lOMoAR cP SD |12827 373
Chapter 06: Ethics in Public and Community Health Nursing Practice
Stanhope: Foundations for Population Health in Community/Public Health Nursing,
MULTIPLE CHOICE
1. Which of the following is generally considered to be nursing’s first code of ethics?
a. Nightingale Pledge
b. Code for Professional Nurses
c. Code of Ethics for Nurses
d. Principles of the Ethical Practice of Public Health
ANS: A
The Nightingale Pledge is generally considered to be nursing’s first code of ethics. After the Nightinga
Professional Nurses was formally adopted by the ANA House of Delegates in 1950. It was amended an
until, in 2001 the ANA House of Delegates adopted the Code of Ethics for Nurses with Interpretive Sta
the Ethical Practice of Public Health was approved in 2002.
2. A nurse didn’t know what to do when faced with a particular ethical dilemma because an option that w
didn’t seem possible. The nurse decided to talk to the agency supervisor and decide what action to take
best describes the nurse’s actions?
a. Appropriate, because the supervisor is responsible for the nurse’s choices.
b. Intelligent, because the supervisor has access to resource persons (clergy,
physicians, administrators) who might know of options the nurse hadn’t
considered.
c. Justified, because this provides an opportunity to discuss the issue but the nurse
maintains responsibility for the decision.
d. Wise, because the supervisor would be more knowledgeable concerning agency
priorities and traditional practices.
ANS: C
Ethically, each nurse is responsible for his or her own decisions and cannot avoid ethical accountabilit
to a supervisor or any external rule or policy. The supervisor is not responsible for the nurse’s choices,
responsibility for his/her own decisions. The nurse should have access to the same resources as the sup
similar knowledge as the supervisor.
3. Which of the following is the first and most crucial step in a generic ethical decision-making process?
a. Assess the context or environment in which the decision must be made.
b. Consider the various ethical principles or theories.
c. Identify the ethical issues and dilemmas.
d. Make a decision and act on it.
ANS: C
The first step in the ethical decision-making framework is to identify the ethical issue or dilemma. Afte
identifying the ethical concern, the following steps are: (2) place the ethical issue or dilemma within a
obtain all relevant facts, (4) reformulate ethical issues or dilemmas, if needed, (5) consider appropriate
options, (6) make the decision and take action, and (7) evaluate the decision and action.
4. A nurse is asked to meet with a family who recently immigrated from Botswana (Africa). After the ph
wife’s diagnosis of breast cancer, the family thanks the physician and starts to leave. Ethically, which o
nurse’s most important action?
a. Emphasizing that the family must set up a surgical appointment for the wife
immediately
b. Assessing the family’s current living situation, including insurance and other
assets
c. Educating the family concerning the usual treatment and the prognosis of breast
cancer
d. Interviewing the family concerning their perspective of the threat to the family’s
well-being
, lOMoAR cP SD |12827 373
5. The nurse learns that a family has declined an elective medical intervention for a health care problem b
care would drastically reduce the family’s resources and ability to meet the needs of other family mem
the following actions should be taken by the nurse?
a. Appreciate that the family has made the decision that it feels is best and take no
further action if it is clear the family has made an informed choice.
b. Stress that each individual in society has a right to health care and the family will
have to create some way to raise funds for the needed treatment.
c. Talk to the media to see whether a campaign to raise funds for the family can be
created.
d. Try to convince the agency to give the care for free, even if it means economic
stress for the agency, because the medical need is obvious.
ANS: A
According to Callahan, although the nurse may attempt moral persuasion to change the family’s value
immediate and grievous harm, no ethical requirement exists to interfere with the family’s values. Beca
or grievous harm, it is not in the best interest of the nurse to interfere with the family’s decision. Thus,
an appropriate action for the nurse to take.
6. Some nurses are debating about the appropriate action to take in relation to a particular family. The fat
family members have chosen to continue working rather than take time off to care for the ill family me
a wife’s responsibility to care for an ill husband.” Which of the following ethical approaches is being u
a. Consequentialism
b. Communitarianism
c. Deontological ethics
d. Principlism
ANS: C
The nurse is focusing on duty, which is a deontological approach based on the moral obligation to eng
nurse is focusing on duty, which is a deontological approach based on the moral obligation to engage i
this understanding, none of the other options correctly describes the nurse’s statement.
7. Some nurses are debating about the appropriate action to take in relation to a particular family. One me
and the other family members have chosen to continue working rather than take time off to care for the
nurse states, “The whole family is being affected and will fall apart if they don’t focus on their family’
else.” Which of the following ethical approaches is being used by this nurse?
a. Communitarianism
b. Deontology
c. Principlism
d. Utilitarianism
ANS: D
By focusing on the whole family, not individual members, and the consequences or outcomes for the w
time of stress, the nurse is taking a utilitarian approach. Principlism relies on these ethical principles to
Communitarianism is similar to virtue ethics and looks at the relationship and responsibility between t
community. The ethical approach of deontology describes adhering to moral rules or duty rather than t
actions.
