Test Bank for Professional Nursing Concepts & Challenges, 8th Edition By Beth Black

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Test Bank for Professional Nursing Concepts & Challenges, 8th Edition By Beth Black

 

 

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Chapter 06: Legal Aspects of Professional Nursing Practice

Black: Professional Nursing: Concepts & Challenges, 8th Edition

 

MULTIPLE CHOICE

 

  1. Which of the following is an example of civil law?
a. Possession of marijuana
b. Assault and battery
c. Giving alcohol to a minor
d. Child custody case

 

 

ANS:  D

 

  Feedback
A Possession of marijuana is an example of a violation of criminal law: possession of an illegal substance.
B Assault and battery comes under the purview of criminal law.
C Giving alcohol to a minor is an example of a violation of criminal law.
D Civil law recognizes and enforces the rights of individuals, such as disputes over legal rights or duties of individuals in relation to one another. A child custody case is an example of civil law.

 

 

DIF:    Cognitive Level: Comprehension   REF:   Page 106

 

  1. The nurse practice act of a state defines the scope and responsibilities of nursing practice in that state. Which of the following is true regarding nurse practice acts?
a. They determine the educational requirements for licensure.
b. They describe the process for gaining membership to a professional organization.
c. They regulate how many professional nursing organizations may be formed.
d. They define the practice of medicine in relation to nursing.

 

 

ANS:  A

 

  Feedback
A Nurse practice acts define the minimum educational qualifications and other requirements for licensure.
B Nurse practice acts do not describe the process for admission to the state board of nursing.
C Nurse practice acts do not regulate nursing organizations.
D Nurse practice acts have no authority over medical practice issues.

 

 

DIF:    Cognitive Level: Comprehension   REF:   Page 107

 

  1. Which of the following falls under the jurisdiction of the state board of nursing?
a. Approving or reject applications for new nursing education programs
b. Expanding the provisions of the nurse practice act
c. Reducing the provisions of the nurse practice act
d. Right to suspend the need for licensure of registered nurses (RNs) in times of extreme shortage

 

 

ANS:  A

 

  Feedback
A Schools of nursing must have state approval from the state board of nursing to operate.
B The state board of nursing can enforce the nurse practice act but cannot expand it.
C The state board of nursing can enforce the nurse practice act but cannot reduce it.
D The state board of nursing does not have the authority to suspend the licensure requirement for any reason.

 

 

DIF:    Cognitive Level: Comprehension   REF:   Page 108

 

  1. The most common reason that nurses are disciplined by the state board of nursing is
a. making medication errors.
b. following unsafe nursing practice.
c. practicing while impaired.
d. abandoning patients.

 

 

ANS:  C

 

  Feedback
A Medication errors are not the most common cause of nurses having their licenses suspended.
B Unsafe nursing practice is a reason to have a license suspended but not the most common reason.
C The most common reason that the state board suspends a nurse’s license is for practicing while impaired.
D Abandoning patients is not the most common reason for suspending nursing licenses.

 

 

DIF:    Cognitive Level: Knowledge          REF:   Page 108

 

  1. What is the primary function of the National Council of State Boards of Nursing (NCSBN)?
a. Overseeing decisions made by state boards of nursing
b. Developing the NCLEX-RN® and NCLEX-PN® licensing examinations
c. Administering the NCLEX examination at testing centers
d. Overseeing granting licensure by endorsement

 

 

ANS:  B

 

  Feedback
A The NCSBN does not have the authority to oversee state boards of nursing.
B The NCSBN develops the test plan and items for the NCLEX examination.
C States, not the NCSBN, administer the NCLEX examination.
D State boards of nursing, not the NCSBN, grant licensure through endorsement.

 

 

DIF:    Cognitive Level: Comprehension   REF:   Page 109

 

  1. Which of the following actions by the nurse constitutes professional malpractice?
a. Administering a preoperative sedative in the patient holding area instead of in the patient’s room
b. Failing to notify the physician of a potassium level of 4 mEq/L
c. Placing the head of the bed flat when a patient is receiving a tube feeding, causing the patient to aspirate the mixture
d. Administering a routine medication 10 minutes late because of a unit emergency

 

 

ANS:  C

 

  Feedback
A Administering a preoperative sedative in the patient holding area instead of in the patient’s room does no harm to the patient.
B Failing to notify the physician of a potassium level of 4 mEq/L does not necessarily do harm to the patient.
C The reasonable nurse would know that the head of the bed must be elevated when the patient is receiving a tube feeding.
D No harm resulted from administering a routine medication 10 minutes late because of a unit emergency.

