EAQs Ethics

Which information is correct regarding the similarities and differences between the deontological and utilitarianism system of ethics? Select all that apply. a. The difference between utilitarianism and deontology is the focus on outcomes. b. Utilitarianism takes into consideration the usefulness of an action; deontology does not look into consequences. c. Utilitarianism measures the effect that an act will have; deontology looks to the presence of principles regardless of outcome. d. Utilitarianism measures the effect that an act will have; deontology looks to the presence of principle regardless of the outcome. e. Utilitarianism and deontology are closely related to the ethics of care because both ideologies promote a philosophy that focuses on understanding relationships. f. Both utilitarianism and deontology look into the nature of relationships and propose that the natural urge to be influenced by relationship is a positive value.

a, b, c Rationale: The difference b/w utilitarianism & deontology is the focus on outcomes of the effects. Utilitarianism takes into consideration the usefulness of an action; deontology does not look into consequences. Utilitarianism measures the effect that an act will have; deontology looks to the presence of principles regardless of the outcome/ Ethics of care and feminist ethics are closely related b/c both promote a philosophy that focuses on understanding relationships, especially personal narratives Feminist ethics look into the nature of relationships and propose that the natural urge to be influenced by relationships is a positive value.

Which of these is an ethical issue related to the long-term care setting? Select all that apply. a. Guardianship b. Power of attorney c. Advance directives d. Responsible party designation e. Do-not-resuscitate (DNR) orders f. Adherence to a patient's bill of rights

a, b, c, d, e, f Rationale: Resident rights are a universal priority in all long-term care settings. Guardianship, power of attorney, advance directives, responsible party designation, do-not-resuscitate orders, and adherence to a patient's bill of rights are all ethical issues related to the long-term care setting.

Which scenarios mentioned by the student nurse relate to the health care ethic of fidelity? Select all that apply. a. Monitoring a client after providing non-pharmacological measures to relieve anxiety due to hospitalization. b. Noting that the pain relief measures provided to that client have been ineffective, the nurse formulates a different plan of care. c. Ensuring that the client understands the risks and benefits of an experimental treatment before signing the appropriate consent form. d. Carefully evaluating the advantages and disadvantages of the client's plan of care to ensure that the risks do not outweigh the benefits. e. Caring for a client who refuses to be touched by people of certain skin color, the nurse continues to provide care because other colleagues refuse to attend to the client.

a, b, e Rationale: According to the health care ethic of fidelity, the nurse is required to keep all health care promises made to the client. If the nurse assesses the client to relieve anxiety regarding hospitalization, it is essential to monitor for effectiveness of the treatment plan after initiating interventions. If the nurse assesses the client for pain and notes that relief measures have been ineffective, the nurse would formulate alternate treatment plans. Fidelity also involves an unwillingness to abandon clients when care becomes controversial or complex. In the given situation, the client has a controversial belief system about skin color. However, the nurse continues to provide care even when other colleagues refuse to do so. The health care ethic of autonomy dels with the inclusion of clients in important decisions regarding care plans. The client is required to understand the risks and benefits of experimental procedures before signing the consent form. This ensures the client's independence. The health care ethic of nonmaleficence focuses on doing no harm. In the given situation, the nurse ensures that the risks of the treatment plan do not outweigh the benefits, to minimize harm to the client.

The registered nurse is educating a nursing student about the process of resolving an ethical dilemma. Which information would the nurse provide regarding negotiation of outcomes? a. "The nurse would provide a personal point of view." b. "Negotiations would be held in formal settings only." c. "Negotiation takes place immediately after gathering information." d. "The group agrees to a statement of the problem during the negotiation process."

a. "The nurse would provide a personal point of view." Rationale: During the process of negotiating outcomes, the nurse is required to provide a personal point of view. Negotiations may take place informally at the client's bedside or in a formal setting. After gathering relevant information regarding an ethical dilemma, the nurse is required to examine their own values and formulate an opinion regarding the matter. When verbalizing the problem, the group agrees to a statement of the problem to begin discussions. This step is performed before negotiating outcomes. Negotiations take place after determining all possible courses of action.

