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

Module 44 Ethics

The Concept of Ethics

1) The nurse is caring for a client in the intensive care unit (ICU) who was in a motor vehicle
accident. The physician asks the nurse to extubate the client because there is no communication
between the brain and body due to a cervical fracture. The family agrees with the decision of the
physician, but the nurse is uncomfortable pulling the tube. The nurse is experiencing difficulty
because of:
A) An ethical conflict.
B) Personal values.
C) Legal issues.
D) Cultural values.
Answer: B
Explanation:
A) The nurse is distressed because of personal values, which are in conflict with causing the
client's death. The decision is within ethical principles. Cultural values are not in evidenced in
this instance. Extubating this client would not be a legal decision.
B) The nurse is distressed because of personal values, which are in conflict with causing the
client's death. The decision is within ethical principles. Cultural values are not in evidenced in
this instance. Extubating this client would not be a legal decision.
C) The nurse is distressed because of personal values, which are in conflict with causing the
client's death. The decision is within ethical principles. Cultural values are not in evidenced in
this instance. Extubating this client would not be a legal decision.
D) The nurse is distressed because of personal values, which are in conflict with causing the
client's death. The decision is within ethical principles. Cultural values are not in evidenced in
this instance. Extubating this client would not be a legal decision.
Page Ref: 2564
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Nursing Process: Implementation
Learning Outcome: 1. Summarize the relationship between values and ethics in the nursing
profession.

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2) A nurse is caring for an elderly male client with terminal cancer. The client's family wants to
continue treatment, but the client has told the nurse he would like to discontinue treatment and
go home. The nurse agrees to be present while the client tells his family of his wishes. The nurse
is supporting which of the following principles?
A) Beneficence for the client
B) Autonomy for the client
C) Nonmaleficence for the client
D) Justice for the client
Answer: B
Explanation:
A) Autonomy refers to the right to make one's own decisions. The nurse is supporting this
principle by supporting the client in his decision. Nonmaleficence is the duty to "do no harm."
Justice is often referred to as fairness. Beneficence means "doing good."
B) Autonomy refers to the right to make one's own decisions. The nurse is supporting this
principle by supporting the client in his decision. Nonmaleficence is the duty to "do no harm."
Justice is often referred to as fairness. Beneficence means "doing good."
C) Autonomy refers to the right to make one's own decisions. The nurse is supporting this
principle by supporting the client in his decision. Nonmaleficence is the duty to "do no harm."
Justice is often referred to as fairness. Beneficence means "doing good."
D) Autonomy refers to the right to make one's own decisions. The nurse is supporting this
principle by supporting the client in his decision. Nonmaleficence is the duty to "do no harm."
Justice is often referred to as fairness. Beneficence means "doing good."
Page Ref: 2564
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Evaluation
Learning Outcome: 2. Examine the principles of ethical decision making.

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3) A nurse educator is teaching a group of nursing students about the American Nurses
Association (ANA) code of ethics for professional nurses. Which student nurse response
describes the ANA code of ethics?
A) "It alleviates suffering for those cared for by professional nurses."
B) "It provides standards for professional nursing practice."
C) "It reflects legal judgments in professional nursing practice."
D) "It serves as legal standards for professional nursing practice."
Answer: B
Explanation:
A) The ANA Code of Ethics is a formal statement of the group's ideals and values. It is a set of
ethical principles that serves as a standard for professional actions. Codes of ethics usually have
higher requirements than legal standards, and they are never lower than the legal standards of the
profession. Codes of ethics do not necessarily reflect legal judgments. Codes of ethics provide
the atmosphere in which the nurse is able to alleviate suffering.
B) The ANA Code of Ethics is a formal statement of the group's ideals and values. It is a set of
ethical principles that serves as a standard for professional actions. Codes of ethics usually have
higher requirements than legal standards, and they are never lower than the legal standards of the
profession. Codes of ethics do not necessarily reflect legal judgments. Codes of ethics provide
the atmosphere in which the nurse is able to alleviate suffering.
C) The ANA Code of Ethics is a formal statement of the group's ideals and values. It is a set of
ethical principles that serves as a standard for professional actions. Codes of ethics usually have
higher requirements than legal standards, and they are never lower than the legal standards of the
profession. Codes of ethics do not necessarily reflect legal judgments. Codes of ethics provide
the atmosphere in which the nurse is able to alleviate suffering.
D) The ANA Code of Ethics is a formal statement of the group's ideals and values. It is a set of
ethical principles that serves as a standard for professional actions. Codes of ethics usually have
higher requirements than legal standards, and they are never lower than the legal standards of the
profession. Codes of ethics do not necessarily reflect legal judgments. Codes of ethics provide
the atmosphere in which the nurse is able to alleviate suffering.
Page Ref: 2568
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Implementation
Learning Outcome: 3. Explain the ANA Code of Ethics.

