Foundations Chapter 6: PrepU
Which statement by the nurse is an example of deception? -"I will administer your pain medication as soon as it is due." -"It is important to get out of bed to prevent pneumonia." -"This injection of procaine will feel like a little pinch." -"I am going to teach you how to give yourself insulin."
-"This injection of procaine will feel like a little pinch."
Which statement by the nurse is an example of deception? -"I will administer your pain medication as soon as it is due." -"It is important to get out of bed to prevent pneumonia." -"This injection of procaine will feel like a little pinch." -"I am going to teach you how to give yourself insulin."
-"This injection of procaine will feel like a little pinch." Telling a client that an injection of procaine will feel like a little pinch is not being truthful, and is defined as a deception. Telling a client that pain medicine will be administered when it is time is being truthful. Telling a client to get out of bed also supports a nursing intervention. Teaching a client how to give an injection is important for the client to take care of himself or herself.
A nurse practices the professional value of autonomy when providing nursing care for clients. Which nursing actions best describe the use of this value? Select all that apply. -A nurse stays past shift end to continue caring for a client in critical condition. -A nurse researches a new procedure that would benefit a client. -A nurse keeps a promise to call a client's health care provider regarding pain relief. -A nurse reads The Patient Care Partnership to a visually impaired client. -A nurse collaborates with other health care team members to ensure the best possible treatment for a client. -A novice nurse seeks the help of a more experienced nurse to insert a catheter in a client.
-A nurse reads The Patient Care Partnership to a visually impaired client. -A nurse collaborates with other health care team members to ensure the best possible
Which example best describes feminist ethics? -A combination of elements of utilitarian and deontologic theories that offer specific action guidelines for practice -Attention directed to the specific situation of individual clients viewed within the context of their life narratives -The formal study of ethical issues that arise in the practice of nursing -An approach critiquing existing patterns of oppression and domination in society
-An approach critiquing existing patterns of oppression and domination in society Feminist ethics offer an approach critiquing existing patterns of oppression and domination in society, especially as they affect women and the poor. The principle-based approach to ethics combines elements of utilitarian and deontologic theories and offers specific action guidelines for practice. The care-based approach directs attention to the specific situation of individual clients viewed within the context of their life narratives. The formal study of ethical issues that arise in the practice of nursing describes nursing ethics.
A nurse is preparing a presentation about ethical and legal issues for nurses. As part of the presentation, the nurse is planning to review the different types of laws. Which example would the nurse include as an intentional tort? Select all that apply. -Negligence -Misdemeanor -Assault -False imprisonment -Libel
-Assault -False imprisonment -Libel Intentional torts include assault, false imprisonment, and libel. Negligence is an unintentional tort. Misdemeanor is considered a crime.
A nurse volunteers to serve on the hospital ethics committee. Which indicates that the nurse knows the purpose of an ethics committee? -Assist in decision making based on the client's best interests. -Decide the care for a client who is unable to voice an opinion. -Convince the family to choose a specific course of action. -Present options about the type of care.
-Assist in decision making based on the client's best interests.
A nurse volunteers to serve on the hospital ethics committee. Which indicates that the nurse knows the purpose of an ethics committee? -Assist in decision making based on the client's best interests. -Decide the care for a client who is unable to voice an opinion. -Convince the family to choose a specific course of action. -Present options about the type of care.
-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 and to promote shared decision making between the client (or surrogates if decisionally incapacitated) and the clinicians. The committee would not convince, decide, or present options about the type of care. This is not the role of an ethics committee.
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? -Beneficence -Confidentiality -Autonomy -Justice
-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 woman age 83 years who has suffered a cerebrovascular accident and is unable to swallow refuses the insertion of a feeding tube. This is an example of what ethical principle? -Nonmaleficence -Veracity -Autonomy -Justice
-Autonomy Autonomy essentially means independence and the ability to be self-directed.
A nurse who provides the information and support that clients and their families need to make the decision that is right for them is practicing what principle of bioethics? -Autonomy -Nonmaleficence -Justice -Fidelity
-Autonomy Autonomy, also known as self-determination, is respecting the rights of clients or their surrogates to make health care decisions. The nurse would provide the information and support the client's and family's need to make the decision that is right for them, including collaborating with other members of the health care team to advocate for the client. Nonmaleficence is the avoidance of causing harm. Justice is giving each individual their due and acting fairly. Fidelity is the keeping of promises.
