Chapter 3 Fundamentals
The nursing student demonstrates the need for further instruction with which statement concerning moral values?
"Moral values give individuals some sense of what is right and wrong." Chapter 6: Values, Ethics, and Advocacy - Page 102-103 Moral values give individuals the ability to identify correct behaviors and the ability to discern right from wrong.
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 Chapter 6: Values, Ethics, and Advocacy - Page 101 Autonomy entails the ability to make a choice free from external constraints. Beneficence is the duty to do good and the active promotion of benevolent acts. Confidentiality relates to the concept of privacy. Justice states that like cases should be treated alike.
A nurse working in a critical care unit has experienced personal tragedy, extreme shortage of staff in the work environment, and health issues. The nurse has overcome much of these hardships and is now mentoring other nurses in similar situations. What behavior is this nurse demonstrating?
Moral resilience Chapter 6: Values, Ethics, and Advocacy - Page 31 Moral resilience is the developed capacity to respond well to morally distressing experiences and to emerge strong. This nurse has demonstrated that although life issues have been overwhelming, there is an emergence of strength and resilience. Moral distress occurs when you know the right thing to do but either personal or institutional factors make it difficult to follow the correct course of action. Conscientious objection is the refusal to participate in certain types of treatment and care based on the fact that these activities violate the nurse's personal and professional ethical beliefs and standards. There is not an ethical dilemma present between the nurse and the workplace.
A nurse is caring for a hospitalized client. Which nursing actions demonstrate a caring and compassionate attitude? Select all that apply.
Notifying the client before leaving for lunch Offering snacks and beverages to visiting family Listening to the client tell stories about past experiences Explaining all nursing procedures clearly Chapter 6: Values, Ethics, and Advocacy - Page 105 One of the best methods for avoiding lawsuits is to administer compassionate care. Notifying the client before leaving for lunch, offering snacks and beverages to visiting family, explaining all nursing procedures clearly, and listening to the client tell stories are examples of a caring and compassionate attitude. Leaving the room promptly once care is completed does not demonstrate care or compassion.
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 moral Chapter 6: Values, Ethics, and Advocacy - Page 103 A personal moral is a standard of right and wrong that helps a person determine the correct or permissible action in a given situation. Professional values in nursing are a set of beliefs about the worth of things, about what matters, that provide the foundation for nursing practice and guide the nurse's interactions with clients, colleagues, and the public. Ethical principles are a set of specific concepts that guide a person's actions. A legal obligation is something that is required by law.
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 Chapter 6: Values, Ethics, and Advocacy - Page 17 Shared decision making is recommended by most ethicists and involves considering both the client's preferences and the nurse's expertise to make the best decision. The paternalistic model involves the clinician making the decisions. The client sovereignty model involves the client making all the decisions without input from the clinician. Ethical decision making is that based on a personal or organizational code of ethics.
Which nursing action(s) best demonstrate the ethical principle of autonomy? Select all that apply.
The nurse checks to ensure an informed consent document is signed prior to transferring the client for a surgical procedure. The nurse documents that a client refused a new medication. Chapter 6: Values, Ethics, and Advocacy - Page 104 Autonomy is respect for the client's right to make health care decisions. Informed consent and right to refuse medications are a part of autonomy. Reviewing standards of practice and checking a medication dosage are related to nonmaleficence. Yearly continuing education is related to keeping the promise to remain competent (fidelity).
A nurse is of the Catholic faith and votes pro-life. This nurse is considered to have:
personal values. Chapter 6: Values, Ethics, and Advocacy - Page 98 The only information given here tells us that this nurse has personal values on a particular issues. Personal values are ideas or beliefs a person considers important and feels strongly about. Moral agency is the ability to do the ethically right thing because one knows it is the right thing to do. Ethics is a systematic study of principles of right and wrong conduct, virtue and vice, and good and evil as they relate to conduct and human flourishing. Legal obligations are behaviors and actions required by law.
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?" Chapter 6: Values, Ethics, and Advocacy - Page 101 Altruism is a concern for the welfare and well-being of others. Being concerned about quality of care, mentoring other professionals, and taking risks to benefit others are examples of altruism. Privacy rights reflect the professional value of human dignity. Fairness and equality reflect the professional value of social justice.
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. Chapter 6: Values, Ethics, and Advocacy - Page 101 The professional value of altruism is a concern for the welfare and well-being of others. In professional practice, altruism is reflected by the nurse's concern for the welfare of clients, other nurses, and other healthcare providers. It includes demonstrating an understanding of the cultures, beliefs, and perspectives of others. Altruism is demonstrated by the nurse researching the culture of a Muslim client when planning nursing care. Consulting a client when planning care to determine priorities and helping an older adult client fill out an informed consent form demonstrate the value of autonomy, which is the right to self-determination. Promoting universal access to health care for underserved populations demonstrates the value of social justice.
Which best defines value clarification?
