chapter 6-prep u
A nurse believes that abortion is an acceptable option if a pregnancy results from a situation of rape. What is the best description of this belief?
Personal value
A nurse incorporates the "five values that epitomize the caring professional nurse" (identified by the American Association of Colleges of Nursing) into a home health care nursing practice. Which attribute is best described as acting in accordance with an appropriate code of ethics and accepted standards of practice?
d-Integrity The American Association of Colleges of Nursing defines integrity as acting in accordance with an appropriate code of ethics and accepted standards of practice. Altruism is a concern for the welfare and well-being of others. Autonomy is the right to self-determination, and human dignity is respect for the inherent worth and uniqueness of individuals and populations.
A nurse is most likely to experience ethical distress in which client situation?
Continuing intravenous fluids for a client who wants to die
The nurse has an ethical dilemma and is using the ethical decision-making steps to guide to a correct decision. Place in order the steps the nurse uses in this process.
-Gather data and assess the situation. -Identify the ethical problem. -Identify and weigh the alternatives. -Implement the decision. -Evaluate the decision.
A nurse who has worked on a unit for 8 years is conflicted about asking to meet with the charge nurse about staffing ratios. Which question(s) reflect the professional value of altruism in this decision? Select all that apply.
-"Am I able to provide safe and efficient care to my clients?" -"Am I willing to take this risk to help protect my fellow nurses?" -"Will less experienced nurses on the unit learn from my actions?"
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 infant 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."
Which best defines value clarification?
A process by which people come to understand their own values and value systems
Which word is best described as protection and support of another's rights?
Advocacy
An illegal immigrant with no health insurance sustained life-threatening injuries in an automobile accident. Which action in this case demonstrates the ethical principle of justice?
Airlifting the client to a local trauma center for emergency surgery
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
Which example best describes feminist ethics?
An approach critiquing existing patterns of oppression and domination in society
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.
Which ethical principle refers to the obligation to do good?
Beneficence
Which example most accurately depicts the ethical principle of autonomy?
Describing a surgery to a client before the consent is signed
A nurse who is caring for a new mother realizes that the woman is not prepared to go home with her newborn after a hospital stay of only 24 hours. However, hospital policy dictates that the mother be discharged. This nurse may be faced with which moral problem?
Ethical distress
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 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
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 healthcare provider
The nurse beginning practice would like to access the standards for ethical practice. Which organization should the nurse research for these standards?
International Council of Nurses
The nurse is managing the care for a postoperative client. How does the nurse demonstrate advocacy?
Limiting visitors due to the client reporting pain
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
The nurse has identified an ethical dilemma that has the potential to interfere with a client receiving optimal care. The nurse discussed this issue with the charge nurse on the unit. What action should the nurse choose next?
Monitor for resolution of the problem.
A nurse knows that the expression "Do not cause harm" refers to which ethical principle?
Nonmaleficence
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 the nurse's own judgments based on the nurse's expertise. Which type of healthcare decision making does this represent?
Shared decision making
Which 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.
What are standards for decision-making that endure for a significant time in one's life?
Values
What is the term for the beliefs held by the individual about what matters?
Values
A client tells the nurse that the client does not want to have a painful procedure. By respecting and supporting the client's right to make decisions, the nurse is demonstrating:
advocacy
A client tells the nurse that the client does not want to have a painful procedure. By respecting and supporting the client's right to make decisions, the nurse is demonstrating:
advocacy.
A nurse caring for patients in an institutional setting expresses a commitment to social justice. What action best exemplifies this attribute?
b-Documenting care accurately and honestly The American Association of Colleges of Nursing lists promoting universal access to health care as an example of social justice. Providing honest information and documenting care accurately and honestly are examples of integrity, and planning care in partnership with patients is an example of autonomy.
A nurse is acting inappropriately and has an odor of alcohol. This behavior breaches the principle of:
ethical conduct.
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
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 cannot do it anymore." What ethical problem is the adult child experiencing?
moral distress
A nurse shows client advocacy by:
offering a hospice consultation to a client who is terminally ill.
What would be an example of the nurse practicing fidelity? The nurse:
stays with a client during death as promised.
A nurse is preparing a client for discharge from the cardiac unit and observes cigarettes in the client's belongings. The nurse asks the client to consider the client's health and that of the client's spouse. This is an example of:
values clarification
Which is the best definition of ethics?
The formal, systematic study of moral beliefs
Which action would cause a charge nurse to have concerns about a nurse's moral agency?
