STUDY GUIDE # 4 VALUES, ETHICS and ADVOCACY

1. Standards of nursing practice serve as a guide for: A. Safe nursing care and management B. Evaluation of nursing care rendered C. Proper nursing approaches and techniques D. Nursing practice in the different fields of nursing

A. Safe nursing care and management

A professional nurse with a commitment to social justice is most apt to: a. Provide honest information to patients and the public b. Promote universal access to healthcare c. Plan care in partnership with patients d. Document care accurately and honestly

b. Promote universal access to healthcare

The nurse holds in confidence personal information and uses judgment in sharing this information.

Nurses and People

The nurse maintains a standard of personal health such that the ability to provide care is not compromised

Nurses and Practice

The nurse uses judgment regarding individual competence when accepting and delegating responsibility.

Nurses and Practice

The nurse, in providing care, ensures that use of technology and scientific advances are compatible with the safety, dignity and rights of people.

Nurses and Practice

1. The nurse, acting through the professional organization, participates in creating and maintaining safe, equitable social and economic working conditions in nursing.

Nurses and Profession

The nurse assumes the major role in determining and implementing acceptable standards of clinical nursing practice, management, research and education.

Nurses and Profession

When an older nurse complains that nurses just aren't ethical anymore, the REPLY THAT REFLECTS THE BEST understanding of moral development is: A. "The ability to behave ethically must be carefully cultivated; may be we don't value this sufficiently to pay it the attention it deserves." B. "I don't agree that nurse were more ethical in the past. It's the new age and the ethics are new!" C. "Ethics is genetically determined... it's like having blue or brown eyes. Maybe we're evolving out of the ethical sense you and your generation had." D. "No kidding! Who could be ethical in a practice setting like this!"

A. "The ability to behave ethically must be carefully cultivated; may be we don't value this sufficiently to pay it the attention it deserves."

A code of ethics is best defined as: A. A set of values to which one is personally committed. B. Formal guidelines and standards for professional actions C. A statement of minimum standards of competent practice D. Guidelines to which members of the profession are legally bound

A. A set of values to which one is personally committed.

The nurse is administering medication, and the client states, " I've never seen this pill before." What should the nurse do next? A. Check the medication orders B. Reassure the client that the physician must have ordered it C. Teach the client about the effects of the medication D. Inform the client that pills often look different because of different brands

A. Check the medication orders

An alert, oriented, adult Jehovah Witness client is refusing blood even though he realizes he could die. The wife, who is not a believer, asks that blood be given. How should the situation be handled? A. Do not give blood, respecting the client's right to refuse. B. Give blood as the wife wants because refusal would be suicidal. C. Contact the hospital administrator and take protective custody of the client D. See if the client has an advanced directive prior to making the decision.

A. Do not give blood, respecting the client's right to refuse.

While giving the change of shift report to the oncoming night shift nurse, the evening shift nurse smells alcohol on the night shift nurse's breath. The evening shift nurse should: A. Immediately report this finding to the nursing supervisor B. Observe the nurse-manager to read in the morning C. Leave a note for the nurse-manager to read in the morning D. Ask the nurse if she has been drinking

A. Immediately report this finding to the nursing supervisor

Your female elderly client after recovering from her hip replacement, as you do your routine assessment she verbalized that she wants to go home. The family wants her to go to a nursing home. If you were acting as a client advocate, you would perform which of the following actions? A. Inform the family that the client has a right to decide on her own B. Ask the primary care provider to discharge the client to home C. Suggest the client hire a lawyer to protect her rights D. Help the client and family communicate their views to each other

A. Inform the family that the client has a right to decide on her own

Ethics is concerned with the following, EXCEPT: A. Personal standards of right and wrong B. Practice of beliefs of a certain group C. Investigating issues about human behavior D. Exercising critical and rational judgment in one's choices and decisions

A. Personal standards of right and wrong

1. A professional nurse committed to the principle of autonomy would be careful to: A. Provide the information and support a patient needed to make decisions to advance her own interests B. Treat each patient fairly, trying to give everyone his or her due C. Keep any promises made to a patient or another professional caregiver D. Avoid causing harm to a patient

A. Provide the information and support a patient needed to make decisions to advance her own interests

1. Following a motor vehicle crash, the parents of a child with no apparent brain function refuse to permit withdrawal of life support from the child. Although the nurse believes the child should be allowed to die and organ donation considered, the nurse supports their decision. Which moral principle provides the basis for the nurse's actions? A. Respect for autonomy B. Nonmaleficence C. Beneficence D. Justice

