Chapter 6: Values, Ethics, and Advocacy

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

Nonmaleficence

A nurse who is infected with 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.

Nonmaleficence, veracity, fidelity

The nurse is caring for clients in a hospital setting. Which situations encountered by the nurse have a significant ethical component?

Addressing a suspected breach in confidentiality Helping a client make end-of-life decisions Deciding how to reassign staff in light of budget cuts Deciding when to stop cardiopulmonary resuscitation (CPR) on a client in cardiac arrest

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

Advocacy

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?

"I can't believe the client is giving that precious infant up for adoption." "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."

Which statement regarding the Code of Ethics for Nurses is most accurate?

"The code is an expression of nursing's own understanding of its commitment to society."

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 practices the ethical principle of autonomy when providing nursing care for clients. Which nursing actions best describe the use of this value? Select all that apply.

A nurse reads The Patient Care Partnership to a visually impaired client. A nurse asks the surgeon to further explain details of a surgery to a client before obtaining informed consent.

Which best defines value clarification?

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

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 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 altruism in 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?

Which example best describes feminist ethics?

An approach critiquing existing patterns of oppression and domination in society

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.

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

A nurse is providing care to a client with end-stage cancer. After weighing the alternatives, the client decides not to participate in a clinical trial offered and is requesting no further treatment. The nurse advocates for the client's decision based on the understanding that the client has the right to self-determination, interpreting the client's decision as reflecting which ethical principle?

Autonomy

What ethical principle is related to the idea of self-determination?

Autonomy

Which ethical principle refers to the obligation to do good?

Beneficence

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.

Which nursing situation is an example of an ethical dilemma?

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

Which example most accurately depicts the ethical principle of autonomy?

Describing a surgery to a client before the consent is signed

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

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

In the delivery of care, the nurse acts in accordance with nursing standards and the code of ethics and reports a medication error that the nurse has made. The nurse is most clearly demonstrating which professional value?

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

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

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

Limiting visitors due to the client reporting pain

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

Lobbying for an expansion of healthcare resources and benefits to those in poverty

Which actions by the nurse demonstrate the ethical principle of fidelity?

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

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 is reviewing The International Council of Nurses (ICN) Code of Ethics for Nurses. Based on this code, the nurse would identify which responsibilities as being fundamental? Select all that apply.

Promoting health, preventing illness, restoring health, alleviating suffering

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.

A nurse is asked to serve on an ethics committee. Which roles would the nurse be required to fill on the committee? Select all that apply.

Serving as a liaison between the family and the committee members Presenting explanations about technical terminology Advocating for the client's wishes

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

A client continues to complain of pain despite receiving medication. The family states, "In our culture it is acceptable to complain out loud." What would be the best response by the nurse?

Tell me more about your cultural beliefs.

A nurse is applying a care-based approach to an ethical dilemma. When integrating this approach, which concept should the nurse keep in mind?

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

Which is the best definition of ethics?

The formal, systematic study of moral beliefs

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.

Nurses who value client advocacy follow what guidelines?

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

When providing nursing care to clients, the nurse is required to adhere to ethical values and legal rules to guide practice behavior. Which values would be included? Select all that apply:

Veracity, fidelity, privacy, confidentiality

which traits are examples of virtues that can exemplify character and conduct as a professional nurse?

Trustworthiness, humility, compassion

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.

A parent teaches a child not to drink and drive; however, the parent does drink and drive. This action results in:

a failure to model one's own values.

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

ethical conduct.

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.

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

Ethical distress is:

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

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

paternalism

The nurse is attempting to clarify the values of an adolescent client. The nurse should identify what factor as having the greatest influence on an adolescent's value formation during this developmental stage?

peers

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

personal values

A nurse is providing care to an older adult client who was just diagnosed with cancer. The client together with the immediate family discuss their preferences with the health care providers involved. The health care providers offer their clinical recommendations about possible treatments. Ultimately, the group arrives at a decision. The nurse interprets this decision-making process as reflecting which type?

shared

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

values