Ethics

When caring for a patient, the nurse is distressed over an ethical dilemma and attempts to resolve it. Arrange in order the steps involved in the resolution of an ethical dilemma. 1. Clearly verbalize the ethical problem. 2.Gather information about the case. 3.Distinguish among facts, values, and opinion 4.Identify the course of action and draw a plan. 5.Evaluate the action plan.

ANS: 2,3,1,4,5 2.Gather information about the case. 3.Distinguish among facts, values, and opinion 1. Clearly verbalize the ethical problem. 4.Identify the course of action and draw a plan. 5.Evaluate the action plan. The first step in resolving an ethical dilemma is to gather information relevant to the case from the perspective of the patient, family, institution, and society. Next, the nurse should distinguish among facts, values, and opinion. Verbalizing the problem helps; although it may not be easy, creating a clear statement of the dilemma helps to facilitate discussion and ensure that the final plan is effective. Next, a course of action should be identified and a plan discussed. The implemented plan should be evaluated over time.

1.A 73-year-old patient with hypertension is awaiting a triple cardiac bypass surgery. The patient is hard of hearing and did not understand what the surgeon said regarding the surgery. The daughter is concerned that the patient does not understand the risks of the surgery. If not clarified, this would be a violation of what principle? a. Autonomy b. Justice c. Fidelity d. Nonmaleficence

ANS: A Autonomy refers to a persons independence. As a principle in bioethics, autonomy represents an agreement to respect a patients right to determine a course of action. Justice refers to the principle of fairness: fair treatment and fair distribution of health care resources. Fidelity refers to the agreement to keep promises and is based on the virtue of caring. Nonmaleficence is actively seeking to do no harm.

A patient is diagnosed with breast cancer. The healthcare provider educates the patient about the treatment options. The healthcare provider recommends and highly favors chemotherapy; however, the patient chooses to undergo surgery. Which is the most appropriate intervention? A. Prepare the patient for surgery. B. Order the patient to undergo chemotherapy. C. Convince the patient of the disadvantages of surgery. D. Convince the patient of the advantages of chemotherapy.

ANS: A Autonomy refers to respecting the patient's decisions about health and promoting patient participation in decision making. Agreeing to the patient's preferred method of treatment aligns with the principle of autonomy. Ordering the patient to undergo chemotherapy is disrespectful of the patient's autonomy. Convincing the patient of the disadvantages of surgery and advantages of chemotherapy with the objective to change the decision is an unethical nursing practice. The patient should be provided with unbiased information on the treatment options available.

11.Which behavior best indicates that the nurse is fulfilling ethical responsibilities? a. Delivers competent care b. Applies the scientific process c. Forms interpersonal relationships d. Evaluates new computerized technologies

ANS: A Delivers competent care is the best example because the American Nurses Association (ANA) and the International Council of Nurses (ICN) publish codes of ethics for nurses that set principles of behavior for nurses to embrace. They reflect common underlying principles that shape professional nursing practice, including responsibility, accountability, respect for confidentiality, competency, judgment, and advocacy. The scientific process, interpersonal relationships, and new technologies do not indicate ethical behavior like competent care.

The nurse is assessing a patient who has arthralgia. The nurse is preparing a plan for pain management. The nurse monitors the patient's response and revises the plan to reduce the pain. Which statement about the nurse's action is correct? A. The nurse is showing fidelity. B. The nurse is advocating for the patient. C. The nurse is showing responsibility toward patient care. D. The nurse is following the principle of accountability

ANS: A Fidelity refers to the agreement to keep promises. The nurse assesses the patient's needs and performs interventions to fulfill them. If the interventions are not found to be effective, the nurse still follows through on the actions and modifies the care plan to reduce the pain. Advocacy, responsibility, and accountability are principles of the codes of ethics. Advocacy is when the nurse speaks up for patient rights. Responsibility refers to a willingness to respect one's professional obligations and follow through on promises. Accountability is when one is answerable for one's actions.

