MORAL
Which action is included in Step 3 of the MORAL decision-making model?
1. Realizing information gaps
2. Resolving the dilemma
3. Requesting a review of opposing viewpoints
4. Recognizing the values and options of all major players
2. Resolving the dilemma
Confidentiality will be maintained by the nurse who believes in and values the ethical principle of:
1. Fidelity
2. Veracity
3. Beneficence
4. Autonomy
4. Autonomy
The emergency department nurse is providing discharge teaching to a patient. The patient asks the nurse, “I appreciate everything you’ve done for me and I really like you. Can I take you out for dinner?” Which response does the nurse choose?
1. “Yes, that would be nice. It is really great to be appreciated.”
2. “No, and please do not ask again. Your request is inappropriate.”
3. “I appreciate your kindness, but I will have to decline your offer.”
4. “We cannot socialize until 3 days following your hospital discharge.”
3. “I appreciate your kindness, but I will have to decline your offer.”
The postoperative care unit (PACU) nurse provides care to a patient who underwent a total hip replacement. The nurse is aware that the patient is a practicing Jehovah’s Witness. The primary care provider orders administration of blood for treatment of severe postoperative anemia. The patient is still very drowsy following general anesthesia and is unable to discuss the plan of care. The nurse understands the blood transfusion is necessary for the patient’s survival. However, the nurse is also aware that the patient’s religious beliefs may prohibit the patient from receiving blood products. Which term best describes the conflict the nurse is experiencing?
1. Ethical distress
2. Ethical dilemma
3. Moral dilemma
4. Moral distress
2. Ethical dilemma
The nurse states, “I believe nurses who do not regularly exercise should not talk to patients about the importance of physical activity. Nurses should practice what they teach.” Which term best relates to the content of the nurse’s statement?
1. Morals
2. Ethics
3. Values
4. Compromise
3. Values
An alert, oriented, competent older adult patient is diagnosed with a terminal illness. The patient requests a Do Not Attempt Resuscitation order. The patient’s family members oppose the patient’s decision and ask the healthcare team to ignore the request. Despite lengthy discussions among the patient, physician, nurse, and family, the conflict is unresolved. The nurse asks the hospital chaplain to help the family and healthcare team members understand each other’s opposing views. Which step of the MORAL model is the nurse implementing?
1. M—Massage the dilemma
2. O—Outline the options
3. R—Resolve the dilemma
4. L—Look back and evaluate
2. O—Outline the options
An alert, oriented, competent 87-year-old patient requests a Do Not Attempt Resuscitate order. The patient’s family members oppose the patient’s decision and ask the hospital’s ethics committee to intervene on their behalf. Which framework is the ethics committee most likely as a guide for their decision making process?
1. Social justice
2. Patient benefit
3. Autonomy
4. Human dignity
3. Autonomy
The nurse provides care to an alert, oriented patient who is prescribed a blood transfusion for treatment of severe anemia. The patient refuses the treatment. The primary care provider explains to the patient that the blood transfusion is necessary for survival; however, the patient continues to refuse the transfusion. Which action does the nurse anticipate implementing?
1. Document the patient’s confusion and administer the blood.
2. Request a psychological evaluation to ensure that the patient understands the risks.
3. Ask family members to persuade the patient to consent to receiving blood.
4. Follow the patient’s wishes and do not administer the blood.
4. Follow the patient’s wishes and do not administer the blood.
Which issue represents an internal constraint that may prevent the implementation of ethical decisions?
1. Nurse administrators are viewed by staff nurses as being primarily a source of punishment.
2. Nurses view other staff nurses as being unsupportive on ethical issues.
3. Nursing students are socialized to follow orders and not to question them.
4. Nurses fear retaliation from primary care providers who disagree with nursing decisions.
3. Nursing students are socialized to follow orders and not to question them.
The nurse is assigned to provide care to a patient who developed septicemia following an abortion. The nurse believes abortion is murder of the unborn child. Which concept most specifically requires the nurse to provide high-quality patient care regardless of personal beliefs?
1. Values
2. Moral beliefs
3. Bioethics
4. Nursing ethics
4. Nursing ethics
Through application of the MORAL model to decision making, the nurse who opposes abortion determines that caring for patients who undergo an abortion is still an ethical duty. Which outcome is the best indicator that the nurse effectively applied the MORAL model to the decision making process?