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4) The nursing instructor is conducting a class regarding nursing ethics with a group of first-year
nursing students. The instructor determines that the students have retained the necessary
information when the student makes which statement regarding the ANA Code of Ethics?
A) "It is used by all health care professionals."
B) "It guides nurses in their professional behavior and relationships."
C) "It is the only code of ethics available for nurses."
D) "It forms the basis for possible lawsuits."
Answer: B
Explanation:
A) The ANA Code of Ethics is a guide for nurses in their work with clients and other
professionals. There is also an International Code of Ethics promulgated by the International
Council of Nurses. Each profession has its own code of ethics. State laws regarding nursing are
the basis of lawsuits, not the Code of Ethics.
B) The ANA Code of Ethics is a guide for nurses in their work with clients and other
professionals. There is also an International Code of Ethics promulgated by the International
Council of Nurses. Each profession has its own code of ethics. State laws regarding nursing are
the basis of lawsuits, not the Code of Ethics.
C) The ANA Code of Ethics is a guide for nurses in their work with clients and other
professionals. There is also an International Code of Ethics promulgated by the International
Council of Nurses. Each profession has its own code of ethics. State laws regarding nursing are
the basis of lawsuits, not the Code of Ethics.
D) The ANA Code of Ethics is a guide for nurses in their work with clients and other
professionals. There is also an International Code of Ethics promulgated by the International
Council of Nurses. Each profession has its own code of ethics. State laws regarding nursing are
the basis of lawsuits, not the Code of Ethics.
Page Ref: 2568
Cognitive Level: Analyzing
Client Need: Safe and Effective Care Environment
Nursing Process: Evaluation
Learning Outcome: 4. Integrate the ANA Code of Ethics in providing individual client care.

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5) A nurse is volunteering time in a local free clinic that provides care to the underinsured
population. By volunteering time to work in the clinic, this nurse is demonstrating which
professional value?
A) Human dignity
B) Social justice
C) Integrity
D) Altruism
Answer: B
Explanation:
A) Social justice is upholding fairness on a social scale. This value is demonstrated in
professional practice when the nurse works to ensure equal treatment under the law and equal
access to quality health care. Human dignity is respect for the worth and uniqueness of
individuals and populations. Altruism is concern for the welfare and well-being of others.
Integrity is acting in accordance with an appropriate code of ethics and accepted standards of
practice.
B) Social justice is upholding fairness on a social scale. This value is demonstrated in
professional practice when the nurse works to ensure equal treatment under the law and equal
access to quality health care. Human dignity is respect for the worth and uniqueness of
individuals and populations. Altruism is concern for the welfare and well-being of others.
Integrity is acting in accordance with an appropriate code of ethics and accepted standards of
practice.
C) Social justice is upholding fairness on a social scale. This value is demonstrated in
professional practice when the nurse works to ensure equal treatment under the law and equal
access to quality health care. Human dignity is respect for the worth and uniqueness of
individuals and populations. Altruism is concern for the welfare and well-being of others.
Integrity is acting in accordance with an appropriate code of ethics and accepted standards of
practice.
D) Social justice is upholding fairness on a social scale. This value is demonstrated in
professional practice when the nurse works to ensure equal treatment under the law and equal
access to quality health care. Human dignity is respect for the worth and uniqueness of
individuals and populations. Altruism is concern for the welfare and well-being of others.
Integrity is acting in accordance with an appropriate code of ethics and accepted standards of
practice.
Page Ref: 2564
Cognitive Level: Applying
Client Need: Health Promotion and Maintenance
Nursing Process: Implementation
Learning Outcome: 5. Discuss how personal values influence individual care.

