C HAPTER 04: E THICAL I SSUES
1. The nurse-manager has learned there is conflict between a nonresponsive
client’s famil y memb ers about the best plan of care. The manager
recognizes the complex ethics of this situation. What is the manager’s best
action?
a. Base a decision on the most recent precedent in the organization.
b. Make contact with the hospital’s ethics committee.
c. Refer the famil y to the hospital’s spiritual care service.
d. Ask an impartial staff member to mediate.
ANS: B
Feedback:
An ethics committee can bring needed experience, perspective, and
insight to challenging ethical situations. Precedent cannot always be
used as a guide because each situation is unique even if they appear
superficiall y similar. Clients and families often benefit from spiritual
care, but this does not help the manager make a good decision.
Mediation can sometimes be beneficial, but this does not re lease the
nurse-manager from addressing the situation as best as he or she can.
PTS: 1 DIF: Moderate REF: Page: 102 OBJ: 4
NAT: Client Needs: Safe and Effective Care Environment:
Management of Care TOP: Chapter Number: 04: Title:
Collaborate Through Int erprofessional Ethics Committees
KEY: Integrated Process: Nursing Process BLM:
Cognitive Level: Appl y NOT: Multiple Choice
,2. In which situation would the nurse be justified in overriding a client’s
right to confidentiality?
a. An older adult client discloses to the nurse that her son occasionall y
hits her.
b. A client states that he does not want to know the results of his
recent diagnostic test.
c. A client does not want her husband to know that she is a client on
the unit.
d. A teenage client asks the nurse not to te ll her parents that she is
pregnant.
ANS: A
Feedback:
Health-care managers are required by law to report certain cases, such
as drug abuse in employees, elder abuse, and child abuse. This is
considered a justifiable violation of confidentialit y. The m anager is
obliged to respect client confidentialit y around disclosing pregnancy,
acknowledging a hospital admission, or not wanting to know diagnostic
results.
PTS: 1 DIF: Moderate REF: Page: 93 OBJ: 3
NAT: Client Needs: Safe and Effective Care Enviro nment:
Management of Care TOP: Chapter Number: 04: Title:
Confidentialit y (Respecting Privileged Information) KEY:
Integrated Process: Nursing Process BLM: Cognitive Level:
Anal yze NOT: Multiple Choice
, 3. The new nurse-manager has committed to modeling the leadership roles
associated with applying ethics in the workplace. What is the manager’s
best action?
a. Demonstrate self-awareness about his or her own beliefs, morals,
and values.
b. Ensure that individual rights are always prioritized over collective
rights.
c. Delegate ethical decision making to staff nurses whenever possible.
d. Ensure nurses are responsible for scrutinizing each other’s behavior
to monitor for ethical violations.
ANS: A
Feedback:
A core competency for ethical leadership is evaluating one’s own
values and beliefs. This form of self -reflection is foundational for
providing ethical care and promoting in others. The balance between
individual and collective rights is situation -specific; individual rights
are not always priorities over group inte rests. The manager must show
leadership in ethical decision making and cannot always delegate this
important function to staff. Ethical nurses are observant for violations,
but this should not result in an environment where each nurse is
“scrutinizing” col leagues’ practice.
PTS: 1 DIF: Moderate REF: Page: 87 OBJ: 8 | 10
NAT: Client Needs: Safe and Effective Care Environment:
Management of Care TOP: Chapter Number: 04: Title:
Display 4.1 Leadership Roles and Management Functions
Associated With Ethics KEY: Integrated Process: Nursing
1. The nurse-manager has learned there is conflict between a nonresponsive
client’s famil y memb ers about the best plan of care. The manager
recognizes the complex ethics of this situation. What is the manager’s best
action?
a. Base a decision on the most recent precedent in the organization.
b. Make contact with the hospital’s ethics committee.
c. Refer the famil y to the hospital’s spiritual care service.
d. Ask an impartial staff member to mediate.
ANS: B
Feedback:
An ethics committee can bring needed experience, perspective, and
insight to challenging ethical situations. Precedent cannot always be
used as a guide because each situation is unique even if they appear
superficiall y similar. Clients and families often benefit from spiritual
care, but this does not help the manager make a good decision.
Mediation can sometimes be beneficial, but this does not re lease the
nurse-manager from addressing the situation as best as he or she can.
PTS: 1 DIF: Moderate REF: Page: 102 OBJ: 4
NAT: Client Needs: Safe and Effective Care Environment:
Management of Care TOP: Chapter Number: 04: Title:
Collaborate Through Int erprofessional Ethics Committees
KEY: Integrated Process: Nursing Process BLM:
Cognitive Level: Appl y NOT: Multiple Choice
,2. In which situation would the nurse be justified in overriding a client’s
right to confidentiality?
a. An older adult client discloses to the nurse that her son occasionall y
hits her.
b. A client states that he does not want to know the results of his
recent diagnostic test.
c. A client does not want her husband to know that she is a client on
the unit.
d. A teenage client asks the nurse not to te ll her parents that she is
pregnant.
ANS: A
Feedback:
Health-care managers are required by law to report certain cases, such
as drug abuse in employees, elder abuse, and child abuse. This is
considered a justifiable violation of confidentialit y. The m anager is
obliged to respect client confidentialit y around disclosing pregnancy,
acknowledging a hospital admission, or not wanting to know diagnostic
results.
PTS: 1 DIF: Moderate REF: Page: 93 OBJ: 3
NAT: Client Needs: Safe and Effective Care Enviro nment:
Management of Care TOP: Chapter Number: 04: Title:
Confidentialit y (Respecting Privileged Information) KEY:
Integrated Process: Nursing Process BLM: Cognitive Level:
Anal yze NOT: Multiple Choice
, 3. The new nurse-manager has committed to modeling the leadership roles
associated with applying ethics in the workplace. What is the manager’s
best action?
a. Demonstrate self-awareness about his or her own beliefs, morals,
and values.
b. Ensure that individual rights are always prioritized over collective
rights.
c. Delegate ethical decision making to staff nurses whenever possible.
d. Ensure nurses are responsible for scrutinizing each other’s behavior
to monitor for ethical violations.
ANS: A
Feedback:
A core competency for ethical leadership is evaluating one’s own
values and beliefs. This form of self -reflection is foundational for
providing ethical care and promoting in others. The balance between
individual and collective rights is situation -specific; individual rights
are not always priorities over group inte rests. The manager must show
leadership in ethical decision making and cannot always delegate this
important function to staff. Ethical nurses are observant for violations,
but this should not result in an environment where each nurse is
“scrutinizing” col leagues’ practice.
PTS: 1 DIF: Moderate REF: Page: 87 OBJ: 8 | 10
NAT: Client Needs: Safe and Effective Care Environment:
Management of Care TOP: Chapter Number: 04: Title:
Display 4.1 Leadership Roles and Management Functions
Associated With Ethics KEY: Integrated Process: Nursing
