nursing ethical exam

eing answerable for one's own action is assuming: Accountability Responsibility Nonmaleficence Veracity

Accountability Question 20 Explanation: Accountability means being answerable to one's own actions. Nonmaleficence is avoiding harm. Veracity is truth telling. Responsibility is the execution of duties associated with nurse's particular role.

Question 31 Which type of moral theory, rigidly applied, would most likely lead a person to consider euthanasia morally wrong, even when it is done to end the pain and suffering of a patient? • Deontology • Relational ethics • Naturalism • Utilitarianism

Deontology

The principles or standards that influence behavior and decision making which are based on experience, religion, education and culture is called: values morals ethics standards of practice

values Question 4 Explanation: Values are principles or standards that influence behavior and decision making which are based on experience, religion, education and culture. A moral belief is the personal conviction that something is absolutely right or wrong in all situations. Ethics is the promotion of philosophical and theological study of morality, moral judgments and moral problems. It reflects the principles or standards that govern proper conduct related to professional behavior.

Question 20 A community nurse speaks with a post-op patient recovering at home after double mastectomy surgery necessitated by breast cancer. The surgeon has told the patient that they were able to remove 100% of the tumour they could see during surgery, but her medical team recommends a course of chemotherapy to increase the patient's chance that the cancer will not return. The nurse learns that the patient is well informed and understands the medical impact of treatment options presented by the health care team, but worries if she'll be able to cope with the side effects of chemo. The patient also worries what might happen if she chooses not to have chemo. She lives alone and has no close family or friends she would like to involve in her decision-making. She asks the nurse "What do you think I should do?" Which nurse response would be most helpful to this patient? • Advise the patient to ask her doctor which course of action is best. • Answer the patient's question and provide your opinion. • Ask the patient to tell the nurse more about herself. What is important to this patient in her lifestyle? What does she value? • Provide educational resources so the patient can learn more about the consequences of each potential action

• Advise the patient to ask her doctor which course of action is best.

Question 11Which statement best explains the role of the nurse when planning care for a culturally and gender diverse population? • Include care that is culturally congruent with the staff as directed by policies of the institution. • Focus only on the needs of the client, ignoring the nurse's beliefs and practices. • Blend those values of both the nurse and the client which maximize client health. • Be aware of one's own bias and values, providing care that focuses on the client's individual needs.

.• Focus only on the needs of the client, ignoring the nurse's beliefs and practices.

The fundamental responsibility of a nurse according to the International Council of Nurse Code for Nurses are the following apart from: Prevention of illness Promotion of health Restoration of health Aggravation of suffering

Aggravation of suffering Question 23 Explanation: The fundamental responsibility of the nurse is to promote heath, prevent illness, restore health and alleviate (not aggravate) suffering.

A wrong dose of drug is administered by the nurse. The nurse is responsible to whom? Client Physician who ordered the drug Society All of these

All of these Question 6 Explanation: The nurse is accountable to the client who received the drug, the physician who ordered it, the nursing service that set the standards of expected performance and society which demands professional excellence.

Nursing ethics provides the standards for professional behavior and is the study of principles of right and wrong for nurses. This set of standards states the duties and obligations of nurses to: Client Other health professionals Community All of these

All of these Question 9 Explanation: Nursing ethics states the duties and obligations of nurses to clients, other health professionals, profession and community.

Informed consent is a method that promotes: Autonomy Nonmaleficence Beneficence Justice

Autonomy Question 21 Explanation: Autonomy is the personal liberty of action and self-determination. Informed consent promotes this ethical principle and respects the client's decision.

The duty to respect privileged information is called: Fidelity Justice Veracity Confidentiality

Confidentiality Question 8 Explanation: Confidentiality is the duty to respect privileged information. Justice requires treating each other fairly and giving persons their due. However problems like limited availability of resources complicate the application of the distribution of justice. To promote justice in this case, nurse may employ the practice of triage to distribute nursing care properly in spite of limited resources. Veracity is duty to tell the truth.

Question 17If a nurse upholds the profession's code of ethics, practises within the established scope of practice, and take steps to remain competent, which ethical principle are they applying? • Beneficence • Autonomy • Fidelity • Non-maleficence

Fidelity

Question 38 During a team meeting, a physician asks other members of the team, the patient, and the patient's family for their input on the best plan of care. What ethical theory does best illustrate? Feminist ethics Relational ethics Hierarchy ethics Virtue ethics

Relational ethics

The client on renal dialysis informs the nurse that he wants to stop the series of dialysis. The nurse should appropriately do which action in response to the client's decision? Inform the client that the doctor must decide what to do. Tell the client that he must finish his series of renal dialysis. Respect the client's decision and provide comfort measures. Leave the client and attend other patients.