Which ethical principle refers to the obligation to do good? -Fidelity -Beneficence -Veracity -Nonmaleficence
-Beneficence
Which ethical principle refers to the obligation to do good? -Fidelity -Beneficence -Veracity -Nonmaleficence
-Beneficence Beneficence is the duty to do good and the active promotion of benevolent acts. Fidelity refers to the duty to be faithful to one's commitments. Veracity is the obligation to tell the truth. Nonmaleficence is the duty not to inflict, as well as to prevent and remove, harm; it is more binding than beneficence.
A nurse is caring for a woman 28 years of age who has delivered a baby by Cesarean section. She describes her pain as a 9. The nurse medicates her for pain. This is an example of which ethical framework? -Justice -Fidelity -Beneficence -Nonmaleficence
-Beneficence Beneficence means doing or promoting good. The treatment of the client's pain is the nurse's act of doing good.
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 -Deontology -Utilitarianism -Principle-based ethics
-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 is the study of the nature of duty and obligation. Utilitarianism is the doctrine that actions are right if they are useful or for the benefit of a majority. Principle-based ethics each prioritize goals and principles that exist beyond the particularities of the nurse-client relationship.
When examining values, a nurse notes that one country uses physician-assisted suicide and another country considers physician-assisted suicide as illegal and punishable with imprisonment. How are these two views on physician-assisted suicide affected? -Economically -Spiritually -Ethically -Culturally
-Culturally Daily living is expressed in many traditions and customs; understanding these differences is cultural value orientation.
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 can't do it anymore." What ethical problem is the adult child experiencing? -Dilemma -Distress -Uncertainty -Dissatisfaction
-Distress Ethical distress is when someone wants to do the right thing but is not able. The adult child brings the parent to the emergency department to maintain the client's safety, although the child needs to take care of the parent. Dilemma is a situation in which a difficult choice has to be made between two or more alternatives, especially equally undesirable ones. The client is not experiencing a dilemma. Uncertainty means a feeling of not knowing what will happen. The adult child is certain that he or she cannot care for the parent. Dissatisfaction implies a sense of dislike for, or unhappiness in, one's surroundings. While the adult child is unhappy, this is not the primary ethical problem.
A nurse cultivates dispositions that enable practicing nursing in a manner in which he or she believes in. This nurse is displaying what essential element of ethical agency? -Ethical sensibility -Ethical responsiveness -Ethical character -Ethical valuing
-Ethical character Ethical character is the development or cultivation of virtues such as humility, courage, and integrity to name just a few. The development or cultivation of these virtues allows the nurse to practice in a manner in which the nurse believes in.
A nurse who is caring for a new mother realizes that the woman is not prepared to go home with her newborn after a hospital stay of only 24 hours. However, hospital policy dictates that the mother be discharged. This nurse may be faced with which moral problem? -Ethical uncertainty -Ethical distress -Ethical dilemma -Ethical dissatisfaction
-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. Ethical dilemmas arise when attempted adherence to basic ethical principles results in two conflicting courses of action.
Which statement best conveys the concept of ethical agency? -Ethical practice requires a skill set that must be conscientiously learned and nurtured. -Individuals who enter the nursing profession often innately possess ethical characteristics. -Ethical practice is best learned and fostered by surrounding oneself with people who exhibit ethical character. -A nurse's understanding and execution of ethical practice is primarily a result of increased years of experience.
-Ethical practice requires a skill set that must be conscientiously learned and nurtured. Ethical agency must be cultivated in the same way that nurses cultivate the ability to do the scientifically right thing in response to a physiologic alteration. It is inaccurate to assume that it will passively develop from the presence of other ethical practitioners, or from years of experience. It is not an innate characteristic of personality.
Using the nursing process to make ethical decisions involves following several steps. Which step is the nurse implementing when she reflects on the decision-making process and the role it will play in making future decisions? -Evaluating -Diagnosing -Planning -Implementing
-Evaluating Evaluating an ethical decision involves reflecting on the process and evaluating those elements that will be helpful in the future. The nurse may also question how this experience can improve reasoning and decision making in the future. Diagnosing the ethical problem involves stating the problem clearly. Planning includes identifying the options and exploring the probable short-term and long-term consequences. Implementing includes the implementation of the decision and comparing the outcomes of the action with what was considered and hoped for in advance.
