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Chapter 19: Ethical Issues

MULTIPLE CHOICE
1. A nurse is educating an adult patient on patient rights, according to the American Hospital

Association. The teaching has been effective when the adult states that the patients rights
include:
a. choice of diet to be eaten during hospitalization.
b. considerate and respectful care from all care providers.
c. medical care regardless of ability to pay.
d. information from nurses about diagnosis and prognosis.
ANS: B

When you are a patient in the hospital, you have the right to receive considerate and respectful
care. The American Hospital Association published a Patient's Bill of Rights, which is now
revised and called The Patient Care Partnership. This document reflects acknowledgment of
patients rights to participate in their health care and was developed as a response to consumer
criticism of paternalistic provider care. The statements detail the patient's rights with
corresponding provider responsibilities. This document reflects the increasing emphasis on
patient autonomy in health care and defines the limits of provider influence and control. It
does not contain information on diets, nursing diagnosis, or the ability to pay for medical care.
PTS:
OBJ:
TOP:
MSC:

1
DIF: Cognitive Level: Evaluation
REF: pp. 421-423
Discuss the moral implications of the ANA and ICN codes of ethics.
Patient rights
NCLEX: Safe and effective care environmentmanagement of care

2. A nurse manager is teaching the purpose of the nurses Code of Ethics to a group of high

school students. Which statement by one of the students indicates that the teaching has been
effective? The purpose of the nurses Code of Ethics is
a. to assist in clarifying the individual nurses personal values and goals.
b. to differentiate between moral and immoral acts.
c. to guide the behavior of the professional nurse.
d. to identify acts that are legal for the nurse to perform.
ANS: C

The American Nurses Association (ANA) Code of Ethics (2001) is a statement to society that
outlines the values, concerns, and goals of the profession. It should be compatible with the
values and goals of each nurse. It does not outline moral or immoral acts or make statements
regarding legal aspects of nursing.
PTS: 1
DIF: Cognitive Level: Evaluation
REF: p. 428
OBJ: Discuss the moral implications of the ANA and ICN codes of ethics.
TOP: Ethics
MSC: NCLEX: Not applicable
3. Which statement best describes the Code of Ethics of the American Nurses Association?
a. A moral statement of accountability for practicing nurses and for student nurses
b. A legal document describing the responsibilities of the nurse
c. A statement regarding nursing care that outlines principles for the hospital to use to

evaluate quality of care

d. A document that is used as a guide for the nurse to consider in the decision-making

process in legal situations


ANS: B

The Code of Ethics is a moral statement of accountability for practicing nurses and for student
nurses. It is a statement to society that outlines the values, concerns, and goals of the
profession, thereby addressing accountability. The code provides direction for ethical
decisions and behavior by repeatedly emphasizing the obligations and responsibilities that the
nursepatient relationship entails. It lacks legal enforceability and is not a legal document like
licensure laws
PTS: 1
DIF: Cognitive Level: Analysis
REF: p. 428
OBJ: Discuss the moral implications of the ANA and ICN codes of ethics.
TOP: Ethics
MSC: NCLEX: Not applicable
4. Which ethical principle is applied when the nurse acts to safeguard the patient and the public

by reporting poor nursing practice?


a. Autonomy
b. Fidelity

c. Justice
d. Veracity

ANS: D

Veracitythe duty to tell the truthis represented in this situation. Autonomy is the right of
the patient to make an informed decision. Fidelity means to act in a way that is loyal, such as
keeping information private and confidential. Justice requires the nurse to treat all patients
fairly without regard to age, socioeconomic status, or other variables.
PTS: 1
DIF: Cognitive Level: Analysis
REF: p. 423
OBJ: Discuss the role of the nurse in ethical health care issues. TOP: Ethics
MSC: NCLEX: Safe and effective care environmentmanagement of care
5. What ethical principle is implemented, or supported, when the nurse encourages a patient to

be involved in planning and implementing self-care?


c. Justice
d. Veracity

a. Autonomy
b. Fidelity
ANS: A

A patients right to self-determination implies the freedom to make choices and decisions
about ones own care without interference even if those decisions are not in agreement with
those of the health care team. Justice is the duty to treat all patients fairly without regard to
age, socioeconomic status, or other variables. This principle involves the allocation of scarce
and expensive health care resources. Fidelity involves keeping information confidential and
maintaining privacy and trust. Veracity is the duty to tell the truth.
PTS: 1
DIF: Cognitive Level: Analysis
REF: p. 421
OBJ: Discuss the role of the nurse in ethical health care issues. TOP: Ethics
MSC: NCLEX: Safe and effective care environmentmanagement of care
6. The ethical principle of autonomy is not applicable in which patient situation?
a. The patient does not speak or understand the English language.
b. The patient is unaware of who or where he or she is.
c. The patient has been in a long-term care facility for 10 years.
d. The patient has values that conflict with the caregivers values.

