Student Resource Multiple Choice Questions (Ch.1-12)

11. What is the main role of an ethics committee? a. Consultation b. Education c. Policy d. All of the above

ANS: D Correct D: Ethics committees offer suggestions but do not direct care decisions. Educating staff on ethical issues is a key responsibility. Changing technologies require the need for evolving policies and guidelines around everyday ethical issues, and the committee is the expert opinion on these matters.

T or F: 2. A code of ethics identifies disciplinary actions and resulting consequences for nurses who are investigated for misconduct.

ANS: F Correct: A professional body normally implements discipline and consequences.

How is consent for organ donation obtained in Canada? A. From an advance directive B. By consulting with the client's family C. From organ donor cards D. Consent is presumed, unless stated otherwise

B. Because organ donor cards have no legal value, the family must always be approached for consent.

What are the three branches of the Canadian government? A. Political, legal, and fiscal B. Judicial, executive, and legislative C. Judicial, civil, and political D. Democratic, economic, and fiscal

B. The courts make up the judicial branch. The executive branch is comprised of the Queen and her ministers. The legislative branch contains of Parliament and the provincial legislatures.

What is the primary source of law in Quebec? A. Statute law B. Jurisprudence C. The Civil Code D. Criminal law

C. The Civil Code of Quebec details many legal rules and principles, such as rules governing marriage, property, and corporate law.

T or F: In addition to having obligations to clients, nurses also have rights regarding what they can expect as professional.

T. Like all Canadians, nurses have rights under the Charter of Rights and Freedoms. Nurses must consider these rights in the context of their responsibilities and obligations to clients.

Which of the following is an example of malpractice? A. Ignoring the principles of asepsis when providing wound care B. Not stopping to assist at the scene of an accident C. Refusing to work overtime D. Practising without a valid nursing licence

A. Malpractice is the performance of an act in a way that does not conform to the recognized standard of care.

Canada's voluntary approach to organ donation, requiring expressed consent, is based on which of the following ethical principles? A. Beneficence B. Nomaleficence C. Justice D. Autonomy

A. Organ donation is an act of doing good and avoiding harm.

4. Which primary ethical nursing value is being followed by a nurse who respects the wishes of a patient to decline to receive information about her health condition? a. Promoting and respecting informed decision making b. Preserving dignity c. Being accountable d. Promoting health and well-being

ANS: A Correct A: Nurses promote autonomy and self-determination in patients, allowing them to make their own choices.

6. Which of the following rationales explains the development of the ethical endeavours section of the CNA Code of Ethics? a. Nurses are expanding their advocacy role. b. Canadians have become more diverse and have different health care needs. c. Nurses work with more "English as a second language" clients. d. Health resources are increasingly scarce.

ANS: B Correct B: Canadians have become more diverse and have different health care needs. Nurses today work with the homeless, within the military, and with new immigrants to Canada. Increased numbers of immigrants, for instance, are at risk of deteriorating health as part of the transition to living in Canadian society.

12. Who of the following is likely to be a member of a hospital ethics committee? a. Funeral director b. Chaplain c. Community activist d. Palliative care volunteer

ANS: B Correct B: Chaplains are often part of an ethics committee. The committee is usually made up of professional staff with a certain level of experience in and knowledge of ethical issues.

2. Which of the following is true of the Canadian Nurses Association's Code of Ethics for Registered Nurses? a. It offers suggestions on resolving routine practice issues. b. It contains a dispute resolution mechanism. c. It offers a framework and guide for ethical practice. d. It is closely aligned with the physician's code of ethics.

ANS: C Correct C: The Code contains nursing values and ethical responsibilities, as well as ethical endeavours, all of which guide and frame ethical reflection and decision making in nursing practice.

7. Which of the following statements best describes the intended result of the ethical decision-making process? a. There must only be one possible outcome. b. There must be several equally acceptable options. c. The goal is to discuss options, not decisions. d. More than one proposed intervention may be ethical.

ANS: D Correct D: More than one proposed intervention may be ethical and reflective of good ethical practice.

8. Which of the following is being used by an interdisciplinary team that implements and evaluates a plan of action after considering key players, clarifying values, and exploring alternatives? a. A code of ethics b. An ethics committee c. Practice standards d. An ethical decision-making model

ANS: D Correct D: The process described is standard in ethical decision-making models.

Which of the following was a focus of codes of ethics during earlier nursing times? a. Professional standards b. Practice standards c. The scope of practice standards d. The virtue and morality of nurses

ANS: D Correct D: The virtue, character, and morality of nurses were the focus of early nursing codes of ethics, in addition to key principles that guided nursing practice.

On which of the following occasions might a nurse experience moral distress? a. He is asked to remain at work for four additional hours after the end of his shift in order to help his colleagues b. He makes a medication error c. His terminally ill patient asks him to help end her life d. A patient's family member files a complaint against him

c. The nurse may agree with the value that the patient has a right to choose to die, but the law does not support this belief.

Under what circumstances can a health care professional proceed with treatment without consent? A. In an emergency, with no advance directives or proxy available B. When the family instructs the team to continue treating C. When the family cannot reach consensus on a treatment plan D. When the benefits of treatment outweigh the risks

A. An individual has a right to informed consent. Family members cannot make decisions if the client is competent. If there is no available advance directive or proxy to consent to care, the health care professional has to do what she judges to be in the client's best interests, based on the information that she has at that time.

Which areas of law are governed by civil law? A. Property, family, tort, and negligence B. Assault and burglary C. Business fraud and treason D. Tax evasion and insurance fraud

A. Civil law deals with these and other areas, such as contracts and copyrights.

When will a hospital ethics committee become involved in the care of a patient? A. When there is a difference of opinion between the family and the treating team regarding the plan of care B. When the client is a high profile media personality C. When the client is a staff member D. During strike action by nurses

A. Ethics committees exist to provide education, guidelines, advice, and support in dealing with complex ethical issues.

A conscious 17-year-old client refuses a blood transfusion. Can the medical team proceed if it is in the client's best interest? A. Only if a court decides that the client is not competent B. Yes; the client is below the age of majority C. Yes; the parents can provide written consent D. Only if a court decides that it is in the client's best interest

A. Even if the medical team disagrees with the client, they are required to respect the decision of a competent individual.