8. Some nurses are debating about the appropriate action to take in relation to a particular family. One me
and the other family members have chosen to continue working rather than take time off to care for the
nurse states, “But it doesn’t have to be an either/or situation. Perhaps each family member could take a
3 days. That way they could all take a turn at helping and yet not upset their employers. Wouldn’t that
following ethical approaches is being used by this nurse?
a. Communitarianism
b. Deontology
c. Principlism
d. Utilitarianism
ANS: C
The nurse is focusing on ethical principles—in this case, beneficence (do good for the ill family memb
harm, even to the employer), and justice (everyone takes a turn and shares equally). Communitarianism
Chapter 06: Ethics in Public and Community Health Nursing Practice
Stanhope: Foundations for Population Health in Community/Public Health Nursing,
MULTIPLE CHOICE
1. Which of the following is generally considered to be nursing’s first code of ethics?
a. Nightingale Pledge
b. Code for Professional Nurses
c. Code of Ethics for Nurses
d. Principles of the Ethical Practice of Public Health
ANS: A
The Nightingale Pledge is generally considered to be nursing’s first code of ethics. After the Nightinga
Professional Nurses was formally adopted by the ANA House of Delegates in 1950. It was amended an
until, in 2001 the ANA House of Delegates adopted the Code of Ethics for Nurses with Interpretive Sta
the Ethical Practice of Public Health was approved in 2002.
2. A nurse didn’t know what to do when faced with a particular ethical dilemma because an option that w
didn’t seem possible. The nurse decided to talk to the agency supervisor and decide what action to take
best describes the nurse’s actions?
a. Appropriate, because the supervisor is responsible for the nurse’s choices.
b. Intelligent, because the supervisor has access to resource persons (clergy,
physicians, administrators) who might know of options the nurse hadn’t
considered.
c. Justified, because this provides an opportunity to discuss the issue but the nurse
maintains responsibility for the decision.
d. Wise, because the supervisor would be more knowledgeable concerning agency
priorities and traditional practices.
ANS: C
Ethically, each nurse is responsible for his or her own decisions and cannot avoid ethical accountabilit
to a supervisor or any external rule or policy. The supervisor is not responsible for the nurse’s choices,
responsibility for his/her own decisions. The nurse should have access to the same resources as the sup
similar knowledge as the supervisor.
3. Which of the following is the first and most crucial step in a generic ethical decision-making process?
a. Assess the context or environment in which the decision must be made.
b. Consider the various ethical principles or theories.
c. Identify the ethical issues and dilemmas.
d. Make a decision and act on it.
ANS: C
The first step in the ethical decision-making framework is to identify the ethical issue or dilemma. Afte
identifying the ethical concern, the following steps are: (2) place the ethical issue or dilemma within a
obtain all relevant facts, (4) reformulate ethical issues or dilemmas, if needed, (5) consider appropriate
options, (6) make the decision and take action, and (7) evaluate the decision and action.
4. A nurse is asked to meet with a family who recently immigrated from Botswana (Africa). After the ph
wife’s diagnosis of breast cancer, the family thanks the physician and starts to leave. Ethically, which o
nurse’s most important action?
a. Emphasizing that the family must set up a surgical appointment for the wife
immediately
b. Assessing the family’s current living situation, including insurance and other
assets
c. Educating the family concerning the usual treatment and the prognosis of breast
cancer
d. Interviewing the family concerning their perspective of the threat to the family’s
well-being
, lOMoAR cP SD |12827 373
5. The nurse learns that a family has declined an elective medical intervention for a health care problem b
care would drastically reduce the family’s resources and ability to meet the needs of other family mem
the following actions should be taken by the nurse?
a. Appreciate that the family has made the decision that it feels is best and take no
further action if it is clear the family has made an informed choice.
b. Stress that each individual in society has a right to health care and the family will
have to create some way to raise funds for the needed treatment.
c. Talk to the media to see whether a campaign to raise funds for the family can be
created.
d. Try to convince the agency to give the care for free, even if it means economic
stress for the agency, because the medical need is obvious.
ANS: A
According to Callahan, although the nurse may attempt moral persuasion to change the family’s value
immediate and grievous harm, no ethical requirement exists to interfere with the family’s values. Beca
or grievous harm, it is not in the best interest of the nurse to interfere with the family’s decision. Thus,
an appropriate action for the nurse to take.
6. Some nurses are debating about the appropriate action to take in relation to a particular family. The fat
family members have chosen to continue working rather than take time off to care for the ill family me
a wife’s responsibility to care for an ill husband.” Which of the following ethical approaches is being u
a. Consequentialism
b. Communitarianism
c. Deontological ethics
d. Principlism
ANS: C
The nurse is focusing on duty, which is a deontological approach based on the moral obligation to eng
nurse is focusing on duty, which is a deontological approach based on the moral obligation to engage i
this understanding, none of the other options correctly describes the nurse’s statement.
7. Some nurses are debating about the appropriate action to take in relation to a particular family. One me
and the other family members have chosen to continue working rather than take time off to care for the
nurse states, “The whole family is being affected and will fall apart if they don’t focus on their family’
else.” Which of the following ethical approaches is being used by this nurse?
a. Communitarianism
b. Deontology
c. Principlism
d. Utilitarianism
ANS: D
By focusing on the whole family, not individual members, and the consequences or outcomes for the w
time of stress, the nurse is taking a utilitarian approach. Principlism relies on these ethical principles to
Communitarianism is similar to virtue ethics and looks at the relationship and responsibility between t
community. The ethical approach of deontology describes adhering to moral rules or duty rather than t
actions.
8. Some nurses are debating about the appropriate action to take in relation to a particular family. One me
and the other family members have chosen to continue working rather than take time off to care for the
nurse states, “But it doesn’t have to be an either/or situation. Perhaps each family member could take a
3 days. That way they could all take a turn at helping and yet not upset their employers. Wouldn’t that
following ethical approaches is being used by this nurse?
a. Communitarianism
b. Deontology
c. Principlism
d. Utilitarianism
ANS: C
The nurse is focusing on ethical principles—in this case, beneficence (do good for the ill family memb
harm, even to the employer), and justice (everyone takes a turn and shares equally). Communitarianism