 

 

DIF:    Cognitive Level: Analysis               REF:   Page 110

 

  1. The nurse forgets to give the patient a dose of antibiotic. Later in the shift, the patient goes into cardiac arrest and dies. What element is lacking to support malpractice?
a. Duty of care
b. Breach of duty
c. Specific injury
d. Proximate cause

 

 

ANS:  D

 

  Feedback
A There is nothing to support that the nurse did not assume the duty of care of the patient.
B Although the nurse breached her duty by not administering the antibiotic, there also has to be support that this action caused the injury.
C Although one might claim injury (cardiac arrest and death), the link to the nurse’s action is not supported.
D There is no support that failing to administer the antibiotic caused the cardiac arrest and death.

 

 

DIF:    Cognitive Level: Analysis               REF:   Page 111

 

  1. Analysis of cases of reported negligence from 1995 to 2001 demonstrated that the majority of cases occurred in which patient care setting?
a. Acute care
b. Psychiatric
c. Nursing homes and long-term care facilities
d. Home health

 

 

ANS:  A

 

  Feedback
A The majority of negligence cases (60%) occurred in acute care settings.
B Psychiatric settings accounted for only 8% of the cases of negligence.
C Nursing homes accounted for 18% of the cases of negligence.
D Home health settings accounted for only 2% of the cases of negligence.

 

 

DIF:    Cognitive Level: Knowledge          REF:   Page 112

 

  1. A competent resident in a long-term care facility refuses an ordered antidepressant medication. The nurse believes the patient needs the medication because he is clearly showing signs of depression and dissolves the medication in juice without telling the patient. This illustrates negligence by failure to
a. follow the standard of care.
b. assess and monitor a patient.
c. communicate with a patient.
d. document.

 

 

ANS:  C

 

  Feedback
A The standard of care was followed as related to the giving of an ordered medication.
B The nurse assessed the patient and determined he still needed the medication because he was showing signs of depression.
C The nurse did not communicate with the patient to determine why he did not want to take the medication. Based on the information she gathered, further actions could have been taken.
D There is no evidence that the nurse did not document the administration of the medication.

 

 

DIF:    Cognitive Level: Application          REF:   Page 112

 

  1. A nursing student got a thank-you card from a patient’s family and had another student take a photo of the student with the family. The student asks the nursing instructor if it would be alright to post the photo on Facebook. Which response by the instructor is best?
a. “Yes, as long as you ask the family if that would be OK.”
b. “I think that would be OK, but you should check hospital policy.”
c. “No, posting pictures of patients and families on social media sites is not acceptable.”
d. “No, that could lead to a malpractice suit by the patient or family.”

 

 

ANS:  C

 

  Feedback
A Confidentiality and Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulations place severe restrictions on nurses’ use of social media sites. The student should not post the photo.
B The hospital probably has a policy regarding the use of social media sites, but the student should also be instructed to check the nursing school’s policies as well. Most such policies prohibit or severely restrict what nurses and students can post. Even if there are no policies in place, the student should not post the photo due to ethical and HIPAA considerations.
C The student would be wise to not post the photo on any social media site. Posts are neither “private” or inaccessible once deleted.
D In order to prove a claim of malpractice, four elements are needed; duty, breach of duty, harm, and causation. This would most likely not be a case of malpractice.

 

 

DIF:    Cognitive Level: Analysis               REF:   Page 114

 

  1. The nurse giving medications to a pediatric patient notes that an order for a medication is considerably larger than the usual dose. The nurse looks up the medication in a pharmacology book and finds the prescribed dose is too large. Which action should the nurse take?
a. Documenting the findings in the chart after giving the medication
b. Calling the nursing supervisor and ask what to do next
c. Calling the pharmacist to obtain the usual dosage
d. Notifying the physician of these findings before giving the medication

 

 

ANS:  D

 

  Feedback
A Documentation is important, but the order needs to be clarified before the medication is administered.
B Although seeking advice from the supervisor is helpful, the nurse still needs to clarify the order with the physician who wrote it.
C Although the pharmacist can check the dosage calculation and provide supportive information to the nurse, he or she is unable to change the order; only the physician can do that.
D The nurse notifying the physician of her findings before giving the medication allows the physician to clarify the order if written incorrectly or to clarify his rationale for the increased amount.

 

 

DIF:    Cognitive Level: Analysis               REF:   Page 121

 

  1. Which of the following nursing responsibilities can never be delegated?
a. Complex tasks
b. Evaluation
c. Medication administration
d. Accountability

 

 

ANS:  D

 

  Feedback
A Complex tasks can be delegated if the person has been trained to perform the task.
B While an unlicensed assistive personnel (UAP) is not qualified to evaluate results, if the nurse delegates something to another RN, the second RN is responsible for evaluating the results and acting appropriately.
C Medication administration in some states can delegated (to a limited degree) to UAPs.
D Professional accountability cannot be delegated.

