Chapter 06: Values, Ethics, and Advocacy
A nurse demonstrates the professional value known as altruism when caring for patients in a long-term care facility. What is an example of a nursing action based on this value?
A nurse researches the culture of a Muslim patient when planning patient care.
Which of the following best describes feminist ethics?
An approach critiquing existing patterns of oppression and domination in society.
Which ethical principle refers to the obligation to do good?
Beneficence Benefit the patient, and balance benefits against risks and harms. Commit yourself to actively promoting the patient's benefit (health and well-being or good dying). Be sensitive to the fact that individuals (patients, family members, and professional caregivers) may identify benefits and harms differently. A benefit to one may be a burden to another.
A client is brought to the emergency department by her son, who states, "I am unable to care for my mother anymore." The nurses identifies this son's ethical problem as being which of the following?
Distress
A nursing student learns to model behavior exemplified by the instructor. This is an example of?
Ethical conduct
A client is scheduled to have an elective surgical procedure performed and cannot decide if he wants to do it or not. He asks the nurse to help him make the decision because he does not feel that he knows enough about the procedure. Which of the following is the best way for this nurse to advocate for this client?
Facilitate the client's decision by allowing him to verbalize his feelings and by providing information to help him assess his options
A female client is brought to the emergency room with matted hair, bruising, and malnutrition. The nurse suspects physical abuse and neglect. The nurse states, "this happens to many women." Which type of ethical approach is the nurse exhibiting?
Feminist
A client rings the call bell to request pain medication. Upon performing the pain assessment, the nurse informs the client that she will return with the pain medication. The nurse's promise to return with the pain medication is an example of which principle of bioethics?
Fidelity Keep promises. Be faithful to the promise you made to the public to be competent and to be willing to use your competence to benefit the patients entrusted to your care. Never abandon a patient entrusted to your care without first providing for the patient's needs.
An older adult patient has had a severe stroke and is unable to swallow. The patient has no cognitive deficits and is adamant that he does not receive a feeding tube or intravenous nutrition. Members of the care team have taught the patient that he will not survive without one of these two interventions. What is the most ethical response to this situation?
Honor the patient's wishes and advocate for the rejection of artificial feeding methods.
A nurse obtains an order for a bed alarm for a confused client. This is an example of which of the following ethical principles?
Paternalism Does preventing potential harm justify violating the patient's right to autonomy and make it acceptable for the nurse to act as a "parent," choosing an action the patient does not want because the nurse believes it to be in the patient's best interest?
A nursing student reports to the instructor that a medication due at 9 a.m. was omitted. Which of the following principles is the student demonstrating?
Integrity Integrity is acting in accordance with an appropriate code of ethics and accepted standards of practice. Integrity is reflected in professional practice when the nurse is honest and provides care based on an ethical framework that is accepted within the profession. Sample professional behaviors include the following: Provides honest information to patients and the public Documents care accurately and honestly Seeks to remedy errors made by self or others Demonstrates accountability for own actions
The nurse is managing the care for a post operative client. How does the nurse demonstrate advocacy?
Limiting visitors due to client complaining of pain
A nurse knows the ethical term "Do not cause harm" is an example of:
Nonmaleficence Avoid causing harm. Seek not to inflict harm; seek to prevent harm or risk of harm whenever possible.
Which of the following nursing situations is an example of an ethical dilemma?
Performing cardiac compressions when a signed Do Not Resuscitate order (DNR) is not available Ethical dilemmas arise when attempted adherence to basic ethical principles results in two conflicting courses of action.
A nurse is having lunch in the break room and overhears the other nurses talking about a difficult client in an inappropriate way. The nurses attempt to engage them in the conversation. Which of the following responses by the nurse would best represent behavior that supports the value of human dignity in nursing practice?
Saying that she believes that this discussion is inappropriate and disrespectful to the client and that she does not want to be a part of it
A nurse is caring for an older adult who has cancer and is experiencing complications requiring a revision of the plan of care. The nurse sits down with the client and the family and discusses their preferences while sharing her judgments based on her expertise. Which of the following types of health care decision making does this represent?
Shared decision making
Nursing students in an ethics class have been asked to define "ethics." What would be the best definition of ethics?
The formal, systematic study of moral beliefs.
Which of the following is a characteristic of the care-based approach to bioethics?
The promotion of the dignity and respect of clients as people
Nurses who value client advocacy follow what guideline?
They give priority to the good of the individual client rather than to the good of society in general.
A nurse may experience ethical distress in which client situation?
continuing IV fluids for a client who wants to die
A nurse is administering evening medications and notices that a medication was omitted during the day shift. Which statement demonstrates the principle of accountability?
filling out an occurrence report and notifying the health care provider
What would be an example of the nurse practicing fidelity? The nurse:
stays with the client during his death as promised.
Which of the following is a characteristic of the care-based approach to bioethics?
the promotion of the dignity and respect of clients as people
Which are examples of virtues that can exemplify character and conduct as a professional nurse? Select all that apply.
•Trustworthiness •Humility •Compassion
A nurse volunteers to serve on the hospital ethics committee. Which of the following indicates that the nurse knows what the purpose of an ethics committee is?
Assist in decision making based on the client's best interests.
A client age 46 years has been diagnosed with cancer. He has met with the oncologist and is now weighing his options to undergo chemotherapy or radiation as his treatment. This client is utilizing which ethical principle in making his decision?
