NUR242 / NUR 242 Exam 1 (Latest 2025 / 2026): Medical-Surgical Nursing Concepts | Questions and Verified Answers | 100% Correct | Grade A - Galen

NUR242 / NUR 242 Exam 1 (Latest 2025 / 2026): Medical-Surgical Nursing Concepts | Questions and Verified Answers | 100% Correct | Grade A - Galen • Question: Nurse witnesses another nurse providing care without prosper hand hygiene and reports this to the charge nurse. The charge nurse is friends with the other and refuses to take action. This is an example of: Answer: Moral distress Question: A nurse manager who makes decisions based on what will benefit the majority of the nurse managers subordinates is using what type of ethical framework for decision making? Answer: Utilitarianism Question: Which isn't an element of ethical decision making: beneficence, utility, paternalism, pragmatism Answer: Pragmatism Question: Nancy is a loyal and trustworthy nurse that performs the duties that are expected of her. Which principle of ethical reasoning is Nancy displaying? Answer: Fidelity Question: The nurse in a unit is caring for several clients. To distribute nursing care the nurse used the principle of triage due to the limited availability of resources. The nurse is promoting which ethical principle? Answer: Justice Question: Nursing ethics provides the standards for professional behavior and is the study of principles of right and wrong for nurses. The standard states the duties and obligations of the nurse should include which of of the following: individual, community, client, all of them? Answer: All of them Question: When does a moral issue become an ethical dilemma? Answer: When forced to choose between two or more undesirable alternatives. Question: The nurse manager didn't hire sally for the assistant manager job. The nurse manager informed sally that she was a great fit but an internal candidate was selected instead. The real reason sally wasn't hired was because her drug test was positive. Which of the principles of ethical reasoning didn't the nurse follow? Answer: Veracity Question: A client is advised by the doctor to undergo chemo. An informed consent is not yet signed. The client requests info related to chemo and the drugs that will be given to him. The nurse explains the side effects and meds. The nurse answered all questions even though the client chose not to undergo chemo. The nurse uses which principle of ethical reasoning? Answer: Veracity Question: Nurse Bobby avoids deliberate harm and risk of harm during his performance of nursing actions. The nurse is promoting which ethical principle? Answer: Nonmaleficence Question: What does provision one state? Answer: Nurse practices with compassion and respect for inherent dignity, worth and unique attributes of every person Patient has right to decide for themselves- autonomy to accept or refuse or terminate care (ie no more feeding tube) Question: What does provision 2 state? Answer: Nurse's primary commitment is to the patient, whether an individual, family, group, community or population Question: What does provision 3 state? Answer: Nurse promotes, advocates for and protects rights, health and safety of patient Question: What does provision 4 state? Answer: Nurse has the authority, accountability and responsibility for nursing practice, makes decisions and takes action consistent with the obligation to promote health and provide optimal care Question: What does provision 5 state? Answer: Nurse owes same duties to self as others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competency and continue personal and professional growth (ie CE every 2 yrs) Question: What does provision 7 state? Answer: The nurse in all roles and setting advances the profession thru research and scholarly inquiry, professional standards of development and the generation of both nursing and health policy Question: What does provision 8 state? Answer: Nurse collaborated with other health professionals and the public to protect human rights, promote health diplomacy and reduce health disparities Question: What are examples of vulnerable subjects? Answer: Kids, fetuses and human embryos, pregnant, cognitively impaired, prisoners, terminally ill, elderly, undeserved population, economically disadvantage people, traumatized and comatose pt Question: What is conscientious objection? Answer: Enable patient to refuse participation in an activity that violates personal values or beliefs (work where you agree with the vision) Question: What does provision 9 state? Answer: The profession of nursing collectively through its professional organizations must articulate nursing values, maintain the integrity of the profession and integrate principals or social justice into nursing and health policy Question: Ethics are ________, _______ and _______ Answer: Unapologetic, aspirational and non- negotiable Question: What is the doctrine of double effect? Answer: Nurse may give meds with the intent s/s of dying even though secondary impact may decrease respiration's, and perhaps hasten death- the nurses actions don't