Fundamentals of Nursing - Ch 6

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A home health nurse who performs a careful safety assessment of the home of a frail elderly patient to prevent harm to the patient is acting in accord with which of the principles of bioethics? A. Autonomy B. Beneficence C. Justice D. Fidelity E. Nonmaleficence

E. Nonmaleficence

An ethical conflict exists around a female patient's expressed desire to have a neighbor make her treatment decisions, an individual who the patient's children characterize as a predator. Place the steps in order: 1. Make and evaluate a decision 2. Gather relevent data about the situation 3. Apply ethical principles to the situation 4. Identify the different options 5. Clearly identify the ethical problem

2. Gather relevent data about the situation 5. Clearly identify the ethical problem 4. Identify the different options 3. Apply ethical principles to the situation 1. Make and evaluate a decision

When an older nurse complains that nurses just aren't ethical anymore, which reply reflects the best understanding of moral development? A. "The ability to behave ethically must be carefully cultivated; maybe we don't value this sufficiently to pay it the attention it deserves." B. "I don't agree that nurses were more ethical in the past. It's a new age and the ethics are new!" C. "Ethics is genetically determined...it's like having blue or brown eyes. Maybe we're evolving out of the ethical sense you and your generation had." D. "No kidding! Who could be ethical in a practice setting like this!"

A. "The ability to behave ethically must be carefully cultivated; maybe we don't value this sufficiently to pay it the attention it deserves."

Which of the following statements best conveys the concept of ethical agency? A. Ethical practice requires a skill set that must be conscientiously learned and nurtured B. Ethical practice is best learned and fostered by surrounding oneself with people who exhibit ethical character C. A nurse's understanding and execution of ethical practice is primarily a result of increased years of experience D. Individuals who enter the nursing profession often innately possess ethical characteristics

A. Ethical practice requires a skill set that must be conscientiously learned and nurtured

A professional nurse committed to the principle of autonomy would be careful to: A. Provide the information and support a patient needed to make decisions to advance her own interests B. Treat each patient fairly, trying to give veryone his/her own due C. Keep any promises made to a patient or another professional caregiver D. Avoid causing harm to a patient

A. Provide the information and support a patient needed to make decisions to advance her own interests

Upon entering the hospital system, the nurse discusses the patient's rights and responsibilities that he is entitled to in the institution. The information the nurse discusses is commonly referred to as: A. a Patient's Bill of Rights B. The Bill of Rights for Registered Nurses C. Standards of Clinical Nursing Practice D. The Code of Ethics for Nurses

A. a Patient's Bill of Rights

Janie wants to call an ethic consult to clarify treatment goals for a patient no longer able to speak for himself. She believes his dying is being prolong painfully. She is troubled when the patient's doctor tells her that she'll be fired if she raises questions about his care or calls the consult. This is a good example of : A. Ethical uncertainty B. Ethical distress C. Ethical dilemma

B. Ethical distress

Using the nursing process to make ethical decisions involves following several steps. Whis step is the nurse implementing when he or she reflects on the decision-making process and the role it will play in making future decisions? A. Implementing B. Evaluating C. Diagnosing D. Plannine

B. Evaluating

A parent of a 17yo high school student is allowing the child to make the decision on the college he will attend. When the child requests direction from the parent in making this decision, the parent responds by informing him that he will need to make this decision on his own. This is an example of which type of value transmission? A. Moralizing B. Laissez-faire C. Responsible choice D. Modeling

B. Laissez-faire

A professional nurse with a commitment to social justice is most apt to: A. Provide honest information to patients and the public B. Promote universal access to healthcare C. Plan care in partnership with patients D. Document care accurately and honestly

B. Promote universal access to healthcare

A 56yo male patient is experiencing withdrawal from alcohol and is placing himself at risk for falls by repeatedly attempting to scale his bedrails. Benzodiazepines have failed to alleviate his agitation and the nurse is considereing obtaining an order for physical retraints to ensure his safety. The nurse should recognize that his measure may constitute: A. advocacy B. paternalism C. harm D. deception

B. paternalism

Which of the following is the best professional response to a patient who tells you that she believes that "white nurses are smarter than nurses of color: and then asks if you agree? A. "You are right!" (The patient/customer is always right!) B. "What I think doesn't matter. What's important is whatever you believe." (Value neutrality) C. "I don't beleive being smart is related to race or ethnicity." (Commitment to human dignity)

C. "I don't beleive being smart is related to race or ethnicity." (Commitment to human dignity)

In the delivery of care, the nurse acts in accordance with nursing standards and the code of ethics and reports a medication error that she has made. The nurse is most clearly demonstrating which of the following professional values? A. Altruism B. Social justice C. Integrity D. Human dignity

C. Integrity

A nurse is providing care for three patients on a medical unit, two of whom are significantly more acute than the third. The nurse is making a concerted effort to ensure that the less acute patient still receives a reasonable amount of time, attention, and care during the course of the shift. Which of the following is the nurse attempting to enact? A. Nonmaleficence B. Fidelity C. Justice D. Beneficence

C. Justice

Which of the following actions most clearly demonstrates a nurse's commitment to social justice? A. Answering a patien'ts questions about her care clearly and accurately B. Ensuring that a hospital patient's diet is culturally acceptable C. Lobbying for an expansion of Medicare eligibility and benefits D. Documenting nursing care in a timely, honest, and thorough manner

C. Lobbying for an expansion of Medicare eligibility and benefits

A patient with a diagnosis of colorectal cancer has been presented with her treatment options but wishes to defer any decisions to her uncle, who acts in the role of a family patriarch within the patient's culture. Which of the following is the patient's right to self-determination best protected by? A. Holding a family meeting and encouraging the patient to speak on her own behalf B. Teaching the patient about her right to autonomy C. Respecting the patient's desire to have the uncle make choices on her behalf D. Revisiting the decision when the uncle is not present at the bedside

