Chapter 6: Values, Ethics, and Advocacy, Ethical Systems of Healthcare, Healthcare & Ethics, Ch. 6 Values, Ethics, and Advocacy (PrepU), Ethical Healthcare and Genetics
Each person's happiness is equally important
Utilitarianism
Right actions are those that produce the greatest balance of happiness over unhappiness
Utilitarianism
W: One person's good can be another's evil
Utilitarianism
The nurse has been educating a young adult client about living with type 1 diabetes and the importance of adhering to a strict dietary regimen. The client is repeatedly admitted and is not following the prescribed plan. What statement made by the nurse may facilitate values clarification for the client?
"Rank the three most important things in your life."
Which statement by the nurse is an example of deception?
"This injection of procaine will feel like a little pinch."
A charge nurse has implemented staff education on nursing values. The nurse would determine that further education is required when which statement(s) are overheard? Select all that apply.
"I can't believe she is giving that precious baby up for adoption." "His gonorrhea test was positive. That's what he gets for sleeping around." "If that was my mother, I sure wouldn't make her a no-code."
It is time for a nurse to renew licensure. The nurse says, "I need some really easy and quick continuing education hours. I don't understand why we have to do these every year." What is the nurse's coworker's best response?
"Life-long learning is part of the code for nurses."
A nurse's friend states, "I admire you so much. I would love to be a nurse, but I don't think I have the courage." Which response will the nurse make?
"You can work on being more courageous as you learn to be a nurse."
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 boy explores religions of friends in hopes of developing his own faith. A teenage girl tries alcohol at a party with her friends.
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 example best describes feminist ethics?
An approach critiquing existing patterns of oppression and domination in society
Which ethical principle refers to the obligation to do good?
Beneficence
Which theory of ethics prioritizes the nurse's relationship with clients and the nurse's character in the practice of ethical nursing?
Care-based ethics
Emphasis is on moral rules and duty
Deontology
Emphasis on autonomy, justice, and kind acts
Deontology
If not willing for everyone to follow the rule, then it is not morally permissible
Deontology
People treated as ends, never means
Deontology
S: It provides a moral status for humans
Deontology
S: Moral rules are universal
Deontology
W: It says nothing about other living things
Deontology
W: Rules can be abstract
Deontology
A nurse is involved in ethical decision making. Place the steps in the order that the nurse would follow to achieve an ethical decision.
Describe the situation and factors associated with the ethical problem. Clarify that the issue is ethical in nature. Identify options and explore short- and long-term consequences. Make the decision. Determine the effectiveness of the decision and implications for the future.
Any act that conforms to the law of God is right; an act that breaks God's law is wrong
Divine Command Theory
Moral standards depend on God who is all-knowing
Divine Command Theory
S: Gives reasons why man should behave morally
Divine Command Theory
S: Gives worth to all equally
Divine Command Theory
A nurse is providing care for three clients on a medical unit, two of whom are significantly more acute than the third. The nurse is making a concerted effort to ensure that the less acute client still receives a reasonable amount of time, attention, and care during the course of the shift. Which of the following is the nurse attempting to enact?
Justice
Which action would cause a charge nurse to have concerns about a nurse's moral agency?
The nurse was seen at a grocery store after calling in sick.
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.
An illegal immigrant with no health insurance sustained life-threatening injuries following an automobile accident. Which action demonstrates the ethical principle of justice?
airlifting the client to a local trauma center for emergency surgery
To practice ethically, the nurse should:
avoid allowing her judgment to guide practice
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 nursing action demonstrates the principle of fidelity?
filing an incident report after making a medication error
A nurse shows client advocacy by:
offering a hospice consultation to a client who is terminally ill.
An adolescence is in the process of value formation. What does the nurse determine that will be the greatest influence in the child's formation of values in this developmental stage?
peers.
A nurse is of the Catholic faith and votes pro-life. He is considered to have:
personal values.
W: Can be arbitrary depending on interpretation
Divine Command Theory
A parent of a 17-year-old high school student is allowing the child to make the decision on the college that will be attended. When the child requests direction from the parent in making this decision, the parent responds by stating, "You will need to make this decision on your own." What type of value transmission is the parent displaying?
Laissez-faire
The nurse is managing the care for a postoperative client. How does the nurse demonstrate advocacy?
Limiting visitors due to client complaining of pain
An older adult 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 type of ethical situation?
Moral distress
A nurse working in a critical care unit has experienced personal tragedy, extreme shortage of staff in the work environment, and health issues. The nurse has overcome much of these hardships and is now mentoring other nurses in similar situations. What behavior is this nurse demonstrating?
Moral resilience
A nurse knows the ethical term "Do not cause harm" is an example of
Nonmaleficence
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 nurse obtains an order for a bed alarm for a confused client. This is an example of which ethical principle?
Paternalism
Actions judges right or wrong solely on their consequences
Utilitarianism
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
A nurse is caring for a client with a complete spinal cord injury that has caused paraplegia. The client is very distraught and asks the nurse, "Are they sure, even with therapy, I will never walk again?" Which statement made by the nurse demonstrates veracity?
"You have a complete injury, which results in a total loss of movement and sensation below the level of injury."
