Nursing: A Concept-Based Approach to Learning, 2e (Pearson)

Module 43 Advocacy

The Concept of Advocacy

1) The nurse is caring for a terminally ill child. The parents have decided to remove their child
from life support. This decision was met with much opposition from other nurses on the unit.
Which action by the nurse displays the role of advocate?
A) Respecting the parents' decision
B) Telling the parents they are making the right decision
C) Asking to be assigned to a different client
D) Referring the parents to social services
Answer: A
Explanation:
A) The nurse best advocates for the family by supporting the family's right to make this decision.
Telling the clients they are making the right decision is inappropriate and does not support
advocacy. Referring the parents to another entity points to feelings of unease about the parents'
choice. Asking to be assigned to another client does not honor the right of clients and families to
make decisions about health care.
B) The nurse best advocates for the family by supporting the family's right to make this decision.
Tell the clients they are making the right decision is inappropriate and does not support
advocacy. Referring the parents to another entity points to feelings of unease about the parents'
choice. Asking to be assigned to another client does not honor the right of clients and families to
make decisions about health care.
C) The nurse best advocates for the family by supporting the family's right to make this decision.
Tell the clients they are making the right decision is inappropriate and does not support
advocacy. Referring the parents to another entity points to feelings of unease about the parents'
choice. Asking to be assigned to another client does not honor the right of clients and families to
make decisions about health care.
D) The nurse best advocates for the family by supporting the family's right to make this decision.
Tell the clients they are making the right decision is inappropriate and does not support
advocacy. Referring the parents to another entity points to feelings of unease about the parents'
choice. Asking to be assigned to another client does not honor the right of clients and families to
make decisions about health care.
Page Ref: 2558-2559
Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Nursing Process: Evaluation
Learning Outcome: 2. Discuss the nurse's role of advocate.

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2) A nurse is volunteering at a local free clinic. By providing client care to an inadequately
insured population, the nurse is demonstrating which value of client advocacy?
A) The client has the right to make choices and decisions.
B) The nurse has the responsibility to ensure the client has access to healthcare services.
C) The client has the right to expect a nurse-client relationship based on shared respect.
D) The nurse has the responsibility to make choices and decisions.
Answer: B
Explanation:
A) The nurse has the responsibility to ensure the client has access to healthcare services that
meet health needs. Although the client does have the right to make choices and decisions, the
nurse volunteering at a free clinic to provide health care to the underinsured does not
demonstrate this value. Although the client does have the right to expect a nurse-client
relationship based on shared respect, the nurse volunteering at a free clinic to provide health care
to the underinsured does not demonstrate this value. The nurse's responsibility to make choices
and decisions is not one of the values basic to client advocacy.
B) The nurse has the responsibility to ensure the client has access to healthcare services that meet
health needs. Although the client does have the right to make choices and decisions, the nurse
volunteering at a free clinic to provide health care to the underinsured does not demonstrate this
value. Although the client does have the right to expect a nurse-client relationship based on
shared respect, the nurse volunteering at a free clinic to provide health care to the underinsured
does not demonstrate this value. The nurse's responsibility to make choices and decisions is not
one of the values basic to client advocacy.
C) The nurse has the responsibility to ensure the client has access to healthcare services that meet
health needs. Although the client does have the right to make choices and decisions, the nurse
volunteering at a free clinic to provide health care to the underinsured does not demonstrate this
value. Although the client does have the right to expect a nurse-client relationship based on
shared respect, the nurse volunteering at a free clinic to provide health care to the underinsured
does not demonstrate this value. The nurse's responsibility to make choices and decisions is not
one of the values basic to client advocacy.
D) The nurse has the responsibility to ensure the client has access to healthcare services that
meet health needs. Although the client does have the right to make choices and decisions, the
nurse volunteering at a free clinic to provide health care to the underinsured does not
demonstrate this value. Although the client does have the right to expect a nurse-client
relationship based on shared respect, the nurse volunteering at a free clinic to provide health care
to the underinsured does not demonstrate this value. The nurse's responsibility to make choices
and decisions is not one of the values basic to client advocacy.
Page Ref: 2559
Cognitive Level: Analyzing
Client Need: Health Promotion and Maintenance
Nursing Process: Implementation
Learning Outcome: 3. Describe the values basic to client advocacy.

