ch 6: values, ethics, advocacy

Which statement regarding the Code of Ethics for Nurses is most accurate? "The code is an expression of nursing's own understanding of its commitment to society." "The code provides nurses with specific guidelines for practice." "The code critiques existing patterns of oppression and domination in society." "The code enables nurses to provide good care to clients."

"The code is an expression of nursing's own understanding of its commitment to society." The Code of Ethics for Nurses provides nurses with a nonnegotiable statement of the ethical obligations of individuals who enter the nursing profession. It serves as an expression of nursing's own understanding of its commitment to society. The feminist ethics approach critiques patterns of oppression and domination in society. Clinical virtues enable nurses to provide good care to clients. The principle-based approach to ethics provides nurses with specific action guidelines for practice.

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. "The gonorrhea test was positive. That's what the client gets for sleeping around." "Smoking has been shown to be a risk for many illnesses, including heart disease and cancer." "If you are going to have extramarital sex, please protect yourself by using a condom." "I can't believe the client is giving that precious infant up for adoption." "If that was my mother, I sure wouldn't agree to a no-code."

"The gonorrhea test was positive. That's what the client gets for sleeping around." "I can't believe the client is giving that precious infant up for adoption." "If that was my mother, I sure wouldn't agree to a no-code."

Which statement by the nurse is an example of deception? "This injection of procaine will feel like a little pinch." "I am going to teach you how to give yourself insulin." "I will administer your pain medication as soon as it is due." "It is important to get out of bed to prevent pneumonia."

"This injection of procaine will feel like a little pinch." Telling a client that an injection of procaine will feel like a little pinch is not being truthful, and is defined as a deception. Telling a client that pain medicine will be administered when it is time is being truthful. Telling a client to get out of bed also supports a nursing intervention. Teaching a client how to give an injection is important for the client to take care of himself or herself.

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. "Can I discuss this matter without violating my client's privacy?" "Will less experienced nurses on the unit learn from my actions?" "Am I willing to take this risk to help protect my fellow nurses?" "Are my clients receiving equal treatment?" "Am I able to provide safe and efficient care to my clients?"

"Will less experienced nurses on the unit learn from my actions?" "Am I willing to take this risk to help protect my fellow nurses?" "Am I able to provide safe and efficient care to my clients?" 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 is caring for a client with a complete spinal cord injury that has caused paraplegia. The client is very distraught and asks the nurse, "Are they sure, even with therapy, I will never walk again?" Which statement made by the nurse demonstrates veracity? "Sometimes with physical therapy, a person may notice some improvement with movement." "It is too soon to tell. There is always a possibility you will regain movement in your legs." "You have a complete injury, which results in a total loss of movement and sensation below the level of injury." "I see you are upset; I can ask your health care provider to stop by and explain your injury in more detail."

"You have a complete injury, which results in a total loss of movement and sensation below the level of injury." Veracity means the duty to be honest and avoid deceiving or misleading a client. Personnel demonstrate respect for this right by explaining to the client the status of the client's health problem, the benefits and risks of treatment, alternative forms of treatment, and consequences if the treatment is not administered. The other statements are not providing the truth about the client's condition, or are avoiding telling the truth.

Which best defines value clarification? A systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil, as they relate to conduct A belief about the worth of something, about what matters, that acts as a standard to guide one's behavior A process by which people come to understand their own values and value systems An organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct

A process by which people come to understand their own values and value systems 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? Telling a child an injection will feel like a pinch before the nurse gives the injection Allowing a child to decide not to have an intravenous line inserted Teaching children right from wrong and telling them the reason behind a bad action Modeling healthy behaviors for adolescents, such as not smoking electronic cigarettes

Allowing a child to decide not to have an intravenous line inserted 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 adolescents good behavior. Telling the child about the injection feeling like a pinch is not an approach to value transmission.

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? Confidentiality Beneficence Justice Autonomy

Autonomy 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.

Which theory of ethics prioritizes the nurse's relationship with clients and the nurse's character in the practice of ethical nursing? Principle-based ethics Care-based ethics Utilitarianism Deontology

Care-based ethics Central to the care-based approach to ethics is the nurse's relationships with clients and the nurse's "being," or character and identity. Deontology is the study of the nature of duty and obligation. Utilitarianism is the doctrine that actions are right if they are useful or for the benefit of a majority. Principle-based ethics prioritizes goals and principles that exist beyond the particularities of the nurse-client relationship.

The International Council of Nurses (ICN) Code of Ethics for Nurses (2012) has which elements? Select all that apply. Family Coworkers Profession Practice People

Coworkers Profession Practice People The International Code of Ethics is based on the nurse's responsibility to act ethically toward people, practice, profession, and coworkers. Family, although important, is not included among those elements.