cause the death, the terminal illness causes the death Question: What does interdisciplinary mean? Answer: What does interprofessional mean? What does transprofessional mean? Interdisciplinary- relating to more than one branch of knowledge. Interprofessional- peers from two or more professions in health and social care learn together during all or part of their professional training with the object of cultivating collaborative practice for providing client- or patient-centered health care. Transprofessional- collaboration with non-professionals Question: <____% of worlds health research Bridget is spent on 90% of issues that don't matter Answer: <10% Question: ______= study of morality through variety of different approaches ________ _______= helps us recognize where there's an ethical problem _______ _______ and ______= enables us to think critically to rank our ethical obligations and priorities Answer: Ethics Ethical sensitivity Ethical reflection and analysis Question: _______ _______ ______= method ensuring that the action We take is well reasoned and can be justified ______ _____= enables us to act on our decisions even under the most challenging circumstances ______= branch of philosophy that considers fundamental questions about the nature, source and meaning of concepts good or bad, right or wrong Answer: Ethical decision making Moral courage Metaethics Question: ______ ______= ethics that serve the larger community (ie abortion's, physician assisted suicide) _______ _______= formal/informal principles and values that guide behavior, decisions an actions take. By organization (ie billions of dollars spent annually resulting from healthcare fraud and abuse) _____ ______= refers to ethical standards and expectations of a particular profession (code of ethics for nurses, ANA committee) Answer: Societal ethics Organizational ethics Professional ethics Question: ______ ______= deals with very specific judgement about right and wrong in everyday actions ______ ______= process of applying ethicL theory and reasoning to delay life Answer: Normative ethics Applied ethics Question: ______= ethical questions surrounding biological sciences, healthcare technology and policy ________ ______= involved with decision making at bedside and patient specific issues _______ ______= patients personal ethic foundation/ practice Answer: Bioethics Clinical ethics Personal ethics Question: What are some sources of ethics? Answer: Familu, peers, religion, culture, society, profession, personal experiences Question: _______ ______= problem with ethical dimension ______ ______= problem where in order to do something right, you must do something wrong Answer: Ethical problem Ethical dilemma Question: Ethical analysis and decision making? What are the 4 topics? Answer: Systematic approach of ethical analysis to the process of making a decision Question: 4 topics: Answer: Medical indications, patient preference, QOL, contextual features Question: ______ _____ ________= duty to do something or refrain from doing something ______ _____= allows decision maker to review each ethical problem/issue on case by case basis- compares relative goals, duties and rights ____ ______= suggests that ppl make decisions based only on what seems right/reasonable according to their value system or culture _____ _____= ethical principles are universal and constant and that ethical decision making shouldn't vary as a result of individual circumstances or cultural differences Answer: duty-based reasoning intuitionist framework ethical relativism ethical universalism Question: ______= freedom of choice or accepting responsibility for one's choice ______= related to beneficence in that one person assumes the authority to make a decision for another ______= reflects a belief utilitarianism- whats best for the common good outweighs whats best for individual Answer: autonomy paternalism utility Question: _____= how people feel about need for truth telling or acceptability of deception ______= obligation to observe privacy of another and hold certain info to strict confidence Answer: veracity confidentiality Question: separate legal and ethical issues- what does this mean? Answer: collaborate through ethics committees- what does this mean? legal controls are general, clear and philosophically impartial; ethical controls are much less clear and individualized assist with problem-solving in ethical issues; committees are typically interprofessional and organized to concisely and reflectively consider significant/difficult/ambiguous value issues related to patient care or organizational activities Question: use institutional review boards appropriately- what does this mean? Answer: foster an ethical work environment- what does this mean? primarily formed to protect rights and welfare of research subjects; provide oversight to ensure that individuals conducting research adhere to ethical principles that were articulated by a board Question: to role model ethical behavior; working as a team with a standard for behavior can promote a positive