Question 1

As Julia was handing off to Steven during shift change, she mentioned that the family of Mrs. R. in room 240 has called at least eight times in the last 5 hours to ask how she was doing. Steven responded, "If they're so concerned, why haven't any of them come to visit?" Julia rolled her eyes and said, "Oh, if I only had a magic wand that could make people want to be like they should, rather than do what they feel like they have to, or ought to do." Julia's wish is an example of which ethical theory?

A) Christian
B) Renaissance
C) Virtue
D) Deontology

Virtue

Accepted Answer

A.Incorrect. Christian ethics uses the golden rule as its central guide to ethical conduct.
B.Incorrect. Renaissance ethics does not apply to the scenario provided.
C.Correct. The virtue ethic theory encompasses the nature of how one should be in the world rather than what one ought to do.
D.Incorrect. Respect for persons and the idea that moral rules are absolute regardless of one's wants or desires is the foundation of Deontology (Kantian ethics).

Question 2

An inner-city state-funded hospital was slated for closure at the end of the year. Despite the closure, Denita was determined to provide high-quality care until the doors were locked for good. While Denita was well intentioned, the reality of decreasing supplies, administrators focused on consolidating patients and resources with other hospitals, not to mention the overall stress of potential job losses made it very difficult to provide the level of care required. When Denita voiced concerns to her supervisor, she was told, "Don't tell me; tell the governor." And she did. Denita called the governor's office to explain her concern about not fulfilling her moral and legal obligation as a professional nurse. Which term specifically addresses Denita's concern?

A) Ethics
B) Beneficence
C) Justice
D) Respect

Beneficence

Accepted Answer

A.Incorrect. Ethics is a much broader term and would not satisfy the question posed.
B.Correct. Beneficence is to do good and requires nurses to act in ways that benefit or are good for patients.
C.Incorrect. Justice is the ethical principal that relates to fair, equitable, and appropriate treatment.
D.Incorrect. Respect does specifically address Denita's concern. Denita is concerned about being able to take care of her patients by acting in ways that are good for and to the benefit of her patients. Respect is not an acceptable answer for the scenario.

Question 3

Bill and Krista discussed the ethical responsibility of insurance companies during their lunch break. A major insurance company that serviced the majority of patients in the area announced that in 3 months they would begin denying claims for nonessential ER visits, requiring that their insured pay out of pocket. Bill's face was beet red as he argued that insurance companies aren't denying the premium checks, but they have the nerve to deny an ER claim. Krista was all for the change, saying, "Look, health care is expensive. If I brought my daughter into the ER every time she sneezed, there wouldn't be any insurance for anyone." She added, "We can't keep paying everyone's bills just because they don't want to take care of themselves and follow the rules." Both Bill and Krista seem to be very clear in their respective values. After reading the scenario, which ethical theory best represents Krista's viewpoint?

A) Divine Command
B) Kantian
C) Utilitarianism
D) Social Contract

Social Contract

Accepted Answer

A.Incorrect. Divine Command theory is based on the Ten Commandments and clearly would not explain Krista's ethical philosophy.
B.Incorrect. According to Kantian Ethics, respect for persons and the idea that moral rules are absolute regardless of one's wants or desires.
C.Incorrect. Utilitarianism believes that actions are right or wrong solely based on their consequences, and the only thing considered when assessing consequence is the amount of happiness or unhappiness that results.
D.Correct. The Social Contract theory proposes that there is a limited altruism to assist people who cannot care for themselves and that because of scarcity, we must work hard for things to survive.

Question 4

____________ deals with principles of moral reasoning and fundamental agreement.&#10;A) Natural ethics&#10;B) Rational ethics&#10;C) Religious ethics&#10;D) Transcultural ethics

Accepted Answer

A.Incorrect. In the theory of natural ethics, the world is considered a rational order with values and purposes built into its very nature and accounts for values and virtues of the good.
B.Correct. Rational ethics deals with principles of moral reasoning followed by a fundamental agreement of what is good, moral, or lawful in society.
C.Incorrect. Religiously oriented ethics deal with virtue, specifically the notion of the good, of faith, hope and love.
D.Incorrect. Transcultural ethics has a dynamic definition, which vastly exceeds the definition in question 6.

