Bioethics in Nursing Practice Set 1 (Answer Key With Rationale)

BIOETHICS IN NURSING PRACTICE SET 1 (Answer Key with Rationale) Preare! By" Ro##ie $ia#res% RN 1& C& The 'ost aror aroriate iate nrsin nrsin inter*ention is to !is+ss !is+ss with the ,a'ily ossi#le oran !onation sin+e #rain-!eath +riteria is alrea!y 'et& The !e+ision to with!raw li,e sort is not within the s+oe o, nrsin ra+ti+e&  There is no nee! ,or se!ation se!ation #e+ase #e+ase the atient is #rain !ea!& Althoh Althoh tal.in to sta/ 'e'#ers a#ot their ,eelin is also ne+essary% ne+essary% it isn0t the rst a+tion to ta.e& 2& B& Nrse 3arren 3arren has so.en so.en to his +olleae a#ot the the isse roerly roerly #t the nrse0s #eha*ior hasn0t +hane& There,ore% the ne4t ste is to a!!ress the isse to the 'anaer& It is inaroriate to tal. to other sta/ 'e'#ers a#ot the isse #e+ase they !on0t ha*e the athority to #rin the +olleae0s ra+ti+e to +o'lian+e& A nrse shol! ne*er oint ot to a atient that a sta/ is not 'eetin the stan!ar!s& 5& 6& Nrse 7enny shol! shol! le an in+i!ent reort& Callin the hosital0s hosital0s lawyer is not the 8o# o, Nrse 7enny& Ta.in no a+tion is not an aroriate a+tion& 6o+'entin that she has i*en one +asle instea! o, two *iolates the *irte o, *era+ity an! the rin+ile o, non-'ale+en+e& 9& A& A nrse nrse who who sse+ts sse+ts another another nrse o, i'aire! i'aire! ra+ti+e has a !ty to reort the +olleae to the nrsin ser*isor& I, Nrse Palo ,ails to !o that% he 'ay also ,a+e a !is+ilinary a+tion& A nrse shol! not +o*er ,or an i'aire! nrse or i*e hi' one 'ore +han+e& This a+tion la+es atients in !aner an! re*ent the i'aire! nrse ,ro' re+ei*in hel& The nrse shol! reort to the nrse ser*isor #t not to the se+rity or the oli+e& :& B& ;e!i+al in,or'ation in,or'ation a#ot a#ot a atient +an #e #e !is+lose! !is+lose! only only to the ,ollowin< ,ollowin< the atient% whoe*er is in-+hare o, the atient% those who 'ay #e a/e+te! #y the atient0s health an! to leiti'ate athorities or those who are !ire+tly !ire+tly in*ol*e! in the +are o, the atient& =& A& $i#elos state'ents in rints rints an! i+tres i+tres in the wor.la+e are ethi+ally an! leally rohi#ite!& This shol! #e a!!resse! !ire+tly to the nrsin ser*isor& Callin the se+rity is nne+essary& Otion B an! 6 are not the 'ost aroriate a+tions to ta.e& >& B& An in,or'e! +onsent re?ires re?ires the hysi+ian to i*e enoh in,or'ation in,or'ation to the atient an! his sini+ant others in or!er to 'a.e !e+isions roerly rear!in rear!in the atient0s health& The atient nee!s to n!erstan! ,lly the ro+e!re that will #e !one& It is #ase! on the atient0s wishes% not the ,a'ily0s wishes% an! the in,or'e! +onsent is not +on+erne! a#ot the hysi+ian0s +o'eten+e& @& C& A reasona#le reasona#le ssi+ion o, a#se a#se is +reate! #y the state'ents o, the the 'other& Health+are ro*i!ers are 'an!ate! #y law to reort sse+te! a#se& The nrse nee!s not to witness the #eatin in a+tality& 6i*ertin the attention o, the 'other is in+orre+t #e+ase it ,ails to !eal with the leal o#liation to reort reasona#le ssi+ion o, an a#se&