A. Respect for autonomy

An instructor asks her students to take part in a research project by allowing her to measure their height and weight. The instructor says it isn't a course requirement but she would really appreciate their participation. Which human subjects right is at greatest risk of being violated in this situation? A. Right to privacy B. Right to disclosure C. Right to not be harmed Right to self-determination

A. Right to privacy

One of your chronically ill patients is always irritable that she shouts at anybody who enters the ward. One of these responses is indicative of your knowledge about the rights of patients in the health care system: A. The patient has the right to a kind and considerate care B. The patient has the right to say nor or do anything that pleases him C. The hospital has the right to place a patient in isolation or physical restraint D. The patient has the right to be informed of all hospital requirements and policies

A. The patient has the right to a kind and considerate care

1. This defines the expectations of a profession: A. Values B. Principlism C. Framework D. Professional code of ethics

A. Values

An 85 year old man is refusing dialysis for his kidney failure. The primary ethical principle involved is: A. Justice B. Autonomy C. Nonmaleficence Beneficence

B. Autonomy

With regard to ethical situations in client care, the most important nursing responsibility is to: A. Remain neutral and fair in ethical decisions B. Be accountable for the morality of one's own action C. Act only when absolutely certain the action is ethically correct Realize that the physician is responsible for deciding ethical questions

B. Be accountable for the morality of one's own action

Mrs. Green rides the elevator to the third floor where her husband is a client. While on the elevator, Mrs. Green hears two nurses talking about Mr. Green. They are discussing the physical assessment result and the potential prognosis and whether he should be told. The nurse are violating which of the following ethical principles? A. Autonomy B. Confidentiality C. Beneficence D. Non-maleficence

B. Confidentiality

A client was voluntarily admitted to the inpatient psychiatric admission for anxiety. He is alert, oriented, and denies suicidal ideation. He states that he wants to leave. The most appropriate ethical and legal action by the nurse would be? A. Inform the client that he is not able to leave AMA (Against medical advice). B. Contact the attending physician. C. Determine the current level of anxiety. D. Provide discharge instructions.

B. Contact the attending physician.

Which ethical principle represents the duty to be faithful to a patient? A. Autonomy B. Fidelity C. Beneficence D. Justice

B. Fidelity

The adoption of the Code of Ethics is an obligation of the: A. Board of Nursing B. Registered Nurses C. Professional Regulation Commission D. Accredited National Nursing Association

B. Registered Nurses

Gail comes to her clinic visit with bruises on her arms and neck. She had a broken leg shortly before her pregnancy. She has also missed the last two appointments. You suspect abuse. What could you say to Gail? A. "Are you being abused? If you are, then you should have him thrown in jail". B. "I know you are being abused, but it will be OK. Most men stop when they realize it could hurt the baby." C. "You've missed your last two appointments and have bruises on your body. Is there a problem at home? I can help you get appropriate help, if "let me". D. "Do you keep bumping into things? This can happen because your center of gravity changes during pregnancy."

C. "You've missed your last two appointments and have bruises on your body. Is there a problem at home? I can help you get appropriate help, if "let me".

The client does not want chemotherapy, but the family says he should take it. What is the best response by the nurse? A. Ask the client if he has discussed this with his religious advisor. B. Help the client think about his family and their concerns. C. Assert the client's right to make the ultimate decision. D. Share with the client what the nurse would do in that situation.

C. Assert the client's right to make the ultimate decision.

Health care issues often become an ethical dilemma because of which of the following? A. Decisions must be made based on individual systems B. A client's legal rights co-exist with a health profession. C. Choices involved do not appear to be clearly right or wrong D. Decisions must be made quietly, often under a stressful condition

C. Choices involved do not appear to be clearly right or wrong

Maintaining confidentiality of patient information is part of nurse's: A. Advocacy role B. Role as a counselor C. Ethical and legal obligations D. Managerial and leadership functions

C. Ethical and legal obligations

A situation in which the best of course of action is often not clear, and strong ethical reasons exists to support each position: A. Confusion B. Moral distress C. Ethical dilemma D. Ethical distress

C. Ethical dilemma

While performing an assessment of a 75-year-old client in the emergency department, a nurse notes many ecchymotic (bluish colored) areas in various stages of healing on his body. Which action should the nurse perform first? A. Notify the nursing supervisor. B. Notify the physician. C. Obtain information as to how these bruises occurred. D. Document the findings

C. Obtain information as to how these bruises occurred.

In providing information to others, the nurse is guided by the principles: "Patient's right to privacy and public's right to know." At the emergency room which is considered as appropriate nursing action? A. Release all available data B. Only general information may be given C. Seek permission from the adult companions of the patient D. Wait till the hospital Director who will determine what information to give

C. Seek permission from the adult companions of the patient

1. Which of the following situations is most clearly violation of the underlying principles associated with professional nursing ethics? A. A hospital's policy permits use of internal fetal monitoring during labor. However, there is literature to both support and refute the value of this practice. B. When asked about the purpose of a medication, a nurse colleague responds, "Oh, I never look them up. I just give what is prescribed." C. The nurses on the unit agree to sponsor a fund-raising event to support a labor strike proposed by fellow nurse at another facility. D. A client report that he didn't quite tell the doctor the truth when asked if he was following his therapeutic diet at home.