When examining values, a nurse notes that one country allows physician-assisted suicide and another outlaws it, making it punishable by imprisonment. Which factors best explain the differences in values between these two countries? Ethical Economic Spiritual Cultural

Cultural Daily living is expressed in many traditions and customs; understanding these differences is cultural value orientation. Because it is primarily culture that determines a society's values, cultural factors best explain the differences in values between these two countries. Although economic, spiritual, and ethical factors may be involved in value formation, a society's value system is most influenced by culture.

Six adolescents were killed in an accident following a night of drinking. The older brother of one of the victims bought beer for the group because none of them was old enough to purchase alcohol. Which statement(s) regarding the brother's action reflect customs rather than communal or personal ethical standards? Select all that apply. Underage persons should not drink alcohol. Drinking alcohol is a rite of passage. People should not provide alcohol to underage persons. People should not drink alcohol. Big brothers often introduce their younger siblings to alcohol.

Drinking alcohol is a rite of passage. Big brothers often introduce their younger siblings to alcohol. The ethical statements are that people should not provide alcohol to underage persons (communal standard), underage persons should not drink alcohol (communal standard), and people should not drink alcohol (personal standard). Communal standards are often the basis of law. Personal standards are specific to the person holding the value. The nurse must distinguish ethical statements from customs such as drinking as a rite of passage and big brothers introducing younger siblings to alcohol.

A female client is brought to the emergency room with matted hair, bruising, and malnutrition. The nurse suspects physical abuse and neglect. The nurse states, "This happens to many women." Which type of ethical approach is the nurse exhibiting? Values clarification Paternalism Moralizing Feminist

Feminist A feminist approach is one in which the focus is on specific problems and concerns faced by women. The statement that "this happens to many women" is an example of a feminist approach. Paternalism is action limiting a person's or group's liberty or autonomy that is intended to promote their own good (e.g., if the nurse stated that "I must make all decisions about this client's care for her, as she's not in any shape to do so herself"). Values clarification is a self-assessment process that enables a person to discover the content and strength of the person's own system of values. An example of this would be if the nurse stated, "I feel bad for the client, as no one deserves this." Moralizing is to comment on issues of right and wrong, typically with an unfounded air of superiority. An example of this would be if the nurse stated, "If she was a good girl, this would have never happened to her."

A nurse is providing care to a client and is preparing the client for breakfast. The nurse assists the client out of bed to the chair and then helps the client open the items on the breakfast tray. The client begins to eat breakfast. The nurse tells the client, "I'll be back in about 10 minutes to check on you. In the meantime, here is your call light in case you need me." About 10 minutes later, the nurse returns to check on the client. The nurse is demonstrating which ethical principle? Autonomy Justice Fidelity Nonmaleficence

Fidelity Fidelity involves keeping promises and being faithful to the promises made. In this case, the nurse tells the client that she will return in 10 minutes and then follows through with the promise. Nonmaleficence involves doing no harm and avoiding actions that deliberately harm a person. Autonomy refers to the right to make one's own decisions. Justice involves treating each person fairly and without judgment.

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? Human dignity Integrity Altruism Social justice

Integrity The nurse is demonstrating integrity, which is defined as acting in accordance with an appropriate code of ethics and accepted standards of practice. Seeking to remedy errors made by self or others is an example of integrity. Altruism is a concern for the welfare and being of others. Social justice is upholding moral, legal, and humanistic principles. Human dignity is respect for the inherent worth and uniqueness of individuals and populations.

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

Integrity The principle of integrity is based on the honesty of a nurse according to professional standards. In this instance, the nurse reported the occurrence of the missed medication to the charge nurse. The definition of altruism is concern for others; it can best be explained by a nurse concerned about how a client will care for self after discharge. Social justice is a concept of fair and just relations between the individual and society and is related to wealth and distribution of goods in a society. Autonomy is the right to self-determination or acting independently and making decisions.

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 ethical principle is the nurse attempting to practice? Fidelity Nonmaleficence Beneficence Justice

Justice The ethical principle of justice includes an effort to fairly distribute benefits and to minimize discrimination, even when circumstances make this difficult to achieve. This is demonstrated by the nurse's efforts to fairly distribute the nurse's time and care. Beneficence is the ethical principle of promoting good. Nonmaleficence states that one should not do harm to clients. Fidelity is faithfulness to a person, cause, or belief, demonstrated by continuing loyalty and support.

The nurse has identified an ethical dilemma that has the potential to interfere with a client receiving optimal care. The nurse discussed this issue with the charge nurse on the unit. What action should the nurse choose next? Monitor for resolution of the problem. Inform the family that the ethical issue has been reported. Report the issue to the hospital medical director. Depend on the charge nurse to handle the issue from this point.

Monitor for resolution of the problem. Simply reporting the issue does not complete the nurse's obligation in this situation. The nurse should monitor for resolution of the issue, at least to the point where it no longer interferes with client care. The nurse has already reported the issue up the chain-of-command, so further reporting is not necessary at this time. There is no particular reason to inform the family.

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

Paternalism Making a decision for a client who is confused to prevent an injury is an example of paternalism. Deception occurs when the true nature or reason is concealed and the client is deprived of basic human rights. Confidentiality requires a health care provider to keep a client's personal health information private unless consent to release the information is provided by the client. Conflict is a disagreement or argument and does not represent the example in this question.