Which statement would be appropriate to include in a lecture for nursing students related to ethics and legal principles? a. Beneficence emphasizes promoting good, actively seeking benefit, and ensuring the client's well-being. b. After the nurse has delegated a task or activity, the unlicensed assistive personnel (UAP) is accountable for the task or activity. c. Social justice is an obligation to protect a client as an advocate when a client is not capable of self-determination. d. There is a universal list that all states use that describes tasks that can be safely delegated and assigned to nursing team members.

a. Beneficence emphasizes promoting good, actively seeking benefit, and ensuring the client's well-being. Rationale: Beneficence is the ethical principle that emphasizes promoting good, actively seeking benefit, and ensuring the client's well-being. The nurse is always accountable for the task or activity that is delegated. Social justice refers to equality, the idea that all clients should be treated with fairness and equity. Each state designates which tasks may be safely delegated and assigned to nursing team members; there is no universal list that all states use to describe tasks that can be delegated.

Which action would the nurse take to comply with the ethic of nonmaleficence in the health care setting? a. Focus on doing no harm. b. Keep promises made to clients. c. Respect the autonomy of clients. d. Keep the best interests of the client in mind.

a. Focus on doing no harm. Rationale: To comply with the ethic of nonmaleficence, the nurse would focus on doing no harm. The health care ethic fidelity requires the nurse to keep promises made to the client by following through on the plan of care. To comply with the ethic of autonomy, the nurse would include the client in the decision-making process when developing care plan. To comply with the health care ethic of beneficence, the nurse is required to keep the best interests of the client in mind when providing care.

Which action would the nurse take initially to advocate for the client and achieve resolution when caring for a client with terminal cancer who desires to receive hospice care at home rather than pursue further treatment against the advice of both the health care provider and the immediate family? a. Help the client clarify their values prioritize actions. b. Brainstorm possible alternative solutions for this issue c. Empower the client to decide to resolve the situation. d. Provide support and reassurance as the client makes decisions

a. Help the client clarify their values prioritize actions. Rationale: The nursing process as a problem-solving approach can be used by the nurse to help the client resolve value or ethically laden issues. In the first step of the process, the nurse would help the client illuminate values because values influence behaviors, feelings, and goals. Brainstorming occurs in the planning phase and helps generate alternatives. In the implementation stage, the nurse empowers the client to make decisions, providing support and reassurance.

To meet the criteria of ethical practice, which action would the nurse who witnessed the spouse of a client fall take? a. Initiate an agency incident report. b. Report the fall to the state (provincial) health department. c. Write a brief description of the incident to be kept by the nurse manager. d. Determine that no documentation is needed because the visitor is not a client in the hospital.

a. Initiate an agency incident report. Rationale: Health care agencies document the occurrence of any event out of the ordinary that results in or has the potential to harm a client, employee, or visitor. Falls by visitors are not required to be reported to state (provincial) health departments. However, incident reports are required to be presented to accrediting agencies for review when an agency is in the process of being accredited. Writing a brief description of the incident to be kept by the nurse manager is not a requirement of ethical practice. However, the nurse who is involved in an incident or is a witness to an incident would write an accurate description of the event, along with the names of individuals involved. This documentation would be kept by the nurse at home. Lawsuits may take several years before they come to trial, and personal notes may help the nurse recall the event. The documentation must accurately contain the same elements included in the formal incident report. Taking no action is irresponsible. All events out of the ordinary that result in or have the potential to harm a visitor would be documented in an agency incident report.

An older client is treated in the emergency department for soft tissue injuries that the medical team suspects might be caused by physical abuse. An adult child states that the client is confused and often falls down. A mini-mental examination indicates that the client is oriented to person, place, and time. Which action would the nurse take next? a. Interview the client without the presence of family members. b. Suggest that the client call law enforcement officers if threatened by family members. c. Accept the adult child's explanation until more data can be collected. d. Refer the client's clinical record to the hospital ethics committee for review.

a. Interview the client without the presence of family members. Privacy may provide an environment that is conducive to the client sharing information about the situation. The client needs to be kept safe; this action ensures additional time for assessment to rule out the possibility of abuse. Suggestion that the client call law enforcement is premature; further assessment is needed. If abuse is determined to be likely, the nurse and other staff have an obligation to notify the appropriate agency. Accepting the adult child's explanation until more data can be collected will form a separate relationship with the adult child, which is not in the client's best interest. Referring the client's clinical record to the hospital ethics committee for review is inappropriate; this situation presents a legal, not ethical, issue.

Which information is accurate regarding the role of value clarification in the resolution of ethical dilemmas? a. Tolerating differences of opinion b. Reinforcing or challenging family values c. Accepting strong values by individuals as facts d. Relating values to facts when dealing with ethical issues

a. Tolerating differences of opinion Rationale: The process of value clarification involves tolerating differences of opinion with others. This often helps in the resolution of ethical dilemmas. Value formation involves reinforcing or challenging family values when influenced by external forces. The nurse needs to understand that many individuals have such strong values that they consider them to be facts. The nurse would be able to distinguish between values and facts. Value clarification is possible if the nurse is able to understand that facts are different from values. This enables one to develop tolerance toward other's opinions.