ANS: B

This principle assumes rational thinking on the part of the individual, and being unaware of
who and where the patient is, is not indicative of the ethical principle of autonomy. Autonomy
is a patients right to self-determination implies the freedom to make choices and decisions
about ones own care without interference even if those decisions are not in agreement with
those of the health care team. In the other situations, the patient has rational thinking even
though he or she may not understand or speak English because an interpreter could assist.
PTS: 1
DIF: Cognitive Level: Application
OBJ: Discuss the role of the nurse in ethical health care issues.
MSC: NCLEX: Not applicable

REF: p. 421
TOP: Ethics

7. A nurse is educating a nurse aide on patient confidentiality. The nurse believes the teaching to

be effective when the nurse aide states that confidentiality will be maintained by a nurse who
believes in and values the ethical principle of
a. veracity.
c. justice.
b. autonomy.
d. fidelity.
ANS: D

Fidelity involves keeping information confidential and maintaining privacy and trust. Veracity
means to tell the truth. Autonomy involves the patient making an informed decision and
implies the freedom to make choices and decisions about ones own care without interference
even if those decisions are not in agreement with those of the health care team. Justice is the
duty to treat all patients fairly without regard to age, socioeconomic status, or other variables.
PTS: 1
DIF: Cognitive Level: Evaluation
OBJ: Discuss the role of the nurse in ethical health care issues.
MSC: NCLEX: Not applicable

REF: p. 422
TOP: Ethics

8. A patient who has a terminal illness wants to be able to take a prescription medication to end

life when suffering becomes unbearable. The patient asks the nurse for advice. Operating from
a deontological point of reference, what action does the nurse take?
a. Advises the patient about local providers willing to participate
b. Assesses the patient for more information about the situation
c. Determines what kind of insurance the patient has before acting
d. Tells the patient that they cannot participate in this action
ANS: D

Deontology is rule-bound and inflexible, obtaining moral authority from absolutes revealed by
God. To preserve the sanctity of life, the nurse cannot participate in this situation. Advising
the patient of providers to see is working from a teleological viewpoint because the end
(patient death) might be seen as outweighing the means (helping the patient find a provider to
provide a lethal prescription of drugs). Assessing the situation to see how the patient is
affected (versus how some other patient would be affected) is situational. Determining
financial status is not related to a specific philosophical outlook but might violate the principle
of justice.
PTS:
OBJ:
TOP:
MSC:

1
DIF: Cognitive Level: Application
REF: p. 424
Discuss the role of the nurse in ethical health care issues.
Communication and Documentation
NCLEX: Safe and effective care environmentmanagement of care

9. The nurse is very busy caring for a large case load. An adult patient mentions that by having

slow mobility, people just do things for me rather than allowing me to do as much as possible
on my own. To solve the dilemma of needing to conserve time versus supporting the patients
involvement in self- care, what principle may help the nurse?
a. Veracity
c. Justice
b. Fidelity
d. Autonomy
ANS: D

Autonomy implies the freedom to have choices and make decisions about ones own care
without interference. Just because this patient is slow does not mean he or she cannot make
choices and participate in self-care. Justice is the duty to treat all patients fairly without regard
to age, socioeconomic status, or other variables. This principle involves the allocation of
scarce and expensive health care resources. Veracity is the duty to tell the truth. Fidelity
involves keeping information confidential and maintaining privacy and trust.
PTS: 1
DIF: Cognitive Level: Analysis
OBJ: Discuss the role of the nurse in ethical health care issues.
MSC: NCLEX: Not applicable

REF: p. 421
TOP: Ethics

10. What element in health care is most responsible for the ethical dilemma of whether health care

is a privilege or a right?
a. Cost
b. Technology

c. Consumerism
d. Worker shortage

ANS: A

Variables of the justice principle involve the allocation of scarce or expensive health care
resources. The following questions are a few examples illustrating this principle: What kind of
access to health care should illegal immigrants receivepreventive care or only more costly
emergency care? How should the health care of children be allocated? Should all children
receive the same health care regardless of ability to pay?
PTS: 1
DIF: Cognitive Level: Analysis
OBJ: Discuss the role of the nurse in ethical health care issues.
MSC: NCLEX: Not applicable

REF: p. 442
TOP: Ethics

11. Advance directives such as the health care proxy and living will support what ethical

principle?
a. Veracity
b. Advocacy

c. Beneficence
d. Autonomy

ANS: D

Autonomy implies the freedom to make choices and decisions about ones own care without
interference even if those decisions are not in agreement with those of the health care team.
Veracity is the duty to tell the truth. Beneficence is the duty to actively do good for patients.
Speaking out on behalf of the patient is an essential part of the advocacy role of the nurse.
PTS: 1
DIF: Cognitive Level: Analysis
REF: p. 421
OBJ: Discuss the role of the nurse in ethical health care issues. TOP: Ethics
MSC: NCLEX: Safe and effective care environmentmanagement of care

12. A nurse is educating themself on the ANA Code of Ethics. Which action by the nurse would

be unethical, according to the ANA Code of Ethics?


Joining unions or bargaining units
Engaging in lobbying related to health care issues
Reporting an incompetent or impaired colleague
Refusing to care for a patient who is diagnosed as HIV positive

a.
b.
c.
d.