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3) A charge nurse notices that a coworker who is assigned to client care has come to work with a
black eye. The charge nurse is aware that the nurse lives with her boyfriend, who has caused
problems in the past. What is the best action by the charge nurse?
A) Notify security to approach the nurse about the situation.
B) Discuss the situation with the nurse in a private setting.
C) Ask the other staff members if abuse is involved.
D) Ignore the situation until the nurse shows a willingness to talk.
Answer: B
Explanation:
A) The charge nurse should discuss the situation with the nurse in private and offer options of
help. The charge nurse should not ignore the situation and should advocate for the nurse.
Security cannot address situations that do not occur on hospital grounds. It would be a breach of
confidentiality to talk to the rest of the staff.
B) The charge nurse should discuss the situation with the nurse in private and offer options of
help. The charge nurse should not ignore the situation and should advocate for the nurse.
Security cannot address situations that do not occur on hospital grounds. It would be a breach of
confidentiality to talk to the rest of the staff.
C) The charge nurse should discuss the situation with the nurse in private and offer options of
help. The charge nurse should not ignore the situation and should advocate for the nurse.
Security cannot address situations that do not occur on hospital grounds. It would be a breach of
confidentiality to talk to the rest of the staff.
D) The charge nurse should discuss the situation with the nurse in private and offer options of
help. The charge nurse should not ignore the situation and should advocate for the nurse.
Security cannot address situations that do not occur on hospital grounds. It would be a breach of
confidentiality to talk to the rest of the staff.
Page Ref: 2560
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Nursing Process: Implementation
Learning Outcome: 4. Examine strategies for advocating in different care settings.

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4) The home health nurse is assigned to care for a client who requires wound care. The nurse is
assessing the family's ability to change a dressing on a wound that the client cannot reach. The
nurse asks the family to change the dressing while the nurse watches. What is the most
appropriate response by the nurse?
A) "Great job! Let me show you a technique that can make the dressing change more effective."
B) "This wound will never heal if you change the dressing that way."
C) "I'll come and do it every day so that the wound will heal more quickly."
D) "You are not doing it right. I will just have to come every day until you learn how."
Answer: A
Explanation:
A) To facilitate the client and family member learning this skill, the nurse evaluates their efforts
and gently helps them make some changes. This empowers the family and increases the chances
of healing. Saying that the family is doing it wrong is demoralizing. Sarcasm only lowers the
self-esteem of the family member. Offering to do it every day sends the message that the nurse
does not trust the family's ability to learn the proper procedure.
B) To facilitate the client and family member learning this skill, the nurse evaluates their efforts
and gently helps them make some changes. This empowers the family and increases the chances
of healing. Saying that the family is doing it wrong is demoralizing. Sarcasm only lowers the
self-esteem of the family member. Offering to do it every day sends the message that the nurse
does not trust the family's ability to learn the proper procedure.
C) To facilitate the client and family member learning this skill, the nurse evaluates their efforts
and gently helps them make some changes. This empowers the family and increases the chances
of healing. Saying that the family is doing it wrong is demoralizing. Sarcasm only lowers the
self-esteem of the family member. Offering to do it every day sends the message that the nurse
does not trust the family's ability to learn the proper procedure.
D) To facilitate the client and family member learning this skill, the nurse evaluates their efforts
and gently helps them make some changes. This empowers the family and increases the chances
of healing. Saying that the family is doing it wrong is demoralizing. Sarcasm only lowers the
self-esteem of the family member. Offering to do it every day sends the message that the nurse
does not trust the family's ability to learn the proper procedure.
Page Ref: 2561
Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Nursing Process: Evaluation
Learning Outcome: 5. Explain the importance of empowering the client and methods for doing
so.

