The term ethics refers to the decisions that a nurse makes during her practice. She often pulls from a variety of ethical theories to help shape those decisions. Morals are related to ethics but are also supported by the nurse’s culture and ethnic background. The code of conduct outlines her responsibilities and the appropriate behavior within the organization. Veracity refers to the need for health care providers to always tell the truth when giving information to their patients.
The Nursing Code of Ethics refers to principles that guide a nurse’s decision-making and standards of practice. The standards in the Code are universal, meaning that they should apply to every nurse, regardless of their location or type of nursing practice. Adherence to the Code of Ethics is not optional.
The patient’s right to self-determination describes the right that a patient has for decision-making during care. The patient has the ultimate responsibility for making his or her own decisions, regardless of whether the physician or nurse agrees. This may include completely withdrawing care or choosing a less popular option. The practitioner must be careful to avoid coercing the patient but must be sure that the patient has all of the information needed to make an informed decision. If a patient is unable to make his or her own decisions, he or she has the right to appoint someone (usually family or a close friend) to make those decisions.
There are multiple steps in making ethical decisions, including: identifying the problem and ethical issue, researching the issue, determining who will make the final decision, evaluating the ethical issues surrounding the health problem, looking for alternatives, carrying out the plan, and modifying it based on an evaluation of the proposal.
Beneficence is the principle of doing right by the patient, as in acting in his or her best interest. Autonomy refers to the patient’s right to make his or her own decisions regarding care. Veracity refers to the idea that health care providers are required to be honest with their patients and always tell the truth. Nonmaleficence is the idea that the nurse should do no harm to their patients.
The answer is deontology, which focuses on the obligations of the nurse as the basis for making ethical decisions. The primary focus of utilitarianism is to do the most good for the most number of people. Virtue theory looks at the intention of the action; the belief is that actions done with good intentions are ethical. Egoist theory focuses on the best interests of the individual.
The Health Insurance Portability and Accountability Act is legislation that was designed to protect a patient’s privacy. It requires health care providers to obtain written permission from the patient before sharing any protected health information with another individual or organization. This includes protecting the electronic medical record to ensure that data are not compromised. The patient is entitled to share personal information with whomever they choose.
Informed consent should only be obtained by the physician and must be done before any procedure or treatment. The physician is responsible for counseling the patient, including risks, benefits, alternatives, processes, procedures, and prognoses. The nurse’s role is to help the patient sign the forms, once the patient has been appropriately counseled by the physician. If informed consent has not been obtained, it is the nurse’s responsibility to bring it to the attention of the physician.
While it is true that patients have a right to privacy, the nurse is also responsible for reporting suspicious injuries. The patient reports that the gun went off while cleaning it, but the entrance wound is in his back, making his story suspicious. Because it appears that the gunshot wound is the result of criminal activity, the nurse must make the report to the police department.
Apricots are low in potassium; therefore, it is a suitable snack of the client on a potassium-restricted diet. Raisins, oranges, and bananas are all good sources of potassium; therefore, answers A, B, and C are incorrect.
No special preparation is needed for the blood test for H. pylori. Answer A is incorrect because the client is not NPO before the test. Answer C is incorrect because it refers to preparation for the breath test. Answer D is incorrect because glucose is not administered before the test.
Oral potassium supplements should be given in at least 4oz. of juice or other liquid, to prevent gastric upset and to disguise the unpleasant taste. Answers A, C, and D are incorrect because they cause gastric upset.
Fresh specimens are essential for accurate diagnosis of CMV. Answer A is incorrect because cultures of urine, sputum, and oral swab are preferred. Answer B is incorrect because pregnant caregivers should not be assigned to care for clients with suspected or known infection with CMV. Answer C is incorrect because a convalescent culture is obtained 2–4 weeks after diagnosis.
The client should receive pain medication 30 minutes before the application of Sulfamylon. Answer A is incorrect because it refers to silver nitrate. Answer B is incorrect because it refers to Silvadene. Answer C is incorrect because it refers to Betadine.
Gingival hyperplasia is a side effect of Dilantin; therefore, the nurse should provide oral hygiene and gum care every shift. Answers A, B, and C do not apply to the medication; therefore, they are incorrect.
Zofran is given before chemotherapy to prevent nausea. Answers A, B, and D are not associated with the medication; therefore, they are incorrect.
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NCLEX-RN Test #2