The care of a dying child presents many ethical issues. Which of the following is a societal belief that might affect decision making? A. Parents expect to die before their child B. Children do not experience pain in the same way as adults C. Children can make their own health care decisions D. All life is worth living

A. In our culture, the expectation is that children will outlive their parents. This may result in making decisions that attempt to prevent the child from dying at all costs.

Why do professional bodies require a code of ethics? A. Because they serve society as a whole B. Ethical considerations only affect professional people C. The law does not protect the rights of the individual D. University programs require the study of ethics

A. Many professional groups (such as nurses, engineers, and teachers) serve the public, and therefore require guidelines to ensure the ethical practice of their members.

A colleague arrives at work smelling of alcohol and slurring her speech. What should the nurse's action be? A. Inform his supervisor and reassign patients B. Have her lie down for a couple of hours so that she is fit to care for patients C. Inform the police and have her escorted from the building D. Ignore the issue, and offer to administer her medications during the shift

A. Most provincial statutes state that professionals have a duty to report if a colleague is practising under the influence of drugs and alcohol. In addition, nurses have a duty to protect their patients from harm.

Which of the following obligations do nurses have in relation to clients' health information? A. Confidentiality B. Disclosure to family members C. Faxing of records to other institutions D. Legibility of writing

A. Nurses have both a legal and ethical obligation to maintain the confidentiality of patient records.

For a nurse to be subject to criminal proceedings, which of the following must have allegedly taken place? A. The nurse committed an offence under the Criminal Code of Canada B. The nurse provided substandard care C. The nurse did not pay his fees D. The nurse was guilty of professional misconduct

A. Only alleged criminal acts can be subject to criminal proceedings.

What regulatory role does the Canadian Nurses Association have? A. None B. Outlining educational guidelines for entry to practise C. Initiating inquiry procedures for alleged nurse incompetence D. Providing political influence in health care policy

A. The Canadian Nurses Association promotes and supports nurse regulations in each province or territory, but does not have a regulatory function of its own.

If litigation takes place, on what standard will a nurse be judged? A. The standard of a reasonably competent nurse B. The standard of knowledge of a layperson C. The standard outlined by the Canadian Nurses Association D. The standard accepted by the school that the nurse graduated from

A. The nurse will be judged according to the standard of normal competencies that a professional of his experience and area of employment is expected to uphold. This might vary from institution to institution.

Nurses have which of the following rights, under the Canadian Charter of Rights and Freedoms? A. Privacy, respect, and freedom of expression B. The right to persuade families to change a treatment plan C. Access to any inpatient file in their facility D. The right to refuse to care for certain groups of patients

A. These are fundamental rights for everyone in Canada.

T or F: Ethical principles inform only modern codes of ethics.

ANS. F. Correct: Ethical principles have been documented as far back as 1780 B.C. and form the basis of both historical and modern codes of ethics.

9. Which of the following best describes the goals of an ethics committee? a. To provide a single view toward the outcome of an ethical issue b. To present various views or "lenses" on the issues c. To develop standards of practice for nurses d. To ensure that comfort is achieved

ANS: B Correct B: Ethics committees present various views of or "lenses" on the issues, and there can be more than one alternative outcome.

3. Which primary value from the CNA Code of Ethics is being followed by a nurse who intervenes to address an unsafe nursing practice? a. Being accountable b. Providing safe, compassionate, competent, and ethical care c. Promoting justice d. Promoting health and well-being

ANS: B Correct B: Nurses question and intervene to address unsafe, noncompassionate, unethical, or incompetent practice or conditions that interfere with their ability to provide safe, compassionate, competent, and ethical care.

5. Which of the following statements best describes the "ethical responsibilities" in the CNA Code of Ethics? a. Ethical responsibility deals with ethical endeavours. b. Nurses' ethical responsibilities are informed by seven primary values. c. Social justice must be addressed consistently. d. Primary nursing values outline caring responsibilities.

ANS: B Correct B: The seven primary values in Part I of the Code inform nurses' ethical responsibilities, which help guide nurses' decision making.

10. Which of the following is a nurse demonstrating if he takes an unresolved ethical situation forward to an ethics committee? a. Nonmaleficence b. Beneficence c. Accountability d. Promoting justice

ANS: C Correct C: Being accountable is one of the primary nursing values in the CNA Code of Ethics. This nurse is demonstrating responsibility and accountability.

Which of the following is an example of professional misconduct? A. Following verbal physician orders B. Failing to meet a standard of practice for the nursing profession C. Holding two or more simultaneous positions of employment D. Contesting a physician's decision regarding a patient

B. All nurses are expected to deliver care to a minimum standard. The basis for this standard comes from both professional bodies and current literature.

Which of the following terms describes an individual touching another, without consent? A. Assault B. Battery C. Intention to harm D. Assumed implied consent

B. Canadian law supports an individual's right to determine the course of their lives and privacy.

Why is it detrimental to make late entries in nursing documentation look contemporaneous? A. The nurse might make a mistake in his entry B. The accuracy of the documentation will be called into question C. The timeline of the documentation will be altered D. The documentation of other health care professionals will not be compatible with that of nurses

B. Ideally, all charting should be contemporaneous. In an instance where a nurse is charting several hours after an event, he should indicate that this is the case. It will explain any possible deviations in the timeline that might otherwise look like falsified records.

How can a decision made by the Supreme Court of Canada be overturned? A. By petition from the provincial appeal court B. By a change of law in Parliament C. By request from the Governor General D. By appointing a new judge

B. In Canada, a change of law in Parliament or an amendment to the Constitution is the only way for a Supreme Court decision to be changed.