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5) The nurse is working in a low-income neighborhood as a home health nurse. During one of
the home care visits to the neighborhood, the nurse notes that the children's playground has
broken equipment, which the children continue to play on. The nurse has already contacted the
owner of the playground about the issue. What action might the nurse take as a public advocate?
A) Write an article to the local newspaper to gain public attention.
B) No action is required; this is a civil problem beyond the realm of the nurse.
C) Call the police to report the owner's neglect.
D) Tell the parents they should not pay their rent until the playground is fixed.
Answer: A
Explanation:
A) Prevention of injury to client is very much a part of nursing. The nurse should initially contact
the owner. Because this was ineffective it is appropriate for the nurse to write an article or talk to
an individual on the town council. The police are a protection against crime and are not likely to
do anything about the situation. Telling the parents not to pay their rent until the playground is
fixed is not appropriate. Civil problem or not, the nurse has an obligation to protect the
neighborhood children from injury and should act on it.
B) Prevention of injury to client is very much a part of nursing. The nurse should initially contact
the owner. Because this was ineffective it is appropriate for the nurse to write an article or talk to
an individual on the town council. The police are a protection against crime and are not likely to
do anything about the situation. Telling the parents not to pay their rent until the playground is
fixed is not appropriate. Civil problem or not, the nurse has an obligation to protect the
neighborhood children from injury and should act on it.
C) Prevention of injury to client is very much a part of nursing. The nurse should initially contact
the owner. Because this was ineffective it is appropriate for the nurse to write an article or talk to
an individual on the town council. The police are a protection against crime and are not likely to
do anything about the situation. Telling the parents not to pay their rent until the playground is
fixed is not appropriate. Civil problem or not, the nurse has an obligation to protect the
neighborhood children from injury and should act on it.
D) Prevention of injury to client is very much a part of nursing. The nurse should initially contact
the owner. Because this was ineffective it is appropriate for the nurse to write an article or talk to
an individual on the town council. The police are a protection against crime and are not likely to
do anything about the situation. Telling the parents not to pay their rent until the playground is
fixed is not appropriate. Civil problem or not, the nurse has an obligation to protect the
neighborhood children from injury and should act on it.
Page Ref: 2559
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Implementation
Learning Outcome: 6. Differentiate between professional and public advocacy and provide
examples of each.

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6) The nurse has been working in a long-term care facility for 1 week. The nurse notes that
during the evening meal, an unlicensed assistive personnel (UAP) takes a tray to a client who is
unable to cut up and eat the food independently. The nurse helps the client with dinner and plans
which of the following to advocate for the client?
A) Report the UAP for neglect.
B) Notify the physician.
C) Call the client's family to have them assist with evening meals.
D) Discuss the situation with the director of nursing.
Answer: D
Explanation:
A) The nurse would advocate getting the client's plan changed because the goal is to have
someone available to help the client eat for every meal. Notifying the doctor will not help the
client. The family might be able to help at times but cannot be expected to come for every meal.
The nurse assesses that this happens at every meal and seeks to change how this client is cared
for, not just changing one healthcare worker. The UAP is not neglecting the client. The UAP is
assigned tasks by the nurse in charge of the client.
B) The nurse would advocate getting the client's plan changed because the goal is to have
someone available to help the client eat for every meal. Notifying the doctor will not help the
client. The family might be able to help at times but cannot be expected to come for every meal.
The nurse assesses that this happens at every meal and seeks to change how this client is cared
for, not just changing one healthcare worker. The UAP is not neglecting the client. The UAP is
assigned tasks by the nurse in charge of the client.
C) The nurse would advocate getting the client's plan changed because the goal is to have
someone available to help the client eat for every meal. Notifying the doctor will not help the
client. The family might be able to help at times but cannot be expected to come for every meal.
The nurse assesses that this happens at every meal and seeks to change how this client is cared
for, not just changing one healthcare worker. The UAP is not neglecting the client. The UAP is
assigned tasks by the nurse in charge of the client.
D) The nurse would advocate getting the client's plan changed because the goal is to have
someone available to help the client eat for every meal. Notifying the doctor will not help the
client. The family might be able to help at times but cannot be expected to come for every meal.
The nurse assesses that this happens at every meal and seeks to change how this client is cared
for, not just changing one healthcare worker. The UAP is not neglecting the client. The UAP is
assigned tasks by the nurse in charge of the client.
Page Ref: 2561
Cognitive Level: Evaluating
Client Need: Physiological Integrity
Nursing Process: Implementation
Learning Outcome: 7. Contrast the need for advocacy among members of vulnerable
populations versus general populations.

