Chapter 11: Ethics Applied to Nursing: Personal vs. Professional Ethics My Nursing Test Banks

Chapter 11: Ethics Applied to Nursing: Personal vs. Professional Ethics

Test Bank

MULTIPLE CHOICE

1. The nurse states, I like being part of the health care team caring for the traditional two-parent family during the postpartum period as they bond with their newborn. This statement reveals the nurses

a.

values.

b.

duty.

c.

fidelity.

d.

ethics.

ANS: A

Values involve the worth assigned to an idea or action. In this statement the nurse reveals that she values the traditional two-parent family. The statement does not clearly address any of the other options.

DIF: Cognitive Level: Application REF: p. 119 OBJ: 2

TOP: Values KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

2. A student nurse asks, Whats the difference between laws and ethics? Which response best explains the difference between nursing laws and ethics?

a.

Ethics refer to expected behavior of nurses, but laws require mandatory observance by nurses.

b.

Nursing ethics are formalized by statutes, whereas laws are permissive codes.

c.

Ethics are derived from laws, whereas laws are enacted by non-nurse legislators.

d.

Ethics are specific to individual agencies, but laws are state specific.

ANS: A

Ethics refers to behaviors nurses ought to observe. Laws refers to statutes that must be observed. None of the other options state this.

DIF: Cognitive Level: Application REF: pp. 118-119 OBJ: 12

TOP: Ethical vs. legal aspects of practice KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

3. The nurse providing care for patients or residents must act on the knowledge that a basic right of a patient or a resident is to receive

a.

considerate and respectful care from all care providers.

b.

information about the diagnosis and prognosis from the practical nurse.

c.

the medical care of their choice, regardless of their ability to pay.

d.

any food requested and in as large a quantity as desired.

ANS: A

The individual rights of patients are an important ethical theme in health care. It is imperative that nurses separate personal ethics from nursing ethics and provide appropriate care to patients regardless of whether the nurse likes or dislikes the patient and regardless of the nurses values relating to the patients lifestyle, ethnicity, or other factors. Receiving information about the diagnosis and prognosis is not considered a right that is met by the LPN/LVN. The remaining options are not rights.

DIF: Cognitive Level: Knowledge REF: p. 121 OBJ: 3

TOP: Individual rights KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment

4. A major change in medical ethics that affected nursing occurred when the Western secular belief system shifted emphasis from duties to

a.

individual autonomy and rights.

b.

satisfying Medicare regulations.

c.

the cost-effectiveness of care.

d.

nonmaleficence.

ANS: A

Freedom of choice (autonomy) and the ability to assert ones individual rights have become the major operative beliefs of the Western secular belief system affecting medical ethics today. These beliefs, in turn, affect the way nurses interact with patients. Satisfying Medicare regulations and the cost-effectiveness of care are not aspects of the Western secular belief system. The remaining option is an ethical principle that has always been important in medical ethics.

DIF: Cognitive Level: Comprehension REF: p. 121 OBJ: 3

TOP: Impact of Western secular belief system KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

5. The patient asks the nurse, I overheard the instructor talking to a student about accountability. What does the word accountability really mean? The best response by the nurse would be

a.

It is a transfer of responsibility for wrong actions.

b.

It is shared responsibility with the physician for wrongdoing.

c.

It is taking personal responsibility for ones nursing actions.

d.

It is giving up responsibility when the situation dictates.

ANS: C

Accountability means that one is personally answerable for specific actions. The other options do not accurately explain accountability.

DIF: Cognitive Level: Application REF: p. 122 OBJ: 5

TOP: Accountability KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

6. When a student nurse prepares diligently for a clinical assignment, the ethical principle being observed is

a.

autonomy.

b.

justice.

c.

nonmaleficence.

d.

fear of punishment.

ANS: C

Being prepared to provide skillful nursing care, anticipating problems that may occur, and thinking through alternative solutions qualifies as observing the principle of doing no harm. Autonomy and justice are not principles that apply. Fear of punishment is not an ethical principle.

DIF: Cognitive Level: Comprehension REF: pp. 122-123 OBJ: 6

TOP: Nonmaleficence KEY: Nursing Process Step: N/A

MSC: NCLEX: Safe, Effective Care Environment

7. Encouraging a patient to be involved in planning and carrying out his or her own care is a nursing action that supports the ethical principle of

a.

confidentiality.

b.

privacy.

c.

autonomy.

d.

justice.

ANS: C

Autonomy means being free to choose. Possible patient choices include identifying goals and care measures compatible with ones culture, religion, and personal values.

DIF: Cognitive Level: Application REF: p. 121 OBJ: 8

TOP: Autonomy KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

8. Leaving an unconscious patient exposed during a treatment or procedure is a violation of the ethical principle of

a.

fidelity.

b.

autonomy.

c.

justice.

d.

veracity.

