, TESTBANK FOR Bioethical Decision Making in
Nursing, Fifth Edition Gladys Husted
Notes
1- The file is chapter after chapter.
2- We have shown you few pages sample.
3- The file contains all Appendix and Excel sheet
if it exists.
4- We have all what you need, we make update
at every time. There are many new editions
waiting you.
5- If you think you purchased the wrong file You
can contact us at every time, we can replace it
with true one.
Our email:
, CHAPTER 1
Ethical Foundations
CHAPTER SUMMARY
The chapter begins with the purpose of ethics and moves to discuss bioethics. Then a simple
paradox is presented. The resolution to this paradox illustrates a number of basic points such
as the process by which one learns the nature of one’s self and others, how one produces one’s
own development, how one discovers what it is to be a fully developed person, and how ethical
thought and action can be mastered. The ethical history of every individual recapitulates the
history of mankind. In each case, the original inspiration of ethical thinking and the aim of
ethics is the resolution to the problem of successful living. This will be the approach to ethics
taken in this book—the successful pursuit of life, health, and well-being. It is the pursuit of this
that Socrates, the first great ethicist of the Western world, called a life worth living. The purpose
and need for ethics is described. This is captured well in the vignette of an individual being
marooned on a desert island. This location, along with the health care setting, is a test of one’s
character and a challenge to one’s ethical nature. Bioethics is discussed in some detail since this
is the focus of the book. There is a brief discussion of a practice-based ethic that is also discussed
in other chapters, but with a different focus. A very brief discussion (an extensive discussion is
in Chapter 6) of the four prominent ethical systems (deontology, utilitarianism, social relativism,
and emotivism) is given to help the reader see that something more is needed; that these are not
sufficient for bioethics. The chapter ends with a brief discussion of symphonology as a practice-
based, patient-centered ethic.
MAJOR FOCUS AREAS
Need to understand oneself Purpose of ethics
Bioethics
The importance of understanding self and others
Human behavior and human character
Virtue Purpose of practice-based ethics Need for ethics when alone on a desert island Brief
overview of the contemporary ethical systems
Beginning discussion of Symphonology
CLASSROOM ACTIVITIES
Activity 1: Self-Awareness and the Meaning of Being Human
Have students do the following:
• Discuss what they know about themselves that can guide their interaction with others.
• Conduct a thought experiment about characteristics of humanness and relate it to what they
know about themselves.
Copyright © Springer Publishing Company, LLC. All Rights Reserved. 1
,2 Bioethical Decision Making in Nursing
• Imagine that you know nothing about yourself or of what it means to be human; you have
been beamed in from outer space where there are no rational life-forms. Discuss how you
could care for others without any knowledge of what it means to be human. Could you?
Activity 2: Regarding the Movie Castaway (if not everyone has seen it, a very brief description
can be given)
• Did the main character need ethics? Why or why not.
Activity 3: Journaling
• Have students discuss or write in a journal the injustices that they see in health care.
• Take one of the injustices and have them examine how they could begin to make a change.
TEST BANK QUESTIONS FOR CHAPTER 1
1. The purpose of ethics is: (Select all that apply)
A. Acting on one’s beliefs
B. Making judgments of benefit versus harm*
C. Creating ethical situations
D. Dealing with alternatives*
2. The paradox of the hammer relates to: (Select all that apply)
A. The value of similarities with other humans*
B. Knowing yourself first through others*
C. The value of learning through experience*
D. The understanding of self*
3. If alone on a desert island, ethical decision making is:
A. Necessary
B. Possible
C. Possible but not necessary
D. Possible and necessary*
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
, 1: Ethical Foundations 3
4. Symphonology is the study of:
A. Interactions among similar people
B. Agreements*
C. Ethical decisions and actions
D. Systems of ethics
5. Symphonology holds that certain things matter such as: (Select all that apply)
A. Character*
B. Bringing about the greatest good for the greatest number
C. Intention*
D. Virtue*
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
, CHAPTER 2
The Ethical Journey
CHAPTER SUMMARY
The beginning of the foundation of Symphonology is explored. Individual rights is defined and
discussed as the foundation for ethical interaction. The first humorous vignette uses an example
of cavemen to “drive home” the importance of individual rights and the disastrous effects of aggression.
