During a seminar on ethics, the educator realizes that more information is needed when a participant describes which situation as a violation of the ethical principle of autonomy?
- A. An older person with advanced stages of Alzheimer's disease is denied the right to ambulate in the hallway.
- B. A mentally competent adult refuses medical treatment for the autoimmune disease lupus erythematosus, stating that this condition reflects the will of a higher power.
- C. A mentally competent visitor fell during visiting hours but refused to be examined by the physician on call.
- D. A mentally competent adult with a broken wrist refuses to be given a local anesthetic prior to a procedure.
Correct Answer: A
Rationale: The correct answer is A because denying the older person with Alzheimer's disease the right to ambulate violates their autonomy by restricting their freedom to make choices about their own body and movement. Autonomy is the ethical principle that respects an individual's right to make decisions about their own health and well-being. In this situation, the person should have the autonomy to decide whether or not they want to ambulate, even if they have advanced Alzheimer's disease.
Choice B is incorrect because the mentally competent adult has the right to refuse medical treatment based on their beliefs, which is an expression of autonomy.
Choice C is incorrect because the mentally competent visitor has the right to refuse examination, which is also an expression of autonomy.
Choice D is incorrect because the mentally competent adult has the right to refuse a local anesthetic, which is also an expression of autonomy.
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A nurse entering the job market wants to be certain that the first position is rewarding and allows for growth as a registered nurse. According to the Hallmarks of the Professional Nursing Environment, the nurse should ask:
- A. about the philosophy related to clinical care to determine the role of RNs in deciding outcomes related quality outcomes.
- B. if professional development opportunities are supported through paid leave and tuition reimbursement.
- C. how compensation packages compare to others in the same area and nationally.
- D. what the projected need for RNs is in the next 5 years and current turnover rate.
Correct Answer: B
Rationale: The correct answer is B because professional development opportunities supported through paid leave and tuition reimbursement are crucial for a nurse's growth. This allows for continuous learning, skill enhancement, and career advancement. It indicates that the organization values its nurses and invests in their development. The other choices, A, C, and D, while important in their own right, do not directly address the nurse's growth and professional development. Choice A focuses on the philosophy of care, not personal growth. Choice C is mainly about compensation, not professional development. Choice D pertains to workforce planning, not individual career advancement.
A registered nurse is on break and checking e-mails. One e-mail contains a picture of a celebrity who is a patient in the hospital, and on the same floor, where the nurse works. Included with the photo is a message, "check out my Facebook," which contains additional photographs of the patient. The nurse immediately deletes the picture to prevent having to report the "friend" to supervisors. Based on the action of the nurse who received the message, which statement is correct?
- A. The nurse is not at risk for having his or her license suspended since removing the photos made them temporary and invisible to all others.
- B. Because the nurse did not send the message and immediately deleted the photo, there is no risk for discipline.
- C. Failing to report receiving the message demonstrates poor ethical and legal role-modeling as well as placing the nurse at risk for discipline.
- D. Because the patient is on the same floor as the one on which the nurse works, the information can be ethically and legally shared.
Correct Answer: C
Rationale: The correct answer is C. The nurse is at risk for discipline because failing to report the receipt of the message demonstrates poor ethical and legal role-modeling. By deleting the photo and not reporting the incident, the nurse is not upholding patient confidentiality and is potentially violating privacy laws. Sharing patient information, even if the patient is on the same floor, is unethical and illegal. Choices A and B are incorrect because simply deleting the photos does not absolve the nurse from potential consequences, and not being the sender does not excuse the nurse from being responsible for maintaining patient confidentiality. Choice D is incorrect because sharing patient information without authorization is a violation of ethical and legal standards.
Although a hospital reversed all charges when a client was the victim of wrong site surgery, the court awarded the client $5 million. The client was able to return to work in 6 weeks and had no permanent damages. This monetary compensation is termed:
- A. res ipsa loquitur.
- B. punitive damages.
- C. vicarious liability.
- D. immunity.
Correct Answer: B
Rationale: The correct answer is B: punitive damages. Punitive damages are awarded to punish the defendant for their wrongful actions. In this case, the hospital's negligence in performing wrong site surgery resulted in harm to the client, even though the hospital reversed the charges. The court awarded $5 million to punish the hospital for their negligence, as the client suffered emotional distress and the potential risk of harm. The other choices are incorrect because:
A: res ipsa loquitur is a legal doctrine used to shift the burden of proof from the plaintiff to the defendant in cases where the negligence is obvious.
C: vicarious liability holds an employer responsible for the actions of their employees, which is not directly applicable in this scenario.
D: immunity refers to protection from legal liability, which is not relevant in a case where the court awarded monetary compensation.
A team of experienced nurses work together to develop algorithms that are converted into checklists to ensure standardization of commonly performed procedures. The focus of this team is primarily on which Institute of Medicine (IOM) competency?
- A. Safety
- B. Timely
- C. Equitable
- D. Patient-centered care
Correct Answer: A
Rationale: The correct answer is A: Safety. The team of nurses developing algorithms and checklists aims to ensure standardization of procedures, which directly relates to patient safety. Safety is a fundamental competency in healthcare, as it involves minimizing harm to patients. Standardization through checklists helps reduce errors and promote consistency in care delivery. Timely care (B) focuses on providing care promptly, equitable care (C) emphasizes fairness and eliminating disparities, and patient-centered care (D) prioritizes individual preferences and needs. While these competencies are important in healthcare, in this scenario, the team's primary focus on standardization aligns with the safety competency.
A researcher calculated the risk-to-benefit ratio and concluded that no harmful effects were associated with a survey of college sophomores. The researcher was applying the principles of:
- A. beneficence.
- B. human dignity.
- C. justice.
- D. human rights.
Correct Answer: A
Rationale: The correct answer is A: beneficence. Beneficence refers to the ethical principle of maximizing benefits and minimizing harm in research. In this scenario, the researcher calculated the risk-to-benefit ratio and concluded that no harmful effects were associated with the survey of college sophomores. By considering the well-being of the research participants and ensuring that the benefits outweigh any potential risks, the researcher demonstrated the application of beneficence.
Summary:
Choice A is correct because it aligns with the ethical principle of beneficence in research. Choices B, C, and D are incorrect as they do not directly relate to the consideration of risks and benefits in research involving human participants.