Ethical Considerations in Nursing Practice, Exams of Advanced Education

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BSNC 1020 Final exam (Module 4 and 5)

questions and answers

A nurse is working in a hospital where there is a shortage of nursing staff, and the nurse-patient ratios are consistently too high. One evening, the nurse is assigned to a busy medical-surgical unit with more patients than they can safely care for. The nurse is responsible for administering medications, monitoring vital signs, and providing personal care to the patients. What ethical in this scenario? a. Ethical indifference b. Ethical dilemma c. Ethical disengagement d. Ethical distress - Answer -d. Ethical distress What is the 4 Principle of Bioethics a. Autonomy, Beneficence, Nonmaleficence, Justice b. Self-awareness, Autonomous, personal identity c. All of the above d. None of the above - Answer -a. Autonomy, Beneficence, Nonmaleficence, Justice What is the 7 Nursing Value? - Answer -1. Providing safe, compassionate, competent, and ethical care

2. promoting health and well-being
3. Promoting and respecting informed decision-making
4. Honouring dignity
5. maintaining privacy and confidentiality
6. Promoting justice
7. Being accountable What is ethical distress? a. Arise when there are equally compelling reasons for and against two or more possible courses of action, and where choosing one course of action means that something else is relinquished or let go. b. Can occur when nurses normalize the disregard of their ethical commitments c. Arises when nurses are unable to act according to their moral judgment

d. A situation where there are conflicts between one or more values and uncertainty about the correct course of action. - Answer -c. Arises when nurses are unable to act according to their moral judgment What is Ethical Dilemma? a. Arise when there are equally compelling reasons for and against two or more possible courses of action, and where choosing one course of action means that something else is relinquished or let go. b. Can occur when nurses normalize the disregard of their ethical commitments c. Arises when nurses are unable to act according to their moral judgment d. A situation where there are conflicts between one or more values and uncertainty about the correct course of action. - Answer -a. Arise when there are equally compelling reasons for and against two or more possible courses of action, and where choosing one course of action means that something else is relinquished or let go. What is ethical indifference? a. Implies a failure to assume the ethical responsibilities of the profession, leaving one in a passive state that calls into question the moral integrity of the nurse as well as imperiling the obligation to protect the vulnerable patient b. Can occur when nurses normalize the disregard of their ethical commitments c. Arises when nurses are unable to act according to their moral judgment d. A situation where there are conflicts between one or more values and uncert - Answer -a. Implies a failure to assume the ethical responsibilities of the profession, leaving one in a passive state that calls into question the moral integrity of the nurse as well as imperiling the obligation to protect the vulnerable patient What is ethical disengagement? a. Arise when there are equally compelling reasons for and against two or more possible courses of action, and where choosing one course of action means that something else is relinquished or let go. b. Can occur when nurses normalize the disregard of their ethical commitments c. Arises when nurses are unable to act according to their moral judgment d. A situation where there are conflicts between one or more values and uncertainty about the correct course of acti - Answer -b. Can occur when nurses normalize the disregard of their ethical commitments What is ethical problem? a. Arise when there are equally compelling reasons for and against two or more possible courses of action, and where choosing one course of action means that something else is relinquished or let go. b. Can occur when nurses normalize the disregard of their ethical commitments c. Arises when nurses are unable to act according to their moral judgment

d. A situation where there are conflicts between one or more values and uncertainty about the correct course of action. - Answer -d. A situation where there are conflicts between one or more values and uncertainty about the correct course of action. What is ethical residue? a. Can occur when nurses normalize the disregard of their ethical commitments b. Arises when nurses are unable to act according to their moral judgment c. What each of us carries with us from times in our lives when, in the face of morally distressing situations, we have been seriously compromised d. A situation where there are conflicts between one or more values and uncertainty about the correct course of action. - Answer -c. What each of us carries with us from times in our lives when, in the face of morally distressing situations, we have been seriously compromised What is ethical violation? a. Can occur when nurses normalize the disregard of their ethical commitments b. Arises when nurses are unable to act according to their moral judgment c. A situation where there are conflicts between one or more values and uncertainty about the correct course of action. d. Involve actions or failures to act that breach fundamental duties to the persons receiving care or to colleagues and other healthcare providers - Answer -d. Involve actions or failures to act that breach fundamental duties to the persons receiving care or to colleagues and other healthcare providers A nurse was required to assist in the resuscitation of a terminally ill patient against the patient's previously expressed wishes. The patient ultimately did not survive, and the nurse was left with ongoing feelings of moral distress and guilt, questioning whether they acted in the patient's best interests or respected their autonomy. what ethical in this case? a. Ethical dilemma b. Ethical distress c. Ethical problem d. Ethical residue - Answer -d. Ethical residue A nurse is assigned to care for a terminally ill patient in the last stages of life. The patient's family has expressed a desire for more frequent updates and emotional support. The nurse provides basic medical care but does not engage with the family, respond to their emotional needs, or offer additional support. What type of ethical in this scenario? a. Ethical indifference b. Ethical dilemma c. Ethical distress

