Deck 6: Ethics in Community Health Nursing Practice

Question 1

A man, bleeding profusely and screaming, perhaps out of fear, cries out "I've got a right to see a doctor. I'm hurt. Someone has to take care of me!" What ethical premise could justify such a demand?

A) All hospitals receive provincial/territorial funding, and all employed adults pay taxes; so, all adults have a right to what their tax money has purchased.
B) Saving an individual's life improves society and upholds tradition.
C) Our society believes that all persons should be treated equally and that basic needs, such as being saved from death, if possible, should be met.
D) The man has a property right to his own body, and government is responsible to ensure that property rights are protected.

Answer 1

Our society believes that all persons should be treated equally and that basic needs, such as being saved from death, if possible, should be met.

Question 2

What is the central, most important concept or action in nursing today?

A) Adapting to the use of computers and other technological advances
B) Caring
C) Distinguishing nursing care from medical care
D) Seeking evidence-based outcomes

Answer 2

Caring

Question 3

A CHN has been asked to meet with a couple who recently emigrated from Botswana. The clinic doctor told the man about his wife's diagnosis of breast cancer, and the couple was about to leave. Although all of the following actions by the CHN might be appropriate, which is the most important action, ethically?

A) Insisting that the family set up a surgical appointment for the wife immediately
B) Assessing the family's current living situation, including insurance and other assets
C) Educating the family about breast cancer, including the standard treatment and the prognosis
D) Interviewing the family to find out about their perception of the threat to the family's well-being

Answer 3

Interviewing the family to find out about their perception of the threat to the family's well-being

Question 4

A CHN finds that a family has decided to refuse medical intervention for a particular health concern because the intervention could affect the family member's ability to return to work, and consequently the family's resources would be drastically reduced. Which of the following actions by the CHN would ethically be most appropriate in this situation?

A) The CHN should appreciate that the couple has made the decision that they feel is best for their family and take no further action if it is clear that they have made an informed choice.
B) The CHN should insist that every individual in society has a right to health care and that the family will have to find some way to raise funds for the needed treatment.
C) The CHN should talk to the social worker on the health care team to see if he or she can convince the couple to agree to the medical intervention.
D) The CHN should arrange a meeting with the family to discuss the consequences of the couple's decision.

Question 5

A team of CHNs disagree about the appropriate action to take in relation to a family with an ill family member who have chosen to continue working at their jobs instead of take time off to care for the ill family member. One CHN states, "It is the wife's responsibility to care for her ill husband." What type of thinking is this CHN applying?

A) Consequentialism
B) Deontological ethics
C) Principlism
D) Utilitarianism

Question 6

After hearing the debates about an appropriate course of action for a specific client, a CHN expresses a desire for a rule that would help with decision making. What criteria could the CHN apply to this rule for his or her decision making?

A) The rule absolutely will not get the CHN in trouble with the employer.
B) The rule will gain the support of an expert, such as a spiritual leader.
C) The CHN would recommend the rule to anyone in a similar situation.
D) The supervisor would feel comfortable reporting the rule to the administration.

Question 7

Most of us believe that everyone should receive his or her fair share, that one should always be fair, and that each person should be allowed maximum liberty to make decisions about the self. What does such an approach not take into account?

A) The needs of society as a whole
B) The inconsistent desire or need for a share of resources
C) The predisposition in some people for a need to be taken care of
D) Insufficient resources to give everyone a fair share

Question 8

Gilligan and Noddings both believe in the morality of responsibility in relationships. They emphasize connection. What term describes this belief?

A) A distributive justice approach
B) A feminine ethic
C) A principled approach
D) Virtue ethics

Question 9

A pregnant teenage client asks a CHN to provide information on abortions and a list of health care providers who offer abortion services. The CHN has very strong personal beliefs against abortion that would get in the way of helping the client. What should the CHN do?

A) Call in another CHN to care for this client.
B) Explain, from the personal perspective, all the reasons why abortion should be made illegal.
C) Offer the client a combination of oral contraceptives to induce spontaneous abortion.
D) Provide information on alternatives to abortion and give the client information on adoption agencies.

Question 10

A community health nurse (CHN) facing an ethical dilemma is not able to determine which option would have the best outcome. She talks to her supervisor and lets the supervisor decide which action to take. Into which ethical category does the CHN's decision fall?

