BRUNNERnANDnSUDDARTHSnTEXTBOOKnOFnMEDICALnSURGICALnNURSINGn14THnEDITIONnHINKLEnTESTnBAN
K
TestnBankn-nBrunnern&nSuddarth'snTextbooknofnMedical-SurgicalnNursingn14en(Hinklen2017) 41
Chapter 03: Critical Thinking, Ethical Decision Making and the Nursing P
n n n n n n n n n n
rocess
1. Annursenhasnbeennofferednanpositionnonnannobstetricnunitnandnhasnlearnednthatnthenunitnoffersntherapeuticnab
ortions,nanprocedurenwhichncontradictsnthennursesnpersonalnbeliefs.nWhatnisnthennursesnethicaln obligationnt
onthesenpatients?
A) Then nursen shouldn adheren ton professionaln standardsn ofn practicen andn offern servicen ton thesen patients.
B) Then nursen shouldn maken then choicen ton declinen thisn positionn andn pursuen an differentn nursingn role.
C) Then nursen shouldn declinen ton caren forn then patientsn consideringn abortion.
D) Then nursen shouldn expressn alternativesn ton womenn consideringn terminatingn theirn pregnancy.
Ans: B
Feedback:
Tonavoidnfacingnethicalndilemmas,nnursesncannfollowncertainnstrategies.nFornexample,nwhennapplyingnfornanjo
b,nannursenshouldnasknquestionsnregardingnthenpatientnpopulation.nIfnannursenisnuncomfortablenwithnanparticula
rn situation,n thenn notn acceptingn then positionn wouldn ben then bestn option.n Then nursen isn onlyn requirednbynlawn(
andnpracticenstandards)ntonprovidencarentonthenpatientsnthenclinicnaccepts;nthennursenmaynnotndiscriminatenbet
weennpatientsnandnthennursenexpressingnhisnornhernownnopinionnandnprovidingnanothern optionnisninappropriat
e.
2. An terminallyn illn patientn youn aren caringn forn isn complainingn ofn pain.n Then physiciann hasn orderedn an largen dosen
ofn intravenousn opioidsn byn continuousn infusion.n Youn known thatn onen ofn then adversen effectsn ofn thisn medicinen
isnrespiratoryndepression.nWhennyounassessnyournpatientsnrespiratorynstatus,nyounfindnthatnthenratenhasndecreas
ednfromn16nbreathsnpernminutenton10nbreathsnpernminute.nWhatnactionnshouldnyountake?
A) Decreasen then raten ofn IVn infusion.
B) Stimulaten then patientn inn ordern ton increasen respiratoryn rate.
C) Reportn then decreasedn respiratoryn raten ton then physician.
D) Allown then patientn ton restn comfortably.
Ans: C
Feedback:
End-ofn lifen issuesn thatn oftenn involven ethicaln dilemmasn includen painn control,n don notn resuscitaten orders,n life-
NURSINGTB.COM
, BRUNNERnANDnSUDDARTHSnTEXTBOOKnOFnMEDICALnSURGICALnNURSINGn14THnEDITIONnHINKLEnTESTnBAN
K
TestnBankn-nBrunnern&nSuddarth'snTextbooknofnMedical-SurgicalnNursingn14en(Hinklen2017) 42
supportnmeasures,nandnadministrationnofnfoodnandnfluids.nThenrisknofnrespiratoryndepressionnisnnotnthen inte
ntnofnthenactionnofnpainncontrol.nRespiratoryndepressionnshouldnnotnbenusednasnannexcusentonwithholdn painn
medicationnfornanterminallynillnpatient.nThenpatientsnrespiratorynstatusnshouldnbencarefullynmonitorednandnan
ynchangesnshouldnbenreportedntonthenphysician.
3. Annadultnpatientnhasnrequestednandonnotnresuscitaten(DNR)norderninnlightnofnhisnrecentndiagnosisnwithnlatensta
genpancreaticncancer.nThenpatientsnsonnandndaughter-in-
lawnarenstronglynopposedntonthenpatientsn request.nWhatnisnthenprimarynresponsibilitynofnthennurseninnthisnsit
uation?
A) Performn an slown coden untiln andecisionn isn made.
B) Honorn then requestn ofn then patient.
C) Contactn an socialn workern orn mediatorn ton intervene.
