fundamentals-chp 6

Which statement by the nurse is an example of deception?

"This injection of procaine will feel like a little pinch."

Nursing practice consistent with the Code of Ethics for Nurses includes which actions? Select all that apply.

**Delivering culturally safe care **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

Which nursing actions best describe the use of the professional value of human dignity? Select all that apply.

A nurse provides privacy for an older adult client. A nurse plans individualized nursing care for clients. A nurse refuses to discuss a client with a curious friend. The nurse includes the client in developing the plan of care.

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

keeping promises and commitments made to others

fidelity

process that distributes benefits, risks, and costs fairly

justice

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.

Social Justice

upholding moral, legal, and humanistic principles

action-guiding theory of ethics that states that the rightness or wrongness of an action depends on the consequences of the action

utilitarian

organization of values ranked along a continuum of importance

value system:

set of beliefs that are meaningful in life and that influence relationships with others deals and beliefs held by an individual or group about what matters; as a standard to guide one's behavior.

values

process by which people come to understand their own values and value system

values clarification

Making Ethical Decisions

Gather data and assess the situation. Identify the ethical problem. Identify and weigh the alternatives. Implement the decision. Evaluate the decision.

approach to bioethics that directs attention to the specific situations of individual patients viewed within the context of their life narrative

care-based approach

principles that reflect the primary goals, values, and obligations of the profession

code of ethics

altruism

concern for the welfare and well-being of others

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

conscientious objection

ethical system in which actions are right or wrong independent of the consequences they produce

deontologic

self-determination; being independent and self-governing entails the ability to make a choice free from external constraints

autonomy

an approach to bioethics that offers specific action guides

principle-based approach

Which example best describes feminist ethics?

An approach critiquing existing patterns of oppression and domination in society

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

A nurse is providing care to a client with end-stage cancer. After weighing the alternatives, the client decides not to participate in a clinical trial offered and is requesting no further treatment. The nurse advocates for the client's decision based on the understanding that the client has the right to self-determination, interpreting the client's decision as reflecting which ethical principle?

Autonomy

Which statement best conveys the concept of ethical agency?

Ethical practice requires a skill set that must be conscientiously learned and nurtured. Explanation: 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.

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

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 obtains an order for a bed alarm for a confused client. This is an example of which ethical principle?

Paternalism

Examples of Ethical Problems

Paternalism Deception Privacy Confidentiality Allocation of scarce nursing resources Valid consent or refusal Conflicts concerning new technologies Unprofessional, incompetent, unethical, or illegal physician practice Unprofessional, incompetent, unethical, or illegal nurse practice Short staffing and whistle-blowing Beginning-of-life issues End-of-life issues

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

People Practice Profession Coworkers

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.

Paternalism

acting for clients without their consent to secure good or prevent harm.

integrity

acting in accordance with an appropriate code of ethics and accepted standards of practice based on the honesty of a nurse according to professional standards

the duty to do good and the active promotion of benevolent acts.

beneficence

Patient advocacy is:

central to the roles and identity

system dealing with standards of character and behavior related to what is right and wrong

ethics

A laissez-faire

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.

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.

Confidentiality involves

The nurse is reviewing charges to clients for surgical procedures and observes different charges dependent upon insurance status. The nurse immediately reports this bias in charges to the supervisor for action. What principle of bioethics is the nurse demonstrating?

Justice

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. Explanation: 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.

The nurse strives to uphold human dignity when providing care to clients. Which behaviors by the nurse would best exemplify this value? Select all that apply.

Protects the privacy of the client Maintains confidentiality Promotes universal health care Provides culturally competent care

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

protection and support of another's rights

advocacy

To practice ethically, the nurse should avoid:

allowing the nurse's own judgment to guide practice.

Values essential to the professional nurse

altruism, autonomy, human dignity, integrity, social justice

ethics that encompass all those perspectives that seek to understand human nature and behavior, the domain of social science, and the natural world

bioethics

situation that arises when attempted adherence to basic ethical principles results in two conflicting courses of action

ethical dilemma

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:

ethical distress. Explanation: 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.

bill of rights

exist for both patients and registered nurse

type of ethical approach that aims to critique existing patterns of oppression and domination in society, especially as these affect women and the poor

feminist ethics

ability to behave in an ethical way; to do the ethically right thing because it is the right thing to do

moral agency

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

developed capacity to respond well to morally distressing experiences and to emerge strong

moral resilience

like ethics, concerned with what constitutes right action; more informal and personal than the term ethics

morals

conducting procedures and interventions in a safe manner so that no harm is caused to the client.

nonmaleficence

a subset of bioethics; formal study of ethical issues that arise in the practice of nursing and of the analysis used by nurses to make ethical judgments

nursing ethics:

moral distress

occurs when the individual knows the right thing to do but organizational constraints make it difficult to take the right course of action

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.

privacy

human dignity

respect for the inherent worth and uniqueness of individuals and populations

human excellences; cultivated dispositions of character and conduct that motivate and enable us to be good human beings

virtues