prepU Chapter 6: Values, Ethics, and Advocacy

Which of the following statements by the nurse is an example of deception?

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

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

stays with the client during his death as promised

A nurse completing admission paperwork asks the client about having an advanced directive. The client states, "I do not know, what is an advanced directive?" What is the nurse's best response?

"It is a written document that identifies a person's preferences regarding which medical interventions to use in the event of a terminal condition."

The client is a 40-year-old man admitted s/p repair of a femoral fracture. He discloses that he has a history of an addiction to painkillers and asks that the nurse assist him in adhering to his recovery from this addiction by not administering any narcotics. As the nurse reviews postoperative orders for the client, the nurse notes that his physician has ordered Codeine 30 mg p.o. q6 hours for pain. How does the nurse best approach this situation?

Asks the physician to remove this order from the client's chart.

A nurse volunteers to serve on the hospital ethics committee. Which of the following indicates that the nurse knows what the purpose of an ethics committee is?

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

A client age 46 years has been diagnosed with cancer. He has met with the oncologist and is now weighing his options to undergo chemotherapy or radiation as his treatment. This client is utilizing which ethical principle in making his decision?

Autonomy

A nurse who provides the information and support that clients and their families need to make the decision that is right for them is practicing what principle of bioethics?

Autonomy

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

Autonomy

Which ethical principle refers to the obligation to do good?

Beneficence

A nurse fails to communicate a change in the client's condition to the physician. Which element related to proving malpractice has been met?

Breach of duty

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

Evaluating

A client is scheduled to have an elective surgical procedure performed and cannot decide if he wants to do it or not. He asks the nurse to help him make the decision because he does not feel that he knows enough about the procedure. Which of the following is the best way for this nurse to advocate for this client?

Facilitate the client's decision by allowing him to verbalize his feelings and by providing information to help him assess his options.

A nurse on the oncology unit is caring for a client on hospice care. The client is weak and is resting. The client's daughter comes storming onto the unit and demands that the nurse do everything she can to treat her mother. This is an example of what type of values conflict?

Family conflict

A nursing student reports to the instructor that a medication due at 9 a.m. was omitted. Which of the following principles is the student demonstrating?

Integrity

In the delivery of care, the nurse acts in accordance with nursing standards and the code of ethics and reports a medication error that she has made. The nurse is most clearly demonstrating which professional value?

Integrity

A parent of a high school student age 17 years is allowing the child to make the decision on the college he will attend. When the child requests direction from the parent in making this decision, the parent responds by informing him that he will need to make this decision on his own. This is an example of which type of value transmission?

Laissez-faire

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

Limiting visitors due to client complaining of pain

A nursing faculty is discussing laissez-faire values with students. Which of the following is an example of those values?

Parents allowing a child to decide not to have an intravenous line inserted

A nurse is aware that the principle of autonomy is being applied in which situation?

The client has decided to stop chemotherapy treatments.

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.

A nurse arrives on the medical unit wearing large dangling earrings. This is an example of which type of conduct?

Unprofessional

A nurse shows client advocacy by:

offering a hospice consultation to a client who is terminally ill.

A nurse is driving on a back country road when a man flags the nurse down and yells that his wife is having a baby. As a registered nurse she is eager to help. The nurse recalls that she is covered under the Good Samaritan Law. This law states:

that the nurse's license is protected if she acts in a reasonable manner given the circumstances.

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

the promotion of the dignity and respect of clients as people

What is the term for the beliefs held by the individual about what matters?

values

Which of the following nursing situations is an example of the care-based approach to ethics? Select all that apply

• Holding the hand of a dying client • Providing a back rub to a client on bed rest • Involving the parent in the bed bath of a child

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

Which word is best described by the following: the protection and support of another's rights?

Advocacy

A nurse has completed four hours of his eight-hour shift on a medical-surgical unit when he receives a phone call from the nursing supervisor. The nursing supervisor informs him that he needs 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 he has been busy with his client assignment 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?