What is contributory negligence? A. The negligence of a professional against a plaintiff B. The extent to which a plaintiff is responsible for damage or harm C. The extent to which a third party has caused damage D. The negligence of an institution toward an individual

B. In common law provinces, a defendant's award will be reduced by the amount that he or she is deemed to have contributed to the damage by his or her behaviour (e.g., a defendant may only receive partial damages when she is knocked off her bicycle, if at the time she was crossing a red light).

Which of the following treatments or procedures is an example of "rationing" in health care? a. Vaccinations b. Organ donation c. Prenatal care d. Open heart surgery

B. Organ donation requires the allocation of a limited amount of donor organs to those recipients that will benefit the most, rather than to everyone who requires an organ.

What is the primary purpose of the governing bodies of the nursing profession? A. Monitoring nurse education B. Promoting the welfare of the public C. Contributing to federal drug legislation D. Acting as legal counsel for nurses

B. Regulatory bodies for all health professions protect the public from incompetent or unethical practitioners.

Why should nurses study ethics? A. It is a requirement of the nursing registration body B. They need a basis from which to make decisions and be accountable C. It means that they can bypass the law if a decision they make has an ethical basis D. They are able to have more comprehensive discussions with client families

B. Studying ethics enables the nurse to justify her positions and decision-making processes, and allows her to participate in team discussions when trying to reach a consensus about a patient's care.

What conflict exists for a nurse who hears about the poor practice of a colleague from a patient? A. Loyalty to his colleague versus the need to protect the public B. His duty to report professional misconduct versus patient confidentiality C. Patient confidentiality versus his colleague's right to be presumed innocent D. Loss of promotion opportunities versus patient safety

B. The conversation between the nurse and client is protected by confidentiality. However, the nurse can be exempted if there is potential for harm, and if he restricts his disclosure of the conversation to only relevant facts.

What is the goal of palliation? A. Prolonging life B. Promoting a quality dying process and dignified death C. Controlling pain D. Hastening the end of life

B. The goal of palliation is to allow the client a dignified death by offering adequate symptom management, as well as emotional and psychological support.

What important factor must be taken into account when someone grants "power of attorney" to another individual? A. The relationship of the individual to the grantor B. The capacity of the grantor at the creation of the document C. The witnessing of the documentation D. The financial benefit to the attorney taking on this responsibility

B. The grantor must be competent at the time of deciding who will hold the power of attorney.

What is an examination for discovery? A. Disclosure of the jury list B. Disclosure of relevant evidence by both parties in a lawsuit C. Cross-examination of a key witness D. Disclosure of all of the defendant's relevant documents

B. This eliminates the element of surprise in litigation, and hopefully reduces the amount of time spent in trial.

What is euthanasia? A. A form of assisted suicide B. An act that results in the immediate death of a terminally ill patient C. A clause in an advance directive D. A legal option in palliation

B. This is an illegal act in Canada, and has sometimes been referred to as "mercy killing".

Why is it advantageous for nurses to have knowledge of ethical theories and principles? a. it encourages nurses to critique others' points of view b. it allows nurses to justify and defend their positions on a situation c. it allows nurses to use rhetoric to convince an interdisciplinary team d. it allows nurses to convince patients to choose comfort measures only

B. it is appropriate for nurses to justify and defend positions on an ethical patient situation. often the nurse knows the patient best and has relevant information to contribute to the decision-making process.

Why do nurses need to have an understanding of ethics? a. nurses do not share the same perspectives of health care with other health care professionals b. morality and care are at the heart of nursing practice c. ethics enables nurses to choose the correct course of action d. convincing family members of compassionate courses of action is best done by nurses

B. nurses study ethics because morality and care are at the heart of nursing practice

What is proxy consent to treatment? A. A decision made by the medical team to treat in the best interest of the client B. The written consent to treatment signed by the client C. Consent given by a third party designated by the client D. A decision made by the court to treat the client

C. A proxy is ideally delegated the task of providing consent in instances when the client can predict deteoriation of competence. Parents are proxy decision makers for children.

What is the purpose of an enacted legal definition of nursing? A. It allows greater access to the profession B. It enables allied health professionals to perform nursing tasks C. It draws a distinction between nursing and other professional practices D. It holds nurses more accountable for their actions

C. An enacted legal definition describes the nature and scope of nursing in a province or territory, and will aid the courts in interpreting statutes related to health care delivery issues.

What is statute law? A. A set of rules developed by a professional association of lawyers B. Unwritten laws based on doctrine C. A set of written rules passed by a parliament or regulatory body D. Law that is described in the civil code

C. An example of statute law is Ontario's Regulated Health Professions Act (1991).

Which of the following situations is most professionally challenging for a nurse when making ethical decisions? A. His workload is too heavy to allow adequate care to be given B. Lack of experience means that he is swayed by the opinions of more senior colleagues C. Multiple accountabilities to the client, family, colleagues, and the law may be in conflict D. His knowledge of hospital policy is not adequate

C. An option that may be deemed ethical by a nurse and his client's family may not be supported by the law and his professional nursing body, so the course of action to take is unclear.

If a nurse suspects that her client did not give informed consent, what is her responsibility? A. Repeat the information to the client B. Ignore her suspicion, as it is not her responsibility to obtain consent C. Contact the physician in charge of care to discuss the information with the client again D. Contact the family of the client, to express her concern

C. As a patient advocate, it is the nurse's duty to ensure that the client has all of the necessary information and/or competence needed to give informed consent.

How is "battery" defined? A. A non-intentional tort B. A legal act of self defence C. Intentional interference or contact with a nonconsenting other D. Unintentional interference or contact with a nonconsenting other

C. Battery is defined in common law as the intentional bringing about of a harmful or offensive and nonconsensual contact upon another.

