chapter 6 ETHICS

A nurse who is infected with human immunodeficiency virus (HIV) accidentally gets a cut while debriding a wound, exposing the client to possible HIV infection. Failure of the nurse to report this incident violates which ethical principles

veracity fidelity

A nursing student states he is able to put himself in his client's shoes. He states he understands the situation of the ill client. This is considered to be an act of:

empathy: immediate projection of self to the situation of others, causing strong emotional reactions and motivation, and either appropriate caring behavior and/or related reflection.

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

Autonomy is the capacity to make an informed, uncoerced decision. Describing surgery to a client before a consent is signed provides the client with all of the information needed to make an informed decision, thus an autonomous one

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; entails the ability to make a choice free from external constraints

Nonmaleficence

preventing harm from being done to a client..

Human dignity

respect for the inherent worth and uniqueness of individuals and populations.

A nurse is contributing to the analysis of an ethical dilemma. When analysing the dilemma according to the ethical framework, what is most important for the nurse to take into consideration?

standards of conduct Ethics is the branch of philosophy dealing with standards of conduct and moral judgment. It does not directly address law. It includes, but is not limited to, decision making and competing priorities

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

stays with the client during his death as promised. Fidelity requires the nurse to keep promises made and to be faithful to one's commitments.

Implementing includes

the implementation of the decision and comparing the outcomes of the action with what was considered and hoped for in advance.

When an untoward occurrence occurs,

the nurse will be considered to be accountable when the proper actions are taken. In this instance, an occurrence form is filled out for follow-up, and the provider is notified as this may change outcomes in the client's condition

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

Social justice

upholding moral, legal, and humanistic principles

A nurse is caring for a woman 28 years of age who has delivered a baby by Cesarean section. She describes her pain as a 9. The nurse medicates her for pain. This is an example of which ethical framework?

Beneficence

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?

A feminist approach

example of ethical 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.

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

Advocacy

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

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

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

Parents allowing a child to decide not to have an intravenous line inserted A laissez-faire environment is one that allows others, especially children, to make decisions without guidance, resulting in a decision that may not be a sound one

n 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?

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.

Which statement by the nurse is an example of deception?

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

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

Values values act as a standard to guide one's behavior

Altruism

a concern for the welfare and being of others

A school nurse interviewing parents of a child who is doing poorly in school determines that the parents practice a laissez-faire method of discipline. What are examples of this form of value transmission? Select all that apply.

a teenage girl trying alcohol at a party with her friends and a teenage boy exploring religions of friends in hopes of developing his own faith.

Paternalism

acting for clients without their consent to secure good or prevent harm. example: bed alarm for confused client, restraints

The deontologic theory

an action is right or wrong independent of its consequences.

Deception and confidentiality can result in ethical problems

for nurses when there is a conflict between the client's and nurse's values/interests

principle-based approach

combines elements of utilitarian and deontologic theories and offers specific action guidelines for practice

Supporting a client during a hospitalization

ethical principle of doing what is right and the focus of client centered care

A nurse is administering evening medications and notices that a medication was omitted during the day shift. Which statement demonstrates the principle of accountability?

filling out an occurrence report and notifying the health care provider

The care-based approach

focuses on the specific situations of individual clients, and characteristics of this approach include promoting the dignity and respect of clients and people

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 End-of-life decisions uses nonmaleficence ethical principal. Resuscitation and allocation of resources uses the ethical principle of justice. Confidentiality is affected by privacy. A nurse's choice of continuing education is not an ethical issue.

Ethics

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.

Planning includes

identifying the options and exploring the probable short-term and long-term consequences.

Justice

involves giving each client his due and acting fairly

Diagnosing the ethical problem

involves stating the problem clearly

Negligence

is an unintentional tort

Autonomy

is respecting the rights of clients or their surrogates to make health care decisions; it is also known as self-determination

Beneficence

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

Which nursing situations are examples 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

Which example best describes feminist ethics?

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

A nurse is preparing a presentation about ethical and legal issues for nurses. As part of the presentation, the nurse is planning to review the different types of laws. Which example would the nurse include as an intentional tort? Select all that apply.

assault, false imprisonment, and libel

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.

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 an ethical decision involves reflecting on the process and evaluating those elements that will be helpful in the future. The nurse may also question how this experience can improve reasoning and decision making in the future.

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

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

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 is keeping one's promises and never abandoning a client entrusted to one's care without first providing for the client's needs.

A nursing student reports to the instructor that a medication due at 9 am was omitted. Which principle is the student demonstrating?

Integrity ; honesty of a nurse according to professional standards. In this instance, the student reported the occurrence of the missed medication to the clinical faculty

Which nursing situation is an example of an ethical dilemma

Performing cardiac compressions when a signed Do Not Resuscitate order (DNR) is not available If there is no signed DNR, then legally cardiac compressions must be started

A nurse believes that abortion is an acceptable option if a pregnancy results from a situation of rape. What is the best description of this belief?

Personal mortality, set of beliefs about the standards of right and wrong that helps a person determine the correct or permissible action in a given situation.

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 type of health care decision making does this represent?

Shared decision making; recommended by most ethicists and involves the client's preferences and the nurse's expertise to make the best decision without input from the clinician.

To practice ethically, the nurse should:

avoid allowing her judgment to guide practice. Personal convictions apply only to situations and decisions pertaining to the individual. In ethical practice, nurses avoid allowing personal judgments to bias their treatment of clients.

criticisms of bioethics.

emphasize the relevance of clinical experience and the need for an orientation toward service

Which traits are examples of virtues that can exemplify character and conduct as a professional nurse? Select all that apply.

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.

A nurse is caring for a client who is a practicing Jehovah's Witness. The physician orders two units of packed cells based on his low hemoglobin and hematocrit levels. The nurse states to the surgeon that it is unethical to go against the client's beliefs even though his blood counts are very low. What is the best description of the nurse's intentions?

acting in the client's best interest Nurses' ethical obligations include acting in the best interest of their clients, not only as individual practitioners, but also as members of the nursing profession, the health care team, and the community at large.

Nurses as advocates

must realize that they do not make decisions for their clients, but they can facilitate decision making by allowing the client to verbalize feelings and by providing information to help the pt assess options

Deception and conflict are

negative traits that do not exemplify professional virtues

A nurse shows client advocacy by:

offering a hospice consultation to a client who is terminally ill. ensure that the best interests are being met. A hospice consult is an appropriate example.

Nurses who value client advocacy follow what guideline?

the nurse would give priority to the good of the individual client rather than to the good of society in general would not choose the claims of the client's well-being over the claims of the client's autonomy would not make decisions for clients who are uninformed concerning the client's rights and opportunities.

An ethics committee will meet

when a client is unable to make an end-of-life decision and the family cannot come to a consensus. 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 decisionally incapacitated) and the clinicians.