Nursing Elites

1. Which of the following aspects of gerontological nursing would be most likely classified under private law?

• A. The regulation of who may call himself or herself a 'nurse'
• B. The contract between an older adult resident of a care facility and the owners of the facility
• C. The legal criteria for declaring an individual mentally incompetent
• D. The criminal consequences for instances of elder abuse

Correct answer: B

Rationale: The correct answer is B because private law deals with relationships between individuals and organizations, such as the contract between an individual and the care facility. Choices A, C, and D are not classified under private law. Choice A pertains to professional regulation and is a matter of public law. Choice C involves legal criteria and decision-making related to mental competence, falling under public law. Choice D concerns criminal consequences, which are also part of public law.

2. Nurse M obtains a signature on an informed consent form from Mr. Y, who is later shown to have a fluctuating level of mental competency. In this case, what is Nurse M's most likely legal position?

• A. Freedom from liability because Mr. Y signed the form
• B. Possibly liable for a violation of Mr. Y's rights
• C. Liable unless a malpractice insurance policy is in effect
• D. Not liable because no family member had a durable power of attorney

Correct answer: B

Rationale: An informed consent may be considered invalid if the patient does not fully understand what he or she is signing. Patients with a fluctuating level of mental function are incapable of granting legally sound consent. Nurse M could be held liable for a violation of Mr. Y's rights as he did not have the capacity to provide informed consent. The presence of an insurance policy and the legal status of family members are irrelevant in this context and do not absolve Nurse M of potential liability.

3. What is a standard of care?

• A. A relationship in which a nurse has assumed responsibility for the care of a patient
• B. A policy or procedure established by a health care agency or professional association
• C. The norm for what a reasonable individual would do in a similar circumstance
• D. A public law that, if violated, can result in liability for the nurse

Correct answer: C

Rationale: A standard of care is the level of care that a reasonably prudent person with similar training and experience would provide in a similar circumstance. Choice A is incorrect because it describes the nurse-patient relationship. Choice B is incorrect as it refers to specific policies or procedures. Choice D is incorrect as it describes a law rather than the expected level of care.

4. Which of the following actions can a nurse safely take without risk of liability?

• A. Questioning a doctor's written orders for medication
• B. Permitting a volunteer to move a patient
• C. Using a blood pressure cuff that is sometimes sticking
• D. Asking a family member to deliver routine medication to a patient's room

Correct answer: A

Rationale: The correct answer is A: Questioning a doctor's written orders for medication. Under the doctrine of respondent superior, nurses can face liability risks for various actions. Permitting volunteers to move patients, using malfunctioning equipment, or tasking unqualified staff can pose liability risks. Questioning medication orders is a responsibility to ensure patient safety. It is crucial for nurses to clarify any doubts or raise concerns about medication orders to prevent potential harm to patients.

5. A nurse has been providing care for a 69-year-old female client who has recently had her right foot amputated as a result of a chronic diabetic foot ulcer. The nurse undertook to perform debridement of the wound despite her lack of relevant education and experience. The client experienced permanent nerve damage as a result of the nurse's misguided efforts. Which category of legal liability is most likely relevant in this case?

• A. Larceny
• B. Assault
• C. Invasion of privacy
• D. Negligence

Correct answer: D

Rationale: In this case, the most likely relevant category of legal liability is negligence. Negligence involves the commission of an improper act, as exemplified by the nurse's actions of performing a procedure without the necessary education and experience, leading to permanent nerve damage for the client. Larceny refers to theft, assault involves a deliberate threat to harm, and invasion of privacy pertains to the violation of a person's right to privacy. Therefore, in this scenario, the nurse's actions align more closely with negligence.

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