PrepU chapter 6 Values, Ethics, and Advocacy
A charge nurse is always careful to listen carefully to clients and to be respectful of their privacy and care needs. The nurse says, "I want the staff on this unit to see me interacting with clients in the manner I would like for them to interact with clients." The nurse is using which technique to guide value development of the staff? Responsible choice Modeling Moralizing Laissez-faire
Modeling
To practice ethically, the nurse should avoid: allowing an ethics committee to guide the nurse's practice. allowing the nurse's own personal judgment to guide practice. reviewing past cases before making decisions about practice. asking the client's family about their views on caring.
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 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.
While riding in the elevator, a nurse discusses the HIV-positive status of a client with other colleagues. The nurse's action reflects: false imprisonment. defamation of character. professional negligence. invasion of privacy.
invasion of privacy. Explanation: The nurse's action reflects an invasion of the client's privacy. Disclosing confidential information to an unauthorized third party subjects the nurse to liability for invasion of privacy, even if the information is true. Defamation of character includes false communication that results in injury to a person's reputation. Negligence is an act of omission or commission. Prevention of movement or unjustified retention of a person without consent may be false imprisonment.
A nurse is of the Catholic faith and votes pro-life. This nurse is considered to have: legal obligations. moral agency. ethics. personal values.
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.
Which are goals of nursing theory? (Select all that apply.) Provide knowledge and a rationale for client interventions Provide a rationale for appropriate nursing actions in a given situation Identify and define concepts that are important to nursing Increase the nursing body of knowledge Provide a definition for nursing
Provide knowledge and a rationale for client interventions Provide a rationale for appropriate nursing actions in a given situation Identify and define concepts that are important to nursing Increase the nursing body of knowledge Nursing theory does not provide a precise definition of nursing, but does direct nursing to a common goal.
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. altruism. justice. ad' vo* ko*` si
advocacy. Explanation: 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.
An older adult was just diagnosed with stage 4 pancreatic cancer. The client states, "I am so overwhelmed and I feel like everyone has already decided that I need to be put in hospice care." Complete the following sentence by choosing from the lists of options. The nurse upholds the principle of autonomy by
offering to answer questions the client may have about care and treatment options -providing the client with the information needed to obtain a second opinion
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. "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." "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 baby up for adoption." gonorrhea gá nờ ría ờ benh da lieu a contagious inflammation of the genital mucous membrane caused gocococcus
"I can't believe she is giving that precious baby up for adoption." "His gonorrhea test was positive. That's what he gets for sleeping around." "If that was my mother, I sure wouldn't make her a no-code. Being judgmental, as in the options about adoption, gonorrhea, and code-status, does not reflect the values desired in a nurse. Professional nurses do not assume that their personal values are more correct than those of their clients. Nurses are obligated, however, to provide health information such as recommending condom use and smoking cessation.
Which example best describes feminist ethics? 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 A combination of elements of utilitarian and deontologic theories that offer specific action guidelines for practice An approach critiquing existing patterns of oppression and domination in society
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? Decide the care for a client who is unable to voice an opinion. Assist in decision making based on the client's best interests. Convince the family to choose a specific course of action. 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 volunteers to serve on the hospital ethics committee. Which action should the nurse expect to take as a member of the ethics committee? Present options about the type of care. Assist in decision making based on the client's best interests. Decide the care for a client who is unable to voice an opinion. Convince the family to choose a specific course of action.
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.
Which example most accurately depicts the ethical principle of autonomy? 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 depict: mieu ta do* pi'kt
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.
What would be an example of the nurse practicing fidelity? The nurse: withholds information as requested. stays with a client during death as promised. provides continuity of care. regulates visitors.
stays with a client during death as promised. Explanation: 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.
The nursing student is describing moral values to another student. Which statement is correct? "Moral values give individuals some sense of what is right and wrong." "Moral values are assigned by one's religion." "Moral values place an emphasis on emotional attitudes." "Moral values determine one's beliefs about others."
"Moral values give individuals some sense of what is right and wrong." Explanation: Moral values give individuals the ability to identify correct behaviors and the ability to discern right from wrong.
Which clinical situation is addressed by the provisions of the Health Insurance Portability and Accountability Act (HIPAA)? A client wishes to appeal her insurance company's refusal to reimburse for a diagnostic test. A client has asked for a second opinion regarding treatment options for her diagnosis of ovarian cancer. A client who resides in Indiana has required hospitalization during a vacation in Hawaii. A client has asked a nurse if he can read the documentation that his physician wrote in his chart.
