Health Care Law Giddens: 58

A new nurse needs further teaching when stating a valid consent involves which action?

a. It must be presented to the patient by a nurse.
b. The consent includes information about the risks and benefits of the procedure.
c. The patient must have the capacity to give consent.
d. The patient must voluntarily give consent.
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A new nurse needs further teaching when stating a valid consent involves which action?

a. It must be presented to the patient by a nurse.
b. The consent includes information about the risks and benefits of the procedure.
c. The patient must have the capacity to give consent.
d. The patient must voluntarily give consent.
a. The person presenting the informed consent document must be the provider performing the procedure. To be valid, information for consent must be given by the provider who will be performing the procedure and includes information about the risks and benefits of the procedure. The patient must voluntarily give consent.
Which of the following is an example of a medical malpractice tort liability?
a. A patient is informed of all known side effects of a medication and voluntarily takes the medication. The patient experiences an adverse effect from a medication prescribed by a physician.

b. A nurse follows the standard of care for initiating an intravenous line, but the patient's vein bursts, causing a hematoma and the need for minor surgery to evacuate the fluid.

c. A surgeon does not complete the postprocedure count process, and a sponge is retained in the patient's abdominal cavity.

d. The Department of Justice fines an organization for releasing protected health information to a pharmaceutical company without individual patient consent
c.
For tort liability to attach, four elements must be satisfied: duty, breach, causation, and harm.
An adverse effect experienced by a patient who was informed of all known side effects of a medication, is prescribed the medication, and voluntarily takes the medication is an adverse event, not a tort liability. When a nurse follows the standard of care for initiating an intravenous line, but the patient's vein bursts, this is an adverse event and not a tort liability. Releasing protected health information to a pharmaceutical company without individual patient consent is regulated by federal law enforcement; it is considered employer liability and may be considered to be criminal if proven to be purposeful and egregious.
A nurse protecting a patient's right to consent to a procedure is represented in which of the following answers?

a. Finding that the informed consent document is not with the chart, the nurse gives the patient another consent document to sign before the procedure.

b. When the nurse finds that the informed consent document is not yet complete, she holds the patient's pre-procedure narcotics until the physician can obtain patient consent.

c. The nurse finds that the consent form is unsigned in the chart and waits until after the procedure to get the document signed.

d. Knowing the patient is not competent to sign a consent form, the nurse asks the friend who came with the patient to sign it.
b.
To be valid, information for consent must be given prior to the procedure by the provider who will be performing the procedure and the information given must include a description of the procedure, a description of the risks and benefits of the procedure, and a discussion of any alternatives to the proposed procedure. Consent by the patient must be voluntarily given, and the person who consents must have the capacity to consent. Capacity can be determined by the health care provider and may be affected by drugs or the current or underlying medical condition. If the patient is unable to give consent directly, he or she may designate a person who can give consent on his or her behalf. If such a person is not designated by the patient, most states provide a statutory solution or a law that lists "statutory surrogates."
Which of the following statements is true regarding The Joint Commission's authority relating to healthcare organizations?

a. The Joint Commission standards have the same effect as law, and organizations can be fined by The Joint Commission for noncompliance.

b. The Joint Commission regulations have no effect on the legal process in health care.

c. The Joint Commission serves as an advisor to the federal government in establishing fines related to noncompliance.

d. The Joint Commission regulations may be seen as having the effect of law because they accredit organizations to bill Medicare and the standards are frequently used in malpractice cases.
d.
The Joint Commission standards do not have the same effect as law; however, they are often utilized as best practice standards in a malpractice case against which negligence is measured. The Joint Commission does not establish fines for noncompliance.
Which of the following would be a violation of the Consolidated Omnibus Budget Reconciliation Act and Emergency Medical Treatment and Active Labor Act of 1986?

a. The hospital emergency room physician suspects that a patient is not competent in making decisions for his post-care treatment. The physician does not complete a competency evaluation prior to transfer for a non-emergent treatment and allows the patient with suspected incompetence to sign the consent for transfer.

b. After providing a medical screening examination, the patient's attending physician determines that transfer for a psychiatric service is necessary and not provided by the hospital. The attending seeks consent from the competent surrogate decision maker for the patient prior to transfer.

c. The patient's attending physician determines the patient to be in stable condition after completing the medical screening examination and stabilizing the patient. The patient's condition would deteriorate without a life-saving procedure not available at the hospital. The physician explains the risks of staying at the hospital and the risks of the transfer to the patient's power of attorney. Informed consent is received from the patient's power of attorney for the transfer.

d. The hospital does not contract with the patient's insurance company. The emergency room physician completes a medical screening examination and stabilizes the patient for discharge. The patient financial services department informs the patient of insurance status after discharge and arranges for payment options.
a.
The physician who allows the patient with suspected incompetence to sign the consent for transfer did not complete the medical screening examination. EMTALA required that any hospital that operated an emergency department and received Medicare funds provide an appropriate screening examination to anyone who presented and stabilize any emergency medical condition prior to transfer to another facility.
The nurse is working with a student nurse who is not yet licensed. Which of the following is true?

a. The student nurse may perform nursing actions until he or she has passed the licensing examination.

b. The student nurse is not responsible for his or her actions as a student under the state licensing law.

c. The student nurse may perform nursing actions only under the supervision of a licensed nurse.

d. The student nurse must apply for a temporary student nurse permit to practice as a student.
c.
By most state laws, nursing students may perform nursing actions before they are licensed but only under the supervision of a licensed nurse. The student is responsible for his or her own actions; however, the supervising nurse may also be responsible, depending on the situation. No special permit is required to practice as a student in an approved school of nursing.
The nurse is interviewing for a position in the hospital. During the interview, the interviewer asks the nurse when she plans to start a family. The nurse applicant can legally respond:

a. No, not until I get married.
b. I plan to start a family when I get benefits.
c. I don't know and will let you know when I do.
d. You do not have a right to ask me that question.
d.
In employment practice, it is illegal to ask about family planning. The nurse is not obligated to disclose family planning.