Question 1

The nursing faculty member correctly classifies the American Nurses Association (ANA)Code of Ethics as a tool for
A)articulating actions that incorporate professional values.
B)describing ethics associated with membership in the ANA.
C)listing and explaining ethical principles used in nursing.
D)solving ethical dilemmas encountered in daily practice.

Accepted Answer

The ANA Code of Ethics articulates actions that exemplify the ethics of professional nursing.Although the code is not a list of behaviors,some activities are specified,and others can be inferred.
The ethics described in the ANA Code pertain to the profession of nursing,not just to members of the ANA.
The code does not contain a list and explanation of ethical principles.
The code is not a tool for problem solving.

Question 2

A nurse feels strongly that nursing practice should be based on justice.The action by the nurse that best demonstrates this principle is to
A)allow patients to make their own decisions regarding nursing care.
B)make sure all patients get their meals ordered at the same time.
C)spend the same amount of time with each patient during the shift.
D)use a consistent approach in deciding which patients to see first.

Accepted Answer

When a nurse cares for multiple patients,their needs often conflict.The nurse practicing within the principle of justice has a clear plan for deciding how to allocate her or his time as a resource,seeing to it that those with the most pressing needs are seen first and that other patients' needs are cared for as well during the shift.Doing so according to a consistent standard helps ensure that personal biases do not influence this decision.
Allowing patients to make their own decisions regarding nursing care would relate more to autonomy,which is the right to self-determination and to make choices regarding health care.
On the surface,making sure all patients get their meals ordered at the same time sounds fair and just,but it does not take into account individual patient needs.
Spending the same amount of time with each patient does not allow for individual patient needs.

Question 3

A nurse is complaining about the pharmacy being too slow in delivering medications.The nurse describes an example in which a patient could have been harmed from the delay and is angry because the nurse knows it is critical that certain medications be given on time.This nurse is most likely experiencing
A)caregiver fatigue.
B)job burnout.
C)moral distress.
D)personal fatigue.

Accepted Answer

Moral distress occurs when a person feels uneasy about a situation in which he or she knows the right course of action but is unable to perform it.This nurse is suffering from moral distress.
Caregiver fatigue occurs when the burden of giving care is too great for an individual.It is often used to describe a situation involving a lay person giving care to a significant other.Although this might be the case,it is not the most likely answer.
Job burnout occurs when the demands of the job are too great and often leads to nurses leaving the profession or to change jobs.This could be a component of the problem,but it is not the best answer because it is too narrow in focus.
Personal fatigue is certainly a barrier to providing excellent patient care,but it does not appear to be involved in this situation.

Question 4

A nurse who was previously known to be a role model has become distant and cool toward patients.The manager suspects the nurse is experiencing moral distress.Which action by the nurse's manager would be best in this situation?
A)Ask the nurse about perceived barriers to caregiving.
B)Remind the nurse that patient relations are important.
C)Ask whether the nurse needs to take a vacation or time off.
D)Tell the nurse that others have noticed a behavior change.

Accepted Answer

Moral distress is caused when a person knows the right thing to do but is unable to do it.The manager should ask the nurse about any barriers encountered that have prevented effective caregiving.
Patient relations are important but not as important as a nurse who is engaged and meeting the individualized needs of the patients.Telling the nurse anything,rather that inquiring about the difficulty,does not allow for exploration of the problem.
The nurse may indeed be fatigued and in need of time off,but this option is so narrow that it does not allow exploring the real problem.
Telling the nurse that others have noticed a behavior change should certainly be part of a discussion with the nurse,but this should be used as a lead-in to finding out the nature of the problem.This option does not go far enough.

Question 5

A faculty member explains that professional ethics
A)guide behavior based on group consensus.
B)is completely an individual nurse's concern.
C)is optional in groups considered professions.
D)should not consider the goals of the profession.

Accepted Answer

Members of a profession come to group consensus on what they consider ethical actions;then each individual nurse is responsible for making sure his or her practice incorporates these "good" actions as conceptualized by the group.
Professional ethics,although acted on by individual nurses,reflect the professional group's consensus of what is ethical.
One requirement for an occupation to be considered a profession is the existence of a professional code of conduct that guides the members of that group.
The goals of a profession do partially determine what is considered ethical or nonethical action.

Question 6

A nurse studying the history of nursing ethics over the years would conclude that
A)articles show the topics of concern have stayed fairly similar.
B)ethics has been slow in responding to independent practice.
C)nurses' behavior in caring for sick patients is the main subject.
D)the subject has evolved to more abstract situational ethics.