Respect the client's decision and provide comfort measures. Question 17 Explanation: Respect for autonomy must be acknowledged when the client disagrees with health care professionals, as well as when the client agrees with the recommendations of the health care team.

External constraints can influence voluntariness in situations related to informed consent. These constraint least likely include: Coercion Fraud Undue violence Significant trauma

Significant trauma Question 2 Explanation: Significant trauma is an internal constraint. A, B, and C are all external constraints

Question 36 The healthcare has outlined the nature of proposed plan of treatment and identified its expected benefits risks and side effects. the patient is cognitively able to understand the options and implication of them and when asked if he has any questions about it, he responds" no" what legal requirement is missing from this process of obtaining informed consent? Nobody asked the patient if identified goals of care confirmed with the patient own goals. The implication of not following the treatment plan were not discussed. The patient spouse wasn't invited to participate in the conversation about thetreatment. The health team didn't ask for the patient's consent in writing.

The health team didn't ask for the patient's consent in writing.

Professional accountability serves for the following purpose except for: To provide basis for ethical decision To respect the decision of the client. To maintain standards of health To evaluate new professional practices and reassess existing ones

To respect the decision of the client. Question 24 Explanation: Autonomy not accountability respects the decision made by the client. The purposes of professional accountability are: • To provide basis for ethical decision • To maintain standards of health • To evaluate new professional practices and reassess existing ones

When does a moral issue become an ethical issue? When the choices are clearly denoting which is right and wrong. When values of a person develops and changes over time. When there is no acceptable reason for the wrong choice once it is done. When the choice is no longer clear between right and wrong.

When the choice is no longer clear between right and wrong. Question 19 Explanation: A moral belief is the personal conviction that something is absolutely right or wrong in all situations. A person is generally unwilling to change personal opinions on issues of a moral nature. However, when the choice is no longer clear between right and wrong the moral issue becomes an ethical one. For example, a person who morally believes that abortion is wrong but is faced with a pregnancy condition that would cause death of the mother if the fetus is not aborted. The moral issue (abortion) becomes an ethical one in this case. The ethical choice of not aborting the fetus but would end the life of the mother or aborting the fetus that would save the life of the mother would then cause confusion to the person involved.

Question 39 A nurse promises a patient that she/he will return in five minutes to sit and speak with him. What ethical principle does this situation illustrate? Morality Fidelity Confidentiality Justice

Fidelity

Question 15 The emergency room team decides that the most critically ill patient will be treatedfirst. Which of the following ethical principles is illustrated by the decision-makingprocess in this case? • Respect •Justice • Beneficence • Autonomy

Justice

A nurse performs CPR on a choking patient and in the process breaks the sternum, which then leads to the patient's death. Which ethical theory would say that the nurse's actions were inherently good because of the intent, regardless of the outcome? • Deontology • Naturalism • Rationalism • Utilitarianism

Deontology

Ethics in nursing profession is very important. The type of ethics that presents a factual narration of moral behaviors is called: Mataethics Normative ethics Descriptive ethics All of these

Descriptive ethics Question 16 Explanation: Descriptive ethics presents a factual narration of moral behaviors. Metaethics is concerned with theoretical issues of meaning and justification. It is the portion of ethics that centers on the extent to which judgments are reasonable or otherwise justifiable. Normative ethics raises a question about what is right or what to be done in a situation that calls for an ethical decision.

To make autonomous decisions and actions, clients must be offered enough information and has the following criteria: Free of internal and external influences A minor Unconscious Comatose patient

Free of internal and external influences Question 5 Explanation: Autonomous decision making should be free of internal and external influences. Minors, unconscious and patients in coma have to rely on others for decision-making.

