OCN Legal Flashcards: 10 Practice Questions & Answers

The nurse's primary legal responsibility is to witness the signature and verify that the patient is competent and the signature is voluntary. The nurse must also ensure the patient understands they have the right to withdraw consent. RATIONALE: It is the provider's (physician's) legal duty to explain the procedure, risks, benefits, and alternatives. If the nurse realizes the patient does not understand the treatment, the nurse must notify the provider and ensure further education occurs before the signature is obtained. EXAM TIP: ONCC often tests the distinction between the provider's duty (disclosure) and the nurse's duty (witnessing and advocacy).

The PSDA requires healthcare facilities receiving Medicare/Medicaid funding to: 1. Ask patients if they have an advance directive; 2. Provide written information about their rights to accept or refuse treatment; and 3. Document the presence of an advance directive in the medical record. RATIONALE: The nurse does not have to ensure the patient HAS a directive, but must ensure they are INFORMED of their right to one. If a patient lacks a directive, the nurse should facilitate access to resources (social work/chaplaincy) to create one.

Incident reports are generally considered privileged or protected internal documents for Quality Improvement (QI) and are not part of the legal medical record. Mentioning the report in the patient's chart (Incident report filed and sent to risk management) makes the report discoverable by the plaintiff's attorney in a lawsuit. CLINICAL REASONING: The nurse should document the facts of the error, the patient's assessment, the provider notification, and any interventions in the chart, but never the existence of the internal administrative report itself.

The nurse has a mandatory Duty to Report an impaired colleague to the supervisor or the State Board of Nursing. RATIONALE: Patient safety is the priority. Failure to report a colleague suspected of substance diversion or impairment can lead to legal action against the observing nurse for negligence if a patient is harmed. Many states provide Alternative to Discipline programs for nurses who seek help, but the initial report is a legal requirement to protect the public.

This violates the Duty of Disclosure and the principles of Good Clinical Practice (GCP). Investigators must disclose all known potential risks. If a new risk is identified during the trial, current participants must be re-consented with the updated information. EXAM TIP: On the OCN, look for scenarios where information is withheld to encourage enrollment; this is a violation of the Nuremberg Code and Belmont Report standards incorporated into modern clinical trial law (45 CFR 46).