Accepted Answer

Over the years,ethical concerns have grown more complex and increasingly abstract.
Topics of concern have changed over the years and no longer focus on law and conduct.
Ethics has evolved to keep pace with increasing independence in nursing practice.
Nurses' behavior in caring for sick patients was an early focus of nursing ethics.

Question 7

A nurse is assessing factors that may influence a patient's decision-making ability.Which assessment by the nurse would provide the most useful information?
A)Financial ability to pay for care
B)How long the patient has to decide
C)The patient's current pain level
D)What information is available

Accepted Answer

Constraints to autonomy include patient variables that affect the person's capacity to make choices.Factors such as pain,cognitive ability,and fatigue can all influence this.
Financial ability to pay for health care does not have an effect on autonomy.
How long the patient has to decide should not affect the patient's ability to make decisions.The patient may or may not have enough information to make an informed decision,but this does not affect the personal abilities to choose.

Question 8

A patient is in pain and requests pain medication.The nurse sees that it is too early to administer the medication.Practicing under the principle of veracity,the nurse should
A)bring the medication a little bit early to give the patient pain relief.
B)call the physician and request an extra dose of the pain medication.
C)sit with the patient and offer nonpharmacological pain interventions.
D)tell the patient when to expect the medication and bring it on time.

Accepted Answer

Keeping one's word by returning when the patient expects upholds the principle of veracity,which involves telling the truth and not deceiving others.
Giving the pain medication a little early would not be upholding the principle of veracity,which involves telling the truth and not deceiving others.
Calling the physician and requesting an extra dose of the pain medication might be a good intervention,but this is not related to veracity,which involves telling the truth and not deceiving others.
Nonpharmacological interventions might help reduce the patient's pain,but this is not related to veracity,which involves telling the truth and not deceiving others.

Question 9

The nurse knows that the American Nurses Association (ANA)adopted its first code of ethics in
A)1893.
B)1896.
C)1950.
D)1969.

Accepted Answer

The ANA accepted the code of ethics in 1950.
The code of ethics was not established in 1893,1896,or 1969.

Question 10

A nurse admits a patient with end-stage cancer who is very obviously in pain yet refuses pain medication because of the desire to remain aware of family members who are present.The best example of the nurse acting under the ethical principle of beneficence is to
A)assess the patient and pain thoroughly and discuss the patient's wishes.
B)call the doctor and get orders for around-the-clock pain medication anyway.
C)tell the patient and family that the patient has the right to refuse treatment.
D)try convincing the patient that the family does not want her to be in pain.

Accepted Answer

The heart of ethical nursing practice is a therapeutic nurse-patient relationship in which the nurse's actions are influenced by each patient's unique situation.To follow the principle of beneficence,the nurse needs to promote good understanding of the patient's wishes.After obtaining this information,the nurse can move on to a plan to manage the patient's pain that is acceptable to the patient (possibly nonpharmacological therapies).But without having this information first,the nurse cannot treat the patient's pain in a beneficent manner.
One option might be to call the doctor and get pain medication ordered so it will be available should the patient change her mind.But first,the nurse needs to understand the patient's wishes and desires in order to assist the physician in ordering the most appropriate medication.It is not beneficent to merely get pain medication ordered anyway.
The patient does have the right to refuse any treatment (if the patient is able to make reasoned judgments),but this corresponds to the principle of autonomy.
Trying to convince the patient to act in accordance with the wishes of others is not promoting beneficence.

Question 11

The practicing nurse best understands the concept of ethics to mean
A)acting on what is right in a situation.
B)always doing what patients want.
C)being of good moral character.
D)following strict guidelines for action.

Accepted Answer

The nurse who practices ethically can analyze ethical conflicts in light of situational variables to determine what is right and wrong and then act on what is right.
Patients do have the right to make their own decisions,even when they could cause harm,but being ethical does not mean a blanket approval for the patient to do what he or she wants in every situation.The patient may not understand the facts of a situation,may be impaired by drugs or alcohol,or may have cognitive disabilities that preclude full understanding.
Being of good moral character certainly does play into ethical practice,but ethical practice goes well beyond just a characteristic and requires action.
No strict guidelines exist for ethical behavior,but standards can be used to guide ethical decision making and action.No one set of guidelines will apply to every situation.

