Chapter 06: Values, Ethics, and Advocacy

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 has completed 4 hours of an 8-hour shift on a medical-surgical unit when the nursing supervisor calls. The nursing supervisor directs the nurse to give a report to the other two 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 the nurse has been busy with client assignments and feels this will overwhelm the nurses on the medical-surgical unit. The supervisor informs the nurse that the need is greater on the telemetry unit. This is an example of which type of ethical problem?

Allocation of scarce nursing resources

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.

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 baby 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."

It is time for a nurse to renew licensure. The nurse says, "I need some really easy and quick continuing education hours. I don't understand why we have to do these every year." What is the nurse's coworker's best response?

"Life-long learning is part of the code for nurses."

The nursing student is describing moral values to another student. Which statement is correct?

"Moral values give individuals some sense of what is right and wrong."

An older female client has just informed her family that she does not want to have surgery if the biopsy on a lung mass shows malignancy. Which statement(s), made by family members, violate the concept of feminist ethics? Select all that apply.

"Of course you would have the surgery." "Daddy will want you to have the surgery." "You need to do what the doctor thinks is best for you." "If it was me who was sick, you would want me to have the surgery."

Which statement by the nurse is an example of deception?

"This injection of procaine will feel like a little pinch."

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 nurse demonstrates the professional value known as altruism when caring for clients in a long-term care facility. What nursing action demonstrates this behavior?

A nurse researches the culture of a Muslim client when planning care.

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

Which word is best described as protection and support of another's rights?

Advocacy

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

To practice ethically, the nurse should avoid:

Allowing the nurse's own personal judgment to guide practice

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

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

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

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 ethical principle is related to the idea of self-determination?

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

The unit where a nurse works is undergoing structural changes along with changes in client load and managerial style. The nurse feels disorganized and stressed and is having difficulty sleeping. The nurse wonders if these feelings are related to the changes at work. What next step should the nurse choose in the 4A plan to address this issue?

Committing to self-care

Which nursing situation is an example of an ethical dilemma?

Deciding whether to perform cardiac compressions against a client's wishes

Which example most accurately depicts the ethical principle of autonomy?

Describing a surgery to a client before the consent is signed

A client rings the call bell to request pain medication. On performing the pain assessment, the nurse informs the client that the nurse will return with the pain medication. After a few moments, the nurse returns with the pain medication. The nurse's returning with the pain medication is an example of which principle of bioethics?

Fidelity

A nurse reports to the charge nurse that a client medication due at 9 am was omitted. Which principle is the nurse demonstrating?

Integrity

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

The foundation for decisions about resource allocation throughout a society or group is based on the ethical principle of:

Justice

Ethical distress is:

Knowing the correct action but being unable to perform it due to constraints

A nurse knows that the expression "Do not cause harm" refers to which ethical principle?

Nonmaleficence

A nurse obtains an order for a bed alarm for a confused client. This is an example of which ethical principle?

Paternalism

Parents giving money to a child for receiving an exemplary report from school is an example of which type of value transmission?

Rewarding

A nurse is asked to serve on an ethics committee. Which roles would the nurse be required to fill on the committee? Select all that apply.

Serving as a liaison between the family and the committee members Presenting explanations about technical terminology Advocating for the client's wishes

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 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

What would be an example of the nurse practicing fidelity? The nurse:

Stays with a client during death as promised

A nurse gives the 400 IU of a vitamin supplement that was in the client's medications instead of the 200 IU that was prescribed. The dosage was given when the unit was busy admitting three clients and another client was in crisis. Which action(s) by the nurse demonstrate the professional value of integrity? Select all that apply.

The nurse documents the dose given. The nurse completes a variance or incident report

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

Which is a characteristic of the care-based approach to bioethics?

The promotion of the dignity and respect of clients as people

Which traits are examples of virtues that can exemplify character and conduct as a professional nurse? Select all that apply

Trustworthiness Humility Compassion

What is the term for the beliefs held by the individual about what matters?

Values

Which nursing actions best describe the use of the professional value of human dignity? Select all that apply.

The nurse includes the client in developing the plan of care. A nurse provides privacy for an older adult client. A nurse plans individualized nursing care for clients. A nurse refuses to discuss a client with a curious friend.