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Legal And Ethical Issues For Healthcare

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Legal And Ethical Issues For Healthcare Professions 3rd Edition by Elsevier -Test Bank

Chapter 06: The Medical Malpractice Lawsuit and the Trial Process

Test Bank

MULTIPLE CHOICE

1. Which of the following students might be guilty of ordinary negligence?

The student explains a procedure to a patient using a patient information sheet as a


a. prompt.

The student draws blood from the patient for lab tests to be performed that day, though
b.
no one told her directly to do so.
c. The student eats an orange while talking with a patient in the reception area.

The student moves a patient in a wheelchair at a high speed and does not use wheel
d.
brakes during stops.

ANS: D

Ordinary negligence is conduct that involves unreasonable risk of harm. The student’s reckless
behavior would be considered ordinary negligence.

DIF: Cognitive Level: Application REF: pp. 84-87

2. Which situation does not illustrate determination of the existence of a duty that has been
breached?

a. A physician mistakenly removes healthy ovaries from a 23-year-old patient.

A radiology technician is reprimanded more than 5 times in writing regarding his inability
b.
to perform his job accurately.

c. A physician’s liability insurance has been canceled 12 times.

d. A nurse performs within the scope of her duties.

ANS: D

The physician removing the ovaries has caused harm to the patient, and the radiology technician
could have caused harm that occurs in the future, as could the physician whose liability insurance
has been canceled so often. A nurse performing within the scope of her duties is fulfilling her
duty to the patient.
DIF: Cognitive Level: Application REF: pp. 85-87

3. What is the term for failure to use or not use the same care as used by a reasonably prudent
person?

a. Negligence

b. Malpractice

c. Abuse

d. Battery

ANS: A

Negligence is a tort in the U.S. court system.

DIF: Cognitive Level: Knowledge REF: p. 86

4. An individual’s responsibility for his or her conduct for failure to meet a standard of care is
called:

a. strict liability.

b. product liability.

c. liability.

d. straight liability.

ANS: C
Strict liability may be proved without demonstrating fault, and product liability is related to the
liability of a manufacturer or vendor for injury to a person by a given product.

DIF: Cognitive Level: Knowledge REF: pp. 91-92

5. Which is an individual’s responsibility for his or her conduct for failure to meet a standard of
care?

a. Liability

b. Sentinel

c. Professionalism

d. Carelessness

ANS: A

Liability is an individual’s responsibility for his conduct for failure to meet a standard of care or
for failure to perform a duty that causes harm to a client.

DIF: Cognitive Level: Comprehension REF: pp. 91-92

6. Allied health professionals can avoid negligence by conducting themselves in which way when
providing patient services?

a. Competently

b. Reasonably

c. Negligently

d. Under a standard of care


ANS: B

Allied health professionals can avoid negligence by conducting themselves reasonably when
providing patient services.

DIF: Cognitive Level: Comprehension REF: pp. 84-87

7. Which is a patient’s compensation for injuries that he or she has sustained?

a. Medical

b. Emotional

c. Financial

d. None of the above

ANS: C

Financial compensation is a patient’s compensation for any sustained injuries.

DIF: Cognitive Level: Knowledge REF: p. 87

8. Which is a way to resolve conflicts using alternative dispute resolution?

a. Negotiation

b. Mediation
c. Arbitration

d. All of the above

ANS: D

Ways to resolve conflicts through alternative dispute resolution include negotiation, mediation,
arbitration, and communication.

DIF: Cognitive Level: Comprehension REF: pp. 83-84

9. The process by which a neutral third party facilitates dispute resolution is called:

a. mediation.

b. negotiation.

c. arbitration.

d. communication.

ANS: A

Mediation is the process in which a neutral third party facilitates and assists the parties in
resolving a dispute or conflict.

DIF: Cognitive Level: Knowledge REF: pp. 83-84


10. If a physician and patient need a controlled, structured setting, they may wish to try which of
the following?

a. Mediation

b. Negotiation

c. Arbitration

d. Communication

ANS: C

Arbitration is the process of resolving issues in conflict in a more structured setting like formal
litigation.