Which principle did the researcher apply when calculating the risk-benefit ratio and concluding there were no harmful effects associated with a survey of diabetic clients? a. Human dignity b. Human rights c. Beneficence d. Utilitarianism

c. Beneficence Rationale: Beneficence is defined as the promotion of well-being and abstaining from the injuring of others, as well as doing good and being kind and charitable. In this situation, the possible benefits outweigh the possible harm for the clients participating in a research study. Human dignity and human rights are underlying principles of research ethics but are not directly related to the risk-benefit ratio here. Utilitarianism relates to the ethical doctrine that virtue is based on utility, and that conduct would be directed toward promoting the greatest good for the greatest number of people.

Two clients in the same medical facility receive differing levels of care due to the lack of financial resources of the family of one of the clients. The nurse in charge tries to resolve the ethical dilemma at hand. The nurse collects all relevant information regarding the problem from multiple sources. Which action would the nurse take next? a. Verbalize the issue by agreeing to a clear statement of the problem at hand. b. Analyze the situation at hand to determine whether it is an ethical dilemma. c. Examine own values regarding the issue at hand based on the information obtained. d. Negotiate the outcome of the possible course of action through proper group discussions.

c. Examine own values regarding the issue at hand based on the information obtained. Rationale: After gathering relevant information regarding an ethical dilemma, the nurse would proceed by clarifying values. The nurse may examine their own values regarding the issue and segregate the information obtained into facts, opinions, and values. The nurse may verbalize the issue after clarification of values. This is done by agreeing to clear statement of the problem. The first step in dealing with an ethical dilemma is to analyze the situation at hand and determine whether an ethical dilemma actually exists. The nurse may negotiate the outcome of possible courses of action at a later stage. This is done by expressing a point of view and respecting the views of others in involved.

Which point regarding ethics and values requires further education? a. The nurse's point of view offers a unique voice in the resolution of ethical dilemmas. b. Professional nursing promotes accountability, responsibility, advocacy, and confidentiality. c. The American Nurses Association (ANA) code of ethics ensures that the code remains constant. d. Standards ethics in health care consist of autonomy, beneficence, nonmaleficence, justice, and fidelity.

c. The American Nurses Association (ANA) code of ethics ensures that the code remains constant. Rationale: The ANA code of ethics reviews and revises the code regularly to reflect changes in practice. The nurse's point of view offers a unique voice in the resolution of ethical dilemmas by including knowledge based upon clinical and psychosocial observations. Professional nursing promotes accountability, responsibility, advocacy, and confidentiality. Standards ethics in health care consist of autonomy, beneficence, nonmaleficence, justice, and fidelity.

Which point requires correction regarding the characteristics of an ethical issue? a. The situation is perplexing, and it is not easy to think logically or make decision. b. It is not possible to resolve through review of scientific data. c. The problem aims at the greatest good for the greatest number of people. d. The answer to the problem has a profound relevance for areas of human concern.

c. The problem aims at the greatest good for the greatest number of people. Rationale: The utilitarianism system of ethics decides on the right action based on the greatest good for the greatest number of people. This is not a characteristic feature of an ethical dilemma. A situation can be called an ethical dilemma if it fulfills one of three conditions. An ethical issue is challenging and generally cannot be solved through logical decision-making. An ethical issue is challenging and generally cannot be solved through logical decision-making. An ethical issue cannot be solved solely through a review of scientific data. If the answer to a specific problem has a profound relevance for areas of human concern, then it is an ethical issue.

A client in need of a lung transplant tells the nurse, "I will not take the organ of any person belonging to a different religion." The nurse initiates the process for resolving the ethical dilemma by collaborating with other health care team members. Which action would the team take after agreeing to a statement of the problem? a. Interview the family members of the client. b. Initiate negotiations for the appropriate course of action. c. Assess whether the client is satisfied with the course of action taken. d. Determine all the possible courses of action based on available information.

d. Determine all the possible courses of action based on available information. Rationale: When resolving an ethical dilemma, the health care team should determine all possible courses of action after agreeing to a statement of the problem. At this stage, the members of the team weigh all possible options to address the situation. The team should interview the family members of the client to gather relevant information related to the situation. However, this step is performed immediately after deciding that the problem is an ethical dilemma. The team members may negotiate a plan after determining all possible courses of action to address the ethical issue. After resolving an ethical dilemma, the last step is to evaluate the action and the level of success. The team members may assess whether the client is satisfied with the course of action taken, at this stage.