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6) A nurse has taken a position in the hospital setting. The nurse knows one role is that of client
advocate. What must the nurse be aware of in preparation to act as a client advocate?
Select all that apply.
A) The rights of a client in a long-term care facility
B) The health department's client rights statement
C) The hospital's client rights statement
D) State and federal client rights legislation
E) The unit policy manual
Answer: C, D
Explanation:
A) The nurse reviews the rights statement of the hospital because it more specifically identifies
which hospital workers assist clients who feel their rights have been violated. The unit policy
manual will not have a separate policy statement from the hospital. The health department will
have a client rights statement, but the hospital's statement is more specific to the client's need.
The nurse will not need the rights of clients in long-term care facilities as the client is in the
hospital.
B) The nurse reviews the rights statement of the hospital because it more specifically identifies
which hospital workers assist clients who feel their rights have been violated. The unit policy
manual will not have a separate policy statement from the hospital. The health department will
have a client rights statement, but the hospital's statement is more specific to the client's need.
The nurse will not need the rights of clients in long-term care facilities as the client is in the
hospital.
C) The nurse reviews the rights statement of the hospital because it more specifically identifies
which hospital workers assist clients who feel their rights have been violated. The unit policy
manual will not have a separate policy statement from the hospital. The health department will
have a client rights statement, but the hospital's statement is more specific to the client's need.
The nurse will not need the rights of clients in long-term care facilities as the client is in the
hospital.
D) The nurse reviews the rights statement of the hospital because it more specifically identifies
which hospital workers assist clients who feel their rights have been violated. The unit policy
manual will not have a separate policy statement from the hospital. The health department will
have a client rights statement, but the hospital's statement is more specific to the client's need.
The nurse will not need the rights of clients in long-term care facilities as the client is in the
hospital.
E) The nurse reviews the rights statement of the hospital because it more specifically identifies
which hospital workers assist clients who feel their rights have been violated. The unit policy
manual will not have a separate policy statement from the hospital. The health department will
have a client rights statement, but the hospital's statement is more specific to the client's need.
The nurse will not need the rights of clients in long-term care facilities as the client is in the
hospital.
Page Ref: 2566
Cognitive Level: Applying
Client Need: Psychosocial Integrity
Nursing Process: Implementation
Learning Outcome: 8. Demonstrate appropriate steps to approaching ethical dilemmas.

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Exemplar 44.1 Ethical Dilemmas

1) A nurse educator is talking to a student about how to deal with an ethical dilemma in practice.
The educator explains to the student that it is important to make the decision about actions during
an ethical dilemma by:
A) Examining all conflicts in the situation.
B) Investigating all aspects of the situation.
C) Relying on nursing judgment.
D) Making a decision based on the policy of the agency.
Answer: B
Explanation:
A) To avoid making a premature decision, the nurse plans to investigate all aspects of the
dilemma before deciding. Overconfidence can lead to poor decision making. Reading the agency
policy regarding the matter addresses only one aspect of the situation. Examining the conflicts
surrounding the issue is only one aspect of the situation to consider.
B) To avoid making a premature decision, the nurse plans to investigate all aspects of the
dilemma before deciding. Overconfidence can lead to poor decision making. Reading the agency
policy regarding the matter addresses only one aspect of the situation. Examining the conflicts
surrounding the issue is only one aspect of the situation to consider.
C) To avoid making a premature decision, the nurse plans to investigate all aspects of the
dilemma before deciding. Overconfidence can lead to poor decision making. Reading the agency
policy regarding the matter addresses only one aspect of the situation. Examining the conflicts
surrounding the issue is only one aspect of the situation to consider.
D) To avoid making a premature decision, the nurse plans to investigate all aspects of the
dilemma before deciding. Overconfidence can lead to poor decision making. Reading the agency
policy regarding the matter addresses only one aspect of the situation. Examining the conflicts
surrounding the issue is only one aspect of the situation to consider.
Page Ref: 2570
Cognitive Level: Analyzing
Client Need: Safe and Effective Care Environment
Nursing Process: Planning
Learning Outcome: 6. Apply a model to processing an ethical dilemma.