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? Ethical principle Legal obligation Professional value Personal moral

Personal moral 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.

When analyzing an ethical dilemma according to the ethical framework, what is most important for the nurse to take into consideration? Decision-making The relationship between law and values Standards of conduct Conflict between competing priorities

Standards of conduct 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.

Nurses must maintain the privacy of clients. Which example is a breach in privacy and would pose an ethical problem? Taking a picture of a client with the nurse's cell phone Documenting the care in the client's record Participating in a hand-off report at the end of the shift Talking to the family when they visit the client

Taking a picture of a client with the nurse's cell phone Taking a picture of a hospitalized client is a direct breach of privacy. Documenting care in the client's record is a normal and expected duty of a nurse. While delivering care to a client, the nurse may talk to the client's family while they are visiting the client; this does not reflect a breach of privacy. Participating in a hand-off report is an expected and necessary duty of the nurse and does not reflect a breach of privacy.

Which is the best definition of ethics? The formal, systematic study of moral beliefs The informal, systematic study of moral beliefs The adherence to informal personal values The adherence to formal personal values

The formal, systematic study of moral beliefs Ethics is a formal, systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil as they relate to human conduct and human flourishing. "Morals" usually refers to personal or communal standards of right and wrong.

Which action would cause a charge nurse to have concerns about a nurse's moral agency? The nurse was unable to pass a required dosage calculation examination. The nurse was seen at a grocery store after calling in sick. A family member complained that the nurse was slow answering call lights. The nurse often must stay after shift change to complete documentation.

The nurse was seen at a grocery store after calling in sick. The only option with an ethical component possibility is the nurse being seen at the grocery store after calling in sick. It may be that the nurse had no other choice but to go to the grocery store, even if sick, but it would cause the charge nurse to be suspicious. The other options do not reflect an ethical issue because they did not lead to other unethical behaviors, just job performance issues.

Which is a characteristic of the care-based approach to bioethics? The need to emphasize the relevance of clinical experience The promotion of the dignity and respect of clients as people The rightness or wrongness of an action independent of its consequences The need for an orientation toward service

The promotion of the dignity and respect of clients as people The care-based approach to bioethics focuses on the specific situations of individual clients, and characteristics of this approach include promoting the dignity and respect of clients as people. The need to emphasize the relevance of clinical experience and the need for an orientation toward service are part of the criticisms of bioethics. The deontologic theory of ethics says that an action is right or wrong independent of its consequences.

Nurses who value client advocacy follow what guideline? They value their loyalty to an employing institution or to a colleague over their commitment to their clients. They make decisions for clients who are uninformed concerning their rights and opportunities. They choose the claims of the client's well-being over the claims of the client's autonomy. They give priority to the good of the individual client rather than to the good of society in general.

They give priority to the good of the individual client rather than to the good of society in general. Advocacy is the protection and support of another's rights. If the nurse values client advocacy, the nurse would give priority to the good of the individual client rather than to the good of society in general. The nurse would not be demonstrating advocacy if the nurse values the loyalty to an employing institution or to a colleague over the commitment to the client. The nurse demonstrating client advocacy would not choose the claims of the client's well-being over the claims of the client's autonomy. The nurse would not make decisions for clients who are uninformed concerning the client's rights and opportunities.

Which traits are examples of virtues that can exemplify character and conduct as a professional nurse? Select all that apply. Trustworthiness Conflict Deception Compassion Humility

Trustworthiness Compassion Humility Trustworthiness, humility, and compassion are all examples of professional virtues, as well as cultivated dispositions of character and conduct, that motivate and enable us to be good human beings. Deception and conflict are negative traits that do not exemplify professional virtues.

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: confidentiality. advocacy. justice. altruism.

advocacy Advocacy is the protection and support of another person's rights. Nurses have always been strong client advocates, carefully evaluating the competing claims of the client's autonomy (self-determination) and well-being. Altruism is the principle and moral practice of concern for happiness of other human beings, resulting in a quality of life both material and spiritual. Justice is concerned with moral rightness and fairness. Confidentiality is keeping or one's personal information secret or private.

A nurse is acting inappropriately and has an odor of alcohol. This behavior breaches the principle of: fidelity. beneficence. autonomy. ethical conduct.

ethical conduct. Ethical conduct dictates that a nurse act in a professional, safe, competent manner. Drinking alcohol while at work and behaving inappropriately breaches this principle. Beneficence is acting for the good of the client. Fidelity is keeping promises. Autonomy is respecting one's right to self-determination and making decisions. Although the nurse's intoxication will likely lead to breaches in the principles of beneficence, fidelity, and autonomy, there is no evidence of such breaches in these specific principles in this case.

