Deck 9: Ethical and Bioethical Issues in Nursing and Health Care

Question 1

A researcher calculated the risk-to-benefit ratio and concluded that no harmful effects were associated with a survey of college sophomores. The researcher was applying the principles of:

A) beneficence.
B) human dignity.
C) justice.
D) human rights.

Answer 1

beneficence.

Question 2

Practicing nurses participate in employer-sponsored professional development classes that provide case studies related to ethical situations and decision making. Ethical considerations are debated among teams, and an expert helps the class arrive at the "best practices." The nurses are experiencing ethics ______________.

Answer 2

acculturation.
Ethics acculturation is the didactic and experiential process of developing ethical reasoning abilities as a part of ongoing professional education.

Question 3

A nurse is caring for a client who just consented to an elective abortion. The nurse is unsure of his/her own values as they relate to this issue. The nurse must:

A) know his/her own values and how these values relate to beliefs and the philosophy of nursing.
B) rid the impurities in his/her value system.
C) ignore his/her own values.
D) realize that values do not change and that they cannot be influenced by others.

Answer 3

know his/her own values and how these values relate to beliefs and the philosophy of nursing.

Question 4

During a seminar on ethics, the educator realizes that more information is needed when a participant describes which situation as a violation of the ethical principle of autonomy?

A) An older person with advanced stages of Alzheimer's disease is denied the right to ambulate in the hallway.
B) A mentally competent adult refuses medical treatment for the autoimmune disease lupus erythematosus, stating that this condition reflects the will of a higher power.
C) A mentally competent visitor fell during visiting hours but refused to be examined by the physician on call.
D) A mentally competent adult with a broken wrist refuses to be given a local anesthetic prior to a procedure.

Question 5

A client and her husband used in vitro fertilization to become pregnant. The unused sperm was frozen so the couple could have more children later. The husband is killed while in combat, and the client journals her choices and the possible ramifications. She comes to the fertility clinic after looking at the situation from many perspectives and after considering many alternatives. She asks that the sperm be destroyed because her husband's faith prohibited remarrying, and allowing another person to use the sperm would conflict with her late husband's beliefs. The nurse realizes that:

A) the client is in the second step of ethical decision making and that the client's value system is influencing her choices of alternative actions.
B) a logical line of reasoning has led to validation of the decision to destroy the husband's sperm.
C) the client has not been able to navigate the complicated issues inherent in this situation.
D) a rational decision was reached that was based on reflection and on the value systems of the wife and the husband.

Question 6

A 13-year-old female is brought to the family planning clinic by her enraged father, who has just learned that she is pregnant. The pregnant client states, "I want to have this baby and give it up for adoption." However, the father is adamant that she will disgrace the family and demands that the health care providers tell his daughter that she has a physical condition that would prohibit her from carrying this baby to a viable stage. The nurse realizes that this is a conflict that involves the ethical principle of:

A) deontology.
B) veracity.
C) autonomy.
D) beneficence.

Question 7

A family requests that no additional heroic measures be instituted for their terminally ill mother who has advance directives in place. The nurse respects this decision in keeping with the principle of:

A) accountability.
B) autonomy.
C) nonmaleficence.
D) veracity.

Question 8

A nurse who is infected with human immunodeficiency virus (HIV) while working in the operating room seeks revenge by deliberately placing clients at risk by not adhering to universal precautions. This nurse is violating the ethical principle of:

A) veracity.
B) beneficence.
C) nonmaleficence.
D) autonomy.

Question 9

An older adult client is comatose and had one electroencephalogram that indicated no activity. The daughter is very distraught and notices her mother's hand moves when she is talking to her. The daughter asks the nurse, "Is mother responding to my voice?" The nurse, attempting to console the daughter, knows the movement was involuntary but states, "It does appear she did." The nurse is violating which principle of ethics?

A) Autonomy
B) Veracity
C) Utilitarianism
D) Deontology

Question 10

A client is in extreme pain after he was involved in a motor vehicle accident, and morphine has been ordered every hour for pain. The nurse injects saline into the client's IV line and takes the morphine for herself. The nurse is violating which principle of ethics?