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2) A hospice nurse has been working closely with a client who, on several occasions, has asked
about guidance and support in ending life. The nurse recognizes which of the following in regard
to making ethical and moral decisions?
A) Euthanasia has legal implications along with moral and ethical ones.
B) Passive euthanasia is an easy decision to arrive at.
C) Active euthanasia is supported in the Code for Nurses.
D) Assisted suicide is illegal in all states.
Answer: A
Explanation:
A) Determining whether an action is legal is only one aspect of deciding whether it is ethical.
Legality and morality are not one and the same. The nurse must know and follow the legal
statutes of the profession and boundaries within the state before making any decision. Passive
euthanasia involves the withdrawal of extraordinary means of life support and is never an easy
decision. Active euthanasia and assisted suicide are in violation of the Code for Nurses,
according to the position statement by the ANA (1995). Some states and countries have laws
permitting assisted suicide for clients who are severely ill, are near death, and wish to commit
suicide.
B) Determining whether an action is legal is only one aspect of deciding whether it is ethical.
Legality and morality are not one and the same. The nurse must know and follow the legal
statutes of the profession and boundaries within the state before making any decision. Passive
euthanasia involves the withdrawal of extraordinary means of life support and is never an easy
decision. Active euthanasia and assisted suicide are in violation of the Code for Nurses,
according to the position statement by the ANA (1995). Some states and countries have laws
permitting assisted suicide for clients who are severely ill, are near death, and wish to commit
suicide.
C) Determining whether an action is legal is only one aspect of deciding whether it is ethical.
Legality and morality are not one and the same. The nurse must know and follow the legal
statutes of the profession and boundaries within the state before making any decision. Passive
euthanasia involves the withdrawal of extraordinary means of life support and is never an easy
decision. Active euthanasia and assisted suicide are in violation of the Code for Nurses,
according to the position statement by the ANA (1995). Some states and countries have laws
permitting assisted suicide for clients who are severely ill, are near death, and wish to commit
suicide.
D) Determining whether an action is legal is only one aspect of deciding whether it is ethical.
Legality and morality are not one and the same. The nurse must know and follow the legal
statutes of the profession and boundaries within the state before making any decision. Passive
euthanasia involves the withdrawal of extraordinary means of life support and is never an easy
decision. Active euthanasia and assisted suicide are in violation of the Code for Nurses,
according to the position statement by the ANA (1995). Some states and countries have laws
permitting assisted suicide for clients who are severely ill, are near death, and wish to commit
suicide.
Page Ref: 2574
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Implementation
Learning Outcome: 7. Apply ethical principles in situations involving ethical dilemmas.

