Chapter 6 Nursing Fundamentals

Which theory of ethics prioritizes the nurse's relationship with clients and the nurse's character in the practice of ethical nursing?

Care-based ethics

The nurse beginning practice would like to access the standards for ethical practice. Which organization should the nurse research for these standards?

International Council of Nurses

A nurse who has worked on a unit for 8 years is conflicted about asking to meet with the charge nurse about staffing ratios. Which question(s) reflect the professional value of altruismin this decision? Select all that apply.

"Am I able to provide safe and efficient care to my clients?" "Am I willing to take this risk to help protect my fellow nurses?" "Will less experienced nurses on the unit learn from my actions?"

A charge nurse has implemented staff education on nursing values. The nurse would determine that further education is required when which statement(s) are overheard? Select all that apply.

"If that was my mother, I sure wouldn't agree to a no-code." "The gonorrhea test was positive. That's what the client gets for sleeping around." "I can't believe the client is giving that precious baby up for adoption."

Which statement by the nurse is an example of deception?

"This injection of procaine will feel like a little pinch."

A nurse's friend states, "I admire you so much. I would love to be a nurse, but I don't think I have the courage." Which response will the nurse make?

"You can work on being more courageous as you learn to be a nurse."

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."

Which best defines value clarification?

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

A school nurse interviewing parents of a child who is doing poorly in school determines that the parents practice a laissez-faire method of discipline. What are examples of this form of value transmission? Select all that apply.

An adolescent boy explores religions of friends in hopes of developing his own faith. An adolescent girl tries alcohol at a party with her friends.

Which word is best described as protection and support of another's rights?

Advocacy

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?

Airlifting the client to a local trauma center for emergency surgery

Which example best describes feminist ethics?

An approach critiquing existing patterns of oppression and domination in society

A nurse has completed 4 hours of an 8-hour shift on a medical-surgical unit when the nursing supervisor calls. The nursing supervisor directs the nurse to give a report to the other two nurses on the medical-surgical unit and immediately report to the telemetry unit to assist with staff needs on that unit. The nurse informs the supervisor that the nurse has been busy with client assignments and feels this will overwhelm the nurses on the medical-surgical unit. The supervisor informs the nurse that the need is greater on the telemetry unit. This is an example of which type of ethical problem?

Allocation of scarce nursing resources

Which scenario is an example of the laissez-faire approach to value transmission?

Allowing a child to decide not to have an intravenous line inserted

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?

Assist in decision making based on the client's best interests.

Which ethical principle refers to the obligation to do good?

Beneficence

Six adolescents were killed in an accident following a night of drinking. The older brother of one of the victims bought beer for the group because none of them was old enough to purchase alcohol. Which statement(s) regarding the brother's action reflect customs rather than communal or personal ethical standards? Select all that apply.

Big brothers often introduce their younger siblings to alcohol. Drinking alcohol is a rite of passage.

Which nursing situation is an example of an ethical dilemma?

Deciding whether to perform cardiac compressions against a client's wishes

Nursing practice consistent with the Code of Ethics for Nurses includes which actions? Select all that apply.

Delivering culturally safe care Acknowledging that the client is the focus and center of care and remains a part of the treatment team Protecting the client's right to confidentiality and privacy

The nurse is involved in making a decision in an ethical dilemma. Drag and drop the steps of making this decision in correct order. Use all options.

Describe the situation and the contextual factors involved. Determine that the situation is, indeed, an ethical dilemma. Identify personal and professional moral positions of those involved. Compare the outcome of actions with what was expected. Identify how this situation can help with future decision-making.

Which example most accurately depicts the ethical principle of autonomy?

Describing a surgery to a client before the consent is signed

The focus of the unit where a nurse works is changing. The nurse has deeply held moral and religious objections to procedures that will be commonly performed on clients on this new unit. Which action(s) should the nurse take? Select all that apply.

Discuss the situation with the unit nurse manager. Do not compromise the nurse's own personal moral standards.

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 health care provider that they want the client to be resuscitated. Aware of the client's wishes, the nurse is involved in a situation that may involve:

Ethical distress

Which statement best conveys the concept of ethical agency?

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

A nurse is caring for a client with terminal cancer. The family would like the client to continue aggressive treatment but the client has told the nurse that he would prefer comfort care. The nurse speaks to the family about the client's wishes, condition, and terminal state. This action is most likely derived from which nursing obligation?

Ethical principles

Using the nursing process to make ethical decisions involves following several steps. Which step is the nurse implementing when reflecting on the decision-making process and the role it will play in making future decisions?

Evaluating

A female client is brought to the emergency room with matted hair, bruising, and malnutrition. The nurse suspects physical abuse and neglect. The nurse states, "This happens to many women." Which type of ethical approach is the nurse exhibiting?

Feminist

A client rings the call bell to request pain medication. On performing the pain assessment, the nurse informs the client that the nurse will return with the pain medication. After a few moments, the nurse returns with the pain medication. The nurse's returning with the pain medication is an example of which principle of bioethics?

