Fundamentals of Nursing Values, Ethics, and Advocacy

An emergency department nurse and health care team are caring for a semiconscious child age 2 years with numerous fractures and evidence of cigarette burns. They suspect child abuse. The nurse reports the family to the child abuse hotline. The nurse is following which ethical principle?

Nonmaleficence

A nurse shows client advocacy by doing which of the following examples?

Offering a hospice consultation to a client who is terminally ill

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 nurse obtains an order for a bed alarm for a confused client. This is an example of which of the following ethical principles?

Paternalism

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

The nursing faculty is explaining value transmission. The example of a child receiving an exemplary report from school and being given money from the parents can be described as what type of behavior?

Rewarding

What are standards for decision making that endure for a significant time in one's life?

Values

What is the term for the beliefs held by the individual about what matters?

Values

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. Of which of the following is this is an example?

Values clarification

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" what?

Valuing

A nurse educator understands that his teaching was effective regarding the Code of Ethics for Nurses when students state which of the following?

"The code is an expression of nursing's own understanding of its commitment to society."

A nurse demonstrates the professional value known as altruism when caring for patients in a long-term care facility. What is an example of a nursing action based on this value?

A nurse researches the culture of a Muslim patient when planning nursing care.

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.

Which of the following words is best described by the following: the protection and support of another's rights?

Advocacy

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

Which of the following best describes feminist ethics?

An approach critiquing existing patterns of oppression and domination in society

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

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 patient is utilizing which ethical principle in making his decision?

Autonomy

A nurse who provides the information and support that patients and their families need to make the decision that is right for them is practicing what principle of bioethics?

Autonomy

Which of the following ethical principles is related to the idea of self-determination?

Autonomy

Which ethical principle refers to the obligation to do good?

Beneficence

Which of the following theories of ethics most highly prioritizes the nurse's relationship with patients and the nurse's character in the practice of ethical nursing?

Care-based ethics

A nurse may experience ethical distress in which of the following client situations?

Continuing IV fluids for a client who wants to die

A nursing student is studying the principle of autonomy. Which of the following examples most accurately depicts this principle?

Describing surgery to a client before the consent is signed

A nurse pulls the curtains before changing the dressing of the surgical wound on the abdomen of a post-surgical client. What value is served?

Dignity

A client is brought to the emergency department (ED) by the son who states, "I am unable to care for my mother anymore." The nurses identifies this son's ethical problem as being which of the following?

Distress

An elderly client falls out of bed after a nurse inadvertently left the side rails down. The nurse feels guilty and is upset about the incident. This is an example of which of the following types of ethical situations?

Distress

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 character

A nurse is acting inappropriately and has an odor of alcohol. This behavior breaches which of the following?

Ethical conduct

A nursing student learns to model behavior exemplified by the instructor. This is an example of?

Ethical conduct

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

Which of the following statements best conveys the concept of ethical agency?

Ethical practice requires a skill set that must be conscientiously learned and nurtured.

Using the nursing process to make ethical decisions involves following several steps. Which step is the nurse implementing when he or she reflects on the decision-making process and the role it will play in making future decisions?

Evaluating

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.

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?

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

A nurse is providing care for a client with cancer. The client's wife indicates that she does not want her husband to be told he is terminal. This is a breach of which of the following ethical principles?

Fidelity

A nurse is administering evening medications and notices that a medication was omitted during the day shift. Which of the following statements demonstrates the principle of accountability?

Filling out an occurrence report and notifying the health care provider

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

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 of the following professional values?

Integrity

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 patient 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

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

A parent of a high school student age 17 years is allowing the child to make the decision on the college he will attend. When the child requests direction from the parent in making this decision, the parent responds by informing him that he will need to make this decision on his own. This is an example of which type of value transmission?

Laissez-faire

The nurse is managing the care for a post operative client. How does the nurse demonstrate advocacy?

Limiting visitors due to client complaining of pain

Which of the following actions most clearly demonstrates a nurse's commitment to social justice?

Lobbying for an expansion of Medicare eligibility and benefits

A nurse knows the ethical term "Do not cause harm" is an example of:

Nonmaleficence

A nurse is having lunch in the break room and overhears the other nurses talking about a difficult client in an inappropriate way. The nurses attempt to engage them in the conversation. Which of the following responses by the nurse would best represent behavior that supports the value of human dignity in nursing practice?

