Ethics and Values - Pottery and Perry Test Bank PDF

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Potter & Perry: Fundamentals of Nursing, 7th Edition Test Bank Chapter 22: Ethics and Values MULTIPLE CHOICE 1. The client states that she needs to exercise regularly, watch her weight, and reduce her fat intake. This demonstrates that the client: 1. Values health promotion activities 2. Believes she will not become sick 3. Believes she will have a heart attack 4. Has unrealistic expectations for herself ANS: 1 A value is a personal belief about the worth of a given idea, attitude, custom, or object that sets standards that influence behavior. The client is expressing her value of health promotion activities. A belief is a conviction of the truth or reality of a thing. The client does not state she believes these health promotion activities will keep her from becoming sick. A belief is a conviction of the truth of a thing. The client’s statement does not indicate she believes she will have a heart attack. These are not unrealistic expectations. DIF: A REF: 315 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 2. A client has actively picketed for gun control. During a robbery of his business, he was shot in the leg. As the nurse assists him with morning care, which statement would the nurse expect him to make that coincides with his values? 1. “Firearms may have a place in our society.” 2. “Individuals should arm themselves for protection.” 3. “Prosecution should be the maximum for that felon.” 4. “Protection is a necessary evil for the good guy of the world.” ANS: 3 Individual experience influences what we come to value. The client who experienced a gunshot during a robbery of his business may value gun control and verbalize a desire to have his attacker prosecuted for the violent crime. The client who has picketed for gun control and who was gunshot is unlikely to value firearms in our society. The individual who has actively picketed for gun control is unlikely to desire the use of guns. The individual would be more likely to believe that if there were gun control, there would be no need for guns. The individual who has actively picketed for gun control is unlikely to desire the use of guns. The individual would be more likely to believe that if there were gun control, there would be no need for guns. DIF: A REF: 316 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

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3. A secondary school teacher with advanced multiple sclerosis insists on teaching from a wheelchair and being treated the same as other colleagues. The teacher is demonstrating which of the following? 1. Prizing her choice 2. Choosing from alternatives 3. Considering all consequences 4. Acting with a pattern of consistency ANS: 1 The teacher is demonstrating prizing her choice. She cherishes her choice of being treated like everyone else despite her medical condition and publicly affirms the choice by teaching from a wheelchair and insisting she be treated the same as her colleagues. At this point, the teacher is not choosing from alternatives. She could have chosen to quit teaching, but she did not. She has already made her choice. The teacher is not demonstrating considering all consequences. She has already made her choice. At this point, the teacher is not demonstrating acting with a pattern of consistency. She is not repeating a behavior. DIF: A REF: 316 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 4. The nurse recognizes that values clarification interventions are beneficial for the client when: 1. The client and nurse have different beliefs 2. The client is experiencing a values conflict 3. The nurse is unsure of a client’s personal values 4. The client has chosen to reject the normal values ANS: 2 Values clarification can help clients gain an awareness of personal priorities, identify ambiguities in values, and resolve major conflicts between values and behavior. Values clarification for nurses can help nurses strengthen their ability to advocate for a client because nurses are better able to identify personal values and accurately identify the values of the client. Values clarification is not necessarily beneficial for the client when the client and nurse have different beliefs. Values clarification for the client will not necessarily help the nurse who is unsure of the client’s values. Values clarification interventions for the client will help the client, not the nurse, gain awareness. The values that an individual holds reflect cultural and social influences, relationships, and personal needs. Values vary among people and develop and change over time. Therefore it may be inappropriate to state a client has rejected “normal” values when value systems vary among people. What is considered normal to one person may not be to another. DIF: A REF: 316 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment

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5. The nurse is working with the client and trying to clarify the client’s values regarding his care. Which of the following statements reflects an example of the type of response a nurse should use in a values clarification situation? 1. “Your questions were pretty blunt.” 2. “Tell me what you’re thinking right now.” 3. “I’ve felt that way before. I’d be upset, too.” 4. “You seem concerned about your tests. Let me explain them.” ANS: 2 “Tell me what you’re thinking right now” is correct. Values clarification is a process of self-discovery in which the nurse should assist the client. The goal of values clarification with a client is effective nurse-client communication. As the client becomes more willing to express problems and feelings, the nurse can better establish an individualized plan of care. The character of a nurse’s response to a client can motivate the client to examine personal thoughts and actions. When the nurse makes a clarifying response, it should be brief and nonjudgmental. “Your questions were pretty blunt” is incorrect. Values clarification is a process of self-discovery in which the nurse should assist the client. The character of a nurse’s response to a client can motivate the client to examine personal thoughts and actions. When the nurse makes a clarifying response, it should be brief and nonjudgmental. The client is being judgmental in this response. “I’ve felt that way before. I’d be upset, too” is incorrect as well. The nurse should not influence the client with his or her own values, even if they are similar. “You seem concerned about your tests. Let me explain them” is also incorrect. This statement is therapeutic in that it is reflective of a client’s feeling, and offers information. However, it does not encourage the client to examine their values. DIF: A REF: 316 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 6. A nurse’s use of ethical responsibility can best be seen in which of the following nursing actions? 1. Delivery of competent care 2. Formation of interpersonal relationships 3. Correct application of the nursing process 4. Evaluation of new computerized technologies ANS: 1 The term responsibility refers to the characteristics of reliability and dependability. In professional nursing, responsibility includes a duty to perform actions well and thoughtfully. When the nurse provides competent care, the nurse is demonstrating ethical responsibility. Formation of interpersonal relationships is not an ethical responsibility. Application of the nursing process is not an ethical responsibility. Evaluation of new computerized technologies is not an ethical responsibility. DIF:

A

REF: 314-315

OBJ: Comprehension

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TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 7. A nursing student that immediately informs her clinical instructor after she realizes that she has administered the wrong dose of medication to a patient is best described professionally as: 1. Confident 2. Trustworthy 3. Compliant 4. Accountable ANS: 4 Accountability refers to the ability to answer for one’s own actions. The goal is the prevention of injury to the client. The student nurse who informs her instructor of an error is being accountable for her actions and has a goal to prevent injury to the client. The student nurse would not be described professionally as confident (i.e., sure of oneself). The student is not best described as trustworthy. To be trustworthy, one is worthy of trust or confidence and reliable. In this case, the student was not reliable to administer medication correctly. This student nurse is not best described professionally as compliant. The student is not acting in accordance with wishes, commands, or requirements. DIF: A REF: 315 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 8. A client who is recently diagnosed with cancer is encouraged to consider sharing the information with her family so they can support her through the decisions she will need to make regarding her care. The nurse is using the principle of: 1. Confidentiality 2. Fidelity 3. Veracity 4. Justice ANS: 3 Veracity in general means accuracy or conformity to truth. The nurse is encouraging the client to be truthful with the client’s family. Confidentiality means to not impart private matters. Fidelity refers to the agreement to keep promises. Justice refers to fairness. DIF: A OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 9. The correct sequence for attaining the resolution of an ethical problem is: 1. Examine values, evaluate, and identify the problem 2. Evaluate the outcomes, gather data, and consider actions 3. Gather facts, verbalize the problem, and consider actions 4. Recognize the dilemma, evaluate, and gather information

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ANS: 3 The correct sequence for resolving ethical problems is recognizing the dilemma, gathering facts, examining one’s own values, verbalizing the problem, considering actions, negotiating the outcome, and evaluating the action. DIF: A REF: 319 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 10. A nurse is ambivalent as to the need to vigorously suction the secretions of a terminal client in a comatose state. Which of the following is an appropriate statement by the nurse in regard to processing an ethical dilemma? 1. “I just feel like I should not suction this client.” 2. “I need to know the legalities of the living will of this client.” 3. “I cannot figure out what’s right in this situation. I need to collect more data.” 4. “My spiritual beliefs mandate that I continue to provide all the interventions in my scope of practice.” ANS: 3 The first step in processing an ethical dilemma is determining whether the problem is an ethical one. The nurse who cannot figure out what is right, is stating a characteristic of an ethical dilemma, which is that the problem is perplexing. The next step is to gather as much information as possible that is relevant to the case. “I just feel like I should not suction this client” is the nurse is stating the problem according to her feelings. “I need to know the legalities of the living will of this client” is the nurse who wants to know the legalities of the living will of a client is collecting some, but not all, data pertaining to the problem. “My spiritual beliefs mandate that I continue to provide all the interventions in my scope of practice” is the nurse stating her own beliefs. DIF: A REF: 316-317 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 11. Which of the following statements best illustrates the deontological ethical theory? 1. “I believe this disease was allowed by a supreme being.” 2. “He has become a stronger individual through experiencing the loss of his father.” 3. “Under no circumstances would it ever be right for a person to stop CPR efforts.” 4. “The chemotherapy did not cure this person, but it provided a better life for him.” ANS: 3

