Ethics & Issues in Contemporary Nursing 4th Edition, Margaret Test Bank

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Ethics & Issues in Contemporary Nursing 4th Edition, Margaret Test Bank


Test Bank Ethics Issues Contemporary Nursing 4th Edition, Margaret


Chapter 1: Social, Philosophical, and Other Historical Forces Influencing the Development of Nursing

  1. Nursing practice is influenced by:
    a. history.
    b. spiritual beliefs.
    c. religious practice.
    d. philosophical influences.
    e. all of the above.
  2. Empathy is a motive for:
    a. meeting the needs of others. c. becoming a nurse.
    b. moral reasoning and action. d. determining right from wrong.
  3. Professions exist to meet the:
    a. needs of employers. c. needs of society.
    b. needs of individuals. d. needs of families.
  4. Florence Nightingale was a:
    a. model for all nurses.
    b. nurse.
    c. statistician.
    d. social reformer.
    e. all of the above.
  5. Helping professionals find their origin in:
    a. inhumane actions.
    b. perceived social need.
    c. accepted moral needs.
    d. individual values.
    e. All except a.
    f. b and c only.
  6. The overarching belief system of a culture that deals with the cultures beliefs about the nature of the universe is termed:
    a. cosmology. c. values.
    b. religion. d. astrology.
  7. During the Middle Ages:
    a. religions and church-sanctioned secular nursing orders afforded the only legitimate avenue for women who wished to become nurses.
    b. there was an upsurge in the respect afforded to nursing and midwifery, and nurses began to practice autonomously.
    c. healing arts in Denmark and Greece were performed in sacred ceremonies by priests, priestesses, or shamans.
    d. most nurses were women of high social status.
  8. The Dark Period of Nursing when convalescent patients, prostitutes, prisoners, and drunkards provided hospital nursing care occurred during the:
    a. Reformation. c. Middle Ages.
    b. Crusades. d. Early Christian era.
  9. The concept of social need is important to the ethical foundations of the nursing professional because:
    a. nurses must determine the health needs of society.
    b. nursing finds its origin, purpose, and meaning within the context of perceived social need.
    c. theories of sociology are utilized by nursing scholars, many of whom view them as conceptual frameworks for nursing practice.
    d. social need determines the boundaries of the ethical principles of distributive justice, beneficence, and nonmaleficence.
  10. The social status of women affects the status of the nursing profession because:
    a. nursing has traditionally been a profession of women.
    b. throughout history, nurses have been afforded higher social status.
    c. women of higher social status rarely become nurses.
    d. women are more skilled than men at nurturing others.

Chapter 2: Ethical Theory

  1. Ethics is:
    a. a formal process of making illogical and consistent decisions based upon ones beliefs.
    b. a formal process of making logical and random decisions based upon moral beliefs.
    c. a formal process of making logical and consistent decisions based upon moral beliefs.
    d. a formal process of making logical and consistent decisions based upon religious beliefs.
  2. The belief that people can figure out absolute moral rules that derive from the universe or a supreme being is the basis for which moral perspective?
    a. Moral belief c. Deontology
    b. Rationalism d. Naturalism
  3. The nurse maintained confidentiality regarding a patients terminal illness even though family members would have provided emotional and financial support to the patient had they known of the diagnosis. Adhering to this principle regardless of outcome is an example of the application of which ethical theory?
    a. Deontology c. Rationalism
    b. Naturalism d. Utilitarianism
  4. During a hurricane, there is no electricity in a hospital where floodwater is rapidly rising. An ICU nurse manually ventilates a patient with an ambu bag for 6 hours before she makes the difficult decision to leave her patient and help the solitary remaining nurse carry 12 newborns to safety. The nurses decision is most clearly supported by which of the following?
    a. Deontology c. Rationalism
    b. Virtue ethics d. Utilitarianism
  5. Abortion, even to save the life of the mother, would most likely be considered morally wrong by a person rigidly applying which type of moral theory?
    a. Deontology c. Naturalism
    b. Virtue ethics d. Utilitarianism
  6. The Kantian maxim requiring that no action be judged as right, which cannot reasonably become a law by which every person should always abide, is known as:
    a. the categorical imperative. c. deontology.
    b. the practical imperative. d. utilitarianism.
  7. The Kantian maxim requiring that one treat others always as ends and never as a means is known as:
    a. the categorical imperative. c. deontology.
    b. the practical imperative. d. utilitarianism.
  8. Aristotle developed the concept of:
    a. virtue ethics. c. deontology.
    b. utilitarianism. d. rationalism.
  9. ____ attributes differences in moral codes to social conditions, while proposing that most people have underlying psychological tendencies that lead to similar moral judgments.
    a. Rationalism c. Virtue ethics
    b. Naturalism d. Deontology
  10. What theory is based on the rationalist view that the rightness or wrongness of an act depends upon the nature of the act, rather than its consequence?
    a. Deontology c. Kantianism
    b. Formalism d. Act utilitarianism

Chapter 3: Ethical Principles

  1. The principle of beneficence requires the nurse to:
    a. promote harm or evil and do good.
    b. prevent or remove harm and do good.
    c. ask the patient to sign a survey indicating the nurse has been beneficial to his or her care.
    d. avoid harm as a consequence of doing good.
  2. Having freedom to make choices about issues that affect ones life is the principle of:
    a. respect for persons. c. beneficence.
    b. justice. d. autonomy.
  3. ____ is the ethical principle that relates to the concept of faithfulness and the practice of promise keeping.
    a. Morals c. Confidentiality
    b. Fidelity d. Justice
  4. The ethical principle that implies that others are worthy of high regard is:
    a. beneficence. c. respect for persons.
    b. fidelity. d. distributive justice.
  5. A patient requests multiple cosmetic surgeries. At a certain point, the health care team questions if the overall harm that will result from continuing to do these procedures outweighs the benefit. This dialogue, weighing harms against benefits, is more related to which ethical principle?
    a. Beneficence c. Justice
    b. Nonmaleficence d. Veracity
  6. Informed consent is a procedure designed to assure which of the following ethical principles?
    a. Beneficence c. Fidelity
    b. Autonomy d. Nonmaleficence
  7. A nurse sees a patient quietly crying in her room. The nurse enters the room, sits in the chair facing the patient, and says, Something seems to be troubling you. This exchange is an example of the practical application of which of the following ethical principles?
    a. Beneficence c. Veracity
    b. Autonomy d. Nonmaleficence
  8. Three gravely ill patients are candidates for the only vacant bed in the intensive care unit. The health care team decides to assign the bed to the patient with the best chance of recovery. Although many principles apply, the decision-making process in this case illustrates the application of which of the following ethical principles?
    a. Respect for persons c. Beneficence
    b. Justice d. Autonomy
  9. The ethical principle that requires nurses to uphold the professions code of ethics, to practice within the established scope of practice, and to remain competent is which of the following?
    a. Beneficence c. Fidelity
    b. Autonomy d. Nonmaleficence
  10. The ANA Code of Ethics for Nurses recognizes that confidentiality:
    a. flows from respect for persons and is an absolute requirement in all situations.
    b. is restricted to legal regulations and definitions.
    c. is not absolute and may be modified to protect the patient or other innocent people.
    d. None of the above