The importance of purpose and justifiability to the resolution of dilemmas is comprehensively
discussed. Essential for success in developing ethical practice is the need to recognize the nature
of human beings, the need to identify the nature, demands, and purpose of the health care
setting, and the need to recognize the authority that guides and justifies ethical actions. These
form the essential parts of the chapter.
MAJOR FOCUS AREAS
Flawed ethical decisions versus unflawed decisions
The role of justification and purpose in bioethical decision making
The role of nurse and patient
Ethical individualism and the law
The importance of individual rights and rights as a singular term
The ethical approach between the nurse and the patient
Trust and obligation
The skills needed to make the journey to objective, justifiable, and appropriate
ethical decisions
CLASSROOM ACTIVITIES
Activity 1: The Caveman (First Humorous Vignette) and Individual Rights
Have students review the caveman scenario and then discuss the following:
• If there was no such thing as individual rights, what would the world be like?
• What is the importance of individual rights on the enhancement of life—yours and the
patient’s life?
• Why is it necessary for rights to be a singular term?
• What happens if rights were considered a plural term?
• What is the most important lesson to be learned from this humorous vignette?
4 Copyright © Springer Publishing Company, LLC. All Rights Reserved.
, 2: The Ethical Journey 5
Activity 2: The Nurse as the Agent of a Patient and the Nurse as His or Her Own Agent
Have students discuss the following:
• What it means to be an agent for someone else.
• What it means to be one’s own agent.
• What it means to lose the ability to act for self and to be under another’s control.
• How can a nurse act to increase a patient’s agency?
Activity 3: Learning Through Movies or TV
Have students watch a DVD, such as Nursing Diaries: The Rookies, or an old TV show like
M*A*S*H* or ER and reflect on the following:
• What loss of agency is the patient experiencing?
• How is the health care professional shown as the agent of the patient?
• What ethical decisions are being made and are they flawed or unflawed decisions?
• Describe where you see the nurse or health care provider making objective, justifiable, and
appropriate ethical decisions as the patient’s agent.
TEST BANK QUESTIONS FOR CHAPTER 2
1. A flawed ethical decision is one that: (Select all that apply)
A. Does not allow one to change direction.*
B. Will enable a nurse to justify the decision.
C. Will affect a person’s life—one’s vital and fundamental goals.
D. Is nothing more than theorizing.*
2. To justify an ethical decision means that one is able to:
A. Have purposeful foresight.*
B. Devote effort in the resolution of a dilemma.
C. Explain it in terms of policies.
D. Explain it on the perceptual and concrete level.
3. The patient as the final authority in his own care means that the patient: (Select all
that apply)