D) Temporarilyn withholdn nursingn caren untiln then physiciann talksn ton then family.
Ans: B
Feedback:
Thennursenmustnhonornthenpatientsnwishesnandncontinuentonprovidenrequirednnursingncare.nDiscussingnthen
matternwithnthenphysiciannmaynleadntonfurtherncommunicationnwithnthenfamily,nduringnwhichnthenfamilynm
aynreconsiderntheirndecision.nItnisnnotnnormallynappropriatenfornthennursentonseeknthenassistancenofnan socialn
workernornmediator.nAnslowncodenisnconsiderednunethical.
4. Annelderlynpatientnisnadmittedntonyournunitnwithnandiagnosisnofncommunity-
acquirednpneumonia.nDuringnadmissionnthenpatientnstates,nInhavenanlivingnwill.nWhatnimplicationnofnthisnsh
ouldnthennursenrecognize?
A) Thisn documentn isn alwaysn honored,n regardlessn ofn circumstances.
B) Thisn documentn specifiesn then patientsn wishesn beforen hospitalization.
C) Thisn documentn thatn isn bindingn forn then durationn ofn then patientsn life.
D) Thisn documentn hasn beenn drawnn upn byn then patientsn familyn ton determinen DNRn status.
Ans: B
Feedback:
Anlivingnwillnisnonentypenofnadvancendirective.nInnmostnsituations,nlivingnwillsnarenlimitedntonsituationsninnw
hichnthenpatientsnmedicalnconditionnisndeemednterminal.nThenothernanswersnarenincorrectnbecausenlivingnwi
llsnarennotnalwaysnhonored,ntheynarennotnbindingnfornthendurationnofnthenpatientsnlife,nandntheynarennotndraw
nnupnbynthenpatientsnfamily.
NURSINGTB.COM
, BRUNNERnANDnSUDDARTHSnTEXTBOOKnOFnMEDICALnSURGICALnNURSINGn14THnEDITIONnHINKLEnTESTnBAN
K
TestnBankn-nBrunnern&nSuddarth'snTextbooknofnMedical-SurgicalnNursingn14en(Hinklen2017) 43
5. Annursenhasnbeennprovidingnethicalncarenfornmanynyearsnandnisnawarenofnthenneedntonmaintainnthenethicalnprin
ciplenofnnonmaleficence.nWhichnofnthenfollowingnactionsnwouldnbenconsiderednancontradictionnofnthisnprinci
ple?
A) Discussingn an DNRn ordern withn an terminallyn illn patient
B) Assistingn an semi-independentn patientn withn ADLs
C) Refusingn ton administern painn medicationn asn ordered
D) Providingnmorencarenfornonenpatientnthannfornanothern
Ans: C
Feedback:
Thendutynnotntoninflictnasnwellnasnpreventnandnremovenharmnisntermednnonmaleficence.nDiscussingnanDNRno
rdernwithnanterminallynillnpatientnandnassistingnanpatientnwithnADLsnwouldnnotnbenconsideredn contradiction
sntonthennursesndutynofnnonmaleficence.nSomenpatientsnjustifiablynrequirenmorencarenthann others.
6. Younhavenjustntakennreportnfornyournshiftnandnyounarendoingnyourninitialnassessmentnofnyournpatients.nOnen o
fnyournpatientsnasksnyounifnannerrornhasnbeennmadeninnhernmedication.nYounknownthatnannincidentnreportnwasn
filednyesterdaynafternannurseninadvertentlynmissednanscheduledndosenofnthenpatientsnantibiotic.nWhichn ofnthen
followingnprinciplesnwouldnapplynifnyoungivenannaccuratenresponse?
A) Veracity
B) Confidentiality
C) Respect
D) Justice
Ans: A
Feedback:
Thenobligationntontellnthentruthnandnnotndeceivenothersnisntermednveracity.nThenothernanswersnarenincorrectnbeca
usentheynarennotnobligationsntontellnthentruth.
7. Annursenhasnbegunncreatingnanpatientsnplannofncarenshortlynafternthenpatientsnadmission.nItnisnimportantnthatnth
enwordingnofnthenchosennnursingndiagnosesnfallsnwithinnthentaxonomynofnnursing.nWhichnorganizationnisnresp
onsiblenforndevelopingnthentaxonomynofnannursingndiagnosis?
