chapter 6

what are three typical concerns of the nurse advocate

1. representing patients 2. promoting self-determination 3. politicism or whistle-blowing

4 a's that promote moral resilience

Ask (am I feeling distressed? where is that feeling coming from?) Affirm (make a commitment to address moral distress) Assess (identify sources of your distress) Act (preserve your integrity)

which word is best described as protection and support of another's rights a. paternalism b. ethics c. autonomy d. advocacy

d

this is an example of what ethical issue in nursing practice: a postoperative patient asks a student nurse, who is about to administer an intramuscular injection for pain, if this is his first injection. it is the student nurse's first injection and the student is anxious. would the student's intent to decrease the patient's anxiety justify lying to the patient?

deception

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

autonomy

principle of bioethics: respect the rights of patients or their surrogates to make health care decisions

autonomy

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? a. moralizing b. moral distress c. ethical dilemma d. conscientious objection

b

which statement by the nurse is an example of deception a. "it is important to get out of bed to prevent pneumonia" b. "this injection of procaine will feel like a little pinch" c. "I will administer your pain medication as soon as it is due" d. "I am going to teach you how to give yourself insulin"

b

which theory of ethics prioritizes the nurse's relationship with clients and character in the practice of ethical nursing? a. deontology b. care-based ethics c. utilitarianism d. principle-based ethics

b

principle of bioethics: benefit the patient, and balance benefits against risks and harms

beneficence

a nurse obtains an order for a bed alarm for a confused client. this is an example of which ethical principle? a. conflict b. deception c. confidentiality d. paternalism

d

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

principle of bioethics: keep promises

fidelity

principle of bioethics: act fairly

justice

value process: children are taught a complete value system by parents or an institution that allows little opportunity for them to weigh different values

moralizing

principle of bioethics: avoid causing harm

nonmaleficence

cost-containment issues that jeopardize patient welfare, beginning and end-of-life decisions, unethical practices of colleagues are all examples of which type of dilemma

nursing ethics

the formal study of ethical issues that arise in the practice of nursing and of the analysis used by nurses to make and evaluate ethical judgments

nursing ethics

this is an example of what ethical issue in nursing practice: an alert older resident in a long-term care facility is now at high risk for falls but refuses to call nurse for assistance when getting out of bed. should the nurse obtain an order to restrain the patient? does preventing potential harm justify that patient's right to autonomy and make it acceptable for the nurse to make this decision.

paternalism

which concern of nurse advocate is this: nurses are a powerful block of voters whose potential for influencing health care legislation is growing

politicism

which concern of nurse advocate is this: nurse as advocates must realize that they do not make ethical decisions for their patients. instead, they facilitate their patient's own decision making

promoting self-determination

value process: encourages children to explore competing values and to weigh their consequences; support and guidance are offered along the way

responsible choice

which example best describes feminist ethics? a. the formal study of ethical issues that arise in the practice of nursing b. a combination of elements of utilitarian and deontology theories that offer specific action guidelines for practice c. an approach critiquing existing patters of oppression and domination in society d. attention directed to the specific situation of individual clients viewed within the context of their life narratives

c

which nursing actions best describe the use of the professional value of human dignity? select all that apply a. a nurse reports an error made by an incompetent coworker b. the nurse includes the client in developing the plan of care c. a nurse plans individualized nursing care for clients d. a nurse provides honest information to a client about the client's illness e. a nurse provides privacy for an older adult client f. a nurse refuses to discuss a client with a curious friend

b, c, e, f

___ based on three questions 1. what kind of person should I be in order to live a moral life and make good ethical decisions? 2. what are my duties and obligations to other people whose life and well-being may be affected by my actions? 3. what do I owe the common good or the public interest in my life as a member of society?

bio-ethics

nurses who value client advocacy follow what guideline? a. they choose the claims of the client's well-being over the claims of the client's autonomy b. they make decisions for clients who are uninformed concerning their rights and opportunities c. they give priority to the good of the individual client rather than to the good of society in general d. they value their loyalty to an employing institution or to a colleague over their commitment to their clients

c

which example most accurately depicts the ethical principle of autonomy? a. transporting a client to a scheduled physical therapy appointment b. changing a dressing on a wound as needed c. administering a morning dose of insulin before breakfast d. describing a surgery to a client before the consent is signed

d

how do we develop values?

formed during a lifetime involving influences from the environment, family, and culture

value process: children are left to explore values on their own and to develop a personal value system

laissez-faire

value process: children learn what is of high or low value by observing parents, peers, and significant others

modeling

occurs when you know the right thing to do but either personal or institutional factors make it difficult to follow the correct course of action

moral distress

which concern of nurse advocate is this: nurse is often involved as an intermediary between the patient and the family, especially when the patient and family have conflicting ideas about the management of health care situations

representing patients

value process: children are rewarded for demonstrating values held by parents and punished for demonstrating unacceptable values

rewards and punishments

this is an example of what ethical issue in nursing practice: a resident is attempting to perform a spinal tap on an adolescent whom you know dislikes the resident. after one failed attempt, the adolescent tells the resident to stop. the resident asks you to administer an anti anxiety medication to patient to enable to resident to get spinal tap done quickly. should you administer medication knowing the patient no longer consents to the procedure?

valid consent or refusal

organization of values ranked along a continuum of importance

value system

set of beliefs that are meaningful in life and that influence relationships with other

values

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

values

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

virtues

which concern of nurse advocate is this: every nurse who witnesses unsafe care has a duty to patients to report it. however; for too long, nurses may have failed to speak up out of fear of retribution

whistle-blowing