ethics prep u
A nursing student is preparing for the first time to insert an indwelling catheter in a client. The client asks the student if he or she has have performed the procedure before. What is the best response by the student?
"I have practiced the skill in the lab and my instructor will be present during the procedure."
A client of a homecare nurse gives the nurse an envelope with a small amount of money in it, stating, "It's a tip for the good care you give me." Which statement would be the most appropriate response from the nurse?
"I'm grateful that you're satisfied with the care you're receiving, but I can't accept any form of gift."
A public health nurse is responsible for contact tracing of individuals identified in confirmed cases of sexually transmitted infections. The nurse telephones an individual named by a client as a contact. The individual demands the name of the person who identified the individual as a contact. Which is the most appropriate response from the nurse?
"Just as I will protect your privacy, I must protect the privacy of the other people involved."
A nurse is caring for a client who is a hospital employee. The client is diagnosed with genital herpes and is being treated for a urinary tract infection (UTI). A coworker asks the nurse about how the client is doing. What is the nurse's best response?
"Would you like me to let the client know you said hello?"
A nurse is working as part of a research team evaluating children for participation in a research study. The nurse demonstrates respect when the nurse obtains assent from children over which age?
7
Which clinical situation is addressed by the provisions of the Health Insurance Portability and Accountability Act (HIPAA)?
A client has asked a nurse if he can read the documentation that his health care provider wrote in his chart.
Nurses use social media to share ideas, develop professional connections, access educational offerings and forums, receive support, and investigate evidence-based practices. Which is an example of the proper use of social media by a nurse?
A nurse uses a disclaimer to verify that any views the nurse expresses on Facebook are the nurse's alone and not the employer's.
In which circumstance may the nurse legally and ethically disclose confidential information about a client?
A taxi driver's diagnosis of an uncontrolled seizure disorder to a state agency
An unresponsive client with a terminal illness in the hospital has no advanced directive. What are the steps the nurse will follow to practice ethical decision making?
Assess the ethical/moral situations of the problem. Convene an ethics panel. List the alternatives. Decide and evaluate the decision.
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
The depressed client is deciding which type of treatment would be beneficial. The nurse would document that the client is utilizing which ethical principle in this situation?
Autonomy
Nursing practice consistent with the Code of Ethics for Nurses includes which actions?
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 Delivering culturally safe care
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 example best describes feminist ethics?
An approach critiquing existing patterns of oppression and domination in society
A new nursing student is studying ethics in nursing and informs a client who wants to stop medication about its benefits and how the client will continue to feel better only if use of the drug continues. Which concept is the nursing student using?
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
The nurse is caring for a terminally ill client in the intensive care unit that is on life support measures. The family members are opposed in their decision to take the client off of life support. What option does the nurse discuss with the nurse manager?
Contact the ethics committee for their input.
A nurse overhears a second nurse making plans to meet a hospitalized client for a drink after the client has been discharged. Which is the best action for the first nurse to take?
Discuss the conversation directly with the other nurse.
In some cases, the act of providing nursing care in unexpected situations is covered by the Good Samaritan laws. Which nursing action would most likely be covered by these laws?
Emergency care for a choking victim in a restaurant
Healthcare providers use a problem-solving approach for ethical dilemmas. Which is the last step of the ethical decision-making model?
Evaluate the decision in terms of effects and results.
The nurse is caring for a client with end-stage breast cancer. When the nurse takes chemotherapy medication into the client's room, the client states, "I'm too tired to fight any more. I don't want any more medication that may prolong my life." The client's husband is at the bedside and states, "No! You have to give my wife her medication. I can't let her go." What action by the nurse is most appropriate?
Explain to the husband that his wife has the right to refuse medication and care.
A family member of a resident in a long-term care facility reports to the nurse that her mother's diamond ring is missing. Another resident reported a day earlier that a twenty-dollar bill was missing from his/her night table. What should the nurse do in this situation?
Notify the supervisor and call the police.
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 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?
Fidelity
A nurse is searching the Internet for information about theorists associated with moral development. The search reveals several theorists. Which result would the nurse identify as being associated with women and morality?