A) Americann Nursesn Associationn (ANA)
NURSINGTB.COM
K
TestnBankn-nBrunnern&nSuddarth'snTextbooknofnMedical-SurgicalnNursingn14en(Hinklen2017) 41
Chapter 03: Critical Thinking, Ethical Decision Making and the Nursing P
n n n n n n n n n n
rocess
1. Annursenhasnbeennofferednanpositionnonnannobstetricnunitnandnhasnlearnednthatnthenunitnoffersntherapeuticnab
ortions,nanprocedurenwhichncontradictsnthennursesnpersonalnbeliefs.nWhatnisnthennursesnethicaln obligationnt
onthesenpatients?
A) Then nursen shouldn adheren ton professionaln standardsn ofn practicen andn offern servicen ton thesen patients.
B) Then nursen shouldn maken then choicen ton declinen thisn positionn andn pursuen an differentn nursingn role.
C) Then nursen shouldn declinen ton caren forn then patientsn consideringn abortion.
D) Then nursen shouldn expressn alternativesn ton womenn consideringn terminatingn theirn pregnancy.
Ans: B
Feedback:
Tonavoidnfacingnethicalndilemmas,nnursesncannfollowncertainnstrategies.nFornexample,nwhennapplyingnfornanjo
b,nannursenshouldnasknquestionsnregardingnthenpatientnpopulation.nIfnannursenisnuncomfortablenwithnanparticula
rn situation,n thenn notn acceptingn then positionn wouldn ben then bestn option.n Then nursen isn onlyn requirednbynlawn(
andnpracticenstandards)ntonprovidencarentonthenpatientsnthenclinicnaccepts;nthennursenmaynnotndiscriminatenbet
weennpatientsnandnthennursenexpressingnhisnornhernownnopinionnandnprovidingnanothern optionnisninappropriat
e.
2. An terminallyn illn patientn youn aren caringn forn isn complainingn ofn pain.n Then physiciann hasn orderedn an largen dosen
ofn intravenousn opioidsn byn continuousn infusion.n Youn known thatn onen ofn then adversen effectsn ofn thisn medicinen
isnrespiratoryndepression.nWhennyounassessnyournpatientsnrespiratorynstatus,nyounfindnthatnthenratenhasndecreas
ednfromn16nbreathsnpernminutenton10nbreathsnpernminute.nWhatnactionnshouldnyountake?
A) Decreasen then raten ofn IVn infusion.
B) Stimulaten then patientn inn ordern ton increasen respiratoryn rate.
C) Reportn then decreasedn respiratoryn raten ton then physician.
D) Allown then patientn ton restn comfortably.
Ans: C
Feedback:
End-ofn lifen issuesn thatn oftenn involven ethicaln dilemmasn includen painn control,n don notn resuscitaten orders,n life-
NURSINGTB.COM
, BRUNNERnANDnSUDDARTHSnTEXTBOOKnOFnMEDICALnSURGICALnNURSINGn14THnEDITIONnHINKLEnTESTnBAN
K
TestnBankn-nBrunnern&nSuddarth'snTextbooknofnMedical-SurgicalnNursingn14en(Hinklen2017) 42
supportnmeasures,nandnadministrationnofnfoodnandnfluids.nThenrisknofnrespiratoryndepressionnisnnotnthen inte
ntnofnthenactionnofnpainncontrol.nRespiratoryndepressionnshouldnnotnbenusednasnannexcusentonwithholdn painn
medicationnfornanterminallynillnpatient.nThenpatientsnrespiratorynstatusnshouldnbencarefullynmonitorednandnan
ynchangesnshouldnbenreportedntonthenphysician.
3. Annadultnpatientnhasnrequestednandonnotnresuscitaten(DNR)norderninnlightnofnhisnrecentndiagnosisnwithnlatensta
genpancreaticncancer.nThenpatientsnsonnandndaughter-in-
lawnarenstronglynopposedntonthenpatientsn request.nWhatnisnthenprimarynresponsibilitynofnthennurseninnthisnsit
uation?
A) Performn an slown coden untiln andecisionn isn made.
B) Honorn then requestn ofn then patient.
C) Contactn an socialn workern orn mediatorn ton intervene.
D) Temporarilyn withholdn nursingn caren untiln then physiciann talksn ton then family.