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3) The nurse is talking with a parent who decides to decline treatment for a 3-year-old client
whose cancer has metastasized. There is a conflict between the parents and the rest of the family
regarding the withdrawal of care from the child. Which should the nurse consider when
determining the appropriate action for this client?
A) The beliefs of the child
B) The values of the parents
C) The age of the child
D) The values of the rest of the family
Answer: B
Explanation:
A) When confronted with a conflict regarding care, one of the first actions by the nurse is to
consider the values and beliefs of the parents who are making the decision. The age of the child
is not a relevant factor in the decision making if the child is under 18 years. The child is too
young to have values and beliefs. The nurse is respectful with the rest of the family but should
consider the parents' decision only.
B) When confronted with a conflict regarding care, one of the first actions by the nurse is to
consider the values and beliefs of the parents who are making the decision. The age of the child
is not a relevant factor in the decision making if the child is under 18 years. The child is too
young to have values and beliefs. The nurse is respectful with the rest of the family but should
consider the parents' decision only.
C) When confronted with a conflict regarding care, one of the first actions by the nurse is to
consider the values and beliefs of the parents who are making the decision. The age of the child
is not a relevant factor in the decision making if the child is under 18 years. The child is too
young to have values and beliefs. The nurse is respectful with the rest of the family but should
consider the parents' decision only.
D) When confronted with a conflict regarding care, one of the first actions by the nurse is to
consider the values and beliefs of the parents who are making the decision. The age of the child
is not a relevant factor in the decision making if the child is under 18 years. The child is too
young to have values and beliefs. The nurse is respectful with the rest of the family but should
consider the parents' decision only.
Page Ref: 2574
Cognitive Level: Applying
Client Need: Psychosocial Integrity
Nursing Process: Assessment
Learning Outcome: 8. Demonstrate appropriate steps to approaching ethical dilemmas.

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4) A client comes to the clinic and is found to have a sexually transmitted infection (STI). The
client states to the nurse, "Promise you won't tell anyone about my condition." According to the
Health Insurance Portability and Accountability Act (HIPAA) of 1996, what action must the
nurse take?
A) Honor the client's wishes.
B) Respect the client's privacy and confidentiality.
C) Communicate only necessary information.
D) Not disclose any information to anyone.
Answer: C
Explanation:
A) HIPAA includes standards that protect the confidentiality, integrity, and availability of data as
well as standards that define appropriate disclosures of identifiable health information and client
rights protection. Nurses are entrusted with sensitive information, which at times must be
revealed to other healthcare personnel in order to provide appropriate health care. In this case,
the nurse may be required to report information to the state health department. Clients must be
able to trust that their information is secure and will only be shared with appropriate entities.
Nurses should not make promises to keep necessary information private.
B) HIPAA includes standards that protect the confidentiality, integrity, and availability of data as
well as standards that define appropriate disclosures of identifiable health information and client
rights protection. Nurses are entrusted with sensitive information, which at times must be
revealed to other healthcare personnel in order to provide appropriate health care. In this case,
the nurse may be required to report information to the state health department. Clients must be
able to trust that their information is secure and will only be shared with appropriate entities.
Nurses should not make promises to keep necessary information private.
C) HIPAA includes standards that protect the confidentiality, integrity, and availability of data as
well as standards that define appropriate disclosures of identifiable health information and client
rights protection. Nurses are entrusted with sensitive information, which at times must be
revealed to other healthcare personnel in order to provide appropriate health care. In this case,
the nurse may be required to report information to the state health department. Clients must be
able to trust that their information is secure and will only be shared with appropriate entities.
Nurses should not make promises to keep necessary information private.
D) HIPAA includes standards that protect the confidentiality, integrity, and availability of data as
well as standards that define appropriate disclosures of identifiable health information and client
rights protection. Nurses are entrusted with sensitive information, which at times must be
revealed to other healthcare personnel in order to provide appropriate health care. In this case,
the nurse may be required to report information to the state health department. Clients must be
able to trust that their information is secure and will only be shared with appropriate entities.
Nurses should not make promises to keep necessary information private.
Page Ref: 2577
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Implementation
Learning Outcome: 9. Analyze ethical principles used to make decisions in providing individual
client care.

