Ethics Quiz
The foundation for decisions about resource allocation throughout a society or group is based on the ethical principle of:
justice
A nursing faculty is presenting a lecture on ethics. The correct definition of ethical distress is:
knowing the correct action, but unable to perform due to constraints Knowing the correct action but being unable to perform the action due to constraints is the definition of ethical distress.
The client is a 40-year-old man admitted s/p repair of a femoral fracture. He discloses that he has a history of an addiction to painkillers and asks that the nurse assist him in adhering to his recovery from this addiction by not administering any narcotics. As the nurse reviews postoperative orders for the client, the nurse notes that his physician has ordered Codeine 30 mg p.o. q6 hours for pain. How does the nurse best approach this situation?
Asks the physician to remove this order from the client's chart.
Which of the following nursing situations is an example of an ethical dilemma?
Performing cardiac compressions when a signed Do Not Resuscitate order (DNR) is not available An ethical dilemma occurs when it is difficult for a decision to be made. If there is no signed DNR, then legally cardiac compressions must be started. Administering pain medication as ordered, transferring a client to a step-down unit, and discussing the care of a comatose client with the family are all within the ethical scope.
A nurse has completed four hours of his eight-hour shift on a medical-surgical unit when he receives a phone call from the nursing supervisor. The nursing supervisor informs him that he needs 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 he has been busy with his client assignment 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
Standards for ethical practice for nurses are primarily laid out by what organization?
American Nurses Association The ANA Code of Ethics for Nurses is the main source of the ethical principles that nurses must follow.
Which of the following best describes feminist ethics?
An approach critiquing existing patterns of oppression and domination in society.
A client age 46 years has been diagnosed with cancer. He has met with the oncologist and is now weighing his options to undergo chemotherapy or radiation as his treatment. This client is utilizing which ethical principle in making his decision?
Autonomy Autonomy entails the ability to make a choice free from external constraints. Beneficence is the duty to do good and the active promotion of benevolent acts. Confidentiality relates to the concept of privacy. Justice states that like cases should be treated alike.
A nurse fails to communicate a change in the client's condition to the physician. Which element related to proving malpractice has been met?
Breach of duty Failing to communicate a change in the client's condition reflects a breach of duty. Duty describes the relationship between the person and the person being sued. Nurses have a duty to care for their clients. The existence of a duty is rarely an issue in a malpractice suit. The action or lack of action must be proven as the cause of the injury. Damages refer to the injury suffered by the client.
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 Central to the care-based approach to ethics is the nurse's relationships with clients and the nurse's "being," or character and identity. Deontology, utilitarianism, and principle-based ethics each prioritize goals and principles that exist beyond the particularities of the nurse-client relationship
A nursing faculty is discussing laissez-faire values with students. Which of the following is an example of those values?
Parents allowing a child to decide not to have an intravenous line inserted A laissez-faire environment is one that allows others, especially children, to make decisions without guidance, resulting in a decision that may not be a sound one. The other choices are not reflective of the definition of a laissez-faire environment.
A nurse obtains an order for a bed alarm for a confused client. This is an example of which of the following ethical principles?
Paternalism Making a decision for a client who is confused to prevent an injury is an example of paternalism. Deception and conflict would not promote the safety of a client who is unable to make safe decisions and confidentiality does not apply in this instance.
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.
What is the term for the beliefs held by the individual about what matters?
Values
An employee health nurse is assisting a stressed, working mother with value clarification. Which of the following best defines value clarification?
a process by which people come to understand their own values and value systems
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 health care provider
A nurse shows client advocacy by:
offering a hospice consultation to a client who is terminally ill. The definition of advocacy is to ensure that the best interests are being met. A hospice consult is an appropriate example. The other choices do not reflect advocacy for the client.
What would be an example of the nurse practicing fidelity? The nurse:
provides continuity of care. Fidelity requires the nurse to keep promises made and to be faithful to one's commitments.
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 her judgments based on her expertise. Which of the following types of health care decision making does this represent?
shared decision making
In the delivery of care, the nurse acts in accordance with nursing standards and the code of ethics and reports a medication error that she has made. The nurse is most clearly demonstrating which professional value?
