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Leading and Managing in Nursing, 7th
Edition, Chapter 15: Making Decisions
and Solving ProblemsYoder-Wise:
Leading and Managing in Nursing, 7th
Edition, Chapter...Yoder-Wise Ch 3
Legal/Ethical Issues, Chapter 08:
Communication and ConflictYoder-Wise:
Questions and Correct Answers the Latest
Update and Recommended Version
The manager in the coronary care unit believes that the most important ethical considerations
in performance evaluations are that they include the employee's good qualities and that they
give positive direction for professional growth. This belief is an example of:
a. Justice.
b. Fidelity.
c. Beneficence.
d. Nonmaleficence.
→ ANS: D
→ Nonmaleficence refers to "doing no harm." For a nurse manager following this
principle, performance evaluation should emphasize an employee's good qualities and
give positive direction for growth. Destroying the employee's self-esteem and self-
worth would be considered doing harm under this principle.
A patient refuses a simple procedure that you believe is in the patient's best interest. The two
ethical principles that are directly in conflict in such a situation are:
a. Fidelity and justice.
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b. Veracity and fidelity.
c. Autonomy and beneficence.
d. Paternalism and respect for others.
→ ANS: C
→ Autonomy refers to the freedom to make a choice (e.g., refuse a procedure), and
beneficence to doing good (performing a procedure that will benefit the patient).
A staff nurse in the area that you manage has excelled in the delivery of patient education.
You are considering implementing a new job description that would broaden her opportunity
to teach patients and orient new staff members to the value of patient education. The ethical
principle that you are most directly reinforcing is:
a. Justice.
b. Fidelity.
c. Paternalism.
d. Respect for others.
→ ANS: C
→ The principle of paternalism allows one person to make partial decisions for another
and is most frequently deemed to be a negative or undesirable principle. Paternalism,
however, may be used to assist persons to make decisions when they do not have
sufficient data or expertise. Paternalism becomes undesirable when the entire decision
is taken away from the employee.
→
→ justice: treating all persons equally and fairly
→
→ fidelity: keeping one's promises or commitments,
→
→ respect for others: highest principle. respect for others acknowledges the right of
individuals to make decisions and to live by these decisions.
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An individual in a wheelchair is applying for the position of receptionist in an outpatient clinic.
The nurse manager understands that the Americans with Disabilities Act of 1990 requires that
employers:
a. Make reasonable accommodations for persons who are disabled.
b. Allow modified job expectations for persons recovering from alcoholism.
c. Hire disabled individuals before hiring other qualified, non-disabled persons.
d. Treat, for purposes of employment, homosexuals and bisexuals as disabled.
→ ANS: A
→ The purposes of the ADA are to eliminate discrimination against persons with
disabilities and to provide consistent, enforceable standards to address discrimination
in the workplace.
→ The Americans with Disabilities Act of 1990 provides protection to persons with
disabilities and is the most significant civil rights legislation since the Civil Rights Act of
1964. the purpose is to provide a clear and comprehensive national mandate for the
elimination of discrimination against individuals with disabilities and to provide clear,
strong, consistent, enforceable standards addressing discrimination in the workplace.
A member of a patient's family calls the nurse manager of the palliative care unit to express
concern that a member of the family, who died on the weekend, had requested analgesics
from the RNs on duty. An RN came with the analgesic nearly 45 minutes later, just after the
patient had died. The manager is aware that the unit was especially busy that weekend
because many patients were seriously ill, staff had called in ill, and the staffing manager was
unable to completely replace staff who were absent. The manager is deeply troubled that the
family member had to die in pain because it violates what she knows should have been done.
This manager is experiencing:
a. Compromised agency.
b. Moral distress.
c. Moral sensitivity.
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d. Moral dilemma.
→ ANS: B
→ Moral distress is experienced when nurses cannot provide what they perceive to be
best for a given patient. Examples of moral distress include constraints caused by
financial pressures, limited patient care resources, disagreements among family
members regarding patient interventions, and/or limitations imposed by primary
healthcare providers.
→ nurse managers can best assist nurses experiencing moral distress by remembering that
such distress may be lessened through adequate levels of knowledge regarding
nursing ethics and its application, acknowledging that such distress does occur and
serving as an advocate for nurses.
One means of ensuring that nurses floated to other patient care areas in healthcare
organizations are qualified to work in those areas is:
a. Employing additional staff to assist with orientation processes.
b. Cross-educating staff members to other areas of the institution.
c. Transferring patients to units where the staffing pattern is optimal.
d. Orienting staff members to all patient care areas as part of their general orientation to the
institution.
→ ANS: B
→ Nurses should be floated to units as similar as possible to their own to decrease the
potential for liability. Negotiating cross-training, a proactive approach to temporary
staffing problems, reduces the potential for liability.
A staff nurse who was fired for reporting patient abuse to the appropriate state agency files
a whistleblower lawsuit against the former employer. Reasons that the court would use in
upholding a valid whistleblower suit claiming retaliation include that the nurse:
a. Had previously reported the complaint, in writing, to hospital administration.
b. Had threatened to give full details of the patient abuse to local media sources.
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