Test Bank For Evolve resources for Ethics & Issues In
Contemporary Nursing
Four patients in labor all request epidural analgesia to manage their pain at the same
time. Which ethical principle is compromised when only one nurse anesthetist is on
call?
a.Justice
b.Nonmaleficence
c.Beneficence
d.Fidelity - ANSWER ANS: A
Justice refers to fairness and is used frequently in discussion regarding access to
health care resources. Here the just distribution of resources, in this case pain
management, cannot be justly apportioned. Nonmaleficence means do no harm,
beneficence means to do good, and fidelity means to be true to, or honest. Each of
these principles is partially expressed in the question; however, justice is most
comprised because not all laboring patients have equal access to pain management
owing to lack of personnel resources.
The patient tells the nurse that she is afraid to speak up regarding her desire to end
care for fear of upsetting her husband and children. Which principle in the nursing
code of ethics ensures that the nurse will promote the patients cause?
a.Responsibility
b.Advocacy
c.Confidentiality
d.Accountability - ANSWER ANS: B
Nurses advocate for patients when they support the patients cause. A nurses ability
to adequate advocate for a patient is based on the unique relationship that develops
and the opportunity to better understand the patients point of view. Responsibility
refers to respecting ones professional obligations and following through on promises.
Confidentiality deals with privacy issues, and accountability refers to owning ones
actions.
The patients son requests to view the documentation in his mothers medical record.
What is the nurses best response to this request?
a.Ill be happy to get that for you.
b.You will have to talk to the physician about that.
c.You will need your mothers permission.
d.You are not allowed to see it. - ANSWER ANS: C
,The nurse understands that sharing health information is governed by HIPAA
legislation, which defines rights and privileges of patients for protection of privacy.
Private health information cannot be shared without the patients specific permission.
The other three responses either are outright false and/or use poor communication
techniques.
When people work together to solve ethical dilemmas, individuals must examine
their own values. This step is crucial to ensure that
a.The group identifies the one correct solution.
b.Fact is separated from opinion.
c.Judgmental attitudes are not provoked.
d.Different perspectives are respected. - ANSWER ANS: D
Values are personal beliefs that influence opinions. To be able to negotiate
differences in opinions, the nurse must first be clear about personal values, which
will influence behaviors, decisions, and actions. Ethical dilemmas are a problem in
that no one right solution exists.
Ethical dilemmas are common occurrences when caring for patients. The nurse
understands that dilemmas are a result of
a.Presence of conflicting values.
b.Hierarchical systems.
c.judgmental perceptions of patients.
d.Poor communication with the patient. - ANSWER ANS: A
Poor communication and the hierarchical systems that exist in health care, such as
reporting structures within the hospital or the historically unequal relationship
between physicians and nurses, may complicate dilemmas. The primary, underlying
reason that ethical dilemmas occur is that there are no clear cut, universally
accepted solutions to a problem when participating individuals do not share the
same values. Without clarification of values, the nurse may not be able to distinguish
fact from opinion or value, and this can lead to judgmental attitudes.
The nurse questions a physicians order to administer a placebo to the patient. The
nurses action is based on which ethical principle?
a.Autonomy
b.Beneficence
c.Justice
d.Fidelity - ANSWER ANS: A
Autonomy refers to the freedom to make decisions free of external control. In this
case, the nurse questions the physicians order for a placebo because it supports the
patients autonomy. Although beneficence, taking a positive action for others, has
implications here, it is not the primary operating principle. Justice refers to fairness
and is most often used in discussions about access to health care resources. Fidelity
refers to the agreement to keep promises.
The nurse finds it difficult to care for a patient whose advance directive states that no
extraordinary resuscitation measures should be taken. Which step may help the
nurse to find resolution in this assignment?