A) Autonomy
B) Utilitarianism
C) Beneficence
D) Dilemmas

Question 11

In attempting to decide which services should be offered to a community, the public health nurse decides to implement hypertension screening and treatment because most of the residents are hypertensive. This decision is based on the principle of:

A) veracity.
B) values.
C) utilitarianism.
D) autonomy.

Question 12

The Health Care Reform Act provides insurance for all U.S. citizens and legal residents presenting far reaching ethical considerations related to diverse individual patient health care beliefs for those delivering nursing care. Nurses must consider their civil rights under the Rights of conscience and how new health care agendas such as the Patient Protection and Affordable Care Act (PPACA) could affect their practice in situations that may conflict with their own belief system. Today's practicing nurse must:

A) remember it is one's professional duty to render patient-centered care-even when it is in direct conflict with the nurse's own beliefs-or be held liable for withholding treatment.
B) consider whether the right to act according to one's inner beliefs will continue to be permissible when federal health insurance becomes fully enacted.
C) discuss with the patient and family different options in hopes they will accept the nurse's health care beliefs.
D) suggest to the hospital administration that they not accept federal funding to prevent controversial health practices.

Question 13

The nurse who admits making a medication error and immediately files an incident report is demonstrating:

A) accountability.
B) individuality.
C) an injustice.
D) values clarification.

Question 14

The physician who insists on providing treatment in spite of the client's wishes because he "knows best" is reflecting:

A) autonomy.
B) beneficence.
C) justice.
D) paternalism.

Question 15

When assessing an ethical issue, the nurse must 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.

Question 16

Three illegal immigrants with no health insurance or money sustained life-threatening injuries during an automobile accident. Two of these individuals had head trauma and lacerated internal organs. The decision was made to provide extended care in the trauma center after emergency surgery was performed to save their lives. The third individual received only minor injuries, which were treated in the emergency department. The care of the two critical clients was based on the ethical principle of:

A) utilitarianism.
B) deontology.
C) autonomy.
D) veracity.

Question 17

Ethics applied to nursing can best be defined as:

A) doing what is best for the client.
B) making good decisions about care.
C) care based on what should be done in keeping with the values of the client.
D) rules for providing competent care that is based on scientific principles.

Question 18

Throughout their careers, nurses are in an ongoing state of acculturation, gaining experience from formal nursing school classes, clinical experiences, and the ethical issues they encounter in their clinical practice. The ideal outcomes of these ongoing experiences with cultural decision making include: (Select all that apply.)

A) increased trustworthiness.
B)enhanced ability to take into consideration many aspects of ethical situations.
C)confidence to make decisions based on experience and ethical intelligence.
D)improved clinical decision making and advocacy for patient autonomy.
E)authority to make ethical decisions independently that meet personal moral beliefs.

Question 19

A nurse is assigned to a unit where 95% of all patients required total care. Most days the assistive personnel are able to complete their assignments and provide high-quality care. A patient returning from a procedure was somehow "skipped" when daily baths were performed and requests that her care now be provided. The nurse discovers the bed is rumpled and damp. The RN joins with some other staff to bathe the patient, change the bed, and help make the patient comfortable. These staff members are demonstrating:

A) altruism.
B) veracity.
C) autonomy.
D) whistle blowing.

Question 20

In which case does the nurse act as "whistle blower"?

A) One staff member on the unit covers for another nurse, who leaves the premises to purchase illegal substances and signals her friend when she must return.
B) The nurse reports that another nurse is taking medications out of stock medicine for her/himself.
C) A nurse informs respiratory therapy that a patient is now due a treatment.
D) The nurse delegating care to unlicensed assistive personnel makes rounds to ensure all care was rendered properly.

Question 21

When healthy, a patient had requested that all life-sustaining measures be implemented. Now the patient has Alzheimer's and had a deterioration in health that severely limits quality of life. The patient's only child is petitioning that the parent not be placed on life support again and be given only palliative care. The nurse assessing this ethical situation following the procedure would place the steps in what order? (Place in order of the Situation Assessment Procedure). Put a comma and space between each solve choice (for example: a, b, c, d).

A)Discuss with the ethics committee possible alternatives that would be acceptable to the family while considering the patient's wishes.
B)After the family presents two alternatives, work with the committee and family to agree on one alternative.
C)Provide rationale for the selection made.
D)Carefully assess the situation to identify the ethical issue and concerns.