Term
The patient for whom you are caring needs a liver transplant to survive. This patient has been out of work for several months and doesn't have health insurance or enough cash. Even though several ethical principles are at work in this case, what are the principles from highest to lowest priority?
1. Accountability: You as the nurse are accountable for the wellbeing of this patient.
2. Respect for autonomy: This patient's autonomy will be violated if he does not receive the liver transplant.
3. Ethics of care: The caring thing that a nurse could provide this patient is resources for a liver transplant.
4. Justice: The greatest question in this situation is how to determine the just distribution of resources. |
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Definition
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| A child’s immunization may cause discomfort during administration, but the benefits of protection from disease, both for the individual and society, outweigh the temporary discomforts. Which principle is involved in this situation? |
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| When designing a plan for pain management for a postoperative patient, the nurse assesses that the patient’s priority is to be as free of pain as possible. The nurse and patient work together to identify a plan to manage the pain. The nurse continually reviews the plan with the patient to ensure that the patient’s priority is met. Which principle is used to encourage the nurse to monitor the patient’s response to the pain? |
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| A patient is admitted to a medical unit. The patient is fearful of hospitals. The nurse carefully assesses the patient to determine the exact fears and then establishes interventions designed to reduce these fears. In this setting how is the nurse practicing patient advocacy? |
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Definition
| Assessing the patient’s point of view and preparing to articulate it |
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Term
| The application of utilitarianism does not always resolve an ethical dilemma. Which of the following statements best explains why? |
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Definition
| In a diverse community it can be difficult to find agreement on a definition of usefulness, the focus of utilitarianism. |
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Term
| In most ethical dilemmas in health care, the solution to the dilemma requires negotiation among members of the health care team. Why is the nurse’s point of view valuable? |
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Definition
| Nurses develop a relationship with the patient that is unique among all professional health care providers |
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Term
Ethical dilemmas often arise over a conflict of opinion. Reliance on a predictable series of steps can help people in conflict find common ground. All of the following actions can help resolve conflict. What is the best order of these actions in order to promote the resolution of an ethical dilemma?
1. List the actions that could be taken to resolve the dilemma.
2. Agree on a statement of the problem or dilemma that you are trying to resolve.
3. Agree on a plan to evaluate the action over time.
4. Gather all relevant information regarding the clinical, social, and spiritual aspects of the dilemma.
5. Take time to clarify values and distinguish between facts and opinions—your own and those of others involved.
6. Negotiate a plan. |
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| The ANA code of nursing ethics articulates that the nurse “promotes, advocates for, and strives to protect the health, safety, and rights of the patient.” This includes the protection of patient privacy. On the basis of this principle, if you participate in a public online social network such as Facebook, could you post images of a patient’s x-ray film if you obscured or deleted all patient identifiers? |
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Definition
| No, because, even though patient identifiers are removed, someone could identify the patient on the basis of other comments that you make online about his or her condition and your place of work |
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Term
What are the correct steps to resolve an ethical dilemma on a clinical unit? Place the steps in correct order.
1. Clarify values.
2. Ask the question, Is this an ethical dilemma?
3. Verbalize the problem.
4. Gather information.
5. Identify course of action.
6. Evaluate the plan.
7. Negotiate a plan. |
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Definition
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Term
| Resolution of an ethical dilemma involves discussion with the patient, the patient’s family, and participants from all health care disciplines. Which of the following best describes the role of the nurse in the resolution of ethical dilemmas? |
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Definition
| To articulate the nurse’s unique point of view, including knowledge based on clinical and psychosocial observations |
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Term
| A patient at the end of life wants to go home to die, but the family wants every care possible. The nurse contacts the primary care provider about the patient's request. |
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Term
| You tell your patient that you will return in 30 minutes to give him his next pain medication. |
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Definition
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| You administer a once-a-day cardiac medication at the wrong time, but nobody sees it. However, you contact the primary care provider and your head nurse and follow agency procedure. |
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Definition
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Term
| You tell your patient that you will return in 30 minutes to give him his next pain medication. |
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Definition
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Term
| The ethics of care suggests that ethical dilemmas can best be solved by attention to relationships. How does this differ from other ethical practices? (Select all that apply.) |
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Definition
`Ethics of care pays attention to the environment in which caring occurs
`Ethics of care pays attention to the stories of the people involved in the ethical issue
`Ethics of care focuses only on understanding relationships. |
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Term
| It can be difficult to agree on a common definition of the word quality when it comes to quality of life. Why? (Select all that apply.) |
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Definition
`Community values influence definitions of quality, and they are subject to change over time.
