Test bank for fundamentals of canadian nursing concepts process and practice 3th edition by kozier

Type: MC CRNE Competency: Professional Practice CRNE Taxonomy: Knowledge Learning Outcome: 5-4 2 When faced with a difficult decision, why is it important for the nurse to distinguish be

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Chapter 5 Values, Ethics, and Advocacy

1) Which of the following is true about a nursing code of ethics?

A) A code of ethics provides answers for nursing care decisions

B) It describes the ethical commitment and values of the profession

C) It describes the competencies required for safe practice

D) A code of ethics is the legislation that protects the public

Answer: B

Explanation:

A) Incorrect A nursing code of ethics cannot provide answers to particular care decisions; it

reflects the mandate of professional nursing and the elements that must be considered when

making ethical practice decisions

B) Correct A nursing code of ethics reflects the mandate of professional nursing and the

elements that must be considered when making ethical practice decisions The CNA’s Code of

Ethics for Registered Nurses (2008) indicates the values held by the

profession

C) Incorrect The competencies for safe practice are not described in a nursing code of ethics

D) Incorrect A nursing code of ethics is not an act of legislation

Type: MC

CRNE Competency: Professional Practice

CRNE Taxonomy: Knowledge

Learning Outcome: 5-4

2) When faced with a difficult decision, why is it important for the nurse to distinguish between

ethics and law?

A) Legal and moral actions have the same meaning

B) An action must be both legal and moral

C) An action can be legal but not moral

D) A legal action offers the most benefit for the client

Answer: C

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Explanation:

A) Incorrect Laws do reflect the moral values of a society, and they offer guidance in

determining what is moral; however, an action can be legal but not moral B) Incorrect An action can be moral but illegal For example, if a child at

home stops breathing,

it is moral but not legal to exceed the speed limit when driving to the hospital C) Correct An action can be legal but not moral For example, an order for full resuscitation of a

dying client is legal, but the nurse could question whether the act is moral D) Incorrect A court-appointed substitute decision maker or person with

power of attorney can

legally make decisions regarding a client’s care, but these decisions may not provide the most

benefit to the client, emotionally or physically

Type: MC

CRNE Taxonomy: Critical Thinking

2

3) Craig, a second year undergraduate nursing student, realizes that he had omitted a step while

performing an abdominal assessment on his client Which action would

indicate that he is

engaging in reflective practice?

A) Requesting that his clinical instructor re-assigns him to another client

B) Completing and submitting a hospital critical incident form

C) Documenting his perspective of the situation in his daily clinical journal D) Asking one of his peers to repeat the assessment on his behalf

Answer: C

Explanation:

A) Incorrect Re-assigning Craig does not help him to learn from the error, nor does it promote

reflective practice

B) Incorrect This situation would not be considered a critical incident

C) Correct Journal-writing, designed to document and reflect upon significant events, is a useful

strategy to facilitate reflective practice in nursing Models to assist Registered Nurses in selfreflection

are available in the various jurisdictions in Canada, to assist nurses in

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implementing

strategies for continuing competency requirements One example of this is the What? So What?

and Now What? model recommended by the Registered Nurses Association

of Ontario (RNAO)

D) Incorrect Having a peer repeat the assessment does not help Craig to learn from his error

Type: MC

CRNE Taxonomy: Application

4) Why may client advocacy be difficult for nurses?

A) The patient navigator is the person responsible for client advocacy

B) Being an advocate may create conflict with other team members

C) Advocacy conflicts with the utilitarian values of nursing

D) Nurses do not have the appropriate education to be client advocates

Answer: B

Explanation:

A) Incorrect Nurses fulfill an advocacy role for clients and/or families when they cannot do so

for themselves

B) Correct Other health care providers, such as physicians, may resent the implication that

clients need to be protected from them Physicians, too, consider themselves

to be client

advocates, as do many other concerned professionals, such as social workers and

physiotherapists The nurse has a moral obligation to the client but also an obligation to keep the

health care team functioning cohesively

C) Incorrect Utilitarianism is a form of teleological theory, which focuses on what action brings

the most good to the client

D) Incorrect Nurses are educated in how to advocate for clients

Type: MC

3

5) Sheena, a nurse-manager, is on a committee considering funding for a

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community kitchen

There is much controversy regarding a rural vs downtown location What moral theory would be

useful to guide Sheena in her choice of location?