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“Under no circumstances would it ever be right for a person to stop CPR efforts” is correct. Deontology defines actions as right or wrong based on their right-making characteristics, such as fidelity to promises, truthfulness, and justice. Deontology does not look at consequences of actions to determine rightness or wrongness. Fidelity to promises and beneficence may be principles upon which this statement is based on determining wrongness. “I believe this disease was allowed by a supreme being” does not reflect the deontological ethical theory. Because it reflects a relationship between disease and a supreme being, it follows the feminist ethical theory. “He has become a stronger individual through experiencing the loss of his father” does not best illustrate the deontological ethical theory because it is citing a consequence. It follows the utilitarian ethical theory. “The chemotherapy did not cure this person, but it provided a better life for him” does not best illustrate the deontological ethical theory because it is citing a consequence. It follows the utilitarian ethical theory. DIF: A REF: 316-317 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 12. On admission to the hospital, a terminal cancer patient says he has a living will. This document functions to state the client’s desire to: 1. Receive all technical assistance to prolong his life 2. Have his wife make the decisions regarding his care 3. Be allowed to die without life-prolonging techniques 4. Have a lethal injection administered to relieve his suffering ANS: 3 A living will is an advance directive, prepared when the individual is competent and able to make decisions, regarding that person’s specific instructions about end-of-life care. Living wills allow people to specify whether they would want to be intubated, treated with pressor drugs, shocked with electricity, and fed or hydrated intravenously. A living will specifies what interventions the client does not want, so that his or her life will not be prolonged. If his wife has power of attorney she would be able to make decisions regarding the client’s care. Assisted suicide, such as a lethal injection, is not a function of a living will. A living will defines a client’s wishes for withholding treatment that would prolong his or her life. DIF: A REF: 314 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 13. At an accident scene a nurse stopped and began to provide emergency care for the victims. Her actions are best labeled ethically as: 1. Triage 2. Beneficence 3. Nonmaleficence 4. Respect for persons

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ANS: 2 Beneficence refers to taking positive actions to help others, as in providing emergency care at an accident scene. Triage is the screening and classification of casualties to make optimal use of treatment resources and to maximize the survival and welfare of clients. Nonmaleficence is the avoidance of harm or hurt. Respect for persons has to do with treating people equally despite their social standing, for example. DIF: A REF: 314 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 14. The nurse is aware that an ethics committee in a health care facility serves to: 1. Interview all persons involved in a case 2. Illustrate circumstances that demonstrate malpractice 3. Serve as a resource for specific situations that may occur 4. Examine similar previous instances for comparison of outcome decisions ANS: 3 Ethics committees serve as a resource to support the processing of ethical dilemmas. Ethics committees serve several purposes: education, policy recommendation, and case consultation or review. Although an ethics committee may gather further information, ethics committees do not interview all persons involved in a case. Rather, they offer consultation or case review. Illustrating circumstances that demonstrate malpractice is not a purpose of an ethics committee. Examining similar previous instances for comparison of outcome decisions may be part of data gathering to help process an ethical dilemma or for policy recommendation, but it is not the purpose of an ethics committee. DIF: A REF: 321 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 15. In the emergency department a client feels that she has been waiting longer than the other individuals due to the fact that she has no insurance. The ethical principle that is involved in this exact situation is: 1. Justice 2. Autonomy 3. Beneficence 4. Nonmaleficence ANS: 1 Justice refers to treating people fairly. Allocation of resources and access to health care involves the ethical principle of justice. The client without medical insurance should not have to wait longer to receive health care than those with insurance. Autonomy refers to a person’s independence. Autonomy represents an agreement to respect another’s right to determine a course of action. Beneficence refers to taking positive actions to help others. Nonmaleficence refers to the avoidance of harm or hurt.

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DIF: A REF: 314 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 16. Regarding the nurse’s use of the specific ethical principle of autonomy in a client situation, an example would be: 1. Learning to do a procedure safely and effectively 2. Returning to speak to a client at an agreed upon time 3. Preparing the client’s room for comfort and privacy 4. Supporting a client’s right to refuse a specific type of therapy ANS: 4 Following the ethical principle of autonomy, the nurse allows a client to make his or her own decisions regarding care and then supports that decision. Learning how to perform a procedure safely and effectively is a nurse’s use of ethical responsibility. Returning to speak to a client at an agreed upon time demonstrates the ethical principle of fidelity. Preparing the client’s room for comfort and privacy is a nurse’s use of ethical responsibility. DIF: A REF: 314 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 17. Which of the following statements reflects application of the specific ethical principle of confidentiality? 1. “I’m concerned that funding may affect the outpatient program.” 2. “I’m going to make sure that the client understands the instructions.” 3. “I cannot share that information with you about the client’s condition.” 4. “I need to get more information about the client’s personal health history.” ANS: 3 “I cannot share that information with you about the client’s condition” reflects the application of the ethical principle of confidentiality. Information is not to be shared with others without specific client consent. “I’m concerned that funding may affect the outpatient program” reflects a concern regarding allocation of resources. It is not a confid...