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community final.docx, Study notes of Nursing

Utah Valley University (UVU)Nursing

When and by whom was nursing’s first code of ethics written? 1893, by Lystra Gretter 1950, by the ANA House of Delegates 1953, by the International Council of Nurses (ICN) 2001, by the ANA House of Delegates ANS: A The Nightingale Pledge, considered nursing’s first code of ethics, was written by Lystra Gretter in 1893. DIF: Cognitive Level: Remember (Knowledge) REF: p. 53

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• When and by whom was nursing’s first code of ethics written?

• 1893, by Lystra Gretter

• 1950, by the ANA House of Delegates

• 1953, by the International Council of Nurses (ICN)

• 2001, by the ANA House of

Delegates ANS: A

The Nightingale Pledge, considered nursing’s first code of ethics, was written by

Lystra Gretter in 1893.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 53

• A nurse didn’t know what to do when faced with a particular ethical dilemma

because an option that would have a good outcome didn’t seem possible. The

nurse decided to talk to the agency supervisor and decide what action to take.

Which of the following best describes the nurse’s actions?

• Appropriate, because the supervisor is responsible for the nurse’s choices

• Intelligent, because the supervisor has access to resource persons

(clergy, physicians, administrators) who might know of options the nurse

hadn’t considered

• Justified, because this provides an opportunity to discuss the issue

but the nurse maintains responsibility for the decision

• Wise, because the supervisor would be more knowledgeable concerning

agency priorities and traditional practices

ANS: C

Ethically, each nurse is responsible for his or her own decisions and cannot

avoid ethical accountability by relying on obedience to a supervisor or any

external rule or policy.

DIF: Cognitive Level: Apply (Application) REF: p. 54

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When and by whom was nursing’s first code of ethics written?
1893, by Lystra Gretter
1950, by the ANA House of Delegates
1953, by the International Council of Nurses (ICN)
2001, by the ANA House of Delegates ANS: A The Nightingale Pledge, considered nursing’s first code of ethics, was written by Lystra Gretter in 1893. DIF: Cognitive Level: Remember (Knowledge) REF: p. 53
A nurse didn’t know what to do when faced with a particular ethical dilemma because an option that would have a good outcome didn’t seem possible. The nurse decided to talk to the agency supervisor and decide what action to take. Which of the following best describes the nurse’s actions?
Appropriate, because the supervisor is responsible for the nurse’s choices
Intelligent, because the supervisor has access to resource persons (clergy, physicians, administrators) who might know of options the nurse hadn’t considered
Justified, because this provides an opportunity to discuss the issue but the nurse maintains responsibility for the decision
Wise, because the supervisor would be more knowledgeable concerning agency priorities and traditional practices ANS: C Ethically, each nurse is responsible for his or her own decisions and cannot avoid ethical accountability by relying on obedience to a supervisor or any external rule or policy. DIF: Cognitive Level: Apply (Application) REF: p. 54

Which of the following is the first and most crucial step in the ethical decision-making process?
Assess the context or environment in which the decision must be made.
Consider the various ethical principles or theories.
Identify the ethical concerns.
Make a decision and act on it. ANS: C The first step in the ethical decision-making framework is to carefully identify the ethical issue or dilemma. DIF: Cognitive Level: Understand (Comprehension) REF: p. 54
A nurse is asked to meet with a family who recently emigrated from Botswana (Africa). After the clinical doctor tells the husband the wife’s diagnosis of breast cancer, the family thanks the physician and starts to leave. Ethically, which of the following is the nurse’s most important action?
Emphasizing that the family must set up a surgical appointment for the wife immediately
Assessing the family’s current living situation, including insurance and other assets
Educating the family concerning the usual treatment and the prognosis of breast cancer
Interviewing the family concerning their perspective of the threat to the family’s well-being ANS: D Any of the actions might be taken. However, the United States is a multicultural nation with diverse ethnic groups and diverse values. Before any intervention can be made, the health care professionals must understand the family’s cultural, psychological, social, communal, and environmental contexts, because these contexts affect the way issues are formulated and decisions are made. Consequently, it is crucial to interview the