10.Although a registered nurse has been working for several years as a staff nurse on an adult oncology unit, the nurse recently transferred to a pediatric unit in the hospital. The nurse will be in orientation for several days to learn about the different systems and will need to demonstrate proficiency in various pediatric areas such as medication administration. Which behavior is the nurse demonstrating? a. Competency b. Judgment c. Advocacy d. Utilitarianism

ANS: A In the practice of nursing, competence ensures the provision of safe nursing care (proficiency in pediatric medication administration). The agreement to practice with competence is a common denominator for all state regulations and is in the nursing code of ethics. Judgment refers to the ability to form an opinion or draw sound conclusions. Advocacy involves speaking up for patient care issues from your unique perspective and advocating for humane and dignified care. You use a utilitarian ethic when determining the value of something based primarily on its usefulness and effects or consequences. The greatest good for the greatest number of people is the guiding principle for action in this system (utilitarian).

12.A nurse decides to withhold a medication because it will further lower a patients respiratory rate. In this case, the nurse is practicing what principle? a. Responsibility b. Privacy c. Ethics d. Moral behavior

ANS: A Responsibility refers to the execution of duties associated with a nurses role. For example, when administering a medication, you are responsible for assessing the patients need for the medication, giving it safely and correctly, and evaluating the patients response to it. Moral behavior refers to judgment about right and wrong behavior. Ethics refers to the consideration of standards of conduct, particularly the study of right and wrong behavior. A fundamental right of patients is the right to privacy. Privacy becomes a focus of increasing interest as health care becomes digitized, but it is not a focus of this scenario.

A patient with leukemia tells the nurse, "I don't want my family to know about my condition; please keep it confidential." The nurse promises to keep the information confidential while caring for the patient and keeps her word. Which ethical concept does this nursing action reflect? A. Fidelity B. Justice C. Autonomy D. Accountability

ANS: A The ethical concept of fidelity requires the nurse to keep promises. The critically ill patient does not wish to reveal the condition to the family. The nurse keeps the information confidential while caring for the patient and the patient's family. The ethical concept of justice requires the nurse to care equally for all patients. Autonomy refers to the commitment to include patients in decisions about all aspects of their care but does not involve maintaining confidentiality. Accountability refers to the ability to answer for one's actions.

15.A nurse is teaching the staff about the International Council of Nurses Code of Ethics. Which major element of the Code should the nurse include in the teaching session? a. People b. Pride c. Power d. Problems

ANS: A The major elements of the Code include: Nurses and People; Nurses and Practice; Nurses and the Profession; and Nurses and Co-workers. It does not include pride, power, and problems.

Successful ethical discussion depends on people who have a clear sense of personal values. When a group of people share many of the same values, it may be possible to refer for guidance to philosophical principles of utilitarianism. Which statement describes utilitarianism? A. The value of something is determined by its usefulness to society. B. People's values are determined by religious leaders. C. The decision to perform a liver transplant depends on a measure of the moral life that the patient has led so far. D. The best way to determine the solution to an ethical dilemma is to refer the case to the attending physician or healthcare provider.

ANS: A Utilitarianism specifically refers to the greatest good for the greatest number of people, where goodness is determined primarily by usefulness. The concept is easier to apply in a community where shared values allow for agreement about a definition of usefulness. Utilitarianism is not when values are determined by religious leaders, does not take into account the patient's previous moral life, and does not argue that the best way to determine the solution is to refer the case to the provider.

The nurse may come across many ethical dilemmas. To resolve them, it is important to distinguish ethical problems from other problems. Which are characteristics of an ethical problem? Select all that apply. A. It cannot be solved solely through literature review. B. It cannot be easily reasoned with logic. C. The answer to the problem has profound relevance for patient care. D. The problem can be solved by critical thinking. E. The problem involves only hospital management

ANS: A,B,C When solving any ethical dilemma, the first step is to distinguish the ethical problems from other problems. Ethical problems cannot be resolved through literature review only, and they may be difficult to solve logically by the use of reason. The answer to an ethical problem will have a significant influence on patient care. Ethical problems are usually not solved by critical thinking and do not involve only hospital management. They may involve all members of the healthcare team.