Chapter 4: Values Clarification

  1. Axiology is a branch of philosophy that studies:
    a. ethics. c. awareness.
    b. mathematics. d. values.
  2. The process of becoming more conscious of and naming what we value or consider worthy is:
    a. journaling. c. overt values.
    b. values clarification. d. values conflict.
  3. The aim of values clarification is to facilitate the process of:
    a. instilling personal values. c. reacting to personal values.
    b. teaching personal values. d. choosing personal values.
  4. Values that are implicit in expectations of an institution, but not in writing, are termed:
    a. formal values. c. integral values.
    b. covert values. d. overt values.
  5. Nurses may experience values conflict if:
    a. they develop and adhere to moral norms over time.
    b. what they prize and cherish is at odds with patients.
    c. what they see in practice reflects their own beliefs.
    d. they find a common ground in dealing with patients.
  6. An institutions mission statement is a reflection of:
    a. overt values. c. covert values.
    b. personal values. d. implicit values.
  7. A nurse who used to love her job and now frequently exhibits anger, dissatisfaction, frustration, and poor work performance may be experiencing:
    a. moral awareness. c. moral distress.
    b. moral thought. d. moral values.
  8. Values of individual institutions and organized health care systems that are explicitly communicated through philosophy and policy statements are called:
    a. formal values. c. institutional values.
    b. overt values. d. covert values.
  9. Ideals, beliefs, customs, modes of conduct, qualities, or goals that are highly prized or preferred by individuals, groups, or society are termed:
    a. thoughts. c. concepts.
    b. ethics. d. values.
  10. Tools that may assist a person to expand self-awareness include which of the following?
    a. Journaling
    b. Meditation
    c. Therapy
    d. Feedback
    e. All of the above

Chapter 5: Values Development

  1. A basic method of fixing belief whereby the person obstinately adheres to beliefs already held is called:
    a. authority. c. tenacity.
    b. a priori. d. reasoning.
  2. Which of the following is a stage in Level III of Kohlbergs theory?
    a. The Stage of Mutual Interpersonal Expectations, Relationships, and Conformity
    b. The Stage of Punishment and Obedience
    c. The Stage of Social System and Conscience Management
    d. The Stage of Universal Ethical Principles
  3. In Fowlers Stage of Faith Development, Stage 6 is called:
    a. Individuative-Reflective faith. c. Intuitive-Projective faith.
    b. Universalizing faith. d. Synthetic-Conventional faith.
  4. An organizing way of looking at the nature of the universe as a whole and the role of the human in it that incorporates both the physical plane and the interconnected, multidimensional universe is called:
    a. cosmology. c. ethic of care.
    b. values development. d. faith development.
  5. Human values development is often referred to as:
    a. moral development. c. ethical values.
    b. faith development. d. formal operations development.
  6. Human values development reflects the content and process of learning what is right and wrong within a culture.
    a. True b. False
  7. Ethics of Justice is associated with which of the following theorists?
    a. Piaget c. Kohlberg
    b. Gilligan d. Fowler
  8. The moral imperative grounded in relationship with and responsibility for one another is called:
    a. ethic of justice. c. faith development.
    b. ethic of care. d. cognitive development.
  9. The development of intellectual capacities through the time of childhood from birth to around age 15 years refers to:
    a. Kohlbergs theory of moral development.
    b. Piagets stages of cognitive development.
    c. Lao Tsus theory of development.
    d. Fowlers stages of faith development.
  10. In Kohlbergs theory of moral development, the preconventional level includes two stages. They are:
    a. punishment and obedience.
    b. individual instrumental purpose and exchange.
    c. rights and social utility.
    d. a and b.

Chapter 6: Ethics and Professional Nursing

  1. Who authored the first ethics textbook, Nursing Ethics for Hospital and Private Use?
    a. Florence Nightingale c. Isabel Hampton Robb
    b. Lillian Wald d. Abraham Flexner
  2. The roles of the state boards of nursing can include:
    a. overseeing schools of nursing within the states.
    b. enforcing the individual states nurse practice acts.
    c. disciplining nurses.
    d. all of the above.
  3. The minimum expectations for safe nursing care can be defined as:
    a. accountability. c. expertise.
    b. standards of nursing practice. d. authority.
  4. Who was the first nursing theorist to write about caring?
    a. Martha Rogers c. Madeleine Leninger
    b. Jean Watson d. Margaret Newman
  5. Standards of nursing practice are developed within the profession to describe practice and establish the minimum level of safe practice. The purpose of standards of nursing practice can include:
    a. helping to ensure that nurses are competent and safe to practice.
    b. serving as a guide for nurses providing care.
    c. determining whether the actions of nurses accused of malpractice are consistent with reasonable expectations.
    d. all of the above.
  6. A complex, organized occupation preceded by a long training program is a(n):
    a. profession. c. autonomy.
    b. expert. d. nurse.
  7. Flexner listed some of the following traits utilized to identify professions:
    a. Intellectual operations.
    b. Educationally communicable technique.
    c. Self-organization.
    d. Raw materials from science and learning.
    e. All of the above.
  8. ____ relates to the characteristic of having a high level of specialized skill and knowledge.
    a. Profession c. Wisdom
    b. Expertise d. Skill
  9. Self-governing is another word or definition for:
    a. expertise. c. autonomy.
    b. profession. d. accountability.
  10. ____ refers to a person who has an obligation to accept responsibility and to account for actions.
    a. Autonomy c. Authority
    b. Expertise d. Accountability