Allocation of scarce nursing resources

Which of the following best describes feminist ethics?

An approach critiquing existing patterns of oppression and domination in society

An elderly client falls out of bed after a nurse inadvertently left the side rails down. The nurse feels guilty and is upset about the incident. This is an example of which of the following types of ethical situations?

Distress

A nurse working on a critical care unit was informed by a client with multiple sclerosis that she did not wish to be resuscitated in the event of cardiac arrest. The client is no longer able to express her 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 what?

Ethical distress

A client rings the call bell to request pain medication. Upon performing the pain assessment, the nurse informs the client that she will return with the pain medication. The nurse's promise to return with the pain medication is an example of which principle of bioethic

Fidelity

The client is a 2-month-old infant extremely ill from HSV sepsis. Her mother and father have decided to stop additional medical intervention and allow the infant to pass away naturally. The mother does not want her relatives to know that they plan to stop pursuing aggressive medical treatment because it is against their family's religious beliefs to withdraw medical support. What does the nurse tell the client's mother?

Yes, it is her decision who to inform about the family's medical decision.

A nursing student is studying the principle of autonomy. Which example most accurately depicts this principle?

describing surgery to a client before the consent is signed

Nursing students in an ethics class have been asked to define "ethics." What would be the best definition of ethics?

The formal, systematic study of moral beliefs.

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

Care-based ethics

A nurse obtains an order for a bed alarm for a confused client. This is an example of which of the following ethical principles?

Paternalism

The client, age 2, is with his mother in clinic today. He continues to grab for the otoscope, then looks sheepishly toward his mother as she tells him "no". According to Kohlberg (1964), the client is in which stage of learning?

Preconventional

The nursing faculty is explaining value transmission. The example of a child receiving an exemplary report from school and being given money from the parents can be described as what type of behavior?

Rewarding

A nurse is caring for an older adult who has cancer and is experiencing complications requiring a revision of the plan of care. The nurse sits down with the client and the family and discusses their preferences while sharing her judgments based on her expertise. Which of the following types of health care decision making does this represent?

Shared decision making

A nurse uses the utilitarian action guiding theory when deciding how to handle the following ethical conflict: A 13-year old female patient with anorexia refuses to eat food despite the fact that she is slowly starving to death. The parents insist the nurse use a feeding tube to feed her. Which statement is an example of this theory in practice?

The nurse forces food via an eating tube because the end result is good in that it will save the patient's life

The nurse is managing the care of a terminally ill client whose spouse insists that all measures be continued. The nurse speaks to the spouse about obtaining a hospice consult. This is an example of "ethical

Valuing

A nurse needs to be aware of which professional values? Select all that apply.

• Altruism • Autonomy • Human dignity • Social Justice

Nurses have cited specific reasons for a decrease in the quality of nursing care. Select all that apply.

• Inadequate staffing • Decreased satisfaction

Students nurses need to know about the Code of Ethics for Nurses. The Code of Ethics includes a set of principles to follow. Identify the tenets of the Code of Ethics for Nurses. Select all that apply.

• The nurse maintains standards of personal conduct. • The nurse is active in developing a core of research based principles. • The nurse holds personal information as confidential.

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

• Trustworthiness • Humility • Compassion

A nursing faculty is presenting a lecture on ethics. The correct definition of ethical distress is:

knowing the correct action, but unable to perform due to constraints

A nurse pulls the curtains before changing the dressing of the surgical wound on the abdomen of a post-surgical client. What value is served?

Dignity

A client is brought to the emergency department by her son, who states, "I am unable to care for my mother anymore." The nurses identifies this son's ethical problem as being which of the following?

Distress

A nursing student learns to model behavior exemplified by the instructor. This is an example of?

Ethical conduct

A client rings the call bell to request pain medication. Upon performing the pain assessment, the nurse informs the client that she will return with the pain medication. The nurse's promise to return with the pain medication is an example of which principle of bioethics

Fidelity

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

lobbying for an expansion of Medicare eligibility and benefits