Foundations Exam 1 Ch. 6 b.

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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? a. Personal moral b. Professional value c. Legal obligation d. Ethical principle

A personal moral is a standard of right and wrong that helps a person determine the correct or permissible action in a given situation. Professional values in nursing are a set of beliefs about the worth of things, about what matters, that provide the foundation for nursing practice and guide the nurse's interactions with clients, colleagues, and the public. Ethical principles are a set of specific concepts that guide a person's actions. A legal obligation is something that is required by law.

A client tells the nurse that the client does not want to have a painful procedure. By respecting and supporting the client's right to make decisions, the nurse is demonstrating: altruism. justice. confidentiality. advocacy.

Advocacy is the protection and support of another person's rights. Nurses have always been strong client advocates, carefully evaluating the competing claims of the client's autonomy (self-determination) and well-being. Altruism is the principle and moral practice of concern for happiness of other human beings, resulting in a quality of life both material and spiritual. Justice is concerned with moral rightness and fairness. Confidentiality is keeping or one's personal information secret or private.

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 give priority to the good of the individual client rather than to the good of society in general. c. They value their loyalty to an employing institution or to a colleague over their commitment to their clients. d. They make decisions for clients who are uninformed concerning their rights and opportunities.

Advocacy is the protection and support of another's rights. If the nurse values client advocacy, the nurse would give priority to the good of the individual client rather than to the good of society in general. The nurse would not be demonstrating advocacy if the nurse values the loyalty to an employing institution or to a colleague over the commitment to the client. The nurse demonstrating client advocacy would not choose the claims of the client's well-being over the claims of the client's autonomy. The nurse would not make decisions for clients who are uninformed concerning the client's rights and opportunities.

Which word is best described as protection and support of another's rights? a. Autonomy b. Advocacy c. Paternalism d. Ethics

Advocacy is the protection and support of another's rights. Nurses who value client advocacy make sure their loyalty to an employing institution or colleague does not compromise their primary commitment to the client; give priority to the good of the individual client rather than to the good of society in general; and carefully evaluate the competing claims of the client's autonomy and client well-being. Paternalism is acting for clients without their consent to secure good or prevent harm. Autonomy is respecting the rights of clients or their surrogates to make health care decisions; it is also known as self-determination. Ethics is the 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.

A nurse volunteers to serve on the hospital ethics committee. Which action should the nurse expect to take as a member of the ethics committee? Decide the care for a client who is unable to voice an opinion. Present options about the type of care. Assist in decision making based on the client's best interests. Convince the family to choose a specific course of action.

Assist in decision making based on the client's best interests. One reason an ethics committee convenes is when a client is unable to make an end-of-life decision and the family cannot come to a consensus. In this case, 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 the client is decisionally incapacitated) and the clinicians. The committee would not convince, decide, or present options about the type of care. This is not the role of an ethics committee.

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? a. Beneficence b. Confidentiality c. Justice d. Autonomy

Autonomy entails the ability to make a choice free from external constraints. Beneficence is the duty to do good and the active promotion of benevolent acts. Confidentiality relates to the concept of privacy. Justice states that like cases should be treated alike.

What is likely to have the greatest influence on an adolescent's formation of values during this developmental stage? a. Peers b. School administration c. Work d. Awareness of other cultures

In adolescence, peer groups have a major influence on value formation. The attitudes, beliefs, and behaviors that grow out of peer group relationships are powerful. It is generally accepted that the influence of peers exceeds that of school administration, work life, or the awareness of other cultures during this developmental stage.

A parent teaches a child not to drink and drive; however, the parent does drink and drive. This action results in: a. conflict with society. b. insecurity and a lack of safety. c. a disruption in consistency. d. a failure to model one's own values.

Many role models fail to model their own values and, as a result, cause conflict with and confusion in those who look up to them, such as children (not society, in general). The primary result of this action, which is saying one thing and doing another, is not so much insecurity and a lack of safety or a disruption in consistency as it is a failure to reflect one's own values.

A nurse working on a critical care unit was informed by a client with multiple sclerosis that the client did not wish to be resuscitated in the event of cardiac arrest. Now the client is no longer able to express 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: a. paternalism. b. confidentiality. c. deception. d. ethical distress.

The nurse is involved in a situation that involves 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. Paternalism is acting for clients without their consent to secure good or prevent harm. Deception and confidentiality can result in ethical problems for nurses when there is a conflict between the client's and nurse's values/interests. In this scenario, the nurse is aware of the client's wishes, but the conflict lies with the family and thus the nurse will experience ethical distress.

A nurse reports to the charge nurse that a client medication due at 9 am was omitted. Which principle is the nurse demonstrating? a. Social justice b. Altruism c. Integrity d. Autonomy

The principle of integrity is based on the honesty of a nurse according to professional standards. In this instance, the nurse reported the occurrence of the missed medication to the charge nurse. The definition of altruism is concern for others; it can best be explained by a nurse concerned about how a client will care for self after discharge. Social justice is a concept of fair and just relations between the individual and society and is related to wealth and distribution of goods in a society. Autonomy is the right to self-determination or acting independently and making decisions.

