Legal Considerations

Every question here, with the answer

1. A nurse needs to obtain a client's medication history, including medications that may reveal treatment for specific diseases. Which action best protects the client's legal right to confidentiality?

   1. Discuss the medication list with a family member who is nearby.
   2. Ask the client about medications at the nurses' station to save time.
   3. Delay the medication history because medication information is not protected health information.
   4. Review the medication list with the client in a private area.

   Answer: Review the medication list with the client in a private area.

   Medication information can reveal sensitive health information, so the nurse should protect privacy during the discussion. The other actions risk sharing confidential information without the client's express authorization or minimize the confidentiality required when obtaining a medication history.

2. A nurse is teaching a new employee about when protected health information may be disclosed without the client's consent. Which situations should the nurse include? Select all that apply.

   1. Providing PHI to an insurance company involved in the client's care.
   2. Sharing relevant PHI with another provider who is treating the client.
   3. Releasing PHI in cases of abuse or neglect.
   4. Releasing PHI when required by law or court order to protect public health.
   5. Discussing the client's condition in the cafeteria while using the client's name.

   Answer: Providing PHI to an insurance company involved in the client's care., Sharing relevant PHI with another provider who is treating the client., Releasing PHI in cases of abuse or neglect., Releasing PHI when required by law or court order to protect public health.

   PHI may be shared with treating providers and insurance companies, and it may also be released when required by law or court order for public health protection or in abuse or neglect cases. Discussing a client by name in a cafeteria is a common-area disclosure risk and violates the need to protect confidentiality.

3. A client asks why current drug approval requires evidence that a medication works, not just that it is safe. Which federal legislation should the nurse identify as first requiring proof of both effectiveness and safety?

   1. Kefauver-Harris Amendments to the Food, Drug, and Cosmetic Act
   2. Durham-Humphrey Amendment to the Food, Drug, and Cosmetic Act
   3. Controlled Substances Act
   4. Pure Food and Drug Act of 1906

   Answer: Kefauver-Harris Amendments to the Food, Drug, and Cosmetic Act

   The Kefauver-Harris Amendments were the first to require manufacturers to release proof of a drug's effectiveness as well as safety. The Pure Food and Drug Act focused on labeling and interstate drug sales, the Durham-Humphrey Amendment distinguished prescription from nonprescription drugs, and the Controlled Substances Act addressed controls for habit-forming drugs.

4. A nurse educator is explaining the Meaningful Use element associated with adoption of electronic health records. Which objectives should the educator include? Select all that apply.

   1. Replacing the HIPAA Privacy Rule for protected health information.
   2. Prohibiting drug labels from containing false or misleading information.
   3. Advancing clinical processes to improve the quality of health care.
   4. Use of the EHR in a meaningful, significant way.
   5. Improving client outcomes through the use of quality measures.

   Answer: Advancing clinical processes to improve the quality of health care., Use of the EHR in a meaningful, significant way., Improving client outcomes through the use of quality measures.

   Meaningful Use objectives included meaningful EHR use, advancing clinical processes, and improving client outcomes through quality measures. It did not replace HIPAA privacy protections, and prohibiting false or misleading drug labels is associated with federal drug-labeling legislation, not Meaningful Use.

5. A nurse with a multistate license issued in Oklahoma accepts a nursing assignment in Texas. Which statement best reflects the nurse's legal responsibility?

   1. The nurse must know and follow Texas nursing laws while practicing in Texas.
   2. The nurse is exempt from state nursing laws because the license is multistate.
   3. The nurse follows only Oklahoma nursing laws because Oklahoma issued the license.
   4. The nurse practices under the Texas board of nursing's license while in Texas.

   Answer: The nurse must know and follow Texas nursing laws while practicing in Texas.

   A multistate license allows practice under a single license, but the nurse remains responsible for knowing and following the laws of the state where care is provided. Renewal and disciplinary actions remain the responsibility of the state issuing the license, but that does not remove the duty to follow the practice state's laws.

6. A nursing student is preparing for clinical practice and is concerned about safety and accountability. Which actions are consistent with the section's guidelines for students in the practice setting? Select all that apply.

   1. Performing a procedure outside the student's scope if a staff nurse is busy.
   2. Ensuring understanding of the educational program's and facility's policies before accepting an assignment.
   3. Never going to a clinical site while impaired, including from sleep deprivation.
   4. Seeking assistance if not prepared for a procedure.
   5. Informing the faculty when unprepared for an assignment.

   Answer: Ensuring understanding of the educational program's and facility's policies before accepting an assignment., Never going to a clinical site while impaired, including from sleep deprivation., Seeking assistance if not prepared for a procedure., Informing the faculty when unprepared for an assignment.

   Students should inform faculty when unprepared, seek assistance for procedures, avoid clinical practice while impaired, and understand program and facility policies before accepting assignments. Performing outside the scope of practice is specifically prohibited and conflicts with safe, effective client care.