Chapter 7: Ethical Decision Making

  1. Which term is described as a personal consciousness of the moral importance that guides personal action in a particular situation?
    a. Dilemma c. Ethic
    b. Problem d. Moral integrity
  2. The first step in the ethical decision-making process is:
    a. implementing the strategy. c. evaluating outcomes of an action.
    b. gathering data. d. articulating the problem.
  3. ____________ occurs when we sense that there is a moral problem but are not sure of the morally correct action.
    a. Moral distress c. Moral dilemma
    b. Moral uncertainty d. Practical dilemma
  4. When a person is aware of a moral problem, acknowledges moral responsibility, and makes a moral judgment about the correct action, yet is constrained from the self-determined morally correct action, the person is experiencing:
    a. moral distress. c. moral outrage.
    b. moral uncertainty. d. moral reckoning.
  5. Moral dilemmas occur when:
    a. the nurse is unsure of the morally correct action.
    b. there are conflicting moral claims.
    c. moral claims conflict with practical claims.
    d. participants disagree on the appropriate course of action.
  6. The nurse manager asks Martha, a staff nurse, if she will work an additional 4 hours at the end of her shift. Marthas patient is unstable, and there is insufficient staff on the next shift to care for her adequately. If she works overtime, Martha will break a promise she made to take her children to the circus. This situation is an example of:
    a. moral distress. c. moral reckoning.
    b. a moral dilemma. d. a practical dilemma.
  7. A registered nurse witnesses another nurse violating a patients autonomy. Even though she did not participate in the action, the nurse who witnessed the act experiences powerlessness, frustration, and anger. This reaction describes which of the following?
    a. Moral distress c. Moral outrage
    b. Moral uncertainty d. Moral dilemma
  8. Physicians sometimes make unilateral decisions in morally important situations because:
    a. moral decision making is reserved for physicians.
    b. nurses are seldom aware of the patients wishes and life context.
    c. there is, sometimes, power imbalance in the health care setting.
    d. it is illegal for nurses to participate in moral decision making.
  9. Moral integrity is defined as:
    a. the likelihood that someone will make the same decision repeatedly over time.
    b. soundness, reliability, wholeness, and integration of moral character.
    c. self-knowledge combined with decision-making skill.
    d. the ability to make cogent moral decisions.
  10. A problem consists of:
    a. uncertainties and unintended consequences.
    b. disagreements among participants as to the best course of action.
    c. moral claims that conflict with practical claims.
    d. a discrepancy between the current situation and a desired state.

Chapter 8: Legal Issues

  1. Changes in Medicare and Medicaid laws and statutory recognition of nursing in advanced practice (including prescriptive authority) are examples of what type of law?
    a. Legislative law c. Administrative law
    b. Constitutional law d. Common law
  2. Law that generally involves relationships between individuals, rather than between the state and individuals, is:
    a. public law. c. tort law.
    b. contract law. d. civil law.
  3. Fraud, invasion of privacy, assault, battery, and false imprisonment are examples of:
    a. intentional torts. c. unintentional torts.
    b. malpractice. d. negligence.
  4. First- and second-degree murder, arson, burgarly, extortion, kidnapping, rape, and robbery are examples of which type of crime?
    a. Misdemeanor c. Felony
    b. Precedent d. Citation
  5. The system of binding rules of action or conduct that governs the behavior of people in respect to relationships with others and with the government is:
    a. ethics. c. morals.
    b. law. d. intentional tort.
  6. A set of rules and principles that describes the powers of a government and the rights of the people refers to:
    a. constitutional law. c. common law.
    b. statutory/legislative law. d. administrative law.
  7. Formal laws written and enacted by federal, state, or local legislatures are known as:
    a. statutory/legislative law. c. administrative law.
    b. constitutional law. d. common law.
  8. Law that involves the operation of government agencies is:
    a. common law. c. constitutional law.
    b. administrative law. d. statutory/legislative law.
  9. Law that defines a persons rights and obligations in relation to the government and describes the various divisions of government and their powers refers to:
    a. criminal law. c. common law.
    b. misdemeanors. d. public law.
  10. The branch of law that deals with actions considered harmful to society is:
    a. administrative law. c. criminal law.
    b. common law. d. constitutional law.

Chapter 9: Professional Relationship Issues

  1. _____________ occurs when one directs hostile or aggressive behavior toward another member of the same group.
    a. Discrimination c. Sexual harassment
    b. Lateral violence d. Disparate impact
  2. Any physiologic disorder or condition, cosmetic disfigurement, or anatomical loss affecting any body system is a:
    a. mental impairment. c. physical impairment.
    b. disability. d. major life enjoyment.
  3. Cues for recognizing harassment could include:
    a. invasion of space. c. confirmation.
    b. lack of respect. d. all of the above.
  4. The nurses primary obligation is to which of the following?
    a. The patient c. The physician
    b. The employer d. The profession
  5. A staff nurse suspects that her friend, another nurse on her unit, is impaired by illicit drugs. The nurse doesnt want to get her friend in trouble, but she fears that patients may be harmed. This conflict of loyalty is an example of:
    a. a moral dilemma. c. moral uncertainty.
    b. a practical dilemma. d. moral distress.
  6. A physician writes an order that the registered nurse believes will harm the patient. She views the physician as incompetent. Which of the following is the most appropriate action for the nurse?
    a. She should follow the order anyway because the physicians education is superior to hers.
    b. She should pursue the chain of authority. If the supervisor and others support the physician, she should follow the order.
    c. After pursuing the issue with the physician and her superiors, she should disobey all orders that she believes are illegal, immoral, or incompetent.
    d. If she is forced to follow the order, she should file a formal complaint against the physician.
  7. When delegating patient care activities, the registered nurse has a responsibility to:
    a. assess individual competency when assigning nursing care activities to other health care workers.
    b. divide the activities fairly between health care workers.
    c. teach subordinate health care workers proper techniques and procedures.
    d. observe ancillary staff as they perform delegated activities.
  8. A facility administrator systematically passes over all Hispanic nurses who apply for promotion, regardless of their qualifications and abilities. According to the Civil Rights Act of 1964, this is an example of which of the following?
    a. Disparate impact c. Stereotyping
    b. Segregation d. Disparate treatment
  9. Racism is prohibited by which of the following?
    a. The Civil Rights Act of 1964 c. The ANA Code of Ethics for Nurses
    b. The ICN Code of Ethics for Nurses d. All of the above
  10. Sexual harassment is defined as:
    a. unwelcome sexual advances, requests for sexual favors, and other verbal, nonverbal, or physical conduct of a sexual nature.
    b. multiple episodes of inappropriate sexual behavior in the workplace.
    c. intermittent and continual threats of a sexual nature.
    d. sexual advances, whether welcome or unwelcome, sexual contact, and oral and written communication of a sexual nature.