DIF: Cognitive Level: Comprehension REF: pp. 83-84

11. What term is used to describe the amount of time a plaintiff has after an injury to file a lawsuit?

a. Statute of limitations

b. Discovery rule

c. Release of tortfeasor

d. Respondeat superior

ANS: A

Statute of limitations vary from state to state, but its purpose is to limit the amount of time after
the injury or discovery of the injury (based on the discovery rule) for the plaintiff to file a
lawsuit.
DIF: Cognitive Level: Knowledge REF: p. 84

12. What are the four elements needed in a negligence case?

a. Consent, dereliction of duty, direct cause, damages

b. Denial, direct cause, liability, damages

c. Duty, dereliction of duty, direct cause, damages

d. Duty, direct cause, liability, damages

ANS: C

In order for negligence to be proven, the plaintiff must prove the defendant had a duty to
perform, the defendant was derelict in his/her duty, and the damages incurred were directly
related to the negligent act; and then the court determines what damages were caused by the
defendant.

DIF: Cognitive Level: Knowledge REF: p. 84

13. Damages for financial losses based on actual income and expenses are called:

a. punitive.

b. nominal.

c. compensatory.

d. none of the above.


ANS: C

Compensatory damages are financial losses based on actual income and expenses, for example.
Recovery of these losses can be awarded in a court case. Punitive damages are rewarded to
punish, and nominal damages are small awards given when no major damages were suffered.

DIF: Cognitive Level: Knowledge REF: p. 87

14. Awards that are intended to punish are considered:

a. compensatory.

b. punitive.

c. nominal.

d. none of the above.

ANS: B

Punitive means “to punish” and punitive awards are usually based on an intentional act that was
performed and used to punish for the wrongful act. They are usually large amounts of money.

DIF: Cognitive Level: Knowledge REF: p. 87

15. “The thing speaks for itself” is called:

a. res ipsa loquitur.

b. respondeat superior.
c. res judicata.

d. duces tecum.

ANS: A

Res ipsa loquitur means that there is clear evidence of negligence and there was no possible way
that the patient (plaintiff) could have effected a different outcome or contributed to the damages
or injury.

DIF: Cognitive Level: Knowledge REF: p. 88

16. A defendant does not want to go through a trial, and wants the issue at hand dealt with
expediently. He may use:

a. a release of tortfeasor.

b. alternative dispute resolution.

c. the discovery rule.

d. all of the above.

ANS: B

Alternative dispute resolution can be used instead of going to trial, and can include arbitration or
mediation.

DIF: Cognitive Level: Application REF: p. 88


17. This type of defense is a denial of negligence.

a. Denial

b. Affirmative

c. Emergency care

d. Good Samaritan

ANS: B

An affirmative defense asserts that the outcome was contributed to or possibly caused by other
factors beyond the alleged negligence, either contributory negligence or comparative negligence.

DIF: Cognitive Level: Comprehension REF: p. 89

18. When the defendant shows that the plaintiff’s actions or inaction was a contributing factor in
the damages, this is considered:

a. ordinary negligence.

b. negligence.

c. comparative negligence.

d. straight negligence.

ANS: C

In this form of defense, the defendant shows that the actions or inaction of the plaintiff was a
contributing factor in the damages that were incurred. For example, suppose a patient suffers
from complications from a surgical procedure that resulted in damages or further injury, but the
patient did not follow up with the physician or notify the physician immediately that there was a
problem; then the lack of follow-up by the plaintiff was partially responsible for the damages.

DIF: Cognitive Level: Comprehension REF: p. 89

19. In this type of defense, the medical record plays the largest part of the defense.

a. Affirmative

b. Emergency care

c. Assumption of risk

d. Good Samaritan

ANS: C

In assumption of risk, the medical record is the best defense, if documented properly, accurately,
and completely. The records should show the entire series of events leading up to the point of the
alleged negligence.

DIF: Cognitive Level: Comprehension REF: p. 91

20. “Let the master answer” is:

a. res ipsa loquitur.

b. respondeat superior.

c. res judicata.

d. duces tecum.
ANS: B

Under the respondeat superior doctrine, the physician or provider would be liable for the actions
of anyone under their employ. All parties involved would be liable for their contribution in the
case, but the one held most responsible is the highest licensed of the practice and/or the employer
of the individual named that caused the harm and/or showed negligence.

DIF: Cognitive Level: Knowledge REF: pp. 85, 91

21. To help prevent malpractice, a healthcare provider should:

a. work within their scope of practice.

b. make promises to cure a patient.

c. treat patients as if they were friends.

d. with permission from a superior, work outside their job description.

ANS: A

A healthcare provider should always work within their scope of practice, or potentially face a
malpractice suit. They should never make promises to a patient, and never work outside their job
description. The provider should also never treat patients as if they were friend, but should
always treat a patient with dignity and respect.