Saying that she believes that this discussion is inappropriate and disrespectful to the client and that she does not want to be a part of it

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

What would be an example of the nurse practicing fidelity? The nurse:

Stays with the patient during his or her death as promised

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.

A nurse is aware that the principle of autonomy is being applied in which situation?

The client has decided 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.

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.

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

Nurses who value patient advocacy follow what guideline?

They give priority to the good of the individual patient rather than to the good of society in general.

Which of the following statements by the nurse is an example of deception?

This injection of Novocain will feel like a little pinch."

A nurse arrives on the medical unit wearing large dangling earrings. This is an example of which of the following types of conduct?

Unprofessional

Nurses must maintain the privacy of clients. Which example is a breach in privacy and would pose an ethical problem?

taking a picture of a client with the nurse's cell phone.

A nurse instructor is teaching students about the use of ethical agency in nursing practice. Which statements accurately represent the basic principles of ethics? (Select all that apply.)

• The ability to be ethical begins in childhood and develops gradually. • Ethics is a systematic inquiry into the principles of right and wrong conduct, of virtue and vice, and of good and evil, as they relate to conduct. • A commitment to developing one's ability to act ethically is known as one's ethical agency.

Which nursing actions best describe the use of the professional value of altruism? (Select all that apply.)

• A nurse demonstrates an understanding of the culture of his or her patient. • A nurse becomes a mentor to a student nurse working on her floor. • A nurse respects the right of a Native American to call in a shaman for a consultation.

Which nursing actions best describe the use of the professional value of human dignity? (Select all that apply.)

• A nurse provides privacy for an elderly patient. • A nurse plans individualized nursing care for his or her patients. • A nurse refuses to discuss a patient with a curious friend.

Nurses practice the professional value of autonomy when providing nursing care for patients. Which nursing actions best describe the use of this value? (Select all that apply.)

• A nurse reads the Patient Bill of Rights to a visually impaired patient. • A nurse collaborates with other health care team members to ensure the best possible treatment for a patient.

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.)

• 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 nurse needs to be aware of which professional values? Select all that apply.

• Altruism • Autonomy • Human dignity • Social Justice

A nurse is involved valuing. Identify the activities of value processing. Select all that apply

• Choosing • Acting • Prizing

Which of the following are examples of nursing situations that 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 when to stop cardiopulmonary resuscitation (CPR) on a client in cardiac arrest

Which of the following are examples of nursing situations that 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 when to stop cardiopulmonary resuscitation (CPR) on a client in cardiac arrest

Nurses have cited specific reasons for a decrease in the quality of nursing care. Select all that apply.

• Inadequate staffing • Decreased satisfaction

Which of the following actions by the nurse demonstrate the ethical principle of fidelity? Select all that apply.

• Maintaining current nursing registration and meeting continuing education requirements • Performing an intervention for a client at the time that was promised • Taking an extra client assignment due to high acuity

The International Council of Nurses (ICN) Code of Ethics for Nurses (2005) has which of the following elements? Select all that apply.

• People • Practice • Profession • Co-workers

A nurse is serving on an ethics committee. Which of the following are roles of the nurse? Select all that apply.

• Presenting explanations about technical terminology • Serving as a liaison between the family and the committee members • Advocating for the client's wishes

Nurses uphold human dignity when providing care. Examples of this behavior would include what? Select all that apply

• Protecting the privacy of the client • Maintaining confidentiality • Providing culturally competent care

Nurses uphold human dignity when providing care. Examples of this behavior would include what? Select all that apply.

• Protecting the privacy of the client • Maintaining confidentiality • Providing culturally competent care

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 Correct

Students nurses need to know about the Code of Ethics for Nurses. The Code of Ethics includes a set of principles to follow. Identify the tenets of the Code of Ethics for Nurses. Select all that apply.

• The nurse maintains standards of personal conduct. • The nurse is active in developing a core of research based principles. • The nurse holds personal information as confidential.

A nurse seeks to incorporate the principle of bioethics known as nonmaleficence when caring for patients in a long-term care facility. Which nursing actions best exemplify this principle?

• The nurse performs regular patient assessments for pressure ulcers. • The nurse follows "medication rights" when administering medicine to patients.

Which of the following are examples of virtues that can exemplify character and conduct as a professional nurse? Select all that apply.

• Trustworthiness • Compassion • Humility