& 6& Nrse Ryan shol! shol! re,er re,er the the atient to a se4 +onselor or to other ro,essional& ;a.in aroriate re,errals is a *ali! art o, lannin the atient0s +are& The nrse !oesn0t nor'ally ro*i!e se4 +onselin& 1&B& 1& B& Re,errin the atient to a health +are ro,essional ro,essional with .nowle!e o, +o''nity resor+es is the #est inter*ention to ensre +o'lian+e o, a ho'eless atient& E!+atin E!+atin the atient a#ot his health 'ay hel% #t the #asi+ ne+essities li.e shelter% ,oo! an! +lothin 'st #e 'et rst& Pro*i!in ,or'al e!+ation an! atte'tin to +onta+t ,a'ily 'e'#ers are inaroriate when +arin ,or a ho'eless atient& 11&B& The !isease o, a atient atient nee! not #e in #li+ *iew li.e li.e in !oor la#els la#els o, atient0s roo's& Plain la#el o, re*erse isolation or stri+t isolation is enoh to ensre sa,ety o, health+are wor.ers& Otions A% C an! 6 are #t art o, the rin+ile o, +on!entiality& 12&6& The ,a'ily nee!s to n!erstan! n!erstan! what #rain #rain !eath is #e,ore #e,ore tal.in a#ot oran !onation& They nee! ti'e to a++et the !eath o, their ,a'ily 'e'#er& An en*iron'ent +on!+i*e to !is+ssin an e'otional isse is nee!e!& Chael is not the roer la+e where they wol! !is+ss their +on+erns& The hrase li,e sort syste'D 'ay i*e ,a'ily ,alse hoe that the atient is still ali*e& An! the 'ore the ,a'ily 'e'#ers are resent !rin !is+ssion% !is+ssion% the 'ore !i+lt it will #e to !is+ss isses an! attain nity in a !e+ision& 15&6& It is the role an! o#liation o#liation o, the hysi+ian hysi+ian to in,or' in,or' the atient& The nrse is o#liate! to in,or' the hysi+ian that the atient is !e'an!in in,or'ation& The nrse has an ethi+al o#liation to #e trth,l% #t the hysi+ian has the o#liation to in,or' the atient& Rear!less o, whether the atient has the riht to *iew her re+or!% the atient is not in the osition to interret the in,or'ation ,on! in the +hart& Aain% that is the role o, the hysi+ian& 19&6& 1:&C& 1=&6& 1>&B& 1@&C& 1&B& 2&A& 21&6& 22&C& 25&C& 29&B& 2:&C& 2=&C& 2>&B& 2@&B& 2&C& 5&C& 51&6& 52&6 55&B&

59&C& It is the leal o#liation o, the witness to *eri,y that the sinatre too. la+e& It is the leal o#liation o#liation o, the atten!in hysi+ian% hysi+ian% not the nrse% nrse% to +on!+t the in,or'e! +onsent ro+ess& It is the atten!in hysi+ian0s o#liation% not the nrse% to ,lly in,or' the atient& An! it is not ne+essary to o#tain ,a'ily +onsent& 5:&C& It is the leal an! ethi+al o#liation o, the nrse to reort in+i!ents in+i!ents s+h as 'e!i+ation errors that e4oses the atient to har'& Failin to +he+. the 'e!i+ation re+or! to see i, a !r ha! #een i*en is a ,or' o, 'e!i+ation error& Reortin the other nrse ,ails to !is+hare the leal an! ethi+al o#liation to reort any error& A+tal har' to the +lient is not a rere?isite ,or lin an in+i!ent reort% an! ,ailre to reort the in+i!ent !oes nothin to re*ent ,tre in+i!ents& It is not the leal an! ethi+al o#liation o, the hysi+ian to in,or' the nrse a#ot the nee! to reort a 'e!i+ation error& 5=&A& Hosi+e +are is ,or atients who are ter'inally ill an! their ,a'ilies or +arei*ers& Berea*e'ent +onselin is a*aila#le e*en a,ter the !eath o, a atient& E!