Integrity The nurse is demonstrating integrity, which is defined as acting in accordance with an appropriate code of ethics and accepted standards of practice. Seeking to remedy errors made by self or others is an example of integrity. Altruism is a concern for the welfare and being of others. Social justice is upholding moral, legal, and humanistic principles. Human dignity is respect for the inherent worth and uniqueness of individuals and populations.
A nursing student reports to the instructor that a medication due at 9 a.m. was omitted. Which of the following principles is the student demonstrating?
Integrity The principle of integrity is based on the honesty of a nurse according to professional standards. In this instance, the student reported the occurrence of the missed medication. The definition of altruism is concern for others, social justice is upholding of principles, and autonomy is the right to self-determination, so those choices are not correct.
A nurse knows the ethical term "Do not cause harm" is an example of:
Nonmaleficence Nonmaleficence is the conduction of procedures and interventions in a safe manner so that no harm is caused to the client. The other choices do not reflect the definition of this ethical term.
A nurse is aware that the principle of autonomy is being applied in which situation?
The client has decided to stop chemotherapy treatments. The principle of autonomy respects the client's right to make his own decisions, and is refelcted in the client who decides to stop chemotherapy treatments. The other choices do not reflect autonomy as the client is not making the decisions.
The nurse is managing the care of a terminally ill client whose spouse insists that all measures be continued. The nurse speaks to the spouse about obtaining a hospice consult. This is an example of "ethical":
Valuing Ethical valuing is the belief about worth, as in speaking to the spouse and placing value on the life and wishes of the client. The other choices do not define valuing.
A nursing student is studying the principle of autonomy. Which example most accurately depicts this principle?
describing surgery to a client before the consent is signed Describing surgery to a client before a consent is signed provides the client with all of the information needed to make an informed decision, thus an autonomous one. The other choices are not reflective of client decision making.
Which of the following is a characteristic of the care-based approach to bioethics?
the promotion of the dignity and respect of clients as people The care-based approach to bioethics focuses on the specific situations of individual clients, and characteristics of this approach include promoting the dignity and respect of clients and people. The need to emphasize the relevance of clinical experience and the need for an orientation toward service are part of the criticisms of bioethics. The deontologic theory of ethics says that an action is right or wrong independent of its consequences.
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 her health and the health of her husband. This is an example of:
values clarification.
Which of the following nursing situations is an example of the care-based approach to ethics? Select all that apply.
• Providing a back rub to a client on bed rest • Holding the hand of a dying client • Involving the parent in the bed bath of a child
Which of the following are examples of virtues that can exemplify character and conduct as a professional nurse? Select all that apply.
• Trustworthiness • Humility • Compassion
A nurse volunteers to serve on the hospital ethics committee. Which of the following indicates that the nurse knows what the purpose of an ethics committee is?
Assist in decision making based on the client's best interests. An ethics committee will meet when a client is unable to make an end-of-life decision and the family cannot come to a consensus. The committee members are there to advocate for the best interest of the client. The committee would not convince, decide, or present options about the type of care. This is not the role of an ethics committee.
Which of the following are examples of virtues that can exemplify character and conduct as a professional nurse? Select all that apply.
• Trustworthiness • Humility • Compassion Trustworthiness, humility, and compassion are all examples of professional virtues and cultivated dispositions of character and conduct that motivate and enable us to be good human beings. Deception and conflict are not positive examples so are not correct choices.
A nurse uses the utilitarian action guiding theory when deciding how to handle the following ethical conflict: A 13-year old female patient with anorexia refuses to eat food despite the fact that she is slowly starving to death. The parents insist the nurse use a feeding tube to feed her. Which statement is an example of this theory in practice?
The nurse forces food via an eating tube because the end result is good in that it will save the patient's life. Ethical theories or frameworks are systems of thought that attempt to explain how we ought to live and why. The utilitarian action guiding theory examines the rightness or wrongness of an action depends on the consequences of the action. The example of this theory in practice would be that the nurse forces food via an eating tube when the end result is good in that it will save the client's life. The other three options are not examples of the utilitarian action guiding theory. Another action guiding theory would be the theory of deontologic. Deontologic theory would be an action is found to be right or wrong based on a rule, independent of its consequences.