ethical climate; other interventions: encouraging staff to openly discuss ethical issues Answer: Question: _______ ___ ______= humans have unconditional moral worth- treat each with dignity, value and respect ______= directs us to act in ways that avoid harm to others including risk of harm (ie pain, disability, death) ______= obligation to do good by acting in ways that promote best interest of others (health and well-being) Answer: respect for persons nonmaleficence beneficence Question: _____ ______= concern with treating people equal, fair and appropriate (care and tx with no discrimination) _____= to act in ways that are loyal (keeping promises, doing what is expected of you) Answer: social justice fidelity Question: _____ ___ _____= moral duties are seen as self-evident, needing no further justification (acting accordingly to specific duty bc its the right thing to do) _____ ____ ____= teleological view that moral actions are defined entirely basis of outcomes or consequences of action (protect as many ppl as possible) ______ ___ _____= classified under general category of virtue ethics (combo of good intention to protect while seeking best possible outcome for all _____ ___ _____= focused on nature and obligations inherent in human relationships and community (will seek open communication and collaboration approach that emphasizes caring and dec. harm to patient) Answer: ethics of duty ethics of consequences ethics of character ethics of relationship Question: what is moral distress? what are the 2 parts? Answer: what are the 3 patterns of response? occurs when youre unable to act upon what you believe is morally appropriate action to take or when you act in a manner contrary to your values (ie you know what to do but dont think you can due to barriers (internal- self doubt; and external- inadeq staffing, poor relationships with colleagues) Question: 2 parts: Answer: 1. frustration, anger, guilt, anxiety 2. reactive distress/moral residue- lingering feelings that can accom. overtime with each experience of moral distress Question: 3 patterns of response: Answer: 1. voicing opposition to plan of care 2. be passive/withdraw 3. phys and psych stresses lead to burnout Question: _______ _______= advances in genetics (ie being able to select genetic traits) ____= mandatory reporting (ie abuse that needs to be reported but patient doesnt want to) _____ _____= at end of life (what patient wants may not be what family wants) _______ _____= healthcare organization (inc. quality care with cost effective, safety to patient, technology, insurance) _____ ___ _____= at bedside (marijuana- legal but not federally- lack of EBP research for or against) Answer: genetic enhancement confidentiality advance directives uncompensated care conflict of interest Question: ________ _______= individual questions why mortality in practice is even necessary _______ _____/ ______ _______= individual is unsure which moral principles or values apply and may even include uncertainty as to what moral problem is ______ ______= individual with these is immoral act of another but feels powerless to stop it Answer: moral indifference moral uncertainty/moral conflict moral outrage Question: _____ ______= encourages decision making based on what provides the greatest good for greatest number of ppl ______ ___ _____= individuals have basic inherent rights that shouldnt be interfered with Answer: utilitarian theory rights-based reasoning Question: what are the 5 principles of ethical reasoning? Answer: autonomy, paternalism, utility, veracity, confidentiality Question: what are the 5 ethical principles? Answer: respect for persons, non maleficence, beneficence, social justice, fidelity Question: what aew the 4 ethical theories? Answer: ethics of duty, ethics of consequences, ethics of character, ethics of relationship Question: what are the 4 moral issues faced by nurses? Answer: moral indifference, moral uncertainty, moral conflict, moral outrage Question: ______ _____/______ _____= leaders are born, not made. when a situation requires leadership, prior education or special prep Answer: doesnt occur (traits: confidence, decisiveness, friendly) Question: what are the 4 attributes? Answer: Great Man/Trait Theory 4 attributes: attributes: honesty, forward looking, inspiring, competent Question: _______ _______= effective leaders use different behaviors than ineffective leaders (high concern for employee needs, task accomplishment, organized) Answer: behavioral leadership Question: ________ and ________ ______= some leadership approaches are effective in one situation and not in others. Education and training enhance this leadership- challenges assumption that there is "one best way to lead" Answer: situational and contingency theory Question: _______ and _______ ______= assumption that leaders inspire, intellectually stimulate and recognize contributions of their followers (charm, motivate, encourage performance, trust to achieve) Answer: charismatic and transformational theory Question: ____ ______= assumes interconnectedness