Chapter 10: Practice Issues Related to Technology

  1. Which of the following can be both a benefit and challenge of technological advances in health care?
    a. Supports healthy living c. Can prolong living
    b. Availability and cost d. Alleviates suffering
  2. In assessing a patients quality of life (QOL), the nurse needs to understand that QOL:
    a. is an objective measure of comfort and factors that make life worth living.
    b. is only considered good if the patient feels fulfilled and can be independent.
    c. generally means the same thing to most patients, families, and nurses.
    d. includes subjective ideas about conditions of life and functional ability.
  3. Since a prime nursing focus is to relieve suffering, nurses must understand that health care technologies:
    a. are good because they always support a patients health and well-being.
    b. may cause conflict between doing good and avoiding harm to patients.
    c. are necessary interventions even if they cause patients to suffer.
    d. may cause nurses to do harmful things to patients against their wishes.
  4. Appropriate utilization of health care technology requires that health care providers, patients, and families understand its:
    a. purpose, benefits, limitations. c. outcomes, benefits, cost.
    b. cost, availability, usefulness. d. risks, availability, purpose.
  5. Ethical dilemmas that arise from use of life-sustaining technologies may be associated with all of the following except:
    a. attitudes and beliefs about when life begins.
    b. attitudes about what constitutes death.
    c. unreasonable expectations of medical interventions.
    d. similar opinions regarding use of technology.
  6. Ethical considerations related to situations of medical futility relate to which of the following?
    a. Views about whether the intervention is prolonging living or prolonging dying
    b. Values and views of involved parties regarding what is benefit or burden
    c. Values of involved parties regarding availability and cost of the medical care
    d. a and b
    e. All of the above
  7. Withholding or removing treatments where the burden or harm to the person is determined to outweigh benefits is:
    a. allowing the person to die as a result of the natural progression of the disease process.
    b. causing the painless death of the person in order to end or prevent more suffering.
    c. providing the person the means to end his or her own life when they are ready to die.
    d. following the directives to avoid suffering included in do not resuscitate orders.
  8. Do not resuscitate (DNR) orders indicate that:
    a. medical therapies and interventions are to be avoided.
    b. life-sustaining interventions are to be discontinued.
    c. cardiopulmonary resuscitation (CPR) is to be avoided.
    d. palliative care is to be discontinued or avoided.
  9. Palliative care includes all of the following except:
    a. comprehensive, interdisciplinary, and total care.
    b. aggressive treatment of chronic health problems.
    c. comfort and support of patients and families.
    d. delivery of coordinated and continuous services.
  10. Ethical and legal obligation to protect the confidentiality of patient information directs nurses to do which of the following regarding electronic storing and transfer of personal health information?
    a. Avoid using fax machines to transfer personal health information.
    b. Share personal secure passwords with immediate co-workers only.
    c. Rely on HIPAA regulations to assure the security of electronic devices.
    d. Use password-protected screen savers and data encryption technology.

Chapter 11: Practice Issues Related to Patient Self-Determination

  1. What is the legal protection of a patients right to personal autonomy?
    a. Paternalism c. Informed consent
    b. Advanced directives d. Competence
  2. The nurses role and responsibilities in informed consent include all the following except:
    a. verifying that the patient is aware of options and implications of each.
    b. advocating to ensure that criteria for autonomous decision making is met.
    c. explaining the procedure to the patient when the doctor cannot do so.
    d. signing as a witness attesting that the patient is giving consent willingly.
  3. Competence is:
    a. a legal action physicians can impose on patients who are elderly and confused.
    b. the ability of a patient to understand medical options and treatment.
    c. a legal ruling regarding a persons ability to make meaningful life decisions.
    d. the ability of a patient to communicate about current events.
  4. If a patient is not given the opportunity to ask questions about a procedure prior to the start of the procedure, which patient right is being violated?
    a. Autonomy c. Advance directives
    b. Justice d. Informed consent
  5. The law passed in 1991 that requires institutions receiving Medicaid or Medicare funding to provide written information to adult patients regarding their right to make health care decisions is the:
    a. Uniform Health Care Information Act.
    b. Patient Self-Determination Act.
    c. Patient Bill of Rights.
    d. Civil Rights Act.
  6. A nurse is caring for a patient with cancer, who describes using an herbal preparation and guided imagery as part of her treatment. Considerations related to patient self-determination would direct the nurse to:
    a. honor the patients right to use therapies other than conventional medicine to address her health care needs.
    b. tell the patient that she should stop these therapies because they have no research to support them.
    c. inform the patient that she has a right to do what she wants, but that its crazy to mix different traditions.
    d. encourage the patient to share the herbal preparation with other patients to see if it might help them as well.
  7. In dealing with a patients lifestyle choices, nurses need to remember the instructions in the American Nurses Association Code of Ethics, which would include:
    a. respect human dignity.
    b. avoid value judgments.
    c. practice compassion.
    d. a and b.
    e. all of the above.
  8. A nurse who discusses a patients condition and treatment with family members who were not authorized to have medical information disclosed to them is breaching:
    a. autonomy. c. competence.
    b. paternalism. d. confidentiality.
  9. Having the freedom to make choices about issues that affect our own lives and to make decisions about personal goals is called:
    a. paternalism. c. autonomy.
    b. informed consent. d. competence.
  10. Instructions that indicate health care interventions to initiate or withhold, or that designate someone who will act as a surrogate in making such decisions in the event that we lose decision-making capacity is termed:
    a. informed consent. c. paternalism.
    b. autonomy. d. advanced directives.

