NCLEX-RNManagement of CareHard

A nurse fails to check a client's chart before administering medication and does not notice a documented allergy to penicillin. The nurse administers penicillin, and the client develops anaphylaxis requiring emergency intervention. Which statement identifies why this situation meets the legal criteria for malpractice?

  1. AThe client experienced an adverse reaction, which automatically constitutes malpractice regardless of the cause
  2. BThe nurse had a duty of care, breached that duty by not checking the allergy, and the breach directly caused client harm
  3. CThe physician who prescribed the medication is solely liable, not the nurse who administered it
  4. DMalpractice only applies when there is intent to harm the client, which is not present in this scenario
Show answer & explanation

Correct answer: B. The nurse had a duty of care, breached that duty by not checking the allergy, and the breach directly caused client harm

Malpractice requires four elements: duty, breach of duty, causation, and damages. The nurse had a duty to verify allergies before administration, breached that duty by failing to check, and this breach directly caused the client's anaphylactic reaction (damages) — meeting all four legal criteria.

Why the other options are wrong

  • A. An adverse outcome alone does not constitute malpractice without proof of breach and causation.
  • C. The administering nurse has an independent duty to verify allergies regardless of the prescriber's order.
  • D. Malpractice does not require intent; it is based on negligence, not intentional harm.

Elements of Malpractice

Malpractice (professional negligence) requires proof of four elements: duty of care, breach of that duty, causation linking the breach to harm, and actual damages suffered by the client.

  • Duty: nurse's professional obligation to the client
  • Breach: failure to meet the standard of care
  • Causation: breach directly caused the injury
  • Damages: actual harm resulted

Memory trick: Duty, Breach, Cause, Damage — the 4 D's of malpractice.

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