A client has asked a nurse if he can read the documentation that his physician wrote in his chart. Among the provisions of HIPAA are clients' rights to see and read their medical records. Negotiation with an insurance provider, the necessity of a second opinion, and out-of-state care are aspects of care that fall within the specific auspices of HIPAA.
A nurse practices the ethical principle of autonomy when providing nursing care for clients. Which nursing actions best describe the use of this value? Select all that apply. A nurse reads The Patient Care Partnership to a visually impaired client. A novice nurse seeks the help of a more experienced nurse to insert a catheter in a client. A nurse asks the surgeon to further explain details of a surgery to a client before obtaining informed consent. A nurse researches a new procedure that would benefit a client. A nurse stays past shift end to continue caring for a client in critical condition. A nurse keeps a promise to call a client's healthcare provider regarding pain relief.
A nurse reads The Patient Care Partnership to a visually impaired client. A nurse asks the surgeon to further explain details of a surgery to a client before obtaining informed consent. The professional value of autonomy is the right to self-determination. When the nurse reads The Patient Care Partnership to a visually impaired client, the nurse is demonstrating autonomy. A nurse asking the surgeon to further explain details of a surgery to a client before obtaining informed consent is another example of autonomy. Staying past the end of a shift and researching a new procedure demonstrate the ethical principle of beneficence. Keeping a promise to call a client's healthcare provider demonstrates the ethical principle of fidelity. Seeking the help of a more experienced nurse to insert a catheter in a client demonstrates the ethical principle of nonmaleficence.
Which of the following words is best described by the following: the protection and support of another's rights? a) Paternalism b) Advocacy c) Ethics d) Autonomy
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.
Which word is best described as protection and support of another's rights? Advocacy Ethics Autonomy Paternalism
Advocacy Explanation: 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.
Which example best describes feminist ethics? A combination of elements of utilitarian and deontologic theories that offer specific action guidelines for practice Attention directed 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 An approach critiquing existing patterns of oppression and domination in society
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.
Which ethical principle is related to the idea of self-determination? Beneficence Nonmaleficence Autonomy Confidentiality
Autonomy quyen tu chu Autonomy refers to self-rule, or self-determination; it respects the rights of clients or their surrogates to make healthcare decisions. Beneficence is the duty to do good and the active promotion of benevolent acts. Confidentiality is related to the concept of privacy. Nonmaleficence is the duty not to inflict harm, as well as to prevent and remove harm.
Which ethical principle refers to the obligation to do good? a) Nonmaleficence b) Veracity c) Fidelity d) Beneficence
Beneficence (action that promote good for others)
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 Deontology Utilitarianism Principle-based ethics
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.
Which traits are examples of virtues that can exemplify character and conduct as a professional nurse? Select all that apply. Compassion Deception Conflict Trustworthiness Humility
Compassion Trustworthiness 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 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? Nursing education principles Advanced practice licensure guidelines Ethical principles Legal responsibilities
Ethical principles 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. 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.
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 Values clarification Moralizing Paternalism
Feminist Explanation: 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 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? Fidelity Justice Nonmaleficence Autonomy
Fidelity Explanation: 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.
The nurse is caring for clients in a hospital setting. Which situations encountered by the nurse have a significant ethical component? Select all that apply.
Helping a client make end-of-life decisions Addressing a suspected breach in confidentiality Deciding how to reassign staff in light of budget cuts Deciding when to stop cardiopulmonary resuscitation (CPR) on a client in cardiac arrest There are four basic ethical principles that guide nursing practice: autonomy, nonmaleficence, beneficence, and justice. Many nurses add fidelity, veracity, accountability, privacy, and confidentiality to this list because they play a central role in the tradition of nursing (and medical) ethics and guide the behavior of health care professionals toward clients and their families. End-of-life and CPR decisions often involve the ethical principles of autonomy and nonmaleficence. Allocation of resources in light of budgetary constraints involves the ethical principle of justice. A breach in confidentiality involves the ethical principles of confidentiality and privacy. A nurse's choice of continuing education is not an ethical issue.
The nurse is counseling a woman who states: "I'm never going to find a husband; every time I start dating I end up getting hurt. I'm not even going to try anymore." This woman is in what stage of Carol Gilligan's theory of moral development? Level 2—goodness Level 1—selfishness Level 3—nonviolence
Level 1—selfishness This woman is in Level 1 of Gilligan's theory of moral development. In Level 1, the focus is on one's own needs. In Level 2, moral judgment is based on shared norms and expectations, and societal values are adopted. In Level 3, a changed understanding of self and a redefinition of morality allow reconciliation of selfishness and responsibility. Nonviolence (the injunction against hurting) governs all moral judgments and actions.