`Individual experiences influence perceptions of quality in different ways, making consensus difficult
`he value of elements such as cognitive skills, ability to perform meaningful work, and relationship to family is difficult to quantify using objective measure
`Statistical analysis is difficult to apply when the outcome cannot be quantified. |
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Term
| Which of the following properly applies an ethical principle to justify access to health care? (Select all that apply.) |
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Definition
`access to health care reflects the commitment of society to principles of beneficence and justice. Correct
`If low income compromises access to care, respect for autonomy is compromised.
Poor access to affordable health care causes harm that is ethically troubling because nonmaleficence is a basic principle of health care ethics |
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Term
| Two patient deaths have occurred on a medical unit in the last month. The staff notices that everyone feels pressured and team members are getting into more arguments. As a nurse on the unit, what will best help you manage this stress? |
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Definition
| Two patient deaths have occurred on a medical unit in the last month. The staff notices that everyone feels pressured and team members are getting into more arguments. As a nurse on the unit, what will best help you manage this stress? |
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Term
| A nurse has seen many cancer patients struggle with pain management because they are afraid of becoming addicted to the medicine. Pain control is a priority for cancer care. By helping patients focus on their values and beliefs about pain control, a nurse can best make clinical decisions. This is an example of: |
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Definition
| Applying ethical criteria. |
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Term
| A nurse prepares to insert a Foley catheter. The procedure manual calls for the patient to lie in the dorsal recumbent position. The patient complains of having back pain when lying on her back. Despite this, the nurse positions the patient supine with knees flexed as the manual recommends and begins to insert the catheter. This is an example of: |
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Definition
| A nurse prepares to insert a Foley catheter. The procedure manual calls for the patient to lie in the dorsal recumbent position. The patient complains of having back pain when lying on her back. Despite this, the nurse positions the patient supine with knees flexed as the manual recommends and begins to insert the catheter. This is an example of: |
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Term
| A nurse is preparing medications for a patient. The nurse checks the name of the medication on the label with the name of the medication on the doctor’s order. At the bedside the nurse checks the patient’s name against the medication order as well. The nurse is following which critical thinking attitude: |
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Definition
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| By using known criteria in conducting an assessment such as reviewing with a patient the typical characteristics of pain, a nurse is demonstrating which critical thinking attitude? |
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Definition
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Term
| A nurse just started working at a well-baby clinic. One of her recent experiences was to help a mother learn the steps of breastfeeding. During the first clinic visit the mother had difficulty positioning the baby during feeding. After the visit the nurse considers what affected the inability of the mother to breastfeed, including the mother’s obesity and inexperience. The nurse’s review of the situation is called: |
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Definition
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Term
Place the steps of the scientific method in their correct order with number 1 being the first step of the process.
1. Formulate a question or hypothesis. 2. Evaluate results of the study. 3. Collect data. 4. Identify the problem. 5. Test the question or hypothesis. |
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Definition
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Term
| An aspect of clinical decision making is knowing the patient. Which of the following is the most critical aspect of developing the ability to know the patient? |
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Definition
| Spending time establishing relationships with patients |
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Term
| A nurse enters a 72-year-old patient’s home and begins to observe her behaviors and examine her physical condition. The nurse learns that the patient lives alone and notices bruising on the patient’s leg. When watching the patient walk, the nurse notes that she has an unsteady gait and leans to one side. The patient admits to having fallen in the past. The nurse identifies the patient as having the nursing diagnosis of Risk for Falls. This scenario is an example of: |
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Definition
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Term
| Be objective in asking questions of a patient. |
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Definition
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Term
| Be tolerant of the patient's views and beliefs |
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Definition
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Term
| Organize assessment on the basis of patient priorities. |
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Definition
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Term
| Anticipate how a patient might respond to a treatment. |
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Definition
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| A nurse on a busy medicine unit is assigned to four patients. It is 10 am. Two patients have medications due and one of those has a specimen of urine to be collected. One patient is having complications from surgery and is being prepared to return to the operating room. The fourth patient requires instructions about activity restrictions before going home this afternoon. Which of the following should the nurse use in making clinical decisions appropriate for the patient group? (Select all that apply.) |
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Definition
`Consider availability of assistive personnel to obtain the specimen
`Combine activities to resolve more than one patient problem
`Analyze the diagnoses/problems and decide which are most urgent based on patients’ needs |
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Term
| A nurse changed a patient’s surgical wound dressing the day before and now prepares for another dressing change. The nurse had difficulty removing the gauze from the wound bed yesterday, causing the patient discomfort. Today he gives the patient an analgesic 30 minutes before the dressing change. Then he adds some sterile saline to loosen the gauze for a few minutes before removing it. The patient reports that the procedure was much more comfortable. Which of the following describes the nurse’s approach to the dressing change? (Select all that apply.) |
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Definition
`Complex critical thinking
`Experience |
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Term
| Which of the following describes a nurse’s application of a specific knowledge base during critical thinking? (Select all that apply.) |
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Definition
`Initiative in reading current evidence from the literature
`Application of nursing theory
`Considering holistic view of patient needs |
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Term
| In which of the following examples is a nurse applying critical thinking skills in practice? (Select all that apply.) |
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Definition
`The nurse thinks back about a personal experience before administering a medication subcutaneously.