Chapter 12: Scholarship Issues

  1. Two core values basic to academic integrity and to ethical treatment of research data are:
    a. plagiarism and cheating. c. beneficence and integrity.
    b. cheating and forgery. d. veracity and integrity.
  2. Which of the following documents was developed to set forth principles for the ethical conduct of research in response to human rights violations during World War II?
    a. Belmont Report c. Nuremberg Code
    b. ANA Code of Ethics d. Declaration of Helsinki
  3. A nurse researcher who decides to discontinue a research project because the findings indicate that the risks of the study outweigh the benefits is applying the principle of:
    a. beneficence. c. trustworthiness.
    b. justice. d. confidentiality.
  4. A nurse researcher would address protection of human rights by assuring that the research protocol includes all the following except:
    a. right to freedom from injury. c. right to autonomy.
    b. right to privacy. d. right to free medical care.
  5. Recruiting participants for a study by offering them a sizeable amount of money, travel expense, and reimbursement of medical fees can be considered a form of:
    a. full disclosure. c. right to fair treatment.
    b. coercion. d. compensation.
  6. Of utmost importance in the ethical treatment of data are the integrity and honesty of the:
    a. statistician. c. researcher.
    b. participants. d. data collector.
  7. Issues affecting academic integrity include:
    a. plagiarism and cheating. c. editing and forgery.
    b. cheating and editing. d. forgery and consulting.
  8. The process of obtaining consent from children ages 7 to 18 years old is called:
    a. full disclosure. c. right to treatment.
    b. assent. d. trustworthiness.
  9. Taking anothers ideas or work and presenting them as our own is called:
    a. veracity. c. fidelity.
    b. cheating. d. plagiarism.
  10. The _____________ was issued by the World Medical Assembly in 1964 and revised in 1975 and 2008 to guide clinical research.
    a. Belmont Report c. Declaration of Helsinki
    b. ANA Code of Ethics d. Nuremberg Code

Chapter 13: Global Consciousness in the Twenty-First Century

  1. Disasters may be termed:
    a. natural. d. a and c
    b. technological. e. a, b, and c
    c. accidental.
  2. Nursing involvement with refugees and displaced persons can occur at what levels?
    a. Emergency needs d. All of the above
    b. Care and maintenance e. a and b
    c. Seeking ongoing solutions
  3. Health problems or potential problems related to disruption of the natural balance of nature include:
    a. asthma and autism.
    b. toxins in soil and breast milk.
    c. malnutrition and birth defects.
    d. a and c
    e. a, b, and c
  4. A nurse who practices environmentally responsible health care would do all of the following except:
    a. assure proper disposal of toxic wastes at the hospital.
    b. dispose of outdated medications by flushing down the toilet.
    c. engage in recycling and river cleanup in the community.
    d. phone or write legislators regarding mercury levels in fish.
  5. Which of the following is an assumption of the Western worldview that contributes to lack of consideration of Earth ethics?
    a. Understanding that humans are intricately connected with the natural world
    b. Appreciating that all species have core value and an intrinsic right to exist
    c. Recognizing that human health is dependent on the health of the Earth
    d. Believing that humans have a right to do anything they want with nature
  6. The precautionary principle affirms that, when there is reasonable suspicion of harm of a new product, process, intervention, or technology and scientific uncertainty regarding cause and effect of this harm, people:
    a. should rely on the developer to assure product safety.
    b. have few legal rights related to preventing harm.
    c. have a duty to take action to prevent harm.
    d. have to prove cause and effect before taking action.
  7. Ethically prioritizing health care treatment and management of victims during a disaster includes all of the following except:
    a. separating victims into groups based on medical needs and intervention capabilities.
    b. focusing on the technical needs of victims, leaving emotional concerns for others.
    c. providing impartial assistance to each victim without waiting to be asked.
    d. making decisions solely on a persons emergency status, not on nonmedical criteria.
  8. When doing triage in a disaster situation, leaving a person whose injuries are beyond treatment with the available resources to attend to someone whose injuries, though serious, can be cared for with resources available is considered:
    a. unprofessional behavior. c. inappropriate nursing care.
    b. abandonment of the person. d. ethically appropriate.
  9. Nursing care of victims beyond the emergency response to a disaster and health care of displaced persons are similar in which of the following ways?
    a. The need to address emotional and mental health
    b. The need for sanitation and communicable disease control
    c. The majority of those needing care are women and children
    d. a and b
    e. b and c
  10. Nurses can find guidance for an ethical response to war in professional codes. Directives in these codes include all of the following except:
    a. respect life and human dignity.
    b. advocate for prevention of conflict.
    c. always adhere to governmental policies.
    d. provide equitable care for all victims.