among parts of a system and between the system and its external environment interaction among the interconnected parts can effect the entire system Answer: complexity leadership Question: _______ ______ _____= setting in which most nurses work. formal nurse leaders play important role. clinical nurses usually frontline. nursing practice geared toward delivery of healthcare ____________= attribute of effective leaders- leaders who communicate; helps with understanding direction and decision-making _____ _____= process of connecting healthcare services and resources to patient- crucial for leaders to contribute ______= essential within and among organization within and across disciplines- essential to efficient organization. skilled nurses encourage this and model it- it also enhances communication and delivery of care Answer: healthcare organizations communication care coordination collaboration Question: ______ _____ _____= nurse leaders help ensure that the actions of the org. unit and individuals contribute- leaders are attuned to standards and processes that an org. uses to provide high quality care ______= guides practice- formal leaders use it to create organizational processes and work environment that contributes to satisfaction, productivity and retention of nursing staff ______= leaders practice and role model high ethical standards. clinical and interprofessional leaders rely on their models to protect and advocate for patient in all aspects of patient care Answer: health care quality evidence ethics Question: ________ leader= make ALL decisions and are generally most concerned with the tasks to be accomplished- maintain distance from their followers- motivate through threat- often used for quick decisions and emergencies Answer: autocratic leaders Question: ______ leaders= involves followers in decision making- participatory leadership style- useful when followers are experienced workers and theyre committed to the goal (also good socially and educated) Answer: democratic leaders Question: _______-________ leaders- leader doesnt interfere with employees and their work- they stand at a distance, give followers freedom to make decisions to accomplish work- provide very little info and communication- typically wait until crisis to make decisions- work best with experienced workers, but causes apathy, insufficiency and chaos Answer: Laissez-Faire leaders Question: ________ leader- focus on daily operations of an org. and develop an exchange relationship with their followers- rewards followers when they perform and corrects them when necessary- get things done and satisfy their own and their followers interests Answer: transactional leaders Question: _____ leader= use approaches that change or transform individuals- inspire and intellectually stimulate followers and recognize their contributions. expectations are high and often challenge followers- they communicate organizational vision to their followers- focus on longterm and involves developing ppl and organization Answer: transformational leaders Question: ______ leaders= transparent and ethical in their dealings with followers- genuine, empathetic, reliable and believable- perceived by others to be warm, optimistic, respectful. they focus on establishing relationships that embody trust and show commitment to the development of their followers Answer: authentic leaders Question: _________ leadership= assoc. with work teams- an approach in which employees are empowered to distribute leadership responsibilities broadly within a group- they lead one another to achieve a goal- effective with professionals - with project focused workgroups- highly interactive and enables employees to develop skills Answer: shared leadership Question: name some benefits of a autocratic leadership? disadvantages? Answer: benefits: task oriented, emergent decisions, useful with group without skill or knowledge disadvantages: distant from followers, lose benefit of collaboration, communication flows downward, dont do well with followers making mistakes, dont like alot of new ideas, like input to certain extent Question: benefits of democratic leadership- what 3 things? benefits? disadvantages? Answer: benefits: 3 THINGS: responsibility, accountability, feedback receptive to ideas, communication, decision making involves others, constructive criticism disadvantages: less control maintained, less efficient quantitively, not useful when followers arent experienced, communication difficult sometimes Question: benefits of Lassez-Faire leadership? disadvantages? Answer: benefits: flexible, avoids confrontation, doesnt criticize, decision making throughout group, strong communication, works well with highly skilled people disadvantages: little or no control or direction by leader, rarely see change (good or bad) Question: benefits of transactional leadership? disadvantages? Answer: benefits: goal oriented, focus on tasks and getting work done, examines causes, rewards based, sticks to mission and vision and values, keeps employees informed, likes structure