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A nurse is teaching a class on torts.
The nurse should include which of the following situations as an example of negligence?

A client who is competent refuses an antidepressant medication. The nurse dissolves the medication in food and administers it to her without her knowledge.

A client who is alert and oriented makes an informed decision to leave the hospital against medical advice. The nurse applies restraints to the client to prevent him from leaving.

A nurse finds a client who is on a low-sodium diet eating salted potato chips. The nurse tells the client that she will apply wrist restraints if he does not stop eating the salted potato chips.

A nurse identifies the absence of peripheral pulsation in a casted extremity in the early morning and reports it to the provider in the early afternoon.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Administering medication without a competent client's knowledge or consent constitutes battery, an intentional tort. Battery involves an unconsented touching of another person, even if the intent is benevolent. This action violates the client's autonomy and right to self-determination regarding their medical treatment, which is a fundamental ethical and legal principle in healthcare.

Choice B rationale

Applying restraints to a competent, alert, and oriented client who wishes to leave against medical advice is false imprisonment, an intentional tort. False imprisonment involves the unlawful restraint of a person against their will. Competent adults have the right to refuse treatment and discharge themselves, and their freedom of movement cannot be unduly restricted.

Choice C rationale

Threatening to apply restraints to a client for not adhering to a dietary restriction constitutes assault, an intentional tort. Assault involves placing another person in reasonable apprehension of an immediate harmful or offensive contact. While dietary adherence is important, threatening physical restraint for non-compliance is an inappropriate and unlawful response.

Choice D rationale

This scenario exemplifies negligence, which is unintentional tort. Negligence occurs when a healthcare professional fails to act as a reasonably prudent nurse would under similar circumstances, resulting in harm to the patient. The delay in reporting a critical change in a client's condition, such as absent peripheral pulsation, falls below the standard of care and can lead to severe and irreversible tissue damage or limb loss.

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Correct Answer is C

Explanation

Choice A rationale

Calling in additional staff from home involves complex decision-making regarding staffing needs, skill mix, and regulatory requirements, which falls outside the scope of practice for unlicensed assistive personnel. This task requires a registered nurse's clinical judgment and professional accountability to ensure appropriate patient care staffing levels.

Choice B rationale

Assisting medics with inter-facility transport involves patient assessment, monitoring, and potentially administering medications or interventions during transit. These activities require specialized training, licensure, and clinical judgment possessed by paramedics or registered nurses, not within the UAP's scope of practice.

Choice C rationale

Updating vital signs is a fundamental skill within the UAP's scope of practice, as it involves routine data collection and documentation. Recognizing and reporting changes in vital signs to the charge nurse aligns with the UAP's role in assisting with patient monitoring and contributing to the nursing assessment process.

Choice D rationale

Disclosing patient information to family members, even in an emergency, requires adherence to patient confidentiality regulations (e.g., HIPAA) and the nurse's clinical judgment to accurately convey complex medical information. This is a responsibility of a licensed nurse, not a UAP, to ensure ethical and legal compliance.

A. Apply wrist and leg restraints to the client. B. Administer medication to sedate the client. C. Call the family and ask them to stay with the client. D. Move the client to a room closer to the nurses' station.

Correct Answer is D

Explanation

Choice A rationale

Applying wrist and leg restraints significantly restricts a client's movement and can exacerbate confusion and agitation, potentially leading to increased injury risk and psychological distress. This intervention can also impair circulation and skin integrity if not meticulously monitored, and should only be used as a last resort when less restrictive measures have failed. Normal physiological response to restraint includes increased anxiety.

Choice B rationale

Administering medication to sedate a client might reduce restlessness temporarily but could also deepen confusion, increase the risk of falls, and mask underlying medical issues causing the change in mental status. Pharmacological interventions should be carefully considered, with the lowest effective dose, and after a thorough assessment of the cause of the altered mental state. Normal sedation levels aim for calm without excessive drowsiness.

Choice C rationale

While involving family can be supportive, expecting them to stay with the client constantly in a hospital setting may not always be feasible or sustainable. Although family presence can provide comfort and reorientation, it does not directly address the immediate environmental safety needs of a confused and restless client in a hospital. Normal family roles are supportive.

Choice D rationale

Moving the client to a room closer to the nurses' station allows for more frequent and direct observation by nursing staff. This increased proximity enables prompt intervention if the client attempts to get out of bed, falls, or exhibits further changes in mental status, enhancing safety without resorting to restrictive measures. Normal nursing practice prioritizes close monitoring for at-risk clients.

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A nurse is teaching a class on torts. The nurse should include which of the following situations as an example of negligence?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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A nurse is teaching a class on torts.
The nurse should include which of the following situations as an example of negligence?