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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.
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The nurse must choose between two undesirable alternatives involving a client the nurse is caring for. The client wants to be told about the prognosis, and the family member does not want the client to know. What type of situation is the nurse in?
- A. Ethical dilemma
- B. Bioethical dilemma
- C. Value dilemma
- D. Personal dilemma
Correct Answer: A
Rationale: An ethical dilemma is a situation in which an individual must choose between two undesirable alternatives, and it often involves examining rights and obligations of particular individuals. A bioethical dilemma is an ethical question surrounding life and death questions and concerns regarding quality of life as it relates to advanced technology. Values are ideals and beliefs that are held by an individual or group. This does not relate to a personal dilemma because it does not affect the nurse.
Which of the following is stated in a living will?
- A. Legal consent regarding healthcare
- B. Designation of another person as healthcare proxy
- C. Wishes regarding healthcare if terminally ill
- D. Medical prescriptions for end-of-life instructions
Correct Answer: C
Rationale: A living will is a document that states a client's wishes regarding healthcare if the client is terminally ill. It is not necessarily a legal consent. A client may designate another person to be the medical durable power of attorney or healthcare proxy. Do-not-resuscitate orders contain written medical prescriptions for end-of-life instructions.
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.
The nurse is preparing a client for a colonoscopy at the hospital. Who does the nurse understand is responsible for obtaining the informed consent from this client?
- A. The nurse
- B. The primary provider
- C. The nurse manager
- D. The health care provider's office nurse
Correct Answer: B
Rationale: The primary provider obtains the informed consent and must inform the client of the description of the procedure, potential benefits, material risk involved, acceptable alternatives available, expected outcome, and consequences if the procedure is not done.
Which of the following is a true statement about a living will?
- A. It states the client's wishes regarding healthcare if terminally ill.
- B. It specifies information regarding nontreatment only.
- C. It is legal consent.
- D. It is a type of financial agreement.
Correct Answer: A
Rationale: A living will states the client's wishes regarding healthcare if terminally ill. It does not specify information regarding nontreatment only, it is not a legal consent, and it is not a type of financial agreement.