ch 40 Flashcards
A patient suffered a brain injury from a motor vehicle accident and has no brain activity. The patient has a living will which states no heroic measures. The family requests that no additional heroic measures be instituted for their son. The nurse respects this decision in keeping with which principle?
a. Accountability
b. Autonomy
c. Nonmaleficence d. Veracity
ANS: B
Patients and families must be treated in a way that respects their autonomy and their ability to express their wishes and make informed choices about their treatment. Accountability is inherent in the nurse’s ethical obligation to uphold the highest standards of practice and care, assume full personal and professional responsibility for every action, and commit to maintaining quality in the skill and knowledge base of the profession. Nonmaleficence is a principle that implies a duty not to inflict harm. In ethical terms, nonmaleficence means to abstain from injuring others and to help others further their own well-being by removing harm and eliminating threats. Veracity means telling the truth as a moral and ethical requirement.
A male patient suffered a brain injury from a motor vehicle accident and has no brain activity. The spouse has come up to see the patient every day for the past 2 months. She asks the nurse, “Do you think when he moves his hands he is responding to my voice?” The nurse feels bad because she believes the movements are involuntary, and the prognosis is grim for this patient. She states, “He can hear you, and it appears he did respond to your voice.” The nurse is violating which principle of ethics?
a. Autonomy
b. Veracity
c. Utilitarianism d. Deontology
ANS: B
Veracity is the principle of telling the truth in a given situation. Autonomy is the principle of respect for the individual person; this concept states that humans have incalculable worth or moral dignity. Utilitarianism is an approach that is rooted in the assumption that an action or practice is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences. Giving the spouse false reassurance is not a good consequence. Deontological theory claims that a decision is right only if it conforms to an overriding moral duty and wrong only if it violates that moral duty. Persons are to be treated as ends in themselves and never as means to the ends of others.
The nurse is faced with an ethical issue. When assessing the ethical issue, which action should the nurse perform first?
a. Ask, “What is the issue?”
b. Identify all possible alternatives.
c. Select the best option from a list of alternatives.
d. Justify the choice of action or inaction.
ANS: A
The first step in the situational assessment procedure is to find out the technical and scientific facts and assess the human dimension of the situation—the feelings, emotions, attitudes, and opinions. Trying to understand the full picture of a situation is time consuming and requires examination from many different perspectives, but it is worth the time and effort that is required to understand an issue fully before moving forward in the assessment procedure. Identifying alternatives is the second step in the situation assessment procedure. A set of alternatives cannot be established until an assessment has been completed. Selecting the best option is actually the third step in the situation assessment procedure. Options cannot be selected until an assessment has been done to define the issue. Justifying the action or inaction is the final step in the situational assessment procedure. No justification can be made until the assessment and action phases have been completed.
A nursing student is conducting a survey of fellow nursing students. Which ethical concept is the student following when calculating the risk-to-benefit ratio and concluding that no harmful effects were associated with a survey?
a. Beneficence
b. Human dignity
c. Justice
d. Human rights
ANS: A
Beneficence is a term that is defined as promoting goodness, kindness, and charity. In ethical terms, beneficence means to provide benefit to others by promoting their good. Human dignity is the inherent worth and uniqueness of a person. Justice involves upholding moral and legal principles. Human rights are the basic rights of each individual.
A nurse on the unit makes an error in the calculation of the dose of medication for a critically ill patient. The patient suffered no ill consequences from the administration. The nurse decides not to report the error or file an incident report. The nurse is violating which principle of ethics?
a. Fidelity
b. Individuality
c. Justice
d. Values clarification
ANS: A
Fidelity is the principle that requires us to act in ways that are loyal. In the role of a nurse, such action includes keeping your promises, doing what is expected of you, performing your duties, and being trustworthy. Individuality is something that distinguishes one person or thing from others. Injustice is when a person is denied a right or entitlement. Values clarification is a tool that allows the nurse to examine personal values in terms of ethical situations.
An unconscious patient is treated in the emergency department for head trauma. The patient is unconscious and on life support for 2 weeks prior to making a full recovery. The initial actions of the medical team are based on which ethical principle?
a. Utilitarianism
b. Deontology
c. Autonomy d. Veracity
ANS: B
Deontology is an approach that is rooted in the assumption that humans are rational and act out of principles that are consistent and objective and that compel them to do what is right. Deontological theory claims that a decision is right only if it conforms to an overriding moral duty and wrong only if it violates that moral duty. Utilitarianism is an approach that is rooted in the assumption that an action or practice is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences. An attempt is made to determine which actions will lead to the greatest ratio of benefit to harm for all persons involved in the dilemma. Autonomy is the principle of respect for the individual person. People are free to form their own judgments and perform whatever actions they choose. Veracity is defined as telling the truth in personal communication as a moral and ethical requirement.
A drug-addicted nurse switches a patient’s morphine injection with normal saline so that the nurse can use the morphine. The nurse is violating which principles of ethics? (Select all that apply.)
a. Autonomy
b. Utilitarianism
c. Beneficence
d. Dilemmas
e. Veracity
ANS: A, B, C, E
Beneficence is providing benefit to others by promoting their welfare. In general terms, to be beneficent is to promote goodness, kindness, and charity. By taking the patient’s pain medication and substituting saline, the nurse did harm, not good, for the patient. Autonomy is the principle of respect for the individual person; the nurse does not respect someone upon whom the nurse is inflicting harm. Utilitarianism is the principle that assumes that an action is right if it leads to the greatest possible balance of good consequences or to the least possible balance of bad consequences. Because the patient’s pain medication was taken away, the consequences were all bad. Dilemmas are not included as a principle of ethics. Veracity involves truth-telling.
