Phillipss Manual of IV Therapeutics
1. A nurse is attempting to initiate I.V. therapy for a client diagnosed with
gastroenteritis. The client is combative and resists the nurse's efforts to
start the I.V. Which action by the nurse would result in an intentional tort? a.
Failure to document the client's combativeness
b. Refusing to wear gloves while starting the I.V.
c. Failure to report the client's combativeness to a physician
d. Starting an I.V. on a coherent client against the client's wishes: d. Starting
an I.V. on a coherent client against the client's wishes
ANS: D
Intentional torts include assault and battery, false imprisonment, using restraints
as a form of false imprisonment, defamation of character, and breach of
confidentiality. Reference: Cockburn, T., & Madden, B. (2006). Intentional torts
claims in medical cases. J Law Med, 13(3), 311-335.
2. A nurse who is caring for clients understands that he or she should
provide care that meets at least the minimum standards of practice for
nursing. Which phrase regarding standards of practice is most accurate?
a. Standards of practice focus on the care provider and define needed activi-
ties and behaviors.
b. Standards of practice focus on the recipient of care and describe the
outcomes of care.
c. Standards of practice are written laws enacted by the legislature.
d. Standards of practice are the result of the performance of a function or
process.: a. Standards of practice focus on the care provider and define
needed activities and behaviors.
ANS: A
Standards of practice are criteria for measuring performance against the optimal
achievable degree of clinical excellence. These standards are formulated to
communicate expectations of nursing practice. Agencies are influential in
developing standards of practice.
3. A nurse is caring for multiple clients in a rehabilitation facility. During the
shift, the nurse notes that several medical devices are not functioning
properly. According to the Safe Medical Devices Act, which problems
should be reported to the U.S. Food and Drug Administration (FDA)?
SELECT ALL THAT APPLY.
,a. Outdated medication
b. Misleading packaging
c. Cracked or leaking I.V. solution bag
d. Defective infusion pump tubing: b. Misleading packaging
c. Cracked or leaking I.V. solution bag
d. Defective infusion pump tubing
ANS: B, C, D
Misleading packaging, cracked or leaking I.V. solutions bags, and defective
infusion pump tubing should all be reported to the FDA because these problems
indicate product integrity issues. Ensuring that medical devices in domestic
commercial distribution are safe and effective for their intended purposes is a
professional responsibility. Outdated medication should be discarded and reported
to the facility pharmacy.
Reference: U.S. Food and Drug Administration, MedWatch. (2005). Voluntary
reporting by health professionals. Retrieved from
www.fda.gov/medwatch/report/hcp.htm March 11, 2013.
4. A staff nurse is serving on a hospital's quality-assurance task force. On
which quality-assurance models is the task force most likely to focus?
SELECT ALL THAT APPLY. a. Standards of care
b. Standards of practice
c. Performance improvement
d. Continuous quality improvement: b. Standards of practice
c. Performance improvement
d. Continuous quality improvement
ANS: B, C, D
The task force is most likely to focus on standards of practice, performance
improvement, and continuous quality improvement. These quality-assurance
models focus on the recipients of care. Standards of practice focus on the
provider, and define the activities and behaviors needed to achieve patient
outcomes.
Reference: Phillips, L. (2010). Manual of I.V. therapeutics: Evidence-based
infusion therapy (5th ed.). Philadelphia, PA: F.A. Davis.
, Phillipss Manual of IV Therapeutics
5. A nurse is planning for the discharge of a hospitalized client. The nurse
reviews the client's plan of care to determine whether all client outcomes
were achieved. Which methods should the nurse use to evaluate the client's
outcomes? SELECT ALL THAT APPLY.
a. Collect data to determine whether standards were met.
b. Identify controllable or uncontrollable variables.
c. Determine the cause of the problem by comparing actual care with estab-
lished standards.
d. Re-evaluate to determine whether corrective action is effective and
improve-ment in service is obtained.
e. Contact The Joint Commission (JCAHO) Web site for standards.: a. Collect
data to determine whether standards were met.
b. Identify controllable or uncontrollable variables.
c. Determine the cause of the problem by comparing actual care with established
standards.
d. Re-evaluate to determine whether corrective action is effective and
improvement in service is obtained.
ANS: A, B, C, D
Methods used to collect and determine outcomes for clients parallel the nursing
process. Collection, identification, problem solving, and re-evaluation are part of
the nursing process. TJC is a nonprofit organization that accredits health-care
facilities and works to improve client care and safety. Reference: Ackley, B., &
Ladwig, G. (2011). Nursing diagnosis handbook: An evidence-based guide to
planning care (9th ed.). St. Louis, MO: Mosby/Elsevier.
6. While caring for a client, a nurse administers an incorrect dose of
medication, causing the client to become ill. The nurse reports the incident
to the nurse manager on the unit. The nurse manager then notifies risk
management. Which risk-management strategies should be used by the
nurse in this situation? SELECT ALL THAT APPLY. a. Documentation
b. Physical assessment
c. Unusual occurrence reports
d. Professional liability insurance: a. Documentation
c. Unusual occurrence reports
, d. Professional liability insurance
ANS: A, C, D
A complete written account of care given to the client, written unusual occurrence
reports, and professional liability insurance to protect the nurse are risk-
management strategies. Reference: Alexander, M., & Webster, H. K. (2010).
Legal issues of infusion nursing. In M. Alexander, A. Corrigan, L. Gorski, J.
Hankins, & R. Perucca
(Eds.), Infusion nursing: An evidence-based approach (pp. 49-59). St.
Louis, MO: Saunders Elsevier.
7. When nurses provide care to clients, nursing actions are governed by
established standards of nursing care, as well as both state and federal
laws.
Which are sources of law? SELECT ALL THAT APPLY.
a. Constitution
b. Statutes
c. State Nurse Practice Acts
d. Joint Commission standards: a. Constitution
b. Statutes
c. State Nurse Practice Acts
ANS: A, B, C
The constitution, statutes, and state Nurse Practice Acts all provide laws that
govern nursing practice. The Joint Commission, along with the American Nurses
Association and specialty organizations, establishes standards of nursing care.
Reference: Alexander, M., & Webster, H. K. (2010). Legal issues of infusion
nursing. In M. Alexander, A. Corrigan, L. Gorski, J. Hankins, & R. Perucca (Eds.),
Infusion nursing: An evidence-based approach (pp. 49-59). St. Louis, MO:
Saunders Elsevier. 8. A new infusion clinic is being started. The nursing
supervisor of the new clinic must conform to specific standards of practice
when developing nursing policies and procedures for the new program. To
which organizational standards of practice must the nurse manager adhere?
SELECT ALL THAT APPLY. a. Centers for Disease Control and Prevention
(CDC) guidelines
b. Infusion Nurses Society (INS) standards