disadvantages: doesnt identify shared values, uses trade offs to get goals (quid pro quo), leader is inflexible, limits employee creativity, insensitive Question: benefits of transformational leadership? disadvantages? Answer: benefits- identifies common values, inspires others with a vision, empowers others, looks at effects, longterm goals, like a safe patient environment, values/morals are important disadvantages: very high expectations, takes time (like a vision), can misuse influence, employees can lose inspiration Question: benefits of authentic leadership? disadvantages? Answer: benefits: reliable, ethical, fair, always have courage to do right thing, focus on relationships, clear expecations and roles, trustworthy disadvantages: longterm, taken advantage of by staff, can result in pretending to be someone youre not, can block team from moving forward Question: benefits of shared leadership? disadvantages? Answer: benefits: teamwork, highly interactive, empowered leadership, shared work, accountability inc. disadvantages: no clear leader, team member doesnt pull weight, members must work well together and respect eachother Question: which leadership style do leaderss typically start at? Answer: Lassez-Faire Question: Name some differences between leadership and management Answer: leadership: look forward, imagine possibilities that the future may bring in order to set direction inspires change, requires vision and imagination requires abstract thinking requires ability to articulate and aptitude to sell requires ability to understand external environment requires risk taking and confidence accountable to entire organization definition: individuals who are at front, taking risk, attempting to achieve a shared goal and inspiring others to action management: monitor and adjust todays work, regularly looking back to ensure goals and objectives are being met manages transformation requires tenacity and specifics, requires concrete data requires ability to interpret and aptitude to teach requires understanding of how work gets done inside of org. requires self discipline requires blind commitment to completing task at hand accountable to team def: org. and coordination of activities of a business in order to achieve defined objectives Question: the _____ _____ _____ assumes that people have certain characteristics or personality traits that make them better leaders than others (ie intelligence, knowledge, judgement, creativity, confidence) Answer: The Great Man Theory Question: _________ leader style= strong control is maintained over the work group; others are motivated by coercion and directed by commands; communication flows downward, decision making doesnt involve others, emphasis is on diff in status ("I and You), criticism is punitive Answer: Authoritarian Question: _______ leader style= less control is maintained; rewards are used to motivate; others are directed thru direction and guidance; communication flows up and down; decision making involves others; emphasis is on "we" rather than "I and You", criticism is constrictive ; leadership should vary according to situation or individuals involved (organizational culture, values of leaders, etc) Answer: Democratic Question: ______-______ leader style= permissive with little or no control, motivates but supports when requested by group or individuals; provides little or no direction; uses up and down communication between groups; places decision making emphasis on group, doesnt criticize Answer: Laissez-Faire Question: _______ leadership theories= leadership behavior is generally determined by the relationship between the leaders personality and the specific situation Answer: interactional leadership theories Question: __________ and __________ leadership= both, leaders and followers have the ability to raise eachother to higher levels of motivation and morality __________= concerned with day to day operations ________= committed and has a vision and is able to empower others with this vision Transactional and transformational leadership Answer: transactional transformational Question: what are the 6 factors of Full-range leadership model/theory? Question: what 3 types of leaders could apply this? Answer: inspirational motivation idealized influence intellectual stimulation individualized consideration active and passive management by exaption absence of leadership leader who could apply 3 leadership styles: Answer: 1. transformational 2. transactional 3. Laissez-Faire Question: what are some distinguishing traits of leaders and management? Answer: they think longer term they look outward toward the larger org. they influence others beyond their own group they emphasize vision, values and motivation they are politically astute they think in terms of change and renewal Question: what is the definition of leadership? Answer: universally accepted definition does not exist an interactive process that provides needed guidance and direction Question: what are the 3 dynamics of leadership? Answer: 1. leader- provides guidance to followers 