Row A
Which of the following is the best example of an ethical dilemma faced by the nurse?
1. Deciding the order in which staff members should take their breaks
2. Deciding whether or not to tell a client about the client’s diagnosis
3.Deciding whether or not to place a client in a private room
4. Deciding whether or not to ask another nurse to care for a very complex patient
2. Deciding whether or not to tell a client about the client’s diagnosis
An ethical dilemma exists when the nurse must make a decision about what is right or wrong, but there are conflicting moral principles or rules with any action taken.
Privacy and confidentiality of all client information is legally protected. In which of the following situations would the nurse make an exception to this practice?
1. When the nurse decides that the family has a right to know the client’s diagnosis
2. When a visitor insists that he has been given permission by the client
3. When a family member offers information about their loved one
4. When the client threatens self-harm and harm to others
4. When the client threatens self-harm and harm to others
Privacy and confidentiality of all client information is protected with the exception of the client who threatens self-harm or endangering the public.
A child's immunization may cause discomfort during administration, but the benefits of protection from disease, both for the individual and society, outweigh the temporary discomforts. Which principle is involved in this situation?
1. Fidelity
2. Beneficence
3. Nonmaleficence
4. Respect for autonomy
2. Beneficence
An advanced practice nurse evaluates a patient for emergency commitment because of the likelihood the patient will do serious harm to others. Which statement best reflects the nurse’s role as patient advocate during the assessment process?
a. “Tell me about any delusions you are experiencing.”
b. “I understand you have had some difficulty today.”
c. “Tell me why you need to threaten or hurt others around you.”
d. “Threatening to hurt others will require that you be committed to the hospital.”
B
The advocacy role of nurses to help patients to obtain, maintain, and fully make use of mental health benefits is critical. Assessment for commitment requires data collection from the patient.
The nurse returns to the client’s room in exactly four hours to administer the next dose of pain medication as promised. Which of the following ethical rules is best demonstrated by the nurse?
1. Confidentiality
2. Nonmaleficence
3. Fidelity
4. Justice
3. Fidelity
Fidelity is the rule demonstrated by this nurse by keeping the promise made and returning with the pain medication. Justice and nonmaleficence are ethical principles dealing with fair distribution of services and doing no harm. These are principles, not rules. Confidentiality is an ethical rule emphasizing the importance of respecting the client’s right to privacy of information.
A patient is admitted to a medical unit. The patient is fearful of hospitals. The nurse carefully assesses the patient to determine the exact fears and then establishes interventions designed to reduce these fears. In this setting how is the nurse practicing patient advocacy?
1. Seeking out the nursing supervisor to talk with the patient
2. Documenting patient fears in the medical record in a timely manner
3. Working to change the hospital environment
4. Assessing the patient's point of view and preparing to articulate it
4. Assessing the patient's point of view and preparing to articulate it
When designing a plan for pain management for a postoperative patient, the nurse assesses that the patient's priority is to be as free of pain as possible. The nurse and patient work together to identify a plan to manage the pain. The nurse continually reviews the plan with the patient to ensure that the patient's priority is met. Which principle is used to encourage the nurse to monitor the patient's response to the pain?
1. Fidelity
2. Beneficence
3. Nonmaleficence
4. Respect for autonomy
1. Fidelity
In most ethical dilemmas in health care, the solution to the dilemma requires negotiation among members of the health care team. Why is the nurse's point of view valuable?
1. Nurses understand the principle of autonomy to guide respect for a patient's self-worth.
2. Nurses have a scope of practice that encourages their presence during ethical discussions.
3. Nurses develop a relationship with the patient that is unique among all professional health care providers.
4. The nurse's code of ethics recommends that a nurse be present at any ethical discussion about patient care.
3. Nurses develop a relationship with the patient that is unique among all professional health care providers.