by the American Nurses Association (ANA).
C. They provide guidelines for the scope, function, and role of nurses.
D. They allow nurses to function independently of healthcare laws.

Answer: C. They provide guidelines for the scope, function, and role of nurses.
Rationale: Nursing standards outline professional expectations and guide safe practice.

Discuss the Ohio Nurse Practice Act Regarding Practice as a Student Nurse Question 16:

Which action by a student nurse violates the Ohio Nurse Practice Act?
A. Performing a procedure under direct supervision.
B. Refusing to care for a patient due to personal discomfort.
C. Asking for assistance when unsure about a task.
D. Following a preceptor’s instructions when administering medication.

Answer: B. Refusing to care for a patient due to personal discomfort.
Rationale: Student nurses must adhere to professional standards and provide unbiased care to all patients.

Discuss the Major Role of the State Board of Nursing Question 17:

Which of the following is NOT a role of the State Board of Nursing?
A. Issuing nursing licenses.
B. Investigating complaints about nurses.
C. Approving nursing school programs.
D. Determining hospital staffing ratios.

Answer: D. Determining hospital staffing ratios.
Rationale: The State Board of Nursing regulates licensing, investigates misconduct, and approves educational programs but does not set staffing ratios.

Define Common Law and Criminal Law Question 18:

A nurse is charged with negligent homicide after administering a lethal dose of medication. This falls under which type of law?
A. Civil law
B. Criminal law
C. Administrative law
D. Contract law

Answer: B. Criminal law
Rationale: Criminal law involves acts that harm individuals or society and are punishable by fines or imprisonment.

Identify Implications of Civil Law in Nursing Practice Question 19:

Which scenario represents a violation of civil law in nursing? (Select all that apply.)
A. A nurse ignores a patient’s call light, resulting in injury.
B. A nurse posts a patient’s private health information online.
C. A nurse administers a medication without verifying allergies.
D. A nurse reports suspected child abuse to authorities.
E. A nurse physically restrains a patient without justification.

Answer: A, B, C, E
Rationale: Civil law violations include negligence, privacy breaches, unauthorized treatments, and wrongful restraint.

Discuss the Basic Requirements for Negligence or Malpractice Question 20:

A nurse fails to assess a patient after a fall, resulting in a delay of treatment. Which element of malpractice is met in this situation?
A. Duty
B. Breach of duty
C. Causation
D. Injury

Answer: B. Breach of duty
Rationale: Breach of duty occurs when a nurse fails to meet the expected standard of care

Introduce Mandatory Reporting Laws Question 21:

Which of the following require mandatory reporting by nurses? (Select all that apply.)
A. A nurse suspects elder abuse.
B. A patient refuses a life-saving blood transfusion.
C. A nurse observes a coworker stealing narcotics.
D. A patient requests medical marijuana in a non-legalized state.
E. A child arrives at the ER with unexplained bruises.

Answer: A, C, E
Rationale: Nurses are legally required to report suspected abuse and impaired healthcare workers

Discuss the Patient’s Bill of Rights Question 22:

A patient asks to review their medical records. What should the nurse do?
A. Deny the request due to HIPAA regulations.
B. Inform the patient they need a court order.
C. Allow the patient to view their records per facility policy.
D. Tell the patient only the physician can grant access.

Answer: C. Allow the patient to view their records per facility policy.
Rationale: Patients have the legal right to access their medical records under the Patient’s Bill of Rights.

Discuss the Role of a Student Nurse Question 23:

Which of the following actions by a student nurse requires intervention by an instructor?
A. Performing a procedure under direct supervision.
B. Calling the physician to report critical lab values.
C. Administering medication without faculty supervision.
D. Refusing to document an error made by another student.

Answer: C. Administering medication without faculty supervision.
Rationale: Student nurses must be supervised when performing procedures that require clinical judgment.

Discuss Ethical Principles Related to Nursing Practice Question 24:

A patient refuses chemotherapy despite knowing it could prolong their life. Which ethical principle is the nurse upholding by respecting their decision?
A. Beneficence
B. Fidelity
C. Autonomy
D. Justice

Answer: C. Autonomy
Rationale: Autonomy allows patients to make their own healthcare decisions.

Apply the Good Samaritan Law Question 25:

A nurse stops to help a car accident victim and provides basic first aid. What action could make the nurse legally liable?
A. Assisting within their scope of practice.
B. Calling 911 after providing aid.
C. Performing a procedure outside their training.
D. Waiting with the patient until EMS arrives.

Answer: C. Performing a procedure outside their training.
Rationale: Good Samaritan Laws protect nurses who act within their scope of practice.