Chapter 44 Ethics & Values

Chapter 44  Ethics & Values

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A patient who is being discharged asks the nurse, “Can I take you out for dinner to show my appreciation for all that you have done for me? I really like you.” The nurse’s best response is which of the following?
a)
“Yes, that would be nice. It is really great to be appreciated.”
b)
“No, and please do not ask again. You should have been told that already.”
c)
“Thank you; however, I have to refuse, even though the thought is appreciated.”
d)
“We will have to wait 3 days after you have been discharged to have a relationship.”

ANS: C
Accepting gifts from patients is a breach of professional boundaries: social contact. Nurses cannot accept gifts from patients in the form of dinners, money, social contact, and the like. The nurse should not enter into a relationship based on the patient’s attempt to compensate her for performing her role responsibilities. Waiting 3 days would not change that. Telling the patient not to ask again, and that she should already know that, borders on rudeness. Although it reflects the understanding about gifts and professional boundaries, it is not an empathetic response and would not help build a trusting relationship.

Difficulty: Moderate
Nursing Process: Interventions
Client Need: Safe and Effective Care
Cognitive Level: Application

PTS: 1

2. Which of the following concepts refers to conflicts that arise between two or more ethical principles in patient care scenarios?
a)
Nursing ethics
b)
Bioethics
c)
Ethical dilemma
d)
Moral distress

ANS: C
An ethical dilemma occurs when a choice must be made between two or more equally undesirable actions, and there is no clearly right or wrong option. Moral distress occurs when someone is unable to carry out his or her moral decision. Nursing ethics refers to ethical questions that arise out of nursing practice. Bioethics is a broader field that refers to the application of ethics to healthcare.

Difficulty: Moderate
Client Need: Safe and Effective Care
Cognitive Level: Knowledge

PTS: 1

3. A mentally competent patient has an extremely low blood count and will likely die without a blood transfusion. The patient knows the risk, but continues to refuse the blood. Which action by the nurse is the most appropriate?
a)
Assume the patient is confused and give the blood anyway.
b)
Request a psychological evaluation to ensure that the patient understands the risk.
c)
Ask family members to intervene and make the patient consent to receiving blood.
d)
Follow the patient’s wishes and do not administer a blood transfusion.

ANS: D
You should follow the patient’s wishes and do not administer a blood transfusion. There is no evidence of confusion; the patient is competent, is aware of the risk, and has given a valid refusal. The nurse should not assume that a patient is confused simply because of the choice a patient makes. A psychological evaluation is not needed simply because the patient refuses treatment that might result in his death. Family members cannot override a patient’s decision. The nurse should respect the patient’s decision.

Difficulty: Moderate
Cognitive Level: Comprehension

PTS: 1

4. A nurse is providing care to a patient who is a Jehovah’s Witness. Against the patient’s wishes, the physician ordered the nurse to give the patient two units of packed red blood cells. The nurse knows that the blood will save the patient’s life, but also that it is against the patient’s wishes; she is unsure what is the right thing for her to do. The nurse is experiencing a(n):
a)
Reflection encounter
b)
Ethical dilemma
c)
Moral outrage
d)
Moral distress

ANS: B
The nurse is experiencing an ethical dilemma based on the conflict between the ethical principles of beneficence and autonomy. The nurse has not yet made a decision. This is not a situation of moral distress, in which the nurse would have made an acceptable moral decision, but was unable to implement it because of external constraints. The nurse does not perceive that others are acting immorally; thus, this is not moral outrage.

Difficulty: Moderate
Nursing Process: Interventions
Client Need: PSI
Cognitive Level: Application

PTS: 1

5. Confidentiality will be maintained by a nurse who believes in and values the ethical principle of:
a)
Fidelity
b)
Veracity
c)
Beneficence
d)
Autonomy

ANS: D
Autonomy refers to a person’s right to choose and his ability to act on that choice. An autonomous person has control over the collection, use, and access of his personal information. This information should not be shared without the patient’s consent. Veracity means to tell the truth. Beneficence is the duty to do or promote good. Fidelity is the obligation to keep promises.

Difficulty: Moderate
Nursing Process: Interventions
Client Need: Safe and Effective Care
Cognitive Level: Comprehension

PTS: 1