NUR 211 Exam 3 Questions with Correctly Solved
Answers
1.1. The patient for whom you are caring needs a liver transplant to survive.
This patient has been out of work for several months and doesn't have
health insurance or enough cash. Even though several ethical principles are
at work in this case, list the principles from highest to lowest priority.
1. Accountability: You as the nurse are accountable for the well-being of
this patient.
2. Respect for autonomy: This patient's autonomy will be violated if he
does not receive the liver transplant.
3. Ethics of care: The caring thing that a nurse could provide this patient
is resources for a liver transplant.
4. Justice: The greatest question in this situation is how to determine the
just distribution of resources.: 4,2,3,1
2.2. Fill in the Blank. The point of the ethical practice is an agreement to
reas- sure the public that in all ways the health care team not only 300works
to heal patients but agrees to do this in the least painful and harmful way
possible. This principle is commonly called the principle of ?:
Nonmaleficence
3.3. A child's immunization may cause discomfort during administration,
but the benefits of protection from disease, both for the individual and
society, outweigh the temporary discomforts. Which principle is involved in
this situ- ation?
1. Fidelity
2. Beneficence
3. Nonmaleficence
4. Respect for autonomy: 2
4.4. When designing a plan for pain management for a postoperative
patient, the nurse assesses that the patient's priority is to be as free of pain
as possible. The nurse and patient work together to identify a plan to
manage the pain. The nurse continually reviews the plan with the patient to
ensure that the patient's priority is met. Which principle is used to
encourage the nurse to monitor the patient's response to the pain?
1. Fidelity
2. Beneficence
3. Nonmaleficence
4. Respect for autonomy: 1
5.5. A patient is admitted to a medical unit. The patient is fearful of
,hospitals. The nurse carefully assesses the patient to determine the exact
fears and then establishes interventions designed to reduce these fears. In
this setting how is the nurse practicing patient advocacy?
1. Seeking out the nursing supervisor to talk with the patient
2. Documenting patient fears in the medical record in a timely manner
3. Working to change the hospital environment
4. Assessing the patient's point of view and preparing to articulate it: 4
6.6. The application of utilitarianism does not always resolve an ethical
dilem- ma. Which of the following statements best explains why?
1. Utilitarianism refers to usefulness and therefore eliminates the need to
talk about spiritual values.
2. In a diverse community it can be difficult to find agreement on a
definition of usefulness, the focus of utilitarianism.
3. Even when agreement about a definition of usefulness exists in a
commu- nity, laws prohibit an application of utilitarianism.
4. Difficult ethical decisions cannot be resolved by talking about the
useful- ness of a procedure.: 2
7.7. The ethics of care suggests that ethical dilemmas can best be solved
by attention to relationships. How does this differ from other ethical
practices? (Select all that apply.)
1. Ethics of care pays attention to the environment in which caring occurs.
2. Ethics of care pays attention to the stories of the people involved in
the ethical issue.
3. Ethics of care is used only in nursing practice.
4. Ethics of care focuses only on the code of ethics for nurses
5. Ethics of care focuses only on understanding relationships.: 1,2,5
8.8. In most ethical dilemmas in health care, the solution to the dilemma
requires negotiation among members of the health care team. Why is
the nurse's point of view valuable?
1. Nurses understand the principle of autonomy to guide respect for a
patient's self-worth.
2. Nurses have a scope of practice that encourages their presence
during ethical discussions.
3. Nurses develop a relationship with the patient that is unique among
all professional health care providers.
4. The nurse's code of ethics recommends that a nurse be present at
any ethical discussion about patient care.: 3
9.9. Ethical dilemmas often arise over a conflict of opinion. Reliance on a
predictable series of steps can help people in conflict find common ground.
All of the following actions can help resolve conflict. What is the best order
,of these actions in order to promote the resolution of an ethical dilemma?
1. List the actions that could be taken to resolve the dilemma.
2. Agree on a statement of the problem or dilemma that you are trying to
resolve.
3. Agree on a plan to evaluate the action over time.
4. Gather all relevant information regarding the clinical, social, and
spiritual aspects of the dilemma.
5. Take time to clarify values and distinguish between facts and
opin- ions—your own and those of others involved.
6. Negotiate a plan.: 4,5,2,1,6,3
10.10. The ANA code of nursing ethics articulates that the nurse "promotes,
advocates for, and strives to protect the health, safety, and rights of the
patient." This includes the protection of patient privacy. On the basis of this
principle, if you participate in a public online social network such as
Facebook, could you post images of a patient's x-ray film if you obscured or
deleted all patient identifiers?
1. Yes, because patient privacy would not be violated since patient
identifiers were removed
2. Yes, because respect for autonomy implies that you have the autonomy
to decide what constitutes privacy
3. No, because, even though patient identifiers are removed, someone could
identify the patient on the basis of other comments that you make online
about his or her condition and your place of work
4. No, because the principle of justice requires you to allocate
resources fairly: 3
11.11. What are the correct steps to resolve an ethical dilemma on a
clinical unit? Place the steps in correct order.