DIF: Cognitive Level: Comprehension REF: p. 92

22. Who can protect a physician from liability?


a. Physician assistant

b. Risk management supervisor

c. Registered nurse

d. Hospital administrator

ANS: B

The risk management supervisor can aid in protecting the provider or respondeat superior from
liability. The risk management supervisor’s duties would include monitoring all aspects of
prevention of malpractice and guarding the practice against issues of fraud and abuse.

DIF: Cognitive Level: Comprehension REF: p. 92

23. The risk management supervisor is responsible for:

a. talking to unruly patients.

b. talking to new employees about their dress code violations.

c. overseeing all written communication for patients.

d. documenting employees’ time records.

ANS: C

As far as communication, the risk management supervisor is responsible for ensuring that all
staff members are up to date on the policies and procedures that pertain to their roles in the
practice and that all HIPAA confidentiality is safeguarded, for communicating with patients, and
for overseeing all written communications.
DIF: Cognitive Level: Comprehension REF: p. 94

24. Establishing and putting into place the forms required for patient encounters, including
informed consent, and for billing is the __________’s job.

a. head nurse.

b. physician.

c. medical assistant.

d. risk management supervisor.

ANS: D

The risk management supervisor is responsible for documentation, including the establishment of
the forms for patient encounters, informed consent, and billing.

DIF: Cognitive Level: Knowledge REF: p. 94

25. Physicians can reduce their liability risks by:

a. obtaining adequate diagnostic results before beginning treatment.

b. double-checking dosage and medication for a patient.

c. having an assistant present during examination.

d. following all of the above practices.


ANS: D

All of the above should be done in addition to avoiding unnecessary use of toxic or risk tests, or
treatments wherever possible.

DIF: Cognitive Level: Comprehension REF: p. 94

Chapter 07: Intentional and Quasi-Intentional Torts

Test Bank

MULTIPLE CHOICE

1. Which would not be considered a tort?

a. Medical malpractice

b. False imprisonment

c. Trespass

d. Theft of narcotics

ANS: D

A tort is harm against a person, and a crime is harm against the state. Almost all torts can be
crimes, but most crimes are not torts.

DIF: Cognitive Level: Knowledge REF: pp. 98-99


2. Which type of tort has at its essence the relationship to or ownership of the thing that causes
harm?

a. Intentional torts

b. Quasi-intentional torts

c. Strict liability

d. Negligence

ANS: C

The essence of strict liability is the relationship to or ownership of the thing that causes harm.
The essence of intentional and quasi-intentional torts is consent.

DIF: Cognitive Level: Comprehension REF: p. 99

3. Which is not among the major intentional torts?

a. Battery

b. Murder

c. Assault

d. False imprisonment

ANS: B

Broadly defined, intentional torts require that there be an intentional interference with one’s
person, reputation, or property. Murder is not one of the major intentional torts and is considered
harm against the state, or a crime.
DIF: Cognitive Level: Comprehension REF: p. 100

4. Placing a person in immediate fear or apprehension of harmful touching without his or her
consent is:

a. assault.

b. battery.

c. consent.

d. negligence.

ANS: A

An assault is a threat or attempt to inflict offensive physical contact or bodily harm on a person
that puts the person in immediate danger of or in apprehension of such harm or contact. Battery
is defined as the harmful or offensive touching of another without consent or a legally justifiable
reason. Consent means permission or approval, and negligence is a careless practice that causes
harm.

DIF: Cognitive Level: Knowledge REF: p. 101

5. During which surgeries would it be reasonable for a physician to remove the organ mentioned
without specific consent?

The physician removes an ovary that contains several cysts instead of removing the cysts
a. alone.

b. The physician finds an unexpected blood clot and removes it during heart surgery.

c. The physician removes a uterus that is full of fibroid tumors.


The physician notices a sebaceous cyst when removing suspicious moles from the surface
d.
of the skin and removes the cyst at the same time.

ANS: B

If a physician finds a blood clot while performing heart surgery, it would be enough of a threat to
be considered an emergency and thus should be removed. However, in all the other situations,
although the surgery might be inevitable, the physician should wait until the patient gives
consent.

DIF: Cognitive Level: Application REF: p. 103

6. Which patient could probably receive a blood transfusion without consent if the physician
obtains a court order?

a. A 65-year-old nursing home patient

b. A 20-year-old victim of an industrial accident

c. A 17-year-old female whose parents refuse a transfusion

d. A 42-year-old mentally incompetent patient who has a legal guardian present

ANS: C

Courts will usually only order a blood transfusion in the case of a minor. If a competent adult
refuses life-saving treatment, the courts will not interfere, nor will they imply consent.