Using the nursing process to make ethical decisions involves following several steps. Which step is the nurse implementing when she reflects on the decision-making process and the role it will play in making future decisions? -Evaluating -Diagnosing -Planning -Implementing
-Evaluating Evaluating an ethical decision involves reflecting on the process and evaluating those elements that will be helpful in the future. The nurse may also question how this experience can improve reasoning and decision making in the future. Diagnosing the ethical problem involves stating the problem clearly. Planning includes identifying the options and exploring the probable short-term and long-term consequences. Implementing includes the implementation of the decision and comparing the outcomes of the action with what was considered and hoped for in advance.
A client is scheduled to have an elective surgical procedure performed and cannot decide if he wants to go forward with the procedure or cancel. He asks the nurse to help him make the decision because he does not feel that he knows enough about the procedure. Which action by the nurse is the best way for this nurse to advocate for the client? -Call the surgeon and have him explain the procedure again. -Facilitate the client's decision by allowing him to verbalize his feelings and by providing information to help him assess his options. -Refer the client to the social worker so that she can call in the people who need to help him make his decision. -Refuse to help the client and state that he must make the decision on his own.
-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. Refusing to help the client is not the best example of client advocacy performed by a nurse.
A parent teaches his or her children not to drink and drive; however, the parent does drink and drive. This action causes -Conflict with society -Failure to reflect own values -Insecurity and lack of safety -Disruption in consistency
-Failure to reflect own values Many role models fail to reflect on their own values and, as a result, model conflict and confusion.
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? -Paternalism -Feminist -Values clarification -Moralizing
-Feminist
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 -Autonomy -Nonmaleficence -Justice
-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.
A nurse states to the client that she will keep her free of pain. However, her family wishes to try a treatment to prolong her life that may necessitate withholding pain medication. This factor will cause an ethical dilemma for the nurse in relation to which ethical principle? -Fidelity -Veracity -Justice -Autonomy
-Fidelity Fidelity means being faithful to one's commitments and promises.
Which nursing situations are examples of the care-based approach to ethics? Select all that apply. -Holding the hand of a dying client -Taking a week's vacation from work -Documenting data in the electronic medical record -Providing a back rub to a client on bed rest -Involving the parent in the bed bath of a child
-Holding the hand of a dying client -Providing a back rub to a client on bed rest -Involving the parent in the bed bath of a child
A nurse manager receives negative survey results citing a decrease in the quality of client care. What areas does the nurse manager research as a causative factor in the decrease of quality care delivery? Select all that apply. -Inadequate staffing patterns -Increase in acuity of clients on the unit -Nurses working 12-hour shifts -Decreased satisfaction of nurses in the workplace Nurses working weekends
-Inadequate staffing patterns -Decreased satisfaction of nurses in the workplace Two of the chief reasons nurses cite for the declining quality of nursing care at their facilities are inadequate staffing and decreased nurse satisfaction. Advocacy on behalf of nurses and the profession has resulted in a tangible tool, the Bill of Rights for Registered Nurses, to aid in improving workplaces and ensuring nurses' ability to provide safe, quality client care. The Bill of Rights is intended to empower nurses by making clear what is absolutely nonnegotiable in the workplace. Nurses working 12-hour shifts, weekends, and increased acuity of patients was not cited in the literature for decreased nursing care.
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 -Altruism -Social justice -Human dignity
-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 am was omitted. Which principle is the student demonstrating? -Altruism -Social justice -Integrity -Autonomy
-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 to the clinical faculty. The definition of altruism is concern for others; it can best be explained by a nurse concerned about how a client will care for himself after discharge. Social justice is a concept of fair and just relations between the individual and society and is related to wealth and distribution of goods in a society. Autonomy is the right to self-determination or acting independently and making decisions.
The nurse beginning practice would like to access the standards for ethical practice. Which organization will the nurse research for these standards? -International Council of Nurses -Canadian Hospital Association -Department of Health Professions -World Health Organization
-International Council of Nurses
The nurse beginning practice would like to access the standards for ethical practice. Which organization will the nurse research for these standards? -International Council of Nurses -Canadian Hospital Association -Department of Health Professions -World Health Organization
-International Council of Nurses The ANA Code of Ethics for Nurses is the main source of the ethical principles that nurses must follow and this is found with the International Council of Nurses and the . The Canadian Hospital Association has not developed standards of ethical practice. Individual state boards of nursing through the department of health professions have laws and regulations that guide practice but not ethical and moral principles. The World Health Organization is a large organization that does not determine ethical practice for nurses.
