NRSG 323 Exam 1
What is the correct order of the steps in ethical decision-making? 1. Evaluate Outcomes 2. Implement the Strategy 3. Gather Data 4. Explore Strategies 5. Articulate the Problem 1, 2, 3, 5, 4 5, 4, 3, 2, 1 3, 5, 4, 2, 1 5, 3, 4, 2, 1
5,3,4,2,1
A nurse does not agree with a physician's order and confronts the physician with anger. Which strategy has the nurse violated? A. Communicate clearly B. Practice with skill C. Project confidence D. Reciprocate respect
A
A patient is at end-of-life and chooses assisted suicide due to the amount of pain. The nurse disagrees with this decision. What is the nurse's responsibility in this situation? A. Ask that the patient be reassigned to another nurse. B. Encourage the patient to reconsider the decision. C. Insist that the patient choose palliative care. D. Tell the patient that the plan of care can include pain relief
A
According to Callahan, what role do emotions play in ethical decisions? A. Both reason and emotion should be active and in accord when making ethical decisions. B. Ethical decisions should be based solely on emotion. C. Ethical decisions should be based solely on reason. D. Emotion plays more of a part in ethical decision making when the decision effects you personally.
A
How are ethics and laws the same? A. Both are built upon a moral foundation. B. Both are congruent with each other. C. Ethics requires laws to be successful. D. Laws are broken and ethical standards are not.
A
How can a nurse limit liability? A. Communicating effectively B. Maintaining quality health insurance C. Making value judgments D. Working in a hospital rather than an office
A
How does the nurse demonstrate fidelity? a. Keeping the nurse's license current b. Being honest with every patient c. Providing care regardless of the consequences d. Reporting a patient who is noncompliant
A
How is ethical decision making similar to or different from the nursing process? A. Both involve very similar steps, including gathering data, implementing interventions or strategies, and evaluating outcomes B. Ethical decision making requires the nurse to take into consideration the nurse's own personal values, where the nursing process does not. C. The nursing process always comes to a rapid conclusion for a plan of care, where ethical decision making always takes a very long time to reach a conclusion. D. The nursing process is much less scientific than the decision-making process
A
In which situation is the patient autonomous? a. The healthcare provider recommends the patient be transferred to long-term care, but the patient goes home instead. b. The healthcare provider offers the patient a choice of care, and the patient allows the healthcare provider to choose. c. The patient does not want recommended surgery but has it any way. d. The patient tells the nurse that the healthcare provider's bedside manner needs improvement
A
Values are actualized through: A. Choices made B. Conceptualized ideas C. Parent teaching D. Personal preferences
A
What does acting with autonomy mean? a. Making one's own choices b. Asking for assistance with decisions c. Demanding respect d. Thinking about personal goals
A
What is a tort? A. A wrong or injury that one suffers because of someone else's action. B. An act that results in an unintended injury or harm to another person. C. Negligence committed by a person in a professional capacity. D. The failure to do something that a reasonable person would avoid doing
A
What is an example of justice in the healthcare arena? a. Setting up triage during a major disaster b. Transferring a client to another floor when staff is overloaded c. Allowing the paying patient to get a medication over a non-paying patient d. Allowing more time in caring for a patient than time spent with another patient
A
What is one way to understand the values of another? A. Appreciate and understand our own values B. Knowing what is right or wrong C. Testing the other person through a moral dilemma D. Trusting that what the other person says is true
A
What is the first step of ethical decision making? A. Articulate the problem and determine a realistic goal. B. Explore potential strategies C. Gather data and identify conflicting moral claims D. Select and implement a strategy
A
What is the nurse's responsibility when a patient chooses complementary therapy? A. Cultivate knowledge of complementary therapies. B. Explore the validity of the patient's choice of complementary therapy. C. Have the patient sign an informed consent if using a complementary therapy. D. Tell the patient that complementary therapies are dangerous.