The nurse is learning about ethics in nursing practice. Which actions should the nurse perform to meet the American Nurses Association (ANA) code of ethics? Select all that apply. A. Consider the patient as the primary commitment. B. Strive to protect the health and rights of the patient. C. Consider personal and professional growth a priority. D. Contribute to nursing practice and knowledge development. E. Ignore other healthcare professionals and perform one's own duties.

ANS: A,B,C,D The nurse's primary commitment is to the patient, whether that is an individual, family, group, or community. As per the American Nurses Association (ANA) code of ethics, the nurse should promote, advocate for, and strive to protect the health, safety, and rights of the patient. The nurse should contribute to nursing practice and knowledge development and thus participate in the advancement of the profession. The professional growth of the nurse should continue alongside patient care. Nurses should collaborate with other healthcare professionals, not just perform their own duties.

Which elements are necessary for the resolution of conflicting opinions? Select all that apply. A. Strict adherence to patient confidentiality B. Patient-centered decision making C. Identification of possible courses of action D. Presumption of good will on the part of all participants E. Participation of families and primary caregivers

ANS: A,B,D,E Resolution of conflicting opinions requires strict adherence to confidentiality in order to protect patient information. Patient-centered decision making helps to resolve the conflict in the patient's best interest. Presumption of good will on the part of all participants helps to foster trust among the participants. Families and primary caregivers can be included in the resolution process for better results. Identifying possible courses of action is the key step in resolving an ethical dilemma; it does not help to resolve a conflict in opinions.

A patient is preoccupied with the feeling that she suffers from breast cancer. She asks the nurse to insist that the healthcare provider perform a mastectomy. Following several tests, the nurse finds that the patient has no symptoms of or risk factors for breast cancer. Which are ethical nursing interventions for this patient? Select all that apply. A. Educate the patient about the risk factors of breast cancer. B. Praise the patient that she has taken a major preventive step. C. Educate the patient on self-examination and mammography. D. Educate the patient about her health status and promote acceptance. E. Respect the patient's decision and encourage a mastectomy.

ANS: A,C,D Educating the patient regarding risk factors for breast cancer may help reduce her preoccupation with it. It may even help her choose lifestyle modifications to reduce the risk factors. Even though a mastectomy would prevent development of breast cancer in the patient, it is not needed in this case. The nurse should encourage the patient to get regular follow-up examinations. Educating the patient about self-examination of the breasts and emphasizing the importance of regular mammograms may help the patient detect cancer early. Because surgery is not an appropriate intervention for the patient, the nurse should not encourage it by praising the patient for her choice. Nor should the nurse encourage the patient to get a mastectomy.

The senior nurse is teaching a group of nursing students about health care ethics. Which are examples of the nurse showing respect for a patient's autonomy? Select all that apply. A. Ensuring that the patient understands the risks of a medical procedure B. Keeping promises by following through on any interventions C. Including the patient when deciding on care D. Ensuring that the patient has read and signed an informed consent before surgery E. Receiving permission from the patient before performing a physical examination

ANS: A,C,D,E Autonomy refers to the patients' right to make their own decisions. The nurse shows respect for a patient's autonomy by ensuring that the patient understands the risks of a medical procedure, by including the patient in all care decisions, by ensuring that a patient has consented to a medical procedure or surgery, and by getting permission from the patient before providing care or completing assessments. When nurses keep promises by following through on interventions, they are acting on the principle of fidelity.

Healthcare institutions establish ethics committees to process ethical dilemmas. Which are purposes of ethics committees? Select all that apply. A. Education B. Patient teaching C. Patient care D. Case consultation E. Policy recommendation

ANS: A,D,E Ethics committees are usually multidisciplinary. They have several purposes such as education, case consultation, and policy recommendation. Any person involved in an ethical dilemma can request access to an ethics committee. Patient teaching and patient care are the responsibility of all members of the healthcare team.

A patient is scheduled for surgery. Before the surgery the patient read the consent form and signed it. This is an example of which principle? A. Justice B. Autonomy C. Beneficence D. Nonmaleficence

ANS: B Autonomy refers to the commitment to include patients in decisions about all aspects of care as a way of acknowledging and protecting a patient's independence. Autonomy means freedom from external control. Justice refers to the promotion of open discussion whenever mistakes occur, or nearly occur, without fear of recrimination. Beneficence refers to taking positive actions to help others. Nonmaleficence refers to the avoidance of harming or hurting others.

