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NURSINGJURISPRUDENCE
BY: ATTY DEIRDREE CODAMON- GALLMAN, RN
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NURSING
JURISPRUDENCE-! department of law which comprise
all legal rules and principles
affecting the practice of nursing.
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NURSING LEGISLATION! the making of laws, or the body of
laws already affecting the practice
of nursing.
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LAW! a rule of civil
conduct
prescribed by thesupreme power ina statecommanding
what is right andprohibiting whatis wrong.
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LEGAL RIGHT! a claim which can
be enforced by
legal meansagainst a personwhose duty is torespect it.
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! COURT MECHANISM:
! LAWSUIT-
proceeding incourt for apurpose.
! Purpose:
1. to enforce a right2. to redress a
wrong
Q If thi k th t h
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Q:If you think that a person hasdone something seriously wrong toyou, the correct action to do get
redress for the injury received is to:
!A. systematically plan on how tohave a vindication for thedamage done
! B. file a lawsuit against theperson for damage
! C. hire someone to take revengefor you
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Parties to cases:! Civil case- Complainant/ defendant
! Criminal case- Plaintiff/ accused
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Q: The person who institutes
legal proceeding is called:!A. Plaintiff
! B. respondent
! C. defendant
! D. Accused
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Q:A hospital filed a case of damagesagainst nurse for breach of contract.
Who is the nurse in the case?
A. complainant
! B. accused
! C. defendant
! D. plaintiff
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STATUTE OF LIMITATIONS- the length of time following the
event during which the plaintiff
may file a suit.! Example: negligence- filed within
2-3 years from occurrence.
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DUE PROCESS! is a fair and
orderly process
which aims toprotect andenforce a
person
s right.
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FUNDAMENTAL REQUIREMENTS OF DUEPROCESS:
! 1. Right to
be informed
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2. Right to remain silent
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3. Right to a competentcounsel
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4. No use of violence, threat,
torture
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! PRE-TRIAL- eliminate matters notin dispute, agree on issues or settle
procedural matters.
! TRIAL-facts are presented and
determined; law applied at theend.
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! SUMMONS- is a writ commandingan authorized person to notify a
party to appear in court to answera complaint made against him.
! WARRANT- presented by an
arresting officer
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! SUBPOENA- is an order thatrequires a person to attend at a
specific time and place to testify asa witness.
! SUBPOENA DUCES TECUM-is a
subpoena that requires a witnessto bring documents/ papers in hispossession.
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A process whereby the BON only compel thepersonal attendance of a witness to bring withhim to the court books, papers and the like to
elucidate the matters in issue:
a.
Warrant
b.
Subpoena
c.
Subpoena duces tecum
d.
Summons
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WITNESS- person givingnecessary details
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Nurses as witness:
! Could not divulge PRIVILEGEDCOMMUNICATIONin a civil case- meansthat the nurse is incompetent to testify on the
communications made to him by the patients,all the device given and all the informationgathered by observation during the seal ofsecrecy.
Exceptions:1. criminal case2. with the patient
s consent3. patient sued doctor for damages
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Q:For privileged communication in thedoctor, the nurse and the patient, the sealof secrecy:
a. forever remains until removed bypatient
b. may be broken upon death of thepatient
c. may be disclosed when the patient is
insane
d. all of the above
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! Testimonies of Facts- factualinformation
! no opinion unless an expert witness
! PERJURY-is the willful telling of a lieunder oath.
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! HEARSAY EVIDENCE-rumors, notadmissible in evidence
! DYING DECLARATION or ANTEMORTEM STATEMENTS-considered
hearsay unless the dying person is a
victim of a crime.
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!APPEALS- review of the case byappellate court and when decided by it,
the final judgment results and matter isended.
! EXECUTION OF JUDGMENT
! Failure to comply means contempt ofcourt
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FELONIES
! acts or omissionspunishable by law.