Princip lism ANS: C The nurse is focusing on duty, which is a deontological approach based on the moral obligation to engage in certain actions. DIF: Cognitive Level: Apply (Application) REF: p. 55
- Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, “The whole family is being affected and will fall apart if they don’t focus on their family’s needs first before anything else.” Which of the following ethical approaches is being used by this nurse?
Communitarianism
Deontological ethics
Principlism
Utilitaria nism ANS: D By focusing on the whole family, not individual members, and the consequences or outcomes for the whole family during this time of stress, the nurse is taking a utilitarian approach. DIF: Cognitive Level: Apply (Application) REF: p. 55
- Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, “But it doesn’t have to be an either/or situation. Perhaps each family member could take a turn calling in sick just 2 or 3 days. That way they could all take a turn at helping and yet not upset their employers. Wouldn’t that be fair?” Which of the following ethical approaches is

being used by this nurse?

Communitarianism
Deontological ethics
Principlism
Utilitaria nism ANS: C The nurse is focusing on ethical principles—in this case, beneficence (do good for the ill family member), nonmaleficence (do no harm, even to the employer), and justice (everyone takes a turn and shares equally). DIF: Cognitive Level: Apply (Application) REF: p. 56
- Some nurses are debating about the appropriate action to take in relation to a particular family. One member of the family is ill, and the other family members have chosen to continue working rather than take time off to care for the ill family member. One nurse states, “It’s not up to us; it’s the family’s decision. They know what is best for them.” Which of the following ethical approaches is being used by this nurse?
Communitarianism
Deontological ethics
Principlism
Utilitaria nism ANS: C The nurse is using an ethical principle, namely autonomy, in which each person

DIF: Cognitive Level: Apply (Application) REF: p. 55

A man entered the emergency department bleeding profusely and screaming, “I’ve got to see a doctor right now! I’ve got a right to see a doctor! I’m hurt. You have to take care of me!” Which of the following premises would ethically justify such a demand for immediate attention?
All hospitals receive federal money and all capable employed adults pay taxes, so all adults have a right to what their tax money has purchased.
Saving an individual’s life improves society and upholds tradition.
Our society believes that all persons should be treated equally and that basic needs, such as not dying if death can be avoided, should be met.
The man has a property right to his own body, and the government is responsible to ensure that property rights are protected. ANS: C The ethical theory of egalitarianism suggests that everyone is entitled to equal rights, equal treatment, and an equal share of the goods of society— and that the government’s role is to ensure this happens, at least on a basic level. Therefore, the man has a right to emergency care. DIF: Cognitive Level: Apply (Application) REF: p. 57
From an ethical standpoint, what is the problem with the belief that everyone should receive his or her fair share, that life should always be fair, and that everyone should make his or her own decisions?
With this belief, the needs of society as a whole are ignored.
Insufficient resources exist to give everyone a fair share.
This belief leads to a propensity for some people to like to be taken care of.
Some people think they deserve more than their fair share. ANS: A

All principles of justice focus on the individual, which ignores the needs of society as a whole. Indeed, the rights of an individual may conflict with the rights of the community as a whole. DIF: Cognitive Level: Apply (Application) REF: p. 57

A physician refuses to order pain medication for a drug addict who has been severely injured in a car accident. When reminded by nurses that pain medication has not been ordered, the physician merely replies that the patient’s suffering from the pain of his injuries will build character and that the addicted patient needs to get off drugs. Which of the following ethical theories is the physician using (or misusing)?
Consequentialism
Communitarianism
Deontological ethics
Virtue ethics ANS: D Virtue ethics emphasizes practical reasoning applied to character development. Although such action by a care provider is paternalistic and unethical on many grounds, the physician may truly be concerned with enabling the injured addict to learn from his experience and possibly develop into a drug-free person. DIF: Cognitive Level: Apply (Application) REF: p. 58
Which of the following is considered the most important goal in nursing today?
Adapting to technological advances such as electronic medical records
Demonstrating caring as the basis of nursing practice
Distinguishing nursing care from medical care
Seeking evidence-based outcomes to demonstrate nursing’s contribution to care