ANS: B

Autonomy includes the patients right to privacy. It is assumed that an autonomous patient would reject unnecessary exposure of the body.

DIF: Cognitive Level: Comprehension REF: p. 124 OBJ: 8

TOP: Autonomy KEY: Nursing Process Step: N/A

MSC: NCLEX: Safe, Effective Care Environment

9. When a treatment team decides to go to court to obtain permission to provide chemotherapy for a child whose parents refuse to give consent for the treatment based on religious grounds, the ethical principles that are in conflict are

a.

fidelity and justice.

b.

beneficence and autonomy.

c.

justice and beneficence.

d.

autonomy and fidelity.

ANS: B

The parents autonomy to make decisions for their child is in conflict with the beneficence of the health care team. The other principles are not relevant to the scenario.

DIF: Cognitive Level: Application REF: pp. 123-124 OBJ: 8

TOP: Role of religion in ethical decisions KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

10. A way of practicing fidelity to a patient would be to

a.

discuss the patient with friends at a social gathering.

b.

document the patients expression of feelings and wishes.

c.

categorize the patient as a down-and-out alcoholic.

d.

develop the care plan without patient input.

ANS: B

The nurse who documents the patients expression of feelings or wishes without subjective interpretation is demonstrating fidelity (being true) to the patient. The other options demonstrate lack of fidelity.

DIF: Cognitive Level: Application REF: p. 125 OBJ: 9

TOP: Fidelity KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment

11. To provide justice to patients on the unit, the nurse must

a.

treat all patients with the same diagnosis utilizing the same plan of care.

b.

treat all patients with equal dignity and respect.

c.

base care on the patients culture, religion, and social status.

d.

determine who is most deserving of extra care.

ANS: B

Being fair does not mean giving every patient the same thing. It means treating them the same; that is, with dignity and respect. Basing care on a patients culture, religion, and social status and determining who is most deserving of extra care would result in care that is provided based on subjective criteria.

DIF: Cognitive Level: Application REF: p. 125 OBJ: 10

TOP: Justice KEY: Nursing Process Step: Implementation

MSC: NCLEX: N/A

12. The patient asks the nurse what he should do about continuing cancer treatment. The nurse responds, You should stop before you get so weak you cant enjoy a few good weeks with your family. This is an example of

a.

fidelity.

b.

beneficence.

c.

nonmaleficence.

d.

beneficent paternalism.

ANS: D

This response assumes the nurse knows what is right for the patient and robs the patient of decision making. It discounts the patients knowledge of self. The scenario does not describe the other ethical principles listed as options.

DIF: Cognitive Level: Application REF: p. 126 OBJ: 11

TOP: Beneficent paternalism KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

13. What ethical principle underlies the statement in the National Federation of Licensed Practical Nurses (NFLPN) Code for Licensed Practical/Vocational Nurses, The practical nurse provides health care to all patients regardless of race, creed, cultural background, disease, or lifestyle?

a.

Autonomy

b.

Confidentiality

c.

Beneficence

d.

Justice

ANS: D

Justice means treating all patients fairly according to their needs; that is, with dignity and respect. The other principles listed in the options do not fit the scenario.

DIF: Cognitive Level: Comprehension REF: p. 125 OBJ: 10

TOP: Justice KEY: Nursing Process Step: N/A

MSC: NCLEX: Safe, Effective Care Environment

14. A nurse injects himself or herself with a narcotic prescribed for a patient. This is an example of

a.

unethical and illegal behavior.

b.

ethical and legal behavior.

c.

unethical but legal behavior.

d.

ethical but illegal behavior.

ANS: A

It is unethical because the nurse has the ethical obligation to place the patients needs above his or her own. It is illegal to use a narcotic prescribed for another person.

DIF: Cognitive Level: Application REF: pp. 119-121 OBJ: 12

TOP: Ethical vs. legal KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

15. A student nurse is assigned to care for a patient with complex nursing care needs. The student was busy and did not prepare in advance for the assignment. In preconference, the student is unable to describe the care to be given and admits not knowing how to execute one of the treatments. The instructor would be ethically justified in

a.

telling the student to be very careful during caregiving.

b.

sending the student home and turning the patients care over to staff.

c.

suspending the student.

d.

dismissing the student from the program.

ANS: B

Nonmaleficence is the operative ethical principle. The student is ethically obligated to provide safe care to assigned patients. The instructor is also obligated to do no harm. Sending the student home and turning the patients care over to staff is a safe alternative to allowing the student to care for the patient. Suspending or dismissing the student from the program does not permit the student to have due process.

DIF: Cognitive Level: Analysis REF: p. 122 OBJ: 6

TOP: Nonmaleficence KEY: Nursing Process Step: N/A

MSC: NCLEX: Safe, Effective Care Environment

16. Which situation can be identified as abandonment of patients by the nurse?

a.

