Ethics
A nurse is caring for a client declared brain dead following a motor vehicle accident. When the nurse enters the client's room, the spouse and family are talking with friends about the possibility of organ donation. Which statement by the nurse reflects an ethical practice dilemma? "If you're thinking about organ donation, my sister is waiting for a kidney transplant. She'd be an excellent recipient. I can give you her phone number." "The healthcare team will support you in your decision on this difficult subject." "I can ask someone to come by to talk with you and answer any questions you may have." "I can come back after you've finished your visit."
"If you're thinking about organ donation, my sister is waiting for a kidney transplant. She'd be an excellent recipient. I can give you her phone number." The nurse demonstrates unethical behavior when discussing personal information with the client's family and suggesting the nurse's sister as an organ recipient. Offering to find resources, answer questions, and provide support to the client's family are within the scope of nursing practice.
Which best defines value clarification? A process by which people come to understand their own values and value systems A belief about the worth of something, about what matters, that acts as a standard to guide one's behavior An organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct A systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil, as they relate to conduct
A process by which people come to understand their own values and value systems Value clarification is a process by which people come to understand their own values and value systems. A value is a belief about the worth of something, about what matters, that acts as a standard to guide one's behavior. A value system is an organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct. Ethics is a systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil, as they relate to conduct.
There are many ethical issues in the care of clients with HIV or HIV/AIDS. What is an ethical issue healthcare providers deal with when caring for clients with HIV/AIDS? Sharing the diagnosis with a support group Caring for a client who can kill other people Disclosure of the client's condition Caring for a client with an infectious terminal disease
Disclosure of the client's condition Despite HIV-specific confidentiality laws, clients infected with AIDS fear that disclosure of their condition will affect employment, health insurance coverage, and even housing. Since healthcare providers do not share a client's diagnosis with a support group, option A is incorrect. Caring for a client with an infectious terminal illness that can be transmitted to other people is a concern for healthcare providers but it is not an ethical issue.
A nurse has been working for 15 hours continuously without a break. The nurse administrator insists that the nurse should go home and sleep. According to the Carper's patterns of nursing knowledge, which pattern of knowing is this indicative of? Ethical knowing Aesthetic knowing Personal knowing Empirical knowing
Ethical knowing Ethical knowledge refers to the knowledge derived from the moral knowledge of the nurse. The nurse administrator understands that the nurse is stressed and requires rest. This indicates moral knowledge. Aesthetic knowing refers to the knowledge gained through the art of nursing. Personal knowing refers to the knowledge gained through experience. Empirical knowing refers to the knowledge that the nurse obtains from the science of nursing.
A client with metastatic brain cancer is admitted to the oncology floor. What action will the admitting nurse take regarding an advanced directive for this client? Decide on a treatment plan if the client cannot. Inform the client or legal guardian of the right to execute an advance directive. Respect the individuals' moral rights. Advise the client to refuse medical treatment if unable to make health care decisions.
Inform the client or legal guardian of the right to execute an advance directive. All clients have a right to execute an advance directive. The admitting nurse would ensure that the client is aware of that right. The facility's ethics committee can decide on a treatment plan if the client is unable and a health care power of attorney has not been appointed. Facility employees are not required by law to respect an individual's moral rights; however, the health care professional should respect the client's individual rights as part of professional responsibility. While a client may refuse medical treatment via an advanced directive, the nurse would not advise this.
Christine Grady is a nurse ethicist that proposed a framework for evaluating ethics. Grady suggested that a independent review is needed for ethical research. This principle is correctly defined as: "Enhancements of health or knowledge must be derived from the research." Informed consent means that "individuals should be informed about the research and provide their voluntary consent." "Scientific objectives, not vulnerability or privilege, and the potential for and distraction of risk and benefits, should determine communities selected as study sites and the inclusion criteria for individual subject." "Within the context of standard clinical practice and the research protocol, risks must be minimized, potential benefits enhanced, and the potential benefits to individuals and knowledge gained for society must outweigh the risks." "Unaffiliated individuals must review the research and approve, amend, or terminate the research."
