Ethics Passpoint

Which moral principle is a nurse applying when the nurse decides what is best for a client and acting without consulting the individual?

paternalism

A nurse takes informed consent from a client scheduled for abdominal surgery. Which is the most appropriate principle behind informed consent?

protects the client's right to self-determination in health care decision making

A nurse is discussing principles in healthcare ethics with the nursing students. Which would be an appropriate example of nonmaleficence?

to protect clients from a chemically impaired practitioner

A nurse is caring for a client declared brain dead following a motor vehicle accident. When the nurse enters the client's room, the spouse and family are talking with friends about the possibility of organ donation. Which statement by the nurse reflects an ethical practice dilemma?

"If you're thinking about organ donation, my sister is waiting for a kidney transplant. She'd be an excellent recipient. I can give you her phone number."

A 16-year-old female approaches a nurse and discloses that she is 11 weeks pregnant. The client asks the nurse how she can obtain a therapeutic abortion. What is the best response by the nurse?

"Let me refer you to a counselor who can assist you with making your decision."

A nurse is accompanying a client to the mall to do some shopping. A neighbor of the nurse approaches and tries to engage the nurse in conversation. What would be the most appropriate response by the nurse to the neighbor?

"Now is not a good time to talk. I will telephone you later."

A client with severe and persistent depression is debating undergoing electroconvulsive therapy (ECT). The client's family asks a nurse to convince the client that this treatment would be beneficial. In educating the family about the client's situation, what statement about client rights should the nurse make?

"The client, treatment team, and family can meet to discuss this treatment option."

A client that works as a pilot tells the nurse that they use illegal drugs for recreational purposes every weekend. Using the ethical principle of nonmaleficence to guide the nurse's interaction with the client, which is the nurse's best response?

"You could easily have an error in judgement and cause a serious accident."

A nurse is working within the managed care delivery model. Which is true regarding managed care?

All systems reflect the values of efficiency and effectiveness.

The nursing staff is divided over withdrawing care from a competent, chronically ill client. The nurse-manager would take which step to meet the needs of the staff?

Contact the institutional ethics committee for strategies.

A nurse assesses a client with psychotic symptoms and determines that the client likely poses a safety threat and needs vest restraints. The client is adamantly opposed to this. What would be the best nursing action?

Contact the physician and obtain necessary orders.

The nurse finds a client lying on the floor next to the bed. After returning the client to bed, assessing for injury, and notifying the health care provider (HCP), the nurse fills out an incident report. What should the nurse do next?

Give the incident report to the nurse-manager.

A client from a correctional facility is admitted to the hospital wearing handcuffs. The nurse caring for the client needs to provide morning care and notices the two correctional officers socializing with the nursing staff at the desk. What is the best action by the nurse in this situation?

Insist that the officers stay in the room at all times.

A nurse is caring for a client with multiple sclerosis. The client informs the nurse that a lawyer is coming to prepare a living will and requests the nurse to sign as witness. Which action should the nurse take?

Note that the nurse caring for the client cannot be a witness.

A client with chronic obstructive pulmonary disease presents with respiratory acidosis and hypoxemia. The client tells the nurse that they don't want to be placed on a ventilator. What action should the nurse take?

Notify the physician immediately to have the physician determine client competency.

The nurse is caring for a client with end-stage cancer whose health status is declining. A prescription is written by the attending health care provider (HCP) to withhold all fluid, but the health care team cannot locate a family member or guardian. The nurse requests an ethics consultation. Which information is true of an ethics consultation? Select all that apply.

Persons requesting an ethics consultation may do so without intimidation or fear of reprisal. Ethics consultations may prevent poor outcomes in cases involving ethical problems. The recommendations of ethics consultants are advisory only.

A nurse in a psychiatric care unit finds that a client with psychosis has become violent and has struck another client in the unit. What action should the nurse take in this case?

Restrain the client, as they are harmful to the other clients.

The nurse provides care to a verbally unresponsive client diagnosed with terminal cancer. The client's family refuses palliation on religious grounds. The nurse experiences great anxiety and distress when caring for the client due to the level of suffering perceived. What action should the nurse take?

Speak to the charge nurse about the nurse's moral conflict.

A client in the hospital for gout reports an excruciating migraine but declines analgesic medications when offered. Later the nurse observes a visitor performing what appears to be a type of physical manipulation of the client's head and neck. The client reports that the visitor is a therapist. The best action for the nurse to take is to:

advise the client how the client might receive adjunct services.

A client who is taking olanzapine states he is being poisoned and refuses to take his scheduled medication. The nurse states, "If you don't take your medication, you'll be put into seclusion." The nurse's statement is an example of which legal concept?

assult

A client being treated for complications of chronic obstructive pulmonary disease needs to be intubated. The client has previously discussed their wish to not be intubated with the client's partner of 5 years, whom the client has designated as healthcare power of attorney. The client's children want their parent to be intubated. A nurse caring for this client knows that

clients commonly confer healthcare power of attorney on someone who shares their personal values and beliefs.

A nurse is caring for a client who is well-known in the community. A person inquires about the medical details of the client, saying that they are a family member. The nurse reveals the requested information. Later, the nurse comes to know that the inquirer was not a family member. Which ethical rule of professional-client relationships has the nurse violated?

confidentiality

An 18-year-old tells the nurse, "Everyone does it, so it is all right," to justify rule-breaking behavior. The nurse realizes this is an example of which level or stage of moral reasoning development as described by Kohlberg?

conventional

The nurse is obtaining informed consent from a client. To adhere to ethical and legal standards, the nurse must ensure that the informed consent consists of what? Select all that apply.

discussion of pertinent information the client's agreement to the plan of care freedom from coercion

A client with severe acute respiratory syndrome privately informs the nurse of a desire not to be placed on a ventilator if the condition worsens. The client's partner and children have repeatedly expressed their desire that every measure be taken for the client. The most appropriate intervention by the nurse would be to:

encourage the client to consider a living will or power of attorney.

Using the nursing process to make ethical decisions involves following several steps. Which step is the nurse implementing when the nurse reflects on the decision-making process and the role it will play in making future decisions?

evaluating

An HIV-positive client discovers that their name is published in a report on HIV care prepared by the nurse. The client strongly opposes this and files a lawsuit against the nurse. Which offense has this nurse committed?

invasion of privacy

A nurse may use self-disclosure with a client if:

it achieves a specific therapeutic goal

A nurse is providing care for three clients 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 client still receives a reasonable amount of time, attention, and care during the course of the shift. Which is the nurse attempting to enact?

justice

A group of nursing students are reviewing current nursing codes of ethics. Such a code is important in the nursing profession because:

nursing practice involves numerous interactions between laws and individual values