Ch. 1 Guidelines, Standards, Legal 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 principles?
A. Fidelity
B. Autonomy
C. Justice
D. Nonmaleficence
B. CORRECT: 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. This is an example of autonomy.
A nurse offers pain medication 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 principles?
A. Fidelity
B. Autonomy
C. Justice
D. Beneficence
D. CORRECT: 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 principles?
A. Fidelity
B. Autonomy
C. Justice
D. Nonmaleficence
C. CORRECT: 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 principle in determining the allocation of these scarce resources.
A nurse questions a medication prescription
as too extreme in light of the client’s advanced age and unstable status. The nurse
understands that this action is an example of
which of the following ethical principles?
A. Fidelity
B. Autonomy
C. Justice
D. Nonmaleficence
D. CORRECT: Nonmaleficence is a commitment to do no harm. In this situation, administering the medication 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 medical‑surgical 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 theirpartner on their durable power of attorney form.
C. CORRECT: Making the decision about initiating enteral tube feedings is an example of an ethical dilemma. A review of scientific data 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.
A nurse observes an assistive personnel (AP)
reprimanding a client for not using the urinal
properly. The AP tells the client that diapers will be used next time the urinal is used improperly. Which of the following torts is the AP committing?
A. Assault
B. Battery
C. False imprisonment
D. Invasion of privacy
A. CORRECT: By threatening the client, the AP is committing assault. The AP’s threats could make the client become fearful and apprehensive.
A nurse is caring for a competent adult client who tells the nurse, “I am leaving the hospital this morning whether the doctor discharges me or not.” The nurse believes that this is not in the client’s best interest, and prepares to administer a PRN sedative medication the client has not requested along with the scheduled morning medication. Which of the
following types of tort is the nurse about to commit?
A. Assault
B. False imprisonment
C. Negligence
D. Breach of confidentiality
B. CORRECT: Administering a medication as a chemical restraint to keep the client from leaving the facility against medical advice is false imprisonment, because the client neither requested nor consented to receiving the sedative.
A nurse in a surgeon’s office is providing preoperative teaching for a client who is scheduled for surgery the following week. The client tells the nurse that “I plan to prepare my advance directives before I come to the hospital.” Which of the following statements made by the client should indicate to the nurse an understanding of advance directives?
A. “I’d rather have my brother make decisions for me, but I know it has to be my wife.”
B. “I know they won’t go ahead with the surgery unless I prepare these forms.”
C. “I plan to write that I don’t want them to keep me on a breathing machine.”
D. “I will get my regular doctor to approve my plan before I hand it in at the hospital.”
C. CORRECT: The client has the right to decide and specify which medical procedures he wants when a life‑threatening situation arises.
A nurse is caring for a client who is about to undergo an elective surgical procedure. The nurse should take which of the following actions regarding informed consent? (Select all that apply.)
A. Make sure the surgeon obtained the client’s consent.
B. Witness the client’s signature on the consent form.
C. Explain the risks and benefits of the procedure.
D. Describe the consequences of choosing not to have the surgery.
E. Tell the client about alternatives to having the surgery.
A. CORRECT: It is the nurse’s responsibility to verify that the surgeon obtained the client’s consent and that the client understands the information the surgeon gave them.
B. CORRECT: It is the nurse’s responsibility to witness the client’s signing of the consent form, and to verify that they are consenting voluntarily and appear to be competent
to do so. The nurse also should verify that the client understands the information the surgeon has provided.
A nurse has noticed several occasions in the past week when another nurse on the unit seemed drowsy and unable to focus on the issue at hand. Today, the nurse was found asleep in a chair in the break room not during a break time. Which of the following actions should the nurse take?
A. Alert the American Nurses Association.
B. Fill out an incident report.
C. Report the observations to the
nurse manager on the unit.
D. Leave the nurse alone to sleep.
C. CORRECT: Any nurse who notices behavior that could jeopardize client care or could indicate a substance use disorder has a duty to report the situation immediately to the nurse manager.
A nurse caring for patients in the intensive care unit develops values from experience to form a personal code of ethics. Which statements best describe this process? Select all that apply.
A) People are born with values.
B) Values act as standards to guide behavior.
C) Values are ranked on a continuum of importance.
D) Values influence beliefs about health and illness.
E) Value systems are not related to personal codes of conduct.
F) Nurses should not let their values influence patient care.
b, c, d.
A value is a belief about the worth of something, about what matters, which acts as a standard to guide one’s behavior. A value system is an organization of values in which each is ranked along a continuum of importance, often leading to a personal code of conduct. A person’s values influence beliefs about human needs, health, and illness; the practice of health behaviors; and human responses to illness. Values guide the practice of nursing care. An individual is not born with values; rather, values are formed during a lifetime from information from the environment, family, and culture.
A pediatric nurse is assessing a 5-year-old boy who has dietary modifications related to his diabetes. His parents tell the nurse that they want him to value good nutritional habits, so they decide to deprive him of a favorite TV program when he becomes angry after they deny him foods not on his diet. This is an example of what mode of value transmission?
A) Modeling
B) Moralizing
C) Laissez-faire
D) Rewarding and punishing
d.
When rewarding and punishing are used to transmit values, children are rewarded for demonstrating values held by parents and punished for demonstrating unacceptable values. Through modeling, children learn what is of high or low value by observing parents, peers, and significant others. Children whose caregivers use the moralizing mode of value transmission are taught a complete value system by parents or an institution (e.g., church or school) that allows little opportunity for them to weigh different values. Those who use the laissez-faire approach to value transmission leave children to explore values on their own (no single set of values is presented as best for all) and to develop a personal value system.
A nurse who is working in a hospital setting uses value clarification to help understand the values that motivate patient behavior. Which examples denote “prizing” in the process of values clarification? Select all that apply.
A) A patient decides to quit smoking following a diagnosis of lung cancer.
B) A patient shows off a new outfit that she is wearing after losing 20 pounds.
C) A patient chooses to work fewer hours following a stress-related myocardial infarction.
D) A patient incorporates a new low-cholesterol diet into his daily routine.
E) A patient joins a gym and schedules classes throughout the year.
F) A patient proudly displays his certificate for completing a marathon.
b, f.
Prizing something one values involves pride, happiness, and public affirmation, such as losing weight or running a marathon. When choosing, one chooses freely from alternatives after careful consideration of the consequences of each alternative, such as quitting smoking and working fewer hours. Finally, the person who values something acts on the value by combining choice and behavior with consistency and regularity, such as joining a gym for the year and following a low-cholesterol diet faithfully.
A nurse incorporates the “five values that epitomize the caring professional nurse” (identified by the American Association of Colleges of Nursing) into a home health care nursing practice. Which attribute is best described as acting in accordance with an appropriate code of ethics and accepted standards of practice?
A) Altruism
B) Autonomy
C) Human dignity
D) Integrity
d.
The American Association of Colleges of Nursing defines integrity as acting in accordance with an appropriate code of ethics and accepted standards of practice. Altruism is a concern for the welfare and well-being of others. Autonomy is the right to self-determination, and human dignity is respect for the inherent worth and uniqueness of individuals and populations.
A nurse caring for patients in an institutional setting expresses a commitment to social justice. What action best exemplifies this attribute?
A) Providing honest information to patients and the public
B) Promoting universal access to health care
C) Planning care in partnership with patients
D) Documenting care accurately and honestly
b.
The American Association of Colleges of Nursing lists promoting universal access to health care as an example of social justice. Providing honest information and documenting care accurately and honestly are examples of integrity, and planning care in partnership with patients is an example of autonomy.