DIF: Cognitive Level: Application REF: pp. 103-104


7. Which can be transferred?

a. Consent

b. Intent

c. Defamation

d. Torts

ANS: B

Transferred intent does not often occur in the medical profession, but a rule of law states, “Intent
follows the bullet.” If one person is harmed in the course of an attempt to harm another, then
courts can transfer that intent. Therefore, a physician would be responsible for the actions of a
medical assistant in his practice.

DIF: Cognitive Level: Knowledge REF: p. 101

8. Consent is implied:

a. when the patient’s life is threatened if the procedure is not performed.

b. when the physician acts in the patient’s best interest.

c. when the physician finds other concerns during the course of surgery.

d. during all of these situations.

ANS: A

Consent is implied during emergencies, and only for those procedures that are absolutely
necessary.
DIF: Cognitive Level: Comprehension REF: p. 103

9. In which situation could sexual activity with a patient be acceptable?

a. The physician and patient are both consenting adults.

b. The patient agrees to sign a release form.

c. The physician has clearly stated his or her intentions with the patient.

d. Sexual activity is never acceptable with patients.

ANS: D

It is considered unethical to engage in sexual activity with a patient. Under no circumstances are
medical practitioners, nurses, or allied health personnel to have sexual relationships with their
patients.

DIF: Cognitive Level: Comprehension REF: pp. 104-105

10. In which situation would a medical facility probably avoid false imprisonment charges?

a. A competent, elderly cancer patient needs surgery and refuses to stay in the hospital.

b. A minor female is held against her parent’s will without a court order.

A severely intoxicated adult male is held in the hospital emergency department and the
c.
physician refuses to release him.

d. A 20-year-old rape victim refuses to press charges to stay at the hospital for treatment.
ANS: C

Medical facilities may be justified in holding severely intoxicated patients against their will, but
competent adults cannot be detained.

DIF: Cognitive Level: Application REF: pp. 105-107

11. A written statement of defamation is known as:

a. slander.

b. assault.

c. libel.

d. negligence.

ANS: C

Defamation wrongfully damages the reputation of another person. Libel comprises written
defamatory statements; slander comprises spoken defamatory statements.

DIF: Cognitive Level: Knowledge REF: p. 109

12. A person arrives at the emergency department complaining of chest pain. While the doctor is
examining the patient, the patient becomes unconscious. The physician performs life-saving
measures to treat the patient. The physician determines that the patient needs emergency
surgery or will definitely die. The patient is rushed to surgery. This is an example of:

a. general consent.
b. ethical dilemma.

c. implied consent.

d. informed consent.

ANS: C

Consent is implied in emergency situations. The situation must be life threatening or pose a risk
of significant physical injury to the patient if the procedures are not performed.

DIF: Cognitive Level: Application REF: pp. 103-104

13. Which is necessary to help healthcare workers avoid accusations of battery?

a. Informed consent

b. General consent

c. Assumed consent

d. Implied consent

ANS: B

General consent is for medical care and treatment for other employees of the hospital to “touch”
the patient even in a therapeutic manner. Do not confuse general consent with an informed
consent to surgery or to other invasive procedures.

DIF: Cognitive Level: Comprehension REF: p. 102


14. Raising a hand to strike a patient, even if the patient was not touched, can be considered:

a. assault.

b. battery.

c. libel.

d. abuse.

ANS: A

An assault places someone in immediate fear or apprehension of a harmful or noxious touching


without the patient’s consent. To commit an assault, the person must be aware that you are about
to touch him or her.

DIF: Cognitive Level: Comprehension REF: p. 101

15. A healthcare professional who believes that an unconscious patient should receive a certain
treatment but knows that the patient’s religious beliefs prohibit such treatment faces:

a. an ethical dilemma.

b. assault.

c. implied consent.

d. battery.

ANS: A
Ethical dilemmas can arise for healthcare professionals when they treat individuals who, for
religious reasons, do not allow certain procedures to be performed. If the healthcare
professionals know about the religious prohibitions, then consent is not implied, even in the case
of a minor.

DIF: Cognitive Level: Comprehension REF: pp. 103-104

16. Use of a restraint on a nursing home patient who is constantly wandering the halls is an example
of:

a. slander.

b. assault.

c. abuse.

d. false imprisonment.