`The nurse uses a pain-rating scale to measure a patient’s pain.
`The nurse gathers data on a patient with a mobility limitation to identify a nursing diagnosis. |
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Term
| A nurse hears a colleague tell a nursing student that she never touches a patient unless she is performing a procedure or doing an assessment. The nurse tells the student that from a caring perspective: |
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Definition
| Touch forms a connection between nurse and patient. |
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Term
| Of the five caring processes described by Swanson, which describes “knowing the patient?” |
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Definition
| Establishing an understanding of a specific patient |
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Term
| A Muslim woman enters the clinic to have a woman’s health examination for the first time. Which nursing behavior applies Swanson’s caring process of “knowing the patient?” |
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Definition
| Gaining an understanding of what a woman’s health examination means to the patient |
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Term
| A patient is fearful of upcoming surgery and a possible cancer diagnosis. He discusses his love for the Bible with his nurse, who recommends a favorite Bible verse. Another nurse tells the patient's nurse that there is no place in nursing for spiritual caring. The patient's nurse replies: |
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Definition
| Spiritual, mind, and body connections can affect health." |
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Term
| When a nurse helps a patient find the meaning of cancer by supporting beliefs about life, this is an example of: |
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Definition
| instilling hope and faith. |
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Term
| An example of a nurse caring behavior that families of acutely ill patients perceive as important to patients' well-being is: |
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Definition
| Asking permission before performing a procedure on a patient. |
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Term
| Listening is not only “taking in” what a patient says, but it also includes: |
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Definition
| Interpreting and understanding what the patient means. |
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Term
| A nurse is caring for an older adult who needs to enter an assisted living facility following discharge from the hospital. Which of the following is an example of listening that displays caring? |
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Definition
| The nurse listens to the patient’s story while sitting on the side of the bed and then summarizes the story. |
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Term
| Presence involves a person-to-person encounter that: |
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Definition
| Conveys a closeness and a sense of caring. |
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Term
| A nurse enters a patient’s room, arranges the supplies for a Foley catheter insertion, and explains the procedure to the patient. She tells the patient what to expect; just before inserting the catheter, she tells the patient to relax and that, once the catheter is in place, she will not feel the bladder pressure. The nurse then proceeds to skillfully insert the Foley catheter. This is an example of what type of touch? |
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Definition
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Term
| A hospice nurse sits at the bedside of a male patient in the final stages of cancer. He and his parents made the decision that he would move home and they would help him in the final stages of his disease. The family participates in his care, but lately the nurse has increased the amount of time she spends with the family. Whenever she enters the room or approaches the patient to give care, she touches his shoulder and tells him that she is present. This is an example of what type of touch? |
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Definition
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Term
| Sustaining faith in one's capacity to get through a situation |
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Definition
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Term
| Striving to understand an event as meaning for another person |
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Definition
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Term
| Being emotionally there for another person |
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Definition
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Term
| Providing for another as he or she would do for themselves |
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Definition
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Term
| Which of the following is a strategy for creating work environments that enable nurses to demonstrate more caring behaviors? (Select all that apply.) |
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Definition
`Increasing the number of nurses who work each shift to decrease the nurse-patient ratio
`Providing nursing staff an opportunity to discuss practice changes they can implement to enhance opportunities for patient caring |
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Term
A nurse demonstrated caring by helping family members to:
(Select all that apply.) |
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Definition
`Become active participants in care.
`Have uninterrupted time for family and patient to be together.