A
What is true about practical dilemmas in nursing? A. Practical dilemmas are grounded in self-interest. B. Practical dilemmas are the same as moral dilemmas. C. Practical dilemmas take precedence over moral dilemmas. D. Practical dilemmas usually involve beneficence
A
What patient results can occur when a nurse displays discrimination against a patient? A. Low self-esteem B. Personal introspection C. Retaliation D. Weight loss
A
Which ethical principle relates to faithfulness and keeping promises? a. Fidelity b. Veracity c. Beneficence d. Nonmaleficence
A
Which situation is a potential conflict for the nurse? A. A nurse has a sick child at home and the office is understaffed. B. The floor nursing staff has a low nurse to patient ratio. C. The patient does not want prescribed medication. D. The patient refuses recommended surgery
A
Why is the nurse's secondary obligation to the employer? A. By being paid, the nurse has a legal and moral obligation to the institution. B. The employer makes the rules and the nurse must abide by them. C. The employer provides additional training for the nurse. D. The nurse must maintain professionalism and the employment contract assists with this
A
Which of the following is true regarding the Civil Rights Act of 1964? (Select all that apply.) A. The Civil Rights Act made it unlawful for an employer to discriminate against any individual because of the person's race. B. The Civil Rights Act It made it unlawful for an employer to discriminate against any individual because of the person's color. C. The Civil Rights Act primarily protects the rights of Caucasians and other minorities. D. The Civil Rights Act made it unlawful for an employer to discriminate against any individual because of the person's religion. E. The Civil Rights Act It made it unlawful for an employer to discriminate against any individual because of the person's national origin.
A, B, D, E
Values are acquired in which of the following ways: SELECT ALL THAT APPLY Through instruction by parents Through socialization Through instruction by teachers Through instruction by religious leaders
All
Moral distress may result in the following: SELECT ALL THAT APPLY Nurse retention Anger Dissatisfaction Poor work performance Burnout
Anger, dissatisfaction, poor work performance, burnout
A nurse falsifies narcotics records. Which type of law did the nurse violate? A. Tort law B. Public law C. Private law D. Contract law
B
A nurse is caring for a patient who smokes and has just been diagnosed with lung cancer. How should the nurse react? A. Ask why the patient continued smoking knowing the potential consequences. B. Encourage the patient to reduce or discontinue smoking. C. Request that family members ensure the patient quit smoking. D. Tell the patient it is too late to stop smoking.
B
A nurse is in an elevator and hears two other nurses making fun of an older adult patient who was crying because the patient was just told she has hepatitis C. Which type of moral stress is this nurse feeling? A. Distress B. Outrage C. Reckoning D. Reflection
B
A nurse reports another nurse who reprimanded a patient for soiling the bed and notes the nurse pulling the sheets from under the patient rapidly. Which ethical principle has this nurse displayed? a. Fidelity b. Beneficence c. Nonmaleficence d. Veracity
B
A patient is diagnosed with end-stage renal failure. The patient's spouse asks the nurse if the patient is going to die soon, and the nurse replies affirmatively. What type of ethical principle is this nurse practicing? a. Fidelity b. Veracity c. Beneficence d. Nonmaleficence
B
Bennie is a nurse caring for Carla, who is recovering from a serious car accident. Bennie knows that imaging studies of Carla's broken leg showed an additional concern, a tumor. Carla asks Bennie about the results of the study. Bennie knows she is supposed to tell Carla the truth in order to uphold the principle of _________________. A. Beneficence B. Veracity C. Nonmaleficence D. Confidentiality
B
How are values learned? A. Choices made by an individual B. Parental teaching C. Set societal expectations D. Verbal instruction
B
In which way does a nurse deal with value conflict? A. Ask the charge nurse to reappoint care for the patient with whom the nurse disagrees to thwart any further disagreement 4 B. Be aware of one's own values to ensure the nurse does not impose them upon the patient C. Explain one's values to the patient encouraging the patient to agree with the nurse's values D. Provide the patient with reasons why the nurse holds a different value to help the patient see it the nurse's way
B
In which way is values clarification important in nursing? A. It enables the nurse to work well with colleagues. B. It enhances the nurse's moral agency. C. It helps the nurse inflict self-morals onto patients. D. It requires the nurse to be self-aware.