Gilligan
A client with cancer of the stomach tells the nurse, "I cannot bear the pain anymore. Please give me some poison to free myself from this agonizing pain." The nurse faces a value conflict. Which is true in such a condition?
Human need may affect the values conflict.
An HIV-positive client discovers that the client's name is published in a research report on HIV care prepared by the client's nurse. The client is hurt and files a lawsuit against the nurse. Which offense has the nurse committed?
Invasion of privacy
Nurse researchers have proposed a study to examine the efficacy of a new wound care product. Which aspect of the methodology demonstrates that the nurses are attempting to maintain the ethical principle of nonmaleficence?
The nurses are taking every responsible measure to ensure that no participants experience impaired wound healing as a result of the study intervention.
A client asks if the medication has any possible negative side effects. The nurse considers the client highly suggestible, believes the medication will benefit the client, and, since the client has no history of cardiovascular disease, does not tell the client of the potential for cardiac dysrhythmias. The nurse's actions involve a conflict between veracity and which other ethical principle?
Nonmaleficence
Which ethical principle requires a nurse to prevent clients from harming themselves or others?
Nonmaleficence
A client with chronic obstructive pulmonary disease presents with respiratory acidosis and hypoxemia. The client tells the nurse that they don't want to be placed on a ventilator. What action should the nurse take?
Notify the physician immediately to have the physician determine client competency.
The healthy adult client is given an opioid prior to a surgical procedure. The nurse is completing the chart and notices the consent form was not signed by the client. Which of the following should the nurse do first?
Notify the physician of the oversight.
A nurse caring for older adults in a long-term care facility is teaching a novice nurse characteristic behaviors of older adults. Which statement is not considered ageism?
Personality is not changed by chronologic aging.
Which is a true statement regarding placebos?
Placebos should never be used to test a client's truthfulness about pain.
While administering a medication via a syringe, a client sharply moves and the nurse accidentally encounters a needlestick. What is the priority nursing action?
Report the needlestick to the nurse manager.
To ensure ethical nursing care when dealing with genetic and genomic information, which principle would the nurse integrate as the foundation for all nursing care?
Respect for people
A nurse is conducting a physical assessment on an adolescent who does not want her parents informed that she had an abortion in the past. Which statement best describes the information security measures the nurse would implement in this situation?
Respect the adolescent's wishes and maintain her confidentiality.
The nurse is obtaining informed consent from a client. To adhere to ethical and legal standards, the nurse must ensure that the informed consent consists of what?
freedom from coercion the client's agreement to the plan of care discussion of pertinent information
The nurse is caring for a 17-year-old girl in the terminal phase of osteosarcoma. Which action demonstrates integration of the recommendations of the American Academy of Pediatrics (AAP) Committee on Bioethics?
Telling the child exactly what to expect of further treatments.
A nurse witnesses a traffic accident and dresses the open wounds sustained by a child. Later, in the hospital, the child develops complications from an infection in the wound. The family holds the nurse responsible for the complications and attempts to file a lawsuit. Which statement is true regarding how the Good Samaritan law applies to this case?
The Good Samaritan law will provide legal immunity to the nurse.
A psychiatric-mental health nurse has developed a therapeutic relationship with a client. Which action would alert the nurse to the possibilty that the relationship may be moving outside professional boundaries?
The client brings the nurse a baked item for their lunch. The nurse tells a friend that the nurse is the only one who truly understands this client. The nurse is spending more time with the client than the others in the group.
An obese client tells the nurse that the client plans to buy an abdominal exerciser to cut down on weight and give the client's body a more aesthetic look. The nurse should identify this as what level of valuing?
future value
A nurse is providing home care to a client with a foot ulcer related to diabetes. The client needs daily insulin injections. Family caregivers do not possess the technical skills to inject insulin. Which should the nurse keep in mind?
The nurse needs to be creative in integrating the technical and relational aspects of care.
The nurse is caring for a client who just learned of a terminal diagnosis. After the physician leaves, the nurse remains to answer further questions so that the client can make an informed decision about further treatment. By providing all available information, the nurse is promoting which ethical principle?