Calling in sick

b.

Floating to a unit after a 2-day orientation to the unit

c.

Starting to care for patients on wing A and being reassigned to wing B

d.

Going off duty without giving report rather than care for patients on an unfamiliar unit

ANS: D

The nurse cannot leave a unit unless able to turn the care of patients over to a qualified nurse.

DIF: Cognitive Level: Analysis REF: p. 124 OBJ: 6

TOP: Abandonment KEY: Nursing Process Step: N/A

MSC: NCLEX: Safe, Effective Care Environment

COMPLETION

1. A system of standards or moral principles that direct actions as being right or wrong is called ____________________.

ANS:

ethics

Ethics is a system of standards or moral principles that direct actions as being right or wrong. Ethics is concerned with the meaning of words such as right, wrong, good, bad, ought, and duty.

DIF: Cognitive Level: Knowledge REF: pp. 119-121 OBJ: 2

TOP: Ethics KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

MULTIPLE RESPONSE

1. The nurse is asked to explain the meaning of ethics to a patient. The nurse should correctly state, Ethics is a system of standards that refer to ideas and actions in terms of being (select all that apply):

a.

right and wrong.

b.

moral and immoral.

c.

legal and illegal.

d.

good and bad.

e.

ought and ought not.

f.

like and dislike.

g.

rights and duties.

ANS: A, B, D, E, G

Ethics is concerned with all of the options except legal and illegal and like and dislike. Ethics and legalities are not the entirely the same, although some ethical principles may be enacted into law. Like and dislike refer to values.

DIF: Cognitive Level: Application REF: pp. 119-121 OBJ: 2

TOP: Ethics KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

2. The introduction of the nursing process and critical thinking into nursing practice has resulted in increased ethical and legal responsibilities for nurses in the areas of (select all that apply):

a.

peer reporting.

b.

accountability.

c.

personal ethics.

d.

patient advocacy.

e.

cost containment.

ANS: A, B, D

Peer monitoring and reporting are essential to patient safety and professional integrity. Accountability means being held accountable for all nursing actions performed. Because the scope of practice has expanded, nursing accountability is greater. Patient advocacy requires the nurse to provide more information to patients. Personal ethics and cost containment are not included as areas of increased ethical and legal responsibility.

DIF: Cognitive Level: Comprehension REF: p. 122 OBJ: 5

TOP: Ethical responsibilities of nurses KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment

3. What actions should be taken by the nurse to increase the possibility of doing no harm while caring for a patient? (Select all that apply.)

a.

Never participate in any action that will deliberately harm the patient.

b.

Question how to do the least amount of harm when doing something that is expected to result in good.

c.

Make sure the patient has agreed to the procedure verbally or in writing.

d.

Perform new procedures without seeking supervision.

e.

Become aware of side effects of commonly administered medications.

ANS: A, B, C, E

Each of these measures, except option D, would increase the potential for nonmaleficence in practice. Performing new procedures without seeking supervision has an increased potential for doing harm.

DIF: Cognitive Level: Comprehension REF: pp. 122-123 OBJ: 6

TOP: Nonmaleficence KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment

4. Which nursing actions are examples of use of the ethical principle of beneficence? (Select all that apply)

a.

The LPN/LVN tells a patient to ask for a second doctors opinion.

b.

The LPN/LVN provides emotional support when the patient cries.

c.

The LPN/LVN places the bed in a low position before leaving the room.

d.

The LPN/LVN places medication the patient brought from home at the nurses station.

e.

The LPN/LVN provides report for the staff of the oncoming shift.

ANS: B, C, D

Beneficence means to do good. It also involves preventing harm, removing harm, and putting the patients interests first.

DIF: Cognitive Level: Application REF: pp. 123-124 OBJ: 7

TOP: Beneficence KEY: Nursing Process Step: Implementation

MSC: NCLEX: Safe, Effective Care Environment

5. Which statements would the nurse evaluate as suggesting that the patients decision has not been autonomous? (Select all that apply.)

a.

I wish I knew for sure that I had all the facts about the treatment.

b.

I thought through all the alternatives.

c.

My son told me emphatically what he thought would be best for the family.

d.

I am going to refuse to take the treatment because it will prolong life.

ANS: A, C

Autonomy means being free to choose. The statement, I wish I knew for sure that I had all the facts about the treatment, suggests that the patient may not have had all the relevant facts. The statement, My son told me emphatically what he thought would be best for the family, suggests undue influence from the family. Thinking through all the facts is part of autonomous decision making, as is acting on ones personal decision.

DIF: Cognitive Level: Analysis REF: p. 124 OBJ: 8

TOP: Autonomy KEY: Nursing Process Step: Assessment (Data Collection)

MSC: NCLEX: Physiological Integrity

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