d. Ethical problem - Answer -a. Ethical indifference A nurse working in a hospice care facility is caring for an elderly patient who is in severe pain due to a terminal illness. The patient has previously expressed their desire to have medical aid in dying, which is legal in their jurisdiction. The patient now requests assistance to end their life, and the nurse is torn between honoring the patient's autonomy and personal beliefs that are against participating in the process. What ethical is that case? a. Ethical problem b. Ethical dilemma - Answer -b. Ethical dilemma A nurse working in a busy hospital is caring for a terminally ill patient who is in a great deal of pain. The patient has been prescribed pain medication, and the nurse administers the medication as ordered. However, the nurse is overwhelmed with a heavy workload, and the patient's condition requires frequent pain assessments and adjustments to the pain management plan. What ethical in this case? a. Ethical indifference b. Ethical dilemma c. Ethical disengagement d. Ethical distress - Answer -c. Ethical disengagement A nurse working in a pediatric unit is faced with the ethical problem of respecting the parents' decision to refuse a medically necessary blood transfusion for their child, based on their religious beliefs. The nurse is concerned about the child's well-being and the potential life-threatening consequences of not receiving the transfusion. What ethical in this scenario? a. Ethical indifference b. Ethical dilemma c. Ethical problem d. Ethical distress - Answer -c. Ethical problem A nurse, frustrated with an agitated patient, uses excessive physical force to restrain the patient, causing harm. What type of ethical in this case? a. Ethical indifference b. Ethical dilemma c. Ethical disengagement d. Ethical distress e. Ethical violation - Answer -e. Ethical violation Ethics is core foundations of nursing practice a. True

b. False - Answer -a. True What is the #1 nursing value in ethics? a. promoting health and well-being b. Promoting and respecting informed decision-making c. Providing safe, compassionate, competent, and ethical care d. Honouring dignity e. maintaining privacy and confidentiality - Answer -c. Providing safe, compassionate, competent, and ethical care How do you provide safe, compassionate, and competent care? (select all that apply) a. Look at how you communicate with the rest of the team to promote safety b. Forming a deeper connection c. Cultural humility d. None of the above - Answer -a. Look at how you communicate with the rest of the team to promote safety b. Forming a deeper connection c. Cultural humility Ethical responsibilities? - Answer -- Related to advocacy

• Related to the law
• Related to BCCNM practice standards Why do we do values clarification? a. RESOLVES ISSUES OF"VALUE CONFLICT" b. Reflecting on decision making in a situation c. Help nurses explore personal values and feelings and to decide how to act on personal beliefs. it also facilitates nurse-patient communication. d. Greater self-awareness and personal insight e. Helps you articulate what matters most and what priorities are guiding your decision making. f. All of the above - Answer -f. All of the above What does professional accountability look like in nursing practice? a. Keeping up with professional standards, laws, and regulations b. Ensuring competence to provide their practices c. MAINTAINING FITNESS TO PRACTICE d. Sharing knowledge with other nurses, nursing students, other health-care providers e. Advocating for comprehensive and equitable mental health care services f. All of the above - Answer -f. All of the above Is the CNA a regulatory tool (it's a guide)?