Question 12

A nurse speaking in the legislature in favor of providing universal health care would best support this cause by calling on the ethical principle of
A)autonomy.
B)beneficence.
C)justice.
D)veracity.

Accepted Answer

The principle of justice relates to fairness and how health care resources should be distributed.The argument may well be made that justice requires equal access to health care for all.
Autonomy is the principle that relates to self-determination.
Beneficence means doing good,which may be applicable to such discussions but is not the strongest principle to use for this argument.
Veracity is telling the truth and keeping promises,which would not be the most applicable concept in this situation.

Question 13

A nurse subscribes to the philosophy of deontology.This means the nurse makes decisions based on
A)cultural competence.
B)equal access.
C)greatest good.
D)perceived duty.

Accepted Answer

Deontology means acting according to a perceived duty.
Deontology does not denote cultural competence.
Deontology does not denote equal access.
Deontology does not denote working for the greatest good.

Question 14

A patient with a head injury is confused and combative and wants to leave the hospital,repeatedly getting out of bed.The nurses obtain an order for soft wrist restraints and a vest restraint.This action best demonstrates
A)beneficence.
B)justice.
C)nonmaleficence.
D)paternalism.

Accepted Answer

This patient is confused and combative after sustaining a head injury.It is reasonable to think the patient does not understand the implications of his or her actions and thus is incapable of making informed decisions.Thus,the nurse needs to use professional judgment and provide care that meets the patient's needs.Overriding a patient's choice for his or her good is called paternalism and can be justified in specific situations.
Beneficence is doing good,but it must take into consideration the patient's needs and wishes in order to provide good.However,this patient is confused and combative and unable to articulate wishes in a way that the nurse can use them when providing good.This is not the best answer to this question because it does not take into account the patient's diminished cognitive abilities.
Justice means using health care resources equally and is not applicable to this situation.
Nonmaleficence means doing no harm,which is not the best answer in this case.

Question 15

A nursing student is skeptical about the concept of professional ethics even being possible,much less a requirement for professional practice.Which statement by this student best justifies this belief?
A)"A group cannot determine what is right in each specific situation."
B)"Each nurse should be smart enough to determine solutions to issues."
C)"Ethics are too personal to be dictated by a professional organization."
D)"There are too many gray areas for any code of ethics to be universally right."

Accepted Answer

"There are too many gray areas for any code of ethics to be universally right" is an understandable statement.Situational variables are innumerable and unique,and they complicate every situation.There are usually no strict right or wrong answers.
A professional code of ethics does not seek to determine correct solutions to every situation but rather attempts to define the ethics that should guide decision making.
The use of ethics is not related to intelligence but rather gives nurses a framework in which to analysis situations.
A requirement of a profession is a code of ethics to guide behavior.The goal is not to dictate to nurses what to do in every situation but to provide guidance for decision making an action in difficult situations.

Question 16

A nurse has volunteered to practice in a disaster area in a developing country where supplies are extremely scarce.Despite bringing large amounts of supplies to the area,the volunteer group members find they are still very limited.The volunteer group decides to focus on providing care according to the ethical concept of utilitarianism.Which action by the group would best fit under this philosophy?
A)Choosing to treat children and pregnant women as priorities
B)Converting vehicles into ambulances for transport to hospitals
C)Establishing a mobile ventilator unit for critically ill patients
D)Providing clean water,food,shelter,and basic health care

Accepted Answer

Utilitarianism focuses on doing the greatest good for the largest number of people.Presumably,the majority of people need fresh water;good food;shelter from the elements;and basic health care such as wound suturing,immunizations,and antibiotics.
Choosing to treat children and pregnant women as priorities would be acting according to a perceived duty (assuming these patients are perceived as more "important" somehow),so this would be more in line with deontology.
Converting vehicles into ambulances for transport to hospitals would not help the largest number of people,most of whom do not require hospitalization.
Establishing a mobile ventilator unit for critically ill patients would only help a small number of people.

Question 17

A nurse is in a difficult patient care situation and thinks that there is an ethical dilemma.The first action this nurse should take is to
A)decide what predominant values are operating in the situation.
B)determine who is involved and uncover their individual goals.
C)identify courses of action and possible consequences of actions.
D)identify the actions that are justifiable.

Accepted Answer

The first step in ethical decision making is to determine what actions are justifiable in the situation.Deciding what predominant values are operating in the situation is an important step in ethical decision making,but identification of justifiable actions is the first step.
Determining who is involved and uncovering their individual goals is an important step in ethical decision making,but identification of justifiable actions is the first step.
Identifying courses of action and possible consequences of actions is an important step in ethical decision making,but identification of justifiable actions is the first step.