The principle of autonomy
Which is a characteristic of the care-based approach to bioethics?
The promotion of the dignity and respect of clients as people
Ethical distress is:
knowing the correct action but being unable to perform it due to constraints.
A hospital board of directors decides to close a pediatric burn treatment center (BTC) that annually admits 50 patients and to open a treatment center for terminally ill AIDS patients (with an expected annual admission of 200). This decision means that the nearest BTC for children is now 300 miles away. What example of ethical reasoning is this decision consistent with?
Utilitarianism
A client with bipolar disorder has been following the prescribed medication regimen. The client indicates to the nurse a desire to stop the medication now that the client is feeling better. The nurse tells the client that most likely the client will have to remain on the medication for life to keep the condition under control. The nurse is practicing which principle?
Veracity
A nurse is discussing principles in healthcare ethics with the nursing students. Which would be an appropriate example of nonmaleficence?
to protect clients from a chemically impaired practitioner
A nurse is presenting a workshop for a group of young women. Part of the workshop focuses on the moral development of women. The nurse integrates information about Gilligan's theory into the presentation, describing the various levels that a woman goes through as morality develops. When describing level 1, the nurse would focus on which area?
Woman's own needs
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 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
The nurse is teaching a client about the importance of adhering to a medication regimen. The client does not believe that it is important. The nurse is communicating which ethical principle?
beneficence
For a hospitalized client, the health care provider (HCP) orders morphine, 4 mg IM, every 4 hours as needed for pain. However, the client refuses to take injections. Which nursing action is most appropriate?
calling the HCP to request an oral pain medication
Which theory of ethics most highly prioritizes the nurse's relationship with clients and the nurse's character in the practice of ethical nursing?
care-based ethics
Several days this week, a nurse takes time after work to read to a visually impaired client who has no family close by. This behavior demonstrates that ethical values:
concern the treatment of others.
Ethical theories provide a means to determine if a particular action is good or bad. Which theory of ethics holds that a person's duties are as important as the outcome or consequences of one's actions?
deontology
A nurse is acting inappropriately and has an odor of alcohol. This behavior breaches the principle of:
ethical conduct.
Using the nursing process to make ethical decisions involves following several steps. Which step is the nurse implementing when the nurse reflects on the decision-making process and the role it will play in making future decisions?
evaluating
A famous actor with bipolar disorder has been admitted in the mental health unit for treatment. A well known news outlet has offered the nurse several thousand dollars to provide information or a picture of the client. The nurse knows that it is their professional duty and legal responsibility to uphold privacy and confidentiality. For each of the behaviors exhibited by the nurse, click to specify whether the behavior upholds the principle of privacy or confidentiality. Nurse's Behaviors Privacy Confidentiality logging off the electronic health record after documenting assessment information obtaining the client's permission before allowing a student nurse to assist with care keeping the door closed while conducting physical assessment asking the client to sign a medical release form before providing information to the health insurance company sharing client information only to the caregivers directly assigned to client care
logging off the electronic health record after documenting assessment information -confidentiality obtaining the client's permission before allowing a student nurse to assist with care - privacy keeping the door closed while conducting physical assessment - privacy asking the client to sign a medical release form before providing information to the health insurance company - confidentiality sharing client information only to the caregivers directly assigned to client care - confidentiality
After teaching a class to a group of nursing students about reporting infectious diseases to the Centers for Disease Control and Prevention, the instructor determines a need for additional discussion when the students identify which infection as being reportable:
pinworm
A client with colorectal cancer has been presented with her treatment options but wishes to defer any decisions to her uncle, who acts in the role of a family patriarch within the client's culture. What best protects the client's right to self-determination?
respecting the client's desire to have the uncle make choices on her behalf
What would be an example of the nurse practicing fidelity? The nurse:
stays with a client during death as promised.
A nurse is caring for a client diagnosed with myocardial infarction. A person identifying himself as the client's friend asks the nurse for the client's records, but the nurse declines. The nurse's unwillingness to divulge the requested information is based on the understanding that which people would be entitled to access to the client's records?
those directly involved in the client's care
