NR 226: Ethics

Written when one speaks falsely about another

libel

Failure to use the degree of skill or learning that would be used under the same circumstance

malpractice

Failure to provide the expected standard of care.

negligence

An unexpected occurrence involving death or serious physical or psychological injury

sentinel

Verbal when one speaks falsely about another

slander

A nurse receives a call from a church member regarding when Mr. Jones may be coming home. The nurse shares that Mr. Jones will be coming home on Friday. Which act did the nurse violate?

HIPPA

Which would the nurse do to comply with the ethic of non maleficence in the health care setting? A. Focus on doing no harm B. Keep promises made to clients C. Respect the autonomy of clients D. Keep the best interests of the client in mind

A. Focus on doing no harm Rationale: To comply with the ethic of non-maleficence, the nurse would focus on doing no harm. The health care ethic fidelity requires the nurse to keep promises made to the client by following through on the plan of care. To comply with the ethic of autonomy, the nurse would include the client in the decision-making process when developing a care plan. To comply with the health care ethic of beneficence, the nurse is required to keep the best interests of the client in mind when providing care.

How is the term "beneficence" in health ethics different from "nonmaleficence"? A. Beneficence invokes taking positive actions to help others whereas nonmaleficence is the avoidance of harm or hurt B. Beneficence refers to fairness, whereas nonmaleficence refers to the agreement to keep promises C. Beneficence stands for all health care professionals, whereas nonmaleficence stands for nursing professionals D. Beneficence refers to the support of a particular cause, whereas nonmaleficence refers to a willingness to respect one's professional obligations

A. Beneficence invokes taking positive actions to help others whereas nonmaleficence is the avoidance of harm or hurt

The nurse gives the wrong medication to a patient and notifies the provider and charge nurse immediately. Which code is the nurse practicing?

Accountability

A nurse is working on a busy psych unit and tells Mr. Jones, "If you don't act right tonight, I am going to lock you up in your room." What tort did the nurse commit? (Threat to do harm)

Assault

Mr. Jones has decided to remove himself from the transplant list when he found out his cancer had returned. What ethical principal is Mr. Jones exercising?

Autonomy

A medical nurse is caring for a patient who is palliative following metastasis. The nurse is aware of the need to uphold the ethical principle of beneficence. How can the nurse best exemplify this principle in the care of this patient? A. The nurse tactfully regulates the number and timing of visitors as per the patient's wishes B. The nurse stays with the patient during his or her death C. The nurse ensures that all members of the care team are aware of the patient's DNR order D. The nurse liaises with members of the care team to ensure continuity of care

B. The nurse stays with the patient during his or her death Rationale: Beneficence is the duty to do good and the active promotion of benevolent acts. Enacting the patient's wishes around visitors is an example of this.

The nurse sees Mr. Jones in the lobby of a nursing home. She shouts, "Mr. Jones I have been looking for you all morning" and then grabs Mr. Jones by the arm and starts to pull him back to his room. Which tort has the nurse commit? (Harmful contact?)

Battery

A nurse is caring for client with a mental illness. Which of the following actions by the nurse demonstrates the ethical concept of autonomy? A. Encouraging client feedback about satisfaction with the facility experience B. Explaining unit rules and policies regarding unacceptable behaviors C. Supporting the client's wish to refuse prescribed medications D. Making sure the client understands expectations for client participation

C. Supporting the client's wish to refuse prescribed medications Rationale: Supporting the client's wishes is an important component of client advocacy.

A nursing instructor is providing education to a group of nursing students about Maslow's basic human needs model. Which scenario promotes achievement of the physiologic needs of the client based on his model? SATA. A. the nurse includes the client's family in care management B. The nurse shares in the excitement of a client that is proud of their granddaughter for passing the NCLEX C. The nurse provides adequate draping to the client with fever D. The nurse listens to the client's stories of victory when he was in the military E. The nurse records the patient's daily dietary regimen

C. The nurse provides adequate draping to the client with fever E. The nurse records the patient's daily dietary regimen Rationale: Selections with content about fever, vital signs, and dietary regimen are included in the physiologic needs of the client. The choice about the client telling stories of victory during his military days belongs to self-actualization. Involving the family in the client's care is promoting the love and belonging level. Being happy for the achievement of a loved one pertains to self-actualization.

A nurse is providing information to a group of nursing students about ethical principles in nursing practice. The nurse should include which of the following examples of beneficence in the instructions? A. A nurse is fair in providing resources to all clients B. A nurse follows through with care offered to a client C. A nurse respects a client's right to determine a course of action D. A nurse tells a client that the flu shot may cause some discomfort but describes the benefits of the immunization

D. A nurse tells a client that the flu shot may cause some discomfort but describes the benefits of the immunization Rationale: Beneficence is described as taking a positive action to help others. Commitment to beneficence helps to guide decisions when the benefits of treatment are challenged by its risks.

Which is appropriate for the nurse to include in the education of the ethical principle of nonmaleficience to a group of nursing students? A. Treat all clients equitably me fairly B. Tell the client the truth about their health C. Help the clients make informed choices D. Act in ways to prevent harm to clients

D. Act in ways to prevent harm to clients Rationale: Nonmaleficence means to act in ways that prevent client harm or even the risk of harm. Telling the truth to clients about their health refers to veracity. Helping clients make informed choices promotes autonomy. Justice involves treating all clients equitably and fairly.

A nurse in a long term care facility is working with an older adult client. Which of the following nursing actions encourages autonomy for the client? A. Planning meals B. Decorating the room C. Scheduling haircut appointments D. Allowing the client to choose social activities

D. Allowing the client to choose social activities

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

D. Individuals being answerable for their actions Rationale: Accountability refers to individuals being answerable for their actions. This idea means that the nurse has to accept the commitment to provide excellent client care and responsibility for the outcomes of his or her actions. Autonomy refers to freedom of choice and responsibility for those choices. Responsibility refers to the duties and activities that an individual is employed to perform. Authority refers to legitimate power to give commands and make final decisions specific to a given position.