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 of the following is the nurse attempting to enact? -Justice -Beneficence -Fidelity -Nonmaleficence
-Justice The ethical principle of justice includes an effort to fairly distribute benefits and to minimize discrimination, even when circumstances make this difficult to achieve. This is demonstrated by the nurse's efforts to fairly distribute her time and care. Beneficence is an ethical principle that addresses the idea that a nurse's actions should promote good. Nonmaleficence states that one should not do harm to patients. Fidelity is faithfulness to a person, cause, or belief, demonstrated by continuing loyalty and support.
The nurse is reviewing charges to clients for surgical procedures and observes different charges dependant upon insurance status. The nurse immediately reports this bias in charges to the supervisor for action. What principle of bioethics is the nurse demonstrating? -Beneficence -Nonmaleficence -Justice -Fidelity
-Justice The nurse is seeking to distribute the benefits, risks, and costs of nursing care justly. When recognizing subtle instances of bias and discrimination. the bioethical principle of justice is being practiced. The principle of nonmaleficence means to avoid doing harm, to remove harm, and to prevent harm. Beneficence is committing oneself to actively promoting the client's health or well being. Fidelity is being faithful to the promise that is made to be competent.
A parent of a 17-year-old high school student is allowing the child to make the decision on the college that will be attended. 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 -Modeling -Moralizing -Responsible choice
-Laissez-faire This situation demonstrates laissez-faire value transmission, which is characterized by allowing the adolescent to explore values on his own and the development of a personal value system. The laissez-faire approach involves little or no guidance and can lead to confusion and conflict. Through modeling, children learn that which is of high or low value by observing parents, peers, and significant others. The moralizing mode of value transmission teaches a complete value system and allows little opportunity for the weighing of different values. Responsible choice encourages children to explore competing values and to weigh their consequences while support and guidance are offered.
The nurse is managing the care for a postoperative client. How does the nurse demonstrate advocacy? -Limiting visitors due to client complaining of pain -Administering pain medication when the pain level reaches 9 on pain scale of 0 to 10 -Changing the channel on the television while providing care -Turning and positioning the client every 4 hours
-Limiting visitors due to client complaining of pain Advocating for clients is a nursing responsibility and is performed with the best interest and welfare of the client in providing safe, competent, and comforting care. Limiting visitors is an example of advocacy. The nurse recognizes that the client is in pain; therefore, limiting the visitors allows for the nurse to advocate for additional measures to allow the client to rest and recover. Administering pain medication and turning and the client every 4 hours are important and necessary interventions for a postoperative client, but this is not advocacy. Changing the channel on the television while providing care also does not promote advocacy.
Nursing students in an ethics class have been asked to define "ethics." What would be the best definition of ethics? -The formal, systematic study of moral beliefs. -The informal, systematic study of moral beliefs. -The adherence to formal personal values. -The adherence to informal personal values.
-The formal, systematic study of moral beliefs. Ethics is a formal inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil as they relate to human conduct and human flourishing. "Morals" usually refers to personal or communal standards of right and wrong.
The nurse is managing the care for a postoperative client. How does the nurse demonstrate advocacy? -Limiting visitors due to client complaining of pain -Administering pain medication when the pain level reaches 9 on pain scale of 0 to 10 -Changing the channel on the television while providing care -Turning and positioning the client every 4 hours
-Limiting visitors due to client complaining of pain Advocating for clients is a nursing responsibility and is performed with the best interest and welfare of the client in providing safe, competent, and comforting care. Limiting visitors is an example of advocacy. The nurse recognizes that the client is in pain; therefore, limiting the visitors allows for the nurse to advocate for additional measures to allow the client to rest and recover. Administering pain medication and turning and the client every 4 hours are important and necessary interventions for a postoperative client, but this is not advocacy. Changing the channel on the television while providing care also does not promote advocacy.
A nurse knows the ethical term "Do not cause harm" is an example of: -Justice -Nonmaleficence -Fidelity -Beneficence
-Nonmaleficence Nonmaleficence is the conduction of procedures and interventions in a safe manner so that no harm is caused to the client. Justice is the idea that the burdens and benefits of new or experimental treatments must be distributed equally among all groups in society. Fidelity is demonstrated by continuing loyalty and support to a client. Beneficence requires that the procedure be provided with the intent of doing good for the client involved.
