Bioethics in Nursing Practice Set 2 (Answer Key With Rationale)

BIOETHICS IN NURSING PRACTICE SET 2 (Answer Key with Rationale) Preare! By" Ro##ie $ia#res% RN &' B' Nrse enny shol! *le an in+i!ent reort' Callin, the hosital-s lawyer is not the .o# o/ Nrse enny' Ta0in, no a+tion is not an aroriate aroriate a+tion' 1o+entin, that she has ,i3en one +asle instea! o/ two 3iolates the 3irte o/ 3era+ity an! the rin+ile o/ non4 ale*+en+e' 2' A' Nrse $eo shol! shol! re/er the atient atient to a se5 se5 +onselor +onselor or to other ro/essional' 6a0in, aroriate re/errals is a 3ali! art o/ lannin, the atient-s +are' The nrse !oesn-t norally ro3i!e se5 +onselin,' 7' 1' It is the role role an! an! o#li,ation o#li,ation o/ o/ the hysi+ian to in/or in/or the the atient'  The nrse is o#li,ate! to in/or the hysi+ian that that the atient is !ean!in, in/oration' in/oration' The nrse nrse has has an ethi+al o#li,ation 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 3iew 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' 8' A' The ost aror aroriate iate nrsin, nrsin, inter3ention is to !is+ss !is+ss with the /aily ossi#le or,an !onation sin+e #rain4!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 #e+ase the atient is #rain !ea!' Altho,h tal0in, to sta9 e#ers a#ot their /eelin, is also ne+essary% it isn-t the *rst a+tion to ta0e' :' B' 6e!i+al in/oration in/oration a#ot a#ot a atient +an #e !is+lose! !is+lose! only to the the /ollowin,; the atient% whoe3er is in4+har,e o/ the atient% those who ay #e a9e+te! #y the atient-s health an! to le,itiate athorities or those who are !ire+tly in3ol3e! in the +are o/ the atient' <' C' Se5al harassent in the wor0la+e wor0la+e is rohi#it rohi#ite! e! #y the law law' Se5ally s,,esti3e .o0es% to+hin,% ressrin, a +o4wor0er /or a !ate an! oen !islay o/ se5ally oriente! hoto,rahs or 3i!eos are e5ales o/ +on!+t that +ol! #e +onsi!ere! se5al harassent' This shol! #e a!!resse! !ire+tly to the nrsin, ser3isor' Callin, the se+rity is nne+essary' Otion A an! B are not the ost aroriate a+tions to ta0e' =' B' Gina has has so0en so0en to his +ollea,e a#ot the isse isse roerly roerly #t #t the nrse-s #eha3ior hasn-t +han,e' There/ore% the ne5t ste is to a!!ress the isse to the ana,er or ser3isor' It is inaroriate to tal0 to other sta9 e#ers a#ot the isse #e+ase they !on-t ha3e the athority to #rin, the +ollea,e-s ra+ti+e to +olian+e' A nrse shol! ne3er oint ot to a atient that a sta9 is not eetin, the stan!ar!s' >' C' The !isea !isease se o/ a atie atient nt nee! nee! not #e #e in #li+ #li+ 3iew 3iew li0e li0e in in !oor la#els o/ atient-s roos' Plain la#el o/ re3erse isolation or stri+t

isolation is eno,h to ensre sa/ety o/ health+are wor0ers' It !oesn-t roote atient +on*!entiality' ?' C' A nrse nrse who who sse+ts sse+ts 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er3isor' 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 +o3er /or an iaire! nrse or ,i3e hi one ore +han+e' This a+tion la+es atients in !an,er an! re3ent the iaire! nrse /ro re+ei3in, hel' The nrse shol! reort to the nrse ser3isor #t not to the se+rity or the oli+e' &@'C' &&'A' &2'C' &7'C' &8'1' &:'1' &<'B' &='A' &>'1' &?'B' 2@'A' 2&'B' 22'B' 27'B' 28'B' 2:'1' 2<'1' 2='C' 2>'A' It is the le,al o#li,ation o#li,ation o/ the witness to 3eri/y 3eri/y that the si,natre si,natre too0 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% to +on!+t the in/ore! +onsent ro+ess' It is the atten!in, hysi+ian-s o#li,ation% 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' 2?'A' It is the le,al an! ethi+al o#li,ation o/ the nrse to reort in+i!ents s+h as e!i+ation errors that e5oses the atient to har' ailin, to +he+0 the e!i+ation re+or! re+or! to see i/ a !r, ha! #een ,i3en 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 re3ent /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' 7@'C' Hosi+e +are is /or atients who are terinally ill an! their /ailies or +are,i3ers' Berea3eent +onselin, is a3aila#le e3en a/ter the !eath o/ a atient' E!+ate! 3olnteers are also art o/ the inter!is+ilinary inter!is+ilinary tea' The ser3i+e is a3aila#le at all ties' There is sally an RN on +all 28 hors a !ay'