Question 5

Nathan's thesis research revealed that federal health-care funding allocation for American citizens currently held as prisoners was substantially larger than federal health-care funding allocation for Native American citizens. As a result of his finding, Nathan not only narrowed his thesis topic to argue for increased federal funding for Native Americans, he also began a vigorous social media campaign to pressure legislators to bring this obvious inequity to the forefront of debate. What approach would you suggest Nathan use to debate this issue?

A) Evidence-based or outcomes-oriented approach
B) Holistic-ethnocentric approach
C) Compromise-caring approach
D) Communitarian communication ethic approach

Accepted Answer

A.Incorrect. Evidence and outcomes are important components of debate; however, they do not satisfy the requirement of the scenario.
B.Incorrect. The intent of the scenario is to encourage and foster discourse (argument) in the hopes of finding common ground.
C.Incorrect. Compromise and caring are the opposite approaches to facilitate argument.
D.Correct. This option is much more attentive to the undercurrents of dissatisfaction and the sense of injustices amongst vulnerable persons or ethnic minorities.

Question 6

Ethics is defined as a code of conduct developed and reinforced in terms of what is good and right in character and behavior. Ethics and morality deal with questions of how people ought to live in society. What rules or norms are suggested with regard to ethics and morals? (Select all that apply.)

A) Tolerance and inclusion
B) Equitable use of resources
C) Dignity for human beings
D) Justice and right action
E) Serving the good

Accepted Answer

A.Incorrect. Tolerance and inclusion are both values.
B.Incorrect. Equitable use of resources suggests that resources are divided equally between individuals or groups.
C.Correct. The terms of what is good and right suggest dignity for human beings (human rights).
D.Correct. Justice and right action in human communities and environments.
E.Correct. Ethics demands serving the good and being responsible for others (ethical demand).

Question 7

According to Boulding, the building of the global civic culture can only be achieved by understanding the historical diversity of values in culture but, at the same time, understanding the things that have united cultures. In the United States, autonomy and self-determination are considered to be the dominant values. What examples can be found that illustrate where mandates in the health-care system may be in direct conflict with autonomy and self-determination? (Select all that apply.)

A) Advance directives
B) Informed consent
C) Billing procedures
D) Health-care providers
E) Treatment risks

Accepted Answer

A.Correct. Familial intervention, change in competency, and physician intervention in cases of futile care may all conflict with autonomy.
B.Correct. Despite being told of the risks, benefits, and alternatives of a procedure, the patient may consent to the treatment yet later find that he or she did not truly understand.
C.Incorrect. Payment for health-care services would not be considered a conflict with autonomy or self-determination.
D.Incorrect. Knowing who the health-care providers are is a patient right, not a value.
E.Incorrect. Treatment risks are part of informed consent; however, treatment risks in and of themselves are not values.

Question 8

In lieu of a final exam in a transcultural ethics in nursing course, the professor assigned groups and asked them to develop a code of ethics for nursing that would apply in every global culture. Which of these assignments is logical? (Select all that apply.)

A) Anna is tasked with demonstrating the universal principle of caring.
B) Joe will investigate how human rights should be recognized.
C) Rico is researching how ethical relativism and universalism can be reconciled.
D) Beth will ensure the principles of transcultural caring are present in the code.
E) Abe is outlining a list of actions or activities that would be considered intolerable.

Accepted Answer

A.Incorrect. While caring is, in fact, a universal principle, it is expressed differently in different cultures.
B.Correct. Due to the integral cultural component to human rights, basic human rights should change due to the pluralistic nature of the world.
C.Correct. A transcultural focused code of ethics could be reconciled if all cultures were able to acknowledge cultural differences.
D.Correct. Cultural differences will most likely be resolved through compassion and fairness, which are hallmarks of transcultural caring.
E.Incorrect. Focus for this assignment needs to remain constant to what unites cultures instead of what separates.