, a.Call for an ethical committee consult.
b.Decline the assignment on religious grounds.
c.Scrutinize her own personal values.
d.Convince the family to challenge the directive. - ANSWER ANS: C
Values develop over time and are influenced by family, schools, religious traditions,
and life experiences. The nurse must recognize that no two humans have the same
set of experiences, and so differences in values are more likely the norm than the
exception. Closer inspection of ones values may be a step in gaining understanding
of another persons perspective. Calling for a consult, declining the assignment, and
convincing the family to challenge the patients directive are not ideal resolutions
because they do not address the reason for the nurses discomfort, which is the
conflict between the nurses values and those of the patient.
The nurse values autonomy above all other principles. Which patient assignment will
the nurse find most difficult to accept?
a.Teenager in labor who requests epidural anesthesia
b.Middle-aged father of three with an advance directive declining life support
c.Elderly patient who requires dialysis
d.Family elder who is making the decisions for a 30-year-old female member -
ANSWER ANS: D
Autonomy refers to freedom from external control. A person who values autonomy
highly may find it difficult to accept situations where the patient is not the primary
decision maker regarding his or her care. A teenager requesting an epidural, a father
with an advanced directive, and an elderly patient requiring dialysis all describe a
patient or family that can make their own decisions and choices regarding care.
Which philosophy of health care ethics would be particularly useful when making
ethical decisions about vulnerable populations?
a.Feminist ethics
b.Deontology
c.Bioethics
d.Utilitarianism - ANSWER ANS: A
Feminist ethics particularly focuses on the nature of relationships, especially those
where there is a power imbalance or a point of view that is not routinely accepted.
Examples of populations that are considered vulnerable include children, pregnant
women, incarcerated persons, and minority groups. Deontology refers to making
decisions or right-making characteristics, bioethics focuses on consensus building,
and utilitarianism speaks to the greatest good for the greatest number.
A nurse argues that we need to reform our health care system because we have a
large number of people who are uninsured and end up needing expensive emergent
care when low-cost measures could have prevented their illnesses. What ethical
framework is she using to make this case?
a.Deontology
b.Ethics of care
c.Feminist ethics
Contemporary Nursing
Four patients in labor all request epidural analgesia to manage their pain at the same
time. Which ethical principle is compromised when only one nurse anesthetist is on
call?
a.Justice
b.Nonmaleficence
c.Beneficence
d.Fidelity - ANSWER ANS: A
Justice refers to fairness and is used frequently in discussion regarding access to
health care resources. Here the just distribution of resources, in this case pain
management, cannot be justly apportioned. Nonmaleficence means do no harm,
beneficence means to do good, and fidelity means to be true to, or honest. Each of
these principles is partially expressed in the question; however, justice is most
comprised because not all laboring patients have equal access to pain management
owing to lack of personnel resources.
The patient tells the nurse that she is afraid to speak up regarding her desire to end
care for fear of upsetting her husband and children. Which principle in the nursing
code of ethics ensures that the nurse will promote the patients cause?
a.Responsibility
b.Advocacy
c.Confidentiality
d.Accountability - ANSWER ANS: B
Nurses advocate for patients when they support the patients cause. A nurses ability
to adequate advocate for a patient is based on the unique relationship that develops
and the opportunity to better understand the patients point of view. Responsibility
refers to respecting ones professional obligations and following through on promises.
Confidentiality deals with privacy issues, and accountability refers to owning ones
actions.
The patients son requests to view the documentation in his mothers medical record.
What is the nurses best response to this request?
a.Ill be happy to get that for you.
b.You will have to talk to the physician about that.
c.You will need your mothers permission.
d.You are not allowed to see it. - ANSWER ANS: C
,The nurse understands that sharing health information is governed by HIPAA
legislation, which defines rights and privileges of patients for protection of privacy.
Private health information cannot be shared without the patients specific permission.
The other three responses either are outright false and/or use poor communication
techniques.
