Chapter 6: Values, Ethics, and Advocacy

An older female client has just informed her family that she does not want to have surgery if the biopsy on a lung mass shows malignancy. Which statement(s), made by family members, violate the concept of feminist ethics?

"Daddy will want you to have the surgery." "Of course you would have the surgery." You need to do what the doctor thinks is best for you." "If it was me who was sick, you would want me to have the surgery."

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?

"The gonorrhea test was positive. That's what the client gets for sleeping around." "I can't believe the client is giving that precious baby 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."

Identify the activities a nurse uses in the process of valuing.

Acting Choosing Pricing

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?

Airlifting the client to a local trauma center for emergency surgery

A nurse is reviewing The International Council of Nurses (IN) Code of Ethics for Nurses. Based on this code, the nurse would identify which responsibilities as being fundamental?

Alleviating suffering Preventing illness Promoting health Restoring health

Which is the best definition of ethics?

The formal, systematic study of moral beliefs.

Which ethical principle is related to the idea of self-determination?

autonomy

A nurse is of the Catholic faith and votes pro-life. This nurse is considered to have:

personal values

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?

Allow the client to verbalize feelings, and provide information to help the client assess options.

Which example best describes feminist ethics?

An approach critiquing existing patterns of oppression and domination in society

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?

Assist in decision making based on the client's best interests.

Which ethical principle refers to the obligation to do good?

Beneficence

Which theory of ethics prioritizes the nurse's relationship with clients and the nurse's character in the practice of ethical nursing?

Care-based ethics

A nurse is most likely to experience ethical distress in which client situation?

Continuing intravenous fluids for a client who wants to die

Which nursing situation is an example of an ethical dilemma?

Deciding whether to perform cardiac compressions against a client's wishes

A nurse is involved in ethical decision-making. Place the steps in the order that the nurse will follow to achieve an ethical decision.

Describe the situation and factors associated with the ethical problem. Clarify that the issue is ethical in nature. Identify options and explore short- and long-term consequences. Make the decision. Determine the effectiveness of the decision and implications for the future.

Which example most accurately depicts the ethical principle of autonomy?

Describing a surgery to a client before the consent is signed

Six teenagers 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?

Drinking alcohol is a rite of passage. Big brothers often introduce their younger siblings to alcohol.

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 physician that they want the client to be resuscitated. Aware of the client's wishes, the nurse is involved in a situation that may involve:

Ethical distress

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?

Evaluating

A nurse is caring for a hospitalized client. Which nursing actions demonstrate a caring and compassionate attitude?

Explaining all nursing procedures clearly Offering snacks and beverages to visiting family Listening to the client tell stories about past experiences Notifying the client before leaving for lunch

The nurse is managing the care for a postoperative client. How does the nurse demonstrate advocacy?

Limiting visitors due to the client reporting pain

A nurse working in a critical care unit has experienced personal tragedy, extreme shortage of staff in the work environment, and health issues. The nurse has overcome much of these hardships and is now mentoring other nurses in similar situations. What behavior is this nurse demonstrating?

Moral resilience

A nurse knows that the expression "Do not cause harm" refers to which ethical principle?

Nonmaleficence

A nurse is caring for an alder adult who has cancer and is experiencing complicatians requiring a revision of the plan of care. The nurse sits down with the client and the family and discusses their preferences while sharing the nurse's own judgments based an the nurse's expertise Which type of healthtare decision making does this represent?

Shared decision making

Several nurses on the same hospital unit communicate on the same social networking site. A nurse posts the following statement to the social networking page, "The lady in room 34 with heart failure was a train wreck!" In which manner has the nurse failed to apply the principles of confidentiality?

Sharing information about a client beyond the area of client care is unacceptable and breaches the client's confidentiality rights.

Which action would cause a charge nurse to have concerns about a nurse's moral agency?

The nurse was seen at a grocery store after calling in sick.

Which is a characteristic of the care-based approach to bioethics?

The promotion of the dignity and respect of clients as people

Nurses who value client advocacy follow what guideline?

They give priority to the good of the individual client rather than to the good of society in general.

Which traits are examples of virtues that can exemplify character and conduct as a professional nurse?

Trustworthiness Humility Compassion

A parent teaches à 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

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:

advocacy

Which word is best described as protection and support of another's rights?

advocacy

To practice ethically, the nurse should avoid:

allowing the nurse's own judgment to guide practice.

A client diagnosed with cancer has met with the oncologist and is now weighing whether to undergo chemotherapy or radiation for treatment. This client is demonstrating which ethical principle in making this decision?

autonomy

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?

cultural

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

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?

feminist

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

integrity

Ethical distress is:

knowing the correct action but being unable to perform it due to constraints.

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?

laissez-faire

Which action most clearly demonstrates a nurse's commitment to social justice?

lobbying for an expansion of health care resources and benefits to those in poverty

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

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

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

What would be an example of the nurse practicing fidelity? The nurse:

stays with a client during death as promised.

Socialization into the nursing profession may have the most significant effect on:

values

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

values

A nurse is applying a care-based approach to an ethical dilemma. When integrating this approach, which concept should the nurse keep in mind?

Attention is needed to focus on each person's individual situation. Clients are people and are to be respected. The caring relationship is essential to the approach.

Which are professional values that the nurse should incorporate into practice?

Social Justice Autonomy Human dignity Altruism