Ethical Decision Making

Course #37075 - $90-


Self-Assessment Questions

    1 . The field of bioethics came into existence because
    A) physicians, lawyers, policymakers, and legislators began to have questions about ethical issues in health care.
    B) scientific advances made it possible for patients to trust completely in their doctor's judgment, leaving no need for their own voice to be heard.
    C) there was a need to talk about how research and healthcare decisions and regulations could be made, who could make them, and what would be their long-term implications.
    D) Both A and C

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    2 . Prior to the 1960s, medical care decisions were primarily
    A) nurse-centered.
    B) patient-centered.
    C) physician-centered.
    D) None of the above

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    3 . Since the 1960s, what three events in U.S. History have caused a shift in the physician-patient relationship?
    A) The Joint Commission, case law, and President Bill Clinton
    B) The Joint Commission, case law, and World War II research and experimentation
    C) World War II research and experimentation, presidential elections, and the Joint Commission
    D) World War II research and experimentation, increased medical technology, modernization of healthcare structure and organization

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    4 . Extensive publicity about three research projects resulted in the establishment of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The three research projects were
    A) the Tuskegee experiment, the Willowbrook State School experiment, and the Belmont experiment.
    B) the Belmont experiment, the Los Alamos project, and the elderly patients with chronic illness injected with live cancer cells.
    C) elderly patients with chronic illness injected with live cancer cells, the Tuskegee experiment, and NutraSweet effects on teenagers.
    D) the Willowbrook State School experiment, the Tuskegee experiment, and the elderly patients with chronic illness injected with live cancer cells.

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    5 . Which court decision brought bioethics to the level of the individual?
    A) Tuskegee case
    B) Nancy Cruzan case
    C) Karen Ann Quinlan case
    D) Protection of Human Subjects case

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    6 . In the Karen Ann Quinlan court case, her father, acting on her behalf, asserted that his daughter would want to terminate life support based upon her
    A) right to die.
    B) wrongful life.
    C) right to privacy.
    D) right to refuse care.

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    7 . The Karen Ann Quinlan case is significant because it was the first case to deal specifically with the question of
    A) physician-assisted suicide.
    B) withdrawing of ventilator support from a permanently unconscious patient.
    C) removing an artificial feeding tube in a permanently unconscious patient.
    D) None of the above

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    8 . The link that made the Nancy Cruzan court case and the Karen Ann Quinlan case similar was
    A) the withdrawing of ventilatory support.
    B) the removal of an artificial feeding tube.
    C) the family members spoke for the individuals.
    D) None of the above

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    9 . During discussions at the state level, one of the agreed upon elements leading to the implementation of the Patient Self-Determination Act (PSDA) was that
    A) incompetent patients have the same rights as competent patients.
    B) the decision-making process should never occur in the clinical setting.
    C) the right to refuse treatment is an issue to be decided at the state level.
    D) artificial nutrition and hydration is not considered a medical treatment.

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    10 . The PSDA of 1990 was legislation at the
    A) state level.
    B) federal level.
    C) county level.
    D) hospital level.

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    11 . The PSDA of 1990 mandated that applicable facilities must
    A) require clients to make out a living will.
    B) provide staff and the community education regarding issues associated with advance directives.
    C) halt care if there is not specific knowledge of the availability of an advanced directive for the patient in need of care.
    D) All of the above

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    12 . The means or tool for the individual to document his or her wishes for future healthcare decisions is called a(n)
    A) prime directive.
    B) advance directive.
    C) last will and testament.
    D) financial durable power of attorney.

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    13 . A physician directive is a legally binding form that allows
    A) patients to write their own treatment orders on the physician order form.
    B) patients to document their treatment wishes should they become unable to speak for themselves.
    C) the named surrogate to act on the financial matters of the patient who is unable to speak for himself/herself.
    D) the patient to name an attorney-in-fact to act on behalf of him/her for healthcare decisions, should the patient become unable to speak for himself/herself.

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    14 . The Joint Commission Patient Rights Standards on Ethical Issues requires that all accredited facilities address
    A) advance directives.
    B) ethical issues in providing care.
    C) patient involvement in care decisions.
    D) All of the above

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    15 . An ethical dilemma is defined as
    A) a real or perceived conflict of values and beliefs.
    B) only found in situations regarding withdrawing of life-support.
    C) the nurse and the physician do not communicate well with the patient.
    D) None of the above

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    16 . Which of the following are considered the most common ethical principles currently applied in healthcare decision making?
    A) Negotiating, harboring, enlisting, issuing, delegating, acceptance
    B) Denial, anger, resistance, bargaining, acceptance, enlisting, issuing
    C) Autonomy, beneficence, non-maleficence, fidelity, right-to-know, justice, veracity
    D) Automotive, benevolent, non-benevolent, finality, wrong-to-know, judicious, veracity

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    17 . Ethical principles that would NOT come into conflict with one another are
    A) autonomy and justice.
    B) fidelity and autonomy.
    C) veracity and non-maleficence.
    D) autonomy and self-determination.

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    18 . Deontologic ethics is
    A) the principle that all people are not of equal value.
    B) a little white lie is okay if it is seen to be in the person's best interest.
    C) based upon the principle that people should always be treated as means to an end.
    D) a system of ethical decision making that stands on moral rules and unwavering principles.