2.A 45-year-old mother of two children has cirrhosis of the liver and is on a waiting list for a liver transplant. She had to meet certain criteria to be eligible to receive a liver. She understands that she is next on the list for a donor liver that matches. This is an example of which ethical principle? a. Autonomy b. Justice c. Fidelity d. Nonmaleficence

ANS: B Justice refers to the principle of fairness. In health care, the term is used to reflect a commitment to fair treatment and fair distribution of health care resources. You may find reference to this principle during discussion about issues of access to care. It is not always clear just how to achieve a fair distribution of resources. Autonomy refers to independence and self-determination. Fidelity refers to the agreement to keep promises and is based on the virtue of caring. Nonmaleficence refers to the fundamental agreement to do no harm.

5.A registered nurse is working on a pediatric oncology unit and caring for four children undergoing chemotherapy. Today a new nursing assistive personnel (NAP) who has passed a competency examination is assigned to the team. The nurse will delegate a portion of the fundamental nursing tasks to the NAP during the shift, but realizes that he or she is still responsible for his or her own actions and is accountable for the care. The nurse is following which principle of behavior? a. Ethical dilemma b. Code of ethics c. Bioethics d. Feminist ethics

ANS: B The code of ethics reflects underlying principles that include responsibility, accountability, respect for confidentiality, competency, judgment, and advocacy. An ethical dilemma exists when the right thing to do is not clear or when members of the health care team cannot agree on the right thing to do. The study of bioethics represents a particular branch of ethics (i.e., the study of ethics within the field of health care). Feminist ethics proposes that we routinely ask how ethical decisions will affect women as a way to repair a history of inequality (Lindeman, 2005).

According to the philosophy of the ethics of care, which is most important when solving ethical dilemmas? A. Patients B. Relationships C. Ethical principles D. Code of ethics for nurses

ANS: B The foundation of the ethics of care is its attention to relationships, as distinguished from other philosophies based more on principles.

8.A registered nurse has recently been reassigned to the gynecology unit at the hospital. The nurse is strongly against abortion because of religious beliefs and contacts the nursing supervisor regarding the assignment because the unit cares for women who are undergoing abortions. The nurse is having a conflict in which area? a. Confidentiality b. Values c. Social networking d. Culture

ANS: B The nurse is having a conflict in values because of religious beliefs and abortion. A value is a personal belief about the worth of an idea, a custom, or an object. Confidentiality is not the issue because no confidences have been broken. Social networking is online communication, which is not the issue in this scenario, values are the issue. The nurse is not having a conflict in culture, but in beliefs and values.

18.A nurse is teaching the staff about how to process an ethical dilemma. Which order should the nurse use to present the steps? a. Evaluate the action. b. Negotiate the outcome. c. State the problem clearly. d. Gather all relevant information. e. Examine own values and opinions. f. Consider possible courses of action. a. d, e, c, f, a, b b. d, e, c, f, b, a c. d, c, e, f, a, b d. d, e, c, b, f, a

ANS: B The steps to process an ethical dilemma include the following: (1) Is this an ethical dilemma? (2) Gather all information relevant to the case. (3) Examine and determine your own values and opinions about the issues. (4) State the problem clearly. (5) Consider possible courses of action. (6) Negotiate the outcome. (7) Evaluate the action.

A child's immunization may cause discomfort during administration, but the benefits of protection from disease, both for the individual and society, outweigh the temporary discomforts. Which principle is involved in this situation? A. Fidelity B. Beneficence C. Nonmaleficence D. Respect for autonomy

ANS: B Whoops

1.A nurse is working with the parents of a seriously ill newborn. Surgery has been proposed for the infant, but the chances of success are unclear. To help the parents resolve this conflict, which steps should the nurse take to process the ethical dilemma? (Select all that apply.) a. Identifying people who can solve this dilemma b. Gathering all relevant information surrounding this dilemma c. Clarifying own values and opinions about the issues d. Consulting a professional ethicist regarding how to proceed with this dilemma e. Considering possible courses of action

ANS: B, C, E The nurse should gather all relevant information, clarify own values and opinions about the issue, and consider possible courses of action. Seven steps are used when solving an ethical dilemma: (1) Asking is it an ethical dilemma?, (2) gathering all information, (3) examining and determining ones own values and opinions about the issue, (4) stating the problem clearly, (5) considering possible courses of action, (6) negotiating an outcome, and (7) evaluating the action. Identifying people who can solve this dilemma and consulting a professional ethicist are not steps of the process.

