BRUNNERhANDhSUDDARTHShTEXTBOOKhOFhMEDICALhSURGICALhNURSINGh14THhEDITIONhHINKLEhTESThBAN
K
TesthBankh-hBrunnerh&hSuddarth'shTextbookhofhMedical-SurgicalhNursingh14eh(Hinkleh2017) 41
Chapter 03: Critical Thinking, Ethical Decision Making and the Nursing Pro
h h h h h h h h h h
cess
1. Ahnursehhashbeenhofferedhahpositionhonhanhobstetrichunithandhhashlearnedhthaththehunithoffershtherapeuticha
bortions,hahprocedurehwhichhcontradictshthehnurseshpersonalhbeliefs.hWhathishthehnurseshethicalhoblig
ationhtohthesehpatients?
A) Theh nurseh shouldh adhereh toh professionalh standardsh ofh practiceh andhofferh serviceh toh theseh patients.
B) Theh nurseh shouldh makeh theh choiceh toh declineh thish positionh andh pursueh ah differenth nursingh role.
C) Theh nurseh shouldh declineh toh careh forh theh patientsh consideringh abortion.
D) Theh nurseh shouldh expressh alternativesh toh womenh consideringh terminatingh theirh pregnancy.
Ans: B
Feedback:
Tohavoidhfacinghethicalhdilemmas,hnurseshcanhfollowhcertainhstrategies.hForhexample,hwhenhapplyinghforhahjo
b,hahnursehshouldhaskhquestionshregardinghthehpatienthpopulation.hIfhahnursehishuncomfortablehwithhahpart
icularhsituation,hthenhnothacceptinghthehpositionhwouldhbehthehbesthoption.hThehnursehishonlyhrequiredhbyhl
awh(andhpracticehstandards)htohprovidehcarehtohthehpatientshthehclinichaccepts;hthehnursehmayhnothdiscrim
inatehbetweenhpatientshandhthehnursehexpressinghhishorhherhownhopinionhandhprovidingh anotherhoptionhis
hinappropriate.
2. Ahterminallyhillhpatienthyouharehcaringhforhishcomplaininghofhpain.hThehphysicianhhashorderedhahlargehdoseh
ofhintravenoushopioidshbyhcontinuoush infusion.hYouhknowhthathonehofhthehadverseheffectshofhthishmedicineh i
shrespiratoryhdepression.hWhenhyouhassesshyourhpatientshrespiratoryhstatus,hyouhfindhthaththehratehhashde
creasedhfromh16hbreathshperhminutehtoh10hbreathshperhminute.hWhathactionhshouldhyouhtake?
A) Decreasehthehratehofh IVh infusion.
B) Stimulateh theh patienth inh orderh toh increaseh respiratoryh rate.
C) Reporth thehdecreasedh respiratoryh rateh toh theh physician.
D) Allowhthehpatienthtoh resthcomfortably.
Ans: C
Feedback:
NURSINGTB.COM
, BRUNNERhANDhSUDDARTHShTEXTBOOKhOFhMEDICALhSURGICALhNURSINGh14THhEDITIONhHINKLEhTESThBAN
K
TesthBankh-hBrunnerh&hSuddarth'shTextbookhofhMedical-SurgicalhNursingh14eh(Hinkleh2017) 42
End-ofhlifeh issuesh thath oftenh involveh ethicalh dilemmash includeh painh control,h doh noth resuscitateh orders,h life-
NURSINGTB.COM
, BRUNNERhANDhSUDDARTHShTEXTBOOKhOFhMEDICALhSURGICALhNURSINGh14THhEDITIONhHINKLEhTESThBAN
K
TesthBankh-hBrunnerh&hSuddarth'shTextbookhofhMedical-SurgicalhNursingh14eh(Hinkleh2017) 43
supporthmeasures,handhadministrationhofhfoodhandhfluids.hThehriskhofhrespiratoryhdepressionhishnoththehi
ntenthofhthehactionhofhpainhcontrol.hRespiratoryhdepressionhshouldhnothbehusedhashanhexcusehtohwithholdhp
ainhmedicationhforhahterminallyhillhpatient.hThehpatientshrespiratoryhstatushshouldhbehcarefullyhmonitoredhandh
anyhchangeshshouldhbehreportedhtohthehphysician.