 

 

DIF:    Cognitive Level: Comprehension   REF:   Page 113

 

  1. The RN asked a nursing assistant to monitor several postoperative patients. Which of the following instructions to the nursing assistant demonstrate appropriate delegation?
a. “Take vital signs every 2 hours, and report to me anything outside of the norms.”
b. “Assess pain using a 10-point scale, and record the score on the chart.”
c. “Record the urine output, and report to me if they have not voided within 4 hours.”
d. “Record the amount of drainage on the dressing on the bedside record.”

 

 

ANS:  C

 

  Feedback
A The nursing assistant is told to report “anything outside of the norms.” An RN should not assume that the nursing assistant knows the specific norms the RN is referring to.
B The nursing assistant should know if there are specific scores that the RN wishes to know about.
C This is the most appropriate instruction because the nursing assistant not only knows what to do but also what specific information to report.
D The RN needs to know the amount of drainage to determine whether any further actions are needed.

 

 

DIF:    Cognitive Level: Application          REF:   Page 113

 

  1. The RN delegates changing a sterile dressing over a central line to a licensed practical/vocational nurse (LPN/LVN). The LPN/LVN contaminated the site during the dressing change, and an infection developed in the patient. Which of the following statements is true?
a. The LPN/LVN is guilty of malpractice.
b. The RN is ultimately responsible for acts he or she delegates.
c. The hospital cannot be held responsible for the acts of its employees.
d. A malpractice suit cannot be brought as no harm came to the patient.

 

 

ANS:  B

 

  Feedback
A Guilt has to be determined in a court of law. The LPN/LVN can be held responsible for actions in relation to the LPN/LVN scope of practice in the state.
B The RN is responsible for tasks delegated to both licensed and unlicensed personnel.
C The hospital can be held responsible for employees not correctly following policies related to the standards of quality care.
D The patient was harmed.

 

 

DIF:    Cognitive Level: Comprehension   REF:   Page 113

 

  1. Which of the following is a legitimate defense to a charge of assault and battery?
a. Presence of a medical order
b. Knowledge of what is best for the patient
c. Informed consent
d. Living will

 

 

ANS:  C

 

  Feedback
A The presence of a medical order does not negate the need for informed consent.
B Even if the treatment is in the patient’s best interest, without informed consent it cannot be done.
C Informed consent is a viable defense against an accusation of assault and battery.
D Having a living will does not replace the need for informed consent.

 

 

DIF:    Cognitive Level: Knowledge          REF:   Page 114

 

  1. In which of the following situations should the legality of an informed consent be questioned?
a. Patient with dementia; consent given by spouse
b. Patient who received a preoperative dose of Demerol before giving consent
c. Patient who is anxious and asks many questions of the physician
d. Patient who expresses concern about the cost of the procedure

 

 

ANS:  B

 

  Feedback
A When the patient is incompetent, a spouse may give informed consent.
B Patients cannot be sedated or impaired and legally give informed consent.
C Patients have a right to ask questions of the health care team.
D Questioning the cost does not negate the legality of the informed consent.

 

 

DIF:    Cognitive Level: Application          REF:   Page 114

 

  1. Which of the following is a nursing responsibility regarding informed consent?
a. Canceling the procedure if the patient has questions
b. Explaining the procedure, risks, and treatment alternatives
c. Serving as a witness, ensuring that the patient does not feel coerced into a decision
d. Ensuring that the physician has completely explained the costs of the procedure

 

 

ANS:  C

 

  Feedback
A The nurse does not have the responsibility to schedule or cancel medical procedures.
B The physician has the responsibility of explaining the procedure, risks, and benefits.
C The nurse can serve as a witness in informed consent.
D The costs of the procedure are not required to be included in the physician’s explanation.

 

 

DIF:    Cognitive Level: Comprehension   REF:   Page 114

 

  1. Which of the following actions is acceptable as an exception to a nurse’s obligation regarding confidentiality?
a. Reporting certain diseases to public health authority
b. Discussing a patient’s care with someone who does not know the patient
c. Leaving printouts of lab reports on the desk in the physicians’ lounge as a convenience
d. Discussing a patient’s condition in a public place as long as the patient’s name is not mentioned

 

 

ANS:  A

 

  Feedback
A Exceptions to confidentiality include reporting certain diseases to the appropriate public health authority.
B It is inappropriate to discuss a patient with anyone outside of the treatment team.
C Patient records must be kept private at all times.
D Even if the patient’s name is not mentioned, discussing a patient in public is a violation of privacy because someone listening may be able to determine the patient’s identity from the discussion.