a. Yes b. No - Answer -a. Yes The CNA code of Ethics as a guide says? a. Both nurses and employers have an obligation to advocate for QUALITY PRACTICE ENVIRONMENS b. Knowing the right thing but can't do it due to system/personal limits c. None of the above - Answer -a. Both nurses and employers have an obligation to advocate for QUALITY PRACTICE ENVIRONMENS What is advocacy? a. Act of supporting/recommending a cause or course of action, undertaken on behalf of persons or issues b. To create greater equity and better health for all c. Relates to improvements in systems and societal structures d. Advocacy requires strong awareness of situational context and understanding of the influence of power and politics on decision making e. Assessing patient's point of view on decision making - Answer -a. Act of supporting/recommending a cause or course of action, undertaken on behalf of persons or issues b. To create greater equity and better health for all c. Relates to improvements in systems and societal structures d. Advocacy requires strong awareness of situational context and understanding of the influence of power and politics on decision making e. Assessing patient's point of view on decision making Advocacy in nursing value #1: Providing safe, compassionate, competent, and ethical care? a. Advocate for discussion of ethical issues among health care team members, patients, and families b. Advocate for use of least restrictive measures when a community health intervention interferes with the individual rights of persons c. Advocate for more comprehensive and equitable mental health care - Answer -a. Advocate for discussion of ethical issues among health care team members, patients, and families Advocacy in nursing value #2: Promoting health and well-being? a. Advocate for discussion of ethical issues among health care team members, patients, and families b. Advocate for use of least restrictive measures when a community health intervention interferes with the individual rights of persons

c. Advocate for more comprehensive and equitable mental health care - Answer -b. Advocate for use of least restrictive measures when a community health intervention interferes with the individual rights of persons Advocacy in nursing value #3: Promoting/respecting informed decision making? (select all that apply) a. Advocate for more comprehensive and equitable mental health care b. Advocate for persons receiving care if they believe the health of those persons is being compromised by factors beyond their control, including decision-making of others c. Protecting patient's right to choice by providing information, obtaining informed consent, and respecting patients' decisions - Answer -b. Advocate for persons receiving care if they believe the health of those persons is being compromised by factors beyond their control, including decision-making of others c. Protecting patient's right to choice by providing information, obtaining informed consent, and respecting patients' decisions Advocacy in nursing value #4: Honouring dignity a. Protecting patients' right to dignity by advocating appropriate use of interventions in order to minimize suffering, intervening if other people fail to respect the dignity of the patient, and working to promote health and social conditions that allow patients to live and die with dignity b. Advocate for more comprehensive and equitable mental health care - Answer -a. Protecting patients' right to dignity by advocating appropriate use of interventions in order to minimize suffering, intervening if other people fail to respect the dignity of the patient, and working to promote health and social conditions that allow patients to live and die with dignity Advocacy in nursing value #5: Maintaining privacy and confidentiality? a. Advocate for more comprehensive and equitable mental health care b. Protect a patient's right to privacy and confidentiality by helping patient access health records, intervening if other health-care members fail to respect patient's privacy, and following policies to protect patient privacy - Answer -b. Protect a patient's right to privacy and confidentiality by helping patient access health records, intervening if other health-care members fail to respect patient's privacy, and following policies to protect patient privacy Advocacy in nursing value #6: Promoting justice?(select all that apply) a. Advocate for health policies that enable fair and inclusive allocation of resources b. Advocate for evidence-informed decision-making in their practice c. Advocate for more comprehensive and equitable mental health care - Answer -a. Advocate for health policies that enable fair and inclusive allocation of resources b. Advocate for evidence-informed decision-making in their practice

Advocacy in nursing value #7: Being accountable? a. Advocate for health policies that enable fair and inclusive allocation of resources b. Advocate for evidence-informed decision-making in their practice c. Advocacy for more comprehensive and equitable mental health care - Answer -c. Advocacy for more comprehensive and equitable mental health care Is ethical endeavour part of nursing regulated responsibilities? a. Yes b. No - Answer -b. No Ethical endeavour is part of ethical practice, so they build on the values? a. True b. False - Answer -a. True Autonomy (select all that apply) a. One's ability to make choices for oneself b. It's fundamental to respect another person's autonomy c. Doing/promoting for others d. Respecting another person's autonomy - Answer -a. One's ability to make choices for oneself b. It's fundamental to respect another person's autonomy d. Respecting another person's autonomy Non-maleficence a. Avoidance of harm/hurt b. Balance risks and benefits to do least harm c. Promotes continuing effort to consider potential for harm even when it may be necessary to promote health d. Doing/promoting for others - Answer -a. Avoidance of harm/hurt b. Balance risks and benefits to do least harm c. Promotes continuing effort to consider potential for harm even when it may be necessary to promote health Beneficence a. One's ability to make choices for oneself b. It's fundamental to respect another person's autonomy c. Doing/promoting for others d. Commitment to the duty/obligation to do/promote good helps guide decisions (ex: vaccination)

e. Best interests of patient than your own (ex: understanding patient's needs) - Answer - c. Doing/promoting for others d. Commitment to the duty/obligation to do/promote good helps guide decisions (ex: vaccination) e. Best interests of patient than your own (ex: understanding patient's needs) Justice a. Fairness b. In allocating limited resources, decisions must be fair and unbiased c. social justice:

