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Chapter 6- Values, Ethics, and Legal Issues

The nurse is preparing to administer a medication ordered by the surgeon in a dose much

higher than is recommended. What action should the nurse take?

1.
Call the surgeon to clarify the order.
A)
Administer the medication as ordered and chart the high dose.
B)
Administer the medication and stay with the patient to observe for adverse

reactions.
C)
Administer the medication in the usual dosage.
D)
Ans: A
Feedback:
Under current nurse practice laws, nurses are responsible for their own actions

regardless of the provider’s written order. If an order is ambiguous or inappropriate, the

nurse must clarify the medication order with the prescribing healthcare provider. If the

nurse is dissatisfied with the provider’s response and still believes that the order is

incorrect or unsafe, he or she must notify a supervisor.

When the nurse inserts an ordered urinary catheter into the patient’s urethra after the
patient has refused the procedure and the patient suffers an injury, the patient may sue
the nurse for which type of tort?
2.
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Battery
A)
Assault
B)
Invasion of privacy
C)
Dereliction of duty
D)
Ans: A
Feedback:
Battery is the actual carrying out of such threat (unlawful touching of a person’s body).

A nurse may be sued for battery if he or she fails to obtain consent for a procedure.

A baccalaureate-prepared nurse is applying for a nurse practitioner position. The nurse is

3.
Well educated and can perform these duties
A)
Able to practice as a nurse practitioner
B)
Educated to practice only with pediatric patients
C)
Practicing beyond his scope according to licensure
D)
Ans: D
Feedback:
A nurse without an advanced practice license is not able to practice beyond his or

her scope in accordance with the Nurse Practice Act.

A nurse fails to administer a medication that prevents seizures, and the patient has a

seizure. The nurse is in violation of the Nurse Practice Act. What type of law is the nurse
4.
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in violation of?

Criminal
A)
Federal
B)
Civil
C)
Supreme
D)
Ans: C
Feedback:
Malpractice cases are generally the kind of civil cases that involve nurses.

A post-anesthesia nurse is reporting about the patient to the intensive care unit nurse in

the elevator. There are staff members and visitors in the elevator. The nurse is
5.
Implementing therapeutic communication
A)
Interacting to maintain coordination of care
B)
Breaching the patient’s confidentiality
C)
Maintaining the continuity of care
D)
Ans: C
Feedback:
The principle of confidentiality requires that information about a patient be kept private.

Discussing patients outside the clinical setting, telling friends or family about patients, or

even discussing patients in the elevator with other workers violates patient confidentiality
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and must be avoided.

When the nurse informs a patient’s employer of his autoimmune deficiency disease, the

nurse is committing the tort of

6.
Breach of contract
A)
Assault
B)
Invasion of privacy
C)
Battery
D)
Ans: C
Feedback:

Nurses have access to information recorded in the medical record, information shared

or observed through care or interactions with friends and family, and through access to

the patient’s body. A loss of privacy occurs if others inappropriately use their access to

a person.

A nurse states to the patient that she will keep her free of pain. However, her family

wishes to try a treatment to prolong her life that may necessitate withholding pain

medication. This factor will cause an ethical dilemma for the nurse in relation to

which ethical principle?

7.
Fidelity
A)
Veracity
B)
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Justice
C)
Autonomy
D)
Ans: A
Feedback:
Fidelity means being faithful to one’s commitments and promises.

An oncology patient in an outpatient chemotherapy clinic asks several questions

regarding his care and treatment. The nurse explains the clinic’s routine, typical side

effects of the chemotherapy, and ways to decrease the number of side effects

experienced. What characteristic is the nurse demonstrating?

8.
Veracity
A)
Fidelity
B)
Justice
C)
Autonomy
D)
Ans: A
Feedback:
Veracity means telling the truth, which is essential to the integrity of the patient–

provider relationship.

The foundation for decisions about resource allocation throughout a society or group is

based on the ethical principle of

9.
Veracity
A)
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Autonomy
B)
Justice
C)
Confidentiality
D)
Ans: C
Feedback:
Justice is the foundation for decisions about resource allocation throughout a society

or group.

The patient being admitted to the oncology unit conveys his wishes regarding
resuscitation in the event of cardiopulmonary arrest. The nurse advises the patient that
it would be in his best interest to obtain which document?
10.
A will
A)
A living will
B)
Proof of healthcare power of attorney
C)
A proxy directive
D)
Ans: B
Feedback:

A living will is an advance directive that specifies the type of medical treatment patients

do or do not want to receive should they be unable to speak for themselves in a terminal

or permanently unconscious condition.

