Online Practice Test 5

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Site Title: Kozier & Erb's Fundamentals of Nursing Book Title: Kozier & Erb's Fundamentals of Nursing Location on Site: Chapter 5 > NCLEX® Review Date/Time Submitted: July 4, 2012 at 3:14 PM (UTC/GMT)

Summary of Results 67% Correct of 15 Scored items: 10 Correct:  67% 5 Incorrect:  33% More information about scoring

1.		Which would the nurse not list as a purpose of the nursing code of ethics when discussing it with a group of new employees? Your Answer: Guiding the profession in self-regulation Correct Answer: Providing solutions for specific ethical situations
		Objective: Explain the uses and limitations of professional codes of ethics. Rationale: Nursing codes of ethics have the purpose of informing the public about minimum professional standards; providing a sign of the profession's commitment to the public; outlining major ethical considerations of the profession; providing ethical standards for professional behavior; guiding the profession in self-regulation; and reminding nurses of the special responsibility they assume when caring for the sick. Nursing Process: Planning Client Need: Safe, Effective Care Environment Cognitive Level: Analysis Strategy: Understand contemporary nursing practice.
2.		When trying to make a responsible ethical decision, what should the nurse understand as the basis for ethical reasoning? Your Answer: Ethical principles and codes
		Objective: Describe ways in which nurses can enhance their ethical decision making and practice. Rationale: Responsible ethical reasoning is rational and systematic, and should be based on ethical principles and codes rather than on emotions, intuition, fixed policies, or precedent. Nursing Process: Planning Client Need: Psychosocial Integrity Cognitive Level: Analysis Strategy: Understand contemporary nursing practice ethics and values.
3.		A nurse working in the Emergency Department is asked to care for an openly gay client with AIDS. The nurse tells her supervisor that caring for the client is against her religious beliefs, and asks if she must take the assignment. Does this nurse have a moral obligation to care for the client? Your Answer: Yes, unless the risk exceeds the responsibility
		Objective: Discuss common ethical issues currently facing health care professionals. Rationale: The moral obligation to care for an HIV-infected client cannot be set aside unless the risk exceeds the responsibility. Nursing Process: Assessment Client Need: Safe, Effective Care Environment Cognitive Level: Analysis Strategy: Understand contemporary nursing practice ethics and values.
4.		A fully alert and competent 89-year-old client is in end-stage liver disease. The client says, "I'm ready to die," and refuses to take food or fluids. The family urges the client to allow the nurse to insert a feeding tube. What is the nurse's moral responsibility? Your Answer: The nurse must consider that the hospital can be sued if she honors the client's request. Correct Answer: The nurse should honor the client's decision.
		Objective: Explain how nurses use knowledge of values to make ethical decisions and facilitate ethical decision making by clients. Rationale: The nurse must honor the competent client's right to refuse food and fluids. Although the family is pleading, the obligation is to the client. Nursing Process: Assessment Client Need: Physiologic Integrity Cognitive Level: Analysis Strategy: Understand contemporary nursing practice ethics and values.
5.		Which act would the nurse consider passive euthanasia? Your Answer: Providing pills to a client wishing to commit suicide Correct Answer: Removing a "no code" client from a ventilator
		Objective: Discuss common ethical issues currently facing health care professionals. Rationale: Passive euthanasia involves withdrawal of extraordinary means of life support, such as a ventilator. Nursing Process: Assessment Client Need: Safe, Effective Care Environment Cognitive Level: Analysis Strategy: Understand contemporary nursing practice ethics and values.
6.		A client with cancer has decided against further treatment. Which nursing action would be most helpful? Your Answer: Making sure the client has accurate information and understands the consequences of the decision
		Objective: Explain how cognitive development, vales, moral frameworks, and code of ethics affect moral decisions. Rationale: To plan effectively, the nurse needs to understand what has influenced the client's decision and whether the client has thought about the results of the decision. The other choices do not respect the client's right to choose. Nursing Process: Implementation Client Need: Psychosocial Integrity Cognitive Level: Application Strategy: Understand contemporary nursing practice ethics and values.
7.		A client asks you not to tell his wife that he has cancer. He does not want to burden her with this information. What would be the most appropriate response by the nurse? Your Answer: "What benefits do you see from doing this?"
		Objective: When presented with an ethical situation, identify the moral issues and principles involved. Rationale: The nurse should discuss the reasons the client does not want his wife to know the diagnosis. This will clarify the benefits the client sees in his decision. The other choices are disrespectful of the client's wishes, or imply something-being afraid to tell-that may not be there. Nursing Process: Implementation Client Need: Psychosocial Integrity Cognitive Level: Application Strategy: Understand contemporary nursing practice ethics and values.
8.		The nurse notes that a client has a slight red rash after taking a dose of an antibiotic. What action by the nurse would demonstrate the moral principle of nonmaleficence? Your Answer: Noting the reaction and getting a new medication ordered