2. follower- follows leader 3. situation Question: Formal vs. informal leaders Answer: formal (ex: chief nursing officer, nursing director, assistant director, charge nurse, nurse mgmt, assoc. dean, state board)- individuals who occupy designated administrative or mgmt positions in an org. informal (experienced staff nurses who are recognized as clinical leaders bc of their expertise, willingness to advocate, involvement in important issues and care, etc) these sometimes move int0o formal leadership positions individuals do not occupy a designated administrative or mgmt position- these individuals are considered informal leaders by their supervisors and peers bc of their capabilities and actions Question: _________= follow leaders; there are no leaders without followers and vise versa. followers are independent; each influence effectiveness of eachother. Answer: followers Question: ________= a leader's ideological statement of a desired long-term future for an organization (requires communication, decision-making and change to work towards) Answer: vision Question: _________= essential for leadership; continuous bw leaders and followers- style depends on leadership style Answer: communication Question: ______-______= all leaders make decisions that affect others and their organizations success; good at this skill is required for successful Answer: leadership decision-making Question: ________= transition process from old state to new state; vital to work towards vision- leaders guide this Answer: change Question: ______ _______= potential influence of one individual over another Answer: social power Question: what are the 6 attributes for effective leadership? Answer: followers, vision, communication, decision making, change and social power Question: what are the 6 types of social powers? Answer: coercive, legitimate, referent, reward, expert, informational Question: name the power... Answer: ______= uses threat of punishment to get followers to respond; women more responsive to this; works better if leader is well liked ______= "you did X for me, so I should do X for you"- leaders have power over their followers bc of position they hold ______= results when followers identify with or aspire to be like their leader (can be positive or negative) _______= ability of one person to reward another for compliance with expectations; women more responsive ______= results when followers respond to their leaders directions bc they perceive that the leader knows best (ie RNs are not experts in engineering) ______= based on leaders ability to influence followers to act by using clear, logical rational arguments and info; indirect power is more Answer: effective coercive legitimate referent reward expert informational Question: what are the 3 leadership skills that were presented in the class video? Answer: 1. stepping outside of comfort zone 2. mentoring 3. being at the table when policy decisions are being made Question: what skills of leaders promote retention? Answer: listening to staff, training sessions, staff support, be fair on and off duty for requests, staff meetings, clinical supervision and mentor, leading from the front, setting high standards, but not unrealistic ones, social events, saying thank you Question: leaders vs. managers? Answer: leaders: often dont have delegated authority, but obtain power through means wider vairety of roles may or may not be part of a formal org. focus on group processes, info, gathering, feedback and empowering others, emphasize interpersonal relationships, direct willing followers, have goals that may or may not reflect the org. managers: org. and coord. of the activities of a business in order to achieve defined objects Question: what are the 10 leadership flaws? Answer: lack of energy, enthusiasm acceptance of own mediocre performance lack of clear vision and direction poor judgement not walking the talk resisting new ideas not learning from mistakes lack of interpersonal skills failing to develop others Question: who was the father of scientific mgmt? Answer: Frederick W. Taylor- developed scientific mgmt principles in 1911: 1. use greatest efficiency of time and energy 2. workers are hired, trained based on their skills 3. workers should be able to view how they fit and contribute to org.- use incentives and rewards 4. relationships bw managers and workers should be cooperative and interdependent, however the manager leads and the worker works Question: who developed the Great Man Theory? Who developed the leadership theories? Answer: Aristotle Lewin and White Question: what are the 4 components of the management process? Answer: planning organizing leading controlling Question: _______= use education as means for role clarification; relationship occurs in professional setting- chosen, not assigned _____= person from a group of managers who leads or supervises a particular area of a company. Companies that use this term often have many directors spread throughout different business functions or roles ______= encompasses direct service to the