• Equitable distribution of benefits and burdens in society
• Broad social change is needed to address DoH and reduce inequalities of health d. One's ability to make choices for oneself - Answer -a. Fairness b. In allocating limited resources, decisions must be fair and unbiased c. Social justice:
• Equitable distribution of benefits and burdens in society
• Broad social change is needed to address DoH and reduce inequalities of health Nursing jurisprudence - Answer -- How the law relates to nursing
• ensures public safety through setting expectations The primary purpose of Practice Standards? a. To guide and direct nurses' practice. They set out levels of performance that BCCNM nurse registrants are required to achieve in their practice. b. Advocate for public health systems that ensure accessibility, universality, portability, and comprehensiveness in necessary health services - Answer -a. To guide and direct nurses' practice. They set out levels of performance that BCCNM nurse registrants are required to achieve in their practice. Documentation What should you do if someone asks you to document a procedure that they did (not you)? a. you can document for them b. You can only document what you as SN has observed - Answer -b. You can only document what you as SN has observed Documentation You are working at a new hospital with a new charting system, beyond infotech troubleshooting, where do you look to see how/what you should be charting? a. Practice standard: Documentation b. Practice standards: privacy and confidentiality c. Organization policy - Answer -a. Practice standard: Documentation

Duty to report If you suspect incompetent or impaired practice or unethical conduct, what should you do? a. Cover them and pretend not seeing b. Report in writing to the appropriate regulatory body c. All of the above - Answer -b. Report in writing to the appropriate regulatory body Medication: If a doctor tells you to administer a medication you've never heard of, where do you look to see if you are able to give the medication? a. Client document b. Practice standard: documentation c. Practice standard: medication - Answer -c. Practice standard: medication Privacy and confidentiality: A mother of an adult patient comes to you and asks how the patient's surgery went. What do you do? a. Tell her the patient condition b. Do not give them any info c. Ask her details information and ID - Answer -b. Do not give them any info Registered nurses or nurse practitioners with BCCNM-certified practice designations and working in a certified practice role may use the titles Registered Nurse (Certified), and RN(C). a. First Call Certified b. Remote Practice Certified c. Reproductive Health (STI and/or CM) Certified. These RNs may have Sexually Transmitted Infection and/or Contraceptive Management sub-certification. d. Opioid Use Disorder Certified e. Licence practical nurse - Answer -a. First Call Certified b. Remote Practice Certified c. Reproductive Health (STI and/or CM) Certified. These RNs may have Sexually Transmitted Infection and/or Contraceptive Management sub-certification. d. Opioid Use Disorder Certified Nurses perform only those medication-related activities,? (select all that apply) a. Relevant provincial or federal legislation or regulations, b. BCCNM standards, limits, and conditions, c. Organizational/employer policies and processes d. The nurse's individual competence.

e. Therapeutic use/indications - Answer -a. Relevant provincial or federal legislation or regulations, b. BCCNM standards, limits, and conditions, c. Organizational/employer policies and processes d. The nurse's individual competence. Before performing any medication-related activity, nurses know the medication's? a. Therapeutic use/indications b. Expected effects c. Dosage(s) d. Precautions e. Contraindications d. Form (e.g. tablet, liquid), and route for administration e. Interactions f. side effects g. Adverse effects h. All of the above - Answer -h. All of the above Duty to provide care: Client is requesting/refusing a particular treatment/procedure. What do you do? a. Listen and explore client's reason for request/refusal and their understanding of options that could meet their needs. b. Be non-judgmental c. Ignore her requests d. All of the above - Answer -a. Listen and explore client's reason for request/refusal and their understanding of options that could meet their needs. b. Be non-judgmental What are some principles for boundaries in the nurse-client relationship? a. Nurse use professional judgement to determine the appropriate boundaries of a therapeutic relationship with each client. b. Nurses do not act as representatives for clients under powers of attorney or representation agreements c. Nurses do not engage in any activity that results in inappropriate financial or personal benefit to themselves or loss to the client d. Nurses in a dual role make it clear to clients when they are acting in a professional capacity and when they are acting in a personal capacity e. All of the above - Answer -e. All of the above Nurses follow BCCNM's Bylaws when they advertise or promote professional services or products. Nurses also recognise the potential for gifts of any value to affect objectivity and use professional judgment when considering their acceptance. Those are examples of which practice standards?