		Objective: Describe ways in which nurses can enhance their ethical decision making and practice. Rationale: Nonmaleficence is the duty to "do no harm." By noting the allergy and calling the physician for a change of medication, the nurse is protecting the client from harm. A cardiac client should not do strenuous exercises; this could cause harm. Getting informed consent allows a client to be autonomous in the decision. A new postoperative client requires assistance when ambulating. Nursing Process: Evaluation Client Need: Safe, Effective Care Environment Cognitive Level: Analysis Strategy: Understand contemporary nursing practice ethics and values.
9.		A mentally competent client with end-stage liver disease continues to consume alcohol after being informed of the consequences of this action. What action best illustrates the nurse's role as a client advocate? Your Answer: Reminding the client that the action may be an end-of-life decision Correct Answer: Accepting the client's choice and not intervening
		Objective: Discuss the advocacy role of the nurse. Rationale: The client has the right to consume alcohol whether others believe it is right or not. By accepting the client's choice, the nurse is acting as a client advocate. The other actions do not respect the client's right to choose. Nursing Process: Implementation Client Need: Psychosocial Integrity Cognitive Level: Application Strategy: Understand contemporary nursing practice ethics and values.
10.		Which of the following terms are moral principles? Select all that apply. Your Answer: Autonomy Beneficence Fidelity
		Objective: Explain how nurses use knowledge of values to make ethical decisions and facilitate ethical decision making by clients. Rationale: Fidelity means being faithful to an agreement or promise. The nurse promises to return with the client's medication. This represents fidelity. Justice represents fairness. Beneficence represents "doing good," but is a term generally used when discussing legal issues. Ethics typically refers to ideals and values. Nursing Process: Assessment Client Need: Safe, Effective Care Environment Cognitive Level: Analysis Strategy: Understand contemporary nursing practice ethics and values.
11.		A client with a low postoperative hemoglobin and hematocrit levels refuses a potentially life saving blood transfusion. When questioning the client about the refusal, the client states, "I know about the risks of AIDS and hepatitis and do not want a blood transfusion." The physician enters the room and begins to coerce the client to accept the blood transfusion. The nurse's best response would be: Your Answer: "The client understands the risks associated with blood transfusions. Perhaps you can speak with him about his concerns."
		By giving the client the opportunity to speak to the physician, the nurse is facilitating communication which will help to make the final decision. Objective: When presented with an ethical situation, identify the moral issues and principles involved. Rationale: Nurses have ethical obligations to their clients, to the agency that employs them, and to physicians. According to the Code of Ethics, the nurse's first loyalty is to the client. Nursing Process: Evaluation Client Need: Safe, Effective Care Environment Cognitive Level: Analysis Strategy: Understand contemporary nursing practice ethics and values.
12.		A 43 year-old client with end stage ovarian cancer is admitted to the hospital with a bowel obstruction. The client in a tremendous amount of pain, states, "please give me enough morphine to kill me." The nurse's best response would be: Your Answer: "I can see that you are in a lot of pain. Let me rub your back too." Correct Answer: "I am trying to understand what you are saying. Describe the pain, where is it? How intense is the pain? What do you normally do for this type of pain?"
		Acknowledging that the client is in pain is the first step in a therapeutic relationship." Objective: Discuss common ethical issues currently facing health care professionals. Rationale: The client is asking for assisted suicide. Active euthanasia is forbidden by law. Nursing Process: Evaluation Client Need: Safe, Effective Care Environment Cognitive Level: Analysis Strategy: Use knowledge of nursing values and ethics.
13.		A famous actress has had plastic surgery. The media contacts the nurse on the unit and asks for information about the surgery. The nurse knows: Your Answer: Nurses are obligated to respect client's privacy and confidentiality.
		Objective: When presented with an ethical situation, identify the moral issues and principles involved. Rationale: No matter who the client is, the nurse may not disclose any information to unauthorized persons. Nursing Process: Evaluation Client Need: Safe, Effective Care Environment Cognitive Level: Analysis Strategy: Use knowledge of nursing ethics and values.
14.		The nurse did not follow hospital procedure and hung a unit of blood on the wrong client. The client had an anaphylactic reaction and the team is called in for emergency treatment. During the resuscitation, the nurse does not reveal that the wrong blood was given. Which moral principles were violated? Select all that apply. Your Answer: Veracity Beneficence
		Objective: When presented with an ethical situation, identify the moral issues and principles involved. Rationale: The moral principle of veracity refers to telling the truth, no matter the outcome. By lying, the nurse jeopardized the health of the client. Beneficence means "doing good." Nursing Process: Evaluation Client Need: Safe, Effective Care Environment Cognitive Level: Analysis Strategy: Use nursing knowledge of practice, issues, and trends.
15.		Which term is defined as answerable to oneself and others for one's own actions? Your Answer: Accountability
		Objective: Explain how cognitive development, values, moral frameworks, and codes of ethics affect moral decisions. Rationale: According to the Code of Ethics for Nurses, accountability means answerable to oneself and others for one's own actions. Nursing Process: Evaluation Client Need: Safe, Effective Care Environment Cognitive Level: Analysis Strategy: Use nursing knowledge of practice, issues, and trends.