Deck 6: Ethical Decision Making

Question 1

A couple is 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 now 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

Answer 1

acting on the choice

Question 2

Which is an example of a nurse demonstrating moral resilience?  

A)A neonatal nurse who believes in the sanctity of life supports the parents' decision not to discontinue feeding their newborn with congenital anomalies. 
B)A home visiting nurse advocates for the palliative patient's right to die at home despite the push from other members of the team for the patient to be hospitalized and have further treatment. 
C)An  ICU nurse increasingly removes himself from discussions regarding ending life support treatment. 
D)An  obstetrical nurse  supports her patient's religious based decision to not have a lifesaving blood transfusion despite the criticism from her colleagues that the patient is making the wrong choice.

Answer 2

An  obstetrical nurse  supports her patient's religious based decision to not have a lifesaving blood transfusion despite the criticism from her colleagues that the patient is making the wrong choice.

Question 3

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

Answer 3

evaluation

Question 4

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

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

Question 5

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 6

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 on an extremely busy shift. 
B)A nurse who has strong religious beliefs opposing abortion is assigned to assist with an elective abortion. 
C)The family of a terminally ill patient on life support suffering from severe, intractable pain refuses to discuss the withdrawal of supportive treatment. 
D)A patient has a cardiopulmonary arrest when the suction apparatus fails.

Question 7

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 8

Which would be considered as part of the "Identify Options" stage of the ethical decision-making process?  

A)questioning if the original ethical problem has been resolved  
B)checking in with yourself and your moral barometer  
C)determining which factors are morally significant  
D)identifying whose decision this is to make

Question 9

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 to the situation  
D)when participants disagree on the appropriate course of action for the moral problem

Question 10

Which of the following best defines moral residue?  

A)when there is a moral problem but you are unsure of the correct action  
B)when there is a moral problem and a nurse seriously compromises their values repeatedly  
C)self-knowledge combined with decision-making skill  
D)the ability to make cogent moral decisions

Question 11

The nurse states that an elderly patient should be allowed to go home rather than into Long Term Care as planned, because he feels everyone deserves to be in their own home. What level of response to an ethical dilemma does this suggest?  

A)expressive  
B)contemplative  
C)reflective  
D)communicative

Question 12

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 13

What step in the process of ethical decision making involves participants excluding results that are 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 14

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 15

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 16

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.

Question 17

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 based on protecting sanctity of life."  
D)"Abortion is morally permissible because the rights of the pregnant woman take priority over the right of the fetus."