Leadership Roles and Management Functions in Nursing: Chapter 4 Exam Questions and Answers, Exams of Nursing

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functions in Nursing theory and application

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Which statement by a nurse most clearly demonstrates an intuitionist framework for ethical decision making, duty based? A. "I've got to look at this situation on the basis of its unique characteristics, not by comparing it to other situations." B. "I'm trying to think of as many different options as I can rather than focusing on those that look most attractive." C. "I'll make the best decision if I choose the option that comes to mind first rather than overanalyzing the situation." D. "It's important that I consider the effect of my decision on the organization, not just the people who are directly involved." - correct answer ✅A. "I've got to look at this situation on the basis of its unique characteristics, not by comparing it to other situations." Feedback: Intuitionist states that each case weighed on a case-by- case basis to determine relative goals, duties, and rights. Consequently, there is a focus on the specific characteristics of a situation, not its commonalities with other situations. Thinking of as many options as possible is a good practice for ethical decision making, but it is not

functions in Nursing theory and application

10th edition Chapter 4 Exam Questions

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specifically aligned with an intuitionist framework. Similarly, considering the effects on the organization is not a particular characteristic of this framework. Intuition does not entail choosing the option that first comes to mind, without any further analysis or consideration Which statement best describes ethics? A. The conflict, power, and interdependency associated with the way we live B. How out lives and relationships are lead in day-to-day circumstances C. What our conduct and actions should be regarding what is right and good D. How people make decisions that they see as legally and morally appropriate - correct answer ✅C. What our conduct and actions should be regarding what is right and good Feedback: Ethics is the systematic study of what a person's conduct and actions should be

functions in Nursing theory and application

10th edition Chapter 4 Exam Questions

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Feedback: Ethical dilemmas involve being forced to choose between two or more undesirable alternatives. Ethical dilemmas are often not amenable to being solved with empirical data; they involve values and beliefs, not only facts. Most ethical dilemmas do not involve a breach of the law; legal issues often have a more clear and unambiguous response. Even though ethical dilemmas are difficult to manage, this does not mean that there is no possibility of a realistic solution. The A nurse is applying the ethical principle of justice when providing care for clients. What action best exemplifies this principle? A. Prioritizing actions that will benefit the largest number of clients B. Meeting continuing education requirements for license renewal C. Respecting clients' rights to make decisions about their care D. Ensuring that time and resources are distributed equitably to clients -

functions in Nursing theory and application

10th edition Chapter 4 Exam Questions

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correct answer ✅D. Ensuring that time and resources are distributed equitably to clients Feedback: The principle of justice states that equals should be treated equally and that unequals should be treated according to their differences; this is the principle of equity. Justice is frequently applied when there are scarcities or competition for resources or benefits. Meeting requirements for licensure is a legal issue, not a principle of ethics. The principle of utility involves prioritizing actions that will benefit the largest number of clients. Respecting clients' rights to make decisions demonstrates autonomy. The only treatment alternative left for a client diagnosed with advanced cancer is a rare, highly experimental bone marrow transfusion with a 10% success rate. Some individuals are arguing that the high cost of the procedure could be better spent providing well-baby screening for 2,000 residents in the service area. What ethical principle is most directly involved in this situation?

functions in Nursing theory and application

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D. Perform a critical self-reflection of the nurse's own morals and values. - correct answer ✅B. Gather as much information about the situation as possible. Feedback: The first step of the MORAL decision-making model is to "massage the dilemma." This involves collecting data about the ethical problem and who should be involved in the decision-making process. However, this does not necessarily mean that the nurse must engage the colleague who is the object of the decision. Outlining options (alternatives) is the second step in the model. It is presumed that a nurse will engage in self-reflection when addressing dilemmas, but this is not an explicit component of the MORAL model A nurse has been asked to stay after a shift and work overtime because three nurses have called in sick. The nurse is reluctant to

functions in Nursing theory and application

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work the overtime because of a social commitment. Duty-based reasoning would dictate that the nurse: A. contact the three nurses to remind them of their obligations. B. base the decision on recent precedents in the health-care organization. C. work overtime because of the responsibility owed to clients. D. carefully weigh the effect of the decision on workplace relationships. - correct answer ✅C. work overtime because of the responsibility owed to clients. Feedback: Duty-based reasoning is an ethical framework stating that some decisions must be made because there is a duty to do something or to refrain from doing something. In this case, it could be construed that the nurse has a duty to care for clients that supersedes social activities. Duty-based reasoning would not prioritize the effect on relationships over the nurse's moral duty. Precedents would not necessarily indicate what the nurse's duty is. Duty-based reasoning emphasizes the nurse's own duty, not that of colleagues

functions in Nursing theory and application

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B. Critical ethical decisions should be made quickly so the situation does not worsen. C. Outcomes are the main criterion for evaluating ethical decision making. D. Accepting some ambiguity and uncertainty is a part of ethical decision making. - correct answer ✅D. Accepting some ambiguity and uncertainty is a part of ethical decision making. Feedback: Ethical decision makers choose between two or more undesirable alternatives, and because they can use only the information and resources available at the time, they must live with some ambiguity and uncertainty. Processes must be considered during ethical decision making, not only outcomes. The nurse should identify as many alternatives as possible during the early stages of decision making, not only desirable alternatives. Ethical decisions often require a careful and methodical approach rather than a quick decision

