Chapter 2 - Professional Ethics and Values

The ANA Code of Ethics with Interpractice Standards guides nurses in ethical behaviours. Provision 3 of the ANA code of Ethics says: "The nurse promotes, advocates for, and strives to protest the health, safety, and rights of the patient." Which of the following best describes an example of this provision? 1. Respecting the patient's privacy and confidentiality when caring for him 2. Serving on a committee that will improve the environment of patient care 3. Maintaining professional boundaries when working with a patient 4. Caring for oneself before trying to care for another person

Answer: 1 Rationales: 1. The ANA Code of Ethics is designed to guide nurses toward quality, ethical, care of patients. There may be times when it is difficutlt o discern the most ethical action, particularly when the lines are blurred as the correct decision. The Code of Ethics provides some guidance that nurses can follow as part of the profession of nursing to uphold standards of ethical care 2. Improving care environments is important but does not address the ANA code 3. Maintaining professional boundaries comes under professional behaviours 4. Caring for self is important; however it does not address quality and ethical care

A nurse is providing care to a patient whose family has previously brought suit against another hospital and two physicians. Under which ethical principle should the nurse practice? 1. Justice 2. Veracity 3. Autonomy 4. Nonmaleficence

Answer: 1 Rationales: 1. All patients are entitled to the best possible care regardless of their socioeconomic status, culture, or situations 2. Veracity refers to truthfulness 3. Autonomy is the right to make one's own decisions 4. Nonmaleficience means to do no harm

A nurse is working on an ethics committee to determine the best course of action for a patient who is dying. The nurse considers the positive and negative outcomes of the decision to assist with choices. Which best describes the distinction of using a list when making an ethical decision? 1. The nurse can back up her reasons for why she has decided to provide a certain type of care. 2. The nurse can compare the benefits of one choice over another 3. The nurse can communicate the best choice of action to the interdisciplinary team 4. The nurse can provide care based on developed policies and standards

Answer: 2 Rationales: 1. Although important to be able to support reasons, lists do not help with this 2. Creating a list of positives and negatives helps when difficult choices need to be made. The list outlines the positive and negative aspects of a decision. It allows the nurse to compare the benefits of making a choice versus the potential disadvantages. When compared side by side, it could help the nurse to make a difficult decision through an easier method 3. Communicating the choice occurs after the list is created 4. Providing care should always be based on policies and standards

A patient asks a nurse if he has to agree to the health provider's treatment plan. The nurse asks the patient about his concerns. Which ethical principle is the nurse applying in this situation? Select all that apply. 1. Beneficence 2. Autonomy 3. Veracity 4. Justice

Answer: 2 Rationales: 1. Beneficence is to do good 2. The principle of autonomy indicates that the client has independence to make decisions and take action for himself or herself. When the nurse asks the patient about his concerns, the nurse is exploring the reasons and allowing the patient to make his own decison 3. Veracity is to be truthful 4. Justice is to treat all patients equally

Which best describes the difference between patient privacy and patient confidentiality? 1. Confidentiality occurs between persons who are close, whereas privacy can affect anyone. 2. Privacy is the right to be free from intrusion into personal matters, whereas confidentiality is protection from sharing a person's information 3. Confidentiality involves the use of technology for protection, whereas privacy uses physical components of protection 4. Privacy involves protection from being watched, whereas confidentiality involves protection from verbal exchanges

Answer: 2 Rationales: 1. Confidentiality is an expectation of anyone who is under treatment 2. Privacy is the condition of being free from being observed or disturbed by other people. Confidentiality has to do with the sharing of someone else's information 3. Technology often causes breaches in confidentiality 4. Confidentiality goes beyond verbal exchanges; breaches can occur electronically or in writing

A nurse's significant other undergoes exploratory surgery at the hospital where the nurse is an employee. Which practice is most appropriate? 1. The nurse is an employee; therefore, access to the chart is permissible 2. Access to the chart requires a signed release form 3. The relationship with the client provides the nurse special access to the chart 4. The nurse can ask the surgeon to discuss the outcome of the surgery

Answer: 2 Rationales: 1. Being an employee does not give permission to access the chart 2. Unless the significant other has authorized any access to information, the only people entitled to information without written consent are the client and those providing direct care 3. The patient still needs to give consent 4. The surgeon cannot discuss the patient's health without consent from the patient

Health Insurance Portability and Accountability Act (HIPPA) regulations guard confidentiality. In several situations, confidentiality can be breached and information can be reported to other entities. Which of the following met these criteria? Select all that apply 1. The patient is from a correctional institution 2. The situation involves child abuse 3. An injury occurred from a firearm 4. The patient is a physcian 5. The breach of information was unintentional

Answer: 2, 3 Rationales: 1. The health information of incarcerated patients is still protected under the Health Insurance Portability and Accountability Act (HIPAA) 2. Although HIPPA provides protections for patient privacy, there are some cases in which health-care providers can disclose patient information to other providers and caregivers. These exceptions typically include care related to criminal acts, such as child or elder abuse, or when a patient is injured because of a firearm or some other weapon 3. Although HIPAA provides protections for patient privacy, there are some cases in which health-care providers can disclose patient information to other providers and caregivers. These exceptions typically include care related to criminal acts, such as child or elder abuse, or when a patient is injured because of a firearm or some other weapon 4. Individual occupations and vocations are protected 5. Any breach of information, intentional or unintentional, violates HIPAA

A nurse is caring for a patient who feels that life should not be prolonged when hope is gone. She has decided that she does not want extraordinary measures taken when her life is at its end. She has discussed her feelings with her family and health-care provider. The nurse realizes that this is an example of: 1. Affirming a value 2. Choosing a value 3. Prizing a value 4. Reflecting a value

Answer: 3 Rationales: 1. To affirm means to strongly state a fact, not indicating satisfaction with the choice 2. Choosing is to decide what is important 3. Prizing a value means being satisfied with a choice and being willing to declare the choice to others. The patient made her choice clear to her family and provider 4. Reflecting a value means considering it

5Several studies have shown that although care planning and advance directives are available to clients, only a minority actually complete them. Which of the following has been shown to be related to completing an advance directive? Select all that apply. 1. African American race 2. Younger age 3. History of chronic illness 4. Lower socioeconomic status 5. Higher education

Answer: 5 Rationales: People are more likely to complete advance directives about their care when they are informed and they understand the ramifications of doing so. Studies have shown that certain populations are more likely to follow through with completing advance directives when compared with others; these populations include those who have higher levels of socioeconomic status, those with higher levels of education, and people have already suffered from a chronic disease

Which of the following demonstrates a nurse as advocating for a patient? The nurse 1. calls a nursing supervisor in conflicting situations 2. reviews and understands the law as it applies to the client's clinical condition 3. documents all clinical changes in the medical record in a timely manner 4. assesses the client's point of view and prepares to articulate this point of view

Answers: 4 Rationales: 1. Calling the supervisor does not demonstrate speaking or advocating for the patient 2. Values and ethics are beliefs 3. Documenting clinical changes is important; however, this is not advocating 4. Nurses strengthen their ability to advocate for a client when nurses are able to identify personal values and then accurately identify the values of the client and articulate the client's point of view