Chapter 6-8 prep u questions

A client comes into the urgent care center to have sutures removed on an arm. The nurse finds significant crusting along the suture line. The client states not having time to get the sutures removed a week prior, as directed. The nurse soaks the crust and attempts to remove the sutures. As the nurse attempts the suture removal, the client frequently pulls the arm away and tells the nurse, "You are taking too long and it is hurting a little bit. Just pull them out and get it over with." Which statement is an example of appropriate therapeutic response? "I am sorry it is taking so long and I am hurting you; next time do not wait too long to get sutures removed or the same thing will happen" "It is taking longer for me to remove the sutures because the delay allowed the crust to form and adhere to the sutures, making it harder and sometimes painful to remove them."

"It is taking longer for me to remove the sutures because the delay allowed the crust to form and adhere to the sutures, making it harder and sometimes painful to remove them."

A nurse is caring for a client with a complete spinal cord injury that has caused paraplegia. The client is very distraught and asks the nurse, "Are they sure, even with therapy, I will never walk again?" Which statement made by the nurse demonstrates veracity?

"You have a complete injury, which results in a total loss of movement and sensation below the level of injury."

The nurse is communicating with a client who has been newly diagnosed with cancer. Which statement(s) by the nurse is nontherapeutic? Select all that apply. "You will be OK. Your health care provider is an excellent surgeon." "Keep your chin up. People survive this type of cancer all the time." "Why did you not seek help when you first noticed a problem?" "This is upsetting news for you. Let's talk about it." "What are your thoughts about what your health care provider has recommended?"

"You will be OK. Your health care provider is an excellent surgeon." "Keep your chin up. People survive this type of cancer all the time." "Why did you not seek help when you first noticed a problem?"

An RN is working on a medical-surgical unit with a licensed practical/vocational nurse (LPN/LVN). Which action by the RN is considered negligent if injury results from this action? a. Asking the LPN/LVN to teach a new diabetic client how to administer insulin b. Delegating oral medication administration to the LPN/LVN

Asking the LPN/LVN to teach a new diabetic client how to administer insulin

Which statement best conveys the concept of ethical agency? a. Ethical practice is best learned and fostered by surrounding oneself with people who exhibit ethical character. b. A nurse's understanding and execution of ethical practice is primarily a result of increased years of experience. c. Individuals who enter the nursing profession often innately possess ethical characteristics. d. Ethical practice requires a skill set that must be conscientiously learned and nurtured.

Ethical practice requires a skill set that must be conscientiously learned and nurtured.

Which statement best conveys the concept of ethical agency? a. Ethical practice requires a skill set that must be conscientiously learned and nurtured. b. Ethical practice is best learned and fostered by surrounding oneself with people who exhibit ethical character c. A nurses understanding of ethical agency is best learned through years of practice

Ethical practice requires a skill set that must be conscientiously learned and nurtured.

Which nursing action demonstrates the principle of fidelity? a. Administering vaccines b. Witnessing a client signature on an informed consent c. Filing an incident report after making a medication error d. treating an uninsured client in the emergency department

Filing an incident report after making a medication error

A nurse works in a nursing care facility that has a policy of regularly using restraints on clients that the nurse believes is unethical. However, the nurse feels obligated to follow the policy because of a fear of being fired. This is an example of which type of ethical situation? a. Moral distress b. Ethical dilemma c. Conscientious objection

Moral distress

A home health nurse performs a careful safety assessment of the home of a frail older adult to prevent harm to the patient. The nurse's action reflects which principle of bioethics? Autonomy Beneficence Justice Fidelity Nonmaleficence

Nonmaleficence

A nurse who is infected with the human immunodeficiency virus (HIV) accidentally gets a cut while debriding a wound, exposing the client to possible HIV infection. Failure of the nurse to report this incident violates which ethical principles? Select all that apply. a. Nonmaleficence b. Veracity c. Autonomy d. Fidelity e. Justice

Nonmaleficence Veracity Fidelity

A home care nurse visits a client who is confined to bed and is cared for by an adult child with substance use disorder. The home is cluttered and unclean, and the nurse notes that the client is wet with urine, has dried feces on the buttocks, and shows signs of dehydration. After caring for the client, the nurse contacts the health care provider and reports the incident to Adult Protective Services. What ethical principle is the nurse practicing? a. Justice b. Autonomy c. Nonmaleficence

Nonmaleficence. The principle of nonmaleficence means to avoid doing harm, to remove harm, and to prevent harm

