Ch 2
Which of the following best describes the ethical concept of values? A. Values are an individual's feelings about situations. B. Values are learned through family systems. C. Values are organized ways of thinking about the meaning of life. D. Values determine the rightness or wrongness of behavior.
ANS: A Page: 15 A. This is correct. Values are how individuals feel about ideas, situations, and concepts. B. This is incorrect. Morals, springing from an individual's conscience, are learned through family systems, instruction, and socialization. C. This is incorrect. Belief systems are organized ways of thinking about why people exist. D. This is incorrect. Ethics deal with the rightness or wrongness of human behavior.
A registered nurse (RN) is caring for a patient who is one of Jehovah's Witnesses and has refused a blood transfusion even though her hemoglobin is dangerously low. After providing information about all the alternatives available and risks and benefits of each, the health-care provider allows the patient to determine which course of treatment she would prefer. The RN knows this is an example of which ethical principle? A. Autonomy B. Nonmaleficence C. Beneficence D. Distributive justice
ANS: A Page: 19 A. This is correct. Autonomy is an individual's right to make his or her own decisions. B. This is incorrect. Nonmaleficence is the responsibility of the nurse to do no harm either intentionally or unintentionally and to protect those who cannot protect themselves. C. This is incorrect. Beneficence is the principle of doing good to others. D. This is incorrect. Distributive justice is the responsibility to fairly allocate scarce resources regardless of gender, sexual orientation, religion, ethnicity, disease, social standing, or any other criteria.
A recent ethical issue has resulted in uneasiness and discomfort for several nurses on a unit. The unit manager has decided to discuss the issues at the next team meeting. The situation has resulted in which of the following for some of the nurses? A. Moral suffering B. Moral distress C. Ethical dilemma D. Veracity
ANS: A Page: 24 A. This is correct. Moral suffering occurs when a situation results in a feeling of uneasiness or concern because of behaviors or circumstances that challenge one's own morals and beliefs. B. This is incorrect. Moral distress occurs when nurses know the action they should take, but are unable to take that action. C. This is incorrect. An ethical dilemma occurs when a situation forces a nurse to choose between two ethical principles. D. This is incorrect. Veracity is an ethical principle that requires nurses to be truthful.
An RN recognizes which of the following as a primary goal of nursing? A. Assist patients to achieve a peaceful death. B. Improve personal knowledge and skill in order to improve patient outcomes. C. Advocate for quality of life over quantity of life. D. Work to control costs so that patients can live the best quality of life possible.
ANS: A Page: 28 A. This is correct. The primary goal of nursing is to keep people alive and well, or if this is not possible to at least assist them to live as comfortably as possible and achieve a peaceful death. B. This is incorrect. Improving nursing knowledge and skills assists nurses in achieving their primary goal. C. This is incorrect. Although nurses seek to provide their patients with the best quality of life possible, this is not the primary goal of nursing. D. This is incorrect. Although controlling costs may lead to improved quality of life, this is not the primary goal of nursing.
Which of the following best describes intrinsic values? A. Intrinsic values are often abstract ideas. B. Intrinsic values are basic needs for sustaining life. C. Intrinsic values are qualities patients consider to be important in their private lives. D. Intrinsic values are qualities patients consider important for nurses to have.
ANS: B Feedback A. This is incorrect. Extrinsic values are not essential to sustaining life and may include physical or abstract objects or meanings. B. This is correct. Intrinsic values are related to sustaining life, such as food and water. C. This is incorrect. Personal values are qualities people consider important in their private lives. D. This is incorrect. Professional values are qualities a professional group consider to be important.
An RN cared for a state senator during the day shift. Later that day he was having dinner with friends when the news mentioned the senator had been hospitalized. The RN's friends asked if he knew what was wrong with the senator. Which ethical principle should the RN consider when replying? A. Fidelity B. Confidentiality C. Veracity D. Accountability
ANS: B Page: 21 A. This is incorrect. The principle of fidelity requires nurses to fulfill all commitments they make and all responsibilities of professional practice. B. This is correct. The principle of confidentiality requires nurses to hold healthcare information and anything patients tell them in the strictest confidence. C. This is incorrect. The principle of veracity requires nurses to be truthful. D. This is incorrect. The principle of accountability requires nurses to accept responsibility for their own answers.