A) The decision is appropriate because the supervisor is responsible for the CHN's choices.
B) The decision is intelligent because the supervisor has access to resource persons (spiritual leaders, physicians, administrators) who may know of options that the CHN has not considered.
C) The decision is advisable, but only as an opportunity to further discuss the issue, because ultimately the CHN is still responsible for her own choice.
D) The decision is smart because the supervisor would be more aware of community priorities.

Question 11

What outcome needs to occur in order to claim that advocacy has been truly successful or effective?

A) Audiences agree with a CHN who is advocating a change.
B) Legislators discuss appropriate legislation to better allocate resources.
C) People demand that the disenfranchised be better treated.
D) Systematic social changes are made to improve quality of life.

Question 12

What is the best way to determine if a CHN has been effective in assessing community health needs and planning and implementing appropriate interventions?

A) Asking the CHN about the basis for the interventions and the CHN's perception of their effectiveness
B) Examining the community's morbidity and mortality rate
C) Reassessing community health needs to determine if they have been met
D) Systematically surveying community residents regarding their perception

Question 13

A team of CHNs disagree about the appropriate action to take in relation to a family with an ill family member who have chosen to continue working at their jobs instead of take time off to care for the ill family member. One CHN states, "The whole family is being affected and will fall apart if they don't focus on the family's needs first." What type of thinking is this CHN applying?

A) Communitarianism
B) Deontological ethics
C) Principlism
D) Utilitarianism

Question 14

A team of CHNs disagree about the appropriate action to take in relation to a family with an ill family member who have chosen to continue working at their jobs instead of take time off to care for the ill family member. One CHN states, "But it doesn't have to be either-or. Perhaps the family members could take turns calling in sick for just 2 or 3 days. That way, they could all help and yet not upset their employers. Wouldn't that be fair?" What type of thinking is this CHN applying?

A) Communitarianism
B) Deontological ethics
C) Principlism
D) Utilitarianism

Question 15

A team of CHNs disagree about the appropriate treatment for Mrs. Mehta, who is likely an excellent candidate for hospice care. The first CHN says that deciding on care, rather than cure, is up to Mrs. Mehta, and no one else can decide for her. The second CHN says that it is the responsibility of the health care team to do what is best for Mrs. Mehta, and if the physician thinks there is still a possibility of cure, then the CHNs should do everything they can to implement the treatment plan. The third CHN says it is not fair for the family to expend all their resources on Mrs. Mehta, who is probably going to die in spite of the care provided by the health care team. What conclusions can be drawn from this dispute?

A) Ethical principles can conflict with each other.
B) The first CHN is correct because autonomy demands that the patient herself decide.
C) The second CHN is correct because professional health care providers profess or promise to always do the best for those under their care.
D) The third CHN is correct because utility demands the maximization of benefit for the majority.

Question 16

In which year and by whom was the first code of ethics for nursing written?

A) In 1893, by Lystra Gretter
B) In 1950, by the American Nurses Association (ANA) House of Delegates
C) In 1954, by the International Council of Nurses (ICN)
D) In 2001, by the American Nurses Association (ANA) House of Delegates

Question 17

A physician refuses to order pain medication for a person with a substance use disorder who was severely injured in a car accident. When the CHN requests medication to be used p.r.n., the physician states that the client's suffering from the pain of his injuries will build character. What ethical theory is the physician using (or misusing)?

A) Consequentialism
B) Communitarianism
C) Virtue ethics
D) Utilitarianism

Question 18

A team of CHNs disagree about the appropriate action to take in relation to a family with an ill family member who have chosen to continue working at their jobs instead of take time off to care for the ill family member. A CHN states, "It's not up to us; it's the family's decision." What type of thinking is this CHN applying?

A) Communitarianism
B) Deontological ethics
C) Principlism
D) Utilitarianism

Question 19

A team of CHNs disagree about the appropriate action to take in relation to a family with an ill family member who have chosen to continue working at their jobs instead of take time off to care for the ill family member. One CHN asks, "What sort of example does this behaviour set for the community? What if everyone always put their jobs before their families?" What type of thinking is this CHN applying?

A) Communitarianism
B) Deontological ethics
C) Principlism
D) Utilitarianism

Question 20

What is the first and most crucial step in the ethical decision-making process?

A) Assessing the context or environment in which a decision must be made
B) Considering the various ethical principles or theories
C) Identifying the ethical concerns
D) Making a decision and acting on it

Question 21

Much ethical debate has revolved around issues in acute health care, for example, the continuation or withdrawal of medical treatment. In such a specific situation, what is typically the dominant concern?

A) Doing what is best for the community
B) Doing what is best for the family
C) Obeying legal mandates
D) Upholding the client's autonomy