Chapter 5: Ethics: Basic Concepts for Nursing Practice My Nursing Test Banks

Chapter 5: Ethics: Basic Concepts for Nursing Practice

Test Bank

MULTIPLE CHOICE

1. Which of the following situations is an example of moral distress?

a.

You hear nurses in the lounge making off-color jokes about a patient. You are afraid to speak up for fear of retaliation.

b.

You have been late for work a couple of times in the last 2 weeks, and your co-workers are covering for you.

c.

You become romantically involved with a co-worker, which is against the unit policy, so you resign your position.

d.

You purposefully use vague language when explaining a patients condition to the family. Staff expects that the patient may be brain-dead, but test results are not yet conclusive.

ANS: A

Feedback

A

The definition of moral distress is distress that results from participating in a perceived moral wrongdoing due to situational constraints despite attempting to make a moral choice.

B

There is no breach of ethics in being late and having co-workers cover for you.

C

The person acts appropriately to the moral issue by resigning the position.

D

The person is acting appropriately under current circumstances.

DIF: Cognitive Level: Analysis REF: p. 91

2. According to Kohlbergs theory of moral development, adolescents who shoplift are operating in which level of moral development?

a.

Preconventional

b.

Conventional

c.

Postconventional

d.

Developmental

ANS: A

Feedback

A

In Kohlbergs preconventional level of moral development, the individual is inattentive to the norms of society and is self-centered.

B

In the conventional level, moral decisions conform to the norms of society.

C

In the postconventional level, the individual has a highly developed moral value system independent of group norms.

D

Developmental is not a level of moral development identified by Kohlberg.

DIF: Cognitive Level: Comprehension REF: p. 93

3. According to Kohlbergs theory of moral development, individuals who act because it is the rule of society are operating in which level of moral development?

a.

Preconventional

b.

Conventional

c.

Postconventional

d.

Developmental

ANS: B

Feedback

A

In Kohlbergs preconventional level of moral development, the individual is inattentive to the norms of society and is self-centered.

B

In the conventional level, moral decisions conform to the norms of society.

C

In the postconventional level, the individual has a highly developed moral value system independent of group norms.

D

Developmental is not a level of moral development identified by Kohlberg.

DIF: Cognitive Level: Comprehension REF: p. 93

4. Flight 93, hijacked on September 11, 2001, crashed into the Pennsylvania countryside because some of the passengers decided to try to take control of the plane and prevent it from being used as a weapon of mass destruction against structures in Washington, D.C. They decided to act despite grave danger to themselves. This is an example of which level of Kohlbergs theory of moral development?

a.

Preconventional

b.

Conventional

c.

Postconventional

d.

Conventional phase 4

ANS: C

Feedback

A

In the preconventional level, the persons self-interest takes precedence over group norms.

B

In the conventional level, the person conforms to group norms.

C

People in the postconventional level of moral development may ignore self-interest and group norms when making decisions and may sacrifice themselves for the group.

D

Phase 4 of the conventional level follows group and cultural norms.

DIF: Cognitive Level: Analysis REF: p. 93

5. According to Kohlbergs theory, which of the following is true of moral development?

a.

Participating in decision making promotes moral reasoning.

b.

Intellectual development has no effect on moral development.

c.

Participating in debates on ethical issues decreases moral development.

d.

Holding people responsible for their actions does not improve moral development.

ANS: A

Feedback

A

Kohlberg thought that certain conditions promote moral development, such as participating in decision making.

B

Kohlberg thought that intellectual development was necessary for advanced moral development.

C

Participating in debates on ethical issues does enhance moral development.

D

Taking responsibility for actions promotes moral development.

DIF: Cognitive Level: Comprehension REF: p. 93

6. Gilligans theory on moral development differed from Kohlbergs theory because Gilligan considered which population not addressed by Kohlberg?

a.

Children

b.

Men

c.

Women

d.

Adolescents

ANS: C

Feedback

A

Kohlberg mostly tested his theory in men and boys.

B

Men were the focus of Kohlbergs theory.

C

Gilligan thought that Kohlbergs theory did not recognize the experience of women in moral development.

D

Gilligans theory did not focus on adolescents.

DIF: Cognitive Level: Knowledge REF: p. 93

7. Which of the following ethical theories is illustrated by the example of following the Golden Rule, Do unto others as you wish them to do unto you?

a.

Deontology

b.

Principalism

c.

Utilitarianism

d.

Virtue ethics

ANS: A

Feedback

A

Deontology states that an act is moral if it originates from good will.

B

Principalism is the use of ethical principles in decision making.

C

Decisions are made based on what will do the greatest good for the greatest number of people. A main tenet of utilitarian ethics is that right or useful actions bring about the greatest good for the greatest number of people.