Regulatory bodies develop nursing standards to reflect the values of the nursing profession. What other purpose do nursing standards have? A. Offer a framework for education programs B. Create a professional identity C. Hold nurses accountable to deliver safe, competent care D. Ensure equal access to care for all clients

C. By ensuring a basic standard of nursing care, regulatory bodies protect the public from incompetent care.

In which of the following areas do clinical ethicists have a role in health care? A. Hiring and disciplining health care personnel B. Purchasing and choosing new equipment C. Consulting with professionals and educating families D. Developing and maintaining adequate record keeping systems

C. Clinical ethicists act as a resource for both families and professionals in dealing with complex care issues.

Which of the following nursing functions requires that nurses have knowledge of current legislation? A. Establishing intravenous access B. Recording a nursing history C. Administering narcotics D. Accessing patient information from charts

C. Dispensation, handling, and use of narcotics are governed by provincial and federal law.

How is the concept of due process best described? A. The process by which legislation is passed B. The payment of fines in a timely manner C. A feature of justice that ensures fair treatment for all D. A feature of the civil code

C. Due process comes from the concept of natural justice, and is protected under Canada's Charter of Rights and Freedoms.

What is expressed consent? A. The decision to withdraw from a treatment facility B. An agreement made with the treating team prior to the commencement of treatment C. A clear statement of consent D. The removal of clothing for an examination

C. Expressed consent is verbal or written consent to treatment or care.

Emphasis on patient safety has promoted which of the following evolutions in nursing culture? A. Increasing the use of restraints B. Ensuring that side rails on all beds are in the upright position C. Being obliged to disclose any harm that may have occurred to patients and families D. Expanding the number of medications that are checked by more than one nurse before administration

C. In an effort to look at all factors involved in an incident when harm occurs, recognition of the role of systems versus the role of the individual promotes a culture of blamelessness and understanding.

Which of the following factors is known to contribute to low organ donation rates? A. Religious beliefs B. Disagreement between family members C. Reluctance of health care professionals to approach this subject with families D. Restrictive definitions of death

C. In countries where there is presumed consent for organ donation (everyone is a donor unless otherwise specified), after an initial increase in donations, a levelling off was noted. This was attributed to the ongoing reluctance of health care professionals to approach grieving families.

Why is nursing documentation so important? A. It is an expected standard of care B. Families and clients need to be able to read nursing notes C. It is the only written evidence of the care a patient has received D. It allows nurses to reflect on their day

C. In court, documentation will be submitted as evidence of what occurred during the patient's care.

If there is concern about a nurse's mental capacity to practise, which of the following actions can a regulatory body take? A. Conduct informal interviews with the nurse's colleagues B. None C. Suspend the nurse's licence, pending her agreement to an examination D. Access the nurse's medical records

C. In order to fulfill the role of protection of the public, the regulatory body must verify the ability of the nurse to safely practise if sufficient evidence has been presented to suggest otherwise.

How is assisted suicide legally defined? A. Mercy killing B. An act that results in the immediate death of a terminally ill patient C. Aiding a physically incapable person in taking his or her own life D. The withdrawal of life-supporting therapies

C. Suicide is the act of taking one's own life. Assisted suicide occurs when an individual lacks the means or physical capacity to perform the act, and enlists the assistance of another to do so.

Which of the following factors has contributed to growth in the field of ethics in recent years? A. Worldwide population growth B. Declining participation in organized religion C. Growing sophistication in science and technology D. Worldwide nursing shortages

C. The capacity to manipulate the time of birth and death raises fundamental ethical dilemmas about what is morally acceptable to society.

Which of the following is an example of implied consent? A. The client withdraws his arm when the nurse is going to give an injection B. The client signs the surgical consent form C. The client offers his arm to have his blood pressure taken D. The client discharges herself from the hospital

C. The client's action of moving his arm towards the nurse to have his blood pressure taken implies that he is consenting to this intervention.

Which of the following represents a dilemma with conflicting ethical and legal issues? A. The distribution of hospital foundation funds within the hospital B. The diversion of patients to hospitals outside of the province C. The wish of a terminally ill patient to end of his life D. The withdrawal of ventilation from a person who has been declared brain dead

C. The patient and the nurse may believe that ending the suffering of the patient is ethically and morally right. However, the law does not allow interventions that actively end another individual's life.

When must a nurse be informed of a complaint lodged against her by her provincial or territorial association? A. After the submission of all relevant documents by the complainant B. After an interview with the nurse's direct supervisor C. Immediately on receipt of the complaint D. Prior to the final decision of the investigating committee

C. The right of immediate notification of complaints is protected by statute, and ensures due process for the defendant.

The draft version of a proposed law is known as which of the following? A. A code B. A statute C. A charter D. A bill

D. A bill is first introduced into the legislature in order to be given a formal reading, and if it passes this stage, it will be open for public debate and study (second reading). Eventually, if it passes a third reading and vote, it will be submitted to the Senate to go through this process again. If it passes in the Senate, it will be submitted to the Governor General, who will give royal assent in order for the bill to become law.

Your client is undergoing a urinary catheterization. The catheter does not pass easily, and the client asks you to stop. What is this an example of? A. Reduced competence B. Informed consent C. Implied consent D. Withdrawal of consent

D. A client may have given implied or expressed consent, but may then decide to withdraw that consent at a later time.

What is a non-intentional tort? A. A premeditated crime B. An act of goodwill C. An action resulting in no permanent harm to the victim D. A decision by a nurse to double a dose of medication

D. A non-intentional tort is a civil wrong committed by an individual causing unintentional injury or damage to a person or property (e.g., by the negligence of an individual).

What is a common source of moral distress for nurses when caring for terminally ill children? A. The challenge of dealing with grieving families B. The provision of inadequate pain relief C. The inability of children to understand what is going on D. The aggressive treatments given to dying children

D. Caring for dying children is always emotionally challenging. Often, children are not competent to make decisions regarding treatment, and it is difficult for professionals and families to accept the end of a child's life. This can result in aggressive treatment being given that may have been withdrawn if the client had been an adult.