functions in Nursing theory and application

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The principle of autonomy would have the greatest bearing on what clinical situation? A. A client is unable to afford the treatment that carries the best chance for a cure. B. A client is discussing a do-not-resuscitate order with the care team. C. The nurse is caring for two clients in pain and must choose which to treat first. D. A nurse is considering whether to report a colleague's rough treatment of a client. - correct answer ✅B. A client is discussing a do-not-resuscitate order with the care team. Feedback: Autonomy, or self-determination, is also referred to as freedom of choice and accepting the responsibility for one's choice. Deciding on resuscitation options involves this principle because the client's preference is the final determinant on the matter. Situations involving scarce resources or time are more closely aligned with issues of justice. The nurse's ethical decision making around reporting bad practice align most closely with

functions in Nursing theory and application

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maintained whether or not the client's right to self-determination remains in place The interdisciplinary team is considering whether to apply the principle of paternalism in the care of a client. What question should guide the team's decision? A. What interventions are in the client's best interest? B. Is the client competent to make decisions? C. What is the client's most likely prognosis? D. Does the client have strong social or family support? - correct answer ✅B. Is the client competent to make decisions? Feedback: Paternalism can be invoked when a client is unable to make sound decisions for himself or herself. Consequently, the client's ability to make decisions underlies the question of whether acting paternalistic is justified or not? The presence or absence of social and family support does not justify or rule out paternalism. Likewise, the particulars of the client's prognosis do not determine whether it is appropriate to be paternalistic. The client's

functions in Nursing theory and application

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competence decides whether the care team is justified in stepping in to act in the client's "best interest." The nurse has been navigating a difficult situation that involved an ethical dilemma. Which factors should be considered when assessing the quality of the nurse's ethical problem-solving process? Select all that apply. A. The number of alternatives that the nurse initially generated B. The process the nurse used for data gathering is not needed C. Precedents in the organization involving similar situations were compared to this one D. The outcomes of the process E. The process that was used to arrive at a decision - correct answer ✅A, D, E Feedback: Outcomes should never be used as the sole criterion for assessing the quality of ethical problem solving because many variables affect outcomes that have no reflection on whether the problem solving was appropriate. Quality, instead, should be evaluated both by

functions in Nursing theory and application

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That is, evaluating the decision-making process. This model does not explicitly involve reaffirming relationships or disseminating the results, even though the model does not preclude these actions. Implementing the decision precedes the evaluation phase. Which statement is correct regarding the distinction between legal and ethical obligations in decision making? A. Ethical controls are much clearer and individualized. B. Legal controls are clearer and philosophically impartial. C. Ethical controls are clearer and philosophically impartial. D. Legal controls are much less clear and individualized. - correct answer ✅B. Legal controls are clearer and philosophically impartial. Feedback: In general, legal controls are clearer and philosophically impartial; ethical controls are much less clear and individualized

functions in Nursing theory and application

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The nurse-manager has learned there is conflict between a nonresponsive client's family members about the best plan of care. The manager recognizes the complex ethics of this situation. What is the manager's best action? A. Make contact with the hospital's ethics committee. B. Refer the family to the hospital's spiritual care service. C. Base a decision on the most recent precedent in the organization. D. Ask an impartial staff member to mediate. - correct answer ✅A. Make contact with the hospital's ethics committee. Feedback: An ethics committee can bring needed experience, perspective, and insight to challenging ethical situations. Precedent cannot always be used as a guide because each situation is unique even if they appear superficially similar. Clients and families often benefit from spiritual care, but this does not help the manager make a good decision. Mediation can sometimes be beneficial, but this does not release the nurse-manager from addressing the situation as best as he or she can.

functions in Nursing theory and application

10th edition Chapter 4 Exam Questions

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The new nurse-manager has committed to modeling the leadership roles associated with applying ethics in the workplace. What is the manager's best action? A. Ensure nurses are responsible for scrutinizing each other's behavior to monitor for ethical violations. B. Demonstrate self-awareness about his or her own beliefs, morals, and values. C. Delegate ethical decision making to staff nurses whenever possible. D. Ensure that individual rights are always prioritized over collective rights. - correct answer ✅B. Demonstrate self-awareness about his or her own beliefs, morals, and values. Feedback: A core competency for ethical leadership is evaluating one's own values and beliefs. This form of self-reflection is foundational for providing ethical care and promoting in others. The balance between individual and collective rights is situation-specific;

functions in Nursing theory and application

10th edition Chapter 4 Exam Questions

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individual rights are not always priorities over group interests. The manager must show leadership in ethical decision making and cannot always delegate this important function to staff. Ethical nurses are observant for violations, but this should not result in an environment where each nurse is "scrutinizing" colleagues' practice Which nurse is experiencing moral distress? A. A heavy workload prevents a nurse from providing the care that each client requires. B. The children of a terminally ill client do not want the client's prognosis communicated to the client. C. A nurse knows that a colleague called in sick to work because the colleague had a social engagement. D. A nurse witnesses a colleague using a racial slur in a conversation with another nurse. - correct answer ✅A. A heavy workload prevents a nurse from providing the care that each client requires. Feedback: Each of the listed situations has an ethical element. However, moral distress