Ethics

what is the ethical theory of Deontology?

"Moral duty" -is the right thing to do -do it because it is right

What is true about psychosocial changes observed in adolescents? Select all that apply. "They search for personal identity." "They develop their own ethical systems." "They consider themselves invincible." "They think of their parents as materialistic." "They get emotionally dependent on their parents."

"They search for personal identity." "They develop their own ethical systems."

what is the ethical theory of ethics of relationship?

"caring" -is the nature and obligation inherent in human relationships

what is the ethical theory of Utilitarian?

"greatest good" -is the greatest good for the greatest number

what is the ethical theory of ethics of character?

"virtue" -is based on life experiences and a willingness to reflect on our actions. be virtuous.

what are the sources fo ethics?

-family -peers -religion -culture -society -profession -personal experiences

How many rights of delegation are there in the nursing practice? Record your answer using a whole number.

5 There are five rights of delegation in nursing practice. They are right task, right circumstances, right person, right direction/communication, and right supervision/evaluation.

What should a nurse understand about healthcare proxies or a durable power of attorney for healthcare? A proxy is a legal document that prohibits the purchase or sale of organs. A proxy is a legal document that ensures the client has the right to refuse medical treatment. A proxy is a legal document that designates a person or persons to make health care decisions on behalf of the client. A proxy is a legal document that directs treatment in accordance with the client's wishes in case of a terminal illness or condition.

A proxy is a legal document that designates a person or persons to make health care decisions on behalf of the client.

A nurse is caring for a client with renal failure. The client wants to go back home but the family members want the client to undergo a kidney transplant. The nurse gives details about the possible threats and benefits of the surgery to the family and informs them that the client wants to stay home. What role does the nurse play here? Educator Manager Caregiver Advocate

Advocate

What are the instances when an adult can give consent for medical treatment? Select all that apply. Any guardian for the adult's ward Any parent for the adult's emancipated minor Any parent for the adult's unemancipated minor Any adult for the treatment of his or her minor brother or sister (if an emergency and parents are not present) As a grandparent for a minor grandchild under normal circumstances

Any guardian for the adult's ward Any parent for the adult's unemancipated minor Any adult for the treatment of his or her minor brother or sister (if an emergency and parents are not present)

A client is presented with the treatment option of electroconvulsive therapy (ECT). After discussion with staff members, the client requests that a family member be called to help make the decision about this treatment. What ethical principle does the nurse consider when supporting the client's request? Justice Veracity Autonomy Beneficence

Autonomy

A nurse who promotes freedom of choice for clients in decision-making best supports which principle? Justice Autonomy Beneficence Paternalism

Autonomy

A nursing student is recalling the definitions of acts that are classified as torts in nursing practice. Which tort involves intentional touching without the client's consent? Battery Invasion of privacy False imprisonment Defamation of character

Battery

A registered nurse is educating a nursing student on the various classifications of torts. What acts are classified as intentional torts in nursing practice? Select all that apply. Battery Assault Negligence Malpractice False Imprisonment

Battery Assault False imprisonment

A visitor from a room adjacent to a client asks the nurse what disease the client has. The nurse responds, "I will not discuss any client's illness with you. Are you concerned about it?" This response is based on the nurse's knowledge that to discuss a client's condition with someone not directly involved with that client is an example of what? Libel Negligence Breach of confidentiality Defamation of character

Breach of confidentiality

Which ethical principles govern a nurse's behavior when making difficult decisions about a client's care at the point of care? Bioethics Metaethics Clinical ethics Research ethics

Clinical ethics

What are external barriers that can prevent a nursing professional from making morally correct actions? Select all that apply. Inadequate staffing Lack of assertiveness Perception of powerlessness Lack of organizational support Poor relationships with colleagues

Inadequate staffing Lack of organizational support Poor relationships with colleagues

Which of these refers to the accountability element of the decision making process? Individuals being answerable for their actions Freedom of choice and responsibility for the choices Duties and activities that an individual is employed to perform Authority to give commands and make final decisions specific to a given position

Individuals being answerable for their actions

How would the student nurse describe a quasi-intentional tort occurring during the practice of nursing? It is a willful act violating a client's rights. It is a civil wrong made against a person or property. It is an act that lacks intent but involves volitional action. It is an unintentional act that includes negligence and malpractice.

It is an act that lacks intent but involves volitional action.