A nurse is caring for a hospitalized client. Which nursing actions demonstrate a caring and compassionate attitude? Select all that apply. Notifying the client before leaving for lunch Offering snacks and beverages to visiting family Listening to the client tell stories about past experiences Explaining all nursing procedures clearly

Notifying the client before leaving for lunch Offering snacks and beverages to visiting family Listening to the client tell stories about past experiences Explaining all nursing procedures clearly

A pediatric nurse is assessing a 5-year-old boy who has dietary modifications related to his diabetes. His parents tell the nurse that they want him to value good nutritional habits, so they decide to deprive him of a favorite TV program when he becomes angry after they deny him foods not on his diet. This is an example of what mode of value transmission? Modeling Moralizing Laissez-faire Rewarding and punishing

Rewarding and punishing

A nurse is applying a care-based approach to an ethical dilemma. When integrating this approach, which concept should the nurse keep in mind? Select all that apply. a. The caring relationship is essential to the approach. b. Clients are people and are to be respected. c. Attention is needed to focus on each person's individual situation. d. Autonomy and beneficence guide any action. e. Benefits to one client typically are benefits to another.

a. The caring relationship is essential to the approach. b. Clients are people and are to be respected. c. Attention is needed to focus on each person's individual situation.

A nurse is of the Catholic faith and votes pro-life. This nurse is considered to have: a. personal values. b. Moral agency c. Ethics

personal values.

A nurse is reviewing the nurse practice act of the state in which the nurse is licensed. The nurse understands that this act was derived from which source of law? a. constitutional b. statutory c. administrative d. common

statutory

A client is brought to the emergency department by an adult child, who states, "I am unable to care for my parent anymore. Although I would like to, financially and physically I cannot do it anymore." What ethical problem is the adult child experiencing? a. Dilemma b. Uncertainty c. moral distress d. ethical dilemma

moral distress

Which is an example of an unintentional tort? a. A nurse gives the client a medication, and the client has an adverse reaction to it. b. Nurses discuss a client's laboratory values in the elevator.

nurse gives the client a medication, and the client has an adverse reaction to it.

An older nurse asks a younger coworker why the new generation of nurses just aren't ethical anymore. Which reply reflects the BEST understanding of moral development? a. "Behaving ethically develops gradually from childhood; maybe my generation doesn't value this enough to develop an ethical code." b. "I don't agree that nurses were more ethical in the past. It's a new age and the ethics are new!" c. "Ethics is genetically determined...it's like having blue or brown eyes. Maybe we're evolving out of the ethical sense your generation had." d. "I agree! It's impossible to be ethical when working in a practice setting like this!"

"Behaving ethically develops gradually from childhood; maybe my generation doesn't value this enough to develop an ethical code."

A nurse has been asked to serve as an expert witness in a malpractice case in which an infant died in the newborn nursery. Which questions should the nurse consider prior to accepting this job? Select all that apply. "How much clinical experience do I have in the newborn nursery?" "Have I ever worked in this hospital system?" "How much education do I have about caring for newborns?" "How would I react if I was sued?" "How would I feel if my child died due to a nurse's malpractice?"

"How much clinical experience do I have in the newborn nursery?" "How much education do I have about caring for newborns?"

The client confronts the nurse, stating, "No one has come into my room to give me the pain medication I requested 2 hours ago. I am in pain!" Which response by the nurse indicates the nurse is using a "defending" communication technique? a. "I have been busy with other clients that required my immediate attention." b. "Why did not you put your light on again and remind me?"

"I have been busy with other clients that required my immediate attention."

A nurse is caring for a client who is newly diagnosed with terminal cancer. The nurse enters the client's room and finds the client sitting in the dark crying. Which statement conveys empathy by the nurse? "I know this is hard for you. Is there any way I can help?" "I am so sorry you are going through this. Can we talk?"

"I know this is hard for you. Is there any way I can help?"

The client is talking to the nurse about recent health problems of immediate family members and the strain the client has been under trying to care for them. The client begins to cry. What response by the nurse demonstrates the most empathy? "Just take your time. I am listening." "It is difficult when family members are ill. It helps if you take some time for yourself."

"Just take your time. I am listening."

While teaching about advance care planning, which fact is important for the nurse to share with a client who has been diagnosed with a terminal illness? a. A durable power of attorney for health care appoints an agent the person trusts to make decisions. b. Living wills provide specific instructions related to the client's personal property upon death.

A durable power of attorney for health care appoints an agent the person trusts to make decisions.