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    19 . Deontologic ethical theories include which of the following in their ethical thought system?
    A) Pragmatism
    B) Utilitarianism
    C) Existentialism
    D) Theory of Justice

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    20 . In natural law ethical theory, which of the following is TRUE?
    A) It is known as the virtue system of ethics.
    B) The fundamental maxim is to do good and avoid evil.
    C) Both A and B
    D) None of the above

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    21 . The transcultural ethical theory is a system based upon
    A) an ethic of caring.
    B) a holistic framework in an environment of differing values, beliefs, and ethical principles.
    C) Both A and B
    D) None of the above

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    22 . The four components that form the framework and model for transcultural nursing ethics are
    A) anger, shock, adapting, and balancing.
    B) principles, precepts, rules, and guidelines.
    C) adapting, adjusting, diversifying and acting.
    D) caring dynamics, principles, context, and universal source.

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    23 . The chief goal of an ethical decision-making framework is to determine right from wrong in situations
    A) of financial interest.
    B) where clear demarcations do not exist.
    C) where the nurse's license is in question.
    D) None of the above

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    24 . Before an ethical decision-making framework can be used successfully, nurses must
    A) subscribe strictly to one ethical system.
    B) clarify her or his own values and subscribe to a particular ethical system or theory.
    C) take numerous courses on ethical theory and be able to define each theoretical system.
    D) None of the above

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    25 . An analytical ethical framework can take many forms, but all are based on
    A) the honor method.
    B) the Hippocratic method.
    C) the prime directive method.
    D) the scientific or problem-solving method.

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    26 . The science of ethical decision making
    A) is useful after thoughts have been organized.
    B) is not very dynamic and useful in day-to-day situations.
    C) does not depend on a set of static rules that are unchanging.
    D) None of the above

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    27 . A framework for ethical decision making presupposes that nurses making decisions know
    A) that a system of ethics exists.
    B) the content of the ethical system.
    C) that the system applies to similar ethical decision-making problems despite multiple variables.
    D) All of the above

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    28 . In order for a patient to be considered a capable decision maker in health care, he or she must be
    A) certified by a judge as competent.
    B) able to converse with healthcare staff.
    C) proven to make healthy and correct decisions.
    D) able to understand information relevant to the decision at hand and be able to weigh the possible alternatives.

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    29 . When following an ethical decision-making framework successfully, who makes the final determination of what should be done in patient care treatment issues?
    A) The nurse
    B) The physician
    C) The patient/family
    D) An objective outside party

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    30 . As delineated in the text, "sorting the issues" involves
    A) brainstorming ethical terms.
    B) identifying the values in conflict.
    C) differentiating facts from values and policy issues.
    D) taking action and communicating what needs to be done.

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    31 . Kohlberg identifies two important correlates of his six stages of moral development. One of these correlates is:
    A) Some people skip the lower stages in moral development.
    B) A person at one stage can understand any stage below him or her.
    C) A person at one stage can understand any stage above him or her.
    D) None of the above

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    32 . Kohlberg presumes there are six stages of moral development. A person making a stage five decision uses the following justification:
    A) "If I do not make that decision, I will be punished."
    B) "If I make that decision, I will be rewarded and other people will help me."
    C) "This decision will contribute to social well-being, and, as members of a society, we have an obligation to every other member."
    D) "Others whom I care about will be pleased if I do this because they have taught me that this is what a good person does."

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    33 . All of the ethical principles discussed in the text are applied to situations common to the healthcare profession. The term that describes healthcare professional ethics is
    A) bioethics.
    B) business ethics.
    C) Socratic ethics.
    D) Platonic ethics.

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    34 . In the text, paternalism presupposes
    A) relatives should know what is best for their loved ones.
    B) health professionals understand what is best for their patients.
    C) the patient's decision is to be the final say in what will be his or her treatment plan.
    D) All of the above

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    35 . The key ethical component in advocacy that allows the nurse to act in the patient's best interest is the
    A) ethics of caring.
    B) paternalistic ethics.
    C) ethics of truth telling.
    D) ethics of consumerism.

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    36 . When developing policy, one should research
    A) facility and community resources.
    B) legal parameters regarding your policy issue.
    C) administrative parameters regarding your policy issue.
    D) All of the above

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    37 . According to the ethical decision making in patient care policy example, who should participate in ethical decision making in patient care?
    A) The family and the physician only
    B) The patient and his/her doctor only
    C) The interdisciplinary healthcare team only
    D) The patient, family or significant other, and the interdisciplinary healthcare team

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    38 . In Case Study 1, R.O.L.E. stands for
    A) random observation of life expectancies.
    B) routing opinions to learned environments.
    C) risky developments, open to suggestion, lifestyle, extenuating circumstances.
    D) risks of medical treatment, opinion of the patient, life quality, external factors.

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    39 . In Case Study 2, what did the nursing supervisor feel the staff nurse was acting upon in the case of the pediatric patient?
    A) Feelings
    B) The law
    C) Ethical principles
    D) The father's request

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    40 . In Case Study 3, which of the following institutions hold liability and ethical responsibility for student clinical performance?
    A) The school holds the full responsibility.
    B) The hospital holds the full responsibility.
    C) The student holds the full responsibility.
    D) Both the school and the hospital hold full responsibility.

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