When people work together to solve ethical dilemmas, individuals must examine
their own values. This step is crucial to ensure that
a.The group identifies the one correct solution.
b.Fact is separated from opinion.
c.Judgmental attitudes are not provoked.
d.Different perspectives are respected. - ANSWER ANS: D
Values are personal beliefs that influence opinions. To be able to negotiate
differences in opinions, the nurse must first be clear about personal values, which
will influence behaviors, decisions, and actions. Ethical dilemmas are a problem in
that no one right solution exists.
Ethical dilemmas are common occurrences when caring for patients. The nurse
understands that dilemmas are a result of
a.Presence of conflicting values.
b.Hierarchical systems.
c.judgmental perceptions of patients.
d.Poor communication with the patient. - ANSWER ANS: A
Poor communication and the hierarchical systems that exist in health care, such as
reporting structures within the hospital or the historically unequal relationship
between physicians and nurses, may complicate dilemmas. The primary, underlying
reason that ethical dilemmas occur is that there are no clear cut, universally
accepted solutions to a problem when participating individuals do not share the
same values. Without clarification of values, the nurse may not be able to distinguish
fact from opinion or value, and this can lead to judgmental attitudes.
The nurse questions a physicians order to administer a placebo to the patient. The
nurses action is based on which ethical principle?
a.Autonomy
b.Beneficence
c.Justice
d.Fidelity - ANSWER ANS: A
Autonomy refers to the freedom to make decisions free of external control. In this
case, the nurse questions the physicians order for a placebo because it supports the
patients autonomy. Although beneficence, taking a positive action for others, has
implications here, it is not the primary operating principle. Justice refers to fairness
and is most often used in discussions about access to health care resources. Fidelity
refers to the agreement to keep promises.
The nurse finds it difficult to care for a patient whose advance directive states that no
extraordinary resuscitation measures should be taken. Which step may help the
nurse to find resolution in this assignment?
, a.Call for an ethical committee consult.
b.Decline the assignment on religious grounds.
c.Scrutinize her own personal values.
d.Convince the family to challenge the directive. - ANSWER ANS: C
Values develop over time and are influenced by family, schools, religious traditions,
and life experiences. The nurse must recognize that no two humans have the same
set of experiences, and so differences in values are more likely the norm than the
exception. Closer inspection of ones values may be a step in gaining understanding
of another persons perspective. Calling for a consult, declining the assignment, and
convincing the family to challenge the patients directive are not ideal resolutions
because they do not address the reason for the nurses discomfort, which is the
conflict between the nurses values and those of the patient.
The nurse values autonomy above all other principles. Which patient assignment will
the nurse find most difficult to accept?
a.Teenager in labor who requests epidural anesthesia
b.Middle-aged father of three with an advance directive declining life support
c.Elderly patient who requires dialysis
d.Family elder who is making the decisions for a 30-year-old female member -
ANSWER ANS: D
Autonomy refers to freedom from external control. A person who values autonomy
highly may find it difficult to accept situations where the patient is not the primary
decision maker regarding his or her care. A teenager requesting an epidural, a father
with an advanced directive, and an elderly patient requiring dialysis all describe a
patient or family that can make their own decisions and choices regarding care.
Which philosophy of health care ethics would be particularly useful when making
ethical decisions about vulnerable populations?
a.Feminist ethics
b.Deontology
c.Bioethics
d.Utilitarianism - ANSWER ANS: A
Feminist ethics particularly focuses on the nature of relationships, especially those
where there is a power imbalance or a point of view that is not routinely accepted.
Examples of populations that are considered vulnerable include children, pregnant
women, incarcerated persons, and minority groups. Deontology refers to making
decisions or right-making characteristics, bioethics focuses on consensus building,
and utilitarianism speaks to the greatest good for the greatest number.
A nurse argues that we need to reform our health care system because we have a
large number of people who are uninsured and end up needing expensive emergent
care when low-cost measures could have prevented their illnesses. What ethical
framework is she using to make this case?
a.Deontology
b.Ethics of care
c.Feminist ethics