Question 1WRONG The portion of ethics that centers on the extent to which judgments are reasonable or otherwise justifiable is: Mataethics Normative ethics Descriptive ethics All of these Question 1 Explanation: Metaethics is concerned with theoretical issues of meaning and justification. It is the portion of ethics that centers on the extent to which judgments are reasonable or otherwise justifiable. Normative ethics raises a question about what is right or what to be done in a situation that calls for an ethical decision. Descriptive ethics presents a factual narration of moral behaviors. Question 2WRONG External constraints can influence voluntariness in situations related to informed consent. These constraint least likely include: Coercion Fraud Undue violence Significant trauma Question 2 Explanation: Significant trauma is an internal constraint. A, B, and C are all external constraints. Question 3CORRECT The nurse in a unit is caring for several clients. To distribute nursing care the nurse utilized the principle of triage due to the limited availability of resources. The nurse is promoting which ethical principle? Fidelity Justice Veracity Confidentiality Question 3 Explanation: Justice requires treating each other fairly and giving persons their due. However problems like limited availability of resources complicate the application of the distribution of justice. To promote justice in this case, nurse may employ the practice of triage to distribute nursing care properly in spite of limited resources. Veracity is duty to tell the truth. Fidelity is the duty to keep promises. Confidentiality is the duty to respect privileged information. Question 4CORRECT The principles or standards that influence behavior and decision making which are based on experience, religion, education and culture is called: values morals ethics standards of practice Question 4 Explanation: Values are principles or standards that influence behavior and decision making which are based on experience, religion, education and culture. A moral belief is the personal conviction that something is absolutely right or wrong in all situations. Ethics is the promotion of philosophical and theological study of morality, moral judgments and moral problems. It reflects the principles or standards that govern proper conduct related to professional behavior. Question 5CORRECT To make autonomous decisions and actions, clients must be offered enough information and has the following criteria: Free of internal and external influences A minor Unconscious Comatose patient Question 5 Explanation: Autonomous decision making should be free of internal and external influences. Minors, unconscious and patients in coma have to rely on others for decision-making. Question 6CORRECT A wrong dose of drug is administered by the nurse. The nurse is responsible to whom? Client Physician who ordered the drug Society All of these Question 6 Explanation: The nurse is accountable to the client who received the drug, the physician who ordered it, the nursing service that set the standards of expected performance and society which demands professional excellence. Question 7WRONG Deciding whether prolonging life in a terminally ill client or doing euthanasia (mercy killing) is an example of what type of ethics? Mataethics Normative ethics Descriptive ethics All of these Question 7 Explanation: Normative ethics raises questions about what is right or what to be done in a situation that calls for an ethical decision. Descriptive ethics presents a factual narration of moral behaviors. Question 8WRONG The duty to respect privileged information is called: Fidelity Justice Veracity Confidentiality Question 8 Explanation: Confidentiality is the duty to respect privileged information. Justice requires treating each other fairly and giving persons their due. However problems like limited availability of resources complicate the application of the distribution of justice. To promote justice in this case, nurse may employ the practice of triage to distribute nursing care properly in spite of limited resources. Veracity is duty to tell the truth. Question 9WRONG Nursing ethics provides the standards for professional behavior and is the study of principles of right and wrong for nurses. This set of standards states the duties and obligations of nurses to: Client Other health professionals Community All of these Question 9 Explanation: Nursing ethics states the duties and obligations of nurses to clients, other health professionals, profession and community. Question 10CORRECT Nurse's code of ethics is a set of ethical principles generally accepted by members of the profession. The standard or principles that a nurse must observe in the practice should promote which duty? Uses judgment in relation to individual competence when accepting and delegating responsibilities. Plays a major role in determining and implementation of desirable standards of nursing practice. Active in developing a core of professional knowledge. Acts through professional organization and participates in establishing and maintaining equitable social and economic working conditions in nursing. Question 10 Explanation: Using judgment in relation to individual competence when accepting and delegating responsibilities is a duty of a nurse to his/her practice. Under the international Council of Nurses Code for Nurses the following duties are pertains to specific criteria: a. Uses judgment in relation to individual competence when accepting and delegating responsibilities. - NURSE AND PRACTICE b. Plays a major role in determining and implementation of desirable standards of nursing practice. - NURSE AND PROFESSION c. Active in developing a core of professional knowledge - NURSE AND PROFESSION d. Acts through professional organization and participates in establishing and maintaining equitable social and economic working conditions in nursing. - NURSE AND PROFESSION Question 11 The execution of duties associated with nurse's particular role is called: Accountability Responsibility Nonmaleficence Veracity

Responsibility Question 11 Explanation: Responsibility is the execution of duties associated with nurse's particular role. Accountability means being answerable to one's own actions. Nonmaleficence is avoiding harm. Veracity is truth telling.