 

 

DIF:    Cognitive Level: Knowledge          REF:   Page 114

 

  1. Which patient rights are guaranteed by HIPAA?
a. Patients are asked to sign a release of responsibility if their health care records inadvertently become a matter of public record.
b. Patients sign a release protecting the health care provider and insurance company against computer file theft.
c. Patients are protected against medical records being indiscriminately shared.
d. Patients may receive a complete copy of their medical records at no cost.

 

 

ANS:  C

 

  Feedback
A Patients’ health records are never to become a matter of public record.
B Health care providers and insurance companies are not protected against computer theft.
C HIPAA protects medical records: written, oral, and electronic.
D Patients have access to their medical records through HIPAA, but they may be assessed a fee.

 

 

DIF:    Cognitive Level: Comprehension   REF:   Page 115

 

  1. A child is tested for genetic abnormalities. After the test results are delivered from the laboratory, a representative of the parents’ medical insurance company calls the nurse’s station and asks for the results of the tests. The nurse’s best response to this request is to
a. refuse to give the information.
b. tell the representative the status of the tests is unknown.
c. give the results as reported because the insurance company is paying for the tests.
d. tell the representative that the test results will need to be obtained from the physician who ordered them.

 

 

ANS:  A

 

  Feedback
A On the basis of HIPAA guidelines, this information is for the patient and health care providers.
B Nurses should not provide false information.
C Giving the test results to the insurance company would violate the HIPAA guidelines.
D Nurses should not provide false information.

 

 

DIF:    Cognitive Level: Application          REF:   Page 115

 

  1. The Patient Self-Determination Act of 1991, as implemented today, is known as providing
a. informed consent.
b. advance directives.
c. patient bill of rights.
d. HIPAA protections.

 

 

ANS:  B

 

  Feedback
A Informed consent assures patient autonomy.
B Advance directives describe an individual’s preferences in regard to medical intervention should the individual become incapacitated, which was the primary intent of the Patient Self-Determination Act of 1991.
C The patient bill of rights assures patients certain basic rights unrelated to becoming incapacitated.
D HIPAA protects medical records from disclosure.

 

 

DIF:    Cognitive Level: Comprehension   REF:   Page 120

 

  1. Which of the following puts the nurse at increased risk for legal action?
a. Delegating a Foley catheter insertion to a LPN/LVN
b. Documenting the exact words a patient uses when complaining
c. Not assessing a patient who is complaining of pain
d. Caring for a postoperative patient who has a pulmonary embolus while being transferred to the chair

 

 

ANS:  C

 

  Feedback
A Proper delegation does not increase risk for legal action.
B Documenting in detail, including using direct quotations when appropriate, will protect the nurse from legal liability.
C Failing to assess a patient constitutes an area of risk.
D The embolus may have been unavoidable, and encouraging postoperative mobility meets the standard of care.

 

 

DIF:    Cognitive Level: Application          REF:   Pages 110-111

 

  1. Which of the following chart entries represents a pitfall in documentation?
a. Restless and combative; SaO2 87%
b. Patient demanding and difficult to please
c. Discovered in bathroom; instructed to ask for assistance before ambulating
d. Three-centimeter area of serosanguineous drainage noted on the dressing to the left hip

 

 

ANS:  B

 

  Feedback
A “Restless and combative; SaO2 87%” is an acceptable chart entry.
B The chart entry is subjective and nonspecific. It also contains judgments about the patient which could be interpreted as bias.
C “Discovered in bathroom; instructed to ask for assistance before ambulating” is an acceptable chart entry; it is accurate and concise.
D “Three-centimeter area of serosanguineous drainage noted on the dressing to the left hip” is complete, accurate, and concise.

 

 

DIF:    Cognitive Level: Application          REF:   Page 121

 

  1. The quality of nursing care is judged by whether nursing actions meet the standard of care. Which of the following is an example of meeting the standard of care?
a. Demonstrating the use of the nursing process when charting
b. Following actions consistent with local practice
c. Monitoring a patient more closely if the equipment has occasionally malfunctioned
d. Bypassing medication checks to save time once the nurse is experienced

 

 

ANS:  A

 

  Feedback
A Charting that includes assessment, planning, intervention, and evaluation must be present in the patient’s record.
B National, not local, standards of practice should be used.
C Nurses must use equipment properly and replace it when it is malfunctioning.
D Proper medication safety checks are the standard of practice for all nurses, including those with experience.

 

 

DIF:    Cognitive Level: Application          REF:   Pages 121-122

 

  1. Which of the following is an important step in preventing legal action against the nurse?
a. Never make a mistake.
b. Deflect blame from yourself as much as possible.
c. Develop caring, therapeutic relationships with patients.
d. Avoid explaining care procedures to patients.

 

 

ANS:  C

 

  Feedback
A It is not reasonable to expect that nurses will never make a mistake.
B Nurses must have accountability for errors.
C Establishing and maintaining good communication and rapport with patients not only is an aspect of best practice but also protects the nurse from lawsuits.
D Nurses should explain all procedures to patients.