A process by which people come to understand their own values and value systems Chapter 6: Values, Ethics, and Advocacy - Page 101 Value clarification is a process by which people come to understand their own values and value systems. A value is a belief about the worth of something, about what matters, that 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. Ethics is a systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil, as they relate to conduct.
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 Chapter 6: Values, Ethics, and Advocacy - Page 100 A laissez-faire approach to value transmission is one that allows others, especially children, to make decisions without guidance, resulting in a decision that may not be a sound one. Teaching a child about right and wrong behavior is a more active learning strategy, and reflects the moralizing approach to value transmission. Modeling or role modeling is leading (and transmitting values) by example—in this case, not smoking electronic cigarettes to show the teenagers good behavior. Telling the child about the injection feeling like a pinch is not an approach to value transmission.
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 Chapter 6: Values, Ethics, and Advocacy - Page 101-104 When respecting autonomy, the nurse supports the client's right to make decisions with informed consent. When promoting the client's well-being, the nurse acts in the best interests of the client. Advocacy is linked to the belief that making choices about health is a fundamental human right that promotes the individual's dignity and well-being. Beneficence is reflected by doing good and promoting what will benefit the client. Justice involves treating each client fairly. Fidelity involves being faithful and keeping promises.
A nurse is most likely to experience ethical distress in which client situation?
Continuing intravenous fluids for a client who wants to die Chapter 6: Values, Ethics, and Advocacy - Page 116 Nurses sometimes have to legally continue orders despite what they feel is right or wrong. This can result in ethical distress, as in this scenario of continuing intravenous fluids. Administering pain medication is promoting comfort and not an ethical issue. Turning and positioning a client as well as ambulating a client will increase comfort, mobility, and healing of the client. Initially, these interventions may be difficult for a new nurse, but eventually the interventions will aid in healing of the client.
A nurse learns to adopt behavior modeled by a charge nurse. What ethical principle or behavior is the nurse most likely to learn through this process?
Ethical conduct Chapter 6: Values, Ethics, and Advocacy - Page 105 By adopting the professional behavior of the charge nurse, the nurse learns appropriate ethical conduct. Standards of practice are specific, official statements established by an organization to guide practice in a profession; they are not learned by adopting the behaviors modeled by one person. Autonomy relates to respecting the right of another person to make one's own decisions. The nurse is not learning this principle in this scenario. Decision making is the thought process of selecting a logical choice from the available options. The nurse is not choosing from a variety of options in this scenario.
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 Chapter 6: Values, Ethics, and Advocacy - Page 104 The principle of fidelity involves the nurse being faithful to the client, who has the right to the truth. By not telling the client, the nurse is not being faithful to the client. Autonomy is the right to self-determination or decision making. The client, not the client's spouse, has the autonomy to determine the extent of the cancer treatment. Beneficence is the act of doing of good. The nurse is not doing good by withholding the information. Nonmaleficence means not harming or inflicting the least harm possible to reach a beneficial outcome. The nurse is inflicting harm by not being faithful to the client.
The nurse strives to uphold human dignity when providing care to clients. Which behaviors by the nurse would best exemplify this value? Select all that apply.
Protects the privacy of the client Maintains confidentiality Provides culturally competent care Chapter 6: Values, Ethics, and Advocacy - Page 101 Human dignity is defined by the right of a person to be valued and respected for one's own sake, and to be treated ethically. The nurse is exemplifying this by protecting privacy, maintaining confidentiality, and providing culturally competent care. Promoting universal health care would better exemplify the value of social justice and, in any case, would not be appropriate an appropriate action when providing care to clients. Demonstrating accountability is not a human dignity issue but is a core concept in the overall nursing care of a client.
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. Utlimately, the group arrives at a decision. The nurse interprets this decision-making process as reflecting which type?
Shared Chapter 6: Values, Ethics, and Advocacy - Page 108 There are three basic models of healthcare decision making. In the paternalistic model, clinicians decide what ought to be done to benefit the client, inform the client, and the client's role is to comply. In the client sovereignty model, clients or their surrogates, expressing their right to be autonomous, tell the clinician what they want, and the clinician's role is to comply. Most ethicists reject these models in their extremes and recommend a model of shared decision making, which respects and uses the preferences of the client and the expertise/judgment of the clinician. Clinical decision making is the process that results from the use of a healthcare decision-making model.
When analyzing an ethical dilemma according to the ethical framework, what is most important for the nurse to take into consideration?
Standards of conduct Chapter 6: Values, Ethics, and Advocacy - Page 102 Ethics is the branch of philosophy dealing with standards of conduct and moral judgment. It does not directly address law. It includes, but is not limited to, decision-making and competing priorities.
What is the term for the beliefs held by the individual about what matters?
Values Chapter 6: Values, Ethics, and Advocacy - Page. 98 Values are ideals and beliefs held by an individual or group about what matters; values act as a standard to guide one's behavior. Ethics are moral principles and values that guide the behavior of honorable people. A moral is a standard for right and wrong. Bioethics is related to ethical questions surrounding life and death, as well as questions and concerns regarding quality of life as it relates to advanced technology.