What is an advance directive? A. A legal will B. Instructions for funeral arrangements C. A directive for palliative care D. A document specifying a patient's instructions for care, should he or she become incompetent

D. Clients often express their wishes regarding their own care prior to becoming ill, through an advance directive (living will). Although not necessarily a legal document, it guides professionals and families in decisions regarding client care.

Which of the following issues represent two main areas of ethical debate in nursing practice? A. Access to patient files and documentation B. Family presence and filming in the birthing room C. Nursing assistants and nursing students participating in care D. Euthanasia and organ donation

D. Euthanasia and organ donation raise complex questions for practitioners that may conflict with their own beliefs about life and death.

Which of the following actions is appropriate for the nurse to take if her 15-year-old client refuses an injection? A. Call his parents and ask their decision B. Ask two colleagues to restrain him while she administers the injection C. Take no further action D. Document her client's wishes, explore the reasons for his decision, and ask for a consultation with the physician

D. If an adolescent is deemed competent by the practitioner, then he or she has the right to confidentiality (including parental knowledge) and the right to refuse treatment. The nurse has an obligation to ensure that the adolescent is aware of the ramifications of his or her decision.

How does legislation define individuals as being capable of consent? A. They have reached the age of majority B. They have literacy skills that allow them to read consent documents C. They have prior medical knowledge of the procedure they will undergo D. They understand the information about and the consequences of the procedure

D. In order to give informed consent, individuals have to understand the nature of a procedure, the consequences of having the procedure, and the possible complications of choosing not to have the procedure.

Informed consent is based on which of the following ethical principles? A. Integrity B. Beneficence C. Veracity D. Autonomy

D. Informed consent is based on the principle that an individual has the right to self-determination.

What is a breach of duty of care? A. Calling in sick on a frequent basis B. Falsifying nursing documentation after an unexpected death C. Refusing to care for a patient because appropriate protection is not available D. Neglecting to medicate a patient for pain in a timely manner

D. Nurses have a statute that imposes a duty of care for their patients. Poor practice, drug use, or medication errors all pose threats to the patients nurses care for.

Why is offering financial reward for organ donation problematic? A. Families might be tempted to turn against their religious beliefs B. There may be conflict about who receives the money C. It would place further financial strain on our health care system D. It adds a coercive element to consent

D. Offering payment for organs would remove the notion of altruism from the donation process, and may put pressure on economically disadvantaged clients.

The legal system of Quebec is principally based on which of the following systems of law? A. French common law B. English common law C. English civil law D. French civil law

D. Quebec was governed exclusively under French civil law until the end of the Seven Years' War, and is now governed by the Civil Code.

Why must nurses be familiar with the legal system? a. some nursing actions are governed by the law. b. nurses' decisions may not be supported by the law c. nurses are sometimes at risk for litigation d. all of the above

D. Reserved or controlled acts, and the administration of narcotics, are two examples of nursing actions governed by law. A nurse may think an action is "ethical" but it may not be supported by law. Nurses' decisions sometimes have untoward consequences, and errors or omissions may lead to negligence claims.

How do regulatory bodies promote the welfare of the public? A. By charging annual professional fees for registration B. By sharing registration records with the public C. By defending members involved in litigation D. By setting and enforcing practice standards

D. Setting professional standards of care protects the public from incompetent caregivers.

When is a nurse required to break confidentiality? A. When a client's next of kin asks for the diagnosis B. When the parents of a 16-year-old ask why their child spent the night in the emergency department C. When the press asks for an update on a trauma victim D. When a client or others may be harmed

D. The CNA's Code of Ethics for Registered Nurses states that confidentiality is fundamental to the nurse-client relationship, and may only be broken if the client will harm himself or others.

Which of the following is a guaranteed legal right under Canada's Charter of Rights and Freedoms? A. Detention without charge B. The requirement that no Parliament will continue for more than five years C. Free mobility between provinces D. Presumption of innocence

D. The presumption of innocence is a fundamental legal right guaranteed by the Charter (the provision that Parliament cannot run longer than five years is a democratic right; the ability to move freely within the country is a mobility right).

A nurse forgets to renew her nursing licence, and continues to work three months after her permit is expired. What charge could her nursing regulatory body bring? A. Late fees and an advance payment of next year's fees B. Professional incompetence C. No charge D. Professional misconduct

D. Under most provincial laws, practising without a licence constitutes professional misconduct.

T or F: the field of ethics is gaining prominence in part because of the growing sophistication of science and technology, which results in an increasing number of ethical dilemmas.

T. Recent advances in genetics adn reproductive biotechnologyh, for ex, have opened up an entirely new array of ethical dilemmas not previously known.

T or F: In order for society to hold nurses to a high standard of competence, restrictions are necessary on rights and privileges.

T. Some restrictions are necessary to keep up high standards. Education, collective bargaining, duties to patients and the legal system all contribute to organizing the collective rights and privileges of nurses as a professional group.

Which of the following ethical dilemmas are raised by the use of donor insemination? a. Confidentiality, screening, and disclosure b. Informed consent and child support payments c. Financial gain for the donor and anonymity d. The possibility of infectious disease and custody rights

a. Donor insemination is currently confidential, but this is problematic if the child should become sick when he or she is older. Screening the donor may have a profound impact on his ability to obtain insurance or employment, if he discovers that he carries a disease. Disclosure is another issue of concern; should a child have the right to know who his or her father is?

Which of the following ethical principles is the foundation of the nurse-patient relationship? a. Fidelity b. Beneficence c. Justice d. Autonomy

a. Fidelity is based on nurses' honesty with those entrusted to their care. It is illustrated by commitment to quality care (e.g., adequate pain control).

What is interdisciplinarity? a. The willingness and ability to work with other disciplines in care b. Believing that you and your fellow health care professionals each have a contribution to care c. Recognizing that all health care professionals have a contribution to care d. Feeling capable and confident in your own discipline

a. Intradisciplinarity is the belief that you and your fellow health care professionals each have a contribution to care. Multidisciplinarity is the recognition of the contribution of all disciplines. Unidisciplinarity is confidence and capability in your own discipline.

