Chapter 6

Which example most accurately depicts the ethical principle of autonomy?

Describing a surgery to a client before the consent is signed explaination Autonomy is the capacity to make an informed, uncoerced decision. Describing a surgery to a client before a consent is signed provides the client with all of the information needed to make an informed decision and thus an autonomous one. The nurse changing a dressing on a wound does not require the client to make an informed decision, nor does administering a morning dose of insulin or transporting a client.

What are standards for decision-making that endure for a significant time in one's life?

Values explaination

A charge nurse has implemented staff education on nursing values. The nurse would determine that further education is required when which statement(s) are overheard? Select all that apply.

"I can't believe the client is giving that precious baby up for adoption." "The gonorrhea test was positive. That's what the client gets for sleeping around." "If that was my mother, I sure wouldn't agree to a no-code." explaination Being judgmental, as in the options about adoption, gonorrhea, and code-status, does not reflect the values desired in a nurse. Professional nurses do not assume that their personal values are more correct than those of their clients. Nurses are obligated, however; to provide health information such as recommending condom use and smoking cessation.

A nurse volunteers to serve on the hospital ethics committee. Which action should the nurse expect to take as a member of the ethics committee?

Assist in decision making based on the client's best interests. explaination One reason an ethics committee convenes is when a client is unable to make an end-of-life decision and the family cannot come to a consensus. In this case, the committee members are there to advocate for the best interest of the client and to promote shared decision making between the client (or surrogates, if the client is decisionally incapacitated) and the clinicians. The committee would not convince, decide, or present options about the type of care. This is not the role of an ethics committee.

A client diagnosed with cancer has met with the oncologist and is now weighing whether to undergo chemotherapy or radiation for treatment. This client is demonstrating which ethical principle in making this decision?

Autonomy explaination Autonomy entails the ability to make a choice free from external constraints. Beneficence is the duty to do good and the active promotion of benevolent acts. Confidentiality relates to the concept of privacy. Justice states that like cases should be treated alike.

A nurse is providing care for a client with cancer. The client's spouse requests that the client not be told that the client is terminal. The nurse complies with this request. The nurse's action is a breach of which ethical principle?

Fidelity explaination The principle of fidelity involves the nurse being faithful to the client, who has the right to the truth. By not telling the client, the nurse is not being faithful to the client. Autonomy is the right to self-determination or decision making. The client, not the client's spouse, has the autonomy to determine the extent of the cancer treatment. Beneficence is the act of doing of good. The nurse is not doing good by withholding the information. Nonmaleficence means not harming or inflicting the least harm possible to reach a beneficial outcome. The nurse is inflicting harm by not being faithful to the client.

A parent of a 17-year-old high school student is allowing the child to decide which college the child will attend. When the child requests direction from the parent in making this decision, the parent responds by stating, "You will need to make this decision on your own." What type of value transmission is the parent displaying?

Laissez-faire

Which statements indicate a correct understanding of the tenets of the Code of Ethics for Nurses? Select all that apply.

The nurse maintains standards of personal conduct. The nurse is active in developing a core of research-based principles. The nurse holds personal information as confidential.

What is the term for the beliefs held by the individual about what matters?

Values explaination Values are ideals and beliefs held by an individual or group about what matters; values act as a standard to guide one's behavior. Ethics are moral principles and values that guide the behavior of honorable people. A moral is a standard for right and wrong. Bioethics is related to ethical questions surrounding life and death, as well as questions and concerns regarding quality of life as it relates to advanced technology.

A nurse reports to the charge nurse that a client medication due at 9 am was omitted. Which principle is the nurse demonstrating?

Integrity explaination The principle of integrity is based on the honesty of a nurse according to professional standards. In this instance, the nurse reported the occurrence of the missed medication to the charge nurse. The definition of altruism is concern for others; it can best be explained by a nurse concerned about how a client will care for self after discharge. Social justice is a concept of fair and just relations between the individual and society and is related to wealth and distribution of goods in a society. Autonomy is the right to self-determination or acting independently and making decisions.

Which statement by the nurse is an example of deception?

"This injection of procaine will feel like a little pinch."

Which scenario is an example of the laissez-faire approach to value transmission?

Allowing a child to decide not to have an intravenous line inserted explaination A laissez-faire approach to value transmission is one that allows others, especially children, to make decisions without guidance, resulting in a decision that may not be a sound one. Teaching a child about right and wrong behavior is a more active learning strategy, and reflects the moralizing approach to value transmission. Modeling or role modeling is leading (and transmitting values) by example—in this case, not smoking electronic cigarettes to show the teenagers good behavior. Telling the child about the injection feeling like a pinch is not an approach to value transmission

Which ethical principle refers to the obligation to do good?