`Have opportunities for the family to discuss their concerns |
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Term
| A student nurse is telling a faculty member that her patient talked about gaining spiritual comfort from being focused on her inner self, including her values and principles. The instructor explains that this is an example of: |
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Definition
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Term
| You are caring for a hospitalized patient who is Muslim and has diabetes. Which of the following items do you need to remove from the meal tray when it is delivered to the patient? |
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Definition
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Term
| A patient has just learned she has been diagnosed with a malignant brain tumor. She is alone; her family will not be arriving from out of town for an hour. You have cared for her for only 2 hours but have a good relationship with her. What might be the most appropriate intervention for support of her spiritual well-being at this time? |
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Definition
| Sit down and talk with the patient; have her discuss her feelings and listen attentively |
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Term
| A patient states that he does not believe in a higher power but instead believes that people bring meaning to what they do. This patient most likely is an: |
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Definition
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Term
| A nurse begins a night shift, assuming care for a critically ill patient who was resuscitated earlier in the day from cardiac arrest. He survived and is physically stable, alert, oriented, and responding appropriately to the nurse’s questions. Knowing that the patient experienced a period when his heart stopped beating, what would be the best approach for the nurse to use with him? |
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Definition
| Sit and encourage the patient to share what he experienced during resuscitation |
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Term
| A nurse is caring for a patient with a seriously advanced infection who asks to have a spiritual care provider come who can offer Blessingway, a practice that attempts to remove ill health. This patient is likely a member of which religion or culture? |
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Definition
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Term
| Evaluation of spiritual care is necessary to determine if a patient’s level of spiritual health has changed following intervention. If the use of rituals was part of a nurse’s care plan, which of the following questions is most appropriate to evaluate its efficacy? |
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Definition
| Were prayer or meditation helpful to you? |
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Term
| A patient who is recovering from a bilateral amputation of the legs below the knee shows transcendence when she states: |
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Definition
| "I see God’s grace and become relaxed when I watch the sun set at night.” |
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Term
| Tell me if you have a higher power or authority that helps you act on your beliefs |
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Definition
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Term
| Describe which activities give you comfort spiritually? |
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Definition
| Interventions to address spiritual needs |
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Term
| To whom do you go for support in times of difficulty? |
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Definition
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Term
| Your illness has kept you from attending church. Is that a problem for you? |
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Definition
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Term
| A nurse is caring for a 78-year-old patient with chronic multiple sclerosis. The patient has severe fatigue, muscle weakness, severe muscle spasms, and difficulties with coordination and balance. Her disease will likely worsen. The nurse has gained the patient’s trust and wants to assess her life satisfaction. Which of the following questions should the nurse ask? (Select all that apply.) |
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Definition
`What about your family makes you proudest?
` Looking back, what is your greatest accomplishment? |
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Term
| A 44-year-old male patient has just been told that his wife and child were killed in an auto accident while coming to visit him in the hospital. Which of the following statements are defining characteristics that support a nursing diagnosis of Spiritual Distress related to loss of family members? (Select all that apply.) |
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Definition
`Why would my God do this to me?”
`I have nothing to live for now.” |
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Term
| A nurse is preparing to teach an older adult who has chronic arthritis how to practice meditation. Which of the following strategies are appropriate? (Select all that apply.) |
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Definition
`Have patient identify a quiet room in the home that has minimal interruptions.
`Suggest use of a quiet fan running in the room
`Show the patient how to sit comfortably with the limitation of his arthritis and focus on a prayer. |
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Term
| A student nurse is developing a plan of care for a 74-year-old female patient who has spiritual distress over losing a spouse. As the nurse develops appropriate interventions, which characteristics of older adults should be considered? (Select all that apply.) |
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Definition
`Older adults achieve spiritual resilience through frequent expressions of gratitude.
`Have the patient determine if her husband left a legacy behind.
`Offer the patient her choice of rituals or participation in exercise. |
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Term
| The nurse is caring for a 50-year-old woman visiting the outpatient medicine clinic. The patient has had type 1 diabetes since age 13. She has numerous complications from her disease, including reduced vision, heart disease, and severe numbness and tingling of the extremities. Knowing that spirituality helps patients cope with their chronic illness, which of the following principles should the nurse apply in practice? (Select all that apply.) |
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Definition
`Pay attention to the patient's spiritual identity throughout the course of her illness
`Listen to the patient's story each visit to the clinic and offer a compassionate presence |
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Term
| Select the three factors that are evident when a healing relationship develops between nurse and patient. |
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Definition
`The nurse being able to realistically mobilize hope for the patient
`Finding an interpretation or understanding of the patient’s illness that is acceptable to the patient
`Helping the patient use spiritual resources that he or she chooses |
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