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The charge nurse is operating from a Christian ethics framework. The imperative
demand of Christian ethics is to treat others as moral equals by permitting them to act
as we do when they occupy a position similar to ours. Kantianism states that decisions
should be made based on moral law and that actions are bound by a sense of moral
duty. Utilitarianism holds that decisions should be made focusing on the end result
being happiness. Ethical egoism promotes the idea that what is right is good for the
individual.
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." - CORRECT
ANSWER ANS: B. "This job will pay the bills, and the workload is light enough for
me."
The applicant's comment reflects an ethical egoism framework. This framework
promotes the idea that decisions are made based on what is good for the individual and
may not take the needs of others into account.
Without authorization, a nurse administers an extra dose of narcotic tranquilizer to an
agitated client. The nurse's coworker observes this action but does nothing for fear of
repercussion. What is the ethical interpretation of the coworker's lack of involvement?
A. Taking no action is still considered an unethical 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. -
CORRECT ANSWER ANS: A. Taking no action is still considered an unethical action
by the coworker.
The coworker's lack of involvement can be interpreted as an unethical action. The
coworker is experiencing an ethical dilemma in which a decision needs to be made
between two unfavorable alternatives. The coworker has a responsibility to report any
observed unethical actions.
Group therapy is strongly encouraged, but not mandatory, on an inpatient psychiatric
unit. The unit manager's policy is that clients can make a choice about whether or not to
attend group therapy. Which ethical principle does the unit manager's policy preserve?
A. Justice
B. Autonomy
C. Veracity
D. Beneficence - CORRECT ANSWER ANS: B. Autonomy
The unit manager's 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.
Which is an example of an intentional tort?
A. A nurse fails to assess a client's 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. - CORRECT ANSWER
ANS: B. A nurse physically places an irritating client in four-point restraints.
,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.
An involuntarily committed client is verbally abusive to the staff and repeatedly
threatening to sue. The client records the full names and phone numbers of the staff.
Which nursing action is most appropriate to decrease the possibility of a lawsuit?
A. Verbally redirect the client, and then limit one-on-one interaction.
B. Involve the hospital's security division as soon as possible.
C. Notify the client that documenting personal staff information is against hospital policy.
D. Continue professional attempts to establish a positive working relationship with the
client. - CORRECT ANSWER ANS: D. Continue professional attempts to establish a
positive working relationship with the client.
The most appropriate nursing action is to continue professional attempts to establish a
positive working relationship with the client. The involuntarily committed client should be
respected and has the right to assert grievances if rights are infringed.
Which statement should a nurse identify as correct regarding a client's right to refuse
treatment?
A. Clients can refuse pharmacological but not psychological treatment.
B. Clients can refuse any treatment at any time.
C. Clients can refuse only electroconvulsive therapy (ECT).
D. Professionals can override treatment refusal if the client is actively suicidal or
homicidal. - CORRECT ANSWER ANS: D. Professionals can override treatment
refusal if the client is actively suicidal or homicidal.
The nurse should understand that health-care professionals can override treatment
refusal when a client is actively suicidal or homicidal. A suicidal or homicidal client who
refuses treatment may be a danger to self or others. This situation should be treated as
an emergency, and treatment may be performed without informed consent.
Which client should a nurse identify as a potential candidate for involuntary
commitment?
A. A client living under a bridge in a cardboard box
B. A client threatening to commit suicide
C. A client who never bathes and wears a wool hat in the summer
D. A client who eats waste out of a garbage can - CORRECT ANSWER ANS: B. A
client threatening to commit suicide.
, The nurse should identify the client threatening to commit suicide as eligible for
involuntary commitment. The suicidal client who refuses treatment is a danger to self
and requires emergency treatment.
A client diagnosed with schizophrenia refuses to take medication, citing the right of
autonomy. Under which circumstance would a nurse have the right to medicate the
client against the client's wishes?
A. When the client makes inappropriate sexual innuendos to a staff member
B. When the client constantly demands inappropriate attention from the nurse
C. When the client physically attacks another client after being confronted in group
therapy
D. When the client refuses to bathe or perform hygienic activities - CORRECT
ANSWER ANS: C. When the client physically attacks another client after being
confronted in group therapy.
The nurse would have the right to medicate a client against his or her wishes if the client
physically attacks another client. This client poses a significant risk to safety and is
incapable of making rational choices. The client's refusal to accept treatment can be
challenged because the client is endangering the safety of others.
A psychiatric nurse working on an inpatient unit receives a call asking if an individual
has been a client in the facility. Which nursing response reflects appropriate legal and
ethical obligations?
A. Refusing to give any information to the caller, citing rules of confidentiality
B. Refusing to give any information to the caller by hanging up
C. Affirming that the person has been seen at the facility but providing no further
information
D. Suggesting that the caller speak to the client's therapist - CORRECT ANSWER
ANS: A. Refusing to give any information to the caller, citing rules of confidentiality.
The most appropriate action by the nurse is to refuse to give any information to the
caller. Admission to the facility would be considered protected health information (PHI)
and should not be disclosed by the nurse without prior client consent.
A client requests information on several medications in order to make an informed
choice about management of depression. A nurse should provide this information to
facilitate which ethical principle?
A. Autonomy
B. Beneficence
C. Nonmaleficence
D. Justice - CORRECT ANSWER ANS: A. Autonomy