! Elements:
1. Deceit-( dolo)
2. Fault-(culpa) -
due to imprudence,negligence or lack offoresight/ skill
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Q: A crime can be committedwith the element of culpa if:
!A. the person committed the crimebecause of ignorance of the law
! B. the person knows the action is acrime and he chooses to do it
! C. the person committed the crime
because he lacked the competency toact correctly
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Stages of felonies
1. Consummated all elements executed,with successful result
2. Frustrated all elements executedbut no successful result
3. Attempted not all elementsexecuted, nosuccessful result
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Degree of Feloniesdegree penalty fine
grave Capitalpunishment or
>6yrs & 1 day
above P6k
Less grave 1 month and 1day to 6 years
not > P 6 Kbut not
P 200
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Q: If the penalty is the deathpenalty, what is the degree of the
felony?
!A. grave
! B. less grave
! C. light felony
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Q: If the fine is exactly P200.,what is the degree?
!A. grave
! B. less grave
! C. light felony
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CLASSIFICATION OF PERSONSCRIMINALLY LIABLE:
1. PRINCIPAL
a. By directparticipation-doer of the act
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b. By inducement-directly force orinduce others
c. By cooperation-indispensable
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2. ACCOMPLICE
-a person who cooperates
accessory before the fact
-absent
at the time crime is committed.
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3. ACCESSORY
accessory after the fact
a. Profits
b. Conceals/ destroys evidence
c.Assists in the escape of the principal
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Situation: Danaya is two-monthspregnant. Her parents do not know
this. Danaya informed her friendAlena about the problem. Alenareferred Danaya to Pirena , an
abortionist. Danaya had anabortion.
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If those involved will be chargedlegally, who is considered as the
principal?a. Danaya b.Alena
c. Pirena d. None of them
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Who is considered as anaccomplice?
a. Danaya b.Alena
c. Pirena d. None of them
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If during the investigation, thepieces of evidence were not found
because Gurna the maid of Pirenaburned it. Gurna is consider as:
a. accomplice b. accessory
c. principal d. co-principal
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A nurse is liable as an accomplice inan abortion if she:
a. Assist in the escape of the offenderb. Refers the pregnant mother to the
abortionist
c. Conceals the evidence of the crimed. None of these
Circumstances
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Circumstances
affectingcriminal
liabilityJ-E-M-A-A
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JUSTIFYING! SELF-DEFENSE
! Unlawful aggression
! Reasonable necessity! Lack of sufficient provocation
! Fulfillment of Duty
! Obedience to an order from superior
! Order must be lawful
! Superior acting within the scope ofpractice
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EXEMPTING! Insane/imbecile
! Performance of a lawful act causesinjury by mere accident
! Under 9 y/o
! Under compulsion of uncontrollable
force
! Under impulse of uncontrollable fear
! Failure to perform an act required bylaw when prevented by some lawful
cause
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MITIGATING! Under 18y/o or over 70 y/o
! No intention to commit so grave awrong
! Sufficient provocation/threat precedingthe act
! Immediate vindication of a graveoffense
! Voluntary surrender
! Deaf & dumb/ with physical defect
! Suffer from such illness that diminishes
willpower
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AGGRAVATING! Treachery/taking advantage of
superior strength or position
! Price, reward, promise
! Use of fire, poison, explosion
! Calamities
!
Craft, fraud or disguiseemployed
! Evident Premeditation
! Cruelty
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ALTERNATIVE! May increase/ decrease criminal
liability depending on the nature
and effects of the crimeRelationship
Intoxication
Degree of instruction/ education
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DRILLS
1. Under compulsion ofuncontrollable force
2. There is sufficient provocation
3. Act is committed with abuse ofconfidence
4. Fulfillment of a duty
5. Offender is over 70 years old
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6. Voluntary surrender
7. Disguise be employed
8. Defense of a stranger
9. Acts under the impulse of anuncontrollable fear
10. Offender is insane
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Q: Premeditating to commit acrime is considered as:
!A. justifying
! B. mitigating
! C. aggravating
! D. exempting
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Q: When the defendant killssomeone accidentally:
!A. justifying
! B. exempting
! C. aggravating
! D. mitigating
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CRIMES CONCERNING
THE NURSE
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! -the victim oroffender is the
! 1. father
! 2. mother
! 3. brothers/sisters
!