The nurse was seen at a grocery store after calling in sick.
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
Which nursing situation is an example of an ethical dilemma?
Deciding whether to perform cardiac compressions against a client's wishes
A nurse reports to the charge nurse that a client medication due at 9 am was omitted. Which principle is the nurse demonstrating?
Integrity
A nurse is providing care to an older adult client who was just diagnosed with cancer. The client together with the immediate family discuss their preferences with the health care providers involved. The health care providers offer their clinical recommendations about possible treatments. Ultimately, the group arrives at a decision. The nurse interprets this decision-making process as reflecting which type?
Shared
A parent teaches a child not to drink and drive; however, the parent does drink and drive. This action results in:
a failure to model one's own values.
A home health nurse performs a careful safety assessment of the home of a frail older adult to prevent harm to the patient. The nurse's action reflects which principle of bioethics?
e-Nonmaleficence Nonmaleficence is defined as the obligation to prevent harm. Autonomy is respect for another's right to make decisions, beneficence obligates us to benefit the patient, justice obligates us to act fairly, and fidelity obligates us to keep our promises.
An older adult was just diagnosed with stage 4 pancreatic cancer. The client states, "I am so overwhelmed and I feel like everyone has already decided that I need to be put in hospice care." Complete the following sentence by choosing from the lists of options. The nurse upholds the principle of autonomy by
offering to answer questions the client may have about care and treatment options providing the client with the information needed to obtain a second opinion
Socialization into the nursing profession may have the most significant effect on:
values
A nurse's friend states, "I admire you so much. I would love to be a nurse, but I don't think I have the courage." Which response will the nurse make?
"You can work on being more courageous as you learn to be a nurse."
A nurse is providing care to a client with end-stage cancer. After weighing the alternatives, the client decides not to participate in a clinical trial offered and is requesting no further treatment. The nurse advocates for the client's decision based on the understanding that the client has the right to self-determination, interpreting the client's decision as reflecting which ethical principle?
Autonomy
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
In the delivery of care, the nurse acts in accordance with nursing standards and the code of ethics and reports a medication error that the nurse has made. The nurse is most clearly demonstrating which professional value?
Integrity
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
An older nurse asks a younger coworker why the new generation of nurses just aren't ethical anymore. Which reply reflects the BEST understanding of moral development?
a-"Behaving ethically develops gradually from childhood; maybe my generation doesn't value this enough to develop an ethical code." The ability to be ethical, to make decisions, and to act in an ethically justified manner begins in childhood and develops gradually.
A hospice nurse is caring for a patient with end-stage cancer. What action demonstrates this nurse's commitment to the principle of autonomy?
a-The nurse helps the patient prepare a durable power of attorney document. The principle of autonomy obligates nurses to provide the information and support patients and their surrogates need to make decisions that advance their interests. Acting with justice means giving each person his or her due, acting with fidelity involves keeping promises to patients, and acting with nonmaleficence means avoiding doing harm to patients.
A nurse working on a critical care unit was informed by a client with multiple sclerosis that the client did not wish to be resuscitated in the event of cardiac arrest. Now the client is no longer able to express wishes, and the family has informed the health care provider that they want the client to be resuscitated. Aware of the client's wishes, the nurse is involved in a situation that may involve:
ethical distress.
Ethical distress is:
knowing the correct action but being unable to perform it due to constraints.
Which statement by the nurse is an example of deception?
"This injection of procaine will feel like a little pinch."
The nurse has been educating a young adult client about living with type 1 diabetes and the importance of adhering to a strict dietary regimen. The client is repeatedly admitted and is not following the prescribed plan. What statement made by the nurse may facilitate values clarification for the client?
"Rank the three most important things in your life."
Nursing practice consistent with the Code of Ethics for Nurses includes which actions? Select all that apply.
-Delivering culturally safe care -Acknowledging that the client is the focus and center of care and remains a part of the treatment team -Protecting the client's right to confidentiality and privacy
When examining values, a nurse notes that one country allows assisted suicide and another outlaws it, making it punishable by imprisonment. Which factors best explain the differences in values between these two countries?
Cultural
Which statement best conveys the concept of ethical agency?
Ethical practice requires a skill set that must be conscientiously learned and nurtured.
