NURS 1130 - LSUE - EXAM 1 - CH 22, 23, 24, 25, 26 |
143 QUESTIONS | WITH COMPLETE SOLUTIONS.
Four patients in labor all request epidural analgesia to manage their pain at the
same time. Which ethical principle is mostcompromised when only one nurse
anesthetist is on call? Answer - Justice
Justice refers to fairness and is used frequently in discussion regarding access
to health care resources. Here the just distribution of resources, in this case
pain management, cannot be justly apportioned. Nonmaleficence refers to
avoidance of harm; beneficence refers to taking positive actions to help others.
Fidelity refers to the agreement to keep promises. Each of these principles is
partially expressed in the question; however, justice is most comprised because
not all laboring patients have equal access to pain management owing to lack
of personnel resources.
The patient reports to the nurse of being afraid to speak up regarding a desire
to end care for fear of upsetting spouse and children. Which principle in the
nursing code of ethics ensures that the nurse will promote the patient's cause?
Answer - Advocacy
Nurses advocate for patients when they support the patient's cause. A nurse's
ability to adequately advocate for a patient is based on the unique relationship
that develops and the opportunity to better understand the patient's point of
view. Responsibility refers to respecting one's professional obligations and
following through on promises. Confidentiality deals with privacy issues, and
accountability refers to answering for one's actions.
,The patient's son requests to view documentation in the medical record. What
is the nurse's best response to this request? Answer - "You will need your
mother's permission."
The mother's permission is needed. The nurse understands that sharing health
information is governed by HIPAA legislation, which defines rights and
privileges of patients for protection of privacy. Private health information
cannot be shared without the patient's specific permission. The nurse cannot
obtain the records without permission. The son can look at it after approval
from the patient. While talking to the physician or getting an order is
appropriate, the patient still has to give consent.
When professionals work together to solve ethical dilemmas, nurses must
examine their own values. What is the bestrationale for this step? Answer - So
different perspectives are respected
Values are personal beliefs that influence behavior. To negotiate differences of
value, it is important to be clear about your own values: what you value, why,
and how you respect your own values even as you try to respect those of
others whose values differ from yours. Ethical dilemmas are a problem in that
no one right solution exists. It is not to separate fact from opinion. Judgmental
attitudes are not to be used, much less provoked.
A nurse is experiencing an ethical dilemma with a patient. Which information
indicates the nurse has a correct understanding of the primary cause of ethical
dilemmas? Answer - Presence of conflicting values
Ethical dilemmas almost always occur in the presence of conflicting values.
While unequal power, judgmental perceptions, and poor communication can
contribute to the dilemma, these are not causes of a dilemma. Without
clarification of values, the nurse may not be able to distinguish fact from
opinion or value, and this can lead to judgmental attitudes.
,The nurse questions a health care provider's decision to not tell the patient
about a cancer diagnosis. Which ethical principle is the nurse trying to uphold
for the patient? Answer - Autonomy
The nurse is upholding autonomy. Autonomy refers to the freedom to make
decisions free of external control. Respect for patient autonomy refers to the
commitment to include patients in decisions about all aspects of care.
Consequentialism is focused on the outcome and is a philosophical approach.
Justice refers to fairness and is most often used in discussions about access to
health care resources. Fidelity refers to the agreement to keep promises.
The nurse finds it difficult to care for a patient whose advance directive states
that no extraordinary resuscitation measures should be taken. Which step may
help the nurse to find resolution in this assignment? Answer - Scrutinize
personal values.
Clarifying values—your own, your patients', your co-workers'—is an important
and effective part of ethical discourse. Calling for a consult, declining the
assignment, and convincing the family to challenge the patient's directive are
not ideal resolutions because they do not address the reason for the nurse's
discomfort, which is the conflict between the nurse's values and those of the
patient. The nurse should value the patient's decisions over the nurse's
personal values.
The nurse values autonomy above all other principles. Which patient
assignment will the nurse find most difficult to accept? Answer - Family elder
who is making the decisions for a young-adult female member
Autonomy refers to freedom from external control. A person who values
autonomy highly may find it difficult to accept situations where the patient is
not the primary decision maker regarding his or her care. A teenager
requesting an epidural, a father with an advance directive, and an elderly
, patient requiring dialysis all describe a patient or family who can make their
own decisions and choices regarding care.
A nurse must make an ethical decision concerning vulnerable patient
populations. Which philosophy of health care ethics would be particularly
useful for this nurse? Answer - Feminist ethics
Feminist ethics particularly focuses on the nature of relationships, especially
those where there is a power imbalance or a point of view that is ignored or
invisible. Deontology refers to making decisions or "right-making
characteristics," bioethics focuses on consensus building, while utilitarianism
and teleology speak to the greatest good for the greatest number.
A nurse agrees with regulations for mandatory immunizations of children. The
nurse believes that immunizations prevent diseases as well as prevent spread
of the disease to others. Which ethical framework is the nurse using? Answer -
Utilitarianism
Utilitarianism is a system of ethics that believes that value is determined by
usefulness. This system of ethics focuses on the outcome of the greatest good
for the greatest number of people. Deontology would not look to
consequences of actions but on the "right-making characteristic" such as
fidelity and justice. The ethics of care emphasizes the role of feelings.
Relationships, which are an important component of feminist ethics, are not
addressed in this case.
The nurse has become aware of missing narcotics in the patient care area.
Which ethical principle obligates the nurse to report the missing medications?