A nurse working on a critical care unit was informed by a client with multiple sclerosis that the client did not wish to be resuscitated in the event of cardiac arrest. Now the client is no longer able to express wishes, and the family has informed the health care provider that they want the client to be resuscitated. Aware of the client's wishes, the nurse is involved in a situation that may involve: paternalism. deception. ethical distress. confidentiality.

ethical distress. The nurse is involved in a situation that involves ethical distress. Ethical distress occurs when the nurse knows the right thing to do but either personal or institutional factors make it difficult to follow the correct course of action. Paternalism is acting for clients without their consent to secure good or prevent harm. Deception and confidentiality can result in ethical problems for nurses when there is a conflict between the client's and nurse's values/interests. In this scenario, the nurse is aware of the client's wishes, but the conflict lies with the family and thus the nurse will experience ethical distress.

A client is brought to the emergency department by an adult child, who states, "I am unable to care for my parent anymore. Although I would like to, financially and physically I cannot do it anymore." What ethical problem is the adult child experiencing? moral distress dissatisfaction ethical dilemma ethical uncertainty

moral distress Moral distress is when someone wants to do the right thing but is not able. The adult child brings the parent to the emergency department to maintain the parent's safety, although the child needs to take care of the parent. Dilemma is a situation in which a difficult choice has to be made between two or more alternatives, especially equally undesirable ones. The client is not experiencing a dilemma. Uncertainty means a feeling of not knowing what will happen. The adult child is certain that he or she cannot care for the parent. Dissatisfaction implies a sense of dislike for, or unhappiness in, one's surroundings. Although the adult child is unhappy, this is not the primary ethical problem.

What would be an example of the nurse practicing fidelity? The nurse: regulates visitors. withholds information as requested. provides continuity of care. stays with a client during death as promised.

stays with a client during death as promised. Fidelity requires the nurse to keep promises made and to be faithful to one's commitments. Regulating visitors is a demonstration of the value of privacy. Withholding client's information as requested is an example of maintaining confidentiality. Providing continuity of care is an example of integrity and professionalism.

Socialization into the nursing profession may have the most significant effect on: planning. documentation. values. roles.

values Socialization into a culture refers not only to the adoption of practices, such as documentation and planning, and ways of relating to one another (roles) but to the very beliefs that one holds to be most important (values). Because values guide one's practices and roles, the most significant effect of socialization into nursing would be its effect on values.

A nurse is preparing a client for discharge from the cardiac unit and observes cigarettes in the client's belongings. The nurse asks the client to consider the client's health and that of the client's spouse. This is an example of: moral distress. ethical dilemma. social justice. values clarification.

values clarification. Values clarification is a process that allows an individual to examine and understand what choices to make. Moral distress is the emotional state that arises from a situation when a nurse feels that the ethically correct action to take is different from what the nurse is tasked with doing. An example of this is the nurse taking away the cigarettes out of the client's belongings bag. Ethical distress occurs when a decision is made regarding what one believes to be the right course of action, but barriers prevent the nurse from carrying out or completing the action. The nurse can expect ethical distress if removing the cigarettes from the client's belongings bag. Social justice is a concept of fair and just relations between the individual and society. An example is the selling of cigarettes to those who had a cardiac event. Moral distress, ethical dilemma, and social justice are not reflected in this scenario.

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." "You don't have to be courageous to be a nurse." "I'm not courageous at all." "It is more important to be smart than it is to be courageous."

"You can work on being more courageous as you learn to be a nurse." Courage is a virtue of nurses that can be learned or strengthened with work. Courage is a quality nurses should possess. Courage is not less important than being intelligent, compassionate, or humble.

Which word is best described as protection and support of another's rights? Paternalism Ethics Autonomy Advocacy

Advocacy Advocacy is the protection and support of another's rights. Nurses who value client advocacy make sure their loyalty to an employing institution or colleague does not compromise their primary commitment to the client; give priority to the good of the individual client rather than to the good of society in general; and carefully evaluate the competing claims of the client's autonomy and client well-being. Paternalism is acting for clients without their consent to secure good or prevent harm. Autonomy is respecting the rights of clients or their surrogates to make health care decisions; it is also known as self-determination. Ethics is the formal, systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil as they relate to conduct and human flourishing.

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? Conflicts concerning new technology Allocation of scarce nursing resources Advocacy in a market-driven environment Deception

Allocation of scarce nursing resources This is a clear example of ethical issues surrounding the allocation of scarce nursing resources and involves distributing nursing care. Advocacy in a market-driven environment and conflicts concerning new technology are not related to the presented situation. Deception is the action of deceiving someone, and the nursing supervisor is not deceiving the nurse.

Which ethical principle refers to the obligation to do good? Veracity Nonmaleficence Fidelity Beneficence

Beneficence Beneficence is the duty to do good and the active promotion of benevolent acts. Fidelity refers to the duty to be faithful to one's commitments. Veracity is the obligation to tell the truth. Nonmaleficence is the duty not to inflict, as well as to prevent and remove, harm; however, there will be times when the action may cause "harm" to promote the "good" such as chemotherapy being used to treat and eliminate cancer, but it causes various adverse effects while trying to reach the ultimate goal..