An RN's current patient and family have presented her with an ethical dilemma. What is the first step the RN should take to find a workable solution to the problem? A. Planning B. Assessment C. Evaluation D. Implementation
ANS: B Page: 26 A. This is incorrect. Planning occurs after all relevant information is collected. Planning involves establishing goals, identifying decision makers, and reviewing all options. B. This is correct. The nursing process can be used to find a solution to an ethical dilemma. The first step is assessment and identification of the problem. C. This is incorrect. Evaluation is the last step of the nursing process, requiring nurses to evaluate the outcomes of the decision made. D. This is incorrect. Implementation is the mutually acceptable plan of action that decision makers agree upon
Although technology has seen many advances, which two ethical principles may be in conflict because of technology? A. Beneficence and justice B. Beneficence and nonmaleficence C. Beneficence and veracity D. Beneficence and confidentiality
ANS: B Page: 29 A. This is incorrect. The principle of justice requires nurses to treat all patients the same. Technology usually does not cause dilemmas between beneficence and justice. B. This is correct. Beneficence is the principle of doing good to benefit others. Nonmaleficence is the principle of doing no harm to others. Technological advances can cause the principles of beneficence and nonmaleficence to develop into an ethical dilemma. C. This is incorrect. Veracity is the ethical principle that requires nurses to tell the truth. Technology usually does not cause dilemmas between beneficence and veracity. D. This is incorrect. Confidentiality is the ethical principle requiring nurses to hold their patient's statements in the strictest confidence. Technology usually does not cause dilemmas between beneficence and confidentiality.
Values are learned through which of the following methods? A. Reading books B. Formal degrees C. Continuous reinforcement D. Meeting diverse individuals
ANS: C Page: 16 A. This is incorrect. Values can be taught directly through societal norms, not through reading books. B. This is incorrect. Values can be taught directly though modeling behavior, not through formal degrees. C. This is correct. Children learn values through continuous reinforcement by watching their parents, friends, teachers, and religious leaders. D. This is incorrect. Values are learned through continuous reinforcement, and not through meeting diverse individuals.
When considering virtue ethics, which of the following is true? A. Virtue ethics attributes behaviors to moral rules. B. Virtue ethics attributes behaviors to knowledge of consequences. C. Virtue ethics focuses on moral character, rather than rules for behavior. D. Virtue ethics is a formal statement of rules for behavior.
ANS: C Page: 23 A. This is incorrect. Deontology attributes behaviors to moral rules and duties. B. This is incorrect. Teleological theories derive rules for behavior from the consequences of the action. C. This is correct. Virtue ethics focuses on qualities and moral character rather than rules or duties. D. This is incorrect. A code of ethics is a formal statement of rules for ethical behavior
An RN is working through an ethical dilemma involving a patient on his unit. He has just identified the decision makers involved. Which step best describes the current stage the RN is working through? A. Assessment B. Diagnosis C. Planning D. Implementation
ANS: C Page: 26 A. This is incorrect. Assessment occurs as nurses collect all necessary information about an ethical dilemma. B. This is incorrect. Nursing diagnosis is not a step in solving ethical dilemmas. C. This is correct. During the planning phase, goals of treatment are established, decision makers are identified, and all options are reviewed. D. This is incorrect. Implementation occurs when all stakeholders arrive at a mutually acceptable decision.
A unit director at a local hospital knows even leadership may face ethical dilemmas. Which of the following should the director take into consideration when dealing with an employee who is incompetent? A. The situation should be tolerated for as long as possible because of the amount of time and paperwork required to terminate an incompetent nurse. B. Incompetence only impacts the individual nurse. C. The director should follow her institution's formal process for reporting and handling practices that jeopardize patient safety. D. Most nurse practice acts direct how to handle incompetent nurses.