Chapter 14: Health Policy Issues

  1. Organized groups with distinct ideologies that seek to control government are called:
    a. partisan parties. c. political parties.
    b. community groups. d. municipal groups.
  2. Which branch of government is involved in the operation of government agencies, such as state boards of nursing and medicine?
    a. Judicial branch c. Executive branch
    b. Administrative branch d. Legislative branch
  3. Nurses function in a variety of roles, and responsible political involvement is an important function of each of these roles. These roles can include:
    a. knowledgeable consumers of health care.
    b. citizens.
    c. professionals whose practice is regulated by the government.
    d. advocates for patients.
    e. all of the above
    f. a, c, and d
  4. When political parties take opposing positions on an issue, the different opinions and subsequent decisions are said to be:
    a. invalid. c. political.
    b. partisan. d. unethical.
  5. Which of the following is true?
    a. Moral issues and political issues are very different.
    b. Knowledge of moral principles will guide policy makers to the one correct policy.
    c. A moral issue can become political in a number of ways.
    d. Judicial precedents are rarely considered when policy is formulated.
  6. Which of the following is both a moral and political issue?
    a. Abortion
    b. Stem cell research
    c. Physician-assisted suicide
    d. All but b above
    e. All of the above
  7. A nurse becomes concerned because her facility consistently requires mandatory overtime, up to 40 additional hours per week. The nurse brings the issue to the attention of her professional organization, and together they approach their legislator. These acts can be considered which of the following?
    a. Policy formulation c. Policy evaluation
    b. Policy implementation d. Policy modification
  8. The nurses organization decides to work toward legislation that would limit mandatory overtime in the workplace. They mobilize large numbers of nurses and community volunteers to write letters and make personal contact with legislators. This form of political activism is known as which of the following?
    a. En masse lobbying c. Grassroots lobbying
    b. Partisan lobbying d. Political lobbying
  9. A nursing professor is actively involved in lobbying for health policy issues. The professor tells the class that these activities are moral duties. What is the best explanation for this statement?
    a. The nursing professor likely learned the sense of duty from her upbringing.
    b. The nursing professor has a deontological ethical perspective.
    c. The ANA and ICN codes of ethics for nurses direct the nurse to promote efforts to meet the health needs of society.
    d. The nursing professor is attempting to influence the students to become politically active.
  10. Which of the following is a health policy issue of concern to the profession of nursing?
    a. Abortion
    b. Third-party reimbursement
    c. Air pollution control
    d. Gun control
    e. All of the above
    f. a, b, and c above

Chapter 15: Economic Issues

  1. Which of the following ethical theories of justice are based upon the rule that it is good to maximize the greatest good for the greatest number of people?
    a. Libertarian theories c. Deontological theories
    b. Utilitarian theories d. Communitarian theories
  2. Three patients arrive at the free clinic in need of the same medication, but there is only enough in stock for one person. The nurse in charge of the clinic asks herself, Who needs this medicine most? This question suggests which of the following?
    a. The nurse is utilizing a material rule of distributive justice to make her decision.
    b. Decisions about how to distribute scarce medications are capricious.
    c. The nurse should collaborate with the clinic physician when she makes this type of decision.
    d. There are no rules regulating distribution of scarce medications in this facility.
  3. The economics of Country A support the rights of property and liberty for each person and allow each citizen to improve life circumstances by his or her own effort. Health care can be purchased or given freely in Country A, but there is no entitlement program to ensure basic health care to vulnerable people. This type of economic structure best describes which of the following?
    a. Marxism c. Democracy
    b. Communitarianism d. Libertarianism
  4. John Rawles suggested that in making decisions of distributive justice, one should examine the situation behind a veil of ignorance so that no one would be able to design principles to favor his or her particular condition. This idea supports which of the following economic theories for which Rawles was a proponent?
    a. Utilitarianism c. Egalitarianism
    b. Communitarianism d. Libertarianism
  5. Different methods of paying for health care in the United States seek to provide superior care, equality of access, and freedom of choice for all citizens, while promoting the public interest through cost-containment programs. Citizens discuss the ideal of equal access to health care for everyone, including care for indigents. Yet, segments of the health care system maintain aspects of a free-market competition. Which of the following statements best describes this system?
    a. Utilitarian theory is the sole basis for U.S. health care financing, forming the foundation of Medicare, Medicaid, and privately purchased health care insurance.
    b. Libertarianism, which espouses a free market system and freedom of choice, undergirds the basic principles of U.S. health care financing.
    c. Several theories of justice try to achieve a balance between competing social goals in the U.S. health care system.
    d. Most health care financing occurs at the community level; therefore communitarian principles are most applicable to U.S. health care economics.
  6. In Canada, almost all people are insured against the cost of all hospital and physician expenses through a government health insurance program. This type of health care financing is commonly called:
    a. fee for service. c. universal health insurance.
    b. managed care. d. voluntary or private insurance.
  7. Which of the following health care financing systems has a strong focus on the principle of autonomy?
    a. Fee for service c. Universal health insurance
    b. Managed care d. Single payer systems
  8. Which of the following is a natural consequence of utilitarian forms of health care financing?
    a. Resources and services will be distributed equally.
    b. Some people will not receive resources and services.
    c. Those people with the greatest need receive the bulk of resources and services.
    d. People who have greater personal resources will receive greater benefit.
  9. Which of the following best describes the connection between ethics and health care financing?
    a. Health care financing is an outcome of social morality and collective beliefs about distribution of health care services in terms of good versus bad, right versus wrong, and harm versus benefit.
    b. Codes of ethics mandate that professionals in each discipline contribute to society through participation in health care policy.
    c. Health care professionals duties center on the individual patient, and health care financing directly impacts each persons ability to receive care.
    d. Health care financing rests upon the ethical principles of distributive justice, beneficence, and nonmaleficence.
  10. A health care system which attempts clinically and financially to control primary health care services in a medical group practice through elimination of redundant facilities and services for the purpose of reducing costs describes which of the following health care financing systems?
    a. Fee for service c. Categorical financing
    b. Universal health care d. Managed care

