Deck 6: Ethical Decision Making

Question 1

When does moral uncertainty occur?

A) when we sense that there is a moral problem, but are not sure of the morally correct action
B) when someone else in the health care setting performs an act the nurse believes to be immoral
C) when two or more mutually exclusive moral claims clearly apply
D) when participants disagree on the appropriate course of action

Answer 1

when we sense that there is a moral problem, but are not sure of the morally correct action

Question 2

The nurse and other members of the healthcare team participate with the patient in making a particularly difficult moral decision. If the CNO Practice Standard for Ethics is properly implemented, which of the following may occur?

A) The nurse disagrees with the decision.
B) Emotions are active and determine the decision.
C) The patient's feelings are devalued, as they are too emotional.
D) Support is provided to the healthcare team and the patient.

Answer 2

Support is provided to the healthcare team and the patient.

Question 3

Which of the following is an example of a moral dilemma?

A) A nurse who is accustomed to working on the prenatal unit floats to the ER.
B) A nurse who has strong religious beliefs opposing abortion is assigned to assist with an elective abortion.
C) A terminally ill patient on life support suffers from severe, intractable pain.
D) A patient has a cardiopulmonary arrest when the suction apparatus fails.

Answer 3

A terminally ill patient on life support suffers from severe, intractable pain.

Question 4

What step in the process of ethical decision making involves the nurse examining the situation for evidence of conflicting obligations, principles, duties, rights, loyalties, values, or beliefs?

A) Identify options.
B) Determine moral perspective.
C) Gather facts in order to clarify issues.
D) Determine desired outcomes.

Question 5

Which of the following best defines moral residue?

A) when you see that there is a moral problem but are not sure of the correct action
B) being asked to compromise your values time and time again
C) self-knowledge combined with decision-making skill
D) the ability to make cogent moral decisions

Question 6

What step in the process of ethical decision making involves participants excluding results that are totally unacceptable, along with their potential consequences?

A) Identify options.
B) Determine moral perspective.
C) Gather data and identify conflicting moral claims.
D) Determine desired outcomes.

Question 7

A couple are pregnant with their second child and, during a routine ultrasound, the physician discovers that the fetus is anencephalic. The life expectancy of an anencephalic baby is only a few weeks after birth. The couple struggle with the choice of whether to terminate the pregnancy at this time or to carry to term. The couple decide to terminate the pregnancy. What stage of the ethical decision making process is this?

A) determining desired outcomes
B) evaluating outcomes of action
C) identifying options
D) acting on the choice

Question 8

The nurse is involving all stakeholders and has identified and proposed new options to institutional guidelines. Applying the nursing process, what stage would the nurse be using, according to the College of Nurses Practice Standard for Ethics?

A) Assessing the situation
B) Deciding upon an approach
C) Taking action
D) Evaluation

Question 9

According to Thomas and Waluchow, which of the following is an example of a pre-reflective statement in response to a moral question?

A) "Abortion should never happen because it is murder."
B) "Abortion is a difficult concept to accept for many because of the social values we place on life."
C) "I disagree with abortion because it will directly cause death. My spiritual beliefs prohibit this on the basis of protecting sanctity of life."
D) "Abortion is morally permissible because the rights of the pregnant woman take priority over the right of the fetus."

Question 10

The nurse manager asks Martha, a staff nurse, if she will work an additional four hours at the end of her shift. Martha's patient is unstable, and there are not enough nurses on the next shift to care for him adequately. If she works overtime, Martha will have to break a promise she made to watch her children's soccer game. What is this situation an example of?

A) moral distress
B) a moral dilemma
C) moral reckoning
D) a practical dilemma

Question 11

Michael, an ICU nurse, worked with the team as they followed the physician's order to discontinue life support on a patient diagnosed with persistent vegetative state. Michael believes that life is sacred and that he has a duty to do whatever it takes to preserve life. Nevertheless, he remained silent as the decision was made, and he assisted his coworkers when they unplugged the respirator. In this situation, what is Michael likely to experience?

A) moral uncertainty
B) moral distress
C) moral outrage
D) moral perplexity

Question 12

When do moral dilemmas occur?

A) when the nurse is unsure of the morally correct action
B) when there are conflicting moral claims
C) when moral claims conflict with practical claims
D) when participants disagree on the appropriate course of action

Question 13

A registered nurse witnesses another nurse violating a patient's autonomy. Even though she did not participate in the action, the nurse who witnessed the act experiences powerlessness, frustration, and anger. What does this reaction describe?

A) moral distress
B) moral uncertainty
C) moral outrage
D) moral disengagement

Question 14

Why do physicians sometimes make unilateral decisions in morally important situations?

A) Moral decision making is reserved for physicians.
B) Nurses are seldom aware of the patient's wishes and life context.
C) There is sometimes a power imbalance in the health care setting.
D) It is illegal for nurses to participate in moral decision making.

Question 15

During which step of the moral decision-making process is it appropriate to determine the key participants?

A) data gathering
B) problem articulation
C) strategy exploration
D) strategy implementation