A) Caring

B) Deontology

C) Fidelity

D) Teleology

Answer: D

Explanation:

A) Incorrect Relationships-based (caring) theories stress courage, generosity, commitment, and

the need to nurture and maintain relationships

B) Incorrect Deontological theories involve an emphasis on individual rights, duties and

obligations They are also known as principle-based theories

C) Incorrect Fidelity means to be faithful to agreements and promises

D) Correct A consequence-based or teleological theory considers a moral act

as one that brings

the most good and the least harm to the greatest number of people This approach is often used in

making decisions about the funding and delivery of health care Teleological theories focus on

issues of fairness

Type: MC

6) What is the agreed-upon basis of nursing ethics?

A) A commitment to others

B) Reflective practice

C) Professional competencies

D) Justice theory

Answer: A

Explanation:

A) Correct The commitment to others as reflected in an attitude of caring is the basis, if not the

whole, of nursing ethics (Marck, 2000b)

B) Incorrect Reflective practice refers to the ability to take information about experience,

knowledge, or skills levels based on assessments, analyze this information,

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and determine how to

act upon this information in the future (RNAO, 2009)

C) Incorrect Professional competencies refer to the knowledge, skills, and judgment required for

professional nursing practice

D) Incorrect The concept of justice (not justice theory), refers to fairness Type: MC

4

7) Which of the following statements is true regarding nursing values?

A) The CNA Code of Ethics ensures ethical practice

B) Nursing values can influence the quality of care delivered

C) Only selected caregiving situations have moral components

D) Nursing values and beliefs mean the same thing

Answer: B

Explanation:

A) Incorrect The code can only outline nurses’ ethical responsibilities and guide nurses in their

reflection and decision-making It cannot ensure ethical practice

B) Correct Nurses must consider how their values might affect the care they give to clients

Certainly, every caregiving situation has moral components and will be

affected by the values,

beliefs, and attitudes of all those involved

C) Incorrect Every caregiving situation has a moral component and will be affected by the

values, beliefs, and attitudes of all those involved

D) Incorrect Beliefs do not necessarily involve values For example, the

statement “If I study

hard, I will get a good grade.” expresses a belief that does not involve a value

By contrast, the

statement “Good grades are really important to me, and I must study hard to obtain good grades.”

involves both a value and a belief

Type: MC

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8) Aggressive cancer therapy is planned for Mr Renaulds, 80 His nurse is stressed, wondering if

the therapy will actually do more harm than good because of the toxic

chemicals used This

nurse is struggling with which of the following principles?

A) Autonomy

B) Justice

C) Beneficence

D) Nonmaleficence

Answer: D

Explanation:

A) Incorrect Autonomy refers to the right to make one’s own decisions

B) Incorrect Justice is often referred to as fairness

C) Incorrect Beneficence means “doing good.” In this case, the benefits are not known, making

the harm more real

D) Correct Nonmaleficence is duty to “do no harm.” Doing intentional harm is never acceptable

in nursing Placing a client at risk of harm is what is depicted in this scenario, and it occurs as a

known consequence of a nursing intervention or some other type of treatment

It is unknown how

much therapy will be of benefit to the client or whether it will actually do more harm Aggressive

cancer therapy is difficult to endure, and given the age of the client, this case

is more suggestive

of nonmaleficence than beneficence

Type: MC

5

9) Latisha is a staff nurse who observes certain religious holidays Her

manager tries to make

sure that these accommodations can be met if possible The manager is

practicing which of the

following values?

A) Integrity

B) Social justice

C) Autonomy

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D) Altruism

Answer: D

Explanation:

A) Incorrect Integrity is acting in accordance with an appropriate code of

ethics and accepted

standards of practice

B) Incorrect Social justice is upholding moral, legal, and humanistic

principles

C) Incorrect Autonomy is the right to self-determination

D) Correct Altruism is a concern for the welfare and well-being of others A professional

behaviour of this value involves demonstrating the understanding of the

cultures, beliefs, and

perspectives of others

Type: MC

10) Which of the following is true about the personal and professional values

of nurses?