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 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 is providing care to a client with end-stage cancer. After weighing the alternatives, the client decides not to participate in a clinical trial offered and is requesting no further treatment. The nurse advocates for the client's decision based on the understanding that the client has the right to self-determination, interpreting the client's decision as reflecting which ethical principle?
Autonomy
Which nursing actions best describe the use of the professional value of human dignity? Select all that apply.
The nurse includes the client in developing the plan of care A nurse provides privacy for an older adult client. A nurse plans individualized nursing care for her clients. A nurse refuses to discuss a client with a curious friend
S: Standards are from a higher authority than humans
Divine Command Theory
W: Can we know the true divine authority?
Divine Command Theory
All morals are valid relative to cultural tastes
Ethical Relativism
No principles are universally valid
Ethical Relativism
S: Brings about tolerance of other cultures
Ethical Relativism
S: Keeps societies from falling apart
Ethical Relativism
The rules of society serve as a standard
Ethical Relativism
W: Confuses what ought to be done with what is currently done
Ethical Relativism
Which statement best conveys the concept of ethical agency?
Ethical practice requires a skill set that must be conscientiously learned and nurtured.
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 nurse is providing care to a client and is preparing the client for breakfast. The nurse assists the client out of bed to the chair then helps the client open the items on the breakfast tray. The client begins to eat breakfast. The nurse tells the client, "I'll be back in about 10 minutes to check on you. In the meantime, here is your call light in case you need me." About 10 minutes later, the nurse returns to check on the client. The nurse is demonstrating which ethical principle?
FIdelity
A parent teaches his or her children not to drink and drive; however, the parent does drink and drive. This action causes
Failure to reflect own values
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
A client requests that the nurse allow her 15 minutes two times a day for prayer during her hospitalization. What value does this represent?
Foundation value
A nursing student reports to the instructor that a medication due at 9 am was omitted. Which principle 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
The nurse is reviewing charges to clients for surgical procedures and observes different charges dependant upon insurance status. The nurse immediately reports this bias in charges to the supervisor for action. What principle of bioethics is the nurse demonstrating?
Justice
A nurse is asked to serve on an ethics committee. Which roles of the nurse would the nurse be required to fill on the committee? Select all that apply.
serving as a liaison between the family and the committee members presenting explanations about technical terminology advocating for the client's wishes
Which nursing situation is an example of an ethical dilemma?
Performing cardiac compressions when a signed Do Not Resuscitate order (DNR) is not available
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 morality
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
A nurse is providing care to an older adult client who was just diagnosed with cancer. The client together with the immediate family discuss their preferences with the health care providers involved. The health care providers offer their clinical recommendations about possible treatments. Utlimately, the group arrives at a decision. The nurse interprets this decision-making process as reflecting which type?
Shared-decision making
A nurse is applying a care-based approach to an ethical dilemma. When integrating this approach, which concept would the nurse need to keep in mind? Select all that apply.
The caring relationship is essential to the approach. Clients are people that are to be respected. Attention is needed to focus on each person's individual situation.
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.
A nurse gives the 400 IU of a vitamin supplement that was in the client's medications instead of the 200 IU that was prescribed. The dosage was given when the unit was busy admitting three clients and another client was in crisis. Which action(s) by the nurse demonstrate the professional value of integrity? Select all that apply.
The nurse completes a variance or incident report. The nurse documents the dose given.
Which traits are examples of virtues that can exemplify character and conduct as a professional nurse? Select all that apply.
Trustworthiness Humility Compassion
S: Promotes human well-being and attempts to lessen human suffering
Utilitarianism
W: Hard to predict accurately all consequences
Utilitarianism
What is the term for the beliefs held by the individual about what matters?
Values
When providing nursing care to clients, the nurse is required to adhere to ethical values and legal rules to guide practice behavior. Which values would be included? Select all that apply.
Veracity Fidelity Privacy Confidentiality
It emphasizes living well and achieving excellence
Virtue Ethics
It seeks to produce good people who act well out of spontaneous goodness
Virtue Ethics
Morals are internal
Virtue Ethics
An employee health nurse is assisting a stressed, working mother with value clarification. Which of the following best defines value clarification?
a process by which people come to understand their own values and value systems
A client tells the nurse that he does not want to have a painful procedure. By respecting and supporting the client's right to make decisions, the nurse is demonstrating:
advocacy.
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
A client is brought to the emergency department by an adult child, who states, "I am unable to care for my parent anymore. Although I would like to, financially and physically I can't do it anymore." What ethical problem is the adult child experiencing?
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:
ethical distress.
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 foundation for decisions about resource allocation throughout a society or group is based on the ethical principle of:
justice
Which action most clearly demonstrates a nurse's commitment to social justice?
lobbying for an expansion of health care resources and benefits
What would be an example of the nurse practicing fidelity? The nurse:
stays with the client during his death as promised.
Which actions by the nurse demonstrate the ethical principle of fidelity? Select all that apply.
maintaining current nursing registration and meeting continuing education requirements performing an intervention for a client at the time that was promised taking an extra client assignment so that client will be cared for
A nurse is preparing a client for discharge from the cardiac unit and observes cigarettes in the client's belongings. The nurse asks the client to consider her health and the health of her spouse. This is an example of:
values clarification