A nursing faculty member is discussing laissez-faire values with students. Which scenario is an example of those values? -Teaching children right from wrong and telling them the reason behind a bad action -Parents allowing a child to decide not to have an intravenous line inserted -Modeling healthy behaviors for teenagers, such as not smoking electronic cigarettes -Telling a child an injection will feel like a pinch before the nurse gives the injection
-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. Teaching a child about right and wrong behavior is a more active learning strategy. Modeling or role modeling is leading by example—in this case, not smoking electronic cigarettes to show the teenagers good behavior. Telling the child about the injection feeling like a pinch shows empathy, as the nurse has described a feeling the child has experienced before.
A nurse obtains an order for a bed alarm for a confused client. This is an example of which ethical principle? -Paternalism -Deception -Confidentiality -Conflict
-Paternalism Making a decision for a client who is confused to prevent an injury is an example of paternalism. Deception occurs when the true nature or reason is concealed and the client is deprived of basic human rights. Confidentiality requires a health care provider to keep a client's personal health information private unless consent to release the information is provided by the client. Conflict is a disagreement or argument and does not represent the example in this question.
A nurse believes that abortion is an acceptable option if a pregnancy results from a situation of rape. What is the best description of this belief? -Personal morality -Professional values -Ethics -Legal obligations
-Personal morality
A nurse believes that abortion is an acceptable option if a pregnancy results from a situation of rape. What is the best description of this belief? -Personal morality -Professional values -Ethics -Legal obligations
-Personal morality Personal morality is the set of beliefs about the standards of right and wrong that helps a person determine the correct or permissible action in a given situation.
The nurse strives to uphold human dignity when providing care to clients. What behavior exemplified by the nurse would be included? Select all that apply. -Protects the privacy of the client -Maintains confidentiality -Promotes universal health care -Provides culturally competent care -Demonstrates accountability
-Protects the privacy of the client -Maintains confidentiality -Provides culturally competent care Human dignity is defined by the right of a person to be valued and respected for one's own sake, and to be treated ethically. The nurse is exemplifying this by protecting privacy, maintaining confidentiality, and providing culturally competent care. The nurse cannot promote universal health care but can provide as much nursing care as possible to respect human dignity. Demonstrating accountability is not a human dignity issue but is a core concept in the overall nursing care of a client.
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 type of health care decision making does this represent? -Ethical decision making -Paternalistic model -Client sovereignty model -Shared decision making
-Shared decision making
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 type of health care decision making does this represent? -Ethical decision making -Paternalistic model -Client sovereignty model -Shared decision making
-Shared decision making Shared decision making is recommended by most ethicists and involves the client's preferences and the nurse's expertise to make the best decision. The paternalistic model involves the clinician making the decisions. The client sovereignty model involves the client making all the decisions without input from the clinician.
The principle of autonomy by a client is applied in which situation? -The family of a client is discussing care with the physician. -An order for an antibiotic is being written in the chart. -The client has decided to stop chemotherapy treatments. -A hospice consult is ordered by the nurse.
-The client has decided to stop chemotherapy treatments. The principle of autonomy respects the client's right to make his or her own decisions, and is reflected in the client who decides to stop chemotherapy treatments.
Nursing students in an ethics class have been asked to define "ethics." What would be the best definition of ethics? -The formal, systematic study of moral beliefs. -The informal, systematic study of moral beliefs. -The adherence to formal personal values. -The adherence to informal personal values.
-The formal, systematic study of moral beliefs.
A nurse uses the utilitarian action guiding theory when deciding how to handle the following ethical conflict: A 13-year old female client 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 client's life. -The nurse refuses to force feed the client because the nurse believes that force feeding a client who refuses food is wrong even if it saves her life. -The nurse believes that force feeding a client could be right or wrong depending on the process used to accomplish the action. -The nurse believes that force feeding a client violates the principles of autonomy and nonmaleficence.
-The nurse forces food via an eating tube because the end result is good in that it will save the client'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 depending on the consequences of the action. The example of this theory in practice would be the nurse force feeding a client via an eating tube when the end result is beneficial— 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 deontologic theory (an action is found to be right or wrong based on a rule, independent of its consequences).
Nurses who value client advocacy follow what guideline? -They value their loyalty to an employing institution or to a colleague over their commitment to their clients. -They give priority to the good of the individual client rather than to the good of society in general. -They choose the claims of the client's well-being over the claims of the client's autonomy. -They make decisions for clients who are uninformed concerning their rights and opportunities.
