ATI Fundamentals: Chapter 3 (Ethical Responsibilities) Flashcards
A nurse is caring for a client who decides not to have surgery despite significant blockages of the coronary arteries. The nurse understands that this client’s choice is an example of which of the following ethical principals?
a. Fidelity
b. Autonomy
c. Justice
d. Nonmaleficence
a. Fidelity is the fulfillment of promises. The nurse has not made an promises, this is the client’s decision.
b. CORRECT: The nurse identifies in this situation, the client is exercising their right to make their own personal decision about surgery, regardless of others’ opinions of what is “best” for them.
c. Justice is fairness in care delivery and in the use of resources. Because the client has chosen not to use them, this principal does not apply.
d. Nonmaleficence is commitment to do no harm. In this situation, harm can occur whether or not the client has surgery. However, because they choose not to, this principal does not apply.
A nurse offers pain meds to a client who is postoperative prior to ambulation. The nurse understands that this aspect of care delivery is an example of which of the following ethical principals?
a. Fidelity
b. Autonomy
c. Justice
d. Beneficence
a. Fidelity is the fulfillment of promises. Unless the nurse has specifically promised the client a pain-free recovery, which is unlikely, this principal does not apply.
b. Autonomy is the right to make personal decisions, even when they are not necessarily in the person’s best interest. In this situation, the nurse is delivering responsible client care. This principal does not apply.
c. Justice is fairness in care delivery and in the use of resources. Pain management is available for all clients who are postoperative, so this principal does not apply.
d. CORRECT: The nurse should identify that beneficence is action that promotes good for others, without any self-interest. By administering pain medication before the client attempts a potentially painful exercise like ambulation, the nurse is taking a specific and positive action to help the client.
A nurse is instructing a group of newly licensed nurses about the responsibilities organ donation and procurement involve. When the nurse explains that all clients waiting for a kidney transplant have to meet the same qualifications, the newly licensed nurses should understand that this aspect of care delivery is an example of which of the following ethical principals?
a. Fidelity
b. Autonomy
c. Justice
d. Nonmaleficence
a. Fidelity is the fulfillment of promises. Because donor organs are scarce resource compared with the numbers of potential recipients who need them, no one can promise anyone an organ. Thus, this principal does not apply.
b. Autonomy is the right to make personal decisions even when they are not necessarily in the person’s best interest. No personal decision is involved with the qualifications for organ recipients.
c. CORRECT: The nurse should identify that justice is fairness in care delivery and in the use of resources. By applying the same qualifications to all potential kidney transplant recipients, organ procurement organizations demonstrate this ethical principal in determining the allocation of these scarce resources.
d. Nonmaleficence is commitment to do no harm. In this situation, harm can occur to organ donors and to recipients. The requirements of the organ procurement organizations are standard procedures and do not address avoidance of harm or injury.
A nurse questions a med prescription as too extreme in light of the clients advanced age and unstable status. The nurse understands that this action is an example of which of the following ethical principals.
a. Fidelity
b. Autonomy
c. Justice
d. Nonmaleficence
a. Fidelity is the fulfillment of promises. The nurse is not addressing a specific promise when they determine the appropriateness of a prescription for the client. Thus, this principal does not apply.
b. Autonomy is the right to make personal decisions, even when they are not necessarily in the person’s best interest. No personal decision is involved when the nurse questions the clients prescription.
c. Justice is fairness in care delivery and in the use of resources. In this situation, the nurse is delivering responsible client care and is not assessing available resources. This principal does not apply.
d. CORRECT: The nurse should identify that nonmaleficence is a commitment to do no harm. In this situation, administering the med could harm the client. By questioning it, the nurse is demonstrating this ethical principle.
A nurse is instructing a group of newly licensed nurses about how to know and what to expect when ethical dilemmas arise. Which of the following situations should the newly licensed nurses identify as an ethical dilemma?
a. A nurse on a med-surg unit demonstrates signs of chemical impairment.
b. A nurse overhears another nurse telling an older adult client that if he doesn’t stay in bed, she will have to apply restraints.
c. A family has conflicting feelings about the initiation of enteral tube feedings for their father who is terminally ill.
d. A client who is terminally ill hesitates to name their partner on their durable power of attorney form.
a. Delivering client care while showing signs of substance use disorder is a legal issue, not an ethical dilemma.
b. A nurse who threatens to restrain a client has committed assault. This is a legal issue, not an ethical dilemma.
c. CORRECT: The nurse should identify that making the decision about initiating enteral tube feedings is an example of an ethical dilemma. A review of scientific date cannot resolve the issue, and it is not easy to resolve. The decision will have a profound effect on the situation and on the client.
d. The selection of a person to make health care decisions on a client’s behalf is a legal decision, not an ethical dilemma.