C. Respecting the patient's desire to have the uncle make choices on her behalf

A friend asks you about the new Bill of Rights for nurses. What can you tell her that accurately reflects the concerns of the drafters of these rights? A. The Bill of Rights was drafted by nurses who care more about themselves than they do about patients B. The Bill of Rights was drafted by union nurses who are always looking for a reason to strike C. The Bill of Rights was drafted to empower nurses and to improve conditions in the workplace

C. The Bill of Rights was drafted to empower nurses and to improve conditions in the workplace

The children of a 78YO female patient with a recent diagnosis of early-stage Alzheimer's disease are attempting to convince their mother to move into an assisted living facility, a move to which the patient is vehemently opposed. Both the patient and her children have expressed to the nurse how they are entrenched in their position. Which of the following statements expresses a utilitarian approach to this? A. Benefits and burdens should be evenly distributed between the children and the patient B. The patient's autonomy and independence are the priority considerations C. The decision should be made in light consequences D. The patient has a right to self-determination that is the ultimate priority

C. The decision should be made in light consequences

A group of nurse researchers has proposed a study to examine the efficacy of a new wound care product. Which of the following aspects of the methodology demonstrates that the nurses are attempting to maintain the ethical principle of nanmaleficence? A. The nurses have organized the study in such a way that the foreseeable risks and benefits are distributed as faily as possible B. The nurses have given multiple opportunities for potential participants to ask questions and have been following the informed consent process systematically C. The nurses are taking every reasonable measure to ensure that no participants experience impaired wound healing as a result of the study intervention D. The nurses have completed a literature review that suggests the new treatment may result in decreased wound healing time

C. The nurses are taking every reasonable measure to ensure that no participants experience impaired wound healing as a result of the study intervention

Nurse advocates often are conflicted about respecting a patient's right to be self-determining, while at the same time wanting to do everything in their power to promote the patient's best interests. Which is the best general guideline for situations like these? A. Patient rules! "It's my life!" B. Nurse rules! "It may be your life, but in this instance you don't know enough to make the right choice!" C. When in conflict, weigh the benefits and risks of following each option and then choose wisely

C. When in conflict, weigh the benefits and risks of following each option and then choose wisely

An employee health nurse is assisting a stressed working mother with value clarification. Which of the following best defines value clarification? A. A systematic injury into principles of right and wrong conduct, of virtue and vice, and of good and evil, as they relate to conduct B. A belief about the worth of something, about what matters, that acts as a standard to guide one's behavior C. An organization of values in which each is rankes along a continuum of importance, often leading to a personal code of conduct D. A process by which people come to understand their own values and value system

D. A process by which people come to understand their own values and value system

A patient who stopped smoking 3 years ago has not resumed smoking and actively encourages other family members to stop smoking. This patient is demonstrating which step in the process of valuing? A. Choosing B. Treasuring C. Prizing D. Acting

D. Acting

A nurse has completed 4 hours of his 8-hour shift on a medical-surgical unit when he receives a phone call from the nursing supervisor. The nursin supervisor informs the nurse that he needs to give a report to two other nurses on the medical-surgical unit and immediately report to the telemetry unit to assist with staff needs on that unit. The nurse informs the supervisor that he has been busy with his patient A. Conflicts concerning new technology B. Advocacy in a market-driven environment C. Deception D. Allocation of scarce nursing resources

D. Allocation of scarce nursing resources

Which of the following theories of ethics most highly prioritizes the nurse's relationship with patients and the nurse's character in the practice of ethical nursing? A. Utilitarianism B. Deontology C. Principle-based ethics D. Care-based ethics

D. Care-based ethics

A patient rings the call bell to request pain medication. Upon performing the pain assessment, the nurse informs the patient that she will return with the pain medication. The nurse's promise to return with the pain medication is an example of which principle of bioethics? A. Autonomy B. Justice C. Nonmaleficence D. Fidelity

D. Fidelity

The American Association of Colleges of Nursing identified five values that epitomize the caring professional nurse. Which of these is best described as acting in accordance with an appropriate code of ethics and accepted standards of practice? A. Altruism B. Autonomy C. Human dignity D. Integrity E. Social Justice

D. Integrity

Mr. S was diagnosted with type 2 diabetes mellitus 3 years ago, but has gailed to integrate regular blood glucose monitoring or dietary modifications into his lifestyle. He has been admitted to the hospital for treatment of acute renal failure secondary to diabetic nephropathy, an event that has prompted Mr. S to reassess his values. Which of the following actions most clearly demonstrates that Mr. S is engaging in? A. Mr. S expresses remorse at how his failure to make lifestyle changes had adversely affected his health B. Mr. S is now able to explain how his choices have contributed to his renal failure C. Mr. S states that he will now begin to check his blood glucose before each meal and at bedtime D. Mr. S expresses pride that he now has the knowledge and skills to take control of his diabetes management

D. Mr. S expresses pride that he now has the knowledge and skills to take control of his diabetes management

Five-year-old Bobby has dietary modifications related to his diabetes. His parents want him to value good nutritional habits and 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? A. Modeling B. Moralizing C. Laissez-faire D. Rewarding and punishing E. Responsible choice

D. Rewarding and punishing

A nurse working on a critical care unit was informed by a patient with muliple sclerosis that she did not wish to be resuscitated in the event of cardiac arrest. The patient is no longer able to express her wishes, and the family has informed the physician that they want the patient to be resuscitated. Aware of the patient's wishes, the nurse is involved in a situation that may experience: A. confidentiality B. deception C. paternalism D. ethical distress

D. ethical distress


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