The nurse receives information about a client through another nurse. The nurse then finds that information has some missing facts. Which critical thinking attitude would the nurse use to clarify the information after talking to the client directly? Fairness Humility Discipline Perseverance

Perseverance Perseverance requires the nurse to be cautious of an easy answer. If the nurse clarifies some information after talking to the client directly, he or she demonstrates perseverance. Fairness requires the nurse to listen to both the sides in any discussion. Humility is associated with recognizing the need for more information for making a decision. When the nurse is thoroughly aware of what is required and manages his or her time effectively, he or she uses discipline.

Which nursing action indicates that the nurse is actively listening to the client? The nurse states his or her own opinions when the client is speaking. The nurse refrains from telling his or her own story to the client. The nurse reads the client's health record during the conversation. The nurse interprets what the client is saying and reiterates in his or her own words.

The nurse interprets what the client is saying and reiterates in his or her own words.

What legal complications might a nurse face for using a restraint without a legal warrant on a client? The nurse may be charged with libel. The nurse may be charged with negligence. The nurse may be charged with malpractice. The nurse may be charged with false imprisonment.

The nurse may be charged with false imprisonment. If a nurse uses restraints without a legal warrant on a client, he/she may be charged with false imprisonment. Libel is the written defamation of character. Negligence is any conduct that falls below the standard of care. Malpractice is a type of negligence that is regarded as professional negligence.

A nurse is obtaining consent from an unemancipated minor to perform an abortion. When would the nurse consider the consent-giving process to be appropriately completed? Select all that apply. When consent has been obtained from the spouse When consent has been given specifically by a court When self-consent has been granted by a court order When consent has been given by a grandparent When consent has been obtained from at least one parent of the minor

When consent has been given specifically by a court When self-consent has been granted by a court order When consent has been obtained from at least one parent of the minor

The nurse is caring for a client who is in pain following surgery. The nurse informs the primary health care provider about the client's request for pain medication. What is the role of the nurse in this situation? Educator Manager Advocate Administrator

advocate

what is veracity?

•Obligation to tell the truth •Never lie! •Never deceive anyone

what are the steps of processing an ethical dilemma?

•Step 1: Ask if this is an ethical dilemma. •Step 2: Gather all relevant information. •Step 3: Clarify values. •Step 4: Verbalize the problem. •Step 5: Identify possible courses of action. •Step 6: Negotiate a plan. Step 7: Evaluate the plan over time.

A primary healthcare provider notes that all conventional treatment procedures have proved to be ineffective in managing a client's disorder. The primary healthcare provider decides to try an experimental treatment. The nurse ensures that the client has understood the implications of the new treatment plan thoroughly and then signs the client's consent form as a witness. Which basic healthcare ethic does the nurse follow in this situation? Justice Autonomy Beneficence Nonmaleficence

Autonomy Autonomy refers to the commitment to include clients in decisions about all aspects of care as a way of acknowledging and protecting their independence. In the given situation, the nurse ensures that the client has thoroughly understood the new treatment plan before gaining written consent. This ensures that the client is involved in the decision-making process appropriately. Justice refers to fairness. The given situation does not deal with fairness. Beneficence refers to taking positive actions to help others. This involves keeping the interests of the client before self-interest. Nonmaleficence is the avoidance of harm or hurt. Weighing the pros and cons of the new treatment plan would involve nonmaleficence.

A nurse on the medical-surgical unit tells other staff members, "That client can just wait for the lorazepam; I get so annoyed when people drink too much." What does this nurse's comment reflect? Demonstration of a personal bias Problem solving based on assessment Determination of client acuity to set priorities Consideration of the complexity of client care

Demonstration of a personal bias

What is a living will? It is a legal document that allows registered nurses to offer special skills to the public. It is an order that directs primary healthcare providers to refrain from reviving clients. It is a written document that directs treatment according to the client's wishes, in case of a terminal illness or condition. It is a legal document that designates a person or persons chosen by a client to make health care decisions on his/her behalf.

It is a written document that directs treatment according to the client's wishes, in case of a terminal illness or condition.

Your actions in response to ethically challenging situations require _____, _____ ,______

courage, compassion, and commitment

what is fidelity?

•Duty to be faithful/loyal •Includes implicit (implied) and explicit (verbally communicated) promises •Make a promise? Follow it through. •Unwillingness to abandon clients regardless of circumstances, even when personal beliefs differ

what is autonomy?

