Ethics and Issues in Contemporary Nursing

Ethics and Issues in Contemporary Nursing Related

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An RN is consistently late to work, causing reassignment of patient care and the need for repeated shift reports. The nurse, who receives a warning for repeated tardiness, states, "My husband left me, I have no car, no family close by, and the bus is always late, which makes me late. The nurse manager doesn't care how hard I try to get here, and I am raising a child by myself." The nurse is using which type of logical fallacy?

  • A. Appeal to emotion
  • B. Appeal to tradition
  • C. Hasty generalization
  • D. Confusing cause and effect
Correct Answer: A

Rationale: The correct answer is A: Appeal to emotion. The nurse is trying to justify their repeated tardiness by appealing to the emotions of the nurse manager, by invoking pity and sympathy. This type of logical fallacy involves using emotional manipulation to distract from the real issue of consistently being late to work. The nurse's personal circumstances are valid but do not excuse the behavior.

Summary of other choices:
B: Appeal to tradition - This fallacy involves justifying a belief or action based on the fact that it has been done that way in the past. This is not evident in the nurse's response.
C: Hasty generalization - Drawing a conclusion based on insufficient evidence. The nurse's explanation is specific to their own situation and not a broad generalization.
D: Confusing cause and effect - Mistaking the cause of a situation for the effect or vice versa. The nurse is trying to use their personal circumstances as the cause of being consistently late, rather than taking responsibility for their actions.

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A group of nurses is presenting the importance of high-quality care during a system- wide meeting of medical-surgical nurses. They point out a finding of the Quality Chasm that:

  • A. being insured has little effect on a person's longevity and the quality of care received.
  • B. lobbyists for the drug companies are able to gain permission for the use of new drugs within 1 year of their discovery.
  • C. although a greater number of lawsuits stem from medication errors, more people actually die from human immunodeficiency virus (HIV) and acquired immunodeficiency disease syndrome (AIDS).
  • D. medication-related errors place a tremendous financial burden on the U.S. health care system.
Correct Answer: D

Rationale: The correct answer is D: medication-related errors place a tremendous financial burden on the U.S. health care system. This answer is correct because medication errors contribute significantly to healthcare costs due to increased hospitalizations, prolonged treatments, and legal expenses. The Quality Chasm report highlights the economic impact of medication errors on the healthcare system, emphasizing the need for improved medication safety practices.

Option A is incorrect because being insured does have a positive impact on a person's access to healthcare services and quality of care. Option B is incorrect as it does not relate to the Quality Chasm findings. Option C is incorrect as it focuses on the comparison of lawsuits and mortality rates related to medication errors and HIV/AIDS, which is not the primary focus of the Quality Chasm report.

What uniquely twenty-first century issue challenges today's professional nurse. (select all that apply)

  • A. Caring for an aging population
  • B. Increased patient acuity
  • C. Access to health care services
  • D. Expanding technology
Correct Answer: A

Rationale: The correct answer is A: Caring for an aging population. This is a uniquely twenty-first-century issue as advancements in healthcare have increased life expectancy, leading to a larger elderly population with complex healthcare needs. Nurses must adapt their skills and knowledge to provide specialized care for this demographic.

B: Increased patient acuity is a common challenge but not unique to the twenty-first century. Nurses have always dealt with varying levels of patient acuity.

C: Access to health care services is an ongoing issue that has been prevalent for many years, not specifically unique to the twenty-first century.

D: Expanding technology is also a significant challenge for nurses in the modern era, but it is not uniquely a twenty-first-century issue as technology has been advancing for decades.

A nurse is approached to sign a union authorization card. If signed, the card:

  • A. authorizes the union to serve as his or her legal representative.
  • B. indicates that the person is requesting additional information about collective bargaining.
  • C. indicates the nurse desires to share information about grievances.
  • D. gives permission for union dues to be deducted from pay.
Correct Answer: A

Rationale: Rationale for Answer A: Signing a union authorization card authorizes the union to serve as the nurse's legal representative in labor negotiations and other matters. By signing, the nurse is indicating consent for the union to act on their behalf. This is a crucial step in the unionization process.

Summary of Other Choices:
B: Requesting additional information about collective bargaining does not require signing a union authorization card.
C: Sharing information about grievances does not necessarily require signing a union authorization card.
D: Deducting union dues from pay is a separate process that typically requires a separate authorization form, not the union authorization card.

A patient is admitted for a hip replacement complicated by uncontrolled diabetes and early dementiThe nurse coordinates referrals to an endocrinologist to establish an insulin protocol and organizes out-patient physical therapy in an Alzheimer's assisted living facility upon discharge. The role of this nurse is the:

  • A. informatics specialist.
  • B. educator.
  • C. case manager.
  • D. quality manager.
Correct Answer: C

Rationale: Step-by-step rationale for why choice C (case manager) is correct:
1. A case manager coordinates referrals and services for patients with complex needs, such as this patient with diabetes and dementia.
2. In this scenario, the nurse is coordinating referrals to an endocrinologist and organizing physical therapy, which aligns with the role of a case manager.
3. Case managers ensure continuity of care and facilitate communication between different healthcare providers.
4. The nurse's role in organizing follow-up care and services for the patient falls under the responsibilities of a case manager.

Summary of why other choices are incorrect:
A: Informatics specialist - This role focuses on managing health information systems, not coordinating referrals and services for patients.
B: Educator - While education may be a component of the nurse's role, the primary focus in this scenario is on coordinating referrals and services, which is more in line with a case manager's responsibilities.
D: Quality manager - Quality managers focus on ensuring healthcare services meet quality standards

An RN delegates to an experienced LPN/LVN the task of administering oral medications to a group of patients. The LPN/LVN accepts the assignment, and the RN knows that the LPN/LVN has had the training and has acquired the skills needed to complete the task. The RN then observes the LPN/LVN recording a patient's medication administration just before entering the patient's room. The priority intervention by the RN is to:

  • A. check the patient's drug packages to ensure that the correct drugs were given.
  • B. stop the LPN/LVN immediately and discuss the possible consequences of his actions in a nonjudgmental manner.
  • C. contact the nurse manager and ask that the LPN/LVN's license be suspended.
  • D. call the pharmacy and ask for replacement medications for the patients.
Correct Answer: B

Rationale: The correct answer is B: stop the LPN/LVN immediately and discuss the possible consequences of his actions in a nonjudgmental manner. This is the priority intervention because it addresses the immediate issue of potentially incorrect documentation and allows for clarity and understanding between the RN and LPN/LVN. It promotes open communication and a chance to correct any errors that may have occurred.

Choice A is incorrect because checking the drug packages after the fact does not address the issue of potentially incorrect documentation and missed medications.

Choice C is incorrect as it is an extreme response that does not promote a collaborative and educational approach to resolving the situation.

Choice D is incorrect as calling the pharmacy for replacement medications is not necessary at this stage and does not address the immediate concern of potentially incorrect documentation.

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