Nokea
A group of students have been challenged to prioritize ethical practice when working with a marginalized population. How should the students best understand the concept of ethics?
- A. The formal, systematic study of moral beliefs
- B. The informal study of patterns of ideal behavior
- C. The adherence to culturally rooted, behavioral norms
- D. The adherence to informal personal values
Correct Answer: A
Rationale: In essence, ethics is the formal, systematic study of moral beliefs, whereas morality is the adherence to informal personal values.
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A terminally ill patient you are caring for is complaining of pain. The physician has ordered a large dose of intravenous opioids by continuous infusion. You know that one of the adverse effects of this medicine is respiratory depression. When you assess your patients respiratory status, you find that the rate has decreased from 16 breaths per minute to 10 breaths per minute. What action should you take?
- A. Decrease the rate of IV infusion.
- B. Stimulate the patient in order to increase respiratory rate.
- C. Report the decreased respiratory rate to the physician.
- D. Allow the patient to rest comfortably.
Correct Answer: C
Rationale: End-of life issues that often involve ethical dilemmas include pain control, do not resuscitate orders, life-support measures, and administration of food and fluids. The risk of respiratory depression is not the intent of the action of pain control. Respiratory depression should not be used as an excuse to withhold pain medication for a terminally ill patient. The patients respiratory status should be carefully monitored and any changes should be reported to the physician.
Your patient has been admitted for a liver biopsy because the physician believes the patient may have liver cancer. The family has told both you and the physician that if the patient is terminal, the family does not want the patient to know. The biopsy results are positive for an aggressive form of liver cancer and the patient asks you repeatedly what the results of the biopsy show. What strategy can you use to give ethical care to this patient?
- A. Obtain the results of the biopsy and provide them to the patient.
- B. Tell the patient that only the physician knows the results of the biopsy.
- C. Promptly communicate the patients request for information to the family and the physician.
- D. Tell the patient that the biopsy results are not back yet in order temporarily to appease him.
Correct Answer: C
Rationale: Strategies nurses could consider include the following: not lying to the patient, providing all information related to nursing procedures and diagnoses, and communicating the patients requests for information to the family and physician. Ethically, you cannot tell the patient the results of the biopsy and you cannot lie to the patient.
A nurse has been providing ethical care for many years and is aware of the need to maintain the ethical principle of nonmaleficence. Which of the following actions would be considered a contradiction of this principle?
- A. Discussing a DNR order with a terminally ill patient
- B. Assisting a semi-independent patient with ADLs
- C. Refusing to administer pain medication as ordered
- D. Providing more care for one patient than for another
Correct Answer: C
Rationale: The duty not to inflict as well as prevent and remove harm is termed nonmaleficence. Discussing a DNR order with a terminally ill patient and assisting a patient with ADLs would not be considered contradictions to the nurses duty of nonmaleficence. Some patients justifiably require more care than others.
A nurse has been using the nursing process as a framework for planning and providing patient care. What action would the nurse do during the evaluation phase of the nursing process?
- A. Have a patient provide input on the quality of care received.
- B. Remove a patients surgical staples on the scheduled postoperative day.
- C. Provide information on a follow-up appointment for a postoperative patient.
- D. Document a patients improved air entry with incentive spirometric use.
Correct Answer: D
Rationale: During the evaluation phase of the nursing process, the nurse determines the patients response to nursing interventions. An example of this is when the nurse documents whether the patients spirometry use has improved his or her condition. A patient does not do the evaluation. Removing staples and providing information on follow-up appointments are interventions, not evaluations.
The nurse is providing care for a patient with chronic obstructive pulmonary disease (COPD). The nurses most recent assessment reveals an SaO2 of 89%. The nurse is aware that part of critical thinking is determining the significance of data that have been gathered. What characteristic of critical thinking is used in determining the best response to this assessment finding?
- A. Extrapolation
- B. Inference
- C. Characterization
- D. Interpretation
Correct Answer: D
Rationale: Nurses use interpretation to determine the significance of data that are gathered. This specific process is not described as extrapolation, inference, or characterization.