The nurse in a unit is caring for several clients. To distribute nursing care the nurse utilized the principle of triage due to the limited availability of resources. The nurse is promoting which ethical principle? Fidelity Justice Veracity Confidentiality

Justice Question 3 Explanation: Justice requires treating each other fairly and giving persons their due. However problems like limited availability of resources complicate the application of the distribution of justice. To promote justice in this case, nurse may employ the practice of triage to distribute nursing care properly in spite of limited resources. Veracity is duty to tell the truth. Fidelity is the duty to keep promises. Confidentiality is the duty to respect privileged information.

Nurse Janine avoids deliberate harm, risk of harm and harm that occurs during her performance of nursing actions. The nurse is promoting which ethical principle? Autonomy Nonmaleficence Beneficence Justice

Nonmaleficence Question 14 Explanation: Duty to do no harm or nonmaleficence is what Nurse Janine is promoting. This ethical principle is also promoted when nurse avoids deliberate harm, risk of harm and harm that occurs during performance of nursing actions. Autonomy is the personal liberty of action and self-determination. Beneficence is doing good or active promotion of good for the benefit of others.

Deciding whether prolonging life in a terminally ill client or doing euthanasia (mercy killing) is an example of what type of ethics? Mataethics Normative ethics Descriptive ethics All of these

Normative ethics Question 7 Explanation: Normative ethics raises questions about what is right or what to be done in a situation that calls for an ethical decision. Descriptive ethics presents a factual narration of moral behaviors.

Question 37 At a drop-in women's clinic, a nurse is assigned to care for a patient who reportedly engages in high-risk behaviour such as having sex for money using drugs and engage amounts of alcohol. The patient's history states that the patient has explained in the past that this lifestyle is better for her than it would have been had she stayed at home with abusive parents. Which action is the best ethical response? Refer the patient to a drug rehabilitation facility, as this will be an important first step to build patient health Encourage the patient to stop her risky sexual activity because it compromises her health and safety Explore what the patient's goals and wishes would consist of and try to support the patient and ensure her safety Arrange for another nurse to provide care as this patient's values are different from the nurses.

Refer the patient to a drug rehabilitation facility, as this will be an important first step to build patient health

Before the nurse administered the client's medication she assessed the client's needs for drugs, and followed the "rights" in drug preparation and administration. After the nurse has given the dose, she evaluated the client's response to the medication given. The nurse is promoting: Accountability Autonomy Responsibility Veracity

Responsibility Question 18 Explanation: Responsibility is the execution of duties associated with nurse's particular role. Accountability means being answerable to one's own actions. Veracity is truth telling.

Free consent is a willingness to participate in situations related to informed consent. There are constraints related to voluntariness, which are the internal and external. Internal constraints include which of the following? Coercion Fraud Undue violence Significant trauma

Significant trauma Question 22 Explanation: Internal constraints include significant trauma, neurological damage, hypoxia, and other compromised physiological states. Psychological states such as grief, suffering, and anxiety can also limit willingness to participate. External constraints can influence voluntariness which includes coercion, duress, fraud, deceit or undue influence.

Nurse's code of ethics is a set of ethical principles generally accepted by members of the profession. The standard or principles that a nurse must observe in the practice should promote which duty? Uses judgment in relation to individual competence when accepting and delegating responsibilities. Plays a major role in determining and implementation of desirable standards of nursing practice. Active in developing a core of professional knowledge. Acts through professional organization and participates in establishing and maintaining equitable social and economic working conditions in nursing.

Uses judgment in relation to individual competence when accepting and delegating responsibilities. Question 10 Explanation: Using judgment in relation to individual competence when accepting and delegating responsibilities is a duty of a nurse to his/her practice. Under the international Council of Nurses Code for Nurses the following duties are pertains to specific criteria: a. Uses judgment in relation to individual competence when accepting and delegating responsibilities. - NURSE AND PRACTICE b. Plays a major role in determining and implementation of desirable standards of nursing practice. - NURSE AND PROFESSION c. Active in developing a core of professional knowledge - NURSE AND PROFESSION d. Acts through professional organization and participates in establishing and maintaining equitable social and economic working conditions in nursing. - NURSE AND PROFESSION

A client is advised by the doctor to undergo chemotherapy. An informed consent is not yet signed. This client requests information related to chemotherapy and the drugs that will be given to him. The nurse explained the side effects of the medications, including the length of treatment and the prognosis of the disease. The nurse answered all the questions of the client honestly even though the client may choose not to undergo chemotherapy. The nurse in this situation is promoting: Fidelity Justice Veracity Confidentiality

Veracity Question 12 Explanation: Veracity is duty to tell the truth. Fidelity is the duty to keep promises. Confidentiality is the duty to respect privileged information. Justice requires treating each other fairly and giving persons their due. However problems like limited availability of resources complicate the application of the distribution of justice. To promote justice in this case, nurse may employ the practice of triage to distribute nursing care properly in spite of limited resources.