Question 18

A nursing instructor tells the class the most important ethical principle involved in informed consent is
A)autonomy.
B)beneficence.
C)confidentiality.
D)veracity.

Accepted Answer

Autonomy is the ability to make one's own decisions.Informed consent is based on this self-determination.
Beneficence is doing good for patients;although this is important in all health care interactions,it is not the most important principle in informed decision making.
Confidentiality is a vital component of ethical practice,but it does not create the foundation for informed consent.
Veracity,or telling the truth and keeping promises,is not the most important principle for informed consent.

Question 19

A nurse explains to a student that the object of beneficence is to
A)consider all the ways patients benefit from action.
B)do the best thing in every patient care scenario.
C)provide "good" according to the patient's wishes.
D)use one's own judgment to make patient care decisions.

Accepted Answer

The object of beneficence is to provide good to the patient,but the meaning of "good" must be clarified within each patient's wishes and desires.
There is no practical way to consider every single way a patient can benefit from an action,particularly when you realize that every patient is a unique individual and will have potential benefits that are unique to him or her.
Doing good for patients is the basis of the principle,but merely doing the best thing does not specify using the patient's preferences and values in each setting.It would also be impossible to accomplish this in every single situation.
Making care decisions without considering the patient's wishes is not practicing ethically,although there are times when professional judgment may be a priority.

Question 20

The nurse explains to a co-worker that in order to practice in an ethical manner,the first thing the nurse must do is to
A)clarify one's own values to be sure they can be helpful in ethical dilemmas
B)find an employer with organizational goals consistent with ethical practice.
C)follow an established set of rules when confronted with an ethics dilemma.
D)understand nursing's role in meeting the professional goals of nursing.

Accepted Answer

The first step to being able to practice in an ethical manner is to understand the goals of nursing as a profession and the responsibility each nurse has in helping the profession meet its goals.
A solid understanding of one's own values is extremely important when working with ethical dilemmas,but this is not the first step in being able to practice in an ethical manner.
Health care organizations and patient care often have competing goals,because all organizations have to consider financial matters that are different from patient care issues.Although some employers may be known for unethical patient care practices,the chances of finding an organization with goals completely consistent with ethical nursing practice are slim.
When working with ethical dilemmas,there are no rules-only guidelines-because when working with people,there are innumerable variations in background and response.Nurses need ethical guidelines and processes to help them in their practices.

Quiz 12: Ethical Dimensions of Nursing and Health Care

The nursing faculty member correctly classifies the American Nurses Association (ANA) Code of Ethics as a tool for

A nurse feels strongly that nursing practice should be based on justice.The action by the nurse that best demonstrates this principle is to

A nurse who was previously known to be a role model has become distant and cool toward patients.The manager suspects the nurse is experiencing moral distress.Which action by the nurse's manager would be best in this situation?

A faculty member explains that professional ethics

A nurse studying the history of nursing ethics over the years would conclude that

A nurse is assessing factors that may influence a patient's decision-making ability.Which assessment by the nurse would provide the most useful information?

A patient is in pain and requests pain medication.The nurse sees that it is too early to administer the medication.Practicing under the principle of veracity,the nurse should

The nurse knows that the American Nurses Association (ANA) adopted its first code of ethics in

A nurse admits a patient with end-stage cancer who is very obviously in pain yet refuses pain medication because of the desire to remain aware of family members who are present.The best example of the nurse acting under the ethical principle of beneficence is to

The practicing nurse best understands the concept of ethics to mean

A nurse speaking in the legislature in favor of providing universal health care would best support this cause by calling on the ethical principle of

A nurse subscribes to the philosophy of deontology.This means the nurse makes decisions based on

A patient with a head injury is confused and combative and wants to leave the hospital,repeatedly getting out of bed.The nurses obtain an order for soft wrist restraints and a vest restraint.This action best demonstrates

A nursing student is skeptical about the concept of professional ethics even being possible,much less a requirement for professional practice.Which statement by this student best justifies this belief?

A nurse is in a difficult patient care situation and thinks that there is an ethical dilemma.The first action this nurse should take is to

A nursing instructor tells the class the most important ethical principle involved in informed consent is

A nurse explains to a student that the object of beneficence is to

The nurse explains to a co-worker that in order to practice in an ethical manner,the first thing the nurse must do is to