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5) The nurse is caring for a client who has chosen to discontinue hemodialysis. The client's
family, however, is not supportive of the decision. The nurse who uses the theory of principles-
based reasoning would make which statement regarding the current situation?
A) "The client understands the decision and the advanced stage of the disease. If the client quits
treatment, the client will die."
B) "I need to try to help the family understand the client's decision so they can work through this
situation together."
C) "This client is of sound mind and is capable of making independent decisions regarding health
care. It really is the client's decision to make."
D) "This client's health is so deteriorated that the treatment is not saving the client's life. It is
prolonging the ultimate outcome, which is death."
Answer: C
Explanation:
A) Principles-based theories stress individual rights, such as autonomy. The client has the ability
to make the decision, and it is his right to autonomy to do that. Trying to help the family
understand the client's decision is an example of a caring-based theory in practice. Caring
theories, or relationship theories, stress courage, generosity, commitment, and the need to nurture
and maintain relationships. Caring theories promote the common good or the welfare of the
group. Considering the client's condition and the outcome of treatment is an example of
consequence-based reasoning, in which the nurse looks at the outcomes of the client's decision.
The client's understanding of his decision and its consequences does not address the client's right
to make a decision autonomously.
B) Principles-based theories stress individual rights, such as autonomy. The client has the ability
to make the decision, and it is his right to autonomy to do that. Trying to help the family
understand the client's decision is an example of a caring-based theory in practice. Caring
theories, or relationship theories, stress courage, generosity, commitment, and the need to nurture
and maintain relationships. Caring theories promote the common good or the welfare of the
group. Considering the client's condition and the outcome of treatment is an example of
consequence-based reasoning, in which the nurse looks at the outcomes of the client's decision.
The client's understanding of his decision and its consequences does not address the client's right
to make a decision autonomously.
C) Principles-based theories stress individual rights, such as autonomy. The client has the ability
to make the decision, and it is his right to autonomy to do that. Trying to help the family
understand the client's decision is an example of a caring-based theory in practice. Caring
theories, or relationship theories, stress courage, generosity, commitment, and the need to nurture
and maintain relationships. Caring theories promote the common good or the welfare of the
group. Considering the client's condition and the outcome of treatment is an example of
consequence-based reasoning, in which the nurse looks at the outcomes of the client's decision.
The client's understanding of his decision and its consequences does not address the client's right
to make a decision autonomously.

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D) Principles-based theories stress individual rights, such as autonomy. The client has the ability
to make the decision, and it is his right to autonomy to do that. Trying to help the family
understand the client's decision is an example of a caring-based theory in practice. Caring
theories, or relationship theories, stress courage, generosity, commitment, and the need to nurture
and maintain relationships. Caring theories promote the common good or the welfare of the
group. Considering the client's condition and the outcome of treatment is an example of
consequence-based reasoning, in which the nurse looks at the outcomes of the client's decision.
The client's understanding of his decision and its consequences does not address the client's right
to make a decision autonomously.
Page Ref: 2571
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Implementation
Learning Outcome: 6. Apply a model to processing an ethical dilemma.

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Copyright © 2015 Pearson Education, Inc.
6) The nurse is caring for an older adult client who will undergo surgery in the morning. While
assessing the client, the nurse discovers that the client does not have an adequate understanding
of the procedure. The nurse discusses the situation with the charge nurse to determine the best
course. The nurses come to the decision that action needs to be taken because of which of the
following?
A) The client is very old and has multiple health problems.
B) The family needs to agree to surgery.
C) The nurse witnessed the consent.
D) The client has a right to informed consent.
Answer: D
Explanation:
A) Sometimes older adults forget and get confused. However, the nurse should notify the
surgeon because the client has the right to informed consent. The client's age is not the reason for
the nurse taking action. The family does not make the decision regarding surgery unless the
client has been declared incompetent by the court. The nurse would want to have the surgery
explained for the client's sake, not because the nurse signed the form.
B) Sometimes older adults forget and get confused. However, the nurse should notify the
surgeon because the client has the right to informed consent. The client's age is not the reason for
the nurse taking action. The family does not make the decision regarding surgery unless the
client has been declared incompetent by the court. The nurse would want to have the surgery
explained for the client's sake, not because the nurse signed the form.
C) Sometimes older adults forget and get confused. However, the nurse should notify the
surgeon because the client has the right to informed consent. The client's age is not the reason for
the nurse taking action. The family does not make the decision regarding surgery unless the
client has been declared incompetent by the court. The nurse would want to have the surgery
explained for the client's sake, not because the nurse signed the form.
D) Sometimes older adults forget and get confused. However, the nurse should notify the
surgeon because the client has the right to informed consent. The client's age is not the reason for
the nurse taking action. The family does not make the decision regarding surgery unless the
client has been declared incompetent by the court. The nurse would want to have the surgery
explained for the client's sake, not because the nurse signed the form.
Page Ref: 2578
Cognitive Level: Applying
Client Need: Physiological Integrity
Nursing Process: Assessment
Learning Outcome: 7. Apply ethical principles in situations involving ethical dilemmas.