B
Josie started work last week in a new department. She was surprised to overhear Nurse Layla spreading a rumor about a coworker. What is the term for Layla's behavior? A. Compassion B. Incivility C. Libel D. Bullying
B
SallyAnn saw her mother die of lymphoma 30 years ago. She has just been diagnosed with the same kind of lymphoma and tells the nurse, Keesha, that she just wants to go straight to hospice and not receive chemotherapy or radiation. Keesha feels she should try the medical therapies before "giving up" and going to hospice. Keesha realizes that SallyAnn: A. Does not have the right to make choices about her own health care practices. B. Has the right to make choices about her own health care practice. C. Is just reliving grief and therefore SallyAnn's choices can be ignored. D. Does not have the right to make poor choices about her own health care practices.
B
What drives common law? A. Federal laws B. Precedents C. Regulations D. State laws
B
What is the nurse's role in informed consent? A. Ensure the patient does not eat before the procedure B. Ensure the patient is knowledgeable of alternative interventions C. Perform the medical intervention D. Reassure the patient that he or she is making the correct choice
B
What is the nurse's role related to the Patient Self-Determination Act and medical procedures? A. Ensuring patients have an advance directive B. Ensuring patients' decisions are followed C. Explaining risks with decisions D. Explaining the procedure to family
B
When does moral uncertainty occur? A. When moral claims compete with nonmoral claims B. When one is unsure of the morally correct action to take C. When options include conflicting moral claims D. When two options that are equally unfavorable
B
Which situation constitutes sexual harassment? A. A female nurse greets her colleague with a smile and tells her she looks nice today. B. A female nurse supervisor is looking at pornographic photos in the break room. C. A male nurse asks a female colleague for coffee. D. A male supervisor tells a female employee she has to work mandatory overtime
B
Which situation illustrates the interaction between justice and autonomy? A. A patient asks the family's opinion prior to agreeing to a plan of care. B. A patient chooses care that will not be covered by insurance but cannot afford the care. C. A patient decides to not go through with a procedure that was previously scheduled. D. A patient insists that a certain procedure is performed although the healthcare provider does not agree
B
. Which situation illustrates a threat to patient autonomy? A. Asking if the patient's family will be included in decision-making. B. Asking the patient if additional information is needed to make a decision. C. Assuming that the patient's thought process is the same as the nurse's. D. Warning the patient that a procedure has risky results.
C
Colette wants to also drink "Essiac Tea," to treat her lung cancer, in addition to receiving chemotherapy. Colette's nurse, Grace, makes sure to not discount the value of the tea, because she recognizes: A. patients have the right to use complementary therapies if they are evidence-based B. patients do not have the right to use complementary therapies C. patients have the right to use complementary therapies D. most patients tell their medical practitioner that they are using complementary therapies
C
Ethical relationships with others begin with: A. Integrity B. Reflection C. Self-knowledge D. Trustworthiness
C
Nurse Tamry is concerned about connecting an IV port to a new medication. She feels mostly—but not completely—confident about the skill. She decides to ask her supervisor for clarification so that she does not harm her patient. Tamry is exhibiting ______________. A. Veracity B. Confidentiality C. Nonmaleficence D. Informed consent
C
Student nurse Janelle heard about a foreign exchange student who had gotten a neurological disease from the measles vaccine. What should Janelle expect the nurse to say when, during clinicals, a parent asks if the measles vaccine is safe? A. "There is no need to read the consent form; just sign it." B. "There are absolutely no risks for this or any other vaccine. Your provider has recommended you receive this vaccine." C. "Although there may be minor side effects, such as redness or swelling, serious side effects are rare. More information is available on the consent form; please let me know if you have other questions." D. "There are no side effects to the vaccine."
C
What are covert values? A. Conscious values B. Explicitly communicated values C. Implicit values often unspoken D. Institutional values
C
What are moral values? A. Behaviors expected by a group B. Societal norms and expectations C. Standards that evaluate what is right or wrong D. Verbalized thoughts on daily life
C
What does nonmaleficence mean? a. To do good b. To be faithful c. To do no harm d. To tell the truth
C
What is the difference between public and private law? A. Private law defines a person's rights and obligations in relation to the government, while public law determines a person's legal rights and obligations in activities that involve other people. B. Private law is based primarily on previous court decisions, while Public law is created through the lawmaking process in state or federal legislatures. C. Public law defines a person's rights and obligations in relation to the government, while private law determines a person's legal rights and obligations in activities that involve other people. D. Public law is based primarily on previous court decisions, while Private law is created through the lawmaking process in state or federal legislatures
C
Which example illustrates the nurse's own values conflicting with institutional values? A. A patient is discharged to a long-term care facility for rehabilitation. B. A patient reports being hungry, but the kitchen is closed. C. The floor the nurse works on is understaffed. D. The nurse must ask for pain medication for a patient.