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7) The nurse is caring for a group of clients on a psychiatric unit. One client has become highly
agitated and is threatening other clients and some of the staff. The nurse escorts the client to the
isolation room, leaving the door open. Which statement by the nurse is most appropriate?
A) "I can't believe you behaved in this manner and upset everyone else."
B) "I'm going to stay here with you in case you want to talk about what happened."
C) "If you do not calm down, I will sedate you for your own safety."
D) "You scared the other clients."
Answer: B
Explanation:
A) The nurse offers support to the client by offering to listen if the client wants to talk about the
episode. Telling the client that the nurse can't believe the behavior is not effective
communication at this point. Threatening the client with medication is not allowed. The
psychiatric client may not be aware enough to realize the impact of behavior on the other clients.
B) The nurse offers support to the client by offering to listen if the client wants to talk about the
episode. Telling the client that the nurse can't believe the behavior is not effective
communication at this point. Threatening the client with medication is not allowed. The
psychiatric client may not be aware enough to realize the impact of behavior on the other clients.
C) The nurse offers support to the client by offering to listen if the client wants to talk about the
episode. Telling the client that the nurse can't believe the behavior is not effective
communication at this point. Threatening the client with medication is not allowed. The
psychiatric client may not be aware enough to realize the impact of behavior on the other clients.
D) The nurse offers support to the client by offering to listen if the client wants to talk about the
episode. Telling the client that the nurse can't believe the behavior is not effective
communication at this point. Threatening the client with medication is not allowed. The
psychiatric client may not be aware enough to realize the impact of behavior on the other clients.
Page Ref: 2561
Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Nursing Process: Implementation
Learning Outcome: 7. Contrast the need for advocacy among members of vulnerable
populations versus the general population.

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8) An 83-year-old woman with metastasized breast cancer informs the nurse that her doctor is
insisting that she participate in a course of chemotherapy, even though the client does not want to
have any further treatment. How can the nurse function as an advocate?
Select all that apply.
A) Tell the client that it is in her best interest to follow the doctor's advice.
B) Inform the doctor about the client's clear wishes not to have further chemotherapy.
C) Ascertain whether or not the client has an advanced care directive and, if not, assist her in
creating one.
D) Discuss the implications of various choices with the client.
E) Avoid interfering in the doctor-patient relationship.
Answer: B, C, D
Explanation:
A) Nurses acting as advocates should honor the moral principles and standards and respect
clients' right to make their own choices. The nurse should continuously advocate for the client in
a professional manner. The nurse serves as both a teacher and an advocate by informing clients
about their rights. When the client makes decisions about his or her treatment other than what is
recommended, it is the nurse's role to ensure that the client is making an informed decision and,
if so, to advocate for the client's right to make autonomous choices.
B) Nurses acting as advocates should honor the moral principles and standards and respect
clients' right to make their own choices. The nurse should continuously advocate for the client in
a professional manner. The nurse serves as both a teacher and an advocate by informing clients
about their rights. When the client makes decisions about his or her treatment other than what is
recommended, it is the nurse's role to ensure that the client is making an informed decision and,
if so, to advocate for the client's right to make autonomous choices.
C) Nurses acting as advocates should honor the moral principles and standards and respect
clients' right to make their own choices. The nurse should continuously advocate for the client in
a professional manner. The nurse serves as both a teacher and an advocate by informing clients
about their rights. When the client makes decisions about his or her treatment other than what is
recommended, it is the nurse's role to ensure that the client is making an informed decision and,
if so, to advocate for the client's right to make autonomous choices.
D) Nurses acting as advocates should honor the moral principles and standards and respect
clients' right to make their own choices. The nurse should continuously advocate for the client in
a professional manner. The nurse serves as both a teacher and an advocate by informing clients
about their rights. When the client makes decisions about his or her treatment other than what is
recommended, it is the nurse's role to ensure that the client is making an informed decision and,
if so, to advocate for the client's right to make autonomous choices.

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E) Nurses acting as advocates should honor the moral principles and standards and respect
clients' right to make their own choices. The nurse should continuously advocate for the client in
a professional manner. The nurse serves as both a teacher and an advocate by informing clients
about their rights. When the client makes decisions about his or her treatment other than what is
recommended, it is the nurse's role to ensure that the client is making an informed decision and,
if so, to advocate for the client's right to make autonomous choices.
Page Ref: 2557-2558
Cognitive Level: Analyzing
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
Nursing Process: Caring
Learning Outcome: 1. Discuss the concept of advocacy, including how it relates to the practice
of nursing.

