Ethics Resources for Nurses

 

MULTIPLE CHOICE

     1.   Which of the following was a focus of codes of ethics during earlier nursing times?

a.
Professional standards
b.
Practice standards
c.
The scope of practice standards
d.
The virtue and morality of nurses

ANS:  D

Correct D: The virtue, character, and morality of nurses were the focus of early nursing codes of ethics, in addition to key principles that guided nursing practice.

Incorrect A: Professional standards have evolved in the current Code; they were not a focus of historical codes of ethics.

Incorrect B: Practice standards were not a part of historical codes of ethics and are not part of the modern Code. Practice standards set out requirements related to specific aspects of registered nurses’ practice.

Incorrect C: The scope of practice standards were not a part of historical codes of ethics and are not part of the modern Code. Scope of practice standards articulate standards, limits, and conditions related to the scope of practice of registered nurses and nurse practitioners.

DIF:    Cognitive level: Comprehension     REF:   p. 62

     2.   Which of the following is true of the Canadian Nurses Association’s Code of Ethics for Registered Nurses?

a.
It offers suggestions on resolving routine practice issues.
b.
It contains a dispute resolution mechanism.
c.
It offers a framework and guide for ethical practice.
d.
It is closely aligned with the physician’s code of ethics.

ANS:  C

Correct C: The Code contains nursing values and ethical responsibilities, as well as ethical endeavours, all of which guide and frame ethical reflection and decision making in nursing practice.

Incorrect A: Practice issues are not discussed in the Code; these are regulatory body issues.

Incorrect B: Dispute resolution mechanisms are part of a collective agreement, not a code of ethics.

Incorrect D: There may be similarities between the two codes because they are both informed by ethical principles; however, there is no alignment between these two codes.

DIF:    Cognitive level: Application           REF:   p. 63

     3.   Which primary value from the CNA Code of Ethics is being followed by a nurse who intervenes to address an unsafe nursing practice?

a.
Being accountable
b.
Providing safe, compassionate, competent, and ethical care
c.
Promoting justice
d.
Promoting health and well-being

ANS:  B

Correct B: Nurses question and intervene to address unsafe, noncompassionate, unethical, or incompetent practice or conditions that interfere with their ability to provide safe, compassionate, competent, and ethical care.

Incorrect A: Nurses are accountable for their actions and answerable for their practice, but this is not directly related to the situation mentioned above.

Incorrect C: Nurses uphold justice by safeguarding human rights, equality, and fairness and by promoting the public good, but this is not directly related to the situation mentioned above.

Incorrect D: Nurses help people attain their highest possible level of health and well-being, but this is not directly related to the situation mentioned above.

DIF:    Cognitive level: Application           REF:   p. 64

     4.   Which primary ethical nursing value is being followed by a nurse who respects the wishes of a patient to decline to receive information about her health condition?

a.
Promoting and respecting informed decision making
b.
Preserving dignity
c.
Being accountable
d.
Promoting health and well-being

ANS:  A

Correct A: Nurses promote autonomy and self-determination in patients, allowing them to make their own choices.

Incorrect B: Nurses recognize and respect the intrinsic worth of each person, but this is not directly related to the patient’s decision making.

Incorrect C: Nurses are individually accountable for their own practice, but this does not have a direct impact on the decisions of the patient.

Incorrect D: Nurses help people attain their highest possible level of health and well-being. This is an important aspect of a patient’s decision making; however, it does not directly involve patient autonomy.

DIF:    Cognitive level: Application           REF:   p. 67

     5.   Which of the following statements best describes the “ethical responsibilities” in the CNA Code of Ethics?

a.
Ethical responsibility deals with ethical endeavours.
b.
Nurses’ ethical responsibilities are informed by seven primary values.
c.
Social justice must be addressed consistently.
d.
Primary nursing values outline caring responsibilities.

ANS:  B

Correct B: The seven primary values in Part I of the Code inform nurses’ ethical responsibilities, which help guide nurses’ decision making.

Incorrect A: Ethical endeavours describe approaches nurses may take to address broader societal inequalities, but they are not directly linked with nurses’ ethical responsibilities.

Incorrect C: Broader societal inequalities may be addressed by approaches promoted by the Code’s ethical endeavours, but this statement is not a description of ethical responsibilities.

Incorrect D: Primary nursing values, which include ethical responsibilities, do not strictly outline these responsibilities.

DIF:    Cognitive level: Comprehension     REF:   p. 63

     6.   Which of the following rationales explains the development of the ethical endeavours section of the CNA Code of Ethics?

a.
Nurses are expanding their advocacy role.
b.
Canadians have become more diverse and have different health care needs.
c.
Nurses work with more “English as a second language” clients.
d.
Health resources are increasingly scarce.

ANS:  B

Correct B: Canadians have become more diverse and have different health care needs. Nurses today work with the homeless, within the military, and with new immigrants to Canada. Increased numbers of immigrants, for instance, are at risk of deteriorating health as part of the transition to living in Canadian society.

Incorrect A: Although advocacy is required, this is not the rationale that explains the development of the ethical endeavours section of the Code.

Incorrect C: This may be true, but it is not the rationale that explains the development of the ethical endeavours section of the Code.

Incorrect D: Appropriate use and distribution of resources is important; however, this was not the primary reason for the development of the ethical endeavours section of the Code.

