fundamentals-chp 6
Which statement by the nurse is an example of deception?
"This injection of procaine will feel like a little pinch."
Nursing practice consistent with the Code of Ethics for Nurses includes which actions? Select all that apply.
**Delivering culturally safe care **Protecting the client's right to confidentiality and privacy **Acknowledging that the client is the focus and center of care and remains a part of the treatment team
Which nursing actions best describe the use of the professional value of human dignity? Select all that apply.
A nurse provides privacy for an older adult client. A nurse plans individualized nursing care for clients. A nurse refuses to discuss a client with a curious friend. The nurse includes the client in developing the plan of care.
An illegal immigrant with no health insurance sustained life-threatening injuries in an automobile accident. Which action in this case demonstrates the ethical principle of justice?
Airlifting the client to a local trauma center for emergency surgery
keeping promises and commitments made to others
fidelity
process that distributes benefits, risks, and costs fairly
justice
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.
Social Justice
upholding moral, legal, and humanistic principles
action-guiding theory of ethics that states that the rightness or wrongness of an action depends on the consequences of the action
utilitarian
organization of values ranked along a continuum of importance
value system:
set of beliefs that are meaningful in life and that influence relationships with others deals and beliefs held by an individual or group about what matters; as a standard to guide one's behavior.
values
process by which people come to understand their own values and value system
values clarification
Making Ethical Decisions
Gather data and assess the situation. Identify the ethical problem. Identify and weigh the alternatives. Implement the decision. Evaluate the decision.
approach to bioethics that directs attention to the specific situations of individual patients viewed within the context of their life narrative
care-based approach
principles that reflect the primary goals, values, and obligations of the profession
code of ethics
altruism
concern for the welfare and well-being of others
refusal to participate in certain types of treatment and care based on the fact that these activities violate the nurse's personal and professional ethical beliefs and standards
conscientious objection
ethical system in which actions are right or wrong independent of the consequences they produce
deontologic
self-determination; being independent and self-governing entails the ability to make a choice free from external constraints
autonomy
an approach to bioethics that offers specific action guides
principle-based approach
Which example best describes feminist ethics?
An approach critiquing existing patterns of oppression and domination in society
A client diagnosed with cancer has met with the oncologist and is now weighing whether to undergo chemotherapy or radiation for treatment. This client is demonstrating which ethical principle in making this decision?
Autonomy
A nurse is providing care to a client with end-stage cancer. After weighing the alternatives, the client decides not to participate in a clinical trial offered and is requesting no further treatment. The nurse advocates for the client's decision based on the understanding that the client has the right to self-determination, interpreting the client's decision as reflecting which ethical principle?
Autonomy
Which statement best conveys the concept of ethical agency?
Ethical practice requires a skill set that must be conscientiously learned and nurtured. Explanation: 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.
A parent of a 17-year-old high school student is allowing the child to decide which college the child will attend. When the child requests direction from the parent in making this decision, the parent responds by stating, "You will need to make this decision on your own." What type of value transmission is the parent displaying?
Laissez-faire
The nurse is managing the care for a postoperative client. How does the nurse demonstrate advocacy?
Limiting visitors due to the client reporting pain
A nurse obtains an order for a bed alarm for a confused client. This is an example of which ethical principle?
Paternalism
Examples of Ethical Problems
Paternalism Deception Privacy Confidentiality Allocation of scarce nursing resources Valid consent or refusal Conflicts concerning new technologies Unprofessional, incompetent, unethical, or illegal physician practice Unprofessional, incompetent, unethical, or illegal nurse practice Short staffing and whistle-blowing Beginning-of-life issues End-of-life issues
The International Council of Nurses (ICN) Code of Ethics for Nurses (2012) has which elements? Select all that apply.
People Practice Profession Coworkers
Which is a characteristic of the care-based approach to bioethics?
The promotion of the dignity and respect of clients as people
Nurses who value client advocacy follow what guideline?
They give priority to the good of the individual client rather than to the good of society in general.