-They give priority to the good of the individual client rather than to the good of society in general. Advocacy is the protection and support of another's rights. If the nurse values client advocacy, the nurse would give priority to the good of the individual client rather than to the good of society in general. The nurse would not be demonstrating advocacy if the nurse values the loyalty to an employing institution or to a colleague over their commitment to their client. The nurse demonstrating client advocacy would not choose the claims of the client's well-being over the claims of the client's autonomy. The nurse would not make decisions for clients who are uninformed concerning the client's rights and opportunities
Which traits are examples of virtues that can exemplify character and conduct as a professional nurse? Select all that apply. -Trustworthiness -Humility -Deception -Conflict -Compassion
-Trustworthiness -Humility -Compassion
What is the term for the beliefs held by the individual about what matters? -Ethics -Values -Morals -Bioethics
-Values
What is the term for the beliefs held by the individual about what matters? -Ethics -Values -Morals -Bioethics
-Values Values are ideals and beliefs held by an individual or group; values act as a standard to guide one's behavior. Ethics are moral principles and values that guide the behavior of honorable people. A moral is a standard for right and wrong. Bioethics is related to ethical questions surrounding life and death, as well as questions and concerns regarding quality of life as it relates to advanced technology.
What are standards for decision making that endure for a significant time in one's life? -Beliefs -Ethics -Roles -Values
-Values Values are standards for decision making that endure for a significant time in one's life.
An oncology client in an outpatient chemotherapy clinic asks several questions regarding his care and treatment. The nurse explains the clinic's routine, typical side effects of the chemotherapy, and ways to decrease the number of side effects experienced. Which characteristic is the nurse demonstrating? -Veracity -Fidelity -Justice -Autonomy
-Veracity
An oncology client in an outpatient chemotherapy clinic asks several questions regarding his care and treatment. The nurse explains the clinic's routine, typical side effects of the chemotherapy, and ways to decrease the number of side effects experienced. Which characteristic is the nurse demonstrating? -Veracity -Fidelity -Justice -Autonomy
-Veracity Veracity means telling the truth, which is essential to the integrity of the client-provider relationship.
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 belief about the worth of something, about what matters, that acts as a standard to guide one's behavior. -an organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct. -a systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil, as they relate to conduct.
-a process by which people come to understand their own values and value systems Value clarification is a process by which people come to understand their own values and value systems. A value is a belief about the worth of something, about what matters, that acts as a standard to guide one's behavior. A value system is an organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct. Ethics is a systematic inquiry into principles of right and wrong conduct, of virtue and vice, and of good and evil, as they relate to conduct.
A nurse is caring for a client who is a practicing Jehovah's Witness. The physician orders two units of packed cells based on his low hemoglobin and hematocrit levels. The nurse states to the surgeon that it is unethical to go against the client's beliefs even though his blood counts are very low. What is the best description of the nurse's intentions? -acting in the client's best interest -siding with the client over the surgeon -observing institutional policies -being legally responsible
-acting in the client's best interest
A nurse is caring for a client who is a practicing Jehovah's Witness. The physician orders two units of packed cells based on his low hemoglobin and hematocrit levels. The nurse states to the surgeon that it is unethical to go against the client's beliefs even though his blood counts are very low. What is the best description of the nurse's intentions? -acting in the client's best interest -siding with the client over the surgeon -observing institutional policies -being legally responsible
-acting in the client's best interest Nurses' ethical obligations include acting in the best interest of their clients, not only as individual practitioners, but also as members of the nursing profession, the health care team, and the community at large.
An illegal immigrant with no health insurance sustained life-threatening injuries following an automobile accident. Which action demonstrates the ethical principle of justice? -airlifting the client to a local trauma center for emergency surgery -avoiding treating the client so as to not do any additional harm -filing the paperwork for the client to receive retroactive health insurance -telling the client honest information about the client's medical condition and prognosis
-airlifting the client to a local trauma center for emergency surgery The ethical principle of justice mandates that clients be treated impartially without discrimination according to age, gender, race, religion, socioeconomic status, weight, marital status, or sexual orientation. An immediate airlift to the local trauma center demonstrates that this client is begin treated impartially. The other actions demonstrate different ethical principles.
To practice ethically, the nurse should: -allow a committee to guide her practice. -review past cases before guiding practice. -avoid allowing her judgment to guide practice. -ask the family their views on caring.