What ethical term refers to fair and equal distribution of health resources?

Justice

A new nurse goes home afterwork and posts on Facebook that her manager is so stupid, and she doesn't know how she keeps her job since her license was suspended last year. Which tort has the nurse committed? (Written when one speaks falsely about another)

Libel = library = WRITTEN

A legal document that communicates a patient's wishes regarding medical treatment in the event the patient is unable to make decisions for themselves. DNR is an example.

Living will

A nurse notices that Mr. Jones is having difficulty breathing. She lifts the HOB 30 degrees and applies oxygen then leaves for lunch without informing anyone. When she returns Mr. Jones is in full blown respiratory distress and the healthcare team is looking to intubate him. Which tort did the nurse commit? (Failure to use the degree of skill or learning that would be used under the same circumstance.)

Malpractice

A patient is NPO, and the nurse gives him a pop. The patient chokes and aspirates. Which tort has the nurse committed? (Failure to provide the expected standard of care.)

Negligence

A patient needing to have his right leg amputated below the knee has the left leg amputated below the knee. This is an example of what kind of event? (An unexpected occurrence involving death or serious physical or psychological injury)

Sentinel

A nurse is discussing a doctor with a patient. The nurse tells the patient the doctor is a terrible doctor and has been arrested for using drugs. The patient's whole family sees this doctor and has decided not to see this doctor anymore. Which tort has the nurse committed? (Verbal when one speaks falsely about another)

Slander = speak = VERBAL

A nurse sees a car accident on the side of the road and stops to help. The patient ends up dying, the nurse is covered under which law?

The good samaritan act

Considers the usefulness of an action and measures the effect that an action will have

Utilitarianism

What is the nurse's role in informed consent?

Witness Consent

A home health nurse is creating a plan of care for a post surgical client. The nurse understands that the clients' basic need of self fulfillment falls in which level of Maslow's hierarchy? A. Physiologic B. Transcendence C. Love and belonging D. Self actualization

D. Self actualization Rationale: Maslow's highest level of human needs is self-actualization, which includes self-fulfillment, desire to know and understand, and aesthetic needs.

What is the difference in conflicting values called?

Ethical

The nurse is discussing with a client the recent loss of a pet, the client states that "no one could ever replace the relationship I had with my Lucy". According to Maslow's hierarchy of needs, the nurse knows that which of the following is not been met for the client? A. Physiological needs B. Self esteem C. Safety and security needs D. Love and belonging needs

D. Love and belonging needs Rationale: LOVE AND BELONGING includes: Needs are for giving and receiving of affection, companionship, satisfactory interpersonal relationships, and identification with a group.

Which action by a nurse demonstrate adherence to the ethical principle of fidelity? A. Keeping an appointment with a client B. Allowing a new mother to hold her stillborn infant C. Confirming that a client going for surgery has signed a consent form D. Refusing to disclose information about a client to the media

A. Keeping an appointment with a client Rationale: Fidelity is the duty to keep one's promises or word. Keeping an appointment the nurse has made with the client is an example of fidelity. Beneficence is the duty to do good for others. Allowing a grieving mother an opportunity to spend time with her infant helps her to process her loss and is an example of beneficence. The ethical principle of autonomy describes an individual's right to choose. In health care, autonomy is the principle underlying informed consent, the right to refuse treatment, and the right to appoint a surrogate decision maker. Confidentiality is not disclosing a client's personal health care information to unauthorized individuals or other entities.

Which information is correct regarding the similarities and differences between the deontological and utilitarianism system of ethics? Select all that apply. One, some, or all responses may be correct. A. both utilitarianism and deontology look into the nature of relationships and propose that the natural urge to be influenced by relationships is a positive value B. utilitarianism takes into consideration the usefulness of an action; deontology does not look into consequences C. utilitarianism measures the effect that an act will have; deontology looks to the presence of principles regardless of the outcome D. the difference between utilitarianism and deontology is the focus on outcomes E. utilitarianism and deontology are closely related to the ethics of care because both ideologies promote a philosophy that focuses on understanding relationships

B. utilitarianism takes into consideration the usefulness of an action; deontology does not look into consequences C. utilitarianism measures the effect that an act will have; deontology looks to the presence of principles regardless of the outcome D. the difference between utilitarianism and deontology is the focus on outcomes Rationale: Ethics of care and feminist ethics are closely related because both promote a philosophy that focuses on understanding relationships, especially personal narratives. Feminist ethics look into the nature of relationships and propose that the natural urge to be influenced by relationships is a positive value.

A nurse tells a parent that the MMR injection may cause a low-grade fever and pain at the injection site. The nurse then explains to the parent the benefit of the immunization. This is an example of which ethical principle?

Beneficience

A nurse manager is preparing to discuss the principle of justice with nursing staff. Which information should NOT be included in the discussion? Select all that apply. A. Health and health care disparity B. Confidentiality C. Civil rights D. HIPAA E. healthy people 2020 and it's leading health indicators

Confidentiality, civil rights, HIPAA Rationale: HIPAA is discussed with the principle of confidentiality. The right for self-determination and civil rights are presented with the principle of autonomy. Health and health care disparity, and Healthy People 2020 and its Leading Health Indicators are addressed with the principle of justice. For further readings refer to Chapter 5 Ethical Issues Related to Health Promotion (Edelman, & Kudzma, 2018). Also, to Chapter 22 Ethics and Values (Potter et al., 2017).