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The nurse has a client who is confused and disrupting the unit by screaming obscenities and making a lot of noise. The client has been medicated as prescribed but is not responding to the sedation. The other clients on the unit are reporting agitation. The nurse makes the decision to move the client to a location further down the hall where there are fewer clients. What theory of ethics is the nurse demonstrating?
- A. Utilitarianism
- B. Deontology
- C. The idea of rights
- D. Obligation of duty
Correct Answer: A
Rationale: Utilitarianism is an outcome-oriented approach for decision making. There are two important principles: 'the greatest good for the greatest number' and 'the end justifies the means.' Deontology argues that consequences are not the only important consideration in ethical dilemmas. The idea of rights and the obligation of duty are not theories.
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Which of the following is a component of the nurse practice acts of various states?
- A. Breaches of duty owed by one person to another
- B. Determining the grounds for disciplinary action
- C. Expected action based on moral or legal obligations
- D. Injury due to the failure to act
Correct Answer: B
Rationale: Nurse practice acts define nursing practice and set standards for nurses in each state. Each state has its own nurse practice act, but one of the common components is the grounds for disciplinary action. Tort law is the body of law that governs breaches of duty owed by one person to another. A duty is an expected action that is based on moral or legal obligations. A tort is an injury that occurred because of another person's intentional or unintentional actions or failure to act.
The LPN administered a medication to a client reporting pain. When checking the armband and the medication administration record, there were no allergies listed. The client then tells the nurse of having informed the admitting nurse of being allergic to that medication. What documentation on the incident form would be the best option?
- A. Medication is administered to client by mouth; reports having an allergy to the medication that causes hives.'
- B. The admitting nurse failed to document that the client has an allergy to the medication.'
- C. The client reports being allergic to the medication, but I really don't think so. I didn't see any hives.'
- D. I should have asked the RN if the client is allergic to any medication.'
Correct Answer: A
Rationale: Healthcare workers complete incident reports when they make or discover errors or when an event occurs that results in harm. The first option is concise and to the point without any accusation. The LPN's documentation should not accuse the admitting nurse of failure to document. The LPN's documentation should not judge the client's statement nor place blame on the client. The LPN's documentation also should not place the blame on oneself.
The nurse is to administer a potassium supplement to the client. The nurse does not check the potassium level prior to administering the medication and later finds that the potassium level was at a critical high. What principle has this nurse violated?
- A. Beneficence
- B. Nonmaleficence
- C. Autonomy
- D. Fidelity
Correct Answer: B
Rationale: Nonmaleficence is the duty to do no harm to the client. For instance, if a nurse fails to check a prescription for an unusually high dose of insulin and administers it, the nurse has violated the principle of nonmaleficence. Beneficence is the duty to do good for the clients assigned to the nurse's care. The nurse has a duty to remove wrist restraints whenever possible (removing a harm) and to help the client regain independence (promoting and doing good). Fidelity is the duty to maintain commitments of professional obligations and responsibilities. Autonomy refers to a client's right to self-determination or the freedom to make choices without opposition.
The nurse understands that laws and ethics are made in order to maintain order and harmony within society. What is the difference between laws and ethics?
- A. Laws are written rules for conduct and actions, and ethics are moral principles and values that guide our behavior.
- B. Laws are written to protect society from unsavory people, and ethics are rules for appropriate behavior.
- C. Laws are written to ensure appropriate behavior and ethics are to conduct actions.
- D. Ethics determine how a client is to be treated, and laws are forms of punishment.
Correct Answer: A
Rationale: Laws are written rules for conduct and actions and ensure the protection of rights, and ethics are moral principles and values that guide the behavior of honorable people. Ethical standards dictate the rightness or wrongness of human behavior. The other answers do not address this as clearly.
The nurse is caring for a client who has been intubated and on a mechanical ventilator and has been restrained with soft wrist restraints. The client no longer requires the restraints, so the nurse removes them. What type of ethical decision making does the nurse display?
- A. Fidelity
- B. Autonomy
- C. Beneficence
- D. Nonmaleficence
Correct Answer: C
Rationale: Beneficence is the duty to do good for the clients assigned to the nurse's care. The nurse has a duty to remove wrist restraints whenever possible (removing a harm) and to help the client regain independence (promoting and doing good). Fidelity is the duty to maintain commitments of professional obligations and responsibilities. Autonomy refers to a client's right to self-determination or the freedom to make choices without opposition. Nonmaleficence is the duty to do no harm to the client.