Chapter 05. Ethical and Legal Issues
Multiple Choice
1. In response to a students question regarding choosing a psychiatric specialty, a
charge nurse states, Mentally ill clients need special care. If I were in that position, Id
want a caring nurse also. From which ethical framework is the charge nurse operating?
A. Kantianism
B. Christian ethics C. Ethical egoism D. Utilitarianism ANS: B
The charge nurse is operating from a Christian ethics framework. A basic principle in
Christian ethics is to do unto others as you would have them do unto you. Kantianism
states that decisions should be based on moral law and that actions are bound by a
sense of moral duty. Utilitarianism holds that decisions should be made with a focus
on the end result being happiness. Ethical egoism promotes the idea that what is right
is good for the individual.
KEY: Cognitive Level: Analysis | Integrated Processes: Caring | Client Need: Safe and
Effective Care
Environment
2. During a hiring interview, which response by a nursing applicant should indicate that
the applicant operates from an ethical egoism framework?
A. I would want to be treated in a caring manner if I were mentally ill. B. This job will
pay the bills, and the workload is light enough for me.
C. I will be happy caring for the mentally ill. Working in Med/Surg kills my back. D. It is
my duty in life to be a psychiatric nurse. It is the right thing to do.
ANS: B
,The applicants comment reflects an ethical egoism framework. This framework
promotes the idea that decisions are based on what is good for the individual and may
not take the needs of others into account.
KEY: Cognitive Level: Analysis | Integrated Processes: Nursing Process: Evaluation |
Client Need: Safe and Effective Care Environment
3. Without authorization, a nurse administers an extra dose of narcotic tranquilizer to
an agitated client. The nurses coworker observes this action but does nothing for fear
of repercussion. What is the ethical interpretation of the coworkers lack of
involvement?
A. Taking no action is still considered an action by the coworker.
B. Taking no action releases the coworker from ethical responsibility.
C. Taking no action is advised when potential adverse consequences are foreseen. D.
Taking no action is acceptable, because the coworker is only a bystander.
ANS: A
The coworkers lack of involvement can be interpreted as an action taken. The
coworker is experiencing an ethical dilemma in which a decision needs to be made
between two unfavorable alternatives. Although the coworker may be struggling with
ethical decision making, he or she has witnessed another nurse dispensing medication
outside of the scope of practice; therefore, from a legal perspective, this should be
reported.
KEY: Cognitive Level: Analysis | Integrated Processes: Nursing Process:
Implementation | Client Need:
Safe and Effective Care Environment
4. Group therapy is strongly encouraged, but not mandatory, on an inpatient
psychiatric unit. The unit managers policy is that clients can make a choice about
whether or not to attend group therapy. Which ethical principle does the unit managers
policy preserve?
A. Justice
, B. Autonomy
C. Veracity
D. Beneficence
ANS: B
The unit managers policy regarding voluntary client participation in group therapy
preserves the ethical principle of autonomy. The principle of autonomy presumes that
individuals are capable of making independent decisions for themselves and that
health-care workers must respect these decisions.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process:
Implementation | Client Need:
Safe and Effective Care Environment
5. Which is an example of an intentional tort?
A. A nurse fails to assess a clients obvious symptoms of neuroleptic malignant
syndrome. B. A nurse physically places an irritating client in four-point restraints.
C. A nurse makes a medication error and does not report the incident. D. A nurse gives
patient information to an unauthorized person.
ANS: B
A tort is a violation of civil law in which an individual has been wronged and can be
intentional or unintentional. A nurse who physically places an irritating client in
restraints has touched the client without consent and has committed an intentional
tort. Examples of unintentional torts are malpractice and negligence actions.
KEY: Cognitive Level: Analysis | Integrated Processes: Nursing Process: Evaluation |
Client Need: Safe and Effective Care Environment
Multiple Choice
1. In response to a students question regarding choosing a psychiatric specialty, a
charge nurse states, Mentally ill clients need special care. If I were in that position, Id
want a caring nurse also. From which ethical framework is the charge nurse operating?
A. Kantianism
B. Christian ethics C. Ethical egoism D. Utilitarianism ANS: B
The charge nurse is operating from a Christian ethics framework. A basic principle in
Christian ethics is to do unto others as you would have them do unto you. Kantianism
states that decisions should be based on moral law and that actions are bound by a
sense of moral duty. Utilitarianism holds that decisions should be made with a focus
on the end result being happiness. Ethical egoism promotes the idea that what is right
is good for the individual.
KEY: Cognitive Level: Analysis | Integrated Processes: Caring | Client Need: Safe and
Effective Care
Environment
2. During a hiring interview, which response by a nursing applicant should indicate that
the applicant operates from an ethical egoism framework?
A. I would want to be treated in a caring manner if I were mentally ill. B. This job will
pay the bills, and the workload is light enough for me.
C. I will be happy caring for the mentally ill. Working in Med/Surg kills my back. D. It is
my duty in life to be a psychiatric nurse. It is the right thing to do.
ANS: B
,The applicants comment reflects an ethical egoism framework. This framework
promotes the idea that decisions are based on what is good for the individual and may
not take the needs of others into account.
KEY: Cognitive Level: Analysis | Integrated Processes: Nursing Process: Evaluation |
Client Need: Safe and Effective Care Environment
3. Without authorization, a nurse administers an extra dose of narcotic tranquilizer to
an agitated client. The nurses coworker observes this action but does nothing for fear
of repercussion. What is the ethical interpretation of the coworkers lack of
involvement?
A. Taking no action is still considered an action by the coworker.
B. Taking no action releases the coworker from ethical responsibility.
C. Taking no action is advised when potential adverse consequences are foreseen. D.
Taking no action is acceptable, because the coworker is only a bystander.
ANS: A
The coworkers lack of involvement can be interpreted as an action taken. The
coworker is experiencing an ethical dilemma in which a decision needs to be made
between two unfavorable alternatives. Although the coworker may be struggling with
ethical decision making, he or she has witnessed another nurse dispensing medication
outside of the scope of practice; therefore, from a legal perspective, this should be
reported.
KEY: Cognitive Level: Analysis | Integrated Processes: Nursing Process:
Implementation | Client Need:
Safe and Effective Care Environment
4. Group therapy is strongly encouraged, but not mandatory, on an inpatient
psychiatric unit. The unit managers policy is that clients can make a choice about
whether or not to attend group therapy. Which ethical principle does the unit managers
policy preserve?
A. Justice
, B. Autonomy
C. Veracity
D. Beneficence
ANS: B
The unit managers policy regarding voluntary client participation in group therapy
preserves the ethical principle of autonomy. The principle of autonomy presumes that
individuals are capable of making independent decisions for themselves and that
health-care workers must respect these decisions.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process:
Implementation | Client Need:
Safe and Effective Care Environment
5. Which is an example of an intentional tort?
A. A nurse fails to assess a clients obvious symptoms of neuroleptic malignant
syndrome. B. A nurse physically places an irritating client in four-point restraints.
C. A nurse makes a medication error and does not report the incident. D. A nurse gives
patient information to an unauthorized person.
ANS: B
A tort is a violation of civil law in which an individual has been wronged and can be
intentional or unintentional. A nurse who physically places an irritating client in
restraints has touched the client without consent and has committed an intentional
tort. Examples of unintentional torts are malpractice and negligence actions.
KEY: Cognitive Level: Analysis | Integrated Processes: Nursing Process: Evaluation |
Client Need: Safe and Effective Care Environment