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9) What are some important nursing advocacy interventions?
Select all that apply.
A) Educating clients and their families about their legal rights
B) Ensuring that clients have the necessary information to make an informed decision or give
informed consent
C) Speaking out for safe practice conditions when threatened by budget cutbacks
D) Supporting medical authority
E) Questioning other healthcare professionals when they provide care that is based on stereotypic
ideas rather than on an assessment of the individual client's needs
Answer: A, B, C, E
Explanation:
A) Clients must understand their rights in order to be able to defend them. As an advocate, the
nurse provides clients with the information they need to make informed decisions and supports
the clients' rights to make their own healthcare decisions. A nurse should understand that
advocacy may require political action. Conflicts may arise over issues that require consultation,
confrontation, or negotiation between the nurse and administrative personnel or between the
nurse and primary care providers. Nursing advocates should respect the diversity of all clients
and promote equal care for all clients.
B) Clients must understand their rights in order to be able to defend them. As an advocate, the
nurse provides clients with the information they need to make informed decisions and supports
the clients' rights to make their own healthcare decisions. A nurse should understand that
advocacy may require political action. Conflicts may arise over issues that require consultation,
confrontation, or negotiation between the nurse and administrative personnel or between the
nurse and primary care providers. Nursing advocates should respect the diversity of all clients
and promote equal care for all clients.
C) Clients must understand their rights in order to be able to defend them. As an advocate, the
nurse provides clients with the information they need to make informed decisions and supports
the clients' rights to make their own healthcare decisions. A nurse should understand that
advocacy may require political action. Conflicts may arise over issues that require consultation,
confrontation, or negotiation between the nurse and administrative personnel or between the
nurse and primary care providers. Nursing advocates should respect the diversity of all clients
and promote equal care for all clients.
D) Clients must understand their rights in order to be able to defend them. As an advocate, the
nurse provides clients with the information they need to make informed decisions and supports
the clients' rights to make their own healthcare decisions. A nurse should understand that
advocacy may require political action. Conflicts may arise over issues that require consultation,
confrontation, or negotiation between the nurse and administrative personnel or between the
nurse and primary care providers. Nursing advocates should respect the diversity of all clients
and promote equal care for all clients.

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E) Clients must understand their rights in order to be able to defend them. As an advocate, the
nurse provides clients with the information they need to make informed decisions and supports
the clients' rights to make their own healthcare decisions. A nurse should understand that
advocacy may require political action. Conflicts may arise over issues that require consultation,
confrontation, or negotiation between the nurse and administrative personnel or between the
nurse and primary care providers. Nursing advocates should respect the diversity of all clients
and promote equal care for all clients.
Page Ref: 2557-2560
Cognitive Level: Analyzing
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
Nursing Process: Implementation
Learning Outcome: 8. Summarize advocacy interventions, including resources available within
the interdisciplinary team.

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10) An OR nurse notices that the nurse-anesthesiologist for her next scheduled surgery seems to
be unsteady. When she comes close to the anesthesiologist, she is aware of a strong odor of
alcohol. What should the nurse do?
Select all that apply.
A) Assume that the surgeon is handling any problem.
B) Immediately report it to a supervisor.
C) Respect the privacy of the anesthesiologist.
D) Decide that a professional coworker is unlikely to come to the OR impaired.
E) Follow the state board guidelines.
Answer: B, E
Explanation:
A) A nurse who suspects a colleague of engaging in illegal, immoral, or unethical conduct and
fails to act is in direct violation of the ANA Code of Ethics for Nurses. Nurses have a legal
responsibility to report any professional whom they suspect of engaging in illegal, immoral, or
unethical activities. Although an impaired healthcare provider may view this intervention as an
invasion of privacy, such prompt action will safeguard the client from harm, while at the same
time offer the impaired healthcare provider a chance at recovery. Impairment of a coworker or
team member is the most common situation encountered by healthcare professionals. Nurses
should follow guidelines set forth by the board of nursing for the state in which they work.
B) A nurse who suspects a colleague of engaging in illegal, immoral, or unethical conduct and
fails to act is in direct violation of the ANA Code of Ethics for Nurses. Nurses have a legal
responsibility to report any professional whom they suspect of engaging in illegal, immoral, or
unethical activities. Although an impaired healthcare provider may view this intervention as an
invasion of privacy, such prompt action will safeguard the client from harm, while at the same
time offer the impaired healthcare provider a chance at recovery. Impairment of a coworker or
team member is the most common situation encountered by healthcare professionals. Nurses
should follow guidelines set forth by the board of nursing for the state in which they work.
C) A nurse who suspects a colleague of engaging in illegal, immoral, or unethical conduct and
fails to act is in direct violation of the ANA Code of Ethics for Nurses. Nurses have a legal
responsibility to report any professional whom they suspect of engaging in illegal, immoral, or
unethical activities. Although an impaired healthcare provider may view this intervention as an
invasion of privacy, such prompt action will safeguard the client from harm, while at the same
time offer the impaired healthcare provider a chance at recovery. Impairment of a coworker or
team member is the most common situation encountered by healthcare professionals. Nurses
should follow guidelines set forth by the board of nursing for the state in which they work.
D) A nurse who suspects a colleague of engaging in illegal, immoral, or unethical conduct and
fails to act is in direct violation of the ANA Code of Ethics for Nurses. Nurses have a legal
responsibility to report any professional whom they suspect of engaging in illegal, immoral, or
unethical activities. Although an impaired healthcare provider may view this intervention as an
invasion of privacy, such prompt action will safeguard the client from harm, while at the same
time offer the impaired healthcare provider a chance at recovery. Impairment of a coworker or
team member is the most common situation encountered by healthcare professionals. Nurses
should follow guidelines set forth by the board of nursing for the state in which they work.