The nurse's obligations to the client least like include: Considers the dignity of clients Retains a commitment of welfare to the client Work toward securing and maintaining conditions of employment that satisfy the goals of nursing. Hold confidential all information about a client learned in a health care setting.

Work toward securing and maintaining conditions of employment that satisfy the goals of nursing. Question 25 Explanation: This is the social context of nursing not a specific obligation of the nurse to the patient/client. a. Considers the dignity of clients - obligation to client b. Retains a commitment of welfare to the client - obligation to client c. Work toward securing and maintaining conditions of employment that satisfy the goals of nursing. - social context of nursing d. Hold confidential all information about a client learned in a health care setting. - obligation to client

The one that promotes the philosophical and theological study of morality, moral judgments and moral problems is called: values morals ethics standards of practice

ethics Question 15 Explanation: Ethics is the promotion of philosophical and theological study of morality, moral judgments and moral problems. It reflects the principles or standards that govern proper conduct related to professional behavior. A moral belief is the personal conviction that something is absolutely right or wrong in all situations. Values are principles or standards that influence behavior and decision making which are based on experience, religion, education and culture.

The personal conviction that something is absolutely right or wrong in all situations is called: values morals ethics standards of practice

morals Question 13 Explanation: A moral belief is the personal conviction that something is absolutely right or wrong in all situations. Values are principles or standards that influence behavior and decision making which are based on experience, religion, education and culture. Ethics is the promotion of philosophical and theological study of morality, moral judgments and moral problems. It reflects the principles or standards that govern proper conduct related to professional behavior.

Question 8 A patient expresses a wish to die at home and some members of the health care team have pressured the nurse to talk the family into taking the patient home so his wish can be realized. The family has told the nurse privately that the presence of the patient at home will create intolerable stress for them. Additionally, the nurse knows that community-centred palliative care services are in very short supply in their community, so there would be few resources to support the family at home. What actions should the nurse prioritize in this situation? • Advocate for additional community resources so the family can access the resources they need. • Encourage the family to accept the patient home since the wishes of a patient should take priority. • Suggest a family meeting and invite the facility's clinical ethicist to help facilitate it. • Explain to the patient that the family have explained they wouldnot be able to cope

• Advocate for additional community resources so the family can access the resources they need.

Question 7 Which of the following actions indicate correct application of legal and ethical responsibilities related to advance directives? • An advance care directive indicating a patient's wishes needs to be in writing to be considered legal. • A nurse's role includes informing other health team members of the presence and content of advance directives. • Once an individual has assigned a substitute decision-maker a nurse does not need to involve the patient in ongoing decisions about their care. • Once a capable patient provides an advance care directive indicating their wishes, they cannot change their mind.

• An advance care directive indicating a patient's wishes needs to be in writing to be considered legal.

Question 27 In an understaffed unit you have noticed that one nurse frequently rushes to get work done, engaging in behaviour you question, for example not drawing a curtain around a patient's bed when dressing him, speaking abruptly to patients, rushing a patient to eat quickly and not consistently performing hand hygiene when moving to provide care to a different patient. You have tried to discuss this with the nurse, offered to help her with her tasks and have role modelled more positive behaviour, but the colleague continues their usual practice stating "Once you've worked here a bit longer you'll learn that anything you can do to save time is good - it's the only way we can possibly get everything done each day." Which behaviour represents the most ethically responsible course of action? • Tell your colleague you will need to report her to the patient care manager if she does not modify her behaviour. • Ask to be assigned to work with your colleague so you can protect patients by making up for the gaps in your colleague's care. • Accept the colleague's behaviour since the behaviour is not physically abusive to patients and the unit is a stressful environment. • Ask for a meeting with the patient care manager to discuss your concerns and the impact of understaffing.

• Ask for a meeting with the patient care manager to discuss your concerns and the impact of understaffing.

