Leadership Roles and Management Functions in Nursing: Theory and Application, Exams of Nursing

Download Leadership Roles and Management Functions in Nursing: Theory and Application and more Exams Nursing in PDF only on Docsity! Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide 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 Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide many options as possible is a good practice for ethical decision making, but it is not 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 Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide D. Ensuring that time and resources are distributed equitably to clients - 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 Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide the service area. What ethical principle is most directly involved in this situation? A. Paternalism B. Utility C. Unethical conduct D. Maleficence - correct answer ✅✅B. Utility Feedback: The principle of utility states that what is best for the common good outweighs what is best for the individual. There is no indication of unethical or maleficent (harmful) behavior. Paternalism would be characterized by decisions being made without the client having input A nurse is applying the MORAL decision-making model to a dilemma involving a colleague's possible dishonesty in documentation. What is the nurse's initial action? A. Think of as many alternatives as possible. B. Gather as much information about the situation as possible. Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide C. Engage the colleague in the decision-making process. 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 work the overtime because Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide The nurse is faced with a situation that requires ethical decision making. What statement should guide the nurse's action? A. Only desirable alternatives should be identified when solving ethical dilemmas. 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 Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide 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 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 Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide 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 duty-based reasoning and beneficence for clients. The care team is working with a client who has mental illness and who has been deemed a threat to self and others. It may be justified to take away the client's right to: A. self-determination. B. beneficence. C. justice. D. confidentiality. - correct answer ✅✅A. self- determination. Feedback: When an individual's impaired decision making poses a threat to self or others, it may be in the interests of the client and other people to temporarily remove the client's right Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide 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 the outcome and the process used to make the decision. Rigorous data gathering enhances the decision-making process, but this is not the criteria by which the overall process is gauged. Similarly, precedents can be used to inform decision making but do not constitute the basis for evaluating the overall process. Generating multiple alternatives aids the problem-solving process by identifying as many options as possible. Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide The nurse has applied the MORAL decision-making model to a situation that involved an ethical dilemma. The nurse should complete the process by: A. leading the implementation plan. B. evaluating the effectiveness of the decision- making process. C. disseminating the results of the process to other nurses. D. reaffirming the nurse's relationships with stakeholders. - correct answer ✅✅B. evaluating the effectiveness of the decision-making process. Feedback: The final phase of the MORAL decision- making model involves "looking back." 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. Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide 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 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. Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide 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; 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 Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide 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 occurs when the individual knows the right thing to do but organizational constraints make it difficult to take the right course of action. A nurse who lacks the time and energy to give Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide clients what they need is likely to experience moral distress. Issues of respect, honesty, and confidentiality require ethical decision making, but they do not directly involve a disconnect between the desire and the ability to do the right thing The nurse is practicing in a challenging environment where ethical and moral issues must often be dealt with. Which statement describes how moral uncertainty occurs? A. An individual is unsure which moral principles or values apply and may even include uncertainty as to what the moral problem is. B. An individual witnesses the immoral act of another but feels powerless to stop it. C. An individual is forced to choose between two or more undesirable alternatives. D. An individual knows the right thing to do, but organizational constraints make it difficult to take the right course of action. - correct answer ✅✅A. An individual is unsure which moral principles or values Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide D. Beneficence - correct answer ✅✅C. Paternalism Feedback: Paternalism is when one individual assumes the right to make decisions for another. Justice requires that a person seek fairness, treat "equals" equally, and treat "unequals" according to their differences. Fidelity involves the need to keep promises. Beneficence involves actions that are taken in an effort to promote good A nurse has repeatedly witnessed a physician being dismissive of clients' reports of pain and anxiety. The nurse recognizes that the best action would be to address this behavior with the physician, but the nurse strongly suspects that these concerns would be dismissed. What phenomenon is this nurse experiencing? A. Ethical universalism B. Moral conflict C. Moral outrage D. Ethical relativism - correct answer ✅✅C. Moral outrage Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide Feedback: Moral outrage occurs when an individual witnesses the immoral act of another but feels powerless to stop it. Moral uncertainty or moral conflict occurs when an individual is unsure which moral principles or values apply and may even include uncertainty as to what the moral problem is. Ethical relativism suggests that individuals make decisions based only on what seems right or reasonable according to their value system or culture. Ethical universalism holds that ethical principles are universal and constant and that ethical decision making should not vary as a result of individual circumstances or cultural differences. Which statements concerning autonomy are true? Select all that apply. A. It is based on a person's right to make a choice. B. Its legal equivalent is self-determination. C. It overrides paternalism but not beneficence. D. It is a form of personal liberty. Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide E. It supports the process of progressive employee discipline. - correct answer ✅✅A, B, D, E Feedback: A form of personal liberty, autonomy is also called freedom of choice or accepting the responsibility for one's choice. The legal right of self-determination supports this moral principle. The use of progressive discipline recognizes the autonomy of the employee. The employee, in essence, has the choice to meet organizational expectations or to be disciplined further. If the employee's continued behavior warrants termination, the principle of autonomy says that the employee has made the choice to be terminated by virtue of his or her actions, not by that of the manager. Ethical situations always differ, so it is impossible to state that one particular principle always overrides another Which activity best demonstrates a nursing unit manager's attention to ANA standards for ethics required of that position? Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide conduct research into a particular nursing intervention. In order to ensure that the rights of clients who may participate are protected, the managers should: A. discuss the educator's values, beliefs, and ethics. B. compare the study methodology to the code of ethics. C. refer the educator to the institutional review board. D. ask the hospital ethics committee to approve or deny the application. - correct answer ✅✅C. refer the educator to the institutional review board. Feedback: Institutional review boards (IRBs) are primarily formed to protect the rights and welfare of research subjects. They are the main gatekeepers for research that takes place in the institution. Ethics committees more often deal with specific situations involved in client care. Discussing the educator's values and beliefs is insufficient to protect the rights of participants. There may be some benefit in comparing the research proposal to the code of Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide ethics, but ultimately, this is within the jurisdiction of the IRB policies in a long-term care facility specify that immobile residents should be repositioned at least every 2 hours. Despite this, it is well known that many residence endure long periods without being repositioned. How should the nurse best interpret this situation? A. It is necessary for the nurses at the facility to review the code of ethics B. There is a need for actions to address this theory- practice-ethics gap C. The nurses at the facility are experiencing intrapersonal conflict that affects their practice. D. The nurses at the facility should apply the MORAL decision-making model to address this - correct answer ✅✅B. There is a need for actions to address this theory-practice-ethics gap Feedback: Theory-practice-ethics gaps exist when there is incongruence between what nurses know they should or must do and what they actually do. Intrapersonal conflict is Leadership Roles and Management functions in Nursing theory and application 10th edition Chapter 4 Test bank A+ Guide internal discontent resulting from inconsistency between what should be done and what a nurse can realistically do. However, there is no evidence that this is the case. Reviewing a code of ethics is unlikely to bring about meaningful change without the addition of other incentives. The MORAL decision-making model guides ethical decision making but does not address these gaps between what should be done and what is actually done. A nurse has recognized that many older adult clients on the unit do not receive enough nutrition because they are unable to feed themselves independently. What action by a manager would be most likely to resolve the nurse's moral distress? A. Providing a reference so the nurse can seek new employment B. Acknowledging and validating the nurse's observation C. Hiring more nursing assistants to help feed these clients