C. The nurses on the unit agree to sponsor a fund-raising event to support a labor strike proposed by fellow nurse at another facility.

The physician does not want the patient informed of the possibility of hysterectomy of the although it is indicated in the consent form. Which response is appropriate for the nurse? A. The nurse is obliged to do as told by the physician B. To make such a decision is the physician's right C. The patient has the right to receive the necessary information from the nurse in charge D. "Consult your physician for any questions about the operation" is the advise of the nurse to the Patient

C. The patient has the right to receive the necessary information from the nurse in charge

Nurse advocates often are conflicted about respecting a patient's right to be self-determining, while at the same time wanting to do everything in their power to promote the patient's best interests. Which is the best general guideline for situations like these? A. Patient rules! "It's my life!" B. Nurse rules! "It may be your life but in this instance you don't know enough to make the right choice!" C. When in conflict, weight the benefits and risks of each option and choose wisely. D. Treat the patient fairly, try to give the patient his or her due.

C. When in conflict, weight the benefits and risks of each option and choose wisely.

Which statement is incorrect regarding government requirements about organ donation? A. All families of clients who have died must be approached about organ donation B. The medical examiner should be notified of all potential organ donors C. A request must be made to the family regarding release of the donor's name D. Clients over the age of 70 are not eligible for organ donation

D. Clients over the age of 70 are not eligible for organ donation

1. A nurse give a client the wrong medication. After assessing the client, the nurse completes an incident report. Which statement describes what will occur next? A. The incident will be reported to the state board of nursing. B. The form will be used for an adverse drug reaction (ADR) report C. The medication error will result in the nurse being suspended at the facility D. The incident report will be used for risk management

D. The incident report will be used for risk management

A patient was informed by his attending physician about the need for a major surgery. Which by so doing violates the rights of a patient? A. The patient had the right to choose his doctor or surgeon B. The patient has no obligation to submit himself to the treatment C. If a client cannot read, the consent from must be read to him before it is signed D. The risk of treatment and facts relating to it should not be told to the patient or else he might refuse the surgery

D. The risk of treatment and facts relating to it should not be told to the patient or else he might refuse the surgery

1. The nurse takes appropriate action to safeguard individuals, families and communities when their health is endangered by a co-worker or any other person.

Nurses and Co-Workers

The nurse sustains a co-operative relationship with co-workers in nursing and other fields.

Nurses and Co-Workers

1. In providing care, the nurse promotes an environment in which the human rights, values, customs and spiritual beliefs of the individual, family and community are respected.

Nurses and People

The nurse ensures that the individual receives sufficient information on which to base consent for care and related treatment.

Nurses and People

One of these statements is INCORRECT: A. An act may be ethical but not legal B. Ethics and morals are essentially synonymous C. The purpose of Ethics is to know what are right and wrong ways D. One falls into moral dilemma when his action is contrary to the Code of Ethics for nurses

The purpose of Ethics is to know what are right and wrong ways

In which circumstances may a nurse legally and ethically disclose confidential information about a client? a. The human immunodeficiency virus (HIV) status of a single male client to his family members b. The diagnosis of pancreatic cancer to the client's significant other c. The diagnosis of an uncontrolled seizure disorder of a taxi driver to a state agency d. The client is 32 weeks pregnant with twins and is legally separated

c. The diagnosis of an uncontrolled seizure disorder of a taxi driver to a state agency

1. Providing food and fluids is a moral duty, thus, part of ordinary nursing practice. A nurse is morally obligated to withhold food and fluids (or any treatment) if it is determined to be more ___________to administer them than to withhold them.

harmful

The advocate must be careful to remain _____________ and not convey approval or disapproval of the client's

objective

The overall goal of the client advocate is to protect the client's ___________.

rights

1. Clients have the right to expect a nurse-client relationship that is based on shared respect, trust, collaboration in solving problems related to health and health care needs and consideration of their ______ and ___________.

thoughts, feelings

Advocacy requires accepting and respecting the client's right to decide, even if the nurse believes the decision to be ____________ .

wrong