Chapter 22 Ethics and Values-Fundamentals of Nursing

Chapter 22: Ethics and Values ra ra ra ra




MULTIPLE CHOICE ra




1.
Four hospital client s in labor all request epidural analgesia to manage their pain at th
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e ar



same time. Which ethical principle is most compromised when only one nursing atte
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ndant anesthetist is on call? a. Justice ra ra ra ra




b. Fidelity
c. Beneficence
d. Nonmaleficence
ACCURATE ra



ANSWER:-A
Justice refers to fairness and is used frequently in discussion regarding access to health care r
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esources. Here the just distribution of resources, in this case pain management, cannot be jus
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tly apportioned. Nonmaleficence refers to avoidance of harm; beneficence refers to taking pos
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itive actions to help others. Fidelity refers to the agreement to keep promises. Each of these p
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rinciples is partially expressed in the question; however, justice is most comprised because n
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ot all laboring hospital client s have equal access to pain management owing to lack of personn
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el resources.
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DIF:Apply (application) ra



OBJ:Discuss the role of ethics in professional nursing. TOP:Caring ra ra ra ra ra ra ra ar



MSC: Health Promotion and Maintenance ra ra ra ra




2. The hospital client reports to the nursing attendant of being afraid to speak up regarding
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a desire to end care for fear of upsetting spouse and children. Which principle in the nursi
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n
g code of ethics ensures that the nursing attendant will promote the hospital client ’s caus
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e?
a. Advocacy
b. Responsibility
c. Confidentiality
d. Accountability
ACCURATE ra



ANSWER:-A
Nursing attendant s advocate for hospital client s when they support the hospital client ’s cause
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. A nursing attendant ’s ability to adequately advocate for a hospital client
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is based on the uniq
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ue relationship that develops and the opportunity to better understand the hospital client ’s po
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int of view. Responsibility refers to respecting one’s professional obligations and following thro
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ugh on promises. Confidentiality deals with privacy issues, and accountability refers to answer
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ing for one’s actions.
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DIF:Apply (application) ra

, OBJ:Discuss the role of ethics in professional nursing. TOP:Caring ra ra ra ra ra ra ra ar



MSC: Management of Care ra ra ra




3. The hospital client ’s son requests to view documentation in the medical record.
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What is the nursing attendant ’s best response to this request?
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a. ―I’ll be happy to get that for you.‖ ar ra ar ra ar ra ra




b. ―You are not allowed to look at it.‖ ra ra ra ra ra ra ra




c. ―You will need your mother’s permission.‖ ra ra ra ra ra




d. ―I cannot let you see the chart without a doctor’s order.‖
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ACCURATE ANSWER:-C ra



The mother’s permission is needed. The nursing attendant understands that sharing health in
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formation is governed by HIPAA legislation, which defines rights and privileges of hospital cli
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ent s for protection of privacy. Private health information cannot be shared without the hospi
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tal client ’s specific permission. The nursing attendant cannot obtain the records without per
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mission. The son can look at it after approval from the hospital client . While talking to the ph
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ysician or getting an order is appropriate, the hospital client still has to give consent.
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DIF:Analyze (analysis) ra



OBJ:Discuss the role of ethics in professional nursing. ra ra ra ra ra ra ra ar



TOP:Communication and Documentation MSC: Management of Care ra ra ra ra ra




4. When professionals work together to solve ethical dilemmas, nursing attendant s mus
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t examine their own values.
ar What is the best rationale for this step?
ra ra ra ra ra ra ra ra ra ra ra a.
So fact is separated from opinion.
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b. So different perspectives are respected.
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c. So judgmental attitudes can be provoked.
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d. So the group identifies the one correct solution.
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ACCURATE ANSWER:-B ra



Values are personal beliefs that influence behavior. To negotiate differences of value, it is imp
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ortant to be clear about your own values: what you value, why, and how you respect your own v
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alues even as you try to respect those of others whose values differ from yours. Ethical dilemma
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s are a problem in that no one right solution exists. It is not to separate fact from opinion. Jud
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gmental attitudes are not to be used, much less provoked.
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DIF:Analyze (analysis) ra



OBJ:Utilize values clarification when you apply ethics in practice. ra ra ra ra ra ra ra ra ar



TOP:Planning MSC: Psychosocial Integrity ra ra




5. A nursing attendant is experiencing an ethical dilemma with a hospital client . Recognizin
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g ra



what information as a factor indicates the nursing attendant has a correct understanding o
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f th e primary cause of ethical dilemmas? a. Unequal power
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b. Presence of conflicting values ra ra ra




c. Judgmental perceptions of hospital client s ra ra ra ra ra




d. Poor communication with the hospital client ra ra ra ra ra




ACCURATE ANSWER:-B ra



Ethical dilemmas almost always occur in the presence of conflicting values. While unequal p
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ower, judgmental perceptions, and poor communication can contribute to the dilemma, these a
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, re not causes of a dilemma. Without clarification of values, the nursing attendant may not be
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able to distinguish fact from opinion or value, and this can lead to judgmental attitudes.
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DIF:Understand (comprehension) ra



OBJ:Utilize values clarification when you apply ethics in practice. ra ra ra ra ra ra ra ra ar



TOP:Evaluation MSC: Psychosocial Integrity ra ra




6. The nursing attendant questions a health care provider’s decision to not tell the hospital
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client about a cancer diagnosis. Which ethical principle is the nursing attendant trying
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to uphold for the hospital client ?
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a. Consequentialism
b. Autonomy
c. Fidelity
d. Justice
ACCURATE ANSWER:-B ra



The nursing attendant is upholding autonomy. Autonomy refers to the freedom to make decisio
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ns free of external control. Respect for hospital client autonomy refers to the commitment to in
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clude hospital client s in decisions about all aspects of care. Consequentialism is focused on the
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outcome and is a philosophical approach. Justice refers to fairness and is most often used in disc
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ussions about access to health care resources. Fidelity refers to the agreement to keep promises
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.

DIF:Understand (comprehension) ra



OBJ:Utilize values clarification when you apply ethics in practice. ra ra ra ra ra ra ra ra ar



TOP:Implementation MSC: Management of Care ra ra




7. The nursing attendant finds it difficult to care for a hospital client whose advance directive
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states that no extraordinary resuscitation measures should be taken. Which step may help
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the nursing attendant to find resolution in this assignment?
a ra a.
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Review one’s own personal values. ra ra ra ra




b. Call for an ethical committee consult. ra ra ra ra ra




c. Decline the assignment on religious grounds. ra ra ra ra ra




d. Convince the family to challenge the directive. ra ra ra ra ra ra




ACCURATE ANSWER:-A ra



Clarifying values—your own, your hospital client s’, your co-workers’— ra ra ra ra ra ra ra ra



is an important and effective part of ethical discourse. Calling for a consult, declining the assi
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gnment, and convincing the family to challenge the hospital client ’s directive are not ideal r
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esolutions because they do not address the reason for the nursing attendant ’s discomfort, w
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hich is the conflict between the nursing attendant ’s values and those of the hospital client .
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The nursing attendant should value the hospital client ’s decisions over the nursing attendan
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t ’s personal values.
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DIF:Apply (application) ra



OBJ:Utilize values clarification when you apply ethics in practice. ra ra ra ra ra ra ra ra ar



TOP:Implementation MSC: Psychosocial Integrity ra




8. The nursing attendant values autonomy above all other principles. Which hospital clien
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t assignment will the nursing attendant find most difficult to accept? a. Older-
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adult hospital client who requires dialysis.
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b. Teenager in labor who requests epidural anesthesia. ra ra ra ra ra ra