Beneficence explaination Beneficence is the duty to do good and the active promotion of benevolent acts. Fidelity refers to the duty to be faithful to one's commitments. Veracity is the obligation to tell the truth. Nonmaleficence is the duty not to inflict, as well as to prevent and remove, harm; it is more binding than beneficence.

When examining values, a nurse notes that one country allows physician-assisted suicide and another outlaws it, making it punishable by imprisonment. Which factors best explain the differences in values between these two countries?

Cultural explaination Daily living is expressed in many traditions and customs; understanding these differences is cultural value orientation. Because it is primarily culture that determine's a society's values, cultural factors best explain the differences in values between these two countries. Although economic, spiritual, and ethical factors may be involved in value formation, a society's value system is most influenced by culture.

A nurse is providing care to a client and is preparing the client for breakfast. The nurse assists the client out of bed to the chair and then helps the client open the items on the breakfast tray. The client begins to eat breakfast. The nurse tells the client, "I'll be back in about 10 minutes to check on you. In the meantime, here is your call light in case you need me." About 10 minutes later, the nurse returns to check on the client. The nurse is demonstrating which ethical principle?

Fidelity explaination Fidelity involves keeping promises and being faithful to the promises made. In this case, the nurse tells the client that she will return in 10 minutes and then follows through with the promise. Nonmaleficence involves doing no harm and avoiding actions that deliberately harm a person. Autonomy refers to the right to make one's own decisions. Justice involves treating each person fairly and without judgment.

Which nursing action demonstrates the principle of fidelity?

Filing an incident report after making a medication error explaination Fidelity means being faithful to work-related commitments and obligations. The ethical principle is best demonstrated by the nurse following the employer's policies by completing the incident report following a medication error. Administering vaccines is an example of beneficence; treating an uninsured client in the emergency department is an example of justice; witnessing a client signature on an informed consent is autonomy.

The nurse is managing the care for a postoperative client. How does the nurse demonstrate advocacy?

Limiting visitors due to the client reporting pain explaination Advocating for clients is a nursing responsibility and is performed with the best interest and welfare of the client in providing safe, competent, and comforting care. Limiting visitors is an example of advocacy. The nurse recognizes that the client is in pain; therefore, limiting the visitors allows for the nurse to advocate for additional measures to allow the client to rest and recover. Administering pain medication and turning and the client every 4 hours are important and necessary interventions for a postoperative client, but this is not advocacy. Changing the channel on the television while providing care also does not promote advocacy.

Which action most clearly demonstrates a nurse's commitment to social justice?

Lobbying for an expansion of healthcare resources and benefits to those in poverty explaination Social justice is a professional value that encompasses efforts to promote universal access to health care, such as the expansion of publicly funded programs like Medicare. Culturally competent care is a reflection of human dignity. Answering clients' questions and documenting care accurately are expressions of the value of integrity.

What is likely to have the greatest influence on an adolescent's formation of values during this developmental stage?

Peers explaination In adolescence, peer groups have a major influence on value formation. The attitudes, beliefs, and behaviors that grow out of peer group relationships are powerful. It is generally accepted that the influence of peers exceeds that of school administration, work life, or the awareness of other cultures during this developmental stage.

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.

Using the nursing process to make ethical decisions involves following several steps. Which step is the nurse implementing when reflecting on the decision-making process and the role it will play in making future decisions?

explaination Evaluating an ethical decision involves reflecting on the process and evaluating those elements that will be helpful in the future. The nurse may also question how this experience can improve reasoning and decision making in the future. Diagnosing the ethical problem involves stating the problem clearly. Planning includes identifying the options and exploring the probable short-term and long-term consequences. Implementing includes the implementation of the decision and comparing the outcomes of the action with what was considered and hoped for in advance.

A client is brought to the emergency department by an adult child, who states, "I am unable to care for my parent anymore. Although I would like to, financially and physically I can't do it anymore." What ethical problem is the adult child experiencing?

Distress explaination Ethical distress is when someone wants to do the right thing but is not able. The adult child brings the parent to the emergency department to maintain the client's safety, although the child needs to take care of the parent. Dilemma is a situation in which a difficult choice has to be made between two or more alternatives, especially equally undesirable ones. The client is not experiencing a dilemma. Uncertainty means a feeling of not knowing what will happen. The adult child is certain that he or she cannot care for the parent. Dissatisfaction implies a sense of dislike for, or unhappiness in, one's surroundings. While the adult child is unhappy, this is not the primary ethical problem.