A. Is the one who has the right to determine the decisions for himself.*
B. Can demand anything from the nurse.
C. Is able to refuse care even if the care is beneficial to his health.*
D. Can behave in an aggressive way toward others.
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
,6 Bioethical Decision Making in Nursing
4. The lesson(s) to be learned from the caveman parable is: (Select all that apply)
A. The value of social justice rights.
B. The value of individual rights.*
C. The value of an interpersonal agreement.*
D. The disvalue of aggression.*
5. Rights is:
A. Whatever the law allows.
B. The implicit agreement behind every explicit agreement.*
C. Normal behaviors established by society.
D. A corollary of duty.
6. The value of rights as discussed in this chapter: (Select all that apply)
A. Is an ethical fact that is always honored.
B. Helps prevent disputes.*
C. Helps determine what actions are justifiable actions.*
D. Eliminates the need for constant discussion.*
7. The main reason why the patient is the central focus in bioethical decision making is:
A. The patient is the one receiving the care.
B. The patient believes this.
C. Without patients there would be no health care system.
D. It is basic to the agreement.*
8. Primarily, a patient is vulnerable because:
A. The patient has suffered a decrease in his or her agency.*
B. The patient is unable to communicate his or her wishes.
C. The patient has an illness or a disability.
D. The patient’s life is at risk.
9. Reflect on the discussion in the book about Jane and Nancy. Ethically, Jane does not have to
jump in the water to save Nancy, who is drowning, if she cannot swim because:
A. This would be foolhardy.
B. A rational ethics system could not demand the sacrifice of one’s own life.*
C. There would be no chance of either surviving.
D. Nancy would not want to put Jane’s life at risk.
10. Being an agent for one’s patient means:
A. Acting in place of the patient.
B. Acting as directed by the family when the person cannot make decisions.
C. Acting as the patient would if he could.*
D. Acting as a surrogate decision maker.
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
, CHAPTER 3
The Nurse–Patient Agreement
CHAPTER SUMMARY
The nature of the agreement and the ethical relationship between professional and patient
is further explored. This relationship is based on the recognition of individual rights and is
carried out in accordance with the purpose of the health care environment. The professional–
patient agreement is made possible by individual rights and is structured by the implicit
understanding that guides a nurse and patient’s interaction. Coercion and deception are ruled
out of the nurse–patient interaction since they serve to undermine the proper interaction. The
importance of communication in the nurse–patient agreement is explicated through the second humorous
vignette where two inhabitants of a jungle village are arguing over who has the right to the possession
of the coconut. The role of sameness and probability is examined as to its role in making ethical
decisions for individuals. The nature of the nurse’s agreement with herself is shown to be rooted
in rational self-interest. A patient in need of a nurse needs a rational agent—one who is aware
of the nature of individual rights and interactions, and one who is dedicated to her decision to
become a nurse. A nurse who is indifferent to herself has no reason not to be indifferent to her
patients. Readers are encouraged to examine rights and the agreement as fundamental to their
role as agents of patients. It is important for them to delve into their character structure and
relationships with their patients. The chapter ends with a discussion of the nature of the nurse’s
agreement with herself and how it is rooted in rational self-interest.
MAJOR FOCUS AREAS
The nurse–patient agreement
What is it?
How is it formed?
The importance of the family
Codes of ethics
Difference between implicit and explicit agreements
The reciprocal relationship and the common understandings of nurse and patient
The role of benevolence
The role of communication in forming the agreement
Probability and the use of sameness when caring for a patient who cannot communicate
The agreement with oneself
Rational self-interest
Copyright © Springer Publishing Company, LLC. All Rights Reserved. 7
, 8 Bioethical Decision Making in Nursing
CLASSROOM ACTIVITIES
Activity 1: The Coconut Parable (The Second Humorous Vignette)
Have students reread the story of the coconut and discuss:
• How did unexamined assumptions fail the villagers?
• How would the disagreement among the villagers change if the villagers had communicated?
• What are the lessons learned for health care?
Activity 2: Role Play
• If time permits, have students create a situation or use a real situation in which communica-
tion and unfounded assumptions are preventing the agreement from being realized.
• Have a group of students role play the situation by making unfounded assumptions and fail-
ing to adequately communicate. Then have the rest of the class critique and make suggestions
about how to correctly communicate with all of the parties in the scenario. Or, in lieu of role
play, have students think about communication and false assumptions in their clinical prac-
tice and reflect on this, for example, in a journal or portfolio.
Activity 3: Agreement With Self
• Either for class discussion or as a short assignment, have students examine why they need to
have an agreement with themselves before any meaningful agreement can be made with any
other person.
• What does the agreement obligate the nurse to do and what does it forbid?
Activity 4: The Star Thrower, Loren Eiseley
• Ask students to discuss the Star Thrower in regards to its relevance to the nurse–patient
agreement. (If the link does not work, just go to YouTube and search the title.)
• www.youtube.com/watch?v=-qClChUdlfI
Other Classroom or Online Discussion Questions:
• What would happen if there was not an implicit agreement that permits interaction and care?
• What is the importance of communication for ethical interaction?
• How does the patient gain when a nurse is inspired by rational self-interest?