-avoid allowing her judgment to guide practice. Personal convictions apply only to situations and decisions pertaining to the individual. In ethical practice, nurses avoid allowing personal judgments to bias their treatment of clients.
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 -changing a dressing on a wound as needed -administering a morning dose of insulin before breakfast -transporting a client to a scheduled physical therapy appointment
-describing surgery to a client before the consent is signed Autonomy is the capacity to make an informed, uncoerced decision. 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. Changing a dressing on a wound does not require a decision, nor does administering a morning dose of insulin or transporting a client.
A nursing student states he is able to put himself in his client's shoes. He states he understands the situation of the ill client. This is considered to be an act of: -sympathy. -assurance. -empathy. -disclosure
-empathy. The experience of empathy is an immediate projection of self to the situation of others, causing strong emotional reactions and motivation, and either appropriate caring behavior and/or related reflection.
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: -ethical distress. -paternalism. -deception. -confidentiality.
-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/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.
Which nursing action demonstrates the principle of fidelity? -filing an incident report after making a medication error -administering a vaccination -treating an uninsured client in the emergency department -witnessing a client signature on an informed consent
-filing an incident report after making a medication error
Which nursing action demonstrates the principle of fidelity? -filing an incident report after making a medication error -administering a vaccination -treating an uninsured client in the emergency department -witnessing a client signature on an informed consent
-filing an incident report after making a medication error Fidelity means being faithful to work-related commitments and obligations. The ethical principle is best demonstrated by the nurse following the employer's policies by completing the incident report following a medication error. Administering vaccines is an example of beneficence; treating an uninsured client in the emergency room is an example of justice; witnessing a client signature on an informed consent is autonomy.
The nurse is caring for clients in a hospital setting. Which situations encountered by the nurse have a significant ethical component? Select all that apply. -helping a client make end-of-life decisions -addressing a suspected breach in confidentiality -deciding how to reassign staff in light of budget cuts -deciding which continuing education offerings should be chosen -deciding when to stop cardiopulmonary resuscitation (CPR) on a client in cardiac arrest
-helping a client make end-of-life decisions -addressing a suspected breach in confidentiality -deciding how to reassign staff in light of budget cuts -deciding when to stop cardiopulmonary resuscitation (CPR) on a client in cardiac arrest
The nurse is caring for clients in a hospital setting. Which situations encountered by the nurse have a significant ethical component? Select all that apply. -helping a client make end-of-life decisions -addressing a suspected breach in confidentiality -deciding how to reassign staff in light of budget cuts -deciding which continuing education offerings should be chosen -deciding when to stop cardiopulmonary resuscitation (CPR) on a client in cardiac arrest
-helping a client make end-of-life decisions -addressing a suspected breach in confidentiality -deciding how to reassign staff in light of budget cuts -deciding when to stop cardiopulmonary resuscitation (CPR) on a client in cardiac arrest
A hospital owned by a Catholic order of nuns will not allow tubal ligations to be performed. This is considered to be: -personal morality. -personal values. -institutional policy. -legal obligation.
-institutional policy. Institutional policies are guidelines developed by health care institutions to direct professional practice.
The foundation for decisions about resource allocation throughout a society or group is based on the ethical principle of: -veracity. -autonomy. -justice. -confidentiality.
-justice. Justice is the foundation for decisions about resource allocation throughout a society or group.
A nursing faculty is presenting a lecture on ethics. The correct definition of ethical distress is: -being aware of the principles of right and wrong -supporting the rights of a client during hospitalization -knowing the correct action, but unable to perform due to constraints -belief about worth as a standard to guide behavior
-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 moral or ethical distress. Being aware of knowing what is right and wrong is the first step of having an ethical conscience. Supporting a client during a hospitalization is an ethical principle of doing what is right and the focus of client centered care. Self worth is the understanding that a nurse's has value or worth as a nurse and to know that the actions that a nurse performs is imperative to the nursing profession.
Which action most clearly demonstrates a nurse's commitment to social justice? -lobbying for an expansion of health care resources and benefits -ensuring that a hospital client's diet is culturally acceptable -answering a client's questions about her care clearly and accurately -documenting patient care in a timely, honest, and thorough manner
-lobbying for an expansion of health care resources and benefits Social justice is a professional value that encompasses efforts to promote universal access to health care, such as the expansion of publicly funded programs like Medicare. Culturally competent care is a reflection of human dignity. Answering clients' questions and documenting them accurately are expressions of the value of integrity.