1. The patient is discharged without experiencing complications from the procedure.
2. The nurse believes quality care was delivered and feels satisfied with the decision.
3. The nurse manager commends the nurse for providing excellent patient care.
4. The patient thanks the nurse for being supportive during a difficult time.
2. The nurse believes quality care was delivered and feels satisfied with the decision.
he nursing student is delivering a classroom presentation about professional values identified by the American Association of Colleges of Nursing (AACN). Which example does the nursing student use to illustrate the value of integrity?
1. Acting in accordance with an appropriate code of ethics and standards of practice
2. Treating others fairly regardless of disability
3. Ensuring equal access to quality healthcare
4. Respecting the inherent worth and uniqueness of individuals and populations
1. Acting in accordance with an appropriate code of ethics and standards of practice
The patient is struggling with deciding whether or not to receive experimental treatment. To support the patient’s decision-making process, which action does the nurse take?
1. Offer recommended solutions.
2. Teach the patient how to apply logic to resolve the situation.
3. Advocate for the patient with the primary healthcare provider.
4. Ask the patient questions.
4. Ask the patient questions.
The nurse witnesses the patient’s signature on a consent form to participate in a physician’s research study. After the physician leaves the room, the patient tells the nurse, “I don’t really want to participate, but I’m afraid my doctor will be upset with me if I say no.” To advocate for the patient, which nursing action is most appropriate?
1. Tell the patient the physician will not be upset if she declines to participate.
2. Inform the physician about why the patient agreed to participate.
3. Explain the importance of the research study to the patient.
4. Ask the patient to tell the nurse whether or not any action should be taken.
2. Inform the physician about why the patient agreed to participate.
The nurse admits a patient to the hospital medical-surgical unit of the hospital. During the admission process, the nurse asks whether or not the patient has an advance directive. The basis for the nurse’s inquiry is:
1. The International Council of Nurses (ICN) Code of Ethics for Nurses
2. Values clarification
3. Patient advocacy
4. The Health Insurance Portability and Accountability Act (HIPAA)
3. Patient advocacy
What are the steps of the MORAL Model for ethical decision making ?
M-Massage the Dilemma
O-Outline the Options
R-Resolve the Dilemma
A-Act by Applying the Chosen Option
L-Look back and evaluate
The nursing student asks the nurse educator to explain the American Nurses Association (ANA) Code of Ethics for Nurses. Which statement does the nurse educator include in the explanation?
1. “The ANA Code of Ethics is not subject to public scrutiny.”
2. “The ANA Code of Ethics is not legally binding.”
3. “Nursing codes cannot be used to determine the legality of nursing actions.”
4. “Laws related to nursing practice usually exceed ethical obligations.”
2. “The ANA Code of Ethics is not legally binding.”
The nurse provides care to a 12-year-old patient who is diagnosed with leukemia. The patient’s parents refuse to allow the patient to receive chemotherapy, saying they will not ruin what is left of his life with drugs that will make him feel sicker. Which solution represents an integrity-producing compromise?
1. Supporting the parents’ refusal to include chemotherapy as a patient treatment
2. Instructing the parents that the child will die without chemotherapy
3. Seeking a court order to ensure that chemotherapy is administered
4. Discussing administration of a chemotherapy agent that causes the fewest side effects
4. Discussing administration of a chemotherapy agent that causes the fewest side effects
When faced with a true ethical dilemma, the nurse plans implementation of a variety of strategies to resolve the issue. Which outcome does the nurse anticipate?
1. A satisfying solution will be found if the nurse logically applies more than one strategy for decision making.
2. If the nurse involves other members of the healthcare team in the decision-making process, a compromise will be reached that satisfies everyone.
3. The nurse will probably not find any course of action to be satisfactory, regardless of the strategy, model, or type of reasoning used.
4. A satisfactory decision can be reached that is comfortable for the nurse if the nurse applies a decision model to the dilemma.
3. The nurse will probably not find any course of action to be satisfactory, regardless of the strategy, model, or type of reasoning used.
The nurse’s obligations in ethical situations include which actions? Select all that apply.
1. Advocating for the patient.
2. Engaging with institutional ethics committees.
3. Improving personal ethical decision making abilities.
4. Respecting patient confidentiality.
5. Functioning independently when ethical problems arise.
1. Advocating for the patient.
2. Engaging with institutional ethics committees.
3. Improving personal ethical decision making abilities.
4. Respecting patient confidentiality.