NURS 1130 - LSUE - EXAM 1 - CH 22, 23, 24, 25, 26
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.
,NURS 1130 - LSUE - EXAM 1 - CH 22, 23, 24, 25, 26
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.
,NURS 1130 - LSUE - EXAM 1 - CH 22, 23, 24, 25, 26
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
, NURS 1130 - LSUE - EXAM 1 - CH 22, 23, 24, 25, 26
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 narcotics. Accountability refers to the ability to
answer for one's actions. Advocacy refers to the support of a particular cause. The concept of
confidentiality is very important in health care and involves protecting patients' personal health
information.
A young woman who is pregnant with a fetus exposed to multiple teratogens consents to have
her fetus undergo serial PUBS (percutaneous umbilical blood sampling) to examine how
exposure affects the fetus over time. Although these tests will not improve the fetus's outcomes
and will expose it to some risks, the information gathered may help infants in the future. Which
ethical principle is at greatest risk? - Answer: Nonmaleficence
Nonmaleficence is the ethical principle that focuses on avoidance of harm or hurt. Repeated
PUBS may expose the mother and fetus to some risks. Fidelity refers to the agreement to keep
promises (obtain serial PUBS). Autonomy refers to freedom from external control (mother
consented), and beneficence refers to taking positive actions to help others (may help infants in
the future).
A nurse is discussing quality of life issues with another colleague. Which topic will the nurse
acknowledge for increased attention paid to quality of life concerns? - Answer: Abilities of
disabled persons
The population of disabled persons in the United States and elsewhere has reshaped the
discussion about quality of life (QOL). Health care disparities, an aging population, and health
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.
,NURS 1130 - LSUE - EXAM 1 - CH 22, 23, 24, 25, 26
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.
,NURS 1130 - LSUE - EXAM 1 - CH 22, 23, 24, 25, 26
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
, NURS 1130 - LSUE - EXAM 1 - CH 22, 23, 24, 25, 26
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 narcotics. Accountability refers to the ability to
answer for one's actions. Advocacy refers to the support of a particular cause. The concept of
confidentiality is very important in health care and involves protecting patients' personal health
information.
A young woman who is pregnant with a fetus exposed to multiple teratogens consents to have
her fetus undergo serial PUBS (percutaneous umbilical blood sampling) to examine how
exposure affects the fetus over time. Although these tests will not improve the fetus's outcomes
and will expose it to some risks, the information gathered may help infants in the future. Which
ethical principle is at greatest risk? - Answer: Nonmaleficence
Nonmaleficence is the ethical principle that focuses on avoidance of harm or hurt. Repeated
PUBS may expose the mother and fetus to some risks. Fidelity refers to the agreement to keep
promises (obtain serial PUBS). Autonomy refers to freedom from external control (mother
consented), and beneficence refers to taking positive actions to help others (may help infants in
the future).
A nurse is discussing quality of life issues with another colleague. Which topic will the nurse
acknowledge for increased attention paid to quality of life concerns? - Answer: Abilities of
disabled persons
The population of disabled persons in the United States and elsewhere has reshaped the
discussion about quality of life (QOL). Health care disparities, an aging population, and health