+ate! *olnteers are also art o, the inter!is+ilinary tea'& The ser*i+e is a*aila#le at all ti'es& There is sally an RN on +all 29 hors a !ay& 5>&6& Althoh all o, the atients nee! so+ial ser*i+e an! !is+hare assistan+e% assistan+e% the atient who is newly !ianose! with !ia#etes is at reater ris. o, +o'li+ations +o'li+ations ,ro' the +on!ition an! the otential ,or oor 'anae'ent& Proer !iet an! sa,e 'e!i+ation a!'inistration wol! #e !i+lt ,or a erson who is ho'eless& The other atients are not ,a+e! with the 'ost i''e!iate ris.& 5@&B& The nrse is ethi+ally an! leally o#lie! to ?estion or!ers that aear in+orre+t in or!er to rote+t the atient ,ro' har'& The nrse shol! not ass'e that the or!er is +orre+t& The atient is not an aroriate sor+e to *ali!ate a 'e!i+ation or!er& The a+tions o, the nrses on re*ios shi,ts !o not re'o*e the o#liation to ?estion that or!er% nless there is a +lear note that the or!er has #een ?estione!& 5&A& The atient with +hest ain 'ay #e ha*in a 'yo+ar!ial 'yo+ar!ial in,ar+tion (;I)% an! i''e!iate assess'ent an! inter*ention are riorities& Althoh ain 'anae'ent is i'ortant% ain is an e4e+te! 'ani,estation ,ro' the srery& Hyerly+e'ia o, 1@ is not li,e threatenin& Assess'ent an! inter*ention is ne+essary #t not riorities +o'are! with a atient with +hest ain& Frther assess'ent o, the atient with +al, ain is ne+essary to rle ot a thro'#ohle#itis an! the ossi#ility o, a ,tre l'onary e'#ols& 9&6& The nrse is hol!in the ethi+al o#liation to tell the trth an! to 'a.e the atient aware that% ethi+ally an! leally% the nrse 'ay #e re?ire! #y law to reort the in,or'ation& That is not an a++rate state'ent a#ot the +o!e o, ethi+s& Health o, other eole !oes not ne+essarily ,or+e the !is+losre o, +on!ential in,or'ation& 91&A& Health+are ro,essionals ro,essionals nee! to i!enti,y an! +o'e to ter's with their own ,eelins rear!in interrtion o, renan+y& Nrses whose reliios or 'oral #elie,s !o not sort a#ortion ha*e the riht to re,se the assin'ent o,

+arin ,or atients n!eroin this ro+e!re& The nrse shol! in,or' the e'loyer o, the #elie,s #e,ore #ein assine! atients& The +oni+ts an! !o#ts o, the nrse +an #e rea!ily +o''ni+ate! to wo'en who 'iht alrea!y #e an4ios an! sensiti*e a#ot the ro+e!re& Nrses ha*e the riht to re,se the assin'ent o, +arin ,or wo'en n!eroin a#ortion i, their reliios or 'oral #elie,s !o not sort a#ortion& The nrse 'ay #e e'loye! in an aen+y that er,or's a#ortions% #t 'ay wor. in another se+tion or nit& 92&B& These are li.ely li.ely sins o, an a+te 'yo+ar!ial in,ar+tion in,ar+tion (;I)% whi+h is a +ar!io*as+lar e'eren+y re?irin i''e!iate attention& A+te ;I is otentially ,atal i, not treate! i''e!iately& Pain an! swellin is a 's+los.eletal ro#le' an! not li,e threatenin& A +hil! who *o'ite! on+e sin+e start o, +o'laint !oes not ta.e riority o*er a li,e-threatenin +ar!ia+ +ar!ia+ e'eren+y& $oss o, aetite an! ,atie is not an i''e!iate e'eren+y% 95&6& Patients Patients who are in ani+ nee! i''e!iate