ANS: D

ANA Code 1: The nurse provides services with respect for human dignity and the uniqueness
of the patient unrestricted by considerations of social or economic status, personal attributes,
or the nature of the health problem. Nurses have the right to engage in collective bargaining
and lobbying for health care issues. Nurses have a legal responsibility based on the Nurse
Practice Act in their states to report an incompetent of impaired colleague.
PTS: 1
DIF: Cognitive Level: Application
REF: p. 428
OBJ: Discuss the role of the nurse in ethical health care issues. TOP: Ethics
MSC: NCLEX: Safe and effective care environmentmanagement of care
13. Which action by the nurse shows an understanding of the ethical principle of autonomy?
a. Allowing a patient the right to make decisions regarding his health care even if the

nurse does not agree with his decisions.


b. Making decisions for the patient regarding his care
c. Disregarding the patients decisions because they are not normal according to
society
d. Consulting the attending physician to make decisions for the patient
ANS: A

The nurse shows understanding of the ethical principle of autonomy by allowing patients the
right to make their own health care decisions even if the nurse does not agree with their
decisions. It is not up to the nurse or the attending physician to make health care decisions for
patients.
PTS: 1
DIF: Cognitive Level: Application
REF: p. 421
OBJ: Define terminology commonly used in discussions about ethical issues.
TOP: Understanding ethics
MSC: NCLEX: Safe and effective care environment
14. The nurse is educating a coworker on the ethical principle of beneficence. The nurse judges

the teaching to be effective when her coworker states:


Beneficence involves allowing patient to make their own health care decisions.
Beneficence is the duty to actively do good for patients.
Beneficence is the duty to do no harm.
Beneficence involves treating all patients equally.

a.
b.
c.
d.

ANS: B

Beneficence is the ethical principle of actively doing good for patients. Allowing patients to
make their own health care decisions is autonomy. Doing no harm to the patient is
nonmaleficence. Justice involves treating all patients equally.
PTS: 1
DIF: Cognitive Level: Evaluation
REF: p. 422
OBJ: Define terminology commonly used in discussions about ethical issues.
TOP: Understanding ethics
MSC: NCLEX: Safe and effective care environment

15. What action can the nurse take to uphold the ethical principle of fidelity?
a. Report unscrupulous billing practices.
b. Disclose the results of an HIV test to a patients family.
c. Make health care decisions for a patient.
d. Accept an assignment that is unsafe.
ANS: A

The nurse can uphold the ethical principle of fidelity by reporting unscrupulous billing
practices. Disclosing the results of an HIV test to a patients family would violate fidelity.
Making health care decisions would violate autonomy. Accepting an assignment that is unsafe
violates nonmaleficence.
PTS: 1
DIF: Cognitive Level: Application
REF: p. 422
OBJ: Define terminology commonly used in discussions about ethical issues.
TOP: Understanding ethics
MSC: NCLEX: Safe and effective care environment
16. A nurse is caring for a patient who has just been diagnosed with cancer. The patients family

has requested that the patient not be told at this time because it would be devastating. The
patient asks the nurse if the diagnosis is cancer. If the nurse were to uphold the ethical
principle of veracity, what would the response be?
a. No, you do not have cancer.
b. The physician is unsure of your diagnosis at this time.
c. Yes, that is the diagnosis. Let me call the doctor so that we can have a discussion.
d. Yes, but your family told me that I could not talk to you about the diagnosis.
ANS: C

If the nurse were to uphold the ethical principle of veracity, the nurse would inform the patient
of the diagnosis and involve the physician in the discussion. The nurse should not lie to the
patient or withhold information at the familys request; the patient has a right to know
information regarding his or her health care.
PTS: 1
DIF: Cognitive Level: Synthesis
REF: p. 423
OBJ: Define terminology commonly used in discussions about ethical issues.
TOP: Understanding ethics
MSC: NCLEX: Safe and effective care environment
17. A nurse is educating a group of nursing on the deontological model of ethical reasoning. The

nurse determines that the teaching has been effective when a student states:
a. All life is worthy of respect.
b. Abortions are ethical.
c. Euthanasia is acceptable in certain situations.
d. Lying is acceptable if it benefits the patient.
ANS: A

The deontological model of ethical reasoning states that all life is worthy of respect. Abortions
and euthanasia are never acceptable because they violate the duty to respect the sanctity of all
life. Lying is never acceptable because it violates the duty to tell the truth.
PTS: 1
DIF: Cognitive Level: Evaluation
REF: p. 424
OBJ: Define terminology commonly used in discussions about ethical issues.
TOP: Understanding ethics
MSC: NCLEX: Safe and effective care environment

18. A nurse is educating nursing students on the teleological model of ethical reasoning. The

nurse judges that the education has been effective when a student states:
Abortion is acceptable because it results in fewer unwanted babies.
Abortion is never acceptable because it violates the sanctity of life.
Euthanasia is never acceptable because it violates the sanctity of life.
The rights on individuals should not be sacrificed for the good of the majority.

a.
b.
c.
d.