A nurse knows that the expression "Do not cause harm" refers to which ethical principle? Beneficence Nonmaleficence Fidelity Justice
Nonmaleficence Explanation: 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.
A nurse obtains an order for a bed alarm for a confused client. This is an example of which ethical principle? Paternalism Conflict Deception Confidentiality
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. Reference:
What is likely to have the greatest influence on an adolescent's formation of values during this developmental stage? School administration Awareness of other cultures Work Peers
Peers In adolescence, peer groups have a major influence on value formation. The attitudes, beliefs, and behaviors that grow out of peer group relationships are powerful. It is generally accepted that the influence of peers exceeds that of school administration, work life, or the awareness of other cultures during this developmental stage.
While administering a medication via a syringe, a client sharply moves and the nurse accidentally encounters a needlestick. What is the priority nursing action? Request counseling on the potential for infection. Document the injury. Report the needlestick to the nurse manager. Obtain the client's blood to be tested for HIV and HBV.
Report the needlestick to the nurse manager. Upon encountering a needlestick, the nurse's priority action is to report the injury. Other actions can take place after the injury has been reported.
A client continues to complain of pain despite receiving medication. The family states, "In our culture it is acceptable to complain out loud." What would be the best response by the nurse? Tell me more about your cultural beliefs. It is fine to complain out loud. Describe your home situation to me. The pain medication should have worked by now.
Tell me more about your cultural beliefs. Explanation: It is important for the nurse to learn about how culture affects the client's behavior. Asking the client to explain the client's cultural beliefs will help the nurse to use a care-based approach. Stating that the medication should have worked or stating that it is fine to complain out loud are not examples of a care-based approach. Also, describing the home situation would not be helpful in this instance.
What is the term for the beliefs held by the individual about what matters? Values Bioethics Ethics Morals
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.
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: paternalism. deception. ethical distress. confidentiality.
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.
According to the Health Insurance Portability and Accountability Act (HIPAA) passed in 1996, clients: need to obtain legal representation to update their health records. have the right to copy their health records. can be punished for violating guidelines. are required to obtain health record information through their insurance company.
have the right to copy their health records. HIPAA affords clients the right to see and copy their health records, update their health records, and get a list of disclosures that a health care institution has made for the purposes of treatment, payment, and health care operations. Clients have the right to request a restriction on certain uses or disclosures and choose how to receive this health information. HIPAA includes punishments for anyone caught violating client privacy, but these punishments are not directed at the client because HIPAA was implemented to protect the privacy of an individual's health information.
Ethical distress is: supporting the rights of a client during hospitalization. being aware of the principles of right and wrong. having trouble deciding which of two conflicting ethical principles to follow. 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 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? Modeling Laissez-faire Moralizing Responsible choice
laissez-faire This situation demonstrates laissez-faire value transmission, which is characterized by allowing the adolescent to explore values on his own 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 which is of high or low value 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.
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 Telling the client honest information about the client's medical condition and prognosis Avoiding treating the client so as to not do any additional harm Filing the paperwork for the client to receive retroactive health insurance
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 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 Deception Allocation of scarce nursing resources Advocacy in a market-driven environment
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 scenario is an example of the laissez-faire approach to value transmission? 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 teenagers, such as not smoking electronic cigarettes 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 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 teenagers good behavior. Telling the child about the injection feeling like a pinch is not an approach to value transmission.
To facilitate decision-making, the nurse makes use of the ethical principles as a guide. For each nursing intervention, click to specify whether the action upholds the ethical principle of beneficence, nonmalificence or autonomy. explanation The main premise behind the ethical principle of benificence is to do good for others. In nursing practice, doing good involves implementing interventions geared toward achievig optimum health and well-being. Examples include promoting comfort such as apllying ice pack to a swollen ankle and administering pain medications. The principle of nonmalificence is focused on avoiding or preventing harm. To prevent further decrease in the client's serum potassium level, the nurse puts furosemide, a nonpotassium sparing diuretic, on hold. Informing the heath care provider about a medication that is causing serious adverse effects such as suicidal ideations prevents additional harm to the client. Reporting an impaired nurse to the nurse supervisor avoids the possibility of inflicting injury to clients under the impaired nurse's care. Autonomy refers to the right to self-determination. Clients are entitled to make informed decisions about their health care without intimidation or influence. The client is entitled to have all relevant information provided to them in a language they understand while also respecting cultural diversity. By respecting the client's right to refuse the medication, the nurse demonstrates professional practice that reflects autonomy.