ANS: C Page: 30 A. This is incorrect. Although following regulations may require time and effort, patient safety is the top priority. B. This is incorrect. Incompetence can place patients and the entire staff at risk. C. This is correct. Incompetence jeopardizes patient safety. Therefore, the formal process for handling these practices should be followed. D. This is incorrect. Most nurse practice acts direct the reporting of impaired nurses, but do not address incompetence.
Which of the following statements about ethical principles and laws is true? A. The government holds the power to enforce ethics. B. Laws provide standards that assist in decision making. C. Ethics are very specific. D. As a standard for measuring actions, ethical principles may be the basis for laws.
ANS: D Page: 18 A. This is incorrect. The government holds the power to enforce laws. B. This is incorrect. Ethics provide standards for measuring actions, and therefore assist in decision making. C. This is incorrect. Laws are more specific than ethics. D. This is correct. Ethical principles are a standard for measuring actions. They may form the basis for laws, but are not laws themselves.
Which of the following statements is true regarding nursing ethics? A. Nursing ethics focus on the organizational level at the workplace. B. Nursing ethics focus on the duties and rules of behavior for professional nurses. C. Nursing ethics focus on the moral character of nurses. D. Nursing ethics focus on the experiences and needs of nurses.
ANS: D Page: 23 A. This is incorrect. Organizational ethics focus on the organizational level at the workplace. B. This is incorrect. Deontology focuses on the duties and rules of behavior. C. This is incorrect. Virtue ethics focus on virtues and moral character. D. This is correct. Nursing ethics not only focus on the experiences and needs of nurses, but also on the nurses' perceptions of these experiences.
An RN knows that sometimes, when working through an ethical dilemma, the decision makers are unable to arrive at a mutually agreed upon decision. Which of the following is a reason why an agreement cannot be reached? A. One or more of the parties may be able to reconcile their values. B. The patient's point of view is recognized as valuable. C. The dilemma involves two or more equally unpleasant choices. D. The institution is unable to honor the patient's request.
ANS: D Page: 27 A. This is incorrect. Inability to reconcile belief patterns or values is a reason why a solution to an ethical dilemma may not be reached. B. This is incorrect. If the caregivers do not recognize the worth of the patient's point of view, a solution to an ethical dilemma may not be found. C. This is incorrect. An ethical dilemma is a situation that involves two or more equally unpleasant choices, but this does not mean that an agreement cannot be reached. D. This is correct. A patient may make a request that is not possible within the institution. When this occurs, a solution may not be possible within the institution and the patient may need to be transferred to a different institution that may be able to honor the request
A nurse is providing care to a patient whose family has previously brought suit against hospital and two physicians. Under which ethical principle should the nurse practice? 1. Justice 2. Veracity 3. Autonomy 4. Nonmaleficence
Answer: 1 Rationales: 1. All patients are entitled to the best possible care regardless of their socioeconomic status, culture, or situations.
The ANA code of Ethics With Interpretive Statements guides nurses in ethical behaviors. Provision 3 of the ANA Code of Ethics says: "The nurse promotes, advocates for and strives to protect the health, safety, and rights of the patient." Which of the following best describes an example of this provision? 1. Respecting the patient's privacy and confidentiality when caring for him 2. Serving on a committee that will improve the environment of patient care 3. Maintaining professional boundaries when working with a patient 4. Caring for oneself before trying to care for another person
Answer: 1 Rationales: 1. The ANA Code of Ethics is designed to guide nurses toward quality, ethical care of patients. There may be times when it is difficult to discern the most ethical action, particularly when the lines are blurred as to the correct decision. The Code of Ethics provides some guidance that nurses can follow as part of the profession of nursing to uphold standards of ethical care.
A nurse is working on an ethics committee to determine the best course of action for a patient who is dying. The nurse considers the positive and negative outcomes of the decision to assist with choices. Which best describes the distinction of using a list when making an ethical decision ? 1. The nurse can back up her reasons for why she has decided to provide a certain type of care 2. The nurse can compare the benefits of one choice over another 3. The nurse can communicate the best choice of action to the interdisciplinary team 4. The nurse can provide care based on developed policies and standards
Answer: 2 2. Creating a list of positives and negatives helps when difficult choices need to be made. The list outlines the positive and negative aspects of a decision. It allows the nurse to compare the benefits of making a choice versus the potential disadvantages. When compared side by side, it could help the nurse to make a difficult decision through an easier method.