ANS: A

The teleological model of ethical reasoning is interpreted as meaning the end justifies the
means. The rights of some individuals may be sacrificed for the majority. Therefore, abortion
may be acceptable because it results in fewer unwanted babies. Euthanasia may be acceptable
because it results in decreased suffering.
PTS: 1
DIF: Cognitive Level: Evaluation
REF: p. 425
OBJ: Define terminology commonly used in discussions about ethical issues.
TOP: Understanding ethics
MSC: NCLEX: Safe and effective care environment
19. A nurse and a patient are discussing the patients wishes regarding resuscitation. The patient

decides that resuscitated is not wanted under any circumstances. What action can the nurse
take to identify the ethical issues of the situation?
a. Encourage the patient to discuss his wishes with his family.
b. Encourage the patient to change his mind.
c. Coerce the patient into changing his mind by calling his physician to the bedside.
d. Continue to treat the patient as a full code.
ANS: A

When identifying the ethical issues of the situation, the nurse should encourage the patient to
share his wishes with his family. It is not the position of the nurse to try to change the patients
mind or force him to remain a full code. The nurse should respect the patients wishes and
document them accordingly.
PTS: 1
DIF: Cognitive Level: Application
OBJ: Discuss the role of the nurse in ethical health care issues.
MSC: NCLEX: Safe and effective care environment

REF: p. 424
TOP: Understanding ethics

20. A patient with cancer has decided to end treatment and is discussing end-of-life care with

family. The nurse notices that the attending physician has just ordered another dose of
chemotherapy. What would be the best action for the nurse to take as an advocate for the
patient?
a. Send the order to pharmacy so that the chemotherapy can be prepared.
b. Call the attending physician and request a meeting so that there can be open
communication between the physician, patient and family.
c. Tell the patient that because the chemotherapy has been ordered, it must be given.
d. Request a meeting with the attending physician, patient, and family so the attending
physician can convince the patient to receive the chemotherapy.
ANS: B

As an advocate for the patient, the nurse should advocate for the patient with the attending
physician and family by facilitating communication. It would be best for all parties to be in a
room together so that a discussion can take place. It would not be appropriate to send the
order to pharmacy, try to convince the patient to receive chemotherapy, or to tell the patient
that the drug must be given because it was already ordered.
PTS: 1
DIF: Cognitive Level: Application
OBJ: Discuss the role of the nurse in ethical health care issues.
MSC: NCLEX: Safe and effective care environment

REF: p. 424
TOP: Understanding ethics

21. A young woman has come to the hospital requesting medication to induce an abortion. The

nurse assigned finds it too hard to provide care to this patient because it violates the nurses
ethical principles. Which action would be the best for the nurse to take?
a. Continue to provide care for the patient but refuse to administer the medication.
b. Administer the medication because the doctor ordered it.
c. Find another nurse to provide care for the patient.
d. Try to talk the patient out of taking the medication.
ANS: C

To ensure care for the patient without violating the nurses ethical principles, the nurse should
find another nurse to care for the patient. Because the patient has rights, it would be
inappropriate to try to talk the patient out of receiving the medication or to deny the patients
access to the medication.
PTS:
OBJ:
TOP:
MSC:

1
DIF: Cognitive Level: Application
Discuss the role of the nurse in ethical health care issues.
Controversial ethical issues affecting nursing
NCLEX: Safe and effective care environment

REF: p. 421

22. A nurse is caring for a young patient recovering from a traumatic car accident. The patient has

lost a lot of blood and is in need of a blood transfusion. The patient states< Im a Jehovahs
Witness, and will not accept the blood. The nurse knows the patient will likely not survive if
they do not receive the blood. What action should the nurse take?
a. Administer the blood anyway; the patient will die without it.
b. Try to talk the family into signing the consent for the blood.
c. Call the physician and report the patients decision.
d. Stop all care for the patient to respect their wishes.
ANS: C

The nurse should immediately call the physician to report the patients decision. The nurse
should not administer the blood against the patients wishes or try to talk the family into
signing the consent. The nurse should continue all care for the patient except administration of
the blood.
PTS: 1
DIF: Cognitive Level: Application
OBJ: Discuss the role of the nurse in ethical health care issues.
MSC: NCLEX: Safe and effective care environment

REF: p. 421
TOP: Moral/ethical principles

23. The nurse has an adequate understanding of ethical issues regarding transplantation when

stating which of the following?


a. There are few Americans on the transplantation list.

b. Everyone on the transplantation list receives the organ they need.


c. There is an overabundance of organ donors.
d. The majority of individuals on the transplantation list will die because of the

shortage of organs.
ANS: D

There are almost 110,000 Americans on the transplantation list, and the majority of them will
die without a transplant because of the shortage of available organs.
PTS: 1
DIF: Cognitive Level: Application
OBJ: Discuss the role of the nurse in ethical health care issues.
MSC: NCLEX: Safe and effective care environment

REF: p. 438
TOP: Moral/ethical principles

24. A nurse manager is educating a group of staff nurses about genetics and genomics. The nurse

manager judges that the teaching has been effective when one of the staff nurses states:
a. Health outcomes and treatment of disease processes have not increased with the

study of genetics and genomics.