-respect for persons •Commitment to include clients in all healthcare decisions •Clients have the right to self-determine a course of action without coercion •Must provide ALL information for client to make own decision (consider health literacy) •You are the client's advocate

what are ethical principles?

-similar to a camera lens; Camera lenses can have various magnifications or filters; likewise, situations can be viewed differently, depending on the lens. -autonomy: respect for persons -beneficence -nonmaleficence -justice -fidelity -veracity

what is ethics?

-the study or examination of morality through a variety of different approaches -concepts of right and wrong

Discuss provisions of the ANA Code for Nurses

1. Practice with compassion and respect 2. primary commitment is to client/family 3. promotes/advocates to protect clients 4. responsible and accountable for practice 5. same duties to self as others 6. establish/maintain/improve healthcare environments 7. participates in advancement of profession 8. collaborates with other healthcare professionals and the public 9. profession is responsible for nursing values

what is beneficence?

duty to do good (goodness, kindness, charity) -the centerpiece of caring -best interest of the client is more important than self interest

what are some common ethical issues in nursing?

•Protecting clients' rights and human dignity •Not respecting informed consent treatment •Providing care with risk to the health of the nurse (Patient has HIV-standard precautions such as gloves and hand hygiene. Obese patients - if they fall or have to roll them over on the bed --> back injuries. Combative patients. •Using or not using chemical or physical restraints •Understaffing = burn-out •Prolonging the living and dying process with inappropriate measures •Policies that could threaten the quality of care (organ donations) •Working with unethical or impaired colleagues (if you see someone that is impaired you have a duty to report it)

what is justice?

•Seeks fairness for everyone equally •More specifically, distributive justice refers to distribution of scarce resources (disaster) •Equally disbursed according to: need, effort, merit

A registered nurse is educating a nursing student about the process of resolving an ethical dilemma. What information should the nurse provide regarding negotiation of outcomes? "A nurse should provide a personal point of view." "Negotiations should be held in formal settings only." "Negotiation takes place immediately after gathering information." "The group agrees to a statement of the problem during the negotiation process."

"A nurse should provide a personal point of view." During the process of negotiating outcomes, the nurse is required to provide a personal point of view. Negotiations may take place informally at the client's bedside or in a formal setting. After gathering relevant information regarding an ethical dilemma, the nurse is required to examine his or her own values and formulate an opinion regarding the matter. When verbalizing the problem, the group agrees to a statement of the problem to begin discussions. This step is performed before negotiating outcomes. Negotiations take place after determining all possible courses of action.

what is nonmaleficence?

•Duty to do NO harm •Duty to prevent or remove harm or risk for harm •More binding than beneficence •Balance risk vs. benefits while striving to do the least harm possible •Ex: starting an IV - you stick them with a needle so it hurts, but they need an IV to help with their illness

ethical problem vs. ethical dilemma provide examples

ethical problem: -has aspects of right and wrong, but can be solved by the code of ethics -ex: a situation in which an 80 year old has cancer and a decision must be made on whether or not to offer chemotherapy. Patient wishes, blood counts, kidney and liver function, risks, and benefits are considered. All parties determine that the benefits outweigh the risks and the problem is solved using this line of reasoning ethical dilemma: -not as clear cut and may involve multiple choices -ex: a situation where a patient is medically declared to be in a vegetative state with no chance of recovery. The patient never discussed end-of-life wishes with anyone. The physician and one son recommend discontinuing life-support, but the daughter fiercely opposes any such measures, stating her mother never would have wanted life support discontinued. The decision is much more complicated and can't be solved by a cursory look at the code of ethics. This situation would mist likely be resolved by consensus by the Ethics Committee

Which points are important when giving practical knowledge to nursing students about preventing complications in the hospital? Select all that apply. Nursing students cannot be held accountable for their actions if a client has been harmed. Nursing students cannot be assigned clinical tasks for which they have not been prepared. Nursing students can work as nursing assistants or nurse's aides when not attending classes. Nursing students should tell their instructor immediately after sustaining a needle stick injury. Nursing students may act as witnesses on consent forms for hospital treatments and procedures.

Nursing students cannot be assigned clinical tasks for which they have not been prepared. Nursing students can work as nursing assistants or nurse's aides when not attending classes. Nursing students should tell their instructor immediately after sustaining a needle stick injury.