Which best defines value clarification? An organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct A process by which people come to understand their own values and value systems

A process by which people come to understand their own values and value systems

Which best defines value clarification? a. A belief about the worth of something b. A process by which people come to understand their own values and value systems c. 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

An illegal immigrant with no health insurance sustained life-threatening injuries in an automobile accident. Which action in this case demonstrates the ethical principle of justice? a. Telling the client honest information about the client's medical condition and prognosis b. Airlifting the client to a local trauma center for emergency surgery

Airlifting the client to a local trauma center for emergency surgery

A nurse states the following to another nurse who is constantly forgetting to wash hands between clients: "It looks like you keep forgetting to wash your hands between clients. It's really not safe for your clients. Let's think of some type of reminder we can use to help you remember." This communication is an example of what type of speech? a. therapeutic b. aggressive c. assertive d. organizational

Assertive

A nurse is interviewing a client who has come to the clinic for a follow-up visit. The nurse notices the client does not make eye contact and speaks while looking down. How should the nurse respond? Stop the interview and ask, "How are you feeling?" Assume a position at eye level with the client and continue with the interview.

Assume a position at eye level with the client and continue with the interview.

A nurse who provides the information and support that clients and their families need to make the decision that is right for them is practicing what principle of bioethics? a. autonomy b. nonmalefience c. beneficence

Autonomy

It is important for the nurse to empathize with the client to develop a positive, therapeutic relationship. What is a characteristic of empathy? a. Conveying genuine care to the client b. Identifying with the client's feelings

Conveying genuine care to the client

A client states that the client's recent fall was caused by his scheduled antihypertensive medications being mistakenly administered by two different nurses, an event that is disputed by both of the nurses identified by the client. Which measure should the nurses prioritize when anticipating that legal action may follow? a. Consult with the hospital's legal department as soon as possible. Document the client's claims and the events surrounding the alleged incident.

Document the client's claims and the events surrounding the alleged incident.

A nurse learns to adopt behavior modeled by a charge nurse. What ethical principle or behavior is the nurse most likely to learn through this process? a. Standards of practice b. Decision making c. Ethical conduct

Ethical conduct

A nurse wants to call an ethics consult to clarify treatment goals for a patient no longer able to speak for himself. The nurse believes his dying is being prolonged painfully. The patient's doctor threatens the nurse with firing if the nurse raises questions about the patient's care or calls the consult. What ethical conflict is this nurse experiencing? Ethical uncertainty Ethical distress Ethical dilemma Ethical residue

Ethical distress

A nurse states to the client that the nurse will keep the client free of pain. However, the client's family wishes to try a treatment to prolong the client's life that may necessitate withholding pain medication. This factor will cause an ethical dilemma for the nurse in relation to which ethical principle? a. Fidelity b. Autonomy c. Justice

Fidelity

A nurse incorporates the "five values that epitomize the caring professional nurse" (identified by the American Association of Colleges of Nursing) into a home health care nursing practice. Which attribute is best described as acting in accordance with an appropriate code of ethics and accepted standards of practice? a. Altruism b. Autonomy c. Human dignity d. Integrity

Integrity

The nurse beginning practice would like to access the standards for ethical practice. Which organization should the nurse research for these standards? Department of Health Professions Canadian Hospital Association World Health Organization International Council of Nurses

International Council of Nurses

The nurse is managing the care for a postoperative client. How does the nurse demonstrate advocacy? a. Limiting visitors due to the client reporting pain b. Changing the channel on the television c. Administering pain medication when the clients pain is as a 9

Limiting visitors due to the client reporting pain

Which actions by the nurse demonstrate the ethical principle of fidelity? Select all that apply. Maintaining current nursing registration and meeting continuing education requirements Performing an intervention for a client at the time that was promised Taking scheduled breaks on time Calling in sick due to a lack of sleep Taking an extra client assignment so that the client will be cared for

Maintaining current nursing registration and meeting continuing education requirements Performing an intervention for a client at the time that was promised Taking an extra client assignment so that the client will be cared for

When analyzing an ethical dilemma according to the ethical framework, what is most important for the nurse to take into consideration? a. Decision making b. Standard of conduct c. The relationship between laws and values

Standard of conduct

A nurse has been caring for a client who had a myocardial infarction 2 days ago. During the morning assessment, the nurse asks the client how the client feels. Which scenario warrants further investigation? The client stares at the floor and states, "I feel fine." The client looks at the nurse and states, "I am still not feeling my best."

The client stares at the floor and states, "I feel fine."

A family brings the client to the emergency department in an unconscious state with a head injury. The client requires surgery to remove a blood clot. What would be the appropriate nursing intervention in keeping with the policy of informed consent prior to a surgical procedure? a. The nurse confirms that the client has signed the consent form. b. The nurse confirms that the client's family has signed the consent form. c. The nurse informs the family about advance directives. d. The nurse informs the family about the living will.