assistan+e #e+ase their #eha*ior 'ay reslt in har' to the'sel*es or others& I!enti,yin a!!i+tion is 'ore ti'e +ons'in an! not an easily sol*e! ro#le'& 6eression wol! !e*elo o*er a loner erio! o, ti'e& Ehoria is !ene! as an e4aerate! ,eelin o, well-#ein ('il! elation)& It is nli.ely that a atient who is ehori+ wol! ta.e riority o*er a atient who is ani+.in& 99&6& The only ,a+tally +orre+t answer wol! ro*i!e in,or'ation a#ot +ontrain!i+ations& Oran !onors 'st #e at least 1@ years o, ae& 3ritten +onsent is re?ire!& Fa'ily 'e'#er or leal ar!ian 'ay athorie oran !onation in the a#sen+e o, written !o+'entation #y !onor& 9:&6& Pro*i!in ,oo!s that are +ltrally a++eta#le to the e4tent ossi#le is an i'ortant rin+ile o, +ltral sensiti*ity when lannin nrsin +are& There is no arantee that ,oo! ,ro' any +ltre will !e+rease aitation& Se+i+ ,oo!s are not 'entione!& Ntritional se+i+ations are not in+l!e!& In ,a+t% ,a*orite ,oo!s 'ay not #e ntritionally ntritionally son!& An! e*en thoh ser*in +ltrally re?ire! re?ire! ,oo!s +on*ey a++etan+e% it !oes not arantee +ooeration with other treat'ents& 9=&B& The hysi+ian 'ay not #e aware o, the role that reliios #elie,s #elie,s lay in 'a.in a !e+ision a#ot srery& The nrse !oes not ha*e the riht to en+orae a se+i+ treat'ent that is +ontrary to the atient0s wishes& The atient has the riht to 'a.e the !e+ision& The ,a'ily +ol! #e in+ororate! when e4lorin all otions to hel the atient 'a.e an in,or'e! !e+ision& An! resentin other otions is the role o, the hysi+ian& The role o, the nrse is to assess whether the atient is well in,or'e!% relay in,or'ation ertinent to the !e+ision an! +onr' that a !e+ision is *olntary& 9>&C& In +ase o, the nsal +ir+'stan+es% +ir+'stan+es% a test o, reasona#leness reasona#leness is alie!&  The nrse is e4e+te! to #e e4i#le enoh enoh to rioritie rioritie +are% +are% an! the 'ini'al le*el o, a++eta#le +are is atient sa,ety& Pro*i!in +sto'ary or i!eal +are to so'e atients an! lea*in others withot +are wol! not 'eet the test o, reasona#leness& Re,sin the assin'ent will e4ose the atients

to har' ,ro' a#an!on'ent& Care #y ,a'ily 'e'#ers !oes not o#*iate the nee! ,or nrsin +are or atten!an+e #y the nrse& 9@&C& The nrse has a 'oral an! ro,essional resonsi#ility resonsi#ility to a!*o+ate ,or atients who e4erien+e !e+rease! in!een!en+e% loss o, ,ree!o' o, a+tion an! inter,eren+e with their a#ility to 'a.e atono'os +hoi+es& Coor!inatin a 'eetin #etween the hysi+ian an! ,a'ily 'e'#ers 'ay allow the atient an oortnity to e4ress his or her wishes an! ro'ote awareness o, his or her ,eelins% as well as inen+e ,tre +are !e+isions& All other otions are inaroriate& 9&6& The nrse is o#liate! to let the atient lea*e& 6etainin hi' in any ,or' is a *iolation o, the atient0s #ill o, rihts& :&6& 3hen a!*an+e !ire+ti*es !ire+ti*es state that a atient !oes not want li,e-rolonin inter*entions% nrsin +are ,o+ses on ro*i!in e'otional an! sirital sort an! +o',ort 'easres& The atient still nee!s to #e +he+.e! relarly& The atient an! the ,a'ily shol! not ,eel as i, they ha*e #een a#an!one!