7&'A' Altho,h all o/ the atients nee! so+ial ser3i+e an! !is+har,e !is+har,e assistan+e% the atient who is newly !ia,nose! with !ia#etes is at ,reater ris0 o/ +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 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 ris0' 72'C' 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 3ali!ate a e!i+ation or!er' The a+tions o/ the nrses on re3ios shi/ts !o not reo3e the o#li,ation to estion that or!er% nless there is a +lear note that the or!er has #een estione!' 77'B' The atient with +hest ain ay #e ha3in, a yo+ar!ial in/ar+tion in/ar+tion (6I)% an! ie!iate assessent assessent an! inter3ention are riorities' riorities' Altho,h ain ana,eent is iortant% ain is an e5e+te! ani/estation ani/estat ion /ro the sr,ery' sr,ery' Hyer,ly+eia o/ &=> is not li/e threatenin,' threatenin,' Assessent an! inter3ention is ne+essary #t not riorities +oare! with a atient with +hest ain' rther assessent o/ the atient with +al/ ain is ne+essary 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' 78'C' The nrse is hol!in, the ethi+al o#li,ation to tell the trth an! to a0e 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' 7:'B' Health+are Health+are 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 ha3e 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! shol! in/or in/or the eloyer o/ the #elie/s #e/ore #ein, #ein, assi,ne! atients' The +onDi+ts an! !o#ts o/ the nrse +an #e rea!ily +oni+ate! to woen who i,ht alrea!y #e an5ios an! sensiti3e a#ot the ro+e!re' Nrses ha3e 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% a#ortions% #t ay wor0 in another se+tion or nit' 7<'1' These are li0ely si,ns o/ an a+te yo+ar!ial in/ar+tion (6I)% whi+h is a +ar!io3as+lar eer,en+y reirin, ie!iate attention' A+te 6I is otentially /atal i/ not treate! ie!iately' Pain an! swellin, is a s+los0eletal ro#le an! not li/e threatenin,' A +hil! who 3oite! on+e sin+e start o/ +olaint !oes not ta0e riority o3er a li/e4 threatenin, +ar!ia+ eer,en+y' $oss o/ aetite an! /ati,e is not an ie!iate eer,en+y%

7='B' Patients Patients who are in ani+ nee! ie!iate assistan+e #e+ase their #eha3ior ay reslt in har to thesel3es or others' I!enti/yin, a!!i+tion is ore tie +onsin, an! not an easily sol3e! ro#le' 1eression 1eression wol! !e3elo o3er a lon,er erio! o/ tie' Ehoria is !e*ne! as an e5a,,erate! /eelin, o/ well4#ein, (il! elation)' It is nli0ely that a atient who is ehori+ wol! ta0e riority o3er a atient who is ani+0in,' 7>'A' The only /a+tally +orre+t answer wol! ro3i!e in/oration a#ot +ontrain!i+ations' +ontrain!i+ations' Or,an !onors st #e at least &> years o/ a,e' ritten +onsent is reire!' aily e#er or le,al ,ar!ian ay athoriFe or,an !onation in the a#sen+e o/ written !o+entation #y !onor' 7?'B' Pro3i!in, Pro3i!in, /oo!s that are +ltrally a++eta#le to the e5tent ossi#le is an iortant rin+ile o/ +ltral sensiti3ity 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% /a3orite /oo!s ay not #e ntritionally son!' An! e3en tho,h ser3in, +ltrally reire! /oo!s +on3ey a++etan+e% it !oes not ,arantee +ooeration +ooeration with other treatents' 8@'1' The hysi+ian ay not #e aware o/ the role that reli,ios reli,ios #elie/s lay in a0in, a !e+ision a#ot sr,ery' The nrse !oes not ha3e the ri,ht to en+ora,e a se+i*+ treatent that is +ontrary to the atient-s wishes' The atient has the ri,ht to a0e the !e+ision' The /aily +ol! #e in+ororate! when e5lorin, all otions to hel the atient a0e 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 3olntary' 8&'B' 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 e5e+te! to #e De5i#le eno,h to rioritiFe +are% an! the inial le3el o/ a++eta#le +are is atient sa/ety' Pro3i!in, +stoary or i!eal +are to soe atients an! lea3in, others withot +are wol! not eet the test o/ reasona#leness' Re/sin, the assi,nent will e5ose the atients to har /ro a#an!onent' Care #y /aily e#ers !oes not o#3iate the nee! /or nrsin, +are or atten!an+e #y the nrse' 82'1' The nrse has a oral an! ro/essional resonsi#ility resonsi#ility to a!3o+ate /or atients who e5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 a0e atonoos +hoi+es' Coor!inatin, Coor!inatin, a eetin, #etween the hysi+ian an! /aily e#ers ay allow the atient an oortnity to e5ress his or her wishes an! roote awareness o/ his or her /eelin,s% as well as inDen+e /tre +are !e+isions' All other otions are inaroriate'