D

Virtue ethics refers to character traits of the decision maker, such as honesty, courage, kindness, and integrity.

DIF: Cognitive Level: Application REF: p. 95

8. Which of the following ethical theories is illustrated by the example of triage in disaster nursing?

a.

Deontology

b.

Principalism

c.

Utilitarianism

d.

Virtue ethics

ANS: C

Feedback

A

Deontology states that an act is moral if it originates from good will.

B

Principalism is the use of ethical principles in decision making.

C

Triage in disasters requires decisions to be made on how to do the greatest good for the greatest number of people. A main tenet of utilitarian ethics is that right or useful actions bring about the greatest good for the greatest number of people.

D

Virtue ethics refers to character traits of the decision maker, such as honesty, courage, kindness, and integrity.

DIF: Cognitive Level: Application REF: p. 95

9. Respecting the right of a patient with terminal cancer to refuse chemotherapy is based on a belief in the ethical principle of

a.

justice.

b.

autonomy.

c.

nonmaleficence.

d.

death with dignity.

ANS: B

Feedback

A

Justice refers to the equality of the allocation of services.

B

Autonomy is based on the principle that patients have the right to determine their own course of action.

C

Nonmaleficence refers to the responsibility to do no harm.

D

Death with dignity is not an ethical principle.

DIF: Cognitive Level: Application REF: p. 97

10. Respecting an elderly womans decision to stay in her own home is based on a belief in the ethical principle of

a.

justice.

b.

autonomy.

c.

nonmaleficence.

d.

death with dignity.

ANS: B

Feedback

A

Justice refers to the equality of the allocation of services.

B

Autonomy is based on the principle that patients have the right to determine their own course of action.

C

Nonmaleficence refers to the responsibility to do no harm.

D

Death with dignity is not an ethical principle.

DIF: Cognitive Level: Application REF: p. 97

11. A school nurse teaching school-aged children about water safety is an example of which ethical principle?

a.

Beneficence

b.

Justice

c.

Veracity

d.

Autonomy

ANS: A

Feedback

A

Beneficence can be seen as the doing of good.

B

Justice refers to the equal treatment of all.

C

Veracity is truth telling.

D

Autonomy refers to an individuals right to make his or her own decisions.

DIF: Cognitive Level: Application REF: p. 97

12. A nurse who advocates for a longer stay when a medically indigent patient is being prematurely discharged to reduce hospital cost is relying on which ethical principle?

a.

Justice

b.

Beneficence

c.

Autonomy

d.

Fidelity

ANS: A

Feedback

A

Justice refers to the equal and fair allocation of services based on need. According to this principle, the patient should receive the same care as others in the same condition, regardless of ability to pay.

B

Beneficence simply refers to doing good.

C

Autonomy asserts that individuals have the right to make their own decisions.

D

Fidelity is an incomplete answer, because fidelity refers to faithfulness or honoring ones promises to patients.

DIF: Cognitive Level: Application REF: p. 98

13. The current emphasis on eliminating racially based health disparities is based on which of the following ethical principles?

a.

Double effect

b.

Fidelity

c.

Justice

d.

Veracity

ANS: C

Feedback

A

Double effect is the concept that justifies inflicting harm if the intent is to produce an overall good effect.

B

Fidelity refers to honoring ones promises to patients.

C

The principle of justice states that equals should be treated the same.

D

Veracity is telling the truth.

DIF: Cognitive Level: Application REF: p. 98

14. A nurse is turning a bedfast patient to prevent pressure ulcers. The patient complains that the process is painful. The nurse explains the reason for the turning schedule and completes the task. This is an example of the ethical principle of

a.

autonomy.

b.

fidelity.

c.

nonmaleficence.

d.

veracity.

ANS: C

Feedback

A

Autonomy has to do with individuals being able to make their own decisions.

B

Fidelity refers to honoring ones commitments and promises.

C

Nonmaleficence is defined as the duty to do no harm. Although temporarily painful, not turning the patient would cause actual harm (physical damage), and so this nurse is acting on the principle of nonmaleficence.

D

Veracity refers to being truthful.

DIF: Cognitive Level: Application REF: pp. 97-98

15. A patient who is terminally ill is experiencing great pain. To relieve the patients suffering, the nurse needs to administer larger doses of morphine. This relieves the pain but also inhibits respiration. Which principle justifies the risk of harm?

a.

Justice

b.

Fidelity

c.

Veracity

d.

Double effect

ANS: D

Feedback

A

Justice relates to equal treatment of all.

B

Fidelity is faithfulness to ones commitments.

C

Veracity is being truthful.

D

The principle of double effect addresses actions that may result in a negative effect if the end result is good. The end point justifies the risk of harm.