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
Nursing, Fifth Edition Gladys Husted
Notes
1- The file is chapter after chapter.
2- We have shown you few pages sample.
3- The file contains all Appendix and Excel sheet
if it exists.
4- We have all what you need, we make update
at every time. There are many new editions
waiting you.
5- If you think you purchased the wrong file You
can contact us at every time, we can replace it
with true one.
Our email:
, CHAPTER 1
Ethical Foundations
CHAPTER SUMMARY
The chapter begins with the purpose of ethics and moves to discuss bioethics. Then a simple
paradox is presented. The resolution to this paradox illustrates a number of basic points such
as the process by which one learns the nature of one’s self and others, how one produces one’s
own development, how one discovers what it is to be a fully developed person, and how ethical
thought and action can be mastered. The ethical history of every individual recapitulates the
history of mankind. In each case, the original inspiration of ethical thinking and the aim of
ethics is the resolution to the problem of successful living. This will be the approach to ethics
taken in this book—the successful pursuit of life, health, and well-being. It is the pursuit of this
that Socrates, the first great ethicist of the Western world, called a life worth living. The purpose
and need for ethics is described. This is captured well in the vignette of an individual being
marooned on a desert island. This location, along with the health care setting, is a test of one’s
character and a challenge to one’s ethical nature. Bioethics is discussed in some detail since this
is the focus of the book. There is a brief discussion of a practice-based ethic that is also discussed
in other chapters, but with a different focus. A very brief discussion (an extensive discussion is
in Chapter 6) of the four prominent ethical systems (deontology, utilitarianism, social relativism,
and emotivism) is given to help the reader see that something more is needed; that these are not
sufficient for bioethics. The chapter ends with a brief discussion of symphonology as a practice-
based, patient-centered ethic.
MAJOR FOCUS AREAS
Need to understand oneself Purpose of ethics
Bioethics
The importance of understanding self and others
Human behavior and human character
Virtue Purpose of practice-based ethics Need for ethics when alone on a desert island Brief
overview of the contemporary ethical systems
Beginning discussion of Symphonology
CLASSROOM ACTIVITIES
Activity 1: Self-Awareness and the Meaning of Being Human
Have students do the following:
• Discuss what they know about themselves that can guide their interaction with others.
• Conduct a thought experiment about characteristics of humanness and relate it to what they
know about themselves.
Copyright © Springer Publishing Company, LLC. All Rights Reserved. 1
,2 Bioethical Decision Making in Nursing
• Imagine that you know nothing about yourself or of what it means to be human; you have
been beamed in from outer space where there are no rational life-forms. Discuss how you
could care for others without any knowledge of what it means to be human. Could you?
Activity 2: Regarding the Movie Castaway (if not everyone has seen it, a very brief description
can be given)
• Did the main character need ethics? Why or why not.
Activity 3: Journaling
• Have students discuss or write in a journal the injustices that they see in health care.
• Take one of the injustices and have them examine how they could begin to make a change.
TEST BANK QUESTIONS FOR CHAPTER 1
1. The purpose of ethics is: (Select all that apply)
A. Acting on one’s beliefs
B. Making judgments of benefit versus harm*
C. Creating ethical situations
D. Dealing with alternatives*
2. The paradox of the hammer relates to: (Select all that apply)
A. The value of similarities with other humans*
B. Knowing yourself first through others*
C. The value of learning through experience*
D. The understanding of self*
3. If alone on a desert island, ethical decision making is:
A. Necessary
B. Possible
C. Possible but not necessary
D. Possible and necessary*
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
, 1: Ethical Foundations 3
4. Symphonology is the study of:
A. Interactions among similar people
B. Agreements*
C. Ethical decisions and actions
D. Systems of ethics
5. Symphonology holds that certain things matter such as: (Select all that apply)
A. Character*
B. Bringing about the greatest good for the greatest number
C. Intention*
D. Virtue*
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
, CHAPTER 2
The Ethical Journey
CHAPTER SUMMARY
The beginning of the foundation of Symphonology is explored. Individual rights is defined and
discussed as the foundation for ethical interaction. The first humorous vignette uses an example
of cavemen to “drive home” the importance of individual rights and the disastrous effects of aggression.