1. Clarify values.
2. Ask the question, Is this an ethical dilemma?
3. Verbalize the problem.
4. Gather information.
5. Identify course of action.
6. Evaluate the plan.
7. Negotiate a plan: 2,4,1,3,5,7,6
12.12. Resolution of an ethical dilemma involves discussion with the
patient, the patient's family, and participants from all health care disciplines.
Which of the following best describes the role of the nurse in the resolution
of ethical dilemmas?
1. To articulate the nurse's unique point of view, including knowledge
based on clinical and psychosocial observations.
, 2. To study the literature on current research about the possible clinical
inter- ventions available for the patient in question.
3. To hold a point of view but realize that respect for the authority of
adminis- trators and physicians takes precedence over personal opinion.
4. To allow the patient and the physician to resolve the dilemma on the
basis of ethical principles without regard to personally held values or
opinions.: 1
13.13. It can be difficult to agree on a common definition of the word
quality when it comes to quality of life. Why? (Select all that apply.)
1. Average income varies in different regions of the country.
2. Community values influence definitions of quality, and they are subject
to change over time.
301
3. Individual experiences influence perceptions of quality in different
ways, making consensus difficult.
4.The value of elements such as cognitive skills, ability to perform
meaningful work, and relationship to family is difficult to quantify using
objective mea- sures.
5. Statistical analysis is difficult to apply when the outcome cannot be
quan- tified.
6. Whether or not a person has a job is an objective measure, but it does
not play a role in understanding quality of life.: 2,3,4,5
14.14. Which of the following properly applies an ethical principle to
justify access to health care? (Select all that apply.)
1. Access to health care reflects the commitment of society to principles of
beneficence and justice.
2. If low income compromises access to care, respect for autonomy is
com- promised.
3. Access to health care is a privilege in the United States, not a right.
4. Poor access to affordable health care causes harm that is ethically
troubling because nonmaleficence is a basic principle of health care ethics.
5. Providers are exempt from fidelity to people with drug addiction
because addiction reflects a lack of personal accountability.
6. If a new drug is discovered that cures a disease but at great cost per
patient, the principle of justice suggests that the drug should be made
available to those who can afford it.: 1,2,4
15.15. Match the examples with the professional nursing code of ethics:
a. Advocacy
b. Responsibility
c. Accountability
Answers
1.1. The patient for whom you are caring needs a liver transplant to survive.
This patient has been out of work for several months and doesn't have
health insurance or enough cash. Even though several ethical principles are
at work in this case, list the principles from highest to lowest priority.
1. Accountability: You as the nurse are accountable for the well-being of
this patient.
2. Respect for autonomy: This patient's autonomy will be violated if he
does not receive the liver transplant.
3. Ethics of care: The caring thing that a nurse could provide this patient
is resources for a liver transplant.
4. Justice: The greatest question in this situation is how to determine the
just distribution of resources.: 4,2,3,1
2.2. Fill in the Blank. The point of the ethical practice is an agreement to
reas- sure the public that in all ways the health care team not only 300works
to heal patients but agrees to do this in the least painful and harmful way
possible. This principle is commonly called the principle of ?:
Nonmaleficence
3.3. A child's immunization may cause discomfort during administration,
but the benefits of protection from disease, both for the individual and
society, outweigh the temporary discomforts. Which principle is involved in
this situ- ation?
1. Fidelity
2. Beneficence
3. Nonmaleficence
4. Respect for autonomy: 2
4.4. When designing a plan for pain management for a postoperative
patient, the nurse assesses that the patient's priority is to be as free of pain
as possible. The nurse and patient work together to identify a plan to
manage the pain. The nurse continually reviews the plan with the patient to
ensure that the patient's priority is met. Which principle is used to
encourage the nurse to monitor the patient's response to the pain?
1. Fidelity
2. Beneficence
3. Nonmaleficence
4. Respect for autonomy: 1
5.5. A patient is admitted to a medical unit. The patient is fearful of
,hospitals. The nurse carefully assesses the patient to determine the exact
fears and then establishes interventions designed to reduce these fears. In
this setting how is the nurse practicing patient advocacy?
1. Seeking out the nursing supervisor to talk with the patient
2. Documenting patient fears in the medical record in a timely manner
3. Working to change the hospital environment
4. Assessing the patient's point of view and preparing to articulate it: 4
6.6. The application of utilitarianism does not always resolve an ethical
dilem- ma. Which of the following statements best explains why?
1. Utilitarianism refers to usefulness and therefore eliminates the need to
talk about spiritual values.
2. In a diverse community it can be difficult to find agreement on a
definition of usefulness, the focus of utilitarianism.
3. Even when agreement about a definition of usefulness exists in a
commu- nity, laws prohibit an application of utilitarianism.
