Deck 4: Application of Ethics in Nursing Practice Settings

Question 1

The nurse manager has identified high levels of moral distress on the nursing unit. Which change would be helpful in assisting nurses to cope?

A) Relieving the nurses from service on ethics committees
B) Increasing compensation for overtime hours worked
C) Sending nurses home when they exhibit signs of moral distress
D) Encouraging free discussion of ethical concerns

Answer 1

Encouraging free discussion of ethical concerns

Question 2

A nurse manager has started a dialogue regarding the American Nurses Association (ANA) Code of Ethics for Nurses with Interpretive Statements among staff nurses. Which staff nurse statements would the manager evaluate as indicating poor understanding of this document?

A) "This document describes nursing's own understanding of its commitments to society."
B) "This document is so out of date, they never revise it."
C) "At least the ANA understood that professional ethics are different in different regions of the country."
D) "It is interesting that the ANA first addressed this code over 50 years ago."
E) "This document has established standards by which we should practice."

Answer 2

"This document is so out of date, they never revise it."
"At least the ANA understood that professional ethics are different in different regions of the country."

Question 3

The patient who has been diagnosed with metastatic cancer declines chemotherapy treatments. The nurse assists this patient in explaining this position to other health care providers. What advocacy model is this nurse exemplifying?

A) Patient advocate model
B) Values-based decision model
C) Rights protection model
D) Jurisprudence model

Answer 3

Rights protection model

Question 4

Nurses are revising the policy and procedure manual for the nursing unit. They work to ensure that the policies address more than one person and more than one set of circumstances. Which aspect of policy does this reflect?

A) Generality
B) Scale
C) Normativity
D) Decision determination

Question 5

Nurses believe that there is a need to change policy for their clinical unit. What is the first step these nurses should take when considering this need for new policy?

A) Determining how many people are affected by the policy
B) Identifying the problem
C) Looking for ethical arguments regarding the policy
D) Finding out who has authority to change the policy

Question 6

The nurse believes that a physician's order written at the end of a shift is contrary to the accepted standard of care and could potentially harm the patient. What should the nurse do?

A) Ask the nurse manager what to do.
B) Question the physician regarding the order.
C) Let the next shift make the decision regarding implementation of the order.
D) Complete the order as directed.

Question 7

Unrest on the nursing unit has progressed to moral outrage among the nursing staff. Which statements made by the nurse manager to the chief nursing officer indicates an understanding of this issue?

A) "I am concerned that the quality of care we are providing will reduce if this unrest continues."
B) "We may experience turnover in staff positions if this tension continues."
C) "I think we need to hire some more unlicensed personnel to shift the direct patient care work off the registered nurses."
D) "This will be a good opportunity to get rid of the unit trouble-makers."
E) "I am going to try to divert this energy by asking the nurses to help rewrite the policy and procedures manual."

Question 8

In which ways can the nurse best act as a patient advocate?

A) Participate in continuing education offerings pertinent to the current position.
B) Follow all physician orders precisely and completely.
C) Practice with the patient as priority concern.
D) Educate the patient throughout the hospitalization or other nurse-patient contact.
E) Become active in changing outdated policies or procedures.

Question 9

In nursing school, the student learns that the nurse should always consider the possible outcomes of any nursing action taken. What ethical concept does this consideration support?

A) Slippery slope arguments
B) Perception model
C) Autonomy model
D) Therapeutic jurisprudence

Question 10

The hospital administration asks nursing services to assume housekeeping duties from midnight until 6:00 a.m. Nurses are fearful that this is the first step to shifting complete 24-hour-per-day responsibility for housekeeping duties to nursing services. The nurses believe this would take away from their ability to provide quality nursing care to their patients. This scenario is an example of which ethical concept?

A) The MORAL argument
B) Slippery slope thinking
C) Relevance thinking
D) Reluctance model

Question 11

The nurse is providing care for a patient who was just diagnosed with diabetes mellitus. Which statements reflect this nurse's use of the values-based decision model in this situation?

A) "Tell me about what foods are important to your family celebrations."
B) "Let me help you select your lunch menu as I know you are not familiar with your diet yet."
C) "You can make the decision of when you want to take your daily oral medication dose."
D) "I have written down several websites that will provide accurate information about your disease."
E) "Is there anything you want me to talk to your physician about today?"

Question 12

The nurse intends to lobby the state legislature to write a new code of ethics for the nurses in the state. Is this an appropriate idea?

A) No, federal lawmakers have jurisdiction over codes of ethics.
B) No, the code of ethics is the product of hospital associations across the nation.
C) No, professional nursing organizations write the code of ethics for nurses.
D) Yes, the code of ethics is written and published by individual state legislatures.

Question 13

The nurse uses the MORAL model for ethical decision making at the bedside. Which option reflects the first step (M) of this model?

A) The nurse investigates the opinions of everyone involved in the issue.
B) The nurse evaluates the situation after an intervention is implemented.
C) The nurse implements an intervention and thinks about its impact.
D) The nurse considers the benefits and risks of possible solutions to the problem.

Question 14

The nurse manager of an oncology unit is interviewing nurses for a position. Which statements, made by nurse applicants, would the manager evaluate as indicating ability to respond appropriately to the ethical dilemmas?

A) "I think nurses and physicians should discuss care decisions with patients and families."
B) "I worked an oncology unit for 10 years before we moved here."
C) "I think that most dilemmas can be solved by taking the option that is most logical."
D) "At my last job, we were required to take ethics training each year."
E) "As long as nurses follow orders and policy and procedures ethical dilemmas are unlikely to arise."

Question 15

The nurse manager is conducting a performance review with a nurse who has worked on the unit for 10 years. During the review, the nurse begins to cry and tells the manager, "I just can't do this anymore. I can't sleep because I have such bad nightmares about patients. I can't eat and I've already lost 15 pounds." The nurse manager identifies these findings as being possible signs of which problem?

A) Moral distress
B) Too much focus on the patient
C) Developing incompetence
D) Problems at home