Which example most accurately depicts the ethical principle of autonomy? Describing a surgery to a client before the consent is signed Changing a dressing on a wound as needed Administering a morning dose of insulin before breakfast Transporting a client to a scheduled physical therapy appointment

Describing a surgery to a client before the consent is signed Autonomy is the capacity to make an informed, uncoerced decision. Describing a surgery to a client before a consent is signed provides the client with all of the information needed to make an informed decision and thus an autonomous one. The nurse changing a dressing on a wound does not require the client to make an informed decision, nor does administering a morning dose of insulin or transporting a client.

A hospice nurse is caring for a client with terminal cancer. The family would like the client to continue aggressive therapy to treat the cancer, but the client has voiced to the nurse that no further pursuit of treatment is desired. The nurse speaks to the family about the client's wishes, condition, and terminal state. This action is most likely derived from which nursing obligation? Ethical principles Advanced practice licensure guidelines Legal responsibilities Nursing education principles

Ethical principles hics 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. In this case, the nurse is practicing the ethical principle of autonomy, which is the client's right to self-determination related to choices about care. The nurse's action is not primarily motivated by legal responsibility, nursing education principles, or advanced practice licensure guidelines.

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? Autonomy Justice Fidelity Nonmaleficence

Fidelity Fidelity is keeping one's promises and never abandoning a client entrusted to one's care without first providing for the client's needs. Autonomy respects the rights of clients or their surrogates to make healthcare decisions. Nonmaleficence is preventing harm from being done to a client. Justice involves meeting the needs of each client equitably and acting fairly.

Which nursing action demonstrates the principle of fidelity? Filing an incident report after making a medication error Treating an uninsured client in the emergency department Administering a vaccination Witnessing a client signature on an informed consent

Filing an incident report after making a medication error Fidelity means being faithful to work-related commitments and obligations. The ethical principle is best demonstrated by the nurse following the employer's policies by completing the incident report following a medication error. Administering vaccines is an example of beneficence; treating an uninsured client in the emergency department is an example of justice; witnessing a client signature on an informed consent is autonomy.

A parent of a 17-year-old high school student is allowing the child to decide which college the child will attend. When the child requests direction from the parent in making this decision, the parent responds by stating, "You will need to make this decision on your own." What type of value transmission is the parent displaying? Moralizing Responsible choice Modeling Laissez-faire

Laissez-faire This situation demonstrates laissez-faire value transmission, which is characterized by allowing the adolescent to explore values independently and the development of a personal value system. The laissez-faire approach involves little or no guidance and can lead to confusion and conflict. Through modeling, children learn that which is of high or low value by observing parents, peers, and significant others. The moralizing mode of value transmission teaches a complete value system and allows little opportunity for the weighing of different values. Responsible choice encourages children to explore competing values and to weigh their consequences while support and guidance are offered.

The nurse is managing the care for a postoperative client. How does the nurse demonstrate advocacy? Changing the channel on the television while providing care Limiting visitors due to the client reporting pain Turning and positioning the client every 4 hours Administering pain medication when the pain level reaches 9 on a pain scale of 0 to 10

Limiting visitors due to the client reporting pain Advocating for clients is a nursing responsibility and is performed with the best interest and welfare of the client in providing safe, competent, and comforting care. Limiting visitors is an example of advocacy. The nurse recognizes that the client is in pain; therefore, limiting the visitors allows for the nurse to advocate for additional measures to allow the client to rest and recover. Administering pain medication and turning and the client every 4 hours are important and necessary interventions for a postoperative client, but this is not advocacy. Changing the channel on the television while providing care also does not promote advocacy.

A nurse is caring for a hospitalized client. Which nursing actions demonstrate a caring and compassionate attitude? Select all that apply. Leaving the room promptly once care is completed Listening to the client tell stories about past experiences Explaining all nursing procedures clearly 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 Notifying the client before leaving for lunch Offering snacks and beverages to visiting family 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 knows that the expression "Do not cause harm" refers to which ethical principle? Beneficence Fidelity Justice Nonmaleficence

Nonmaleficence Nonmaleficence is conducting procedures and interventions in a safe manner so that no harm is caused to the client. Justice is the idea that the burdens and benefits of new or experimental treatments must be distributed equally among all groups in society. Fidelity is demonstrated by continuing loyalty and support to a client. Beneficence requires that the procedure be provided with the intent of doing good for the client involved.

What is the term for the beliefs held by the individual about what matters? Bioethics Values Morals Ethics

Values 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.

What are standards for decision-making that endure for a significant time in one's life? Ethics Values Roles Beliefs

Values Values are standards for decision-making that endure for a significant time in one's life. Beliefs are more likely to be changeable and are not necessarily a long-term foundation for decision-making. 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. A role is a set of responsibilities one takes on in relationship to others.

