Contemporary Ethical Issues in Nursing

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An elderly person, age 80, is finding it difficult to live alone and the family is considering long-term care. The elderly person is reasonably healthy, with only normal aging declines, and maintains a healthy appetite. All medications are administered orally and require only minimal assistance. She is financially secure with an income based on retirement from both the military and factory from her deceased husband and herself. The family contacts long- term care and is told that, based on this patient's information:

  • A. Medicare will cover the cost of stay since skilled services are required.
  • B. Medicaid is only for families with dependent children.
  • C. Medicare will pay for home health services should these additional services meet the needs of the individual.
  • D. Medicare will pay regardless of household income or financial status for nursing home care.
Correct Answer: C

Rationale: Rationale for Correct Answer (C): Medicare will pay for home health services should these additional services meet the needs of the individual.

1. Medicare covers home health services for individuals who meet specific criteria, which may include being homebound, needing skilled nursing care, and having a care plan established by a healthcare provider.
2. In this scenario, the elderly person is reasonably healthy and only requires minimal assistance with oral medications, indicating that she may benefit from home health services rather than long-term care.
3. Since the elderly person is financially secure, it is likely that she does not meet the eligibility criteria for Medicaid, which is a need-based program for individuals with limited income and resources.
4. Medicare does not cover long-term care in a nursing home unless specific criteria are met, such as requiring skilled services on a short-term basis. In this case, the elderly person's need for assistance with oral medications does not necessarily qualify as a skilled service for nursing home care.

Summary of Incorrect Choices:
A

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It is important to realize that nurses may seek unionization if: (select all that apply)

  • A. physicians rotate on-call coverage among group members for complicated long-term clients.
  • B. scheduling is presented that provides adequate staffing on holidays by rotation of time off for holidays among nurses.
  • C. incident report trends indicate medication errors are caused by shift reports being taped and heard after nurses from the prior shift have left the unit.
  • D. physicians, nurses, nutritionists, and physical therapists visit concurrently with clients to plan care.
Correct Answer: C

Rationale: Rationale:
Choice C is correct because it highlights a significant issue related to patient safety - medication errors caused by delayed shift reports. This creates a legitimate concern for nurses regarding the effectiveness of communication and ultimately patient care. Seeking unionization could be a way for nurses to address this issue collectively.

Summary:
- Choice A is incorrect as it focuses on physician coverage rather than nurse concerns.
- Choice B is incorrect as it addresses staffing and scheduling but does not directly relate to nurses seeking unionization.
- Choice D is incorrect as it describes a collaborative care approach, which does not necessarily indicate a need for unionization among nurses.

A patient is placed on reserpine (Serpalan) to decrease mild anxiety and treat hypertension. The patient researches the medication on the Internet and finds that this medication comes from which plant?

  • A. Atropa belladonna
  • B. Digitalis purpurea
  • C. Rauwolfia serpentina
  • D. Cephaelis ipecacuanha
Correct Answer: C

Rationale: The correct answer is C: Rauwolfia serpentina. Reserpine is derived from the Rauwolfia serpentina plant. This plant contains alkaloids that act as a central nervous system depressant, reducing anxiety and lowering blood pressure. Atropa belladonna (A) contains toxic alkaloids, Digitalis purpurea (B) contains cardiac glycosides used for heart conditions, and Cephaelis ipecacuanha (D) contains emetine used for inducing vomiting, none of which are related to reserpine's effects.

Which organization provides federal funding for research?

  • A. National Institute of Nursing Research
  • B. Robert Wood Johnson Foundation
  • C. W. K. Kellogg Foundation
  • D. Sigma Theta Tau International
Correct Answer: A

Rationale: The correct answer is A: National Institute of Nursing Research. This organization is part of the National Institutes of Health (NIH) and specifically focuses on funding nursing research. The NIH is a federal agency that provides funding for various scientific research areas, including nursing. The other choices, B: Robert Wood Johnson Foundation, C: W. K. Kellogg Foundation, and D: Sigma Theta Tau International, are not federal organizations and do not provide federal funding. Robert Wood Johnson Foundation is a private philanthropic organization, W. K. Kellogg Foundation is a private foundation focused on children's wellbeing, and Sigma Theta Tau International is an honor society for nursing professionals.

A nurse is assigned to a unit where 95% of all patients required total care. Most days the assistive personnel are able to complete their assignments and provide high-quality care. A patient returning from a procedure was somehow "skipped" when daily baths were performed and requests that her care now be provided. The nurse discovers the bed is rumpled and damp. The RN joins with some other staff to bathe the patient, change the bed, and help make the patient comfortable. These staff members are demonstrating:

  • A. altruism.
  • B. veracity.
  • C. autonomy.
  • D. whistle-blowing.
Correct Answer: A

Rationale: The correct answer is A: altruism. Altruism is the selfless concern for the wellbeing of others, which is demonstrated by the staff members helping the patient in need without hesitation. In this scenario, the staff members are putting the patient's needs above their own, showing compassion and empathy. This aligns with the principle of altruism in nursing, where caregivers prioritize the welfare of their patients.

Choices B, C, and D are incorrect:
B: Veracity refers to truthfulness and honesty. While these are important traits in nursing, they are not the focus of the staff members' actions in this scenario.
C: Autonomy is the right of individuals to make decisions about their own care. In this situation, the patient is not exercising autonomy, but rather relying on the staff for assistance.
D: Whistle-blowing involves reporting unethical or illegal behavior within an organization. There is no indication of any wrongdoing that would require whistle-blowing in this scenario.

Nursing in the 1990s was characterized by:

  • A. men leaving nursing to enter the armed services.
  • B. traditional 8-hour shifts to nurse burnout and compassion fatigue.
  • C. a focus on preventable diseases.
  • D. a decrease in nursing research.
Correct Answer: C

Rationale: The correct answer is C: a focus on preventable diseases. In the 1990s, nursing shifted towards preventative care due to the rise in chronic diseases. Nurses focused on educating patients on disease prevention strategies and promoting healthy lifestyles. This shift was in response to the increasing healthcare costs associated with treating preventable illnesses.

A: Men leaving nursing to enter the armed services is irrelevant to the characterization of nursing in the 1990s.
B: Traditional 8-hour shifts leading to nurse burnout and compassion fatigue may have been a challenge in the 1990s, but it does not characterize the entire nursing profession during that time.
D: There was actually an increase in nursing research during the 1990s, so this choice is incorrect.

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