b. Only researchers benefit from the study of genetics and genomics.
c. This area of study has nothing to do with nurses.
d. Genetics and genomes have increased the ability of health care professionals to
assist patients in improving health outcomes.
ANS: D

The study of genetics and genomes has increased the ability of health care professionals to
assist patients in improving health outcomes. Nurses involved in this area of health care
educate patients; provide support and treatments based in the most current research.
PTS: 1
DIF: Cognitive Level: Evaluation
REF: p. 440
OBJ: Recognize the role of genetics and genomics in nursing practice.
TOP: Moral/ethical principles
MSC: NCLEX: Safe and effective care environment
MULTIPLE RESPONSE
1. A nurse is educating students on physician-assisted suicide (PAS). The nurse judges that the

teaching has been effective when a student states: (Select all that apply.)
a. PAS does not violate any ethical principles.
b. PAS threatens to destroy the fundamental relationship between physician and

patient.
c. PAS does not involve nurses.
d. Quality of life advocates support PAS as an example of personal autonomy and
control.
e. Nurses should be aware of the legal and ethical implications of administering legal
dosages of medications.
ANS: B, D, E

The American Medical Association opposes physician-assisted suicide (PAS) because it


violates the most basic ethical principle: First, do no harm. Physicians have traditionally cared
for living patients, and PAS threatens to destroy this fundamental relationship. On the other
hand, quality of life advocates support PAS as an example of personal autonomy and control.
Nurses working with physicians involved in PAS should be aware of the legal and ethical
implications of administering legal dosages of medications.

PTS: 1
DIF: Cognitive Level: Evaluation
OBJ: Discuss the role of the nurse in ethical health care issues.
MSC: NCLEX: Safe and effective care environment

REF: p. 436
TOP: Moral/ethical principles

Zerwekh: Nursing Today, 7th Edition


Chapter 19: Ethical Issues
Test Bank
MULTIPLE CHOICE
1. According to the American Hospital Association, what is a basic right of
patients?
a. Choice of diet to be eaten during hospitalization
b. Considerate and respectful care from all care providers
c. Medical care regardless of ability to pay
d. Information from nurses about diagnosis and prognosis
ANS: B
When you are a patient in the hospital, you have the right to receive
considerate and respectful care.
DIF:
OBJ:
TOP:
MSC:

Cognitive Level: Comprehension


REF:
p. 404
Discuss the moral implications of the ANA and ICN codes of ethics.
Patient rights
NCLEX: Safe, effective care environmentmanagement of care

2. What is the purpose of the nurses Code of Ethics?


a. To assist in clarifying the individual nurses personal values and
goals
b. To differentiate between moral and immoral acts
c. To guide the behavior of the professional nurse
d. To identify acts that are legal for the nurse to perform
ANS: C
The American Nurses Association (ANA) Code of Ethics (2001) is a
statement to society that outlines the values, concerns, and goals of the
profession. It should be compatible with the values and goals of each
nurse.
DIF: Cognitive Level: Comprehension
REF:
p. 401
OBJ: Discuss the moral implications of the ANA and ICN codes of ethics.
TOP: Ethics
MSC: NCLEX: Not applicable
3. Which statement best describes the Code of Ethics of the American Nurses
Association?
a. A moral statement of accountability for practicing nurses and for

student nurses
b. A legal document describing the responsibilities of the nurse
c. A statement regarding nursing care that outlines principles for the
hospital to use to evaluate quality of care
d. A document that is used as a guide for the nurse to consider in
the decision-making process in legal situations
ANS: B
The code is a statement to society that outlines the values, concerns, and
goals of the profession, thereby addressing accountability. The code
provides direction for ethical decisions and behavior by repeatedly
emphasizing the obligations and responsibilities that the nurse-patient
relationship entails.
DIF: Cognitive Level: Analysis
REF: p. 401
OBJ: Discuss the moral implications of the ANA and ICN codes of ethics.
TOP: Ethics
MSC: NCLEX: Not applicable
4. Which ethical principle is applied when the nurse acts to safeguard the
patient and the public by reporting poor nursing practice?
a. Autonomy
b. Fidelity
c. Justice
d. Veracity
ANS: D
Veracitythe duty to tell the truthis represented in this situation.
DIF: Cognitive Level: Analysis
REF: p. 396
OBJ: Discuss the role of the nurse in ethical health care issues. TOP:
Ethics
MSC: NCLEX: Safe, effective care environmentmanagement of care
5. What ethical principle is implemented, or supported, when the nurse
encourages a patient to be involved in planning and implementing his or
her own care?
a. Autonomy
b. Fidelity
c. Justice
d. Veracity
ANS: A
A patients right to self-determination implies the freedom to make choices
and decisions about ones own care without interference, even if those
decisions are not in agreement with those of the health care team.
DIF: Cognitive Level: Analysis
REF: p. 393
OBJ: Discuss the role of the nurse in ethical health care issues.
Ethics

TOP:

MSC: NCLEX: Safe, effective care environmentmanagement of care


6. The ethical principle of autonomy is not applicable in which patient
situation?
a. The patient does not speak or understand the English language.
b. The patient is unaware of who he is and where he is.
c. The patient has been in a long-term care facility for 10 years.
d. The patient has values that conflict with the caregivers values.
ANS: B
This principle assumes rational thinking on the part of the individual.
DIF: Cognitive Level: Application REF: p. 393
OBJ: Discuss the role of the nurse in ethical health care issues.
Ethics
MSC: NCLEX: Not applicable

TOP:

7. Confidentiality will be maintained by a nurse who believes in and values


the ethical principle of:
a. Veracity
b. Autonomy
c. Justice
d. Fidelity
ANS: D
Fidelity involves keeping information confidential and maintaining privacy
and trust.
DIF: Cognitive Level: Comprehension
REF:
p. 395
OBJ: Discuss the role of the nurse in ethical health care issues.
Ethics
MSC: NCLEX: Not applicable

TOP:

8. The health care team responsible for deciding whether to move a critically
ill patient out of the ICU so that a new patient may be admitted to the unit
is faced with what principle of an ethical dilemma?
a. Veracity
b. Justice
c. Autonomy
d. Deontology
ANS: B
The principle of justice is involved in the allocation of scarce and/or
expensive health care resources.
DIF: Cognitive Level: Analysis
REF: p. 395
OBJ: Discuss the role of the nurse in ethical health care issues.
Ethics
MSC: NCLEX: Not applicable

TOP:

9. The nurse is very busy caring for a large case load. A patient mentions that
because he is slow, people just do things for him rather than allowing him
to do as much as he is able. To solve the dilemma of needing to conserve
time versus supporting the patients involvement in his care, what
principle may help the nurse?
a. Veracity
b. Fidelity
c. Justice
d. Autonomy
ANS: D
Autonomy implies the freedom to have choices and make decisions about
ones own care without interference. Just because this patient says he is
slow does not mean he cannot make choices and participate in his own
care.
DIF: Cognitive Level: Analysis
REF: p. 393
OBJ: Discuss the role of the nurse in ethical health care issues.
Ethics
MSC: NCLEX: Not applicable

TOP:

10. What element in health care is most responsible for the ethical dilemma of
whether health care is a privilege or a right?
a. Cost
b. Technology
c. Consumerism
d. Worker shortage
ANS: A
Variables of the justice principle involve the allocation of scarce and/or
expensive health care resources. The following questions are a few
examples illustrating this principle: What kind of access to health care
should illegal immigrants receivepreventive care or only more costly
emergency care? How should the health care of children be allocated?
Should all children receive the same health care regardless of ability to
pay?
DIF: Cognitive Level: Analysis
REF: p. 415
OBJ: Discuss the role of the nurse in ethical health care issues.
Ethics
MSC: NCLEX: Not applicable

TOP:

11. Advance directives such as the health care proxy and living will support
what ethical principle?
a. Veracity
b. Advocacy
c. Beneficence

d. Autonomy
ANS: D
Autonomy implies the freedom to make choices and decisions about ones
own care without interference, even if those decisions are not in
agreement with those of the health care team.
DIF: Cognitive Level: Analysis
REF: p. 409
OBJ: Discuss the role of the nurse in ethical health care issues. TOP:
Ethics
MSC: NCLEX: Safe, effective care environmentmanagement of care
12. According to the ANA Code of Ethics, which action is unethical for a nurse?
a. Joining unions or bargaining units
b. Engaging in lobbying related to health care issues
c. Reporting an incompetent or impaired colleague
d. Refusing to care for a patient who is diagnosed as HIV-positive
ANS: D
ANA Code 1: The nurse provides services with respect for human dignity
and the uniqueness of the patient unrestricted by considerations of social
or economic status, personal attributes, or the nature of the health
problem.
DIF: Cognitive Level: Comprehension
REF:
p. 401
OBJ: Discuss the role of the nurse in ethical health care issues. TOP:
Ethics
MSC: NCLEX: Safe, effective care environmentmanagement of care
OTHER
1. What documents does the new nursing graduate need to be familiar with
when advising a dying patient and his family of their rights?
ANS:
The new graduate should be familiar with the patients bill of rights,
advance directives (living will and health care proxy), and any other state
legal parameters in this situation.
DIF: Cognitive Level: Application REF: p. 409
OBJ: Discuss the role of the nurse in ethical health care issues. TOP:
Ethics
MSC: NCLEX: Safe, effective care environment-management of care
2. Identify three resources available to assist nurses in resolving ethical
dilemmas in their practice.
ANS:

The Code of Ethics of the American Nurses Association, the Code of Ethics
of the International Council of Nursing (ICN), the Patients Bill of Rights, the
Nuremberg Code, and the relevant hospitals ethical committee are some
of the resources available to the nurse faced with an ethical dilemma.
DIF: Cognitive Level: Application REF: pp. 401, 402
OBJ: Discuss the role of the nurse in ethical health care issues. TOP:
Ethics
MSC: NCLEX: Safe, effective care environment-management of care