A) Personal values are the same as professional values

B) Utilitarianism is an important nursing value

C) Values clarification is a nursing intervention

D) Personal values are always held at a conscious level

Answer: C

Explanation:

A) Incorrect When people can identify their values, they can retain or change them and thus act

based on freely chosen, rather than unconscious, values

B) Incorrect Utilitarianism, one form of consequentialist theory, views a good act as one that

brings the most good and the least harm to the greatest number of people C) Correct When clients hold unclear or conflicting values that are detrimental

to their health,

the nurse should use values clarification as an intervention

D) Incorrect Even though they may be unspoken and perhaps even

unconsciously held, values

underlie all moral dilemmas

Type: MC

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6

11) Mr Hakim, 56, has inoperable cancer and has decided not to have

chemotherapy Although

his nurse believes that everything possible should be done to preserve life, she supports his

decision Which moral principle is being employed by the nurse?

A) Respect for autonomy

B) Nonmaleficence

C) Beneficence

D) Justice

Answer: A

Explanation:

A) Correct In principle-based ethics, the principle of autonomy (respect for persons) states that

individuals have the right to make choices about their own lives It also means showing respect

for others and accepting them as unique individuals with personal histories that influence their

decision making

B) Incorrect Nonmaleficence is the duty to do no harm

C) Incorrect Beneficence is the obligation to do good

D) Incorrect Justice is sometimes referred to as fairness

Type: MC

CRNE Competency: Nurse-Client Partnership

12) Which of the following is a characteristic of ethics rounds in a health care setting?

A) Ethics rounds use only real client cases for discussion

B) Nurses are not members of ethics committees, but can have input

C) Ethics rounds incorporate traditional teaching approaches into discussions D) There is a strong focus on client clinical diagnosis and treatment

Answer: C

Explanation:

A) Incorrect Both hypothetical and real cases are discussed

B) Incorrect Nurses may be members of ethics committees

C) Correct Traditional clinical teaching approaches are used in ethics rounds D) Incorrect The focus of ethics rounds is on ethical dimensions of care rather than clinical

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diagnosis and treatment

Type: MC

7

13) What is the purpose of the mnemonic device LEARN?

A) Providing a framework to establish ethics rounds

B) Organizing acute care practice environments

C) Acting as a framework for solving moral distress issues

D) Enhancing collaboration in ethical decision making

Answer: D

Explanation:

A) Incorrect The mnemonic device LEARN is not intended as a framework for rounds

B) Incorrect The mnemonic device LEARN is not intended as a framework for organizing

practice environments

C) Incorrect The mnemonic device LEARN is not intended as a framework for solving moral

distress issues

D) Correct The mnemonic device LEARN can remind nurses to work toward collaboration in

ethical decisions (Berlin & Fowkes, 1983): Listen to others Explain your

perceptions

Acknowledge and discuss differences Recommend alternatives Negotiate agreement

Type: MC

14) Mr Terrill, 71, has been admitted to hospital with a myocardial infarction and refuses to

have any discussion about advanced directives The nurse should be aware

of which moral

principle affecting his decision?

A) Veracity

B) Autonomy

C) Social justice

D) Nonmaleficence

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Answer: B

Explanation:

A) Incorrect Veracity refers to telling the truth

B) Correct Individuals have the right to make choices about their own lives Autonomy also

means showing respect for others and accepting them as unique individuals with personal

histories that influence their decision making

C) Incorrect Social justice is upholding moral, legal, and humanistic

principles This value is

reflected in professional practice when the nurse works to ensure equal

treatment under the law

and equal access to quality health care

D) Incorrect Nonmaleficence is the duty to do no harm

Type: MC

CRNE Competency: Nurse-Client Partnership

8

15) Mrs Occhino, 68, is ordered to follow a high-protein renal diet She tells the nurse that she

will eat only food brought into the hospital by her family Which approach by the nurse would be

most helpful at this time?

A) Explain that this decision goes against doctor’s orders

B) Offer to arrange for food substitutes that she likes

C) Review the rationale for the diet prescribed for her

D) Ask what led her to make this particular decision

Answer: D

Explanation:

A) Incorrect Although true, this is negating the client’s views and can close off communication

B) Incorrect Substituting food could be harmful, and perhaps not realistic, given the complexity

of the diet ordered

C) Incorrect Repeating the rationale for the diet is assuming the client does not understand the

rationale; this may be interpreted as condescending

D) Correct Values are enduring beliefs or attitudes about the worth of a

person, an object, an

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