DIF:    Cognitive level: Comprehension     REF:   p. 76

     7.   Which of the following statements best describes the intended result of the ethical decision-making process?

a.
There must only be one possible outcome.
b.
There must be several equally acceptable options.
c.
The goal is to discuss options, not decisions.
d.
More than one proposed intervention may be ethical.

ANS:  D

Correct D: More than one proposed intervention may be ethical and reflective of good ethical practice.

Incorrect A: Several possible outcomes should be examined in the ethical decision-making process.

Incorrect B: Acceptable options may not be equal in value to all parties, so this is not the intended result of the ethical decision-making process.

Incorrect C: This is not the goal of the ethical decision-making process.

DIF:    Cognitive level: Comprehension     REF:   p. 78

     8.   Which of the following is being used by an interdisciplinary team that implements and evaluates a plan of action after considering key players, clarifying values, and exploring alternatives?

a.
A code of ethics
b.
An ethics committee
c.
Practice standards
d.
An ethical decision-making model

ANS:  D

Correct D: The process described is standard in ethical decision-making models.

Incorrect A: A code of ethics helps inform ethical decision making but does not directly guide the process described.

Incorrect B: An ethics committee may be involved in the ethical decision-making process but not the entire process as described.

Incorrect C: Practice standards may be part of the discussion when exploring alternatives but are not involved in the entire process described.

DIF:    Cognitive level: Analysis                REF:   pp. 78–79

     9.   Which of the following best describes the goals of an ethics committee?

a.
To provide a single view toward the outcome of an ethical issue
b.
To present various views or “lenses” on the issues
c.
To develop standards of practice for nurses
d.
To ensure that comfort is achieved

ANS:  B

Correct B: Ethics committees present various views of or “lenses” on the issues, and there can be more than one alternative outcome.

Incorrect A: This statement does not describe the goals of an ethics committee.

Incorrect C: Standards of practice are the responsibility of the regulatory body.

Incorrect D: Comfort may be a goal of care that is considered, but, depending on the situation, the key players, and the other goals being considered, may not be the result.

DIF:    Cognitive level: Comprehension     REF:   pp. 79–80

   10.   Which of the following is a nurse demonstrating if he takes an unresolved ethical situation forward to an ethics committee?

a.
Nonmaleficence
b.
Beneficence
c.
Accountability
d.
Promoting justice

ANS:  C

Correct C: Being accountable is one of the primary nursing values in the CNA Code of Ethics. This nurse is demonstrating responsibility and accountability.

Incorrect A: Nonmaleficence means to do no harm. This may be one aspect of what this nurse is doing, but it does not directly describe his actions.

Incorrect B: Beneficence means to always do good. This may be one aspect of what this nurse is doing, but it does not directly describe his actions.

Incorrect D: Not enough is known about this situation to determine if promoting justice is involved.

DIF:    Cognitive level: Synthesis               REF:   p. 73

   11.   What is the main role of an ethics committee?

a.
Consultation
b.
Education
c.
Policy
d.
All of the above

ANS:  D

Correct D: Ethics committees offer suggestions but do not direct care decisions. Educating staff on ethical issues is a key responsibility. Changing technologies require the need for evolving policies and guidelines around everyday ethical issues, and the committee is the expert opinion on these matters.

Incorrect A: Ethics committees offer suggestions but do not direct care decisions. Educating staff on ethical issues is a key responsibility. Changing technologies require the need for evolving policies and guidelines around everyday ethical issues, and the committee is the expert opinion on these matters.

Incorrect B: Ethics committees offer suggestions, but do not direct care decisions. Educating staff on ethical issues is a key responsibility. Changing technologies require the need for evolving policies and guidelines around everyday ethical issues, and the committee is the expert opinion on these matters.

Incorrect C: Ethics committees offer suggestions, but do not direct care decisions. Educating staff on ethical issues is a key responsibility. Changing technologies require the need for evolving policies and guidelines around everyday ethical issues, and the committee is the expert opinion on these matters.

DIF:    Cognitive level: Comprehension     REF:   p. 80

   12.   Who of the following is likely to be a member of a hospital ethics committee?

a.
Funeral director
b.
Chaplain
c.
Community activist
d.
Palliative care volunteer

ANS:  B

Correct B: Chaplains are often part of an ethics committee. The committee is usually made up of professional staff with a certain level of experience in and knowledge of ethical issues.

Incorrect A: Funeral directors are not involved in patient care.

Incorrect C: Community members might be on the occasional ethics committee, but activists are not likely to be included, as they may be advancing a specific cause or agenda (e.g., the right to assisted suicide).

Incorrect D: Volunteers may know the patients but may not have the educational background to be able to participate on the ethics committee.

DIF:    Cognitive level: Comprehension     REF:   p. 81

TRUE/FALSE

     1.   Ethical principles inform only modern codes of ethics.

ANS:  F

Correct: Ethical principles have been documented as far back as 1780 B.C. and form the basis of both historical and modern codes of ethics.

Incorrect: This is not a true statement.

DIF:    Cognitive level: Knowledge            REF:   p. 58

     2.   A code of ethics identifies disciplinary actions and resulting consequences for nurses who are investigated for misconduct.

ANS:  F

Correct: A professional body normally implements discipline and consequences.

Incorrect: A code of ethics establishes a standard by which the nurse is assessed if disciplinary or legal action against the nurse occurs; it does not identify disciplinary actions and resulting consequences.

DIF:    Cognitive level: Comprehension     REF:   p. 61