individual or family as well as activities that promote health and access to health care in communities and the larger public. ... Health advocates are best suited to address the challenge of patient-centered care in our complex healthcare system ______ ______ _____ =the deliberate organization of patient care activities between two or more participants involved in a patient's care to facilitate the appropriate delivery of health care services Answer: mentor director advocate health care coordination Question: what are some recommended competencies for nursing leaders? Answer: personal qualities, interpersonal and thinking skills, setting the vision, communication, initiating change, developing ppl, healthcare knowledge, mgmt skills, business skills Question: integrating leadership roles and mgmt functions- what must be integrated? Answer: think longer term look outward toward larger org. influence others beyond own group emphasize vision, values and motivation politically astute think in terms of change and renewwl Question: ________ ______= individual knows the right thing to do but organizational constraints make it difficult to take the right course of action ______ ______=individual witnesses the immoral act of another but feels powerless to stop it Answer: moral distress moral outrage Question: what are some moral issues faced by nurses? Answer: moral indifference moral uncertainty moral distress moral outrage moral dilemma Question: what are some ethical frameworks for nursing? Answer: utilitarian- provide greatest good for greatest # ppl rights based- individuals have basic rights that shouldnt be interfered with duty based- duty to do or refrain from something intuitionist- each case weighed case by case basis to determine goals and rights Question: what are all of the 9 ethical principles? Answer: autonomy (self-determination) beneficience (doing good) paternalism )one individual assumes right to make decisions for another ) utility (good of many outweighs needs/wants of individual) justice (treating ppl fairly) veracity (truth telling) fidelity (keeping promises) confidentiality (privacy) Question: T/F the Nursing Code of Ethics are NOT legally binding, but act as an ethical standards in which nurses should follow adopted by who? Answer: true adopted by ANA Question: what is the MORAL decision making model? Answer: MASSAGE the dilemma- collect data OUTLINE options REVIEW criteria and resolve AFFIRM position and act LOOK back- evaluate decision making Question: what is the scope of ethics like? what are the 5 types? Answer: broad, encompassing many dimensions- we are all members of a larger society in which we work in org. settings and we function within the parameters of a particular profession. 5 types: Answer: societal ethics organizational ethics professional ethics bioethics and clinical ethics personal ethics Question: what plays a role in ethical analysis and decision making? Answer: useful to apply a systematic approach to ethical analysis to make decisions- . in nursing, usually part of interprofessional team. organizational conflict comittee can be asked to help with mediation of the conflict its important to be able to ask good Q's: ethical Q's: do i have duty to tell the truth? what is the greater harm? to whom is my primary loyalty? Question: name some common ethical issues in nursing Answer: protecting pt rights and dignity informed consent providing care with risk to nurse.s health using/not using chemical restraints coping with staffing patterns that limit patient access to nursing care prolonging living/dying process by inapproproate measures managed care policies that threaten QO care unethical/impaired colleagues Question: what is moral distress? Answer: when you are unable to act upon what you believe is the morally appropriate action to take or when you otherwise act in a manner contrary to your personal values 2 parts of moral distress impact: frustration, anger, guilt, anxiety Moral residue- feelings that linger overtime with each experience Question: name some interrelated concepts of ethics Answer: health policy, healthcare law, health care economics professional identity culture, spirituality, health disparities healthcare quality, safety, evidence, collab, technology and informatics, leadership Question: name some clinical exemplars of ethics Answer: abortion, assisted reproduction, child abuse, confidentiality, informed consent, pain mgmt and addiction, CPR orders, advance directives, terminal sedation, patient safety, use of restraints, medical marijuana, access to experimental tx Question: what are the specific exemplars of ethics? Answer: genetic enhancement confidentiality advance directives uncompensated care conflict of interest Question: what were the top reasons in the moral distress article that the student nurses didnt take action during distressing situations? Answer: i am a subordinate, wanted to preserve relationship with preceptor, felt concerns/questions were due to incomplete knowledge and judgement, didnt know how to respectfully speak up