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NSG 201H -Ethical Concepts for Medical-Surgical Nursing
NSG 201H -Ethical Concepts for Medical-Surgical Nursing
Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. The nurse is providing care to a client who is considered brain dead. The family has opted to end care and the health-care provider asks the nurse to pull the endotracheal (ET) tube. The nurse is uncomfortable with this request. Which is the reason the nurse is experiencing difficulty with this task?
| 1) | An ethical conflict |
| 2) | Personal values |
| 3) | Legal issues |
| 4) | A cultural conflict |
____ 2. The nurse is providing care to an older adult patient with terminal cancer who has opted to discontinue treatment and go home. The patient’s family, however, wants to continue treatment. The nurse agrees to be present while the patient tells the family. Which ethical patient principle is the nurse supporting?
| 1) | Beneficence |
| 2) | Autonomy |
| 3) | Nonmaleficence |
| 4) | Justice |
____ 3. Which statement best describes the American Nurses Association (ANA) Code of Ethics for professional nurses?
| 1) | “It alleviates suffering for those cared for by professional nurses.” |
| 2) | “It provides standards for professional nursing practice.” |
| 3) | “It reflects legal judgments in professional nursing practice.” |
| 4) | “It serves as legal standards for professional nursing practice.” |
NSG 201H -Ethical Concepts for Medical-Surgical Nursing
____ 4. Which statement regarding the American Nurses Association (ANA) Code of Ethics for professional nurses is accurate?
| 1) | “It is used by all health-care professionals.” |
| 2) | “It guides nurses in their professional behavior and relationships.” |
| 3) | “It forms the basis for possible lawsuits.” |
| 4) | “It is the only code of ethics available for nurses.” |
____ 5. Which professional value is the nurse demonstrating by volunteering time to work in a local free clinic?
| 1) | Human dignity |
| 2) | Integrity |
| 3) | Altruism |
| 4) | Social justice |
____ 6. Which action is appropriate when dealing with an ethical dilemma in practice?
| 1) | Relying on nursing judgment |
| 2) | Examining all conflicts in the situation |
| 3) | Investigating all aspects of the situation |
| 4) | Making a decision based on the policy of the agency |
____ 7. The hospice nurse is providing care to a terminal patient who has asked about guidance and support in ending life. Which should the nurse recognize in regards to making an ethical and moral decision in this circumstance?
| 1) | Euthanasia has legal implications along with moral and ethical ones. |
| 2) | Passive euthanasia is an easy decision to arrive at. |
| 3) | Active euthanasia is supported in the Code for Nurses. |
| 4) | Assisted suicide is illegal in all states. |
____ 8. The nurse is providing care to a 3-year-old child whose parents decide to decline further treatment for cancer, which has metastasized. There is a conflict between the child’s parents and the rest of the family. Which should the nurse consider when determining the appropriate action for this patient?
| 1) | The age of the child |
| 2) | The beliefs of the child |
| 3) | The values of the parents |
| 4) | The values of the rest of the family |
____ 9. A patient is diagnosed with a sexually transmitted infections (STI) and states to the nurse, “Promise you will not tell anyone about my condition.” Which action should the nurse take, when considering the Health Insurance Portability and Accountability Act (HIPAA) of 1996?
| 1) | Honor the patient’s wishes |
| 2) | Respect the patient’s privacy and confidentiality. |
| 3) | Communicate only necessary information. |
| 4) | Not disclosing any information to anyone. |
____ 10. The nurse is providing care to an older adult patient who has decided to discontinue the prescribed hemodialysis. The patient’s family, however, is not supportive of this decision. When using the theory of principles-based reasoning, which statement from the nurse is appropriate?
| 1) | “The patient understands the decision and the advanced stage of the disease. If the patient quits treatment, the patient will die.” |
| 2) | “I need to try to help the family understand the patient’s decision so they can work through this situation together.” |
| 3) | “This patient is of sound mind and is capable of making independent decisions regarding health care. It really is the patient’s decision to make.” |
| 4) | “This patient’s health is so deteriorated that the treatment is not saving the patient’s life. It is prolonging the ultimate outcome, which is death.” |
NSG 201H -Ethical Concepts for Medical-Surgical Nursing
____ 11. The nurse is providing care to an older adult patient who is scheduled for surgery. During the preoperative assessment, the nurse discovers that the patient does not have an adequate understanding of the procedure. Which is the reason for the nurse to take action in this situation?
| 1) | The patient is very old and has multiple health problems. |
| 2) | The family needs to agree to the surgery. |
| 3) | The nurse witnessed the consent. |
| 4) | The patient has a right to informed consent. |
____ 12. The nurse is providing care to a patient who states, “My doctor is refusing to treat me because I am noncompliant with his recommendations.” Which is the priority nursing action in this situation?