An important goal of both policy and ethics is to achieve the public good, and both are involved in good citizenship. DIF: Cognitive Level: Understand (Comprehension) REF: p. 60

A new nurse states to a nursing colleague, “But why do I have to be involved in politics? I just want to be the very best clinical nurse I can.” Which of the following would be the best response from the nursing colleague?
“As long as you pay your membership fee to the American Nurses Association, you have participated in the profession’s political endeavors.”
“Political action is the way you try to fulfill your ethical responsibilities to clients.”
“You’re absolutely right; if you are good clinically, you have fulfilled your obligation.”
“When you’ve completed your clinical orientation, then you’ll have time to be involved in politics.” ANS: B To be a good clinical nurse, the nurse needs resources and supportive policies that can be obtained only through political action to ensure those very resources and policies. Many clients are members of vulnerable groups who have often previously lacked access to quality care at an affordable cost. The American Nurses Association Code of Ethics for Nurses emphasizes political action as the mechanism to effect social justice and reform regarding homelessness, violence, and stigmatization. DIF: Cognitive Level: Apply (Application) REF: p. 62
Which of the following would confirm that the nurse’s advocacy has been truly successful or effective?
Audiences agree with the nurse who is serving as advocate.
Legislators discuss appropriate legislation to better allocate resources.
People verbalize that the disenfranchised should be better treated.
Systematic social changes are made to improve quality of life.

ANS: D

Advocacy is the application of information and resources to effect systematic changes that shape the way people in a community live to reduce death and disability and improve quality of life in the community. Although all of these options could be seen as beneficial, only when systematic social changes are made to improve quality of life can advocacy be considered truly effective. DIF: Cognitive Level: Apply (Application) REF: p. 63

How can nurses know whether they have been effective in assessing the community and planning and implementing appropriate interventions?
Ask community leaders for their opinion of the interventions.
Examine the morbidity and mortality rate of the community.
Reassess the community to determine whether obvious needs have been met.
Systematically survey community residents regarding their perception. ANS: B Although all these options might be useful, the end products of appropriate advocacy are decreased morbidity and mortality. In other words, if advocacy has been effective, public health problems will be decreased. DIF: Cognitive Level: Apply (Application) REF: p. 63
What is the relationship between ethics and a community health nursing practice?
Ethics and actual nursing practice are not related.
Knowing ethics allows nurse to recognize the source of most problems.
Ethics is constantly involved in nurses’ clinical decisions.
Although ethics is important, political and legal responsibilities are

Banks Skip to content Home ( List) REGISTER Profile Contact Log Out Login Privacy and Terms Nclex Questions Chapter 05: Cultural Influences in Nursing in Community Health Chapter 05: Cultural Influences in Nursing in Community Health Test Bank MULTIPLE CHOICE

Which of the following best describes most Americans’ attitude toward immigrants? a. Ambivalence because there are no clear solutions about how to address their needs b. Strongly negative because immigrants take jobs that native-born Americans could have instead c. Strongly positive because immigrants bring useful job skills and often join previous family members already in the United States d. Strong opposition to further immigration because of the increasing population in the United States ANS: A Most Americans are ambivalent about immigration, recognizing both the positive and negative aspects involved and realizing that it is a complex issue that has no clear solutions.