Answer - Responsibility
Responsibility refers to one's willingness to respect and adhere to one's
professional obligations. It is the nurse's responsibility to report missing
143 QUESTIONS | WITH COMPLETE SOLUTIONS.
Four patients in labor all request epidural analgesia to manage their pain at the
same time. Which ethical principle is mostcompromised when only one nurse
anesthetist is on call? Answer - Justice
Justice refers to fairness and is used frequently in discussion regarding access
to health care resources. Here the just distribution of resources, in this case
pain management, cannot be justly apportioned. Nonmaleficence refers to
avoidance of harm; beneficence refers to taking positive actions to help others.
Fidelity refers to the agreement to keep promises. Each of these principles is
partially expressed in the question; however, justice is most comprised because
not all laboring patients have equal access to pain management owing to lack
of personnel resources.
The patient reports to the nurse of being afraid to speak up regarding a desire
to end care for fear of upsetting spouse and children. Which principle in the
nursing code of ethics ensures that the nurse will promote the patient's cause?
Answer - Advocacy
Nurses advocate for patients when they support the patient's cause. A nurse's
ability to adequately advocate for a patient is based on the unique relationship
that develops and the opportunity to better understand the patient's point of
view. Responsibility refers to respecting one's professional obligations and
following through on promises. Confidentiality deals with privacy issues, and
accountability refers to answering for one's actions.
,The patient's son requests to view documentation in the medical record. What
is the nurse's best response to this request? Answer - "You will need your
mother's permission."
The mother's permission is needed. The nurse understands that sharing health
information is governed by HIPAA legislation, which defines rights and
privileges of patients for protection of privacy. Private health information
cannot be shared without the patient's specific permission. The nurse cannot
obtain the records without permission. The son can look at it after approval
from the patient. While talking to the physician or getting an order is
appropriate, the patient still has to give consent.
When professionals work together to solve ethical dilemmas, nurses must
examine their own values. What is the bestrationale for this step? Answer - So
different perspectives are respected
Values are personal beliefs that influence behavior. To negotiate differences of
value, it is important to be clear about your own values: what you value, why,
and how you respect your own values even as you try to respect those of
others whose values differ from yours. Ethical dilemmas are a problem in that
no one right solution exists. It is not to separate fact from opinion. Judgmental
attitudes are not to be used, much less provoked.
A nurse is experiencing an ethical dilemma with a patient. Which information
indicates the nurse has a correct understanding of the primary cause of ethical
dilemmas? Answer - Presence of conflicting values
Ethical dilemmas almost always occur in the presence of conflicting values.
While unequal power, judgmental perceptions, and poor communication can
contribute to the dilemma, these are not causes of a dilemma. Without
clarification of values, the nurse may not be able to distinguish fact from
opinion or value, and this can lead to judgmental attitudes.
,The nurse questions a health care provider's decision to not tell the patient
about a cancer diagnosis. Which ethical principle is the nurse trying to uphold
for the patient? Answer - Autonomy
The nurse is upholding autonomy. Autonomy refers to the freedom to make
decisions free of external control. Respect for patient autonomy refers to the
commitment to include patients in decisions about all aspects of care.
Consequentialism is focused on the outcome and is a philosophical approach.
Justice refers to fairness and is most often used in discussions about access to
health care resources. Fidelity refers to the agreement to keep promises.
The nurse finds it difficult to care for a patient whose advance directive states
that no extraordinary resuscitation measures should be taken. Which step may
help the nurse to find resolution in this assignment? Answer - Scrutinize
personal values.
Clarifying values—your own, your patients', your co-workers'—is an important
and effective part of ethical discourse. Calling for a consult, declining the
assignment, and convincing the family to challenge the patient's directive are
not ideal resolutions because they do not address the reason for the nurse's
discomfort, which is the conflict between the nurse's values and those of the
patient. The nurse should value the patient's decisions over the nurse's
personal values.
The nurse values autonomy above all other principles. Which patient
assignment will the nurse find most difficult to accept? Answer - Family elder
who is making the decisions for a young-adult female member
Autonomy refers to freedom from external control. A person who values
autonomy highly may find it difficult to accept situations where the patient is
not the primary decision maker regarding his or her care. A teenager
requesting an epidural, a father with an advance directive, and an elderly
, patient requiring dialysis all describe a patient or family who can make their
own decisions and choices regarding care.
A nurse must make an ethical decision concerning vulnerable patient
populations. Which philosophy of health care ethics would be particularly
useful for this nurse? Answer - Feminist ethics
Feminist ethics particularly focuses on the nature of relationships, especially
those where there is a power imbalance or a point of view that is ignored or
invisible. Deontology refers to making decisions or "right-making
characteristics," bioethics focuses on consensus building, while utilitarianism
and teleology speak to the greatest good for the greatest number.
A nurse agrees with regulations for mandatory immunizations of children. The
nurse believes that immunizations prevent diseases as well as prevent spread
of the disease to others. Which ethical framework is the nurse using? Answer -
Utilitarianism
Utilitarianism is a system of ethics that believes that value is determined by
usefulness. This system of ethics focuses on the outcome of the greatest good
for the greatest number of people. Deontology would not look to
consequences of actions but on the "right-making characteristic" such as
fidelity and justice. The ethics of care emphasizes the role of feelings.
Relationships, which are an important component of feminist ethics, are not
addressed in this case.
The nurse has become aware of missing narcotics in the patient care area.
Which ethical principle obligates the nurse to report the missing medications?
Answer - Responsibility
Responsibility refers to one's willingness to respect and adhere to one's
professional obligations. It is the nurse's responsibility to report missing