A legal document that states a patient’s health-related wishes—such as a preference for

11.
 pain management if the patient becomes terminally ill—and also allows the

patient’s daughter to direct his or her care, is a(an)

Will
A)
Standard of care
B)
License
C)
Advance directive
D)
Ans: D
Feedback:
Patients communicate their wishes to healthcare providers by verbally participating

in healthcare decision making and by employing written documents called advance

directives.

A patient is in a persistent vegetative state. The patient has no immediate family and is a

ward of the state. Under these circumstances, who will speak on her behalf?
12.
Surrogate decision maker
A)
Church-appointed guardian
B)
A significant other
C)
Her best friend
D)
Ans: A
Feedback:
 Infants, young children, people who are severely mentally handicapped or incapacitated,

and people in a persistent vegetative state or coma do not have the capacity to

participate in decision making about their healthcare. For such people, a surrogate

decision maker must be identified to act on their behalf.

An 83-year-old woman who has suffered a cerebrovascular accident and is unable to

swallow refuses the insertion of a feeding tube. This is an example of what ethical
principle?
13.
Nonmaleficence
A)
Veracity
B)
Autonomy
C)
Justice
D)
Ans: C
Feedback:
Autonomy essentially means independence and the ability to be self-directed.

An emergency department nurse and healthcare team, caring for a 2-year-old,

semiconscious child with numerous fractures and evidence of cigarette burns, suspect

child abuse. The nurse reports the family to the child abuse hotline. The nurse is

following which ethical principle?

14.
Beneficence
A)
Nonmaleficence
B)
 Justice
C)
Fidelity
D)
Ans: B
Feedback:

The principle of nonmaleficence means to avoid doing harm, to remove harm, and

to prevent harm.

A home care nurse visits a patient who is confined to bed and is cared for by her

daughter. The daughter is known to suffer from chemical dependence. The home is

cluttered and unclean. During the assessment the nurse notes that the patient is wet with

urine and has dried feces on her buttocks, and demonstrates signs of dehydration. After

caring for the patient, the nurse contacts the physician and reports the incident to Adult

Protective Services. This is an example of which ethical framework?

15.
Justice
A)
Beneficence
B)
Nonmaleficence
C)
Fidelity
D)
Ans: C
Feedback:
The principle of nonmaleficence means to avoid doing harm, to remove harm, and to

prevent harm. Beneficence means doing or promoting good. Nurses work to accomplish
 good for patients by promoting their best interests and striving to achieve

optimal outcomes. The patient’s circumstances indicate harm.

A nurse is caring for a 28-year-old woman who has delivered a baby by cesarean
section. She describes her pain as a 9. The nurse medicates her for pain. This is an
example of which of the following ethical frameworks?
16.
Justice
A)
Fidelity
B)
Beneficence
C)
Nonmaleficence
D)
Ans: C
Feedback:

Beneficence means doing or promoting good. The treatment of the patient’s pain is

the nurse’s act of doing good.

The American Nurses Association’s Code of Ethics for Nurses

17.
Serves to establish personal ethics for nurses
A)
Delineates nurses’ conduct and responsibilities
B)
Serves as a guideline for all healthcare
C)
Plays an important role in legal proceedings
D)
Ans: B
 Feedback:
The ANA recently revised the Code of Ethics for Nurses that delineates the conduct

and responsibilities expected of all nurses in their nursing practices.

A nurse is caring for a patient who is a practicing Jehovah’s Witness. The physician

orders 2 units of packed cells based on his low hemoglobin and hematocrit levels.

The nurse states to the surgeon that it is unethical to go against the patient’s beliefs

even though his blood counts are very low. What is the best description of the nurse’s

intentions?
18.
Acting in the patient’s best interest
A)
Siding with the patient over the surgeon
B)
Observing institutional policies
C)
Being legally responsible
D)
Ans: A
Feedback:
Nurses’ ethical obligations include acting in the best interest of their patients not only as

individual practitioners but also as members of the nursing profession, the healthcare

team, and the community at large.

To practice ethically, the nurse should

19.
Allow a committee to guide her practice
A)
Review past cases before guiding practice
B)
 Avoid allowing her judgment to guide practice
C)
Ask the family their views on caring
D)
Ans: C
Feedback:

Personal convictions apply only to situations and decisions pertaining to the individual.

In ethical practice, nurses avoid allowing personal judgments to bias their treatment of

patients.

A hospital owned by a Catholic order of nuns will not allow tubal ligations to be

performed. This is considered to be

20.
Personal morality
A)
Personal values
B)
Institutional policy
C)
Legal obligation
D)
Ans: C
Feedback:
Institutional policies are guidelines developed by healthcare institutions to

direct professional practice.