C
Which legal document gives directions related to withholding or withdrawing life support if certain conditions exist. A. Durable power of attorney B. Informed consent C. Living will D. Surrogate designation
C
Which of the following enhances the effectiveness of delegation? A. Delegation of assessment tasks B. Delegation to workers untrained in tasks C. Clear communication D. Chastisement in front of coworkers
C
Which source of law applies to the Bill of Rights? A. Administrative B. Common C. Constitutional D. Statutory
C
Which step of ethical decision making includes identifying the key persons involved in the decision-making process? A. Articulate the problem and determine a realistic goal B. Evaluate outcomes and revise plan if needed C. Gather data and identify conflicting moral claims D. Select and implement a strategy
C
Which strategy enforces a nurse's good working relationship with physicians? A. Admit uncertainty. B. Expect respect. C. Project confidence. D. Work at own pace.
C
Why do problems arise in the relationship between the nurse and the institution? A. Nurses offer solutions to potential safety issues in the institution. B. Nurses speak up about increasing quality of patient care in the institution. C. The institution's demands for loyalty are often inequitable. D. The nurse's code of ethics is too stringent for the institution
C
Why is it important for the nurse to know the patient's values regarding healthcare? A. Conflict avoidance B. Outcome measurement C. Patient satisfaction D. Task completion
C
Victoria is a new nurse, eager to understand all her duties on the medical-surgical floor of the hospital. She knows that because she has passed the NCLEX-RN exam and is now licensed, she is held to the standards of the professional code of ethics. By keeping the promises that are part of being a nurse, Victoria will be exhibiting __________________. A. Autonomy B. Noncompliance C. Nonbeneficence D. Fidelity
D
What is informed consent? A. Declaration of no drastic medical measures at end of life. B. Declaration of the patient's right to refuse treatment. C. Legal protection from preventing care when incapacitated. D. Legal protection of a patient's right to autonomy
D
What is moral integrity? A. A character trait that includes a delicate and profound awareness of other people's feelings B. The feeling or emotion that one has when recognizing the suffering of another coupled with the desire to alleviate or prevent the suffering C. The recognition of duty to patient. D. The wholeness and stability of character that leads to trustworthiness
D
What is the difference between administrative law and statutory law? A. Administrative law deals with principles of the Constitution and statutory laws deal with precedents. B. Administrative law deals with the Bill of Rights and statutory law deals with governmental powers. C. Administrative law defines a person's rights and statutory law deals with licensure. D. Administrative law involves government agency and statutory law involves federal and state legislatures
D
What is the nurse's first obligation? A. To colleagues B. To physicians C. To the employer D. To the patient
D
What is the nurse's role with subordinates? A. Allow self-learning B. Demand perfection C. Listen intently D. Send value messages
D
What is the role of an expert nurse witness? A. Demonstrating as much knowledge as a physician. B. Knowing the action of every medication. C. Purporting that nursing is a true profession. D. Remaining neutral and honest when offering an objective opinion.
D
What must a nurse do when making a thoughtful decision? A. Act on instinct, the first choice is usually the right one. B. Ask colleagues to make the decision instead. C. First see if the situation will resolve on its own. D. Gather data and compare options
D
When competent patients give permission for treatments or research, it is termed: A. Noncompliance B. Compliance C. A code of ethics D. Informed consent
D
Which ethic demonstrates respect for persons and the desire to do good for this particular patient on this particular day? A. Ethic of empathy B. Ethic of justice C. Ethic of respect D. Ethic of responsiveness
D
Which is disparate treatment in regard to discrimination? A. A hospital allows time for visits for prayer but only in the hospital chapel. B. A pregnant female gets paid time off after birth but a male employee who just had a baby does not. C. A single person is expected to work overtime when needed and an employee with children is not. D. A supervisor passes over all Latino nurses who apply for a promotion.