The nurse confirms that the client's family has signed the consent form.

A nurse enters a client's room and finds that the client is lying on the floor. The nurse makes the client comfortable on the bed and completes an examination. She informs the health care provider and the nursing supervisor about this incident and also completes an incident report. Which action by the nurse indicates correct knowledge of handling an incident report? a. The nurse makes a copy of the incident report to give to the health care provider. b. The nurse documents a complete description of the happenings in the client's records.

The nurse documents a complete description of the happenings in the client's records.

Which is a characteristic of the care-based approach to bioethics? The promotion of the dignity and respect of clients as people The need for an orientation toward service

The promotion of the dignity and respect of clients as people

A nurse caring for patients in the intensive care unit develops values from experience to form a personal code of ethics. Which statements best describe this process? Select all that apply a. People are born with values. b.Values act as standards to guide behavior. c. Values are ranked on a continuum of importance. d. Values influence beliefs about health and illness. e. Value systems are not related to personal codes of conduct. f. Nurses should not let their values influence patient care

Values act as standards to guide behavior. Values are ranked on a continuum of importance. Values influence beliefs about health and illness.

An oncology client in an outpatient chemotherapy clinic asks several questions regarding care and treatment. The nurse explains the clinic's routine, typical side effects of the chemotherapy, and ways to decrease the number of side effects experienced. Which characteristic is the nurse demonstrating? a. Fidelity b. Veracity c. Autonomy

Veracity

During an admission intake assessment, a nurse uses open-ended questions to gather information. An example of an open-ended question is: a. Can you tell me the medications you take on a daily basis?" b. What did your health care provider tell you about your need to be admitted?

What did your health care provider tell you about your need to be admitted?

A nurse is caring for a client in the community who is at risk for sudden death from a chronic health condition. To reduce the legal risks associated with working with this client, the nurse carries out which action(s)? Select all that apply. a. Follow the prescribed plan of care for the client. b. Explain every nursing intervention in detail. c. Document nursing actions shortly after completion. d. Avoid physically touching the client when possible. e. Ensure client compliance with safety warnings.

a. Follow the prescribed plan of care for the client. b. Explain every nursing intervention in detail. c. Document nursing actions shortly after completion.

During the orientation to the hospital, the staff development educator discusses unit and institutional-based policies. What is the source of the practice rules that result in unit and institutional-based policies? a. Board of nursing b. Health care institution

b. Health care institution

In the provision of care and the establishment of the therapeutic relationship, the nurse must first: a. treat the client with dignity. b. be aware of one's own personality.

be aware of one's own personality.

A client has been in the emergency department for 3 hours for treatment of a migraine headache. Care has been delayed due to a multiple fatality car accident. The client gets up to go to the bathroom unattended, faints, and suffers a subdural hematoma. The family threatens to sue for malpractice. Which element of malpractice will be the most difficult for the attorney to prove? a. breach of duty b. duty c. causation d. damages

causations

When examining values, a nurse notes that one country allows physician-assisted suicide and another outlaws it, making it punishable by imprisonment. Which factors best explain the differences in values between these two countries? a. ethical b. moral c. cultural

cultural

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. ethical distress b. ethical dilemma c. Paternalism

ethical distress.

The nurse is caring for clients in a hospital setting. Which situations encountered by the nurse have a significant ethical component? Select all that apply. Deciding which continuing education offerings to take Addressing a suspected breach in confidentiality Helping a client make end-of-life decisions Deciding when to stop cardiopulmonary resuscitation (CPR) on a client in cardiac arrest Deciding how to reassign staff in light of budget cuts

everything but Deciding which continuing education offerings to take

A nurse is providing care for a client with cancer. The client's spouse requests that the client not be told that the client is terminal. The nurse complies with this request. The nurse's action is a breach of which ethical principle? a. beneficence b. fidelity

fidelity

A hospital owned by a Catholic order of nuns will not allow tubal ligations to be performed. This is considered to be:

institutional policy.

What is likely to have the greatest influence on an adolescent's formation of values during this developmental stage? a. parents b. peers c. teachers d. awareness of other cultures

peers

A client is being prepared for an elective surgical procedure and the consent form has not been signed. Who should the nurse have obtain consent for the procedure? a. The client's family or significant other b. The health care provider performing the surgical procedure

the health care provider performing the surgical procedure

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: a. Moral distress b. Values clarification. c. Ethical dilemma

values clarification.