Copy of Ethics Quiz Fall 2019

A primary nurse completes a nursing assessment of all assigned clients and develops a care plan for each client. Which element of decision-making does the nurse execute in this situation? 1 Authority 2 Autonomy 3 Responsibility 4 Accountability

Responsibility Responsibility refers to duties and activities that an individual is employed to perform. Authority refers to the legitimate power to give commands and make final decisions specific to a given issue. Autonomy refers to freedom of choices and the responsibility for the choices. Accountability refers to individuals being answerable for their actions.

According to which stage of Kohlberg's theory would a nurse ask a higher authority to reduce the treatment expenses of a low-income client? 1 Social contract orientation 2 Society-maintaining orientation 3 Instrument relativist orientation 4 Universal ethical principle orientation

Universal Ethical Principle The universal ethical principle orientation stage of Kohlberg's theory states that an individual may not follow a law if it does not seem just. At this stage, the nurse may ask a higher authority to reduce the treatment expenses of a poorer client. According to the social contract orientation stage, a person follows a law even if it is not necessarily just. According to the society-maintaining orientation stage, an individual shows concern for and makes decisions in accordance to his or her society. During the instrument relativist orientation, a child recognizes that there is more than one correct view.

What is the difference between the social contract orientation stage and the universal ethical principle orientation stage? 1 Social contract orientation involves following laws without question, whereas universal ethical principle orientation involves civil disobedience. 2 Social contract orientation is a part of conventional reasoning, whereas universal ethical principle orientation is a part of postconventional reasoning. 3 Social contract orientation focuses on expanded societal concerns in an individual, whereas universal ethical principle orientation focuses on basic rights and laws. 4 Social contract orientation demonstrates moral decisions based on societal view, whereas universal ethical principle orientation stage outlines individual's response based on physical punishment.

1 Social contract orientation involves following laws without question, whereas universal ethical principle orientation involves civil disobedience. The social contract orientation stage relies on following laws without question, whereas an individual under the universal ethical principle orientation stage may show civil disobedience. Both the social contract orientation stage and the universal ethical principle orientation stage are part of postconventional reasoning. Both stages are related to basic rights and laws. The society-maintaining orientation stage demonstrates moral decisions based on societal laws, whereas the punishment and obedience orientation stage outlines an individual's response based on the threat of physical punishment.

An emaciated older adult with dementia develops a large pressure ulcer after refusing to change position for extended periods of time. The family blames the nurses and threatens to sue. What is considered when determining the source of blame for the pressure ulcer? 1 The client should have been turned regularly. 2 Older clients frequently develop pressure ulcers. 3 The nurse is not responsible to the client's family. 4 Nurses should respect a client's right not to be moved.

1 The client should have been turned regularly. Clients should change position at least every 2 hours to prevent pressure ulcers. The nurse should not deviate from this standard of practice because of the cognitively impaired client's refusal to move. The nurse was negligent for not changing the client's position. Although pressure ulcers may occur, nursing care must include preventive measures. If the client refuses to change position for extended periods of time, the nurse should consult the agency policy or management for a strategy to handle this situation. For example, a formal shared decision-making (SDM) protocol can be instituted upon admission or as soon as refusal has started to involve the client, the client's family, and the healthcare staff with a collaborative agreement on how to resolve the problem. The family is included in the healthcare team, so the nurse is responsible to them. When a capable client refuses necessary health care, the nurse should provide health teaching to promote understanding of the treatment plan. If the client makes an informed decision after an explanation, then the client's rights must be respected; however, this client is cognitively impaired. An SDM would be helpful in this situation.

What should the nurse consider when obtaining an informed consent from a 17-year-old adolescent? 1 Whether the client is allowed to give consent 2 That the client cannot make informed decisions about healthcare 3 Whether the client is permitted to give voluntary consent when parents are not available 4 That the client probably will be unable to choose between alternatives when asked to consent

1 Whether the client is allowed to give consent A person is legally unable to sign a consent until the age of 18 or 19 years (depending upon individual state or provincial laws) unless the client is an emancipated minor or married. The nurse must determine the legal status of the adolescent. Parents or guardians are legally responsible under all circumstances unless the adolescent is an emancipated minor or married. Adolescents have the capacity to choose, but not the legal right in this situation unless they are legally emancipated or married.

A nursing student is citing examples of situations that constitute invasion of privacy. Which examples are accurate? Select all that apply. 1 "A nurse states in a press conference that a famous singer is suffering from throat cancer." 2 "A nurse informs a woman's husband that she has had a miscarriage without consulting with the client." 3 "A nurse tells the parents of a 19-year-old that their child is addicted to drugs without waiting for consent." 4 "A nurse informs the primary healthcare provider that the client has cancer without waiting for consent." 5 "A nurse falsely enters in a client's electronic health record that he or she has a sexually transmitted infection (STI)."