The nurse is practicing according to the professional nursing code of ethics. Which actions are in accordance with the standards of responsibility? Select all that apply. A. Protecting the patient's right to privacy B. Trying to remain competent to practice C. Being responsible for delegated tasks D. Being willing to respect professional obligations E. Supporting the health, safety, and rights of the patients

ANS: B,C,D Nurses should strive to remain competent to practice in order to perform responsibly. All nursing interventions are the responsibility of the nurse, including those that the nurse has delegated. The standards of practice involving responsibility include the nurse's willingness to respect professional obligations and keep promises to patients. Protecting a patient's right to privacy and supporting the health, safety, and rights of a patient are standards of advocacy, not responsibility

Which sources are responsible for the formation of values in an individual? Select all that apply. A. History books B. Schools C. Governments D. Social institutions E. Religious traditions

ANS: B,C,D,E Schools, governments, social institutions, and religious traditions play an important role in the formation of values. A value is a personal belief about the worth of a given idea. Values help to set standards that influence behavior. History books are not a source for the formation of values

Which theory considers the importance of relationships in solving ethical dilemmas but lacks a focus on universal principles? A. Deontology B. Utilitarianism C. Feminist ethics D. Consensus in bioethics

ANS: C Feminist ethics looks to the nature of relationships to guide participants in making difficult decisions. This theory lacks a focus on universal principles. Deontology focuses on providing justice and fidelity to the patient but does not focus on the role of relationships. Utilitarianism proposes that the value of something is determined by its usefulness; it does not focus on the nature of relationships. Consensus in bioethics focuses on bringing about an agreement from all the different points of view but does not emphasize relationships.

3.A registered nurse who works on an oncology unit discussed pain control options that the primary health care provider had ordered with a patient undergoing treatment for pancreatic cancer. The patient requested that the intravenous (IV) pain medication be given on a regular basis. The nurse agreed to provide the IV pain medication as requested and continued to reevaluate the pain levels. The nurse is following which ethical principle? a. Autonomy b. Justice c. Fidelity d. Nonmaleficence

ANS: C Fidelity refers to the agreement to keep promises. The principle of fidelity also promotes the obligation of a nurse to follow through with the care offered to patients. Autonomy refers to independence and self-determination, which is what the patient followed, but the question asked for which principle the nurse followed. Justice refers to fairness or equity of health care resources. Nonmaleficence refers to the fundamental agreement to do no harm.

In most ethical dilemmas in healthcare, the solution to the dilemma requires negotiation among members of the healthcare team. Why is the nurse's point of view valuable? A. Nurses understand the principle of autonomy in guiding respect for patient's self-worth. B. Nurses have a scope of practice that encourages their presence during ethical discussions. C. Nurses develop a relationship to the patient that is unique among all professional healthcare providers. D. The nurse's code of ethics recommends that the nurse be present at any ethical discussion about patient care

ANS: C None of these options is wrong, but the point of the question is to build confidence and even pride in the value of the special body of knowledge that the nurse acquires about patients as a result of the nurse's unique relationship with them.

The nurse is assessing patients in the unit. Which action of the nurse indicates that the nurse follows fidelity? A. Avoiding giving the patient's personal health information to the patient's friend B. Asking if the patient's health insurance covers the patient's medical expenses C. Preparing a plan to manage the pain of the patient and monitoring the responses D. Informing the healthcare provider about the patient's allergic reaction towards the prescribed medicines

ANS: C Preparing a plan to manage the pain of the patient and monitoring the patient's response to the pain indicates fidelity. Fidelity refers to the agreement to keep promises. Refusing to provide the patient's personal health information to the patient's friend indicates that the nurse honors confidentiality. Asking the patient if the health insurance covers the medical expenses indicates justice. Informing the primary healthcare provider of the patient's allergy to the medications and getting a medication change indicates advocacy.