 

 

DIF:    Cognitive Level: Knowledge          REF:   Page 123

 

MULTIPLE RESPONSE

 

  1. The American Nurses Association (ANA) published a guide for state nurses associations seeking to revise their nurse practice acts. According the ANA, which of the following should be included in these revisions? (Select all that apply.)
a. Differentiation between advanced and generalist nursing practice
b. Authority for boards of nursing to oversee UAP
c. Specified frequency of revisions to the nurse practice acts
d. Authority for boards of nursing to regulate prescription writing by advanced practice nurses
e. Nurses’ responsibility for delegating to LPN/LVNs

 

 

ANS:  A, B, D, E

 

  Feedback
Correct “Differentiation between advanced and generalist nursing practice,” “authority for boards of nursing to oversee UAP,” “specified frequency of revisions to the nurse practice acts,” “authority for boards of nursing to regulate prescription writing by advanced practice nurses” and “nurses’ responsibility for delegating to LPN/LVNs” are identified in the ANA’s Model Practice Act published in 1996.
Incorrect The frequency of revision for the nurse practice acts is not addressed.

 

 

DIF:    Cognitive Level: Knowledge          REF:   Page 107

 

  1. The central question in any charge of malpractice is whether the prevailing standard of care was met. Which of the following are considered part of the standard of nursing care? (Select all that apply.)
a. Basic prudent nursing care is a standard.
b. Health care providers determine standards of care in health care settings.
c. Standards of care are never changing.
d. Standards are based on the ethical principle of nonmaleficence.
e. National standards of nursing practice are standards for all nurses.

 

 

ANS:  A, D, E

 

  Feedback
Correct The standard of care reflects a basic minimum level of prudent care for the nurse based on the ethical principle of nonmaleficence or “to do no harm,” and the national standards of nursing relevant to the situation at that time.
Incorrect Nurses, not other health care providers, are responsible for determining whether the standard of nursing care was met. As nursing practice develops, the standards of care change accordingly.

 

 

DIF:    Cognitive Level: Comprehension   REF:   Pages 110-111

 

  1. For a nursing malpractice action, essential characteristics of negligence must be present. Which of the following constitute these essential characteristics? (Select all that apply.)
a. The nurse assumed the responsibility for the patient’s care.
b. The nurse is found to have failed to meet the standard of care.
c. The harm to the patient must be shown to have been caused by the failure to meet the standard of care.
d. Harm to an individual has occurred.
e. The nurse’s action involves acts of commission.

 

 

ANS:  A, B, C, D

 

  Feedback
Correct The nurse assuming the responsibility for the patients’ care, the nurse failing to meet the standard of care, harm occurring to an individual, and the harm being shown to have been caused by the failure to meet the standard of care are the four elements that need to be present to support the charge of malpractice.
Incorrect Malpractice can involve acts of either commission or omission.

 

 

DIF:    Cognitive Level: Comprehension   REF:   Page 111

 

  1. The nurse receives reports on the following patients at the beginning of the shift. Which of the following care activities could be delegated to a nursing assistant? (Select all that apply.)
a. Ambulating a patient who had an emergency appendectomy 8 hours ago, has stable vital signs, and needs to ambulate for the second time
b. Assisting a patient who was in an automobile accident and whose right arm and leg are in traction with bathing
c. Feeding a patient recovering from a stroke resulting in difficulty holding a spoon
d. Taking vital signs, including blood pressure, for a patient with newly diagnosed diabetes and a history of hypertension
e. Measuring a bed-bound patient’s pressure ulcer and assessing the patient’s risk for skin breakdown when turning the patient

 

 

ANS:  A, B, C, D

 

  Feedback
Correct Nursing assistants can assist with hygiene and activities of daily living, especially for patients in stable conditions.
Incorrect UAP cannot interpret data or assess patients, because assessment is part of the nursing process.

 

 

DIF:    Cognitive Level: Analysis               REF:   Page 113

 

Chapter 07: Ethics: Basic Concepts for Professional Nursing Practice

Black: Professional Nursing: Concepts & Challenges, 8th Edition

 

MULTIPLE CHOICE

 

  1. Which of the following situations is an example of moral distress?
a. You hear nurses in the lounge making off-color jokes about a patient. You are afraid to speak up for fear of retaliation.
b. You have been late for work a couple of times in the last 2 weeks, and your co-workers are covering for you.
c. You become romantically involved with a co-worker, which is against the unit policy, so you resign your position.
d. You purposefully use vague language when explaining a patient’s condition to the family. Staff expects that the patient may be brain-dead, but test results are not yet conclusive.