Autonomy Autonomy is the right to self-determination. Professional practice reflects autonomy when the nurse respects patients' rights to make decisions about their health care. Sample professional behaviors include the following: Plans care in partnership with patients Honors the right of patients and families to make decisions about health care Provides information so that patients can make informed choices
Which ethical principle is related to the idea of self-determination?
Autonomy Autonomy is the right to self-determination. Professional practice reflects autonomy when the nurse respects patients' rights to make decisions about their health care. Sample professional behaviors include the following: Plans care in partnership with patients Honors the right of patients and families to make decisions about health care Provides information so that patients can make informed choices
Which theory of ethics prioritizes the nurse's relationship with clients and the nurse's character in the practice of ethical nursing?
Care-based ethics care-based approach, which directs attention to the specific situations of individual patients viewed within the context of their life narrative. The care perspective directs that how you choose to "be" and act each time you encounter a patient or colleague is a matter of ethical significance
A nurse is providing care for a client with cancer. The client's wife indicates that she does not want her husband to be told he is terminal. This is a breach of which ethical principle?
Fidelity Keep promises. Be faithful to the promise you made to the public to be competent and to be willing to use your competence to benefit the patients entrusted to your care. Never abandon a patient entrusted to your care without first providing for the patient's needs.
In the delivery of care, the nurse acts in accordance with nursing standards and the code of ethics and reports a medication error that she has made. The nurse is most clearly demonstrating which professional value?
Integrity Integrity is acting in accordance with an appropriate code of ethics and accepted standards of practice. Integrity is reflected in professional practice when the nurse is honest and provides care based on an ethical framework that is accepted within the profession. Sample professional behaviors include the following: Provides honest information to patients and the public Documents care accurately and honestly Seeks to remedy errors made by self or others Demonstrates accountability for own actions
A nurse is providing care for three clients on a medical unit, two of whom are significantly more acute than the third. The nurse is making a concerted effort to ensure that the less acute client still receives a reasonable amount of time, attention, and care during the course of the shift. Which of the following is the nurse attempting to enact?
Justice Give each his or her due; act fairly. Always seek to distribute the benefits, risks, and costs of nursing care justly. This may involve recognizing subtle instances of bias and discrimination.
The nurse is managing the care of a terminally ill client whose spouse insists that all measures be continued. The nurse speaks to the spouse about obtaining a hospice consult. This is an example of "ethical":
Valuing
A nursing student is studying the principle of autonomy. Which example most accurately depicts this principle?
describing surgery to a client before the consent is signed
Which nursing actions describe the use of the professional value of altruism? Select all that apply.
•A nurse demonstrates an understanding of the culture of his or her client. •A nurse becomes a mentor to a student nurse working on the floor. •A nurse respects the right of a Native American/First Nations client to call in a shaman for a consultation. Altruism is a concern for the welfare and well-being of others. In professional practice, altruism is reflected by the nurse's concern for the welfare of patients, other nurses, and other health care providers. Sample professional behaviors include the following: Demonstrates understanding of cultures, beliefs, and perspectives of others Advocates for patients, particularly the most vulnerable Takes risks on behalf of patients and colleagues Mentors other professionals
Which of the following nursing situations is an example of the care-based approach to ethics? Select all that apply.
•Holding the hand of a dying client •Providing a back rub to a client on bed rest •Involving the parent in the bed bath of a child
When providing nursing care to clients, nurses are required to adhere to ethical values and legal rules to guide behavior. Which values would be included? Select all that apply.
•Veracity •Fidelity •Privacy •Confidentiality
Which of the following statements by the nurse is an example of deception?
"This injection of Novocain will feel like a little pinch."
A nursing faculty is discussing laissez-faire values with students. Which of the following is an example of those values?
Parents allowing a child to decide not to have an intravenous line inserted
What is the term for the beliefs held by the individual about what matters?
Values
Nurses uphold human dignity when providing care. Examples of this behavior would include what? Select all that apply.
•Protecting the privacy of the client •Maintaining confidentiality •Providing culturally competent care
A nurse instructor is educating students about the use of ethical agency in nursing practice. Which statements accurately represent the basic principles of ethics? Select all that apply.
•The ability to be ethical begins in childhood and develops gradually. •Ethics is a systematic inquiry into the principles of right and wrong conduct, of virtue and vice, and of good and evil, as they relate to conduct. •A commitment to developing one's ability to act ethically is known as one's ethical agency.
A nurse has completed four hours of his eight-hour shift on a medical-surgical unit when he receives a phone call from the nursing supervisor. The nursing supervisor informs him that he needs to give a report to the other two nurses on the medical-surgical unit and immediately report to the telemetry unit to assist with staff needs on that unit. The nurse informs the supervisor that he has been busy with his client assignment and feels this will overwhelm the nurses on the medical-surgical unit. The supervisor informs the nurse that the need is greater on the telemetry unit. This is an example of which type of ethical problem?
Allocation of scarce nursing resources
A nurse who provides the information and support that clients and their families need to make the decision that is right for them is practicing what principle of bioethics?
Autonomy Respect the rights of patients or their surrogates to make health care decisions. Provide the information and support patients and families need to make the decision that is right for them, including collaborating with other members of the health care team to advocate for the patient.
A client continues to complain of pain despite receiving medication. The family states, "in our culture it is acceptable to complain out loud." What would be the best response by the nurse?
Tell me more about your cultural beliefs.