Who ultimately enforces legal rights? a. The state b. The Canadian Nurses Association c. The union's bargaining committee d. The civil courts

a. Legal rights are enforced by the coercive power of the state, which compels individuals to behave in certain ways.

What is the legal obligation of an employer to its employee with respect to the working environment? a. To provide safe working environments for its employees b. To provide parking with a reasonable distance from the hospital c. To provide a lawyer if a nurse is involved in a negligence claim d. To provide in-service education for ongoing support of the staff

a. Occupational Health and Safety regulations in all Canadian provinces and territories mandate that a safe working environment be provided.

Which of the following issues result from the aging population of Canada? a. Higher demand for health services b. Increased medication prices c. Decreased average retirement ages d. Increased nursing staff numbers

a. Older adults have more health needs than younger ones, so a proportionate increase in the number of older Canadians means a greater demand on our health care system.

Which of the following are nurses entitled to in their workplace, according to the Charter of Rights and Freedoms? a. Privacy, respect, and freedom of expression b. Three breaks in a twelve-hour shift c. A clean working environment and a place to rest during breaks d. A salary on the same scale as their colleagues in the rest of Canada

a. The Charter of Rights and Freedoms guarantees everyone the right to privacy, respect, and freedom of expression. Breaks, salary, and work environment issues are addressed by labour agreements in each province or territory.

Which of the following situations would require a nurse to break confidentiality? a. He examines a young child, and suspects abuse b. The parents of a 17-year-old client demand to know the results of her toxin screen c. A new mother discloses that her husband is not the father of her child d. The local press contact him to confirm the presence of a child in the hospital

a. The nurse has an obligation to report suspected child abuse in order to protect the child from harm.

Which of the following ethical principles apply when a nurse is required to give care in a situation that he finds ethically conflicting? a. Justice, beneficence, and nonmaleficence b. Autonomy, veracity, and fidelity c. Justice, autonomy, and veracity d. Beneficence, veracity, and fidelity

a. The patient has the right to be treated equitably, to be assisted in his or her time of need, and to be protected from harm.

Which of the following ethical issues is raised by the use of gestational surrogacy? a. The emotional impact on the surrogate mother b. The unavailability of surrogates c. The ability of infertile couples to have children via other methods d. The limited technology required for surrogacy

a. There are many ethical issues raised by surrogacy, including the emotional and physical well-being of the surrogate mother, the effect of surrogacy on her career, the potential health problems of the unborn child, and the possibility of financial coercion.

Which of the following is a well-known teleological theory? a. Utilitarianism b. Categorical imperative c. Relativism d. Hedonism

a. Utilitarianism, as popularized by Mills, proposes that an ethical choice is the one with the best consequences.

Which of the following has mandated that nurses are to have a basic understanding of the Canadian legal system? A. provincial and federal nursing bodies b. the supreme court of canada c. provincial nursing labour unions d. the drug and pharmacies regulation act, 1990

a. provincial and federal regulatory bodies, as well as the CNA"'s code of ethics have certain requirements related to nurses' knowledge and skill

What does a collective agreement refer to? a. A collaboration between families and health professionals b. The work contract that comes from collective bargaining negotiations c. An agreement between nurses to improve the work culture on a unit d. A collaboration between community agencies and hospitals to care for complex patients

b. A collective agreement is the contract under which nurses work.

Why is a moral organizational climate important? a. It allows the hospital to keep its status as a tertiary centre b. It ensures support for health care professionals dealing with complex ethical issues c. It improves chances of recruiting new staff d. It offers health care staff an opportunity to become culturally competent

b. A moral climate will support the ethical practice of nurses, and ensure that the needs of clients are met.

At what gestational age is a child generally thought to be viable? a. 20 weeks b. 26 weeks c. 18 weeks d. 23 weeks

b. An 18- to 20-week-old baby is not able to survive outside of the uterus. At 23 weeks, there is a very slim possibility of survival. At 26 weeks a child can survive, although its premature birth may result in sequelae.

How does the principle of beneficence versus nonmaleficence guide research? a. Participants must have informed consent b. The degree of risk should not outweigh the potential gain for humanity c. Drug companies cannot pay physicians to prescribe experimental drugs d. All consent forms must be written in the language of the participant

b. Beneficence versus nonmaleficence weighs risks versus benefits.

Which of the following are benefits of interprofessional practice (IPP)? a. Reduced wait times for appointments and surgeries b. Improved communication and cooperation between health care professionals c. Increased opportunity for collaborative research d. Improved retention of nursing staff

b. Interprofessional practice is an approach to care that involves communication between involved health care professionals and the patient, in order to achieve a common goal of solving health issues.

If an organization has a culture of patient safety, which of the following is required? a. A commitment to find the individual responsible for an adverse event b. A focus on system issues that are implicated in an adverse event c. The retention of a malpractice lawyer d. The input of family members in planning new construction in the hospital

b. It is known that adverse events come about as the result of not only human error, but also system failures (for example, a nurse administers the wrong medication, but the wrong medication had been supplied to her).

Which of the following theories was developed by the philosopher Kant? a. Utilitarianism b. Moral obligation c. Relativism d. Pluralistic utilitarianism

b. Kant's theory of moral obligation focuses on how we decide what is right.

Can a nurse tell her patient a new diagnosis? a. Never; giving a diagnosis as a cause of symptoms is a controlled act b. Sometimes; the nurse must have the specialty training required to permit her to perform delegated acts c. Always; diagnosis is part of the nurse's role d. Never; giving a diagnosis as a cause of symptoms is exclusively a physician's role

b. Many provinces have legislation that allows nurses who have had adequate education, and are functioning in an extended role (such as that of a nurse practitioner), to give diagnoses to patients.

Are moral rights enforced by law? a. Yes; they are supported by societal norms b. No; however, they are supported by societal norms c. No; however, they are supported by a code of ethics d. Yes; they are supported by the power of the state

b. Moral rights are supported by the ethical principles of autonomy, beneficence, and nonmaleficence. These principles are embedded in the Charter of Rights and Freedoms.