4. ascendants! 5. descendants
! 6. spouse
The killing of another human
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The killing of another humanbeing
Th killi f th h b i ith
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-The killing of another human being withany of the aggravating circumstancesprovided by law.
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treachery
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- the killing of an
infant less than
three daysor 72 hours.
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ACTS OF LASCIVIOUSNESS
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MALICIOUS MISCHIEF
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PHYSICAL INJURIES
1. Serious PhysicalInjuries
2. Less SeriousPhysical Injuries
3. Slight PhysicalInjuries
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ANTI- RAPE LAW(RA 8353)
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I.
! A. MARITAL RAPE
! B. STATUTORYRAPE
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II. Anyone who inserts his penis intothe oral orifice of another by force
is liable under this law.
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III. Anyone whoinserts anything
into the analorifice or genitaliaof another isliable under this
law.
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ROBBERY
- Anyone who getsthe personal
property ofanother with the
use offorce,violence or
intimidation.
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THEFT
-anyone who gets
the personal
property ofanother withoutthe latterspermission.
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ASSAULT
- imminent threatof harmful/
offensive bodycontact
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BATTERY
- intentional,unconsentedtouching ofanother person.
ILLEGAL DETENTION/ FALSE
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ILLEGAL DETENTION/ FALSEIMPRISONMENT
- Deprive anotherof his freedom of
movement or space.
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Patient restraint
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SIMULATION OF BIRTH
! 1. Pretend thata woman gave
birth
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2. Substitution orexchanging of
babies in thenursery
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! 3. intentionallyputting wrong
information inthe birthregistration
form
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DEFAMATION
1. Slander- oral
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2. Libel- written
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Q: The nurse writes the following note inthe clients chart The physician isincompetent because he ordered the
wrong drug dosage.This statementmay lead to a charge of:
a. Assault
b. slander
c. libel
d. Invasion of privacy
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INVASION OF PRIVACY
THE RIGHT TO BE LEFT ALONE, FREEFROM UNWARRANTED PUBLICITY,
RIGHT TO LIVE ONES LIFE* Nurses liable if they divulge any
information from patients chart
to improper or unauthorizedpersons.
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MISDEMEANOR
!An act less than a felony.
Q: A person uses the license of
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Q panother person to practice nursing.Liable for What?
!A. negligence
! B. malpractice
! C. misdemeanor
! D. invasion of privacy
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DRILLS
1. A student nurse is overheardtalking in the cafeteria about a
client and his suicidal tendencies.2. A nurse asks a client why he chose
Dr. Smith for her physician when
this doctor is always rude to thestaff.
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3. A client is told he must pay theremainder of his medical bill before hecan leave the facility.
4. A nurse told the client that she will
inject her with sedatives if he does notcooperate.
5. A nurse forcibly opened the mouth of apedia patient and gave his medication.
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6. A nurse takes the wallet of thepatient while the latter is sleeping.
7. A nurse takes the wallet of thepatient with the use of violence
and intimidation.
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8. A nurse gives a potent injectionof morphine to a patient causing
his death.9. A nurse poisons his client to endhis life.
10. A patient died because of wrongmedication given.
GUIDELINES TO PREVENT
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GUIDELINES TO PREVENTCRIMINAL LIABILITY:
1. Be very familiar with thePhilippine Nursing law
2. Be familiar with the laws affectingnursing practice
3. Know agency rules, regulations,
policies4. Upgrade skills and competence
Q:To upgrade your skills you
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Q:To upgrade your skills, youmust:
!A. enrol in the graduate school
! B. be a member of the PNA
! C. attend seminars and trainings
! D. renew license
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5. Develop good IPR with co-workers6. Consult superior as needed7. Verify vague/ erroneous orders
8. Always keep doctor updated regardingpatient
9. Ensure accurate recording andreporting
10. Get informed consent11. Do not delegate responsibilities to
others
LEGAL CONSIDERATIONS IN
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LEGAL CONSIDERATIONS INCHARTING:
1. Dont tamper withmedical records-(ARD)adding,rewriting and
destroying originalrecord
2. Observe agencysstandards ondocumentation
! complete, concise,specific, use
standardabbreviation
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TELEPHONE ORDERS
TIPS FOR AVOIDING LEGAL
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TIPS FOR AVOIDING LEGALPITFALLS:
1. Patient Falls
! do proper assessment
! appropriate assistance!
use protective measures
! document all nursing
interventions
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2. Medicationerrors
! observe 7 Rs of drug
administration!