Question 5 A 55-year old man named Dr. Smith was treated in emergency with dizziness and a severe headache. The emergency room physician prescribed medication and discharged him with instructions to follow up with his family physician. The nurse caring for Dr. Smith assumes the physician had explained the medication and the patient understood how and why to take it. What ethical principle did the nurse violate in this situation? • Veracity • Confidentiality • Justice • Autonomy

• Autonomy

A nurse performs a pain assessment on a client and requests an order for an analgesic as an intervention. Which of the following ethical principles is being applied in this situation? • Beneficence • Autonomy • Veracity • Fairness

• Beneficence

Question 19 A patient with severe cancer pain is asking for a higher dose of pain medication. The physician has written an order that would allow nursing discretion in analgesia ("Give one to three tablets prn"), but the nurse is reluctant to give the highest dose as she's concerned it may initiate serious side effects or possibly hasten the patient's death. What ethical principles is the nurse struggling to balance in this dilemma? • Beneficence vs non-maleficence • Beneficence vs well being • Beneficence vs justice • Promoting well-being vs honouring dignity

• Beneficence vs non-maleficence

Question 16Nurses make choices about how to allocate their time across their patient assignment on the basis of patient need and level of care. Which of the following ethical principles is illustrated by the decision-making process in this case? • Client choice • Fairness • Honouring dignity • Respect for life

• Client choice

Question 21 While attempting to teach a patient how dietary management to avoid high blood sugar levels can help prevent complications of his diabetes, the patient states "Enough. I don't want to hear any more. When the nurse inquires why the patient feels this way he states "Everybody in my family has diabetes and ready know all about it, i'm going to end up going blind and losing my tez and that's that, no matter what I do. That's what's happened to everyone in my family What would the best nurse response consist of • Ask for a referral to a capacity assessor to evaluate the patient's cognitive stility • Continue to provide information to promote health, but divide the teaching into shorter lessons soit be easier for the patient • Stop questioning the patient and leave him alone to think about what they've discussed so far, then return to the conversation boter • Continue to provide care and share the patient's comments with the interprofessional teams for further discussion

• Continue to provide care and share the patient's comments with the interprofessional teams for further discussion

Question 25 You suspect that a child who is being treated for a broken arm in your emergency department may have been a target of abuse. The child is withdrawn and watchful, has unexplained bruises and their parent reports the fracture is a result of the child's clumsiness. What should you do? • Document your observations and ask colleagues to be alert for additional signs of abuse. • Report the situation to your patient care manager (PCM) and let them decide what action to take next. • Report your concern to your PCM and ensure it is reported to the team for further evaluation and reporting to the Children's Aid Society. • Report your concern to your colleagues and ask them to be alert to additional signs of abuse, following up with them the next day.

• Document your observations and ask colleagues to be alert for additional signs of abuse.

Question 10A nurse who is transferring to a palliative care unit has taken time to explore their own views on death and dying, identifying their values and feelings related to end of life issues. As they begin to work in the unit, what practices would help this newnurse provide ethical care to their patients? • Encourage patients and families to accept choices the health team feel would be best .• Avoid use of words like "death" and "dying" as these can be tooharsh for individuals. • Explore areas of confusion patients and families might have about treatment options. • Offer sympathy as a means of comfort for grieving families

• Encourage patients and families to accept choices the health team feel would be best

Question 34 Which of the following questions might a nurse using an Ethic of Care theoretical approach ask themselves when they are helping a patient identify what is important to them in their decision-making process? • How does this patient identify their personal rights in this situation? • What is this patient's ability to deal with abstract concepts and reason logically? • How concerned is this patient about the reaction of others? • How does this patient view their relationships and responsibilities to self and others?

• How does this patient view their relationships and responsibilities to self and others?

Question 22 As your patient Mr. B. starts to leave his room you remind him to use his walker. "Idon't like using that thing" he complains, but he does go back to retrieve it and usesit to walk down the hall. But later that day you notice him walking unsteadily in the hall without the walker. At one point he starts to lose his balance and your quick response to steady him averts a fall. When you ask a colleague if you need tocomplete an incident report about his near-fall the colleague replies, "No. He didn'tactually fall, so we don't have to report it. Incident reports look bad on your record - maybe people will think you are careless. After all, it was up to you to make sure he was using his walker." What is your ethical responsibility at this point? • Follow the colleague's advice by not mentioning the event, but watch him more closely throughout the day and mention it to the next shift in your afternoon report. • Ignore the colleague's advice and report the near miss at the unit's interprofessional safety meetings to be held the next day. • Follow the colleague's advice, but document the incident in the patient's chart, • Ignore the colleague's advice and consult the nurse-in-charge to clarify what procedures your facility has for documenting "near misses".