DIF: Cognitive Level: Application REF: pp. 97-98

16. Taking a pediatric patient to the playroom on a promised time and day is based on the belief in the ethical principle of

a.

autonomy.

b.

fidelity.

c.

justice.

d.

veracity.

ANS: B

Feedback

A

Autonomy relates to the right of individuals to make their own decisions.

B

Fidelity is being faithful to commitments made to others.

C

Justice refers to the equal treatment of all.

D

Veracity is being truthful.

DIF: Cognitive Level: Application REF: p. 99

17. When nurses receive a patient assignment and accept reports on these patients, they are committed to providing care to those assigned to them. This is based on the ethical principle of

a.

beneficence.

b.

fidelity.

c.

justice.

d.

veracity.

ANS: B

Feedback

A

Beneficence speaks to doing good.

B

Fidelity is being faithful or keeping commitments made to others. In accepting the assignment, the nurse has committed to caring for the patients assigned to her or him.

C

Justice is related to the equal treatment of all.

D

Veracity refers to ones truthfulness.

DIF: Cognitive Level: Application REF: pp. 98-99

18. Answering a terminally ill childs questions about his or her condition honestly is based on a belief in the ethical principle of

a.

autonomy.

b.

fidelity.

c.

justice.

d.

veracity.

ANS: D

Feedback

A

Autonomy relates to the right of an individual to make his or her own decisions.

B

Fidelity refers to being faithful to ones commitments.

C

Justice refers to the equal treatment of all.

D

Veracity is defined as telling the truth. Truthfulness is fundamental in the development and maintenance of trust in a relationship.

DIF: Cognitive Level: Application REF: p. 99

19. A father of four is admitted after an automobile accident in which two of the children were killed. Recognizing that he is in very serious condition, the nurse believes that it would be appropriate to avoid telling him about the death of his children unless he asks directly. This could be considered a violation of the ethical principle of

a.

beneficence.

b.

fidelity.

c.

justice.

d.

veracity.

ANS: D

Feedback

A

Beneficence is the expectation of doing good.

B

Fidelity refers to keeping commitments and promises.

C

Justice is the treatment of all equally.

D

Veracity is truth telling. The nurse is not lying but is not forthcoming with the information about the children.

DIF: Cognitive Level: Application REF: p. 99

20. Which of the following is the best description of a code of ethics?

a.

A document that describes the correct course of action and does not change regardless of societal changes

b.

A document that all professions must have even if not representative of practice

c.

A document that permits others to know what principles guide professional decision making

d.

A document widely open to interpretation by professionals in various settings

ANS: C

Feedback

A

Codes of ethics have been revised through the years to reflect changes in society.

B

Codes are useful only if upheld by members of the profession in their daily practice.

C

The Code of Ethics of nursing is an implied contract through which the profession informs society of the principles and rules by which it functions.

D

The Code of Ethics should be interpreted in a similar way regardless of practice setting.

DIF: Cognitive Level: Comprehension REF: p. 100

21. A nurse is involved in an ethically challenging case. To use an ethical decision-making model, which step should the nurse perform first?

a.

Gather and examine all possible solutions.

b.

Identify the ethical dilemma in the case.

c.

Identify all parties who will be impacted by the decision.

d.

Gather all information important to the situation

ANS: B

Feedback

A

The first step in many ethical decision-making models is to identify the ethical dilemma. Examining all possible solutions comes after this step and gathering information.

B

The first step in many ethical decision-making models is to identify the ethical dilemma.

C

The first step in many ethical decision-making models is to identify the ethical dilemma. Identifying parties affected is not a specific step but is part of identifying the dilemma.

D

The first step in many ethical decision-making models is to identify the ethical dilemma. The next step would be to gather all data related to the situation.

DIF: Cognitive Level: Comprehension REF: p. 102

MULTIPLE RESPONSE

1. Which of the following are activities in the ethical decision making process? (Select all that apply.)

a.

Avoid looking at legal cases or precedents related to the situation.

b.

Determine if the people who are affected by the dilemma have value conflicts.

c.

Brainstorm with others involved to identify all possible solutions.

d.

Evaluate the action taken to determine whether it accomplished its purpose.

e.

Discuss only acceptable solutions that are practical to implement.

ANS: B, C, D

Feedback

Correct

Determining who is affected by the dilemma and identifying possible value conflicts among them, identifying all possible solutions, and evaluating the action taken to determine whether it accomplished its purpose clarify the situation and determine whether the selected action achieved its goal.

Incorrect

A variety of materials including legal documents may help clarify the situation or help identify possible actions. Ethical decision making is not done in isolation. It may involve others but especially must involve the patient and family. All possible solutions should be considered even if they are unusual, complex, or may be difficult to implement.

DIF: Cognitive Level: Comprehension REF: p. 102

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