Zerwekh: Nursing Today, 6th Edition

Test Bank

Chapter 13: Conflict Management

MULTIPLE CHOICE

1. A newborn has several congenital anomalies incompatible with living beyond a


month. He cannot retain formula, and his temperature drops when he is removed
from the warmer. Two nurses who alternate caring for the baby argue about
whether or not to attempt bottle feedings and whether he should be removed
from the warmer to be held. What is the origin of the conflict described?
a. Ethical values
b. Nursing role concerns
c. Personal goals for advancement
d. Personality differences

ANS: A
This situation depicts personal issues based on two separate sets of ethics or
values regarding the infants care. One nurse places value on nutritional needs
and the other on the need for bonding.
DIF: Cognitive Level: Analysis
conflict
TOP: Conflict management

OBJ: Identify common factors that lead to

MSC: NCLEX: Safe, effective care environmentmanagement of care

2. Of the following common areas of conflict between nurses and their clients and
families, which is most easily resolved?
a. Issues of concern about quality of care
b. Issues surrounding treatment decisions
c. Issues of family involvement
d. Issues about quality of parental care

ANS: A
Families typically are concerned with how well their loved one is being attended
to. Conflict often arises out of concerns related to quality of care. This is
something that the nurse can directly address, whereas issues of treatment
decisions, family involvement, and quality of parental care often require more
discussion and intervention.
DIF: Cognitive Level: Comprehension
resolve conflict

OBJ:

Discuss five methods to

TOP: Conflict management


MSC: NCLEX: Safe, effective care environmentmanagement of care

3. What is the best strategy for resolving the conflict in a situation in which two staff
nurses request the same vacation weeks?
a. Accommodation
b. Collaboration
c. Competition
d. Avoidance

ANS: B
Collaboration is the strategy that involves confrontation and problem solving.
Needs, feelings, and desires of both parties are considered to create a win-win
outcome.

DIF: Cognitive Level: Comprehension


resolve conflict

OBJ:

Discuss five methods to

TOP: Conflict management


MSC: NCLEX: Safe, effective care environmentmanagement of care

4. On the unit in which you work, one nurses aide is usually pleasant and helpful;
the other is often abrasive and angry. What is the most important basic guideline
to be observed by a nurse who must resolve a conflict between the two nurses
aides?
a. Deal with issues, not personalities.
b. Require the aides to reach a compromise.
c. Weigh the consequences of each possible solution.
d. Encourage ventilation of anger and use humor to minimize the conflict.

ANS: A
Dealing with the issues and not the personalities is one of seven important key
behaviors in managing conflict. Issues tend to be more concrete, whereas
personalities involve emotional issues.
DIF: Cognitive Level: Comprehension
OBJ: Discuss techniques to use in dealing with difficult people
management

TOP: Conflict

MSC: NCLEX: Safe, effective care environmentmanagement of care

5. One of your peers, a staff nurse, is a potshot artist. She often makes you the
butt of innuendo or teasing digs. You are fed up and decide to take action the
next time it happens. What strategy should be considered as an effective way of
dealing with a sniper?
a. Clam up and allow the individual to fully ventilate her concern.
b. Confront the individual, saying that she is wrong.
c. Coldly withdraw from the individual.
d. Obtain group confirmation or denial of criticism raised by the individual.

ANS: D
When confronting the sniper, it is important to involve the rest of the staff to get
a group consensus of denial or confirmation.
DIF: Cognitive Level: Application
OBJ: Discuss techniques to use in dealing with difficult people
management

TOP: Conflict

MSC: NCLEX: Safe, effective care environmentmanagement of care

6. A staff nurse who has worked on the unit for 6 months voices the following
concerns to another nurse: The clinical nurse leader of the unit often follows me
into the supply room, where she stands blocking the doorway and chats. She
makes opportunities to mention my good looks, muscular physique, or strength in
the context of daily work. She says things like, Youre so handsome, no wonder
your clients like you. As she talks to me, she frequently touches me on the arm,
the shoulder, chest, or the hair, and if Im sitting, she touches my leg. Yesterday,
she patted my arm and said, You know, if we were dating, I might be able to give
you lighter assignments. I dont want to date her. I just want her to leave me
alone! What should I do? What is the best reply?
a. Dont be quite so honorable. Date her and see if you get better
assignments.
b. Confront her with a description of her behavior and tell her that you
want her to stop.
c. Go directly to the human relations office at the agency and tell them
what you just told me.
d. Contact your lawyer and get advice ASAP, in case she decides to turn
the tables and accuse you of advances.

ANS: B
There are two ways to deal with sexual harassment in the workplace: informally
by confrontation and formally through a grievance procedure, keeping a record of
all confrontations and statements in writing. The best first step is to confront the
person directly.
DIF: Cognitive Level: Analysis
OBJ: Identify situations of sexual harassment in the workplace and discuss
possible solutions.