Benificence administering morphine sulfate for the client's abdominal pain applying an ice pack to the client's swollen ankle Nonmalifience putting the client's scheduled furosemide on hold because of hypokalemia informing the health care provider that the client's antipsychotic medications are causing suicidal ideations reporting an impaired nurse to the nurse supervisor Automony withholding a medication after the client has refused and notifying the health care provide providing information in the client's primary language to ensure the client's full understanding answering all of the client's questions about their care before obtaining consent to proceed
A nurse is administering evening medications and notices that a medication was omitted during the day shift. Which statement demonstrates the principle of accountability? Documenting in the chart a narrative note about the occurrence Telling the client that the medication will be given the following morning Filling out an occurrence report and notifying the healthcare provider Administering the medication with the other evening medications
Filling out an occurrence report and notifying the healthcare provider Explanation: 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.
A nurse reports to the charge nurse that a client medication due at 9 am was omitted. Which principle is the nurse demonstrating? Altruism Integrity Autonomy Social justice
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 reports to the charge nurse that a client medication due at 9 am was omitted. Which principle is the nurse demonstrating? Integrity Social justice Autonomy Altruism
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. Reference:
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? Altruism Human dignity Social justice Integrity
Integrity Explanation: 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.
The nurse is managing the care for a postoperative client. How does the nurse demonstrate advocacy? 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 Changing the channel on the television while providing care Limiting visitors due to the client reporting pain
Limiting visitors due to the client reporting pain Explanation: 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 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? Moral distress Ethical dilemma Moralizing Conscientious objection
Moral distress Moral distress Explanation: 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 obtains an order for a bed alarm for a confused client. This is an example of which ethical principle? Conflict Confidentiality Deception Paternalism
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 caring for older adults in a long-term care facility is teaching a novice nurse characteristic behaviors of older adults. Which statement is not considered ageism? Intelligence declines with age. Most older adults are ill and institutionalized. Personality is not changed by chronologic aging. Old age begins at age 65.
Personality is not changed by chronologic aging. geism is a form of prejudice, like racism, in which older adults are stereotyped by characteristics found in only a few members of their group. Fundamental to ageism is the view that older people are different and will remain different; therefore, they do not experience the same desires, needs, and concerns as other adults. The statement not considered ageism would be that personality is not changed by chronologic aging. Most older adults are not ill and institutionalized. Intelligence does not decline with age. Old age does not begin at age 65.
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.
Privacy keeping the door closed while conducting physical assessment obtaining the client's permission before allowing a student nurse to assist with care Confidentiality PrivacyConfidentialitysharing client information only to the caregivers directly assigned to client care logging off the electronic health record after documenting assessment information asking the client to sign a medical release form before providing information to the health insurance company
To ensure that a research study is ethical, a nurse researcher must observe which human rights for participants? Select all that apply. Self-determinism Privacy Anonymity Fair treatment Cure for illness
Self-determinism Privacy Anonymity Fair treatment The five rights outlined in 1985 by the ANA human rights guidelines (self-determinism, privacy and dignity, anonymity and confidentiality, fair treatment, and protection from discomfort and harm) apply to all people involved in research projects and continue to be the standard today. A cure for illness is not a right of research study participants.
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. A family member complained that the nurse was slow answering call lights. The nurse was unable to pass a required dosage calculation examination. The nurse often must stay after shift change to complete documentation.
The nurse was seen at a grocery store after calling in sick. Explanation: 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 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 from the postanesthesia care unit (PACU) transports a client in the elevator with a nurse from the intensive care unit (ICU). There are staff members and visitors in the elevator as well. Which response from the ICU nurse is appropriate when the PACU nurse begins the report? "You can just put the report on the foot of the bed and I will look at it when I get to the room." "Before you begin we need to ensure a family member is present." "Wait and give me a report in the room at the bedside." "I will look at the EHR when I get to the nurse's station."
Wait and give me a report in the room at the bedside." : It is appropriate for the ICU nurse to ask the PACU nurse to wait to give a report at the bedside. Discussing client information in the elevator with family or other workers violates client confidentiality and must be avoided. This also prevents discussions even in the presence of family members. If the report is left on the foot of the bed others may be able to see information. The electronic health record (EHR) is not the place to obtain transfer information so this would not be appropriate.
A parent teaches a child not to drink and drive; however, the parent does drink and drive. This action results in: insecurity and a lack of safety. conflict with society. a failure to model one's own values. a disruption in consistency.
a failure to model one's own values. Explanation: 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.
To practice ethically, the nurse should avoid: 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.
allowing the nurse's own personal judgment to guide practice. Explanation: 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.
