Ethics

A client in a semiprivate room is diagnosed with pediculosis corpus. A nurse will initiate treatment after moving the client to another room. The client's roommate asks the nurse for information about the client. What should the nurse say?

"I'm sorry, but I can't share confidential information." The nurse must advise the client's roommate that she cannot discuss the other client's health care information. Providing specific or even vague information about the client's diagnosis is a breech of confidentiality.

A client informs the nurse that he is leaving the healthcare facility because he is not satisfied with the treatment. The nurse knows that the client's treatment is incomplete and few investigations are scheduled. Which of the following is the most appropriate action by the nurse to prevent false imprisonment?

Ask the client to sign release without medical approval. If a client wants to leave the healthcare facility, the nurse should ask him to sign a release stating that he or she left without medical approval. The nurse cannot restrain the client, because doing so amounts to false imprisonment. Calling the physician is not an appropriate measure. Telling the client that he may not be able to access the healthcare facility again is an inappropriate response because healthcare is a right and the client can access it whenever necessary.

The nurse is caring for a postpartum caesarean client and realizes that she has made a medication error. She administered intravenous morphine instead of intramuscular meperidine. What should be the nurse's immediate action?

Assess the client and contact the physician. An accurate client assessment should be performed, and the physician should be contacted immediately. The nurse should anticipate orders for changes to the management of care in this situation. It is not necessary to contact the local governing body or nursing association to report this error. It may be appropriate to complete an incident or safety learning report as per institutional policy, but the most immediate action should be to assess the client's well being and to report it to the physician. Nurses should uphold the standards for safe, competent, and ethical care and ensure personal and professional accountability as per the American Nurses Association (Canadian Nurses' Association) Code of Ethics.

A client with long-term body-focused repetitive behaviors including trichotillomania (hair pulling) finds support through an online website. The client begins to attend local meetings and realizes that a nurse from the clinic also attends. When approached outside of these meetings, how should the nurse respond?

Discuss this to define the relationship. Social media and self-help groups can contribute to blurred boundaries between personal and professional relationships. The nurse should take the lead to discuss boundaries with the client. This means that the relationship needs to be defined. Generally letting the client do this fails as they do not understand the conflict and respond positively to having contact with their nurse outside of the professional setting. Pretending not to know the client can be hurtful, while leaving the group can be detrimental to the nurse.

A Jehovah's Witness client is admitted after a serious car accident and continues to experience severe anemia after significant blood loss. The family remains adamantly opposed to blood product support. What is the nurse's best intervention?

Offer the client alternative treatment options to consider. In recognizing and respecting the client's religious beliefs and practices, the nurse should research and explore alternative treatment options to offer the client so that healing is not further compromised. It is fruitless to persist in discussing or providing information about a treatment that is being rejected due to deep religious feelings. Requesting a consultation with the chaplaincy department will also not dissuade the client, nor provide medical treatment options.

A nurse working in the operating room is assigned to the suite where therapeutic abortions are to be performed throughout the day. The nurse feels that participation in these procedures conflicts with personal religious beliefs. What should the nurse do after notifying the operating room supervisor?

Remain in the operating room suite until another nurse arrives to take that assignment. If nursing care is requested that is contrary to the nurse's personal values, the nurse must provide appropriate care until alternative care arrangements are in place to meet the client's needs. The other options are not correct, and if the nurse left the suite, it could result in the accusation that the nurse abandoned the client. The nurse should be aware of potential conflicts before accepting an assignment.

The nurse is obtaining informed consent from a client. To adhere to ethical and legal standards, the nurse must ensure that the informed consent consists of which of the following? Select all that apply.

The client's agreement to the plan of care Freedom from coercion Discussion of pertinent information Discussion of pertinent information, the client's agreement to the plan of care, and freedom from coercion are important factors in informed consent. Caregiver preference and opinion could be perceived as coercion. Informed consent does not require verification from next of kin.

A home care nurse is caring for a paralyzed client who needs regular position changes and back massages. A man identifying himself as a family friend inquires if he can be of any help to the family. What should be the nurse's response be?

The nurse should ask the man to talk to the family directly. The nurse should ask the man to talk to the family directly. Revealing information about the client's care is a violation of the client's privacy. The nurse should not invite the gentleman for a learning session, because doing so would be a breach of the client's right to privacy. Referring him to a social worker is not an appropriate choice.

Nurse researchers have proposed a study to examine the efficacy of a new wound care product. Which of the following aspects of the methodology demonstrates that the nurses are attempting to maintain the ethical principle of nonmaleficence?

The nurses are taking every responsible measure to ensure that no participants experience impaired wound healing as a result of the study intervention. The principle of nonmaleficence dictates that nurses avoid causing harm. In this study, this may appear in the form of taking measures to ensure that the intervention will not cause more harm than good. The principle of justice addresses the distribution of risks and benefits and the informed consent process demonstrates that autonomy is being protected. Preliminary indications of the therapeutic value of the intervention show a respect for the principle of beneficence.

A nurse is conducting a presentation for group of adults a local adult community center about advanced directives. After explaining this topic to the group, the nurse determines that the presentation was successful when the group identifies which principle as the underlying reason for creating an advanced directive?

promoting self decision making The underlying ethical principle associated with the creation of advanced directives is autonomy, that is, respect for the client's ability to be self-directed and self-determined. The client is entitled to make decisions about what will happen to the client and the client's body. Beneficence involves doing or promoting good and is the basis for all healthcare actions. It promotes the client's best interests and strives to achieve optimal outcomes. Nonmaleficence means to avoid doing harm, to remove from harm, or to prevent harm. Justice is the principle of fairness with the obligation to treat all clients equally and fairly.