Which best describes the difference between patient privacy and patient confidentiality? 1. Confidentiality occurs between persons who are close, whereas privacy can affect anyone 2. Privacy is the right to be free from intrusion into personal matters, whereas confidentiality is protection from sharing a person's information 3. Confidentiality involves the use of technology for protection, whereas privacy uses physical components of protection 4. Privacy involves protection from being watched, whereas confidentiality involves protection from a verbal exchanges
Answer: 2 2. Privacy is the condition of being free from being observed or disturbed by other people. Confidentiality has to do with the sharing of someone else's information.
A patient asks a nurse if he has to agree to the health provider's treatment plan. The nurse asks the patient his concerns. Which ethical principle is the nurse applying in this situation ? 1. Beneficence 2. Autonomy 3. Veracity 4. Justice
Answer: 2 2. The principle of autonomy indicates that the client has independence to make decisions and take action for himself or herself. When the nurse asks the patient about his concerns, the nurse is exploring the reasons and allowing the patient to make his own decision.
A nurse's significant other undergoes exploratory surgery at the hospital where the nurse is an employee. Which practice is most appropriate? 1. The nurse is an employee; therefore, access to the chart is permissible. 2. Access to the chart requires a signed release form. 3. The relationship with the client provides the nurse special access to the chart. 4. The nurse can ask the surgeon to discuss the outcome of the surgery.
Answer: 2 2. Unless the significant other has authorized any access to information, the only people entitled to information without written consent are the client and those providing direct care.
Health Insurance Portability and Accountability Act (HIPAA) regulations guard confidentiality. In several situations, confidentiality can be breached and information can be reported to other entities. Which of the following meet these criteria ? Select all that apply 1. The patient is from a correctional institution 2. The situation involves child abuse 3. An injury occurred from a firearm 4. The patient is a physician 5. The breach of information was unintentional
Answer: 2,3 2. Although HIPAA provides protections for patient privacy, there are some cases in which health-care providers can disclose patient information to other providers and caregivers. These exceptions typically include care related to criminal acts, such as child or elder abuse, or when a patient is injured because of a firearm or some other weapon. 3. Although HIPAA provides protections for patient privacy, there are some cases in which health-care providers can disclose patient information to other providers and caregivers. These exceptions typically include care related to criminal acts, such as child or elder abuse, or when a patient is injured because of a firearm or some other weapon.
A nurse is caring for a patient who feels that life should not be prolonged when hope is gone. She has decided that she does not want extraordinary measures taken when her life is at its end. She has discussed her feelings with her family and health-care provider. The nurse realizes that this is an example of: 1. Affirming a value 2. Choosing a value 3. Prizing a value 4. Reflecting a value
Answer: 3 3. Prizing a value means being satisfied with a choice and being willing to declare the choice to others. The patient made her choice clear to her family and provider.
Which of the following demonstrates a nurse as advocating for a patient? The nurse 1. calls a nursing supervisor in conflicting situations. 2. reviews and understands the law as it applies to the client's clinical condition. 3. documents all clinical changes in the medical record in a timely manner. 4. assesses the client's point of view and prepares to articulate this point of view.
Answer: 4 4. Nurses strengthen their ability to advocate for a client when nurses are able to identify personal values and then accurately identify the values of the client and articulate the client's point of view.
Several studies have been shown that although care planning and advanced directives are available to clients, only a minority actually complete them. Which of the following has been shown to be related to completing an advanced directive? Select all that apply 1. African American race 2. Younger age 3. History of chronic illness 4. Lower socioeconomic status 5. Higher education
Answer:3, 5 Rationales: People are more likely to complete advance directives about their care when they are informed and they understand the ramifications of doing so. Studies have shown that certain populations are more likely to follow through with completing advance directives when compared with others; these populations include those who have higher levels of socioeconomic status, those with higher levels of education, and people who have already suffered from a chronic disease.