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Copyright © 2015 Pearson Education, Inc.
7) The nurse is caring for a client on a medical-surgical unit. The client complains to the nurse
that the physician has refused to treat the client further if the client continues to be noncompliant
with the physician's recommendations. Which is the priority nursing action for the nurse?
A) Take the issue to the hospital ethics committee.
B) Advise the client to sue the physician.
C) Have the client contact a consumer agency.
D) Notify the physician of the client's complaints.
Answer: A
Explanation:
A) Acting as a client advocate and protecting the client's rights, the nurse should enlist the help
of the hospital ethics committee. The nurse never advises a client to sue but assists the client to
find help resolving the issue. A consumer agency is not appropriate because this is an ethical
matter. The nurse should act on behalf of the client, and the best way to do that is by taking the
issue to the hospital ethics committee, not to the physician.
B) Acting as a client advocate and protecting the client's rights, the nurse should enlist the help
of the hospital ethics committee. The nurse never advises a client to sue but assists the client to
find help resolving the issue. A consumer agency is not appropriate because this is an ethical
matter. The nurse should act on behalf of the client, and the best way to do that is by taking the
issue to the hospital ethics committee, not to the physician.
C) Acting as a client advocate and protecting the client's rights, the nurse should enlist the help
of the hospital ethics committee. The nurse never advises a client to sue but assists the client to
find help resolving the issue. A consumer agency is not appropriate because this is an ethical
matter. The nurse should act on behalf of the client, and the best way to do that is by taking the
issue to the hospital ethics committee, not to the physician.
D) Acting as a client advocate and protecting the client's rights, the nurse should enlist the help
of the hospital ethics committee. The nurse never advises a client to sue but assists the client to
find help resolving the issue. A consumer agency is not appropriate because this is an ethical
matter. The nurse should act on behalf of the client, and the best way to do that is by taking the
issue to the hospital ethics committee, not to the physician.
Page Ref: 2580
Cognitive Level: Applying
Client Need: Psychosocial Integrity
Nursing Process: Implementation
Learning Outcome: 8. Demonstrate appropriate steps to approaching ethical dilemmas.