 

 

ANS:  A

 

  Feedback
A The definition of “moral distress” is distress that results from participating in a perceived moral wrongdoing due to situational constraints despite attempting to make a moral choice.
B There is no breach of ethics in being late and having co-workers cover for you.
C The person acts appropriately to the moral issue by resigning the position.
D The person is acting appropriately under current circumstances.

 

 

DIF:    Cognitive Level: Analysis               REF:   Page 127

 

  1. According to Kohlberg’s theory of moral development, adolescents who shoplift are operating in which level of moral development?
a. Preconventional
b. Conventional
c. Postconventional
d. Developmental

 

 

ANS:  A

 

  Feedback
A In Kohlberg’s preconventional level of moral development, the individual is inattentive to the norms of society and is self-centered.
B In the conventional level, moral decisions conform to the norms of society.
C In the postconventional level, the individual has a highly developed moral value system independent of group norms.
D “Developmental” is not a level of moral development identified by Kohlberg.

 

 

DIF:    Cognitive Level: Comprehension   REF:   Pages 129-130

 

  1. According to Kohlberg’s theory of moral development, individuals who act “because it is the rule of society” are operating in which level of moral development?
a. Preconventional
b. Conventional
c. Postconventional
d. Developmental

 

 

ANS:  B

 

  Feedback
A In Kohlberg’s preconventional level of moral development, the individual is inattentive to the norms of society and is self-centered.
B In the conventional level, moral decisions conform to the norms of society.
C In the postconventional level, the individual has a highly developed moral value system independent of group norms.
D “Developmental” is not a level of moral development identified by Kohlberg.

 

 

DIF:    Cognitive Level: Comprehension   REF:   Page 130

 

  1. Flight 93, hijacked on September 11, 2001, crashed into the Pennsylvania countryside because some of the passengers decided to try to take control of the plane and prevent it from being used as a weapon of mass destruction against structures in Washington, D.C. They decided to act despite grave danger to themselves. This is an example of which level of Kohlberg’s theory of moral development?
a. Preconventional
b. Conventional
c. Postconventional
d. Conventional phase 4

 

 

ANS:  C

 

  Feedback
A In the preconventional level, the person’s self-interest takes precedence over group norms.
B In the conventional level, the person conforms to group norms.
C People in the postconventional level of moral development may ignore self-interest and group norms when making decisions and may sacrifice themselves for the group.
D Phase 4 of the conventional level follows group and cultural norms.

 

 

DIF:    Cognitive Level: Analysis               REF:   Page 130

 

  1. According to Kohlberg’s theory, which of the following is true of moral development?
a. Participating in decision making promotes moral reasoning.
b. Intellectual development has no effect on moral development.
c. Participating in debates on ethical issues decreases moral development.
d. Holding people responsible for their actions does not improve moral development.

 

 

ANS:  A

 

  Feedback
A Kohlberg thought that certain conditions promote moral development, such as participating in decision making.
B Kohlberg thought that intellectual development was necessary for advanced moral development.
C Participating in debates on ethical issues does enhance moral development.
D Taking responsibility for actions promotes moral development.

 

 

DIF:    Cognitive Level: Comprehension   REF:   Page 130

 

  1. Gilligan’s theory on moral development differed from Kohlberg’s theory because Gilligan considered which population not addressed by Kohlberg?
a. Children
b. Men
c. Women
d. Adolescents

 

 

ANS:  C

 

  Feedback
A Kohlberg mostly tested his theory in men and boys.
B Men were the focus of Kohlberg’s theory.
C Gilligan thought that Kohlberg’s theory did not recognize the experience of women in moral development.
D Gilligan’s theory did not focus on adolescents.

 

 

DIF:    Cognitive Level: Knowledge          REF:   Page 130

 

  1. Which of the following ethical theories is illustrated by the example of following the Golden Rule, “Do unto others as you wish them to do unto you”?
a. Deontology
b. Principlism
c. Utilitarianism
d. Virtue ethics

 

 

ANS:  A

 

  Feedback
A Deontology states that an act is moral if it originates from good will.
B Principlism is the use of ethical principles in decision making.
C Decisions are made based on what will do the greatest good for the greatest number of people. A main tenet of utilitarian ethics is that right or useful actions bring about the greatest good for the greatest number of people.
D Virtue ethics refers to character traits of the decision maker, such as honesty, courage, kindness, and integrity.

 

 

DIF:    Cognitive Level: Application          REF:   Page 132

 

  1. Which of the following ethical theories is illustrated by the example of triage in disaster nursing?
a. Deontology
b. Principlism
c. Utilitarianism
d. Virtue ethics

 

 

ANS:  C

 

  Feedback
A Deontology states that an act is moral if it originates from good will.
B Principlism is the use of ethical principles in decision making.
C Triage in disasters requires decisions to be made on how to do the greatest good for the greatest number of people. A main tenet of utilitarian ethics is that right or useful actions bring about the greatest good for the greatest number of people.
D Virtue ethics refers to character traits of the decision maker, such as honesty, courage, kindness, and integrity.