A nurse shows client advocacy by: -insisting that a medication be taken. -offering a hospice consultation to a client who is terminally ill. -sending a client home with verbal discharge instructions. -refusing to allow a spouse to stay by the bedside.
-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. Insisting that a client take a medication does not reflect advocacy for the client. Sending a client home with verbal discharge instructions are normal and customary and does not ensure the best interest are being met. The refusal of not allowing a spouse to stay by the bedside does not support advocacy for the client but the needs of the spouse.
An adolescence is in the process of value formation. What does the nurse determine that will be the greatest influence in the child's formation of values in this developmental stage? -school administration. -work. -awareness of other cultures. -peers.
-peers. In adolescence, peer groups are a major source of value formation. The attitudes, beliefs, and behaviors that grow out of peer group relationships are powerful. It is generally accepted that the influence of peers exceeds that of school administration, work life or the awareness of other cultures.
A nurse is of the Catholic faith and votes pro-life. He is considered to have: -personal morality. -personal values. -ethics. -legal obligations.
-personal values.
A nurse is of the Catholic faith and votes pro-life. He is considered to have: -personal morality. -personal values. -ethics. -legal obligations.
-personal values. Personal values are ideas or beliefs a person considers important and feels strongly about.
A nurse is asked to serve on an ethics committee. Which roles of the nurse 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 -making the final decision about end-of-life care -presenting explanations about technical terminology -advocating for the client's wishes -deciding whether mechanical ventilation is appropriate for a client
-serving as a liaison between the family and the committee members -presenting explanations about technical terminology -advocating for the client's wishes
What would be an example of the nurse practicing fidelity? The nurse: -regulates visitors. -stays with the client during his death as promised. -withholds information as requested. -provides continuity of care.
-stays with the client during his death as promised.
What would be an example of the nurse practicing fidelity? The nurse: -regulates visitors. -stays with the client during his death as promised. -withholds information as requested. -provides continuity of care.
-stays with the client during his death as promised. Fidelity requires the nurse to keep promises made and to be faithful to one's commitments.
Which of the following is a characteristic of the care-based approach to bioethics? -the need to emphasize the relevance of clinical experience -The rightness or wrongness of an action is independent of its consequences. -the promotion of the dignity and respect of clients as people -the need for an orientation toward service
-the promotion of the dignity and respect of clients as people
A public health nurse is involved in planning a community outreach program for a large assisted living community. Due to the aging population within the community, the program will offer hypertension screening and management. This decision is based on which principle? -veracity -nonmaleficence -utilitarianism -autonomy
-utilitarianism
A public health nurse is involved in planning a community outreach program for a large assisted living community. Due to the aging population within the community, the program will offer hypertension screening and management. This decision is based on which principle? -veracity -nonmaleficence -utilitarianism -autonomy
-utilitarianism Teleology, also known as utilitarianism, is ethical decision-making process based on final outcomes and what is best for the most people. The choice that benefits many people justifies harm that may come to a few. The nurse did not display veracity, nonmaleficence, or autonomy in this scenario.
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 spouse. This is an example of: -values clarification. -moral distress. -ethical dilemma. -social justice.
-values clarification.
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 spouse. This is an example of: -values clarification. -moral distress. -ethical dilemma. -social justice.
-values clarification. Values clarification is a process that allows an individual to examine and understand what choices to make. Moral distress is the emotional state that arises from a situation when a nurse feels that the ethically correct action to take is different from what he or she is tasked with doing. An example of this is the nurse taking away the cigarettes out of the client's belongings bag. Ethical distress occurs when a decision is made regarding what one believes to be the right course of action, but barriers prevent the nurse from carrying out or completing the action. The nurse can expect ethical distress if removing the cigarettes from the client's belongings bag. Social justice is a concept of fair and just relations between the individual and society. An example is the selling of cigarettes to those who had a cardiac event. Moral distress, ethical dilemma, and social justice are not reflected in this scenario.
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. -Before meals, a boy says a prayer that he learned from his parents. -A boy is taken for ice cream to celebrate his good report card. -A teenage boy explores religions of friends in hopes of developing his own faith. -A boy is taught how to behave in public by his schoolteacher. -A teenage girl is punished for staying out too late with her friends. -A teenage girl tries alcohol at a party with her friends.
A teenage boy explores religions of friends in hopes of developing his own faith. A teenage girl tries alcohol at a party with her friends.