ANS: D

False imprisonment is the unlawful detention of a person that deprives the person of his or her
personal liberty of movement against his or her will and that is done without any authority to
detain. To be falsely imprisoned, a person must be confined within a specific area against his or
her will, be confined by means of physical barriers and/or by physical force or threat of physical
force, and be aware of the confinement.

DIF: Cognitive Level: Knowledge REF: pp. 105-107

17. Which would not appear in an institution’s policy on use of restraints?

a. Under what circumstances restraints may be used

b. What type of monitoring the patient will require


c. What documentation is adequate to justify use of restraints

d. What type of restraints can be used during a staffing shortage

ANS: D

Your institution’s policy must be clear as to the circumstances under which restraints may be
used, how they are to be used and for how long, what type of monitoring the patient requires,
what documentation is adequate to justify the use of restraints, and how often the physician must
reorder the use of physical restraint.

DIF: Cognitive Level: Comprehension REF: p. 106

18. Quasi-intentional torts include all the following except:

a. slander.

b. invasion of privacy.

c. battery.

d. breach of confidentiality.

ANS: C

Quasi-intentional torts include defamation, invasion of privacy, and breach of confidentiality.


Quasi means “resembling.” Slander, invasion of privacy, and breach of confidentiality all infer
intent.

DIF: Cognitive Level: Knowledge REF: p. 109


19. The statement, “The information is true, but it is information that a person wants to keep
private,” likely pertains to:

a. invasion of privacy.

b. breach of confidentiality.

c. slander.

d. false imprisonment.

ANS: A

Invasion of privacy differs from defamation. In most instances, the information is true, but it is
information that a person wants to keep private.

DIF: Cognitive Level: Comprehension REF: p. 110

20. As a result of increased use of computers in the healthcare setting, the following was
established to decrease the potential for breach of confidentiality:

a. OSHA

b. HIPAA

c. Ethics

d. CMS

ANS: B
The concern over electronic access to medical records is increasing. In 1996, Congress enacted
the Health Insurance Portability and Accountability Act (HIPAA), which called for regulations
to establish criteria for a federal standard in authorizing the release of medical information. In
February 2000, the U.S. Department of Health and Human Services established the final rules for
federal criteria.

DIF: Cognitive Level: Knowledge REF: p. 112

21. If a tort is committed:

a. an individual brings the case against the state.

b. an individual brings the case against another individual.

c. the state brings the case against an individual.

d. both B and C are true.

ANS: B

In a tort, the state does not have any interest in seeing that someone is paid damages for any loss
an individual has sustained.

DIF: Cognitive Level: Knowledge REF: p. 98

22. Committing battery means:

a. a person tried to maliciously hurt a person.

b. a person touched another person with his or her consent or legally justifiable reason.

c. touching something in close proximity to a person without his or her consent.


d. all of the above are true.

ANS: D

Battery can be obvious or subtle. Hitting a person is obvious battery, but so is inserting an IV
into a patient without his or her consent. Battery includes maliciously hurting someone, touching
another person without his or her consent, and touching something close to another person
without his or her consent.

DIF: Cognitive Level: Knowledge REF: p. 101

23. An example of medical battery is:

a. violating a patient’s confidentiality.

b. the patient asks you to remove a catheter and you do so.

c. a surgeon removes the wrong organ during a surgery.

a physician is placing a cast on a patient, and the physician slips and falls and injures the
d.
patient in the process.

ANS: C

Medical battery is when there is consent to perform a procedure, but another procedure is
performed instead.

DIF: Cognitive Level: Comprehension REF: p. 102


24. Which is not a requirement needed to avoid a false imprisonment charge for an involuntary
admission?

a. The statutory provisions for the reason for involuntary commitment exist.

b. All statutory requirements for physician examination have been met in a timely manner.

c. All the patient’s rights have been followed.

All statutory time limits have been exceeded for holding an individual against his or her
d.
will.

ANS: D

Statutory time limits must be met, but cannot be exceeded for holding a patient against his or her
will. To avoid a charge of false imprisonment, there must be a reason, a timely physical
examination must be performed, all appropriate documentation must be in the chart to support
the involuntary admission, and the patient’s rights must be followed.

DIF: Cognitive Level: Comprehension REF: p. 105

25. Documentation for using restraints should include:

a. the type of restraint.

b. the patient’s attitude about being restrained.

c. the type of monitoring the patient will require.

d. the age of the patient.

ANS: C
Documentation should include the circumstances for using restraints, how they will be used and
for how long, justification for use, how often the physician must reorder their use, and the type of
monitoring the patient will require while the restraints are in use.

DIF: Cognitive Level: Comprehension REF: p. 106