Why is trust essential to an ethical nurse?patient relationship? a. Nurses are often acting in place of a parent b. Nurses are in a position of power, as they are caring for people at their most vulnerable c. Nurses make decisions for patients while they are incompetent d. The CNA's Code of Ethics for Registered Nurses states that trust is required

b. Patients trust that nurses will take care of all of their needs in a competent manner. If trust does not exist, then the nurse cannot do her job, and the patient does not get the care that he needs.

What were some of the goals of the Human Genome Project? a. Gender selection, improved reproduction rates, and legislation of these processes b. Identification of genes, determination of base pair sequences, and establishment of a database c. Establishment of guidelines for embryo research and cloning d. Prevention of egg and sperm donation for financial gain

b. The Human Genome Project was launched in 1990 and completed in 2003. In addition, it also examined ethical, social, and legal consequences of new technology.

Which of the following is a negative effect of the overseas recruitment of nurses? a. Overseas nurses will have diverse experiences to share with the Canadian nursing community b. Migration of nurses will cause countries to face an even larger shortage c. Overseas nurses will send their money home to support their families d. Nursing education standards are different in each country

b. The migration of nurses, particularly in developing countries, causes an even greater nursing shortage problem. For this reason, the International Council of Nurses strongly discourages this practice.

A newly hired nurse finds the health care staff on his unit to be hostile and rude. No one responds to him when he asks for help. What is this behaviour an example of? a. Conflict of interest b. Peer-to-peer violence c. Professional malpractice d. Mentoring

b. This type of bullying behaviour, which ostracizes a staff member, is a form of peer-to-peer violence.

If a nurse believes that his assignment is unmanageable, what are his options? a. Refuse to continue his shift and go home b. Alert his supervisor and provide safe care to his patients c. Alert his union representative and the hospital administrator on call d. Inform his patients' families that they will need to participate in care

b. Under the "obey and grieve" rule, the nurse has both a duty to provide care and also to appropriately alert his supervisor about his concerns.

What does a nurse need to do to be able to give culturally competent care? a. Read extensively about different cultural beliefs b. Have basic knowledge of the cultural beliefs of all of the client groups he serves c. Explore values and cultural beliefs with his clients' families d. Meet with his facility's cultural liaison

c. A nurse cannot make assumptions about a client's beliefs based exclusively on cultural background. The nurse must talk with the client to gain an understanding about what is meaningful for him or her, for both care and family involvement.

Which of the following was the major issue addressed by the Nuremberg Code? a. Experimentation on human embryos b. Codes of ethics c. The principle of informed consent for research subjects d. The design of research programs

c. After the trials of Nazis accused of human experimentation at the end of the Second World War, the Nuremberg Code established laws to protect human subjects, who must be competent and able to voluntarily give informed consent.

Which of the following ethical issues is associated with the resuscitation of an infant of 23 weeks' gestational age? a. The disapproval of the health care team b. The risk of contracting an infection in the neonatal intensive care unit c. The high risk of severe impairment d. The parents' relationship with the health care team

c. Controversy surrounds these infants because many feel that resuscitation, and the resulting severe impairment that can follow, is actually a prolongation of the infant's death rather than a life-saving measure.

Which of the following ethical dilemmas is presented by genetic testing of the unborn? The family can choose whether or not to continue with the pregnancy Knowing the results allows the family to plan for the future The parents may be unable to obtain life insurance based on the results The family can choose to give birth in a centre that will have appropriate medical support

c. Genetic testing may reveal a disease carried by the parents that will alter their ability to obtain insurance or employment.

Which of the following is a necessary first step in resolving an ethical dilemma? a. Consulting with a lawyer b. Referring to the Canadian Nurses Association's Code of Ethics for Registered Nurses c. Obtaining all of the facts relating to the moral controversy d. Adhering to hospital policy

c. In order for an effective discussion to take place, all factors have to be considered.

What is in vitro fertilization? a. A fertilization method that guarantees multiple births b. A fertilization method that ensures conception of a child of a specific gender c. Fertilization that occurs outside the body d. Fertilization of a surrogate mother

c. In vitro fertilization is a technology that allows fertilization to occur outside the body, and the implantation of the embryo into a uterus.

If informed consent is not given for a procedure, what is the result? a. There is no consequence, as informed consent is not required by law b. A client may have a negative outcome from their procedure c. The professionals involved can have legal liability for negligence d. The professionals involved will be able to claim that the client was incompetent

c. Informed consent is the moral and legal right of every individual, based on the ethical principle of autonomy.

What is a core belief of family-centred care? a. It is appropriate only when the patient is a child b. It will reduce the workload of overburdened nurses c. It is essential to the treatment of illness, and supports a philosophical approach to care d. It should only be incorporated in noncritical care areas

c. It has been demonstrated that through the collaboration of families, patients, and professionals, better outcomes are achieved and patients are more satisfied with their care.

Which of the following elements can contribute to moral distress in a workplace? a. Low salary and outdated equipment b. Family participation and collaborative care c. Excessively rule-oriented environments and minimal support systems d. Diverse cultural backgrounds and experience levels among health care professionals

c. It has been identified that it is difficult to advocate for families and their needs in environments that are very rule-oriented. Additionally, if there is no one available to listen to concerns, health care professionals feel powerless to address or improve their situations.

What does distributive justice in an organization relate to? a. The fairness of job selection processes b. Organizational policy and procedure c. Outcomes related to allocation of resources d. Processes related to staff ability

c. Justice is an important element in ensuring trust in an organization. Distributive justice is the way that the organization divides its resources such as staff, salary, and benefits.

Which of the following is an effect of a healthy work environment? a. Increased absenteeism b. Increased early retirement c. Higher retention and recruitment d. Higher salary scales

c. Many studies have identified that healthy work environments reduce absenteeism, increase retention of staff, and increase the ability to attract new staff. This in turn improves patient outcomes.