DIF: Cognitive Level: Understand (Comprehension) REF: p. 62

A nurse is about to despair. Earlier in the week, she carefully taught a patient from a different culture exactly how much medication to take and emphasized the importance of taking the correct amount. However, the patient is back in the hospital today with symptoms of an overdose, although the patient denies taking more than the label indicated. Which of the following is the most likely explanation? a. The patient was taking more mediation in the hope of getting well faster. b. The patient was also taking folk medicines that had many of the same effects and perhaps some of the same ingredients as the prescribed medication. c. The patient truly did not understand and thought the dose being taken was correct. d. The patient had a unique response to the medication and should have a smaller dose ordered. ANS: B For fear of disapproval, a person may not tell the nurse that he or she is using folk medicine as well as Western medication. The two medicines may have cumulative effects that could be dangerous to the client. Nurses who lack cultural knowledge may develop feelings of inadequacy and helplessness because they are often unable to effectively help their clients. DIF: Cognitive Level: Analyze (Analysis) REF: p. 74
A nurse wishes to develop cultural competence. Which of the following actions should the nurse take first?

Avoid any pretense of prejudice by treating the client in the same way as any other client. ANS: A Cultural competence in nursing includes adoption of culturally congruent behaviors. Culturally skillful nurses use appropriate touch during conversation, modify the physical distance between themselves and others, and use strategies to avoid cultural misunderstandings while meeting mutually agreed-upon goals. Nurses who strive to be culturally competent respect people from other cultures and value diversity, which helps them to provide more responsive care. DIF: Cognitive Level: Apply (Application) REF: p. 77

A male nurse had a habit of sitting with the lower part of one leg resting over the knee of his opposite leg when collecting a client’s history. He stopped doing this around Muslim clients after being told that Muslims were offended when he exposed the sole of his foot (shoe) to their face. Which of the following was exhibited by the nurse when he changed his behavior? a. Cultural accommodation b. Cultural imposition c. Cultural repatterning d. Cultural skill ANS: D

Cultural skill is the effective integration of cultural knowledge and awareness to meet client needs—in this case, the client’s need to not be offended by having the bottom of the nurse’s foot or shoe in view of the client’s face. The nurse using cultural skill makes sure nonverbal communication techniques take into consideration the client’s use of body language and space. Cultural accommodation involves negotiation with clients to include aspects of their folk practices with the traditional health care system to implement essential treatment plans. Cultural imposition is the process of imposing one’s values on others. Cultural repatterning is working with clients to make changes in their health practices if cultural behaviors are harmful or decrease their well-being. DIF: Cognitive Level: Apply (Application) REF: p. 77

The nurse practitioner (NP) discovered that an immigrant client is not taking the penicillin prescribed because his illness is “hot” and he believes that penicillin, a “hot” medicine, will not provide balance. Which of the following terms best describes the action taken by the NP when the client’s prescription is changed to a different yet equally effective antibiotic? a. Cultural awareness b. Cultural brokering c. Cultural knowledge d. Cultural skill ANS: D Cultural skill involves the provision of care that is beneficial, safe, and satisfying to the client. The medication change allows the client to retain his cultural beliefs and also satisfies the nurse practitioner’s need to prescribe an effective antibiotic.

a. Cultural imposition b. Ethnocen trism c. Rac ism d. Stereotyping ANS: D Stereotyping occurs when someone attributes certain beliefs and behaviors about a group to an individual without giving adequate attention to individual differences. In this instance, the health care worker makes the assumption that clients with low incomes are not educable. The health care worker is guilty of making another assumption as well: noncompliance among other Medicaid clients the worker has known may have been related to an inability to afford nutritious food. DIF: Cognitive Level: Apply (Application) REF: p. 79

A nurse says, “I’m not going to change the way I practice nursing based on where the client is from, because research shows that Western health care technology and research is best.” Which of the following is being demonstrated by the nurse’s statement?

a. Ethnocen trism b. Preju dice c. Rac ism d. Stereotyping ANS: A Ethnocentrism, a type of cultural prejudice at the cultural population level, is the belief that one’s own group determines the standards for behavior by which all other groups are to be judged. For example, some American nurses and providers may think, “The way we do it is the only right way to provide this care.” DIF: Cognitive Level: Apply (Application) REF: p. 79

A nurse states, “The best way to treat a client from another country is to care for them the same way we would want to be cared for. After all, we are all humans with the same wants and needs.” What does this statement reflect in relation to culture?

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ANS: D