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E) A nurse who suspects a colleague of engaging in illegal, immoral, or unethical conduct and
fails to act is in direct violation of the ANA Code of Ethics for Nurses. Nurses have a legal
responsibility to report any professional whom they suspect of engaging in illegal, immoral, or
unethical activities. Although an impaired healthcare provider may view this intervention as an
invasion of privacy, such prompt action will safeguard the client from harm, while at the same
time offer the impaired healthcare provider a chance at recovery. Impairment of a coworker or
team member is the most common situation encountered by healthcare professionals. Nurses
should follow guidelines set forth by the board of nursing for the state in which they work.
Page Ref: 2561
Cognitive Level: Analyzing
Client Need: Safe and Effective Care Environment
Nursing Process: Assessment
Learning Outcome: 9. Distinguish illegal, immoral, or unethical activities of professionals.

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11) A school nurse is particularly concerned about the sports injuries related to ineffective
protective equipment. She decides to participate in a child fatality prevention committee. What
are the advocacy activities this nurse is demonstrating?
Select all that apply.
A) Advocating for vulnerable populations
B) Advocating for fair and equitable access to high-quality care for all clients
C) Ensuring that clients have the necessary information to make an informed decision or give
informed consent
D) Informing the public about issues and concerns
E) Speaking publicly for the health, welfare, and safety of their clients
Answer: A, C, D, E
Explanation:
A) Clients from vulnerable populations, like children, particularly benefit from nursing
advocacy. Although advocating for fair and equitable access is an important advocacy activity, it
is not part of the work of a fatality prevention committee. A child fatality prevention committee
may recognize and act on information early. This type of committee may be able to recognize
patterns and devise related health promotion activities. As advocates, both professional and
public, nurses can speak to promote and effect change.
B) Clients from vulnerable populations, like children, particularly benefit from nursing
advocacy. Although advocating for fair and equitable access is an important advocacy activity, it
is not part of the work of a fatality prevention committee. A child fatality prevention committee
may recognize and act on information early. This type of committee may be able to recognize
patterns and devise related health promotion activities. As advocates, both professional and
public, nurses can speak to promote and effect change.
C) Clients from vulnerable populations, like children, particularly benefit from nursing
advocacy. Although advocating for fair and equitable access is an important advocacy activity, it
is not part of the work of a fatality prevention committee. A child fatality prevention committee
may recognize and act on information early. This type of committee may be able to recognize
patterns and devise related health promotion activities. As advocates, both professional and
public, nurses can speak to promote and effect change.
D) Clients from vulnerable populations, like children, particularly benefit from nursing
advocacy. Although advocating for fair and equitable access is an important advocacy activity, it
is not part of the work of a fatality prevention committee. A child fatality prevention committee
may recognize and act on information early. This type of committee may be able to recognize
patterns and devise related health promotion activities. As advocates, both professional and
public, nurses can speak to promote and effect change.

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E) Clients from vulnerable populations, like children, particularly benefit from nursing advocacy.
Although advocating for fair and equitable access is an important advocacy activity, it is not part
of the work of a fatality prevention committee. A child fatality prevention committee may
recognize and act on information early. This type of committee may be able to recognize patterns
and devise related health promotion activities. As advocates, both professional and public, nurses
can speak to promote and effect change.
Page Ref: 2557, 2560
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
Nursing Process: Analysis
Learning Outcome: 10. Illustrate principles of advocacy in nursing practice.