A nurse is of the Catholic faith and votes pro-life. He is considered to have

21.
Personal morality
A)
 Personal values
B)
Ethics
C)
Legal obligations
D)
Ans: B
Feedback:
Personal values are ideas or beliefs a person considers important and feels strongly about.

A nurse believes that abortion is an acceptable option if a pregnancy results from a

situation of rape. What is the best description of this belief?

22.
Personal morality
A)
Professional values
B)
Ethics
C)
Legal obligations
D)
Ans: A
Feedback:
Personal morality is the set of beliefs about the standards of right and wrong that helps a

person determine the correct or permissible action in a given situation.

Ethics is best defined as

23.
Basis for moral reasoning
A)
Standards of conduct
B)
 Dealing with conflict
C)
Decision making
D)
Ans: B
Feedback:
Ethics is the branch of philosophy dealing with standards of conduct and moral judgment.

A child on a pediatric unit hits one of the other children and subsequently has video

game privileges revoked for the rest of the day. The next day the same child plays with

the other children without any problems in order to avoid losing video game privileges

again. According to Kohlberg, the child is demonstrating what stage of development?

24.
Trust versus mistrust
A)
Moralizing
B)
First-level preconventional stage
C)
Self-actualization
D)
Ans: C
Feedback:
As children progress to toddlerhood, morals and values development begins as they

identify behaviors that elicit reward or punishment. Kohlberg refers to this process as

the first-level preconventional stage when children learn to distinguish right from wrong

and understand the choice between obedience and punishment.

During adolescence, values are primarily formed from

25.
 Schools
A)
Work
B)
Parents
C)
Peers
D)
Ans: D
Feedback:
In adolescence, peer groups are the primary source of value formation. The attitudes,

beliefs, and behaviors that grow out of peer group relationships are powerful.

How are values converted from knowledge into messages which can then be processed as

information?
26.
Religion
A)
Nature
B)
Time
C)
Activity
D)
Ans: A
Feedback:
Values are codified in social institutions such as family, school, and religion. Values

can then be adopted, adapted, or dismissed based on the person’s life experiences and

social system.
 The purpose of a values inquiry discussion with a group of nursing students is to
27.
Examine past decisions
A)
Examine social issues
B)
Alter the group’s views
C)
Improve the group’s image
D)
Ans: B
Feedback:
Values inquiry is a method of examining social issues and the values that motivate human

choices.

The differences between the pro-life and abortion rights movement is an example of
28.
Values inquiry
A)
Social activism
B)
Ethical inconsistency
C)
Values clarification
D)
Ans: A
Feedback:
Values inquiry is a method of examining social issues and the values that motivate human

choices.

A dying patient tells the nurse that he doesn’t want to see his family because he doesn’t
29.
 want to cause them more sadness. Which action by the nurse is most appropriate?

Arrange a meeting between the family and the patient

A)
Help the patient clarify his values
B)
Educate the patient on death and dying concepts
C)
Allow the patient time for quiet reflection
D)
Ans: B
Feedback:
Values clarification is a method of self-discovery by which people identify their personal

values and value rankings. The patient’s value of family may be obscured because of his

overwhelming need to protect his family.

A hospice nurse is caring for a patient with terminal cancer. The family would like the

patient to continue aggressive therapy to treat the cancer, but the patient has voiced to

the nurse that, after much thought, he does not want to pursue any further treatment. The

nurse speaks to the family about the patient’s wishes, condition, and terminal state. This

action is most likely derived from which nursing obligation?

30.
Legal responsibilities
A)
Nursing education principles
B)
Advanced practice licensure guidelines
C)
Moral values
D)
Ans: D
 Feedback:
Moral values involve correct behavior, such as having some sense of right and wrong.

Moral values help direct nurses to deal with human interactions that involve the

integrity of life or health.

A nursing student’s attitude is defined as:

31.
Belief in one’s self
A)
Desire to do good
B)
Disposition toward situations
C)
Choosing between alternatives
D)
Ans: C
Feedback:
An attitude is one’s disposition toward an object or a situation; it can be a mental or

emotional mindset, and it can be positive or negative.

Socialization into the nursing profession may have the most significant effect on
32.
Roles
A)
Values
B)
Documentation
C)
Planning
D)
Ans: B
 Feedback:
Values that the nurse will need to balance include truth, harmony, duty,

and responsibility.

What are standards for decision making that endure for a significant time in one’s life?
33.
Beliefs
A)
Ethics
B)
Roles
C)
Values
D)
Ans: D
Feedback:
Values are standards for decision making that endure for a significant time in one’s life.

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