Check dr
s order!
Understand themedication you willadminister
!
Consult drug
handbook/ pharmacy!
Not exempt fromliability for followingdrs order
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! A co-nurse confided that she has givena medication to the wrong patient.What will you do?
a. advise her to report the incident to the headnurse
b. advise her to keep quiet about what
happened
c.
accompany her to the head nurse to reportthe incidentd.
report her immediately to the head nurse
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3. Equipmentinjuries
! refuse to use a device
not know how to operate
! report adverse events
to superiors
! monitor patientregularly
! bring questionable
orders to the attention
of the doctor or superior
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Failure to communicate
! promptly reportchanges in thepatient
ssymptoms andsigns of distressto the Dr
! properdocumentationof allassessmentsand telephoneconversations
with the Dr
NURSES AND CONTRACTS
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NURSES AND CONTRACTS
! CONTRACT- agreement between atleast two parties which create an
obligation recognized by law.
Elements of a valid contract:
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Elements of a valid contract:
1. given freely/ voluntarily- no coercion/pressure
2. competent parties- 18 yrs old, soundmind
3. lawful object- within the bounds of law
4. valid consideration- has monetaryvalue
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Essential requisites:
1. Consent
2. Object certain
3. Cause of the obligation
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Types of Contract:
1. Implied-terms are inferred fromactions of contracting parties.
2. Expressed-verbal/ written, termsare specified/ given at the time the
contract is made.
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3. Void or inexistent-inexistent from thevery beginning therefore may not beenforced. Ex: contrary to law.
4. Illegal- expressly prohibited by law
like obtained through fraud, undueinfluence or duress.
5. Voidable/annullable-one of the partiesis incapable of giving consent
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5. Formal-agreement among partiesand is required to be in writing by
special laws. Ex: marriage, Deed ofsale
6. Informal-concluded as a result of
a written document where the lawdoes not require the same to be inwriting.
Q: A person entered the clinic of a doctor
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Q: A person entered the clinic of a doctorfor treatment.What type of contract?
!A. formal
! B. implied
! C. informal
! D. expressed
Q: A nurse and a pregnant woman agreedthat the nurse will do home delivery for a
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that the nurse will do home delivery for afee. What type of contract?
!A. informal
! B. implied
! C. expressed
! D. formal
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! BREACH OF CONTRACT-failurewithout legal excuse to
perform any promise whichforms the contract.
The following constitute breach
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The following constitute breachof contract for nursing service:
1. Prevention of performance
2.
Failure of performance because of
inconvenience or difficulty3.
Abandonment of duty
4.
Substitution of performance
Legal excuses in refusing or
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g gfailure to perform a contract:
1. Discovery of materialmisrepresentation
2. Where performance will be illegal3. Impossible by reason of illness
4. Impossible by death of patient ornurse
5. Made for other reasons
6. Contract is insufficient
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Will
! an act whereby aperson ispermitted with
formalities of lawto control tocertain degree thedisposition of a
state to takeeffect after hisdeath.
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! DECEDENT- person whose property is
transmitted through succession.! TESTATOR- a decedent who left a will
! HEIR- a person called to succession
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TYPES OF SUCCESSION:
1. Testate-a person dies leaving a
will.2. Intestate-a person dies without
leaving a will.