| 1) | Have the patient contact a consumer agency. |
| 2) | Advise the patient to sue the health-care provider. |
| 3) | Take the patient’s issue to the hospital ethics committee. |
| 4) | Notify the health-care provider of the patient’s complaints. |
____ 13. A patient diagnosed with acquired immune deficiency syndrome (AIDS) is admitted to the acute care floor. Which stance regarding the care for this patient is supported by the American Nurses Association (ANA) Code of Ethics?
| 1) | The nurse is morally obligated to care for the patient unless the risk exceeds responsibility. |
| 2) | The nurse has the responsibility to ensure the patient gets adequate medical care. |
| 3) | The patient has the right to choose not to disclose his or her condition to staff. |
| 4) | The patient is morally bound to disclose every aspect of his or her condition to staff. |
____ 14. An adolescent patient diagnosed with leukemia decides to stop chemotherapy treatments. The patient’s parents, however, want the health-care team to continue all treatments. Which action by the nurse is appropriate when providing care to this patient and family?
| 1) | Helping the family by providing information and allowing them to voice their concerns |
| 2) | Confronting the parents and telling them not to be “selfish” in their child’s time of need |
| 3) | Calling the authorities immediately |
| 4) | Obtaining a court order to determine the patient is legally able to make his or her own decisions |
____ 15. A patient tells the nurse, “I don’t really like the nurse on the first shift; she treats me bad.” Which action by the nurse is appropriate in order to advocate for this patient?
| 1) | Call the agency patient advocacy department. |
| 2) | Confront the nurse when she comes to work. |
| 3) | Tell the patient he or she has the right to switch nurses. |
| 4) | Call the local authorities. |
____ 16. The nurse is providing care for a postpartum patient who states, “I know my rights and you have to do what I tell you!” Which response by the nurse is appropriate?
| 1) | “I don’t mind doing anything within reason, but you have a responsibility to be considerate to the staff as well.” |
| 2) | “That statement is not included in your patient rights; don’t yell at me.” |
| 3) | “Why do you feel angry … did I do something you did not like?” |
| 4) | “Do you want me to take the baby to the nursery so you can calm down?” |
____ 17. Which is the priority nursing action for the ethical decision-making process?
| 1) | Determine exactly what needs to be decided. |
| 2) | Formulate alternatives to solve the issue. |
| 3) | Implement an action to achieve the greatest benefit with the least amount of risk. |
| 4) | Ascertain if new information is available regarding the issue. |
____ 18. Which number of alternative solutions should be included when conducting ethical decision-making?
| 1) | One |
| 2) | Two |
| 3) | Three |
| 4) | Four |
____ 19. Which ethical principle is the nurse assessing when asking who benefits from the actions of others?
| 1) | Beneficence |
| 2) | Autonomy |
| 3) | Justice |
| 4) | Fidelity |
____ 20. Which ethical principle requires the nurse to be accountable for commitments made to self or others?
| 1) | Beneficence |
| 2) | Autonomy |
| 3) | Justice |
| 4) | Fidelity |
NSG 201H -Ethical Concepts for Medical-Surgical Nursing
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 21. Which should the nurse be aware of when preparing to act as a patient advocate in the hospital setting? Select all that apply.
| 1) | The rights of a patient in a long-term care facility |
| 2) | The health department’s patient rights statement |
| 3) | The hospital’s patient rights statement |
| 4) | State and federal patient rights legislation |
| 5) | The unit policy manual |
____ 22. According to Provision 2 of the American Nurses Association (ANA) Code of Ethics, which member of the health-care team is the nurse’s primary commitment? Select all that apply.
| 1) | Patient |
| 2) | Family |
| 3) | Physician |
| 4) | Community |
| 5) | Surgeon |
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____ 23. Which are ethical issues for the nurse to consider prior to deciding whether or not to honor the picket line during a strike situation? Select all that apply.
| 1) | The need to support coworkers in their efforts to improve working conditions |
| 2) | The need to ensure that clients receive care and are not abandoned |
| 3) | The desire to take some time off |
| 4) | Loyalty to the nurse’s employer |
| 5) | The need for higher pay |
____ 24. The nurse is providing care to a pregnant patient with a history of drug use. The patient refuses testing for human immunodeficiency virus (HIV) despite the recommendation of her nurse-midwife. Which actions by the nurse are appropriate in this situation? Select all that apply.
| 1) | Refusing to treat the patient unless she is tested |
| 2) | Running the test without the patient’s knowledge |
| 3) | Emphasizing the importance of the test to the patient |
| 4) | Offering counseling regarding the testing |
| 5) | Encouraging the patient to reconsider the decision to be tested throughout the pregnancy |
____ 25. A hospice nurse is providing care to a patient diagnosed with ovarian cancer. The patient is concerned that her two daughters are at an increased risk for cancer and asks the nurse for help. Which actions by the nurse are appropriate? Select all that apply.
| 1) | Provide the family with information on hereditary cancer risks. |
| 2) | Assure the client that ovarian cancer is not hereditary. |
| 3) | Offer to refer the daughters to a genetic counselor. |
| 4) | Arrange for the client to have genetic testing. |
| 5) | Tell the client that her additional worrying is too stressful. |