Question 9

A nurse is caring for a 51-year-old patient with kidney disease when it is determined that the patient will need a kidney transplant to prolong life. The patient has let his insurance premiums lapse after being laid off 4 months ago and has no reasonable expectation of having the financial ability to pay for the transplant. Hospital administration has asked that you attend a meeting to discuss whether the hospital will perform the surgery if the financial position of the patient does not change. Which ethical theories and principles will be central to this discussion and decision? (Select all that apply.)

A) Justice and beneficence
B) Biomedical Ethics
C) Transcultural Ethics
D) Social Contract theory
E) Veracity and fidelity

Accepted Answer

A.Correct. Justice describes the ethical principle that relates to fair, equitable, and appropriate treatment, recognizing that giving to some will deny receipt to others who might otherwise have received it.
B.Correct. Some principles of biomedical ethics (beneficence, nonmaleficence, and justice) would be discussed.
C.Incorrect. The immediate purpose of transcultural ethics is to hear and learn from another.
D.Incorrect. It is unlikely the Social Contract theory would dominate the discussion as this theory purports that morality should be understood as something that arises from self-interest or selfishness.
E.Incorrect. Although veracity and fidelity are part of biomedical ethics, individually they do not apply.

Question 10

The parking lot at Mount Sinai Medical Center was filled with TV crew vans and equipment as reporters from all over the area were covering a small plane crash that belonged to an international celebrity. As a high-profile patient was in their care, nurses, physicians, technicians, and even hospital administrators hovered to ensure the highest level of care and attention was given. Meanwhile, the busy ER was full of patients waiting to receive care. The next morning, newspaper and television headlines reported "10-year-old girl dies in ER waiting room of asthma attack while international film star gets all the attention." The hospital responds to the media by issuing a statement asserting that all patients are treated equally. Which aspect(s) of Badiou's Outline of Evil is/are illustrated in the hospital's actions? (Select all that apply.)

A) Assuming authenticity, but deluding by pretending
B) Overpowerment, imposing total power of a truth
C) Class care, malpractice
D) Malicious, horizontal violence
E) Betrayal, rejection of a truth

Accepted Answer

A.Correct. Despite the hospitals' claim of equitable treatment, this clearly did not occur.
B.Incorrect. This applies to intentionally hurting and deceiving colleagues for personal gain.
C.Correct. Class care and malpractice result as an effect of ignoring the needs of one group of patients in favor of another.
D.Incorrect. This is not an accurate response to the scenario as malicious would indicate that the hospital intentionally and purposefully ignored the 10-year-old; horizontal violence refers to peer-on-peer violence (i.e., nurse murders another nurse).
E.Incorrect. Although the patient who died waited for hours with little or no care or communication, this is not the best choice offered.

Question 11

As a result of the ongoing debate of whether or not health care should be considered a right or a privilege, several subcommittees of the Department of Health have been created. One of the subcommittees focuses on the socioeconomic issues of both sides of the debate. What are some examples of questions that members of this committee should ask themselves before developing a recommendation? (Select all that apply.)

A) Will congress accept our recommendations?
B) What resources are available to provide care?
C) Who will pay for health care?
D) Who is justified to receive care?
E) Where can we find potential risks?

Accepted Answer

The answer of As a result of the ongoing debate...

Question 12

Nurses and other health-care professionals are often involved in situations where technology and economic decisions override humanistic and ethical conditions. Often these "less desirable" decisions arise as a result of legal implications, advances in technology, and economic realities. Which of the following scenarios could cause a potential complication in ethical decision-making? (Select all that apply.)

A) After two rounds of chemotherapy, Jane decides to pursue palliative care rather than further chemotherapy treatment that would provide life-saving treatment.
B) Parents refuse blood transfusions for the daughter after significant blood loss following a car accident.
C) Dr. Smith provides information about a procedure, then after hearing the patient express fear and concern, the doctor offers his opinion that the patient should have the procedure.
D) After an involuntary commitment, a patient is injured, requiring stitches. The patient refuses treatment.
E) A patient who has unsuccessfully sued for negligence comes into the ER with vague complaints of pain.

Accepted Answer

The answer of Nurses and other health-care professionals are often...

Deck 3: Transcultural Caring Ethics