Ans: B
Feedback:
Thennursenmustnhonornthenpatientsnwishesnandncontinuentonprovidenrequirednnursingncare.nDiscussingnthen
matternwithnthenphysiciannmaynleadntonfurtherncommunicationnwithnthenfamily,nduringnwhichnthenfamilynm
aynreconsiderntheirndecision.nItnisnnotnnormallynappropriatenfornthennursentonseeknthenassistancenofnan socialn
workernornmediator.nAnslowncodenisnconsiderednunethical.
4. Annelderlynpatientnisnadmittedntonyournunitnwithnandiagnosisnofncommunity-
acquirednpneumonia.nDuringnadmissionnthenpatientnstates,nInhavenanlivingnwill.nWhatnimplicationnofnthisnsh
ouldnthennursenrecognize?
A) Thisn documentn isn alwaysn honored,n regardlessn ofn circumstances.
B) Thisn documentn specifiesn then patientsn wishesn beforen hospitalization.
C) Thisn documentn thatn isn bindingn forn then durationn ofn then patientsn life.
D) Thisn documentn hasn beenn drawnn upn byn then patientsn familyn ton determinen DNRn status.
Ans: B
Feedback:
Anlivingnwillnisnonentypenofnadvancendirective.nInnmostnsituations,nlivingnwillsnarenlimitedntonsituationsninnw
hichnthenpatientsnmedicalnconditionnisndeemednterminal.nThenothernanswersnarenincorrectnbecausenlivingnwi
llsnarennotnalwaysnhonored,ntheynarennotnbindingnfornthendurationnofnthenpatientsnlife,nandntheynarennotndraw
nnupnbynthenpatientsnfamily.
NURSINGTB.COM
, BRUNNERnANDnSUDDARTHSnTEXTBOOKnOFnMEDICALnSURGICALnNURSINGn14THnEDITIONnHINKLEnTESTnBAN
K
TestnBankn-nBrunnern&nSuddarth'snTextbooknofnMedical-SurgicalnNursingn14en(Hinklen2017) 43
5. Annursenhasnbeennprovidingnethicalncarenfornmanynyearsnandnisnawarenofnthenneedntonmaintainnthenethicalnprin
ciplenofnnonmaleficence.nWhichnofnthenfollowingnactionsnwouldnbenconsiderednancontradictionnofnthisnprinci
ple?
A) Discussingn an DNRn ordern withn an terminallyn illn patient
B) Assistingn an semi-independentn patientn withn ADLs
C) Refusingn ton administern painn medicationn asn ordered
D) Providingnmorencarenfornonenpatientnthannfornanothern
Ans: C
Feedback:
Thendutynnotntoninflictnasnwellnasnpreventnandnremovenharmnisntermednnonmaleficence.nDiscussingnanDNRno
rdernwithnanterminallynillnpatientnandnassistingnanpatientnwithnADLsnwouldnnotnbenconsideredn contradiction
sntonthennursesndutynofnnonmaleficence.nSomenpatientsnjustifiablynrequirenmorencarenthann others.
6. Younhavenjustntakennreportnfornyournshiftnandnyounarendoingnyourninitialnassessmentnofnyournpatients.nOnen o
fnyournpatientsnasksnyounifnannerrornhasnbeennmadeninnhernmedication.nYounknownthatnannincidentnreportnwasn
filednyesterdaynafternannurseninadvertentlynmissednanscheduledndosenofnthenpatientsnantibiotic.nWhichn ofnthen
followingnprinciplesnwouldnapplynifnyoungivenannaccuratenresponse?
A) Veracity
B) Confidentiality
C) Respect
D) Justice
Ans: A
Feedback:
Thenobligationntontellnthentruthnandnnotndeceivenothersnisntermednveracity.nThenothernanswersnarenincorrectnbeca
usentheynarennotnobligationsntontellnthentruth.
7. Annursenhasnbegunncreatingnanpatientsnplannofncarenshortlynafternthenpatientsnadmission.nItnisnimportantnthatnth
enwordingnofnthenchosennnursingndiagnosesnfallsnwithinnthentaxonomynofnnursing.nWhichnorganizationnisnresp
onsiblenforndevelopingnthentaxonomynofnannursingndiagnosis?
A) Americann Nursesn Associationn (ANA)
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