Informed consent means that "individuals should be informed about the research and provide their voluntary consent." Informed consent means that "individuals should be informed about the research and provide their voluntary consent." Independent review suggests that unaffiliated individuals must review the research and approve, amend, or terminate the research. Fair subject selection suggests that scientific objectives, not vulnerability or privilege, and the potential for and distraction of risk and benefits, should determine communities selected as study sites and the inclusion criteria for individual subject. Value suggests that enhancements of health or knowledge must be derived from the research. Favorable risk-benefit ratio is correctly defined as "within the context of standard clinical practice and the research protocol, risks must be minimized, potential benefits enhanced, and the potential benefits to individuals and knowledge gained for society must outweigh the risks." Fair subject selection suggests that scientific objectives, not vulnerability or privilege, and the potential for and distraction of risk and benefits, should determine communities selected as study sites and the inclusion criterial for individual subject.
The nurse beginning practice would like to access the standards for ethical practice. Which organization should the nurse research for these standards? International Council of Nurses Canadian Hospital Association Department of Health Professions World Health Organization
International Council of Nurses The American Nurses Association Code of Ethics for Nurses is the main source of the ethical principles that nurses must follow, and this is developed by the International Council of Nurses. The Canadian Hospital Association has not developed standards of ethical practice. Individual state boards of nursing through the department of health professions have laws and regulations that guide practice but not ethical and moral principles. The World Health Organization is a large organization that does not determine ethical practice for nurses.
A nurse is caring for a client with multiple sclerosis. The client informs the nurse that a lawyer is coming to prepare a living will and requests the nurse to sign as witness. Which action should the nurse take? State that the physician will be a witness. Arrange for another colleague to sign as a witness. Note that the nurse caring for the client cannot be a witness. Inform the physician about the living will.
Note that the nurse caring for the client cannot be a witness. A living will is an instructive form of an advance directive. It is a written document that identifies a person's preferences regarding medical interventions to use in a terminal condition, irreversible coma, or persistent vegetative state with no hope of recovery. Employees of the healthcare facility should not sign as witnesses; therefore, the nurse cannot sign as witness. Refusing a client may not be a good communication method; instead, the nurse could politely indicate the reason for declining. Calling for a physician or asking another colleague to sign is an inappropriate action.
A nurse in a psychiatric care unit finds that a client with psychosis has become violent and has struck another client in the unit. What action should the nurse take in this case? Do not restrain the client, as it is equivalent to false imprisonment. Restrain the client, as they are harmful to the other clients. Do not restrain the client, as it is equivalent to battery. Inform the physician and complete a comprehensive assessment.
Restrain the client, as they are harmful to the other clients. The nurse should restrain the client because they are potentially harmful to other clients in the psychiatric care unit. Restraints should be used as a last resort and their use should be justified. Unnecessary restraining can lead to allegations of false imprisonment and battery; both are not applicable in this case, however. The nurse should inform the physician about the client but sometimes it may not be logical to wait for orders to restrain a violent client.
The nurse is caring for a 17-year-old girl in the terminal phase of osteosarcoma. Which action demonstrates integration of the recommendations of the American Academy of Pediatrics (AAP) Committee on Bioethics? Telling the child exactly what to expect of further treatments Encouraging the child to support the wishes of her parents Explaining the prognosis using accepted clinical terminology Allowing the child to listen during discussions of the care plan
Telling the child exactly what to expect of further treatments The committee recommends telling the child exactly what to expect of further treatments and procedures, explaining the prognosis in a developmentally appropriate way to ensure the child's understanding, and endeavoring to gain the child's candid opinion of the proposed care plan. It also recommends that decision making for older children and adolescents should include the assent of the child or adolescent.
The nurse has been asked to identify a location to conduct an interview with a psychiatric-mental health client. Which is an essential consideration when choosing a location? The amount of lighting in a given location The client's right to a stress-free environment The client's right to privacy The amount of distracters in a given location
The client's right to privacy The client's right to privacy is an essential setting consideration. It is an ethical responsibility of the nurse as well as a legal right of the client. Nurses must make critical clinical judgments about the optimal setting that maintains privacy while also ensuring safety.