How is an obligation defined? a. A duty to care for one's patient b. A duty to ensure freedom of speech c. A behaviour that an individual must perform or refrain from to permit the exercise of the rights of another d. A behaviour that is dictated by law to ensure an individual's safety

c. Obligations can be moral or legal, and ensure that our behaviour does not impinge on the rights of another.

What are stem cells? a. Cells that can be found under the epidermis of an adult b. Specialised cells used to assist in reproduction c. Unspecialised cells that can be induced to become cells with specialised function d. Cells removed from the brain stem of a fetus

c. Stem cells are undifferentiated cells that can be found in the human embryo and umbilical cord blood. In adults, stem cells are found in bone marrow (where they can become various blood cells) and in brain and muscle cells (where they are used to replace injured cells).

Which of the following is a nurse's required response when he has limited resources for giving care? a. Refuse to carry on with his shift until more nurses are brought in to help b. Enlist the support of family members to complain to hospital authorities c. Adjust his nursing priorities in order to minimize harm to patients d. Publicize the nursing shortage to the press

c. The CNA's Code of Ethics for Registered Nurses states that a nurse cannot refuse to care. The immediate response for the nurse in this case is to minimize harm to patients.

Which of the following is the major function of the Canadian Nurses Association? a. Proposing laws on safe patient-nurse ratios b. Recruiting new nurses c. Developing standards of education, practice, and ethical conduct d. Political lobbying on health care issues

c. The Canadian Nurses Association participates in political lobbying, proposal of laws, and innovations for recruitment. However, the CNA's main goal is to promote the quality practice of nurses across Canada, ensuring the best care for Canadians.

What is gestational surrogacy? a. The implantation of embryos after cryopreservation b. A pregnancy assisted by donor insemination c. The bearing of a child by an individual for another couple d. The donation of an embryo from one individual to another

c. The phrase commonly used to describe this approach is the use of a surrogate mother. The surrogate may actually be the biological mother, or she may carry an embryo that biologically belongs to the couple.

How is the principle of nonmaleficence best described? a. To protect the patient b. To maintain confidentiality of patient records c. To do no harm d. To ensure equality in society

c. The principle of nonmaleficence—"above all, do no harm"—is expressed in many professional codes, including the Hippocratic Oath.

Under which of the following circumstances can an individual be held in a hospital against their will? a. When it is deemed that it is in his best interests b. Never, since the hospital cannot impose on an individual's autonomy c. Under court order, when it is deemed that patient is a risk to himself and others d. When a child is deemed competent, but is still below the age of majority

c. The treating team must obtain a court order stating that either the individual is incompetent to make decisions, or that he poses a threat to himself or others (such as a patient who is actively suicidal).

Why is the use of stem cells controversial? a. They are obtained and stored by commercial laboratories b. They have the ability to regenerate tissue c. They can be obtained from umbilical cord blood d. They are most often obtained from fetal tissue

d. Controversy surrounds the use of fetal tissue, because it is obtained from elective abortions. In addition to the anti-abortion position, there is concern that women could be coerced into termination for the purposes of stem cell transplantation.

Why does feminist theory reject traditional ethical theory? a. Females are intrinsically ethical beings b. Traditional ethical theories don't address issues of wealth c. Traditional ethical theory is outdated d. Widely known ethical theories are based on a male perspective

d. Feminist theory is critical of traditional ethical theory because it has been developed by men and thus represents a male perspective.

On which ethical principle is informed consent based? a. Justice b. Veracity c. Fidelity d. Autonomy

d. Informed consent is based on an individual's right to make decisions about his or her own health care, with adequate information to make that decision.

Other than the aging population, what other factors have contributed to the increased demand for health care resources in Canada? a. Migration of people between provinces b. A change in the cultural diversity of the population c. An increase in the number of graduating nurses d. A greater number of people kept alive by advanced technology who previously would have died

d. Many populations (e.g., children with cardiac malformation, clients with cystic fibrosis) now live much longer lives because of new surgical techniques and medical advances. They will continue to need support for their health throughout their lives.

What are organizational ethics? a. The disciplining of health care staff who are not culturally competent b. The content of a workplace's mission statement c. Human resource policy d. Values that guide the standards influencing the perception of an organization

d. Organizational ethics define an organization and its role in society.

In the context of the client-health care professional relationship and patient safety, which of the following is an example of disclosure? a. The sharing of a fellow patient's diagnosis b. The sharing of a personal experience c. The sharing of a client's details to aid the police with their inquiries d. The process by which the health care professional tells a client of an adverse event that has affected him

d. Patients have a right to information about themselves, which includes any error that in their care that may have been made.

Which of the following obligations does the nurse have if she finds herself unexpectedly working with a client group that she is ethically conflicted with? a. She has no obligation to care for a client group that she has an ethical conflict with b. She is obliged to care for the clients and should not ask for a change in assignment c. She is obliged to immediately complain about the situation to her superior d. She is obliged to give competent care until alternative arrangements are made

d. Refusing to give care goes against her professional duty to care.

Does a nurse have an obligation to care for someone with a highly contagious disease? a. No; the nurse has a right to ask a colleague to take over care b. Yes; the nurse always has an obligation to give care c. No; the nurse has a right to refuse care d. Yes; the nurse is obligated to give care if protective clothing has been supplied

d. The CNA's Code of Ethics for Registered Nurses states that a nurse has a duty to provide care using appropriate safety precautions.

How is a right defined? a. An obligation to ensure the safety of caregivers b. A need to protect the safety of patients c. A law ensuring freedom of speech d. A claim or privilege to which one is justly entitled, morally or legally

d. The rights of an individual are defined in law or by the moral standard of the society that he or she lives in.

Which parties are involved in a collective agreement? a. Family representatives and health care professionals b. Hospital lawyers and health care professionals c. Community and hospital nurses d. Unions and employers

d. Unions and employers negotiate the collective agreement.