Nokea
A nurse is faced with an ethical dilemma involving a patient. Which question would be most important for the nurse to ask first when engaging in the process of ethical decision making?
- A. What are my own feelings about the situation?
- B. What assumptions am I making that need more data?
- C. What do I know about the situation?
- D. What do I know about the patient?s values?
Correct Answer: C
Rationale: Ethical decision-making begins with gathering facts to understand the situation fully, making 'What do I know about the situation?' the most important first question. This ensures decisions are based on accurate information. While feelings, assumptions, and patient values are important, they are secondary to establishing the factual context.
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A psychiatric nursing class is discussing current trends in mental health care. A student voices the opinion that there should be equitable access to mental health care and resources for those who live in rural areas, for those without health insurance, and for those with very little income. The student nurse?s opinion most closely reflects which ethical principle?
- A. Nonmaleficence
- B. Paternalism
- C. Veracity
- D. Justice
Correct Answer: D
Rationale: The ethical principle of justice emphasizes fairness and equitable distribution of resources and opportunities. The student?s opinion about equitable access to mental health care for underserved populations directly aligns with this principle. Nonmaleficence focuses on avoiding harm, paternalism involves making decisions for others, and veracity pertains to truthfulness, none of which fit as closely.
A nursing student is initiating a relationship with an assigned patient. After meeting and spending approximately 20 minutes talking with the patient, the student makes arrangements to visit again after lunch. After lunch, fellow classmates invite the student to go to the gym with them and a group of patients to play volleyball. The student starts to go with them but then remembers the promise to meet with the patient. The student decides to stay behind and talk to with her patient. The student?s decision reflects which ethical principle?
- A. Autonomy
- B. Beneficence
- C. Fidelity
- D. Veracity
Correct Answer: C
Rationale: Fidelity refers to keeping promises and maintaining loyalty to commitments. By choosing to honor the promise to meet with the patient instead of joining the volleyball game, the student demonstrates fidelity. Autonomy relates to respecting the patient?s decision-making, beneficence involves promoting well-being, and veracity pertains to truthfulness, none of which are as directly relevant.
A 22-year-old patient with schizophrenia is refusing his antipsychotic medication. He states, 'I don?t like the dopey way it makes me feel. I feel like I?m walking under water when I take it.' The nurse explains to him, 'Your schizophrenia is caused by a chemical imbalance in your brain, and this medication helps fix that chemical imbalance. You need to take it so your symptoms will get better.' This conversation reflects a conflict between which two types of ethical principles?
- A. Autonomy and justice
- B. Paternalism and veracity
- C. Justice and nonmaleficence
- D. Autonomy and beneficence
Correct Answer: D
Rationale: The patient?s refusal of medication reflects autonomy (self-determination), while the nurse?s insistence on medication to improve symptoms reflects beneficence (acting for the patient?s benefit). This creates an ethical conflict, as the nurse?s approach prioritizes the patient?s well-being over their right to choose. The other options do not accurately capture this dynamic: justice involves fairness, paternalism involves overriding autonomy, veracity involves truthfulness, and nonmaleficence involves avoiding harm.
In a postclinical conference, a group of students are engaged in a discussion with their instructor. The instructor repeatedly has the students analyze and evaluate the nursing interventions implemented throughout the clinical experience. The students are engaged in which of the following?
- A. Therapeutic use of self
- B. Critical thinking
- C. Interdisciplinary care
- D. Planning care
Correct Answer: B
Rationale: Critical thinking involves analyzing and evaluating information to make reasoned judgments. The instructor?s focus on having students analyze and evaluate nursing interventions aligns with this process, as it encourages reflective and evidence-based reasoning. Therapeutic use of self involves personal engagement with patients, interdisciplinary care involves collaboration with other professionals, and planning care is a specific phase of the nursing process, none of which fit as well.
A nurse is engaged in exercises to develop self-awareness. The nurse is using which tool?
- A. Interdisciplinary care
- B. Reflection
- C. Plan of care
- D. Clinical reasoning
Correct Answer: B
Rationale: Reflection is the process of introspection and self-examination, which is essential for developing self-awareness in nursing. Interdisciplinary care involves collaboration, a plan of care is a structured approach to patient care, and clinical reasoning is a cognitive process for decision-making, none of which directly target self-awareness.