87'A' The nrse is o#li,ate! to let the atient lea3e' 1etainin, hi in any /or is a 3iolation o/ the atient-s #ill o/ ri,hts' 88'B' hen a!3an+e !ire+ti3es state that a atient !oes not want li/e4 rolon,in, inter3entions% nrsin, +are /o+ses on ro3i!in, eotional an! sirital sort an! +o/ort easres' The atient still nee!s to #e +he+0e! re,larly' The atient an! the /aily shol! not /eel as i/ they ha3e #een a#an!one!' Pro3i!in, oth an! s0in +are a0es the atient ore +o/orta#le' Trnin, the atient ro3i!es +o/ort an! re3ents otentially ain/l +oli+ations s+h as ressre l+ers' 8:'1' Nrses are always 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 ista0e wasn-t intentional% stan!ar! ro+e!re wasn-t /ollowe!' 8<'C' A!3an+e !ire+ti3es ,i3e a +oetent atient +ontrol o3er his sitation an! a le,al /or in whi+h to e5ress his wishes a#ot his +are' 1is+ssion 1is+ssion o/ a!3an+e !ire+ti3es isn-t otsi!e the s+oe o/ nrsin, ra+ti+e' The atient-s #ill o/ ri,hts in3ol3es ltile atient ri,hts an! !oes not ro3i!e !etaile! in/oration a#ot a!3an+e !ire+ti3es' A+ti3e ethanasia is ille,al' 8='1' The nrse-s release release o/ in/oration to the atient-s eloyer withot the atient-s +onsent is a #rea+h o/ +on*!entiality' The sti,a asso+iate! with sy+hiatri+ illness ay a9e+t the atient-s 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 she-s a atient in the hosital 8>'B' i/ a atient reests /or 1A6A% the nrse shol! noti/y the hysi+ian ie!iately' I/ the hysi+ian +an not +on3in+e the atient to stay% the hysi+ian will as0 the atient to si,n a 1A6A /or' This /or releases the hosital /ro le,al resonsi#ility' I/ the hysi+ian isn-t a3aila#le% the nrse shol! o#tain the atient-s si,natre on the 1A6A /or' A atient who re/ses to si,n the /or shol! not #e !etaine!; /or+e! !etention 3iolates the atient-s ri,hts' A/ter the atient lea3es% 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' 8?'C' The *rst a+tion wol! #e to rote+t the +hil! #y reo3in, her /ro the roo' Callin, the se+rity is ne+essary #t only a/ter ensrin, the sa/ety o/ the +hil!' As0in, one o/ the /aily e#ers to lea3e the roo or reasonin, with the wol! #e ine9e+ti3e at this oint an! ay e3en es+alate the sitation' :@'A' By lea3in, 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 atient-s roo' E!+atin, the atient a#ot sa/ety easres !oesn-t alle3iate the nrse /ro resonsi#ility /or ensrin, atient sa/ety' The nrse +an-t restrain the atient withot a

hysi+ian-s or!er an! restraints won-t ensre the atient-s sa/ety' 1o+entin, that he le/t the atient !oesn-t e5+se the nrse /ro his resonsi#ility /or ensrin, the atient-s sa/ety' :&'A' Resiratory% +ar!io3as+lar an! nerolo,i+al assessents whi+h are hysiolo,i+al assessents are the riority assessent' :2'A' Altho,h CATs shol! #e aro3e! #y the hysi+ian an! they ay ha3e intera+tions with the treatent lan% the nrse shol! #e theraeti+ in !ealin, with atients with li/e threatenin, threatenin, +on!itions' :7'C' :8'B' ::'1' :<'B' :='C' :>'1' :?'B' <@'A' <&'1' <2'B' <7'B' <8'C' <:'C' <<'C' <='B' <>'C' 'C' =?'A' >@'1' >&'