 

 

DIF:    Cognitive Level: Application          REF:   Page 133

 

  1. Respecting the right of a patient with terminal cancer to refuse chemotherapy is based on a belief in the ethical principle of
a. justice.
b. autonomy.
c. nonmaleficence.
d. death with dignity.

 

 

ANS:  B

 

  Feedback
A “Justice” refers to the equality of the allocation of services.
B Autonomy is based on the principle that patients have the right to determine their own course of action.
C “Nonmaleficence” refers to the responsibility to do no harm.
D Death with dignity is not an ethical principle.

 

 

DIF:    Cognitive Level: Application          REF:   Page 134

 

  1. Respecting an elderly woman’s decision to stay in her own home is based on a belief in the ethical principle of
a. justice.
b. autonomy.
c. nonmaleficence.
d. death with dignity.

 

 

ANS:  B

 

  Feedback
A “Justice” refers to the equality of the allocation of services.
B Autonomy is based on the principle that patients have the right to determine their own course of action.
C “Nonmaleficence” refers to the responsibility to do no harm.
D Death with dignity is not an ethical principle.

 

 

DIF:    Cognitive Level: Application          REF:   Page 134

 

  1. A school nurse teaching school-aged children about water safety is an example of which ethical principle?
a. Beneficence
b. Justice
c. Veracity
d. Autonomy

 

 

ANS:  A

 

  Feedback
A Beneficence can be seen as “the doing of good.”
B “Justice” refers to the equal treatment of all.
C Veracity is truth telling.
D “Autonomy” refers to an individual’s right to make his or her own decisions.

 

 

DIF:    Cognitive Level: Application          REF:   Pages 134-135

 

  1. A nurse who advocates for a longer stay when a medically indigent patient is being prematurely discharged to reduce hospital cost is relying on which ethical principle?
a. Justice
b. Beneficence
c. Autonomy
d. Fidelity

 

 

ANS:  A

 

  Feedback
A “Justice” refers to the equal and fair allocation of services based on need. According to this principle, the patient should receive the same care as others in the same condition, regardless of ability to pay.
B “Beneficence” simply refers to doing good.
C Autonomy asserts that individuals have the right to make their own decisions.
D “Fidelity” is an incomplete answer, because fidelity refers to faithfulness or honoring one’s promises to patients.

 

 

DIF:    Cognitive Level: Application          REF:   Page 135

 

  1. The current emphasis on eliminating racially based health disparities is based on which of the following ethical principles?
a. Double effect
b. Fidelity
c. Justice
d. Veracity

 

 

ANS:  C

 

  Feedback
A Double effect is the concept that justifies inflicting harm if the intent is to produce an overall good effect.
B “Fidelity” refers to honoring one’s promises to patients.
C The principle of justice states that equals should be treated the same.
D Veracity is telling the truth.

 

 

DIF:    Cognitive Level: Application          REF:   Page 135

 

  1. A nurse is turning a bedfast patient to prevent pressure ulcers. The patient complains that the process is painful. The nurse explains the reason for the turning schedule and completes the task. This is an example of the ethical principle of
a. autonomy.
b. fidelity.
c. nonmaleficence.
d. veracity.

 

 

ANS:  C

 

  Feedback
A Autonomy has to do with individuals being able to make their own decisions.
B “Fidelity” refers to honoring one’s commitments and promises.
C “Nonmaleficence” is defined as the duty to do no harm. Although temporarily painful, not turning the patient would cause actual harm (physical damage), and so this nurse is acting on the principle of nonmaleficence.
D “Veracity” refers to being truthful.

 

 

DIF:    Cognitive Level: Application          REF:   Page 135

 

  1. A patient who is terminally ill is experiencing great pain. To relieve the patient’s suffering, the nurse needs to administer larger doses of morphine. This relieves the pain but also inhibits respiration. Which principle justifies the risk of harm?
a. Justice
b. Fidelity
c. Veracity
d. Double effect

 

 

ANS:  D

 

  Feedback
A Justice relates to equal treatment of all.
B Fidelity is faithfulness to one’s commitments.
C Veracity is being truthful.
D The principle of double effect addresses actions that may result in a negative effect if the end result is good. The end point justifies the risk of harm.

 

 

DIF:    Cognitive Level: Application          REF:   Page 135

 

  1. Taking a pediatric patient to the playroom on a promised time and day is based on the belief in the ethical principle of
a. autonomy.
b. fidelity.
c. justice.
d. veracity.