Which word is best described by the following: the protection and support of another's rights?
Advocacy Advocacy is the protection and support of another's rights. Nurses who value client advocacy make sure their loyalty to an employing institution or colleague does not compromise their primary commitment to the client; give priority to the good of the individual client rather than to the good of society in general; and carefully evaluate the competing claims of the client's autonomy and client well-being. Paternalism is acting for clients without their consent to secure good or prevent harm. Autonomy is respecting the rights of clients or their surrogates to make health care decisions; it is also known as self-determination. Ethics is the formal, systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil as they relate to conduct and human flourishing.
Which ethical principle is related to the idea of self-determination?
Autonomy Autonomy refers to self-rule, or self-determination; it respects the rights of clients or their surrogates to make health care decisions. Beneficence is the duty to do good and the active promotion of benevolent acts. Confidentiality is related to the concept of privacy. Nonmaleficence is the duty not to inflict harm, as well as to prevent and remove harm.
A nurse working on a critical care unit was informed by a client with multiple sclerosis that she did not wish to be resuscitated in the event of cardiac arrest. The client is no longer able to express her 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 what?
Ethical distress The nurse is involved in a situation that involves ethical distress. Ethical distress occurs when the nurse knows the right thing to do but either personal or institutional factors make it difficult to follow the correct course of action. Paternalism is acting for clients without their consent to secure good or prevent harm. Deception and confidentiality can result in ethical problems for nurses when there is a conflict between the client's and nurse's values and interests. In this scenario, the nurse is aware of the client's wishes, but the conflict lies with the family and thus the nurse will experience ethical distress.
A client is scheduled to have an elective surgical procedure performed and cannot decide if he wants to do it or not. He asks the nurse to help him make the decision because he does not feel that he knows enough about the procedure. Which of the following is the best way for this nurse to advocate for this client?
Facilitate the client's decision by allowing him to verbalize his feelings and by providing information to help him assess his options. Nurses as advocates must realize that they do not make decisions for their clients, but they can facilitate decision making by allowing the client to verbalize his feelings and by providing information to help him assess his options. This is not an appropriate time to call in the surgeon or the social worker, and refusing to help the client is not the best example of patient advocacy performed by a nurse.
A client rings the call bell to request pain medication. Upon performing the pain assessment, the nurse informs the client that she will return with the pain medication. The nurse's promise to return with the pain medication is an example of which principle of bioethics?
Fidelity Fidelity is keeping one's promises and never abandoning a client entrusted to one's care without first providing for the client's needs. Autonomy respects the rights of clients or their surrogates to make health care decisions. Nonmaleficence is preventing harm from being done to a client. Justice involves giving each client his due and acting fairly.
The client is a 2-month-old infant extremely ill from HSV sepsis. Her mother and father have decided to stop additional medical intervention and allow the infant to pass away naturally. The mother does not want her relatives to know that they plan to stop pursuing aggressive medical treatment because it is against their family's religious beliefs to withdraw medical support. What does the nurse tell the client's mother?
Yes, it is her decision who to inform about the family's medical decision. The United States health care system allows the client to make medical decisions. In the case of a minor, the client is the 2-month-old infant and her primary caregivers are her parents. United States law also gives clients the autonomy to make decisions about medical care that are culturally appropriate. This affords clients the right to share or not share any information about treatment. It is the responsibility of the health care team to uphold the request of clients.
When providing nursing care to clients, nurses are required to adhere to ethical values and legal rules to guide behavior. Which values would be included? Select all that apply.
• Veracity • Fidelity • Privacy • Confidentiality Explanation: The American Hospital Association (AHA) created a brochure with six basic rights for clients and families during hospitalization. In addition to these rights, there are ethical values and legal rules that guide the behavior of health care professionals toward clients and their families. These include veracity, fidelity, privacy, and confidentiality.