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. insecurity and a lack of safety. a disruption in consistency. conflict with society.

a failure to model one's own values. Many role models fail to model their own values and, as a result, cause conflict with and confusion in those who look up to them, such as children (not society, in general). The primary result of this action, which is saying one thing and doing another, is not so much insecurity and a lack of safety or a disruption in consistency as it is a failure to reflect one's own values.

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: altruism. confidentiality. justice. advocacy.

advocacy Advocacy is the protection and support of another person's rights. Nurses have always been strong client advocates, carefully evaluating the competing claims of the client's autonomy (self-determination) and well-being. Altruism is the principle and moral practice of concern for happiness of other human beings, resulting in a quality of life both material and spiritual. Justice is concerned with moral rightness and fairness. Confidentiality is keeping or one's personal information secret or private.

Ethical distress is: supporting the rights of a client during hospitalization. having trouble deciding which of two conflicting ethical principles to follow. being aware of the principles of right and wrong. knowing the correct action but being unable to perform it due to constraints.

knowing the correct action but being unable to perform it due to constraints. Knowing the correct action but being unable to perform it due to constraints is the definition of moral or ethical distress. Being aware of knowing what is right and wrong is the first step of having an ethical conscience. Supporting a client during a hospitalization is an ethical principle of doing what is right (beneficence) and the focus of client-centered care. An ethical dilemma is a situation in which a person has difficulty deciding which of two or more conflicting ethical principles to follow.

A nurse is of the Catholic faith and votes pro-life. This nurse is considered to have: moral agency. legal obligations. personal values. ethics.

personal values. 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.

The nurse has been educating a young adult client about living with type 1 diabetes and the importance of adhering to a strict dietary regimen. The client is repeatedly admitted and is not following the prescribed plan. What statement made by the nurse may facilitate values clarification for the client? "Rank the three most important things in your life." "You will not live a very long life if you continue on this path." "It just seems like you don't want to live." "How can I help you stay on your diet and take your insulin?"

"Rank the three most important things in your life." To facilitate values clarification for this client, first help the client identify basic values and what is most important in the client's life. Having the client complete ranking of important things in life can help the client prioritize when the client is placing low value on health and health behaviors. Asking the client how the nurse can help does not assist the client in facilitating client values. Inferring that the client does not want to live is a judgmental response and may limit future conversations between the nurse and client. Telling the client that the client will not live long is a nontherapeutic and threatening statement that would not facilitate an appreciation for better health.

Which best defines value clarification? A belief about the worth of something, about what matters, that acts as a standard to guide one's behavior An organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct A systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil, as they relate to conduct A process by which people come to understand their own values and value systems

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

Nursing practice consistent with the Code of Ethics for Nurses includes which actions? Select all that apply. Acknowledging that the client is the focus and center of care and remains a part of the treatment team Delivering culturally safe care Assuming responsibility for care with limited collaboration with other healthcare professionals Empathizing with clients and establishing friendships when appropriate Protecting the client's right to confidentiality and privacy

Acknowledging that the client is the focus and center of care and remains a part of the treatment team Delivering culturally safe care Protecting the client's right to confidentiality and privacy Nurses should always deliver culturally safe care, as well as protect the client's right to confidentiality and privacy in healthcare settings. Nurses also should put the client at the center of care and incorporate the client as a part of the healthcare team. As such, nurses must collaborate closely with other members of the healthcare team and include all healthcare professionals caring for the client. Nurses should not cross professional boundaries with their clients by establishing friendships.

The nurse is involved in making a decision in an ethical dilemma. Drag and drop the steps of making this decision in correct order. 5Describe the situation and the contextual factors involved. 2Determine that the situation is, indeed, an ethical dilemma. 1Identify personal and professional moral positions of those involved. 3Identify how this situation can help with future decision-making. 4Compare the outcome of actions with what was expected.

Describe the situation and the contextual factors involved. Determine that the situation is, indeed, an ethical dilemma. 1Identify personal and professional moral positions of those involved. 4Compare the outcome of actions with what was expected. 3Identify how this situation can help with future decision-making. Nurses may find it helpful to use the steps of the nursing process to guide ethical decisions. Assessment includes describing the situation and the contextual factors involved. Diagnosing or identifying the ethical problems is the second step. Planning includes identifying options and exploring the probably short-term and long-term consequences of each for each stakeholder. In this step the nurse must be able to justify the plan ethically and must identify personal and professional moral positions. Implementation includes acting and then comparing the outcome of the action which what was expected. Evaluating includes determining what has been learned from the process and how that learning will impact future decision-making.

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

Ethical practice requires a skill set that must be conscientiously learned and nurtured. Ethical agency must be cultivated in the same way that nurses cultivate the ability to do the scientifically right thing in response to a physiologic alteration. It is inaccurate to assume that it will passively develop from the presence of other ethical practitioners, or from years of experience. It is not an innate characteristic of personality.