a. Boundaries in the nurse-client relationship b. Documentation c. Conflict of interest d. Duty to report - Answer -c. Conflict of interest Nurses may withdraw from care provision or refuse to provide care if they believe that providing care would place them or their clients at an unacceptable level of risk. Nurses consider relevant factors, including: a. The specific circumstances of the situation b. Their legal and professional obligations c. Their contractual obligations d. Negotiating a mutually acceptable withdrawal of service with the client. - Answer -a. The specific circumstances of the situation b. Their legal and professional obligations c. Their contractual obligations When faced with a situation that affects your ability to provide care, examine risks and ethical/moral dilemmas and determine the most appropriate course of action using a decision-making process that includes? a. determining the facts and identifying the issue or concern b. clarifying the issue or concern c. identifying your options and developing a plan d. implementing the plan, evaluating the outcomes of your decision, and amending it if necessary e. where appropriate, making your concerns known to your employer, your union, or BCCNM. f. d and e only - Answer -a. determining the facts and identifying the issue or concern b. clarifying the issue or concern c. identifying your options and developing a plan d. implementing the plan, evaluating the outcomes of your decision, and amending it if necessary e. where appropriate, making your concerns known to your employer, your union, or BCCNM Nurses do not abandon their clients. Abandonment occurs when the nurse has engaged with the client or has accepted an assignment and then discontinues care without? a. negotiating a mutually acceptable withdrawal of service with the client b. arranging for suitable alternative or replacement services c. allowing the employer a reasonable opportunity to provide for alternative or replacement services. d. Their contractual obligations - Answer -a. negotiating a mutually acceptable withdrawal of service with the client

b. arranging for suitable alternative or replacement services c. allowing the employer a reasonable opportunity to provide for alternative or replacement services. Nurses report, in writing, to the appropriate regulatory body when they have reason to believe that a regulated health professional is practising when they? a. are suffering from a mental or physical problem, an emotional disturbance, or an addiction to drugs or alcohol that impairs their ability to practise. b. have a pattern of incompetent practice that may pose a danger to the public c. have behaved unethically in a way that may pose a danger to the public d. otherwise present a danger to the public. e. a only - Answer -a. are suffering from a mental or physical problem, an emotional disturbance, or an addiction to drugs or alcohol that impairs their ability to practise. b. have a pattern of incompetent practice that may pose a danger to the public c. have behaved unethically in a way that may pose a danger to the public d. otherwise present a danger to the public. What is three key purposes of documentation? a. Communication b. Safe and appropriate of nursing care c. Professional and legal standards d. Client information. - Answer -a. Communication b. Safe and appropriate of nursing care c. Professional and legal standards When the nurses need to document their services? a. Nurse document before giving care b. Nurses document at the time they provide care or as soon as possible afterward c. Prior to the end shift. - Answer -b. Nurses document at the time they provide care or as soon as possible afterward Nurses who are self-employed or have responsibility for client records adhere to relevant legislation and BCCNM Bylaws a. True b. False - Answer -a. True Nurses collect, use, and disclose personal and health information only as required to meet their professional responsibilities and/or legislated requirements, or as authorized under the bylaws a. Duty to provide care b. Documentation

c. Privacy and confidentiality d. Conflict of interest - Answer -c. Privacy and confidentiality Registered psychiatric nurses with a BCCNM-certified practice designation and working in a certified practice role may use the titles Registered Psychiatric Nurse (Certified), and RPN(C). If a certified practice registrant wishes to note their specific certification, they may append the following terms? a. First Call Certified b. Remote Practice Certified c. Reproductive Health (STI and/or CM) Certified. These RNs may have Sexually Transmitted Infection and/or Contraceptive Management sub-certification. d. Opioid Use Disorder Certified - Answer -d. Opioid Use Disorder Certified