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12) The nurse providing an initial assessment informs the client of her rights. The nurse knows
which value is basic to client advocacy?
A) The client is a holistic, autonomous being who has the right to make choices and decisions.
B) The nurse has the responsibility to ensure the client's spirituality is respected.
C) The client has the right to refuse care.
D) The client is a dependent being who has the right to expect the nurse to solve all healthcare
needs.
Answer: A
Explanation:
A) Clients deserve advocates who can help them navigate healthcare bureaucracy and help them
access required and needed resources. Values basic to client advocacy include: the client is a
holistic, autonomous being who has the right to make choices and decisions; the client has the
right to expect a nurse-client relationship that is based on shared respect, trust, collaboration in
solving problems related to health and healthcare needs, and consideration of his or her thoughts
and feelings; and the nurse has the responsibility to ensure the client has access to healthcare
services that meet health needs.
B) Clients deserve advocates who can help them navigate healthcare bureaucracy and help them
access required and needed resources. Values basic to client advocacy include: the client is a
holistic, autonomous being who has the right to make choices and decisions; the client has the
right to expect a nurse-client relationship that is based on shared respect, trust, collaboration in
solving problems related to health and healthcare needs, and consideration of his or her thoughts
and feelings; and the nurse has the responsibility to ensure the client has access to healthcare
services that meet health needs.
C) Clients deserve advocates who can help them navigate healthcare bureaucracy and help them
access required and needed resources. Values basic to client advocacy include: the client is a
holistic, autonomous being who has the right to make choices and decisions; the client has the
right to expect a nurse-client relationship that is based on shared respect, trust, collaboration in
solving problems related to health and healthcare needs, and consideration of his or her thoughts
and feelings; and the nurse has the responsibility to ensure the client has access to healthcare
services that meet health needs.
D) Clients deserve advocates who can help them navigate healthcare bureaucracy and help them
access required and needed resources. Values basic to client advocacy include: the client is a
holistic, autonomous being who has the right to make choices and decisions; the client has the
right to expect a nurse-client relationship that is based on shared respect, trust, collaboration in
solving problems related to health and healthcare needs, and consideration of his or her thoughts
and feelings; and the nurse has the responsibility to ensure the client has access to healthcare
services that meet health needs.
Page Ref: 2556
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Implementation
Learning Outcome: 3. Describe the values basic to client advocacy.

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13) The nurse taking care of a Vietnamese client knows to respect the client's family's cultural
views and honor traditions regarding healthcare decision making. In order to be an effective
advocate, which factor or factors are important to the nurse?
Select all that apply.
A) Being assertive and recognizing the rights and values of clients and families
B) Being aware that conflicts may arise
C) Understanding that advocacy may require political action
D) Evaluating advocacy decisions
E) Honoring societal differences
Answer: A, B, C, E
Explanation:
A) It is important for the nurse to remember that client control over health decisions is a Western
view and is not necessarily accepted in other cultures. The nurse must respect the client's and
family's views and honor their traditions regarding healthcare decision making. To be an
effective advocate for all people and cultures, the nurse must do the following: be assertive;
recognize that the rights and values of clients and families must take precedence over those of
healthcare providers; be aware that conflicts may arise over issues that require consultation,
confrontation, or negotiation between the nurse and administration or the primary care provider;
work with community agencies and lay practitioners; and understand that advocacy may require
political action.
B) It is important for the nurse to remember that client control over health decisions is a Western
view and is not necessarily accepted in other cultures. The nurse must respect the client's and
family's views and honor their traditions regarding healthcare decision making. To be an
effective advocate for all people and cultures, the nurse must do the following: be assertive;
recognize that the rights and values of clients and families must take precedence over those of
healthcare providers; be aware that conflicts may arise over issues that require consultation,
confrontation, or negotiation between the nurse and administration or the primary care provider;
work with community agencies and lay practitioners; and understand that advocacy may require
political action.
C) It is important for the nurse to remember that client control over health decisions is a Western
view and is not necessarily accepted in other cultures. The nurse must respect the client's and
family's views and honor their traditions regarding healthcare decision making. To be an
effective advocate for all people and cultures, the nurse must do the following: be assertive;
recognize that the rights and values of clients and families must take precedence over those of
healthcare providers; be aware that conflicts may arise over issues that require consultation,
confrontation, or negotiation between the nurse and administration or the primary care provider;
work with community agencies and lay practitioners; and understand that advocacy may require
political action.
D) It is important for the nurse to remember that client control over health decisions is a Western
view and is not necessarily accepted in other cultures. The nurse must respect the client's and
family's views and honor their traditions regarding healthcare decision making. To be an
effective advocate for all people and cultures, the nurse must do the following: be assertive;
recognize that the rights and values of clients and families must take precedence over those of
healthcare providers; be aware that conflicts may arise over issues that require consultation,
confrontation, or negotiation between the nurse and administration or the primary care provider;
work with community agencies and lay practitioners; and understand that advocacy may require
political action.
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Copyright © 2015 Pearson Education, Inc.
E) It is important for the nurse to remember that client control over health decisions is a Western
view and is not necessarily accepted in other cultures. The nurse must respect the client's and
family's views and honor their traditions regarding healthcare decision making. To be an
effective advocate for all people and cultures, the nurse must do the following: be assertive;
recognize that the rights and values of clients and families must take precedence over those of
healthcare providers; be aware that conflicts may arise over issues that require consultation,
confrontation, or negotiation between the nurse and administration or the primary care provider;
work with community agencies and lay practitioners; and understand that advocacy may require
political action.
Page Ref: 2557
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Implementation
Learning Outcome: 4. Examine strategies for advocating in different care settings.