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

Evaluating Evaluating an ethical decision involves reflecting on the process and evaluating those elements that will be helpful in the future. The nurse may also question how this experience can improve reasoning and decision making in the future. Diagnosing the ethical problem involves stating the problem clearly. Planning includes identifying the options and exploring the probable short-term and long-term consequences. Implementing includes the implementation of the decision and comparing the outcomes of the action with what was considered and hoped for in advance.

Which action most clearly demonstrates a nurse's commitment to social justice? Answering a client's questions about care clearly and accurately Lobbying for an expansion of healthcare resources and benefits to those in poverty Documenting client care in a timely, honest, and thorough manner Ensuring that a hospital client's diet is culturally acceptable

Lobbying for an expansion of healthcare resources and benefits to those in poverty Social justice is a professional value that encompasses efforts to promote universal access to health care, such as the expansion of publicly funded programs like Medicare. Culturally competent care is a reflection of human dignity. Answering clients' questions and documenting care accurately are expressions of the value of integrity.

A nurse is having lunch in the break room and overhears the other nurses talking about a difficult client in an inappropriate way. The nurses attempt to engage her in the conversation. Which response by the nurse would best represent behavior that supports the value of human dignity in nursing practice? Saying that this discussion is inappropriate and disrespectful to the client and that the nurse does not want to be a part of it Getting up and walking out of the break room because the nurse's break is over Sharing what the client did to the nurse last week, though the nurse treats the client with dignity Laughing and joining in the conversation, though the nurse does not believe the client is that bad

Saying that this discussion is inappropriate and disrespectful to the client and that the nurse does not want to be a part of it

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

justice Justice is the foundation for decisions about ethical resource allocation throughout a society or group, because resources must be allocated fairly and equitably. The other ethical principles listed, veracity, autonomy, and confidentiality, have no direct application to resource allocation within society.

To practice ethically, the nurse should avoid: allowing the nurse's own personal judgment to guide practice. allowing an ethics committee to guide the nurse's practice. asking the client's family about their views on caring. reviewing past cases before making decisions about practice.

allowing the nurse's own personal judgment to guide practice. Personal convictions apply only to situations and decisions pertaining to the individual. In ethical professional practice, nurses should avoid allowing personal judgments to bias their treatment of clients. It is appropriate for nurses to allow an ethics committee, past cases, and the views of clients and their families to guide nursing practice.

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? justice beneficence fidelity nonmaleficence

fidelity 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. Justice is acting fairly. In this scenario, the nurse do not need to recognize any bias or discrimination in the distribution of care. 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.

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? conscientious objection ethical dilemma moral resilience moral distress

moral resilience 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.

An illegal immigrant with no health insurance sustained life-threatening injuries in an automobile accident. Which action in this case demonstrates the ethical principle of justice? Filing the paperwork for the client to receive retroactive health insurance Avoiding treating the client so as to not do any additional harm Telling the client honest information about the client's medical condition and prognosis Airlifting the client to a local trauma center for emergency surgery

Airlifting the client to a local trauma center for emergency surgery The ethical principle of justice mandates that clients be treated impartially without discrimination according to age, gender, race, religion, socioeconomic status, weight, marital status, or sexual orientation. An immediate airlift to the local trauma center demonstrates that this client is being treated impartially. Avoiding causing the client additional harm would demonstrate nonmaleficence. Attempting to help the client obtain health insurance would demonstrate beneficence and advocacy. Telling the client the truth about the client's medical condition and prognosis would demonstrate integrity and honesty (veracity).

A client is scheduled to have an elective surgical procedure performed but cannot decide whether to go forward with the procedure or cancel it. The client asks the nurse to help make the decision. Which action by the nurse is the best way for this nurse to advocate for the client? Refuse to help the client, and state that the client alone must make the decision. Call the surgeon, and have the surgeon explain the procedure again. Refer the client to the social worker for help assembling a team to help the client make the decision. Allow the client to verbalize feelings, and provide information to help the client assess options.

Allow the client to verbalize feelings, and provide information to help the client assess options. Nurses as advocates must realize that they do not make decisions for their clients, but they can facilitate decision making by allowing the client to verbalize feelings and by providing information to help the client assess options. This is not an appropriate time to call in the surgeon or the social worker. Refusing to help the client is not the best example of client advocacy performed by a nurse.

A school nurse interviewing parents of a child who is doing poorly in school determines that the parents practice a laissez-faire method of discipline. What are examples of this form of value transmission? Select all that apply. A boy is taken for ice cream to celebrate his good report card. Before meals, a boy says a prayer that he learned from his parents. An adolescent boy explores religions of friends in hopes of developing his own faith. A boy is taught how to behave in public by his schoolteacher. An adolescent girl tries alcohol at a party with her friends. An adolescent girl is punished for staying out too late with her friends.

An adolescent boy explores religions of friends in hopes of developing his own faith. An adolescent girl tries alcohol at a party with her friends. The laissez-faire approach to discipline would leave children to explore values on their own and to develop a personal value system from this exploration. This approach often involves little or no parental guidance, and may lead to confusion and conflict for the child. Examples of this form of discipline would be an adolescent girl trying alcohol at a party with her friends and an adolescent boy exploring religions of friends in hopes of developing his own faith. A child reciting a prayer learned by the parents would not be an example of this method. A child being taken for ice cream to celebrate would not be an example of this method. A child taught how to behave by the school teacher is not an example. An adolescent being punished by the parents for breaking curfew is not an example.