The importance of purpose and justifiability to the resolution of dilemmas is comprehensively
discussed. Essential for success in developing ethical practice is the need to recognize the nature
of human beings, the need to identify the nature, demands, and purpose of the health care
setting, and the need to recognize the authority that guides and justifies ethical actions. These
form the essential parts of the chapter.
MAJOR FOCUS AREAS
Flawed ethical decisions versus unflawed decisions
The role of justification and purpose in bioethical decision making
The role of nurse and patient
Ethical individualism and the law
The importance of individual rights and rights as a singular term
The ethical approach between the nurse and the patient
Trust and obligation
The skills needed to make the journey to objective, justifiable, and appropriate
ethical decisions
CLASSROOM ACTIVITIES
Activity 1: The Caveman (First Humorous Vignette) and Individual Rights
Have students review the caveman scenario and then discuss the following:
• If there was no such thing as individual rights, what would the world be like?
• What is the importance of individual rights on the enhancement of life—yours and the
patient’s life?
• Why is it necessary for rights to be a singular term?
• What happens if rights were considered a plural term?
• What is the most important lesson to be learned from this humorous vignette?
4 Copyright © Springer Publishing Company, LLC. All Rights Reserved.
, 2: The Ethical Journey 5
Activity 2: The Nurse as the Agent of a Patient and the Nurse as His or Her Own Agent
Have students discuss the following:
• What it means to be an agent for someone else.
• What it means to be one’s own agent.
• What it means to lose the ability to act for self and to be under another’s control.
• How can a nurse act to increase a patient’s agency?
Activity 3: Learning Through Movies or TV
Have students watch a DVD, such as Nursing Diaries: The Rookies, or an old TV show like
M*A*S*H* or ER and reflect on the following:
• What loss of agency is the patient experiencing?
• How is the health care professional shown as the agent of the patient?
• What ethical decisions are being made and are they flawed or unflawed decisions?
• Describe where you see the nurse or health care provider making objective, justifiable, and
appropriate ethical decisions as the patient’s agent.
TEST BANK QUESTIONS FOR CHAPTER 2
1. A flawed ethical decision is one that: (Select all that apply)
A. Does not allow one to change direction.*
B. Will enable a nurse to justify the decision.
C. Will affect a person’s life—one’s vital and fundamental goals.
D. Is nothing more than theorizing.*
2. To justify an ethical decision means that one is able to:
A. Have purposeful foresight.*
B. Devote effort in the resolution of a dilemma.
C. Explain it in terms of policies.
D. Explain it on the perceptual and concrete level.
3. The patient as the final authority in his own care means that the patient: (Select all
that apply)