TOP: Conflict management


MSC: NCLEX: Safe, effective care environmentmanagement of care

7. When a nurse manager uses employment seniority to resolve a scheduling


conflict between two nurses, this is an example of a:
a. Win-win strategy
b. Win-lose strategy
c. Lose-lose strategy
d. Compromise strategy

ANS: C
Avoidance is a lose-lose strategy for conflict resolution, which is unassertive and
uncooperative. Both persons in the conflict essentially lose, because the
decision is based on resorting to general rules instead of considering the merits
of each of the individual cases, which would be more of a compromise. Win-win
strategies involve collaboration and problem solving, which lead to cooperation
and objectivity.
DIF: Cognitive Level: Comprehension
with conflict

OBJ:

Discuss five methods to deal

TOP: Conflict management


MSC: NCLEX: Safe, effective care environmentmanagement of care

8. The nurse manager understands that the first step in attempting to resolve an
interpersonal conflict between two nurses is to:
a. Determine the facts related to the situation
b. Schedule a meeting time for resolution
c. Have an accurate understanding of the problem or conflict
d. Have the determination to resolve the conflict

ANS: C

The quality of the outcome of resolving a problem depends on proper recognition


and identification of the problem or issue. This assessment is best addressed by
determining the nature of the differences and the reasons for them. After this has
been achieved, the next steps would be identifying the conflicting facts and
developing ways to implement a plan for resolution.
DIF: Cognitive Level: Comprehension
with conflict

OBJ:

Discuss five methods to deal

TOP: Conflict management


MSC: NCLEX: Safe, effective care environmentmanagement of care

9. During a staff meeting, an upset nursing assistant tells the group that she thinks
the other nursing assistants are given easier client assignments and are always
given their choice of days off. What approach by the nurse manager would be
effective to resolve this conflict?
a. Attempt to persuade the upset nursing assistant to calm down.
b. Tell the group that this type of conversation needs to be handled
privately.
c. Consider transferring the upset nursing assistant to another unit.
d. Acknowledge the feelings of the upset nursing assistant and make a
plan to meet with her.

ANS: D
Conflict negotiation requires dealing with issues, not personalities, by
communicating openly, listening actively to the complaints, sorting out the
issues, identifying key themes of the discussion, and weighing the consequences
and options to resolve the conflict. Acknowledging the nursing assistants feelings
is the first step in this process.
DIF: Cognitive Level: Application
conflict

OBJ: Discuss five methods to deal with

TOP: Conflict management


MSC: NCLEX: Safe, effective care environmentmanagement of care

10. Considering the following terms used to label different styles of handling anger
the Sherman tank, the sniper, the constant complainer, and the clamwhich of
the following comments would you expect a Sherman tank to make?
a. That sure sounded like a put-down to me.
b. How dare you accuse me of not putting away the linen!
c. So, you think you know everything, eh?
d. Why do we always have to rotate shifts?

ANS: B
Sherman tanks attack individuals and have a strong need to prove to themselves
and to others that their view of a situation is right. Their comments are abusive
and abrupt and can be intimidating. Snipers take pot shots at others and are
not as openly aggressive as Sherman tanks. Constant complainers do just that
they complain but offer no solution. Clams also behave like their namethey
clam up and refuse to respond when you need an answer or want to talk.
DIF: Cognitive Level: Application
OBJ: Discuss solutions and alternatives in dealing with anger
management

TOP: Conflict

MSC: NCLEX: Safe, effective care environmentmanagement of care

MULTIPLE RESPONSE

1. The staff nurse understands that which of the following are effective ways to deal
with a sexual harassment issue in the workplace? Select all that apply.
a. Tell the person to stop.
b. Tell your best friend about the incident.
c. File a formal grievance.
d. Explain the situation to your spouse.
e. Play along with the person and document the activities.
f.

Threaten the person with a sexual harassment lawsuit.

ANS: A, B, C, D

There are two ways to deal with sexual harassment workplace conflict: informally
and formally through a grievance procedure. Start with the most direct measure.
Ask the person to STOP! Tell the harasser in clear terms that the behavior makes
you uncomfortable and that you want it to stop immediately. In addition, put your
statement in writing to the person, keeping a copy for yourself. It is also
important to tell other people (for example, family members, friends, your
personal physician, your minister) that this is happening and how you are dealing
with it.
DIF: Cognitive Level: Application
conflict

OBJ: Discuss five methods to deal with

TOP: Conflict management


MSC: NCLEX: Safe, effective care environmentmanagement of care

2. Which of the following are common factors of conflict encountered in nursing?


Select all that apply.
a. Ambiguous boundaries around work responsibilities
b. Unclear communication to family members about visiting hours
c. Nursing assistant placing personal achievement above everything
d. Chief of medicine demanding that the nurse/client ratio be increased
e. Consideration of 26-week termination of pregnancy by a physician
because of mothers health
f.

Vacation schedules posted with new staff members having to work at


least one day during all holidays

ANS: A, B, C, D, E, F
All of these areas are potential factors that can precipitate conflict in a nursing
situationroles, communication, goals, personalities, and conflicting
ethics/values.
DIF: Cognitive Level: Application
conflict

OBJ: Identify common factors that lead to

TOP: Conflict management


MSC: NCLEX: Safe, effective care environmentmanagement of care