Which example best describes feminist ethics? An approach critiquing existing patterns of oppression and domination in society A combination of elements of utilitarian and deontologic theories that offer specific action guidelines for practice The formal study of ethical issues that arise in the practice of nursing Attention directed to the specific situation of individual clients viewed within the context of their life narratives

An approach critiquing existing patterns of oppression and domination in society Feminist ethics offer an approach critiquing existing patterns of oppression and domination in society, especially as they affect women and the poor. The principle-based approach to ethics combines elements of utilitarian and deontologic theories and offers specific action guidelines for practice. The care-based approach directs attention to the specific situation of individual clients viewed within the context of their life narratives. The formal study of ethical issues that arise in the practice of nursing describes nursing ethics.

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? Convince the family to choose a specific course of action. Assist in decision making based on the client's best interests. Decide the care for a client who is unable to voice an opinion. Present options about the type of care.

Assist in decision making based on the client's best interests. One reason an ethics committee convenes is when a client is unable to make an end-of-life decision and the family cannot come to a consensus. In this case, the committee members are there to advocate for the best interest of the client and to promote shared decision making between the client (or surrogates, if the client is legally incapacitated) and the clinicians. The committee would not convince, decide, or present options about the type of care. This is not the role of an ethics committee.

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 Documenting in the chart a narrative note about the occurrence Telling the client that the medication will be given the following morning Administering the medication with the other evening medications

Filling out an occurrence report and notifying the healthcare provider Accountability means that when an error occurs, the nurse takes the proper actions to address it. In this instance, the nurse should fill out an occurrence form for follow-up and notify the provider, as the error may change outcomes in the client's condition. Administering the missed medications with the other evening medications may double up the dose or cause unexpected adverse effects with the other medications. Telling the client that the medication will be administered the following day is not acceptable, as the nurse is suggesting next actions without the provider's knowledge. Documenting in the chart in a narrative about the occurrence does not allow for the health care provider to be notified and aware of a change in the client's condition.

The nurse beginning practice would like to access the standards for ethical practice. Which organization should the nurse research for these standards? World Health Organization Department of Health Professions International Council of Nurses Canadian Hospital Association

International Council of Nurses The American Nurses Association Code of Ethics for Nurses is the main source of the ethical principles that nurses must follow, and this is developed by the International Council of Nurses. The Canadian Hospital Association has not developed standards of ethical practice. Individual state boards of nursing through the department of health professions have laws and regulations that guide practice but not ethical and moral principles. The World Health Organization is a large organization that does not determine ethical practice for nurses.

A nurse works in a nursing care facility that has a policy of regularly using restraints on clients that the nurse believes is unethical. However, the nurse feels obligated to follow the policy because of a fear of being fired. This is an example of which type of ethical situation? Conscientious objection Moralizing Ethical dilemma Moral distress

Moral distress Moral distress is when an individual, in this case the nurse, knows the right thing to do but feels unable to do it. An ethical dilemma is when one is faced with choosing between competing ethical options and not being certain of which is the best. 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/standards. Moralizing is to comment on a client's issues of right and wrong, typically with an unfounded air of superiority.

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 Clinical Paternalistic Client sovereignty

Shared 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.

A famous actor with bipolar disorder has been admitted in the mental health unit for treatment. A well known news outlet has offered the nurse several thousand dollars to provide information or a picture of the client. The nurse knows that it is their professional duty and legal responsibility to uphold privacy and confidentiality. For each of the behaviors exhibited by the nurse, click to specify whether the behavior upholds the principle of privacy or confidentiality. logging off the electronic health record after documenting assessment information obtaining the client's permission before allowing a student nurse to assist with care sharing client information only to the caregivers directly assigned to client care asking the client to sign a medical release form before providing information to the health insurance company keeping the door closed while conducting physical assessment

logging off the electronic health record after documenting assessment information -C obtaining the client's permission before allowing a student nurse to assist with care -P sharing client information only to the caregivers directly assigned to client care -C asking the client to sign a medical release form before providing information to the health insurance company -C keeping the door closed while conducting physical assessment -P Privacy requires the nurse to utilize client information appropriately; that is, limiting access to client information to activities that are only directly related to health care. Upholding privacy includes keeping the door closed while conducting physical assessment and obtaining the client's consent before allowing a student nurse to assist with care. Confidentiality involves protecting client health information from public disclosure. Client information should only be shared with health personnel directly involved in the client's care. This includes controlled access to electronic health records; therefore, the nurse should log off the electronic health record after documenting to avoid unauthorized access to the client's information. If client information needs to be divulged, the nurse should first obtain the client's written permission. An example of this is asking the client to sign a medical release form before providing information to the health insurance.