Paternalism
acting for clients without their consent to secure good or prevent harm.
integrity
acting in accordance with an appropriate code of ethics and accepted standards of practice based on the honesty of a nurse according to professional standards
the duty to do good and the active promotion of benevolent acts.
beneficence
Patient advocacy is:
central to the roles and identity
system dealing with standards of character and behavior related to what is right and wrong
ethics
A laissez-faire
to value transmission is one that allows others, especially children, to make decisions without guidance, resulting in a decision that may not be a sound one.
protecting client health information from public disclosure. Client information should only be shared with health personnel directly involved in the client's care. This includes controlled access to electronic health records; therefore, the nurse should log off the electronic health record after documenting to avoid unauthorized access to the client's information. If client information needs to be divulged, the nurse should first obtain the client's written permission. An example of this is asking the client to sign a medical release form before providing information to the health insurance.
Confidentiality involves
The nurse is reviewing charges to clients for surgical procedures and observes different charges dependent upon insurance status. The nurse immediately reports this bias in charges to the supervisor for action. What principle of bioethics is the nurse demonstrating?
Justice
The nurse has identified an ethical dilemma that has the potential to interfere with a client receiving optimal care. The nurse discussed this issue with the charge nurse on the unit. What action should the nurse choose next?
Monitor for resolution of the problem. Explanation: Simply reporting the issue does not complete the nurse's obligation in this situation. The nurse should monitor for resolution of the issue, at least to the point where it no longer interferes with client care. The nurse has already reported the issue up the chain-of-command, so further reporting is not necessary at this time. There is no particular reason to inform the family.
The nurse strives to uphold human dignity when providing care to clients. Which behaviors by the nurse would best exemplify this value? Select all that apply.
Protects the privacy of the client Maintains confidentiality Promotes universal health care Provides culturally competent care
A client tells the nurse that the client does not want to have a painful procedure. By respecting and supporting the client's right to make decisions, the nurse is demonstrating:
advocacy
protection and support of another's rights
advocacy
To practice ethically, the nurse should avoid:
allowing the nurse's own judgment to guide practice.
Values essential to the professional nurse
altruism, autonomy, human dignity, integrity, social justice
ethics that encompass all those perspectives that seek to understand human nature and behavior, the domain of social science, and the natural world
bioethics
situation that arises when attempted adherence to basic ethical principles results in two conflicting courses of action
ethical dilemma
A nurse working on a critical care unit was informed by a client with multiple sclerosis that the client did not wish to be resuscitated in the event of cardiac arrest. Now the client is no longer able to express wishes, and the family has informed the health care provider that they want the client to be resuscitated. Aware of the client's wishes, the nurse is involved in a situation that may involve:
ethical distress. Explanation: 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.
bill of rights
exist for both patients and registered nurse
type of ethical approach that aims to critique existing patterns of oppression and domination in society, especially as these affect women and the poor
feminist ethics
ability to behave in an ethical way; to do the ethically right thing because it is the right thing to do
moral agency
A nurse working in a critical care unit has experienced personal tragedy, extreme shortage of staff in the work environment, and health issues. The nurse has overcome much of these hardships and is now mentoring other nurses in similar situations. What behavior is this nurse demonstrating?
moral resilience
developed capacity to respond well to morally distressing experiences and to emerge strong
moral resilience
like ethics, concerned with what constitutes right action; more informal and personal than the term ethics
morals
conducting procedures and interventions in a safe manner so that no harm is caused to the client.
nonmaleficence
a subset of bioethics; formal study of ethical issues that arise in the practice of nursing and of the analysis used by nurses to make ethical judgments
nursing ethics:
moral distress
occurs when the individual knows the right thing to do but organizational constraints make it difficult to take the right course of action
requires the nurse to utilize client information appropriately; that is, limiting access to client information to activities that are only directly related to health care. Upholding privacy includes keeping the door closed while conducting physical assessment and obtaining the client's consent before allowing a student nurse to assist with care.
privacy
human dignity
respect for the inherent worth and uniqueness of individuals and populations
human excellences; cultivated dispositions of character and conduct that motivate and enable us to be good human beings
virtues