4. Difficult ethical decisions cannot be resolved by talking about the
useful- ness of a procedure.: 2
7.7. The ethics of care suggests that ethical dilemmas can best be solved
by attention to relationships. How does this differ from other ethical
practices? (Select all that apply.)
1. Ethics of care pays attention to the environment in which caring occurs.
2. Ethics of care pays attention to the stories of the people involved in
the ethical issue.
3. Ethics of care is used only in nursing practice.
4. Ethics of care focuses only on the code of ethics for nurses
5. Ethics of care focuses only on understanding relationships.: 1,2,5
8.8. In most ethical dilemmas in health care, the solution to the dilemma
requires negotiation among members of the health care team. Why is
the nurse's point of view valuable?
1. Nurses understand the principle of autonomy to guide respect for a
patient's self-worth.
2. Nurses have a scope of practice that encourages their presence
during ethical discussions.
3. Nurses develop a relationship with the patient that is unique among
all professional health care providers.
4. The nurse's code of ethics recommends that a nurse be present at
any ethical discussion about patient care.: 3
9.9. Ethical dilemmas often arise over a conflict of opinion. Reliance on a
predictable series of steps can help people in conflict find common ground.
All of the following actions can help resolve conflict. What is the best order
,of these actions in order to promote the resolution of an ethical dilemma?
1. List the actions that could be taken to resolve the dilemma.
2. Agree on a statement of the problem or dilemma that you are trying to
resolve.
3. Agree on a plan to evaluate the action over time.
4. Gather all relevant information regarding the clinical, social, and
spiritual aspects of the dilemma.
5. Take time to clarify values and distinguish between facts and
opin- ions—your own and those of others involved.
6. Negotiate a plan.: 4,5,2,1,6,3
10.10. The ANA code of nursing ethics articulates that the nurse "promotes,
advocates for, and strives to protect the health, safety, and rights of the
patient." This includes the protection of patient privacy. On the basis of this
principle, if you participate in a public online social network such as
Facebook, could you post images of a patient's x-ray film if you obscured or
deleted all patient identifiers?
1. Yes, because patient privacy would not be violated since patient
identifiers were removed
2. Yes, because respect for autonomy implies that you have the autonomy
to decide what constitutes privacy
3. No, because, even though patient identifiers are removed, someone could
identify the patient on the basis of other comments that you make online
about his or her condition and your place of work
4. No, because the principle of justice requires you to allocate
resources fairly: 3
11.11. What are the correct steps to resolve an ethical dilemma on a
clinical unit? Place the steps in correct order.
1. Clarify values.
2. Ask the question, Is this an ethical dilemma?
3. Verbalize the problem.
4. Gather information.
5. Identify course of action.
6. Evaluate the plan.
7. Negotiate a plan: 2,4,1,3,5,7,6
12.12. Resolution of an ethical dilemma involves discussion with the
patient, the patient's family, and participants from all health care disciplines.
Which of the following best describes the role of the nurse in the resolution
of ethical dilemmas?
1. To articulate the nurse's unique point of view, including knowledge
based on clinical and psychosocial observations.
, 2. To study the literature on current research about the possible clinical
inter- ventions available for the patient in question.
3. To hold a point of view but realize that respect for the authority of
adminis- trators and physicians takes precedence over personal opinion.
4. To allow the patient and the physician to resolve the dilemma on the
basis of ethical principles without regard to personally held values or
opinions.: 1
13.13. It can be difficult to agree on a common definition of the word
quality when it comes to quality of life. Why? (Select all that apply.)
1. Average income varies in different regions of the country.
2. Community values influence definitions of quality, and they are subject
to change over time.
301
3. Individual experiences influence perceptions of quality in different
ways, making consensus difficult.
4.The value of elements such as cognitive skills, ability to perform
meaningful work, and relationship to family is difficult to quantify using
objective mea- sures.
5. Statistical analysis is difficult to apply when the outcome cannot be
quan- tified.
6. Whether or not a person has a job is an objective measure, but it does
not play a role in understanding quality of life.: 2,3,4,5
14.14. Which of the following properly applies an ethical principle to
justify access to health care? (Select all that apply.)
1. Access to health care reflects the commitment of society to principles of
beneficence and justice.
2. If low income compromises access to care, respect for autonomy is
com- promised.
3. Access to health care is a privilege in the United States, not a right.
4. Poor access to affordable health care causes harm that is ethically
troubling because nonmaleficence is a basic principle of health care ethics.
5. Providers are exempt from fidelity to people with drug addiction
because addiction reflects a lack of personal accountability.
6. If a new drug is discovered that cures a disease but at great cost per
patient, the principle of justice suggests that the drug should be made
available to those who can afford it.: 1,2,4
15.15. Match the examples with the professional nursing code of ethics:
a. Advocacy
b. Responsibility
c. Accountability