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! TWO KINDS
1. Notarial will-acknowledged before a
notary public, with attestation clause2. Holographic will-entirely written,
dated and signed in the handwriting of
the testator
:
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Who makes wills:
1. those not expressly prohibited by
law2. 18 yrs old
3. sound mind
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Who could be witnesses:
1. sound mind
2. 18 and above
3. not blind, deaf or dumb4. able to read and write
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! Bakekang, 59 years old, is sufferingfrom a debilitating disease but ofsound mind. She has asked you to help
her make a will. How should yourespond to the situation?a. let her dictate and write for herb. call her intended beneficiaries as witnessesc.
assist patient to consult a legal officerd. refuse request since it is not your duty
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2. Note that the will is signedby the
testator.
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3. Note that thewitnesses shall bepresentat the time and sign in the
presence of testator.
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GIFTS MORTIS CAUSA
! disposing of giftsby a person inanticipation of
death/ belief inapproachingdeath.
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Limitations:
1. limited to personal properties
2. acceptance by the recipient3. gifts are revocable and subject to
the claims of creditors without
proof of intent of defrauding them
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! BOARD QUESTIONS:
1. The nurse out of pity unhooked
the patient from a respirator. Thepatient died after 15 minutes. This
type of felony is:
a. consummatedb. frustrated
c. attempted
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2. Circumstances which are said tobe in accordance with the law are
said to be:a. Justifying
b. Exempting
c. Mitigatingd. Aggravating
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3. All of the following are exemptingcircumstances except:
a. Imbecileb. 8 year old
c. performance of a lawful act
d. offender is deaf and dumb
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4. When a politician takes advantageof his power in the performance
of unlawful actions, this isconsidered as:
a. justifying circumstance
b. exempting circumstancec. mitigating circumstance
d. aggravating circumstance
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5. When one alters a record toconceal possible evidence of
negligence, she can be chargedas:
a. accomplice
b. accessoryc. principal
d. co-principal
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! BOARD QUESTIONS:1. A client in a long term care facility refuses to
take his oral medications. The nurse threatensthe client and tells him that, if the medication
isn
t taken, restraints will be applied. Thenurses statement constitutes which legaltort?
a. assaultb. battery
c. negligenced. right to refuse treatment
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2. The nurse is at risk for lawsuit. Which of thefollowing actions will shield her frompossible lawsuits?
1. knowledge and implementation of standardsof care
2. documentation of actions accurately andconcisely
3. document outcome of care
4. following all doctor
s ordera. 1,2,4 b. 2 & 3 c. 1,2,3 d. 2,3,4
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3. One of the midwives in the healthcenter injected Cotrimoxazole to a 5year old patient without the consent ofthe parents. Which of the followingcan the midwife be possibly accusedof?
a. malpracticeb. battery
c. negligenced. assault
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4. If that nurse divulges theinformation that she is caring for
the child of a patient withsexually transmitted disease, shecan be liable for:
a. libelb. slander
c. tort
d invasion of privacy
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5. Two janitors were having a heated argumentas to who shall dispose the waste of apatient with typhoid fever. The first onecalled the other lazyboneand pain in the
neck
within the hearing of the rest of thenurses.The case is:
a. libel
b. invasion of privacy
c. slanderd. negligence
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6. Should the accusation be writtenin the newsletter of the hospital,
such liability is a:a. assault
b. libel
c. slanderd. battery
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7. The nurse observed that in the hospital where sheworked, it is a practice to accept medical orders bytelephone. In this aspect, she should remember thefollowing:
a. T.O should be countersigned by the attendingphysician at the first opportunity to make it legalorder
b. T.O are risky and should not be acceptedc. The nurse could write on the the doctors order
sheet the exact date, time and full name of the drgiving the orderd. The nurse can sign for the doctor on the order sheet! a. 1,4 b. 1,2 c. 3 only d. 1, 3
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8. The nurse noticed that restraining patients is acommon practice. Which of the followingshould she remember?
a. Restraints are necessary so that the nursecould do more work for patients
b. Use of restraints is an effective intervention
c. Restraints require a physicians order
d. Refusal to be restrained is a ground for
terminating the nurse-patient relationship
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! 9. Patient records are very important in courtlitigations. Which of the following safeguardsshould be adopted by the nurse?
! A. follow standard charting
! b. photocopy pts chart before submitting tothe medical records Office
! c. maintain a logbook of potential legal case! all of the above