3. Anhadulthpatienthhashrequestedhahdohnothresuscitateh(DNR)horderhinhlighthofhhishrecenthdiagnosishwithhlatehst
agehpancreatichcancer.hThehpatientshsonhandhdaughter-in-
lawharehstronglyhopposedhtohthehpatientshrequest.hWhathishthehprimaryhresponsibilityhofhthehnursehinhthi
shsituation?
A) Performh ah slowh codehuntilh ahdecisionh ish made.
B) Honorhtheh requesth ofh theh patient.
C) Contacth ah socialh workerh orh mediatorh toh intervene.
D) Temporarilyh withholdh nursingh careh untilh theh physicianh talksh toh theh family.
Ans: B
Feedback:
Thehnursehmusthhonorhthehpatientshwisheshandhcontinuehtohprovidehrequiredhnursinghcare.hDiscussinghthehm
atterhwithhthehphysicianhmayhleadhtohfurtherhcommunicationhwithhthehfamily,hduringhwhichhthehfamilyhm
ayhreconsiderhtheirhdecision.hIthishnothnormallyhappropriatehforhthehnursehtohseekhthehassistancehofhahsoc
ialhworkerhorhmediator.hAhslowhcodehishconsideredhunethical.
4. Anhelderlyhpatienthishadmittedhtohyourhunithwithhahdiagnosishofhcommunity-
acquiredhpneumonia.hDuringhadmissionhthehpatienthstates,hIhhavehahlivinghwill.hWhathimplicationhofhthish
shouldhthehnursehrecognize?
A) Thish documenth ish alwaysh honored,h regardlessh ofh circumstances.
B) Thish documenth specifiesh theh patientsh wishesh beforeh hospitalization.
C) Thish documenth thath ish bindingh forh theh durationh ofh theh patientsh life.
D) Thish documenth hash beenh drawnh uph byh theh patientsh familyh toh determineh DNRh status.
Ans: B
Feedback:
Ahlivinghwillhishonehtypehofhadvancehdirective.hInhmosthsituations,hlivinghwillsharehlimitedhtohsituationshinh
whichhthehpatientshmedicalhconditionhishdeemedhterminal.hThehotherhanswersharehincorrecthbecausehlivinghwi
llsharehnothalwayshhonored,htheyharehnothbindinghforhthehdurationhofhthehpatientshlife,handhtheyharehnothdra
wnhuphbyhthehpatientshfamily.
NURSINGTB.COM
K
TesthBankh-hBrunnerh&hSuddarth'shTextbookhofhMedical-SurgicalhNursingh14eh(Hinkleh2017) 41
Chapter 03: Critical Thinking, Ethical Decision Making and the Nursing Pro
h h h h h h h h h h
cess
1. Ahnursehhashbeenhofferedhahpositionhonhanhobstetrichunithandhhashlearnedhthaththehunithoffershtherapeuticha
bortions,hahprocedurehwhichhcontradictshthehnurseshpersonalhbeliefs.hWhathishthehnurseshethicalhoblig
ationhtohthesehpatients?
A) Theh nurseh shouldh adhereh toh professionalh standardsh ofh practiceh andhofferh serviceh toh theseh patients.
B) Theh nurseh shouldh makeh theh choiceh toh declineh thish positionh andh pursueh ah differenth nursingh role.
C) Theh nurseh shouldh declineh toh careh forh theh patientsh consideringh abortion.
D) Theh nurseh shouldh expressh alternativesh toh womenh consideringh terminatingh theirh pregnancy.
Ans: B
Feedback:
Tohavoidhfacinghethicalhdilemmas,hnurseshcanhfollowhcertainhstrategies.hForhexample,hwhenhapplyinghforhahjo
b,hahnursehshouldhaskhquestionshregardinghthehpatienthpopulation.hIfhahnursehishuncomfortablehwithhahpart
icularhsituation,hthenhnothacceptinghthehpositionhwouldhbehthehbesthoption.hThehnursehishonlyhrequiredhbyhl
awh(andhpracticehstandards)htohprovidehcarehtohthehpatientshthehclinichaccepts;hthehnursehmayhnothdiscrim
inatehbetweenhpatientshandhthehnursehexpressinghhishorhherhownhopinionhandhprovidingh anotherhoptionhis
hinappropriate.