D
Which standard of informed consent relates to the subjective standard? A. Disclosure is consistent with the standards of the profession. B. Disclosure is the procedure's intent. C. Disclosure is what a reasonable person in similar circumstances would need in order to make an informed decision. D. Disclosure is what the particular person wants or needs to know
D
Which of the following is a potential source of malpractice claims against nurses? Ability to communicate Ability to act Failure to properly assess and monitor Failure to administer medications improperly
Failure to properly assess and monitor
Which of these is an instance where a nurse could be accused of a criminal offense under public law? Falsifying narcotic records Libel Invasion of privacy False imprisonment
Falsifying narcotic records
How does a power imbalance-real or perceived-affect the decision making process A. It promotes data collection.t promotes honest and open discourse. It is a stakeholder. It inhibits honest and open discourse.
It inhibits honest and open discourse
What are the components of nursing malpractice? (Select all that apply.) The harm or damage was caused by the breach of duty. Injury, harm, or damage did occur to the patient There was a breach of that duty Injury, harm, or damage might have occurred to the patient The nurse had a duty to the patient There was no breach of that duty
The harm or damage was caused by the breach of duty Injury, harm, or damage did occur to the patient There was a breach of that duty. The nurse had a duty to the patient
What significance do uncertainty, context, and multiple stakeholders have with regards to ethical decisions? They are predictable. They only relate to autonomy. They are intervening factors. They simplify ethical decisions.
They are intervening factors
If you feel discomfort when reason is pointing to a particular answer to anethical decision, what should you do? Go with the most reasonable choice Further explore reasonable arguments and your reactions Discount others' emotional reactions as well as your own Ignore the discomfort
further explore reasonable arguments and your reactions
Which term describes what occurs when a person is aware of a moral problem, acknowledges moral responsibility, and makes a moral judgment about the correct action, yet is constrained from the self-determined morally correct action. moral outrage moral distress ethical dilemna moral reckoning
moral distress
Two types of unintentional torts are negligence and defendants malpractice and plaintiffs negligence and malpractice negligence and plaintiffs
negligence and malpractice
Formal laws that are written and enacted by federal, state, or local legislatures are called statutory laws common laws nursing laws administrative laws
statutory laws
When personal values are at odds with those of patients, colleagues, or an institution, this situation is termed ______________. values clarification moral apathy values conflict self-awareness
values conflict
How should a nurse handle a conflict between veracity and confidentiality when a spouse demands to know if a client is being treated? a. Calm the spouse down b. Ask the charge nurse to decide c. Ask the spouse to leave the premises d. Explain that the information cannot be disclosed
D
Laws (or statutes) that are written and enacted by federal, state, or local legislatures are known as: A. Administrative Laws B. Common Laws C. Constitutional Laws D. Statutory/Legislative Laws
D
Nurse Bridgee has been having difficulty managing her time. She is concerned about the pressure to only spend limited time with patients who are on track for physical recovery, although she feels they may need additional emotional care. Bridgee decides to talk to her supervisor about her perceptions, and she receives an explanation. Allocation of time, a scarce resource, is part of _______________. A. Autonomy B. Noncompliance C. Informed consent D. Distributive justice
D
6. When can a patient's confidentiality be violated? a. When a spouse asks the status of the patient. b. When the computer is shared by several different providers. c. When a nurse who is not treating the patient wants information about the patient. d. When the nurse recognizes that maintaining confidentiality will cause harm to others.
D
In order to acknowledge similarities and differences in values when interacting with others, you should first: Avoid discussing your values with family Insist that you have adopted the institution's values Debate values with coworkers Know your own values
Know your own values
A nurse's ability to act morally and promote positive outcomes for patients, basing actions and decisions on internalized principles and knowledge of right and wrong, good and bad is referred to as: Moral agency Values conflict Axiology Values clarification
Moral agency
If the nurse believes that the patient does not understand the implications of any part of a process requiring informed consent, it is the responsibility of the nurse to intervene. True False
True
Lateral violence is when a person is uncivil or bullies another person who is otherwise an equal True False
True