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

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. Deception and conflict are negative traits that do not exemplify professional virtues.

Which best defines value clarification? a. A systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil, as they relate to conduct b. A process by which people come to understand their own values and value systems c. An organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct d. A belief about the worth of something, about what matters, that acts as a standard to guide one's behavior

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.

Which example most accurately depicts the ethical principle of autonomy? a. Describing a surgery to a client before the consent is signed b. Changing a dressing on a wound as needed c. Administering a morning dose of insulin before breakfast d. Transporting a client to a scheduled physical therapy appointment

a. Describing a surgery to a client before the consent is signed Autonomy is the capacity to make an informed, uncoerced decision. Describing a surgery to a client before a consent is signed provides the client with all of the information needed to make an informed decision and thus an autonomous one. The nurse changing a dressing on a wound does not require the client to make an informed decision, nor does administering a morning dose of insulin or transporting a client.

A client is scheduled to have an elective surgical procedure performed but cannot decide whether to go forward with the procedure or cancel it. The client asks the nurse to help make the decision because the client lacks knowledge about the procedure. Which action by the nurse is the best way for this nurse to advocate for the client? a. Refuse to help the client, and state that the client alone must make the decision. b. Allow the client to verbalize feelings, and provide information to help the client assess options. c. Refer the client to the social worker for help assembling a team to help the client make the decision. 9. Call the surgeon, and have the surgeon explain the procedure again.

b. Allow the client to verbalize feelings, and provide information to help the client assess options. 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 client assess options. This is not an appropriate time to call in the surgeon or the social worker. Refusing to help the client is not the best example of client advocacy performed by a nurse.

To practice ethically, the nurse should avoid: a. allowing an ethics committee to guide the nurse's practice. b. allowing the nurse's own judgment to guide practice. c. reviewing past cases before making decisions about practice. d. asking the client's family about their views on caring.

b. allowing the nurse's own judgment to guide practice. Personal convictions apply only to situations and decisions pertaining to the individual. In ethical professional practice, nurses should avoid allowing personal judgments to bias their treatment of clients. It is appropriate for nurses to allow an ethics committee, past cases, and the views of clients and their families to guide nursing practice.

Which scenario is an example of the laissez-faire approach to value transmission? a. Telling a child an injection will feel like a pinch before the nurse gives the injection b. Modeling healthy behaviors for teenagers, such as not smoking electronic cigarettes c. Allowing a child to decide not to have an intravenous line inserted d. Teaching children right from wrong and telling them the reason behind a bad action

c. Allowing a child to decide not to have an intravenous line inserted A laissez-faire approach to value transmission is one that allows others, especially children, to make decisions without guidance, resulting in a decision that may not be a sound one. Teaching a child about right and wrong behavior is a more active learning strategy, and reflects the moralizing approach to value transmission. Modeling or role modeling is leading (and transmitting values) by example—in this case, not smoking electronic cigarettes to show the teenagers good behavior. Telling the child about the injection feeling like a pinch is not an approach to value transmission.

A nurse obtains an order for a bed alarm for a confused client. This is an example of which ethical principle? a. Deception b. Confidentiality c. Paternalism d. Conflict

c. Paternalism Making a decision for a client who is confused to prevent an injury is an example of paternalism. Deception occurs when the true nature or reason is concealed and the client is deprived of basic human rights. Confidentiality requires a health care provider to keep a client's personal health information private unless consent to release the information is provided by the client. Conflict is a disagreement or argument and does not represent the example in this question.

A nurse seeks to incorporate the principle of bioethics known as nonmaleficence when caring for clients in a long-term care facility. Which nursing actions best exemplify this principle? Select all that apply. a. The nurse follows "medication rights" when administering medicine to clients. b. The nurse arranges for hospice for a client who is terminally ill. c. The nurse performs regular client assessments for pressure injuries. d. The nurse acts fairly when allocating time and resources to clients. e. The nurse provides information to clients to help them make decisions about treatment options. f. The nurse keeps promises to provide diligent care to clients.

c. The nurse performs regular client assessments for pressure injuries. The concept of nonmaleficence refers to the avoidance of causing harm. Examples of nonmaleficence include the nurse performing regular client assessments for pressure ulcers. Nonmaleficence would also include the nurse following "medication rights" when administering medicine to clients. Providing information to clients to help them make decisions about treatment options demonstrates the ethical principle of autonomy. Arranging for hospice care for a client who is terminally ill demonstrates the ethical principle of beneficence. Keeping promises to provide diligent care demonstrates the ethical principle of fidelity. Acting fairly when allocating time and resources demonstrates the ethical principle of justice.


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