14.A community health nurse states, I wish we had just a portion of the dollars spent repairing atherosclerotic hearts to teach the community about cardiovascular risk factors. The nurses statement stems from what philosophy? a. Deontology b. Feminist ethic c. Utilitarianism d. Ethics of care

ANS: C Utilitarianism determines the value of something based primarily on its usefulness. Deontology defines actions as right or wrong according to principles. The feminist ethic asks how ethical decisions will affect women. The ethics of care suggests that health care workers solve ethical dilemmas by the promotion of the fundamental act of caring.

7.A nurse bases ethical decisions on the effect, or consequences, an act will have and uses the following guidelines: the greatest good for the greatest number of people. Which ethical system is the nurse using? a. Legal b. Deontology c. Utilitarianism d. Ethics of care

ANS: C Utilitarianism guides us to measure the effect, or consequences, that an act will have. The greatest good for the greatest number of people is the guiding principle for action in this system. By comparison, deontology focuses less on consequences and looks to the presence of pure principles of autonomy, justice, fidelity, beneficence, and nonmaleficence. Ethical issues differ from legal issues. Legal issues are resolved by reference to laws that tend to be concrete and publicly determined. Ethics of care suggest that health care workers resolve ethical dilemmas by paying attention to relationships and stories of the participants and by promoting a fundamental act of caring.

The registered nurse instructs the student nurse to administer an analgesic to a patient who has undergone appendicitis surgery, but the student nurse forgets to administer the drug and finds that the patient is suffering from severe pain. The student nurse reports the mistake to the registered nurse. Which ethical concept does the student nurse adhere to through this action? A. Fidelity B. Advocacy C. Confidentiality D. Accountability

ANS: D Accountability is being answerable for any right or wrong action. In this case, the student nurse admits that the patient is in pain as a result of the nurse's mistake. Fidelity involves following through on promises. Advocacy is the ethical responsibility to advocate for patient rights. Confidentiality is the ethical responsibility to maintain privacy regarding the patient's condition and information; it is unrelated to the student nurse admitting the mistake.

Under which ethical principle is the patient's personal health information protected? A. Advocacy B. Nonmaleficence C. Beneficence D. Confidentiality

ANS: D Confidentiality is a principle that is used to keep the patient's personal health information private. Advocacy refers to standing up and speaking on the patient's behalf; it does not involve protecting the patient's health information. Nonmaleficence refers to the act of not hurting or harming the patient; it does not include protection of the patient's health information. Beneficence is performing actions that are beneficial to the patient; however, it does not include protecting the patient's health information

17.A nurse is processing an ethical dilemma by focusing on relationships and stories of the participants. Which ethical system is the nurse using? a. Deontology b. Utilitarianism c. Feminist ethics d. Ethics of care

ANS: D Ethics of care suggest that health care workers resolve ethical dilemmas by paying attention to relationships and stories of the participants and by promoting a fundamental act of caring. Attention to relationships distinguishes the ethics of care from other ethical viewpoints because it does not necessarily apply universal principles that are intellectual or analytical. Deontology defines actions as right or wrong based on right-making characteristics such as truth and justice. You use utilitarian ethics when determining the value of something based primarily on its usefulness and effects or consequences. Feminist ethics proposes that we routinely ask how ethical decisions will affect women as a way to repair a history of inequality.

6.The mother of a 45-year-old patient is a retired physician and requests to discuss the patients plan of care with the nurse caring for the patient. What is the nurses best response to this request? a. I will need to ask permission from my supervisor before I can share that information. b. I will show you the chart, just follow me and we can discuss your questions and concerns. c. I would suggest that you leave me out of your family problems. I am here to care for the patient. d. I will have to get the patients permission before I can share that information.