Chapter 16: Social Issues

  1. ____ and ____ continue to be prevalent in the United States as a consequence of the overall economy and changes in government assistance programs and taxes.
    a. Uninsured; racism c. Elderly population; poverty
    b. Racism; homelessness d. Poverty; homelessness
  2. Higher incidence of conditions associated with poor nutrition, trauma, drugs, burns, mental illness, and HIV are being seen in which population?
    a. Children living in poverty c. Elderly living in poverty
    b. Adults living in poverty d. Abused women living in poverty
  3. When considering health care options for patients, nurses need to be aware that federal programs for the indigent cover what percentage of individuals living on incomes below the poverty line?
    a. 25 percent c. 75 percent
    b. 50 percent d. 100 percent
  4. An African American man returned to the emergency room for the fourth time in less than a week complaining of severe epigastric pain. Talk begins at the nurses station regarding whether the patient should even receive treatment as it is his fault the pain is back; they claim he has GERD but never filled the prescription given to him. This behavior by the nurses is an example of what?
    a. Racism c. Victim blaming
    b. Language of violence d. Nonmaleficence
  5. All of the following factors contribute to a domestic violence victim returning to her abusive partner except:
    a. support from the criminal justice system.
    b. lack of housing and suitable job.
    c. pressure from family and friends.
    d. concern for childrens well-being.
  6. Issues that influence the health and health care options of increasing numbers of elderly include which of the following?
    a. Social isolation
    b. Economic hardships
    c. Poverty
    d. Chronic illness
    e. All of the above
  7. If two patients need the same resources in the same medical situation, it is justifiable, when resources are scarce, to limit them to patients having insurance and showing an ability to pay for the resources.
    a. True b. False
  8. Giving preference for health care to those who have the ability to pay is an example of disregarding which ethical principle?
    a. Nonmaleficence c. Beneficence
    b. Justice d. Autonomy
  9. Refusing to discharge an abused child to her home when there is a possibility of further injury is an example of which ethical principle?
    a. Nonmaleficence c. Beneficence
    b. Justice d. Autonomy
  10. The acquisition, harboring, and trade of persons through force, threat, deception, or other forms of coercion with the aim of exploiting them is called:
    a. racism. c. domestic violence.
    b. human trafficking. d. poverty.

Chapter 17: Gender Issues

  1. Salaries in nursing remain relatively low compared with other professions that require high skill levels, education, and responsibility. Which of the following may be responsible for an increase in nursing salaries?
    a. Nursing shortage d. Collective bargaining
    b. Lack of men in nursing e. All of the above
    c. Fair labor legislation f. a, c, and d
  2. Which of the following is a gender-biased term that literally means acting in a fatherly manner?
    a. Sexism c. Nursism
    b. Paternalism d. Parentalism
  3. The statement that nurses are well-bred, well-educated specimens of womanhood is an example of which of the following?
    a. Sexism c. Nursism
    b. Paternalism d. Parentalism
  4. Which of the following situations can be described as paternalism?
    a. The physician decides to withhold news of her sons death because he believes the patient will be less able to recover from her injuries if she is grieving.
    b. The physician calls the health care team, patient, and patients family together to collaborate on alternative strategies to solve an ethical dilemma.
    c. A nursing assistant in the newborn nursery hides in an empty room to bottle-feed a breastfed baby because she says, the mother doesnt have enough milk and he is starving!
    d. All of the above
    e. a and c
  5. An experienced nurse applies for a position in labor and delivery. Even though he is better qualified than other applicants, the nurse manager hires a female nurse. She explains that she wants to protect her patients from being uncomfortable with a male nurse. This situation is an example of which of the following?
    a. Sexism c. Both of the above
    b. Paternalism d. Neither of the above
  6. In the Civil Rights Act of 1964, gender discrimination:
    a. is addressed only in relation to race and ethnicity.
    b. is allowed if gender is a bona fide occupational qualification reasonably necessary to the normal operation of that particular business of enterprise.
    c. is never allowed, even if gender is arguably necessary to the normal operation of that particular business of enterprise.
    d. exempts labor and delivery rooms from gender discrimination law and upholds a hospitals ban on employing nurses who are men in these areas.
  7. A female nurse manager is overly friendly to a young male colleague. She makes sexually explicit remarks and often corners him in the medication room, standing uncomfortably close. This behavior is consistent with which of the following?
    a. Sexual assault c. Sexual harassment
    b. Sexual deviancy d. Hostile work environment
  8. Systematic discrimination against lesbians and gay men in nursing occur as a result of:
    a. institutional policy. c. punitive supervisors.
    b. discriminatory administrative practice. d. all of the above.
  9. According to recent statistics, which of the following groups has the highest proportionate number of nurses with masters and doctoral degrees?
    a. African American nurses c. White nurses
    b. Male nurses d. Asian nurses
  10. As recently as the mid20th century, nursing students were taught to stand and offer the physician a seat and to accompany the physician on rounds, carrying patient charts. This practice is an example of which of the following?
    a. Sexism c. Nursism
    b. Paternalism d. Parentalism

Chapter 18: Transcultural and Spiritual Issues

  1. Knowing about the values, beliefs, behaviors, norms, and customs of a patient who comes from a culture other than your own is:
    a. cultural awareness. c. ethnocentrism.
    b. cultural sensitivity. d. all of the above.
  2. A nurses Egyptian American patient tells her that his health problem was caused by the evil eye and that he needs some blue beads for protection and healing. Cultural sensitivity directs the nurse to:
    a. caringly inform the patient that the evil eye is an old belief and is not real.
    b. make a mental health referral to a local Middle Eastern therapist.
    c. listen respectfully to the patients story and go on with the treatment.
    d. explore more about the blue beads and try to get some for the patient.
  3. Transcultural issues and conflicts are more likely to arise when nurses:
    a. are aware of their own bias and judgments of others.
    b. judge anothers behavior by their own cultural values.
    c. understand their own cultural beliefs and values.
    d. avoid judging others based on preconceived ideas.
  4. When addressing values such as autonomy, beneficence, and the right to self-determination with patients, nurses need to understand that:
    a. all cultures consider these values to be very important in health decisions.
    b. the cultural perspective of all people involved must be considered.
    c. cultural sensitivity means the family must be included in the discussion.
    d. these values are understood pretty much the same in most cultures.
  5. Complementary and alternative (CAM) therapies:
    a. are often derived from a particular cultural tradition.
    b. should only be used within a particular culture.
    c. are incompatible with conventional medicine.
    d. are generally unsafe and should not be used.
  6. A nurse is caring for a patient with cancer who tells her that, in addition to her chemotherapy, she is taking an herbal preparation given her by a Traditional Chinese Medical (TCM) practitioner. Applying the principle of patient self-determination, the nurse should:
    a. tell the patient that she has a right to do what she wants, although it is probably unsafe.
    b. respectfully thank the patient for telling her and go on with the conventional treatment.
    c. inform the patient that it is not wise to mix treatments from two different traditions.
    d. learn more about the TCM treatment and explore the efficacy of all options with her.
  7. Which of the following demonstrates a nurses understanding that good communication is key in providing culturally congruent and spiritually sensitive care?
    a. Determine the patients understanding of the nurses written and spoken language.
    b. Consider a family member to be the best interpreter when the language is different.
    c. Assess patients literacy level and level of understanding of health information.
    d. a and c.
    e. All of the above.
  8. All of the following are important for nurses in providing spiritual care except:
    a. understanding that all spirituality is part of every patient encounter.
    b. sharing the same religious beliefs and values as the patient.
    c. creating an environment open to many beliefs and expressions.
    d. appreciating that religious perspective may influence health choices.
  9. A 69-year-old patient tells his nurse that, because he is a man of faith, he has decided to stop his medical treatment for cancer and rely on prayer for healing. Providing spiritually sensitive care would direct the nurse to:
    a. tell the patient it is good to trust in God, but also important to continue treatment.
    b. explore further the patients beliefs and factors that have led him to this decision.
    c. inform the doctor of what the patient said and suggest she evaluate his competence.
    d. presume that the patient knows what he is doing and tell him she honors his choice.
  10. Self-awareness of ones own spiritual and cultural perspective is important so that nurses:
    a. take care not to impose personal beliefs and values on patients.
    b. can more consciously address culture and spirituality with patients.
    c. are more aware of differences that may cause potential dilemmas.
    d. All of the above.