• Ignore the colleague's advice and consult the nurse-in-charge to clarify what procedures your facility has for documenting "near misses".

Question 33 A patient is hospitalized with traumatic injuries caused by a vehicular collision. Her daughter, who was killed in the accident, was taken to the same hospital. The patient, who had been driving the vehicle, constantly asks the nurse about her daughter. The orthopedic surgeon has told the nurse not to tell the patient about the death of her daughter. The nurse expresses concern to the nurse manager, who says that the orthopedic surgeon will decide when the patient should be told. However, the nurse is not comfortable with this and wonders what should be done. Which of the following terms best describes this situation? • Incongruent values • Values conflict • Overt values • Societal values

• Incongruent values

Question 26 Nurses and allied healthcare workers in a local health region have engaged in negotiations with administration to improve staffing levels for many months without being able to reach agreement. Their collective bargaining unit is recommending that they now take part in a job action that would require them to withdraw their services and "strike" (i. refuse to work) until the administration agrees to return to negotiation discussions. Which action represents the most ethically responsible course of action? • Decline to participate in the job action because it is illegal for nurses to engage in a "strike". • Decline to participate in the job action because nurses have an obligation to maintain their commitments. • Participate in the job action after making all reasonable efforts to ensure clients will be cared for during the strike. • Participate in the strike if the majority of nursing and interprofessional team colleagues agree.

• Participate in the job action after making all reasonable efforts to ensure clients will be cared for during the strike.

Question 12 Cleaning a severely infected foot wound of a patient with diabetes in your emergency department, a nurse learns that this patient had come to the hospital two weeks earlier but had not stayed for treatment. What might a nurse who has a transcultural perspective say at this point? • "Why did you wait so long to come? This wound would have had a much better chance of healing if we'd seen it sooner." • "What was it like the last time you came to the hospital?" • Provide teaching to help the patient learn that people with diabetes need to be particularly careful about foot wounds. • Say nothing. It is good that the patient is here now and you don't want to frighten him away.

• Provide teaching to help the patient learn that people with diabetes need to be particularly careful about foot wounds.

Question 9A patient with an advanced stage of cancer struggles to make a choice between opting for another round of chemotherapy and palliative care. What nursing action would be the best place to start this conversation? • Explain the team's rationale for the proposed treatment plan. • Help the patient articulate their values and what is important to them. • Provide text material that explains the options clearly. • Provide the patient with privacy so they can think through the options.

• Provide text material that explains the options clearly.

Question 29 A cardiac nurse faces an ethical dilemma when her supervisor asks her to float to the obstetrics unit because the obstetrical unit is understaffed and there are few patients in cardiology that day. The nurse is anxious because she has never worked in obstetrics before. What are the first actions the nurse should take in this decision-making process? • Refuse the assignment as she does not feel competent to provide care in an obstetrical setting. • Accept the assignment as she has a commitment to her colleagues and practice environment. • Speak with the supervisor, clearly stating concerns and identifying conflicting obligations. • Speak with the supervisor to discuss how the facility could handle staffing issues in future

• Refuse the assignment as she does not feel competent to provide care in an obstetrical setting.

Question 32 A patient quietly responds "OK" when the nurse asks if they could change the patient's surgical dressing. But as the nurse is setting up the dressing tray they notice that the patient does not engage in eye contact and draws back when touched. The nurse stops performing the dressing and sits down to talk with the patient instead. What ethical theory does this action best illustrate? • Deontology • Relational ethics • Virtue ethics • Utilitarianism

• Relational ethics

Question 13 Mr. Jones, an elderly man who self-identifies as a gay person, becomes angry when a fellow patient, Mr. Smith makes a homophobic gay "joke" in the dining room of their retirement facility. How might the nurse respond to reduce the impact of discrimination? • Attempt to defuse the conflict by explaining that the other patient was just joking. • Avoid future conflict by re-arranging the dining room table assignment so the two patients do not need to sit together and risk annoying each other in future. • Ignore the conflict as it is extremely unlikely that Mr. Smith will change his views. • Say "I'm sorry about that Mr. Jones. I suspect Mr. Smith does not understand how a comment like that can make someone feel. Would you like to talk about it"?