ANS: D Even family members or friends of the patient are not permitted access to the patients personal health information without the patients consent. Federal legislation known as HIPAA (Health Insurance Portability and Accountability Act of 1996) requires that those with access to personal health information not disclose the information to a third party without patient consent. The nurse does not need to ask permission from the supervisor because HIPAA laws state what the nurse can do. I would suggest that you leave me out of your family problems is inappropriate because it ignores the request of the family member. Showing the chart and discussing the care is a violation of HIPAA.

There are seven key steps in the resolution of an ethical dilemma. Which is the second key step in the resolution of an ethical dilemma? A. Negotiate a plan. B. Ask the question. C. Verbalize the problem. D. Gather information relevant to the case.

ANS: D Gathering information relevant to the case is the second key step in the resolution of an ethical dilemma. Information can be obtained from patient, family, institutional, and social perspectives. Negotiating a plan is the sixth step. Asking the question related to the ethical dilemma is the first step. Verbalizing the problem is the fourth step.

13.A patient is about to undergo a new, controversial bone marrow transplant procedure. The procedure may cause periods of pain and suffering. Although nurses agree to do no harm, this procedure may be necessary to promote health. This is an example of which ethnical principle? a. Autonomy b. Justice c. Fidelity d. Nonmaleficence

ANS: D Nonmaleficence refers to the fundamental agreement to do no harm. The principle of nonmaleficence promotes a continuing effort to consider the potential for harm even when it is necessary to promote health. Autonomy refers to a persons independence. Justice refers to the principles of fairness. Fidelity refers to the agreement to keep promises.

16.The code of ethics for nursing sets forth ideals of nursing conduct and was developed by what organization? a. The Board of Nursing b. The American Medical Association c. The National League for Nursing d. The American Nurses Association

ANS: D The American Nurses Association (ANA) and the International Council of Nurses (ICN) publish codes of ethics for nurses that set principles of behavior for them to embrace. The Board of Nursing regulates nursing programs and nursing practice. The American Medical Association deals with physicians. The National League for Nursing is an agency concerned with nursing education.

The nurse is teaching a student nurse about the ethics of care. Which statement made by the student indicates effective learning? A. "The ethics of care emphasize the consequences of the set course of action." B. "The ethics of care emphasize justice and fidelity during medical treatment." C. "The ethics of care emphasize bringing different points of view to harmony." D. "The ethics of care emphasize understanding relationships between the patient and family. "

ANS: D The ethics of care promote a philosophy of understanding relationships between the patient and family. Utilitarianism emphasizes the consequences of the action or treatment provided to the patient. Deontology is the traditional ethical theory that is followed by most healthcare practitioners. It seeks to ensure that patients are treated with justice and fidelity. Consensus in bioethics ensures that different points of view are brought to agreement and harmony. This helps to build agreement and promote respect.

9.A 9-year-old patient was severely burned and has been undergoing whirlpool treatments to debride the wounds. The patient is crying and does not want to go to the physical therapy department for treatment. The registered nurse caring for the patient knows that, even though it is uncomfortable, the patient needs to have the therapy for the wounds to heal properly. The nurse is demonstrating which ethical principle? a. Autonomy b. Bioethics c. Justice d. Beneficence

ANS: D The principle of beneficence promotes taking positive, active steps to help others. It encourages a nurse to do good for the patient. Beneficence guides decisions in which the benefits of a treatment pose a risk to the patients well-being or dignity. Autonomy refers to independence and self-determination. The study of bioethics represents a particular branch of ethics (i.e., the study of ethics within the field of health care). Justice refers to the principle of fairness. In health care the term is used to reflect a commitment to fair treatment and fair distribution of health care resources.

4.A registered nurse knows that an oncology patient undergoing a bone marrow transplant will spend weeks in isolation in the hospital. During that time the patient will be at an increased risk for infection and other complications and may not recover. The nurse ensures that the patient has been given information regarding the risks and potential benefits of the procedure. The nurse is following which ethical principle? a. Autonomy b. Justice c. Fidelity d. Nonmaleficence

ANS: D The principle of nonmaleficence (do no harm) promotes a continuing effort to consider the potential for harm even when it is necessary to promote health. It is helpful in guiding your discussions about new or controversial technologies. Autonomy deals with independence and self-determination. Justice refers to fairness or equity of health care resources. Fidelity refers to maintaining promises and faithfulness.