 

 

ANS:  B

 

  Feedback
A Autonomy relates to the right of individuals to make their own decisions.
B Fidelity is being faithful to commitments made to others.
C “Justice” refers to the equal treatment of all.
D Veracity is being truthful.

 

 

DIF:    Cognitive Level: Application          REF:   Page 137

 

  1. When nurses receive a patient assignment and accept reports on these patients, they are committed to providing care to those assigned to them. This is based on the ethical principle of
a. beneficence.
b. fidelity.
c. justice.
d. veracity.

 

 

ANS:  B

 

  Feedback
A Beneficence speaks to doing good.
B Fidelity is being faithful or keeping commitments made to others. In accepting the assignment, the nurse has committed to caring for the patients assigned to her or him.
C Justice is related to the equal treatment of all.
D “Veracity” refers to one’s truthfulness.

 

 

DIF:    Cognitive Level: Application          REF:   Page 137

 

  1. Answering a terminally ill child’s questions about his or her condition honestly is based on a belief in the ethical principle of
a. autonomy.
b. fidelity.
c. justice.
d. veracity.

 

 

ANS:  D

 

  Feedback
A Autonomy relates to the right of an individual to make his or her own decisions.
B “Fidelity” refers to being faithful to one’s commitments.
C “Justice” refers to the equal treatment of all.
D “Veracity” is defined as telling the truth. Truthfulness is fundamental in the development and maintenance of trust in a relationship.

 

 

DIF:    Cognitive Level: Application          REF:   Page 137

 

  1. A father of four is admitted after an automobile accident in which two of the children were killed. Recognizing that he is in very serious condition, the nurse believes that it would be appropriate to avoid telling him about the death of his children unless he asks directly. This could be considered a violation of the ethical principle of
a. beneficence.
b. fidelity.
c. justice.
d. veracity.

 

 

ANS:  D

 

  Feedback
A Beneficence is the expectation of doing good.
B “Fidelity” refers to keeping commitments and promises.
C Justice is the treatment of all equally.
D Veracity is truth telling. The nurse is not lying but is not forthcoming with the information about the children.

 

 

DIF:    Cognitive Level: Application          REF:   Page 137

 

  1. Which of the following is the best description of a code of ethics?
a. A document that describes the correct course of action and does not change regardless of societal changes
b. A document that all professions must have even if not representative of practice
c. A document that permits others to know what principles guide professional decision making
d. A document widely open to interpretation by professionals in various settings

 

 

ANS:  C

 

  Feedback
A Codes of ethics have been revised through the years to reflect changes in society.
B Codes are useful only if upheld by members of the profession in their daily practice.
C The Code of Ethics of nursing is an implied contract through which the profession informs society of the principles and rules by which it functions.
D The Code of Ethics should be interpreted in a similar way regardless of practice setting.

 

 

DIF:    Cognitive Level: Comprehension   REF:   Page 138

 

  1. A nurse is involved in an ethically challenging case. To use an ethical decision-making model, which step should the nurse perform first?
a. Gather and examine all possible solutions.
b. Identify the ethical dilemma in the case.
c. Identify all parties who will be impacted by the decision.
d. Gather all information important to the situation

 

 

ANS:  B

 

  Feedback
A The first step in many ethical decision-making models is to identify the ethical dilemma. Examining all possible solutions comes after this step and gathering information.
B The first step in many ethical decision-making models is to identify the ethical dilemma.
C The first step in many ethical decision-making models is to identify the ethical dilemma. Identifying parties affected is not a specific step but is part of identifying the dilemma.
D The first step in many ethical decision-making models is to identify the ethical dilemma. The next step would be to gather all data related to the situation.

 

 

DIF:    Cognitive Level: Comprehension   REF:   Page 139

 

MULTIPLE RESPONSE

 

  1. Which of the following are activities in the ethical decision making process? (Select all that apply.)
a. Avoid looking at legal cases or precedents related to the situation.
b. Determine if the people who are affected by the dilemma have value conflicts.
c. Brainstorm with others involved to identify all possible solutions.
d. Evaluate the action taken to determine whether it accomplished its purpose.
e. Discuss only acceptable solutions that are practical to implement.

 

 

ANS:  B, C, D

 

  Feedback
Correct Determining who is affected by the dilemma and identifying possible value conflicts among them, identifying all possible solutions, and evaluating the action taken to determine whether it accomplished its purpose clarify the situation and determine whether the selected action achieved its goal.
Incorrect A variety of materials including legal documents may help clarify the situation or help identify possible actions. Ethical decision making is not done in isolation. It may involve others but especially must involve the patient and family. All possible solutions should be considered even if they are unusual, complex, or may be difficult to implement.

 

 

DIF:    Cognitive Level: Comprehension   REF:   Pages 139-140