& Pro*i!in 'oth an! s.in +are 'a.es the atient 'ore +o',orta#le& Trnin the atient ro*i!es +o',ort an! re*ents otentially ain,l +o'li+ations s+h as ressre l+ers& :1&C& Nrses are always resonsi#le resonsi#le ,or their a+tions& The hosital is lia#le ,or nelient +on!+t o, its e'loyees within the s+oe o, e'loy'ent& Conse?ently% #oth the nrse an! the hosital are lia#le& Althoh the 'ista.e wasn0t intentional% stan!ar! ro+e!re wasn0t ,ollowe!& :2&A& A!*an+e !ire+ti*es i*e a +o'etent atient +ontrol o*er his sitation an! a leal ,or' in whi+h to e4ress his wishes a#ot his +are& 6is+ssion o, a!*an+e !ire+ti*es isn0t otsi!e the s+oe o, nrsin ra+ti+e& The atient0s #ill o, rihts in*ol*es 'ltile atient rihts an! !oes not ro*i!e !etaile! in,or'ation in,or'ation a#ot a!*an+e !ire+ti*es& A+ti*e ethanasia is illeal& :5&B& The nrse0s release release o, in,or'ation to the atient0s e'loyer withot the atient0s +onsent is a #rea+h o, +on!entiality& The sti'a asso+iate! with sy+hiatri+ illness 'ay a/e+t the atient0s e'loy'ent" there,ore% there,ore% it is #etter to 'aintain +on!entiality an! re,rain ,ro' !is+losin any in,or'ation% in+l!in whether she0s a atient in the hosital :9&B& i, a atient re?ests ,or 6A;A% the nrse shol! noti,y the hysi+ian i''e!iately& I, the hysi+ian +an not +on*in+e the atient to stay% the hysi+ian will as. the atient to sin a 6A;A ,or'& This ,or' releases the hosital ,ro' leal resonsi#ility& I, the hysi+ian isn0t a*aila#le% the nrse shol! o#tain the atient0s sinatre on the 6A;A ,or'& A atient who re,ses to sin the ,or' shol! not #e !etaine!< ,or+e! !etention *iolates the atient0s rihts& A,ter the atient lea*es% the nrse shol! !o+'ent the in+i!ent thorohly an! noti,y the hysi+ian that the atient has le,t& ::&B& The rst a+tion wol! #e to rote+t rote+t the +hil! #y re'o*in her ,ro' the roo'& Callin the se+rity is ne+essary #t only a,ter ensrin the sa,ety o, the +hil!& As.in one o, the ,a'ily 'e'#ers to lea*e the roo' or reasonin reasonin with the' wol! #e ine/e+ti*e at this oint an! 'ay e*en es+alate the sitation&

:=&C& By lea*in the atient% the nrse is at ,alt ,or a#an!on'ent& The #etter +orse o, a+tion is to trn on the +all #ell or eli+it hel on the way to the atient0s roo'& E!+atin the atient a#ot sa,ety 'easres !oesn0t alle*iate the nrse ,ro' resonsi#ility ,or ensrin atient sa,ety& The nrse +an0t restrain the atient withot a hysi+ian0s or!er an! restraints won0t ensre the atient0s sa,ety& 6o+'entin that he le,t the atient !oesn0t e4+se the nrse ,ro' his resonsi#ility ,or ensrin the atient0s sa,ety& :>&6& Resiratory% +ar!io*as+lar an! neroloi+al assess'ents whi+h are hysioloi+al assess'ents are the riority assess'ent& :@&6& Althoh CATs shol! #e aro*e! #y the hysi+ian an! they 'ay ha*e intera+tions intera+tions with the treat'ent lan% the nrse shol! #e theraeti+ in !ealin with atients with li,e threatenin +on!itions& :&C& =&6& =1&A& =2&6& =5&B& =9&B& =:&C& ==&B& =>&C& =@&C& =&C& >&A& >1&B& >2&6& >5&C& >9&A& >:&C& >=&6& >>&C& >@&C& >&6& @&6& @1&B& @2&6& @5&B& @9&B& @:&6& @=&C& @>&