2. Ahterminallyhillhpatienthyouharehcaringhforhishcomplaininghofhpain.hThehphysicianhhashorderedhahlargehdoseh
ofhintravenoushopioidshbyhcontinuoush infusion.hYouhknowhthathonehofhthehadverseheffectshofhthishmedicineh i
shrespiratoryhdepression.hWhenhyouhassesshyourhpatientshrespiratoryhstatus,hyouhfindhthaththehratehhashde
creasedhfromh16hbreathshperhminutehtoh10hbreathshperhminute.hWhathactionhshouldhyouhtake?
A) Decreasehthehratehofh IVh infusion.
B) Stimulateh theh patienth inh orderh toh increaseh respiratoryh rate.
C) Reporth thehdecreasedh respiratoryh rateh toh theh physician.
D) Allowhthehpatienthtoh resthcomfortably.
Ans: C
Feedback:
NURSINGTB.COM
, BRUNNERhANDhSUDDARTHShTEXTBOOKhOFhMEDICALhSURGICALhNURSINGh14THhEDITIONhHINKLEhTESThBAN
K
TesthBankh-hBrunnerh&hSuddarth'shTextbookhofhMedical-SurgicalhNursingh14eh(Hinkleh2017) 42
End-ofhlifeh issuesh thath oftenh involveh ethicalh dilemmash includeh painh control,h doh noth resuscitateh orders,h life-
NURSINGTB.COM
, BRUNNERhANDhSUDDARTHShTEXTBOOKhOFhMEDICALhSURGICALhNURSINGh14THhEDITIONhHINKLEhTESThBAN
K
TesthBankh-hBrunnerh&hSuddarth'shTextbookhofhMedical-SurgicalhNursingh14eh(Hinkleh2017) 43
supporthmeasures,handhadministrationhofhfoodhandhfluids.hThehriskhofhrespiratoryhdepressionhishnoththehi
ntenthofhthehactionhofhpainhcontrol.hRespiratoryhdepressionhshouldhnothbehusedhashanhexcusehtohwithholdhp
ainhmedicationhforhahterminallyhillhpatient.hThehpatientshrespiratoryhstatushshouldhbehcarefullyhmonitoredhandh
anyhchangeshshouldhbehreportedhtohthehphysician.
3. Anhadulthpatienthhashrequestedhahdohnothresuscitateh(DNR)horderhinhlighthofhhishrecenthdiagnosishwithhlatehst
agehpancreatichcancer.hThehpatientshsonhandhdaughter-in-
lawharehstronglyhopposedhtohthehpatientshrequest.hWhathishthehprimaryhresponsibilityhofhthehnursehinhthi
shsituation?
A) Performh ah slowh codehuntilh ahdecisionh ish made.
B) Honorhtheh requesth ofh theh patient.
C) Contacth ah socialh workerh orh mediatorh toh intervene.
D) Temporarilyh withholdh nursingh careh untilh theh physicianh talksh toh theh family.
Ans: B
Feedback:
Thehnursehmusthhonorhthehpatientshwisheshandhcontinuehtohprovidehrequiredhnursinghcare.hDiscussinghthehm
atterhwithhthehphysicianhmayhleadhtohfurtherhcommunicationhwithhthehfamily,hduringhwhichhthehfamilyhm
ayhreconsiderhtheirhdecision.hIthishnothnormallyhappropriatehforhthehnursehtohseekhthehassistancehofhahsoc
ialhworkerhorhmediator.hAhslowhcodehishconsideredhunethical.
4. Anhelderlyhpatienthishadmittedhtohyourhunithwithhahdiagnosishofhcommunity-
acquiredhpneumonia.hDuringhadmissionhthehpatienthstates,hIhhavehahlivinghwill.hWhathimplicationhofhthish
shouldhthehnursehrecognize?
A) Thish documenth ish alwaysh honored,h regardlessh ofh circumstances.
B) Thish documenth specifiesh theh patientsh wishesh beforeh hospitalization.
C) Thish documenth thath ish bindingh forh theh durationh ofh theh patientsh life.
D) Thish documenth hash beenh drawnh uph byh theh patientsh familyh toh determineh DNRh status.
Ans: B
Feedback:
Ahlivinghwillhishonehtypehofhadvancehdirective.hInhmosthsituations,hlivinghwillsharehlimitedhtohsituationshinh
whichhthehpatientshmedicalhconditionhishdeemedhterminal.hThehotherhanswersharehincorrecthbecausehlivinghwi
llsharehnothalwayshhonored,htheyharehnothbindinghforhthehdurationhofhthehpatientshlife,handhtheyharehnothdra
wnhuphbyhthehpatientshfamily.
NURSINGTB.COM