A. Is the one who has the right to determine the decisions for himself.*
B. Can demand anything from the nurse.
C. Is able to refuse care even if the care is beneficial to his health.*
D. Can behave in an aggressive way toward others.
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
,6 Bioethical Decision Making in Nursing
4. The lesson(s) to be learned from the caveman parable is: (Select all that apply)
A. The value of social justice rights.
B. The value of individual rights.*
C. The value of an interpersonal agreement.*
D. The disvalue of aggression.*
5. Rights is:
A. Whatever the law allows.
B. The implicit agreement behind every explicit agreement.*
C. Normal behaviors established by society.
D. A corollary of duty.
6. The value of rights as discussed in this chapter: (Select all that apply)
A. Is an ethical fact that is always honored.
B. Helps prevent disputes.*
C. Helps determine what actions are justifiable actions.*
D. Eliminates the need for constant discussion.*
7. The main reason why the patient is the central focus in bioethical decision making is:
A. The patient is the one receiving the care.
B. The patient believes this.
C. Without patients there would be no health care system.
D. It is basic to the agreement.*
8. Primarily, a patient is vulnerable because:
A. The patient has suffered a decrease in his or her agency.*
B. The patient is unable to communicate his or her wishes.
C. The patient has an illness or a disability.
D. The patient’s life is at risk.
9. Reflect on the discussion in the book about Jane and Nancy. Ethically, Jane does not have to
jump in the water to save Nancy, who is drowning, if she cannot swim because:
A. This would be foolhardy.
B. A rational ethics system could not demand the sacrifice of one’s own life.*
C. There would be no chance of either surviving.
D. Nancy would not want to put Jane’s life at risk.
10. Being an agent for one’s patient means:
A. Acting in place of the patient.
B. Acting as directed by the family when the person cannot make decisions.
C. Acting as the patient would if he could.*
D. Acting as a surrogate decision maker.
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
, CHAPTER 3
The Nurse–Patient Agreement
CHAPTER SUMMARY
The nature of the agreement and the ethical relationship between professional and patient
is further explored. This relationship is based on the recognition of individual rights and is
carried out in accordance with the purpose of the health care environment. The professional–
patient agreement is made possible by individual rights and is structured by the implicit
understanding that guides a nurse and patient’s interaction. Coercion and deception are ruled
out of the nurse–patient interaction since they serve to undermine the proper interaction. The
importance of communication in the nurse–patient agreement is explicated through the second humorous
vignette where two inhabitants of a jungle village are arguing over who has the right to the possession
of the coconut. The role of sameness and probability is examined as to its role in making ethical
decisions for individuals. The nature of the nurse’s agreement with herself is shown to be rooted
in rational self-interest. A patient in need of a nurse needs a rational agent—one who is aware
of the nature of individual rights and interactions, and one who is dedicated to her decision to
become a nurse. A nurse who is indifferent to herself has no reason not to be indifferent to her
patients. Readers are encouraged to examine rights and the agreement as fundamental to their
role as agents of patients. It is important for them to delve into their character structure and
relationships with their patients. The chapter ends with a discussion of the nature of the nurse’s
agreement with herself and how it is rooted in rational self-interest.
MAJOR FOCUS AREAS
The nurse–patient agreement
What is it?
How is it formed?
The importance of the family
Codes of ethics
Difference between implicit and explicit agreements
The reciprocal relationship and the common understandings of nurse and patient
The role of benevolence
The role of communication in forming the agreement
Probability and the use of sameness when caring for a patient who cannot communicate
The agreement with oneself
Rational self-interest
Copyright © Springer Publishing Company, LLC. All Rights Reserved. 7
, 8 Bioethical Decision Making in Nursing
CLASSROOM ACTIVITIES
Activity 1: The Coconut Parable (The Second Humorous Vignette)
Have students reread the story of the coconut and discuss:
• How did unexamined assumptions fail the villagers?
• How would the disagreement among the villagers change if the villagers had communicated?
• What are the lessons learned for health care?
Activity 2: Role Play
• If time permits, have students create a situation or use a real situation in which communica-
tion and unfounded assumptions are preventing the agreement from being realized.
• Have a group of students role play the situation by making unfounded assumptions and fail-
ing to adequately communicate. Then have the rest of the class critique and make suggestions
about how to correctly communicate with all of the parties in the scenario. Or, in lieu of role
play, have students think about communication and false assumptions in their clinical prac-
tice and reflect on this, for example, in a journal or portfolio.
Activity 3: Agreement With Self
• Either for class discussion or as a short assignment, have students examine why they need to
have an agreement with themselves before any meaningful agreement can be made with any
other person.
• What does the agreement obligate the nurse to do and what does it forbid?
Activity 4: The Star Thrower, Loren Eiseley
• Ask students to discuss the Star Thrower in regards to its relevance to the nurse–patient
agreement. (If the link does not work, just go to YouTube and search the title.)
• www.youtube.com/watch?v=-qClChUdlfI
Other Classroom or Online Discussion Questions:
• What would happen if there was not an implicit agreement that permits interaction and care?
• What is the importance of communication for ethical interaction?
• How does the patient gain when a nurse is inspired by rational self-interest?
Copyright © Springer Publishing Company, LLC. All Rights Reserved.