• Say "I'm sorry about that Mr. Jones. I suspect Mr. Smith does not understand how a comment like that can make someone feel. Would you like to talk about it"?

Question 28 You observe a colleague preparing medication for a patient who has an order to have "1 or 2 Tylenol # 3 tablets q4 hr prn". The colleague signs for two tablets, setsaside one tablet to give to the patient, and puts the second tablet in his mouth. He turns and notices that you have seen him do this. "Oh! I'm so sorry you saw that! I hurt my back at work yesterday and it's hurting like crazy and the patient said she only needs one pilltoday. Please don't tell!" What would the most ethical first response be? • Agree to say nothing this time, but tell her if you see it happen again you'll need to report it .• Do nothing. This colleague is a friend who supported when you started working on the unit • Tell the colleague you are not comfortable with the situation and ask to talk about it. • Report your sosestions to management as you are concerned on many levels

• Tell the colleague you are not comfortable with the situation and ask to talk about it.•

Question 24 You ask a colleague on your team for advice about a medication error you have made, telling him that you misread the packaging on a medication and mistakenly gave a lower dosage of pain medication to a patient earlier that day. The patient has not experienced any adverse effects due to the lower dose and is unaware of the mistake. The colleague says "Don't worry about it. If you had given too much medication that would be different. But there's no harm done in this case. The patient might get upset and it would look bad on your record." What should your first action be? • Accept your colleague's advice and do not report the incident. • Tell the patient as they deserve to know the truth • Tell the patient care manager and discuss next steps. • Tell the patient's family as you do not want to upset the patient

• Tell the patient care manager and discuss next steps.

Question 6 A patient is refusing to participate in his plan of care. The nurse is aware that the patient's refusal will negatively affect his health outcome. According to the Canadian Nurses Association Code of Ethics, what must the nurse take into consideration? • That the patient's unhealthy life practices require further allocation of resources • That the nurse has the right to refuse to continue care. • That the provision of nursing care must remain non-judgmental. • That the patient requires more teaching to accept the plan of care.

• That the provision of nursing care must remain non-judgmental.

Question 35 As an individual who values honesty and would always want to know the full truth about their own personal health situation, a nurse is concerned that a patient's daughter is adamant that the health team not tell their cognitively intact fatherabout his terminal prognosis. What would be a good first step to resolve this distress? • The nurse should explain to the daughter that everyone has a right to know about their own health and that not telling her father is unfair and wrong. • The nurse should take a moment to identify their own feelings and reactions in this situation, identifying why they are uncomfortable with the situation. • The nurse should talk with colleagues to get suggestions of howto respond and learn what action the team suggests as a response to the daughter's request .• The nurse should avoid talking with the father for the moment, in case he asks about his prognosis.

• The nurse should explain to the daughter that everyone has a right to know about their own health and that not telling her father is unfair and wrong.

Question 14 While you are hanging a dose of iv antibiotics for your newly admitted patient who does not speak English, the patient asks his daughter to ask you about its side effects. The daughter adds that her father did not take the previously prescribed oral medication because it gave him severe gastric distress. Entering the nursing station afterwards you confirm with your team leader that the medication for this patient has arrived from the pharmacy and you have hung the first dose. Your team leader sighs and states "Good. I'm so frustrated dealing with these people who don't even know how to follow instructions and read the instructions on a pill bottle." Which response from the nurse provides the greatest likelihood that the colleague's unethical behaviour will be corrected? • The nurse should say "Actually, talking with the patient I learned that he tried to take the previous medication but it gave him severe gastric distress." • The nurse should interrupt the bias and say "Don't be such a racist - that's a really unfair thing to say." • The nurse should report the team leader's comments to the patient care manager as the comments are racist and unethical. • The nurse should acknowledge that it is frustrating when patients do not comply with treatment regimens.

• The nurse should report the team leader's comments to the patient care manager as the comments are racist and unethical.

A patient and family facing a moral decision choose an action with the support of their nurses and healthcare team members who are using a framework for ethical decision-making. After the action has been implemented, what questions might the nurses ask of themselves and the team? • Am I meeting professional and institutional expectations in this action? • Will individuals be supported in this action? • How was the patient and his family affected? *What action does the team feel will do the most good?

• Will individuals be supported in this action?