1 "A nurse states in a press conference that a famous singer is suffering from throat cancer." 2 "A nurse informs a woman's husband that she has had a miscarriage without consulting with the client." 3 "A nurse tells the parents of a 19-year-old that their child is addicted to drugs without waiting for consent." All medical information of clients is confidential and should not be revealed to unauthorized personnel; a violation of this confidentiality is considered to be an invasion of privacy. Revealing information about a client's illness to media personnel is considered to be invasion of privacy. The nurse should not inform the client's husband about the miscarriage without consulting with the client. In addition, divulging information about an adult client's drug abuse to his or her parents without consent is an invasion of privacy. Informing the primary healthcare provider about the client's illness without waiting for the client's consent is not considered to be an invasion of privacy, because the information is being shared for the purpose of medical treatment. Entering false information in the client's electronic health recording may damage the reputation of the client. This is considered to be libel.

Before a treatment requiring informed consent can be performed, what information must the client be given? Select all that apply. 1 The cost of the treatment 2 Alternative treatment options 3 The risks and benefits of the treatment 4 The risks involved in refusing the treatment 5 The nature of the problem requiring the treatment

2 Alternative treatment options 3 The risks and benefits of the treatment 4 The risks involved in refusing the treatment 5 The nature of the problem requiring the treatment For consent to be legal it must be informed. The information provided to the client includes the nature of the problem or condition, the nature and purpose of the proposed treatment, and the risks and benefits of the treatment. Alternative treatment options, the probability that the proposed treatment will be successful, and the risks involved in not consenting to the treatment must also be provided. Cost of the treatment is not considered relevant to informed consent.

What are the best ways for a nurse to be protected legally? Select all that apply. 1 Ensure that a therapeutic relationship with all clients has been established. 2 Provide care within the parameters of the state or provinces standards for nursing practice. 3 Carry at least $100,000 worth of liability insurance. t4 Document consistently and objectively. Correct5 Clearly document a client's nonadherence to the medical regimen.

2 Provide care within the parameters of the state or provinces standards for nursing practice. 3 Carry at least $100,000 worth of liability insurance. Correct4 Document consistently and objectively. Correct5 Clearly document a client's nonadherence to the medical regimen. Malpractice or negligence must be proven legally. If a nurse is providing the best possible care under the circumstances, and within the scope of nursing practice, it would be difficult to prove allegations. Consistent, objective, and clear documentation also support practice within legal parameters. It is unrealistic that the nurse will have a therapeutic relationship with all clients. Liability insurance protects the nurse if found guilty and a monetary award is made, but it does not reduce the possibility of litigation.

A client asks the nurse, "Because I'm so comfortable talking with you, can we go out for coffee and a movie after I get discharged?" To maintain the boundaries of a therapeutic relationship, how will the nurse respond? 1 "I'm flattered, but that would be professionally unethical." 2 "You feel connected to me now; that will change once you are discharged." 3 "The attention I've been giving you is directed toward getting you better; it isn't social." 4 "A social life is important, so as your nurse let's talk about how you can form friendships."

4 "A social life is important, so as your nurse let's talk about how you can form friendships."

A nurse who is working on a medical-surgical unit receives a phone call requesting information about a client who has undergone surgery. What is the best response by the nurse? 1 "That client is not on our unit. Thank you for calling." 2 "The new privacy laws prevent me from providing any client information over the phone." 3 "The client has requested that no information be given out. You'll need to call the client directly." 4 "It is against the hospital's policy to provide you with any information.

4 "It is against the hospital's policy to provide you with any information. The response "It is against the hospital's policy to provide you with any information." is a factual statement, without indicating whether or not the client is in the hospital. The response "That client is not on our unit. Thank you for calling." is a lie and should be avoided. HIPAA (Canada: FOIPOP) laws do not prohibit the provision of information to others as long as the client consents. The response "The client has requested that no information be given out. You'll need to call the client directly." implies that the client is admitted to the facility; this violates the client's request that no information should be shared with others.

The spouse of a client who is dying tells the primary nurse that the client is asking the nurses to leave the pain medication on the bedside table and fears they are being saved for a suicide attempt. The nurse knows that the staff members have mixed feelings about the client's terminal status and prolonged pain. What is the most ethically appropriate intervention by the nurse? 1 Reporting the information about the medication to the nurse manager 2 Reminding the nurses that they should not leave the medication at the bedside 3 Asking the nurse manager to address the medication problem and the staff's feelings 4 Suggesting a nursing conference to discuss the medication problem and the staff's feelings

4 Suggesting a nursing conference to discuss the medication problem and the staff's feelings