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Copyright © 2015 Pearson Education, Inc.
14) The home health nurse assessing a client notices the client's pain medication is missing 2
weeks' worth of medicine. The client says the only other individual besides she and the nurse
who has been in her home is the other healthcare nurse. The nurse suspects her colleague took
the medicine and must follow which guideline?
A) Call the state board of nursing.
B) Confront the nurse according to agency policy.
C) Call the authorities immediately.
D) Have the client file a police report.
Answer: A
Explanation:
A) Nurses have a legal responsibility to report any professional whom they suspect of engaging
in illegal, immoral, or unethical activities. Normally, the nurse making such a report will do so
following established procedures at the facility at which the nurse is employed. A nurse who
suspects another nurse of impairment should also follow guidelines set forth by the board of
nursing for the state in which he or she works. At other times, the nurse may need to seek the
guidance of the state board of nursing or the American Nurses Association (ANA). A nurse who
suspects a colleague of engaging in illegal, immoral, or unethical conduct and fails to act is in
direct violation of the ANA Code of Ethics for Nurses (ANA, 2010).
B) Nurses have a legal responsibility to report any professional whom they suspect of engaging
in illegal, immoral, or unethical activities. Normally, the nurse making such a report will do so
following established procedures at the facility at which the nurse is employed. A nurse who
suspects another nurse of impairment should also follow guidelines set forth by the board of
nursing for the state in which he or she works. At other times, the nurse may need to seek the
guidance of the state board of nursing or the American Nurses Association (ANA). A nurse who
suspects a colleague of engaging in illegal, immoral, or unethical conduct and fails to act is in
direct violation of the ANA Code of Ethics for Nurses (ANA, 2010).
C) Nurses have a legal responsibility to report any professional whom they suspect of engaging
in illegal, immoral, or unethical activities. Normally, the nurse making such a report will do so
following established procedures at the facility at which the nurse is employed. A nurse who
suspects another nurse of impairment should also follow guidelines set forth by the board of
nursing for the state in which he or she works. At other times, the nurse may need to seek the
guidance of the state board of nursing or the American Nurses Association (ANA). A nurse who
suspects a colleague of engaging in illegal, immoral, or unethical conduct and fails to act is in
direct violation of the ANA Code of Ethics for Nurses (ANA, 2010).
D) Nurses have a legal responsibility to report any professional whom they suspect of engaging
in illegal, immoral, or unethical activities. Normally, the nurse making such a report will do so
following established procedures at the facility at which the nurse is employed. A nurse who
suspects another nurse of impairment should also follow guidelines set forth by the board of
nursing for the state in which he or she works. At other times, the nurse may need to seek the
guidance of the state board of nursing or the American Nurses Association (ANA). A nurse who
suspects a colleague of engaging in illegal, immoral, or unethical conduct and fails to act is in
direct violation of the ANA Code of Ethics for Nurses (ANA, 2010).
Page Ref: 2561
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Implementation
Learning Outcome: 9. Distinguish illegal, immoral, or unethical activities of professionals.
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Copyright © 2015 Pearson Education, Inc.