Which is the best definition of ethics? The formal, systematic study of moral beliefs The informal, systematic study of moral beliefs The adherence to formal personal values The adherence to informal personal values
The formal, systematic study of moral beliefs Ethics is a formal, systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil as they relate to human conduct and human flourishing. "Morals" usually refers to personal or communal standards of right and wrong
Which example may illustrate a breach of confidentiality and security of client information? The nurse provides information over the phone to the client's family member who lives in a neighboring state. The nurse provides information to a professional caregiver involved in the care of the client. The nurse informs a colleague that the colleague should not be discussing client information in the hospital cafeteria. The nurse accesses client information on the computer at the nurse's station then logs off before answering a client's call bell.
The nurse provides information over the phone to the client's family member who lives in a neighboring state. Providing information over the phone to a family member without knowing whether the client wants the family member to know the information is a breach of confidentiality and security of client information. Providing information to a caregiver involved in the care of a client is not a breach in confidentiality, while providing information to a professional not involved in the care of the client is a breach in confidentiality. Client information should not be discussed in public areas such as elevators or the cafeteria. Logging off a computer that displays client data is an appropriate method of protecting client confidentiality and information.
One classic theory in ethics is teleologic theory or consequentialism, which focuses on the ends or consequences of actions. The nurse knows that the best known form of this theory is Formalist theory Utilitarianism Beneficence Double effect
Utilitarianism One classic theory in ethics is teleologic theory or consequentialism, which focuses on the ends or consequences of actions. The best-known form of this theory, utilitarianism, is based on the concept of "the greatest good for the greatest number." Beneficence and double effect are examples of common ethical principles. The formalist theory is another theory in ethics which argues that ethical standards or principles exist independently of the ends or consequences.
The nurse is initiating isolation precautions for a client who has chronic Clostridium difficileinfection. What should the nurse be sure to include with these precautions? remind others to use a mask when caring for this client recognize that this type of infection requires droplet precautions be sure that there are gloves of various sizes and gowns for use include a N95 respirator mask for health care staff entering the room
be sure that there are gloves of various sizes and gowns for use All health care workers and visitors should don a gown and gloves prior to entering the client's room. These bacteria are not transmitted by droplet. An N95 respirator mask is not required for this client.
A client scheduled to have a surgery for a hernia the next day is anxious about the procedure. The nurse assures the client that surgery for hernias is very common and that the prognosis is very good. What skill is the nurse demonstrating? imaginal skills interpersonal skills instrumental skills systems skills
interpersonal skills The scenario reflects the nurse's interpersonal skills. It shows how a person relates with others. The nurse shows imaginal skills when envisioning a plan for adapting and personalizing client care. Instrumental skills are associated with basic physical and intellectual competencies. Systems skills are those that help the nurse see the whole picture and how various parts relate.
During the 1800s, Pinel believed that the cure for mental illness was ... arrest and confinement. placement outside of the community. moral treatment. use of chains.
moral treatment. During the 1800s, the cure for mental illness was believed to be moral treatment, defined as kindness, compassion, and a pleasant environment. Philippe Pinel was one of the first physicians who began using moral treatment in France.
The term used to guide the cultural aspects of nursing care and respect individual differences is: diversity nursing. ethnicity nursing. family nursing. transcultural nursing.
transcultural nursing. Transcultural nursing is the nursing care method that is guided by cultural aspects and respects individual differences.
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 the client's health and that of the client's spouse. This is an example of: values clarification. moral distress. ethical dilemma. social justice.
values clarification. Values clarification is a process that allows an individual to examine and understand what choices to make. Moral distress is the emotional state that arises from a situation when a nurse feels that the ethically correct action to take is different from what the nurse is tasked with doing. An example of this is the nurse taking away the cigarettes out of the client's belongings bag. Ethical distress occurs when a decision is made regarding what one believes to be the right course of action, but barriers prevent the nurse from carrying out or completing the action. The nurse can expect ethical distress if removing the cigarettes from the client's belongings bag. Social justice is a concept of fair and just relations between the individual and society. An example is the selling of cigarettes to those who had a cardiac event. Moral distress, ethical dilemma, and social justice are not reflected in this scenario.