The nurse is caring for a child whose parents refuse a life-saving surgery for the child, stating that surgeries are against their belief system. Which step would the nurse take first to resolve this ethical dilemma? a. Evaluate the outcome of the plan of action over time. b. Verbalize the problem and agree to a statement as a group. c. Examine the nurse's own values critically to formulate an opinion about the issue. d. Obtain information from the child, the parents, health care workers, and other sources.

d. Obtain information from the child, the parents, health care workers, and other sources. Rationale: After determining that an ethical dilemma exists in a situation, the nurse would focus on gathering information from multiple sources. The perspectives obtained from the child, the parents, health care workers, and other sources are helpful because it is essential to incorporate as much knowledge as possible. Evaluating the outcome of the plan of action over time is the last step of resolving an ethical dilemma. After gathering all relevant information regarding the issue and clarifying values, it is essential to verbalize the problem. A group agrees on a simple problem statement to hold a discussion on an issue. After gathering relevant information regarding the ethical dilemma, the nurse would examine their ow values critically to formulate an opinion regarding the matter.

The nurse working in a Catholic hospital discourages clients from using contraceptives per hospital policy. Which category of ethics is the nurse following? a. Societal ethics b. Research ethics c. Professional ethics d. Organizational ethics

d. Organizational ethics Rationale: Organizational ethics help ensure smooth ethical operation of an organization. These ethical codes include sets of rules and regulations to guide the actions and behavior of the members of the organization. Societal ethics are norms that serve a large community and involve legal and regulatory mechanisms. Research ethics are applicable to those conducting research involving human and animal subjects. Professional ethics involve a set of ethical standards and expectations for members of that profession, but unlike organizational ethics, they may apply to many different companies.

Which ability can be inferred when a professional is said to have ethical sensitivity? a. Recognizes ethical dilemmas b. Takes a morally correction action c. Justifies a well-reasoned action e. Thinks critically to rank ethical obligations

a. Recognizes ethical dilemmas Rationale: Having ethical sensitivity helps the nurse recognize if there is an ethical dilemma or issue. Ethical decision-making helps the nurse take morally correct action through reasoning and justification. The ability to think critically to rank ethical obligations is called ethical reflection and analysis.

Which action is appropriate for the registered nurse regarding assisted suicide? a. Nurses may have an open attitude toward the client's end of life. b. Nurses' participation in assisted suicide violates the code of ethics. c. Nurses may listen to the client's expressions of fear and attempt to control the client's pain. d. Nurses can participate in assisted suicide only if the individual could make an oral and written request.

b. Nurses' participation in assisted suicide violates the code of ethics. Rationale: According to the American Nurses Association (ANA), the nurse's participation in assisted suicide would violate their code of ethics. According to the American Association of Colleges of Nursing (AACN) and the International Council of Nurses, the nurse may have an open attitude toward the client's expressions of fear and tend to attempt to control the client's pain. According to the Oregon Death with Dignity Act (1994), the primary health care provider in the state of Oregon can participate in assisted suicide only if an individual with terminal disease makes an oral and written request to end life in a humane and dignified manner.

The nurse notes that a client is refusing a vital lifesaving surgery because of financial constraints. The client's insurance has lapsed and the health care facility's policies do not allow surgeries to be performed free of cost. Which intervention would the nurse do first to deal with the situation? a. Identify all possible courses of action to help the client. b. Verbalize the problem by writing a simple, clear statement. c. Negotiate a plan with other members of the health care team. d. Collect information relevant to the issue from multiple sources.

d. Collect information relevant to the issue from multiple sources. Rationale: The nurse identifies the situation to be an ethical dilemma. When resolving the ethical dilemma, the nurse would first gather all relevant information related to the situation from multiple sources, such as the client, the family, and the institution. The nurse may identify all possible courses of action after gathering information, clarifying values, and verbalizing the problem at hand. It is essential to verbalize the problem by agreeing to a simple, clear statement. This helps the team of health care workers conduct a discussion. However, this step is performed after gathering relevant information and performing value clarification. However, this step is performed after gathering relevant information and performing value clarification. Negotiation of a plan is possible only after identifying all possible courses of action. This step is not performed first by the nurse.