A pediatric nurse is assessing a 5-year-old boy who has dietary modifications related to his diabetes. His parents tell the nurse that they want him to value good nutritional habits, so they decide to deprive him of a favorite TV program when he becomes angry after they deny him foods not on his diet. This is an example of what mode of value transmission?
d-Rewarding and punishing When rewarding and punishing are used to transmit values, children are rewarded for demonstrating values held by parents and punished for demonstrating unacceptable values. Through modeling, children learn what is of high or low value by observing parents, peers, and significant others. Children whose caregivers use the moralizing mode of value transmission are taught a complete value system by parents or an institution (e.g., church or school) that allows little opportunity for them to weigh different values. Those who use the laissez-faire approach to value transmission leave children to explore values on their own (no single set of values is presented as best for all) and to develop a personal value system.
A nurse is of the Catholic faith and votes pro-life. This nurse is considered to have:
personal values.
A nurse is caring for a client with terminal cancer. The family would like the client to continue aggressive treatment but the client has told the nurse that he would prefer comfort care. The nurse speaks to the family about the client's wishes, condition, and terminal state. This action is most likely derived from which nursing obligation?
Ethical principles
A student nurse begins a clinical rotation in a long-term care facility and quickly realizes that certain residents have unmet needs. The student wants to advocate for these residents. Which statements accurately describe this concept? Select all that apply.
a-Advocacy is the protection and support of another's rights. c-Patients with special advocacy needs include the very young and the older adult, those who are seriously ill, and those with disabilities. f-Effective advocacy may entail becoming politically active. Advocacy is the protection and support of another's rights. Among the patients with special advocacy needs are the very young and the older adult, those who are seriously ill, and those with disabilities; this is not a comprehensive list. Effective advocacy may entail becoming politically active. Patient advocacy is the responsibility of every member of the professional caregiving team—not just nurses. Nurse advocates do not make healthcare decisions for their patients and residents. Instead, they facilitate patient decision-making. Advocacy does not entail supporting patients in all their preferences.
A nurse who is working in a hospital setting uses value clarification to help understand the values that motivate patient behavior. Which examples denote "prizing" in the process of values clarification? Select all that apply.
b-A patient shows off a new outfit that she is wearing after losing 20 pounds. f-A patient proudly displays his certificate for completing a marathon. Prizing something one values involves pride, happiness, and public affirmation, such as losing weight or running a marathon. When choosing, one chooses freely from alternatives after careful consideration of the consequences of each alternative, such as quitting smoking and working fewer hours. Finally, the person who values something acts on the value by combining choice and behavior with consistency and regularity, such as joining a gym for the year and following a low-cholesterol diet faithfully.
A nurse wants to call an ethics consult to clarify treatment goals for a patient no longer able to speak for himself. The nurse believes his dying is being prolonged painfully. The patient's doctor threatens the nurse with firing if the nurse raises questions about the patient's care or calls the consult. What ethical conflict is this nurse experiencing?
b-Ethical distress Ethical distress results from knowing the right thing to do but finding it almost impossible to execute because of institutional or other constraints (in this case, the nurse fears the loss of job). Ethical uncertainty results from feeling troubled by a situation but not knowing if it is an ethical problem. Ethical dilemmas occur when the principles of bioethics justify two or more conflicting courses of action. Ethical residue is what nurses experience when they seriously compromise themselves or allow themselves to be compromised.
A nurse caring for patients in the intensive care unit develops values from experience to form a personal code of ethics. Which statements best describe this process? Select all that apply.
b-Values act as standards to guide behavior. c-Values are ranked on a continuum of importance. d-Values influence beliefs about health and illness. A value is a belief about the worth of something, about what matters, which acts as a standard to guide one's behavior. A value system is an organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct. A person's values influence beliefs about human needs, health, and illness; the practice of health behaviors; and human responses to illness. Values guide the practice of nursing care. An individual is not born with values; rather, values are formed during a lifetime from information from the environment, family, and culture.
A famous actor with bipolar disorder has been admitted in the mental health unit for treatment. A well known news outlet has offered the nurse several thousand dollars to provide information or a picture of the client. The nurse knows that it is their professional duty and legal responsibility to uphold privacy and confidentiality. For each of the behaviors exhibited by the nurse, click to specify whether the behavior upholds the principle of privacy or confidentiality.
sharing client information only to the caregivers directly assigned to client care-confidentiality keeping the door closed while conducting physical assessment-privacy obtaining the client's permission before allowing a student nurse to assist with care-privacy logging off the electronic health record after documenting assessment information-confidentiality asking the client to sign a medical release form before providing information to the health insurance company-confidentiality