Chapter 19: Empowerment for Nurses

  1. A nurses response to ethical issues is influenced by:
    a. attitudes about nursings responsibility in health care settings.
    b. personal beliefs and perceptions about nursing and health care.
    c. perceptions of ideal nursing from those outside the profession.
    d. a and b.
    e. a, b, and c.
  2. Emphasis on a nurses role in terms of responsibility to the institution reflects the mind-set that views health care as:
    a. medical cases. c. basic human right.
    b. basic human need. d. commodity.
  3. Current nursing codes direct nurses to be responsible primarily to the patient and advocates for patient rights and needs. This ethical imperative reflects which of these metaphors of nursing?
    a. Legal c. Angel
    b. Military d. Loyalty
  4. Ethical nursing conduct reflected in current nursing codes includes all of the following behaviors except:
    a. following physician orders without question.
    b. being alert for incompetent practice and care.
    c. taking appropriate action to safeguard patients.
    d. reporting practice that might endanger patients.
  5. A nurse who shares knowledge about and involves patients in health care decisions is demonstrating:
    a. power over. c. power with.
    b. power protection. d. power control.
  6. Power over implies all of the following except:
    a. controlling knowledge and people. c. protecting limited resources.
    b. sharing responsibility with others. d. separating leaders and followers.
  7. Nursing empowerment that derives from the perspective of power with or power to:
    a. is given to or delegated to the nurse.
    b. is a directive process regarding change.
    c. is more focused on outcome than process.
    d. is based on mutual love and respect.
  8. Which of the following might hinder nursing empowerment?
    a. Taking action to address system issues
    b. Eliminating divergent and conflicting views
    c. Collaborating and sharing in decision making
    d. Participating in forming institutional policies
  9. For the past few months Antonio has complained about inadequate staffing on all shifts to the administrator of the nursing home where he works as a nurse. He documented poor patient care, including patients not being fed appropriately and several patients who developed serious bedsores after being left for hours on wet linens without being turned. When the administrator repeatedly refused to make any changes, citing economic reasons, Antonio spoke to a reporter at the local paper about the situation. This action of Antonios would be considered:
    a. unethical. c. whistle-blowing.
    b. making trouble. d. unprofessional.
  10. Following physician orders, even if the nurse questions the appropriateness of these orders; upholding the patients faith in the physician, even if the nurse questions the doctors competence; and being loyal to health care colleagues, even at the expense of the patient reflects which of the following metaphors of nursing?
    a. Legal c. Advocacy
    b. Military d. Loyalty

Chapter 20: Facilitating Patient Enpowerment

  1. To enable patient empowerment, nurses need to recognize that:
    a. health professionals know what is best for patients.
    b. patients need help in making health care decisions.
    c. patients are responsible for their own health.
    d. health professionals give power to patients.
  2. Patient empowerment flows from nursings focus on:
    a. advocacy. c. paternalism.
    b. patient care. d. locus of control.
  3. Nursing attitudes that enable patient empowerment include all of the following except:
    a. viewing nurse as partner, facilitator, resource for patients.
    b. directing patients to decisions that support good health outcomes.
    c. maintaining mutual trust and respect regardless of decisions.
    d. being aware of personal values and beliefs related to power.
  4. When Rosalie is passing medications to one of her elderly patients, the patient tells Rosalie that she does not want to take the new medicine because she does not know what it is for and it makes her feel funny. Rosalie tells her that the doctor thinks it will make her feel better so it is best that she take it. Rosalies response is an example of:
    a. patient empowerment. c. paternalistic behavior.
    b. holistic caring. d. patient teaching.
  5. Nursing knowledge that is needed in order to enable empowerment includes:
    a. ethical principles and decision-making process.
    b. values development and their impact on choices.
    c. scientific principles and evidence-based practice.
    d. a and b.
    e. all of the above.
  6. Nurses can enhance patient decision-making capacity by supporting all of the following except:
    a. opportunities for choice. c. experiences of connection.
    b. reliance on authority. d. deepening self-awareness.
  7. A patient who tells you that he cannot lose weight because his job keeps him on the road so he cannot exercise and his wife fixes too many high-calorie meals demonstrates:
    a. internal locus of control. c. negative locus of control.
    b. external locus of control. d. positive locus of control.
  8. Which of the following are potential barriers to empowerment?
    a. Comfort with change c. Limited skills
    b. Sufficient knowledge d. Available resources
  9. Nursing skills needed for enabling empowerment include:
    a. active listening and communication.
    b. collaboration and negotiation.
    c. intuitive and intellectual knowing.
    d. a and b.
    e. all of the above.
  10. Nurses foster patient empowerment when they:
    a. design and set appropriate health goals for patients.
    b. guide patients in selecting appropriate health options.
    c. design strategies within the patients sociocultural context.
    d. tell patients what they believe would be most empowering.


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