Fidelity

A nurse is providing care to a client and is preparing the client for breakfast. The nurse assists the client out of bed to the chair and then helps the client open the items on the breakfast tray. The client begins to eat breakfast. The nurse tells the client, "I'll be back in about 10 minutes to check on you. In the meantime, here is your call light in case you need me." About 10 minutes later, the nurse returns to check on the client. The nurse is demonstrating which ethical principle?

Fidelity

Which nursing action demonstrates the principle of fidelity?

Filing an incident report after making a medication error

A nurse is administering evening medications and notices that a medication was omitted during the day shift. Which statement demonstrates the principle of accountability?

Filling out an occurrence report and notifying the healthcare provider

A nurse reports to the charge nurse that a client medication due at 9 am was omitted. Which principle is the nurse demonstrating?

Integrity

A nurse is providing care for three clients on a medical unit, two of whom are significantly more acute than the third. The nurse is making a concerted effort to ensure that the less acute client still receives a reasonable amount of time, attention, and care during the course of the shift. Which ethical principle is the nurse attempting to practice?

Justice

The nurse is managing the care for a postoperative client. How does the nurse demonstrate advocacy?

Limiting visitors due to the client reporting pain

The nurse has identified an ethical dilemma that has the potential to interfere with a client receiving optimal care. The nurse discussed this issue with the charge nurse on the unit. What action should the nurse choose next?

Monitor for resolution of the problem.

A nurse working in a critical care unit has experienced personal tragedy, extreme shortage of staff in the work environment, and health issues. The nurse has overcome much of these hardships and is now mentoring other nurses in similar situations. What behavior is this nurse demonstrating?

Moral resilience

A nurse knows that the expression "Do not cause harm" refers to which ethical principle?

Nonmaleficence

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 Explaining all nursing procedures clearly Listening to the client tell stories about past experiences

A nurse obtains an order for a bed alarm for a confused client. This is an example of which ethical principle?

Paternalism

What are standards for decision-making that endure for a significant time in one's life?

Values

The nurse is reviewing charges to clients for surgical procedures and observes different charges dependent upon insurance status. How can the nurse best demonstrate a commitment to the ethical principle of justice?

Report this finding to the appropriate supervisor

Several nurses on the same hospital unit communicate on the same social networking site. A nurse posts the following statement to the social networking page, "The lady in room 34 with heart failure was a train wreck!" In which manner has the nurse failed to apply the principles of confidentiality?

Sharing information about a client beyond the area of client care is unacceptable and breaches the client's confidentiality rights.

A nurse gives the 400 IU of a vitamin supplement that was in the client's medications instead of the 200 IU that was prescribed. The dosage was given when the unit was busy admitting three clients and another client was in crisis. Which action(s) by the nurse demonstrate the professional value of integrity? Select all that apply.

The nurse documents the dose given. The nurse completes a variance or incident report.

Ethical practice is evaluated as a portion of the nurse's annual review. Which practice(s) would cause the evaluator to reduce the nurse's score on this section of the review? Select all that apply.

The nurse is frequently late to work. The nurse often speaks harshly to cleaning staff and transport workers.

Which action would cause a charge nurse to have concerns about a nurse's moral agency?

The nurse was seen at a grocery store after calling in sick.

Which is a characteristic of the care-based approach to bioethics?

The promotion of the dignity and respect of clients as people

Nurses who value client advocacy follow what guideline?

They give priority to the good of the individual client rather than to the good of society in general.

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

Trustworthiness Humility Compassion

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:

advocacy

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?

autonomy

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

cultural

A nurse pulls the curtains closed before changing the dressing of the surgical wound on the abdomen of a postsurgical client. What value is served?

dignity

A nurse is acting inappropriately and has an odor of alcohol. This behavior breaches the principle of:

ethical conduct

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?

fidelity

The nurse is participating in a workplace group that is charged with making decisions about resource allocation throughout a community. This nurse is enacting what ethical principle?

justice

Ethical distress is:

knowing the correct action but being unable to perform it due to constraints.

What would be an example of the nurse practicing fidelity? The nurse:

stays with a client during death as promised.

A parent of a 17-year-old high school student is allowing the child to decide which college the child will attend. When the child requests direction from the parent in making this decision, the parent responds by stating, "You will need to make this decision on your own." What type of value transmission is the parent displaying?

laissez-faire

Which action most clearly demonstrates a nurse's commitment to social justice?

lobbying for an expansion of Medicare eligibility and benefits

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?

moral distress

A nurse shows client advocacy by:

offering a hospice consultation to a client who is terminally ill.

An older adult was just diagnosed with stage 4 pancreatic cancer. The client states, "I am so overwhelmed and I feel like everyone has already decided that I need to be put in hospice care." Complete the following sentence by choosing from the lists of options. The nurse upholds the principle of autonomy by

offering to answer questions the client may have about care and treatment options providing the client with the information needed to obtain a second opinion

A nurse is of the Catholic faith and votes pro-life. This nurse is considered to have:

personal values

A nurse is caring for an older adult who has cancer and is experiencing complications requiring a revision of the plan of care. The nurse sits down with the client and the family and discusses their preferences while sharing the nurse's own judgments based on the nurse's expertise. Which type of healthcare decision making does this represent?

shared decision making

Socialization into the nursing profession may have the most significant effect on:

values

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:

values clarification.

What is the term for the beliefs held by the individual about what matters?

valves