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8) When faced with ethical dilemmas, what are some of the elements of risk management that
can assist nurses in decision making?
Select all that apply.
A) Education
B) Peer support and consultation
C) Resource accumulation
D) Righteousness
E) Financial support
Answer: A, B, C
Explanation:
A) In addition to the ANA code of conduct in ethical situations, education and didactic training
represent another source for developing primary risk-management skills. A practitioner's
professional network, consisting of peers, supervisors, and colleagues, can be a significant
resource for primary prevention of ethical challenges. Resource accumulation involves acquiring
the requisite resources and skills prior to the occurrence of a dilemma. Righteousness and
financial support are not elements of risk management.
B) In addition to the ANA code of conduct in ethical situations, education and didactic training
represent another source for developing primary risk-management skills. A practitioner's
professional network, consisting of peers, supervisors, and colleagues, can be a significant
resource for primary prevention of ethical challenges. Resource accumulation involves acquiring
the requisite resources and skills prior to the occurrence of a dilemma. Righteousness and
financial support are not elements of risk management.
C) In addition to the ANA code of conduct in ethical situations, education and didactic training
represent another source for developing primary risk-management skills. A practitioner's
professional network, consisting of peers, supervisors, and colleagues, can be a significant
resource for primary prevention of ethical challenges. Resource accumulation involves acquiring
the requisite resources and skills prior to the occurrence of a dilemma. Righteousness and
financial support are not elements of risk management.
D) In addition to the ANA code of conduct in ethical situations, education and didactic training
represent another source for developing primary risk-management skills. A practitioner's
professional network, consisting of peers, supervisors, and colleagues, can be a significant
resource for primary prevention of ethical challenges. Resource accumulation involves acquiring
the requisite resources and skills prior to the occurrence of a dilemma. Righteousness and
financial support are not elements of risk management.
E) In addition to the ANA code of conduct in ethical situations, education and didactic training
represent another source for developing primary risk-management skills. A practitioner's
professional network, consisting of peers, supervisors, and colleagues, can be a significant
resource for primary prevention of ethical challenges. Resource accumulation involves acquiring
the requisite resources and skills prior to the occurrence of a dilemma. Righteousness and
financial support are not elements of risk management.
Page Ref: 2578
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Planning
Learning Outcome: 1. Propose solutions to ethical dilemmas based on an individual's problem
and ethical principles.

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9) Staff at the hospital have decided to strike in order to try to improve working conditions. What
are some of the ethical issues that a nurse working in the hospital will have to consider when
deciding whether or not to honor the picket line?
Select all that apply.
A) The need to support coworkers in their efforts to improve working conditions
B) The need to ensure that clients receive care and are not abandoned
C) The desire to take some time off
D) Loyalty to the nurse's employer
E) The need for higher pay
Answer: A, B, D
Explanation:
A) Strikers may be concerned about patient care as it is related to adequate staffing. Strikes may
adversely affect patient care and outcomes. Nurses may feel allegiance to a hospital where they
have worked for years. The desire to take time off and the need for higher pay are not ethical
issues.
B) Strikers may be concerned about patient care as it is related to adequate staffing. Strikes may
adversely affect patient care and outcomes. Nurses may feel allegiance to a hospital where they
have worked for years. The desire to take time off and the need for higher pay are not ethical
issues.
C) Strikers may be concerned about patient care as it is related to adequate staffing. Strikes may
adversely affect patient care and outcomes. Nurses may feel allegiance to a hospital where they
have worked for years. The desire to take time off and the need for higher pay are not ethical
issues.
D) Strikers may be concerned about patient care as it is related to adequate staffing. Strikes may
adversely affect patient care and outcomes. Nurses may feel allegiance to a hospital where they
have worked for years. The desire to take time off and the need for higher pay are not ethical
issues.
E) Strikers may be concerned about patient care as it is related to adequate staffing. Strikes may
adversely affect patient care and outcomes. Nurses may feel allegiance to a hospital where they
have worked for years. The desire to take time off and the need for higher pay are not ethical
issues.
Page Ref: 2572
Cognitive Level: Analyzing
Client Need: Safe and Effective Care Environment
Nursing Process: Implementation
Learning Outcome: 2. Analyze conflicts among nursing loyalties and obligations to clients,
families, and the multidisciplinary team and outside organizations.

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Copyright © 2015 Pearson Education, Inc.
10) A pregnant client with a history of drug use refuses testing for HIV, despite the
recommendation of her nurse-midwife. What is the best response by the nurse?
Select all that apply.
A) Refuse to treat the client.
B) Do the testing anyway.
C) Re-emphasize the importance of HIV testing.
D) Offer counseling.
E) Throughout the pregnancy, encourage the client to reconsider the decision not to be tested.
Answer: C, D, E
Explanation:
A) HIV testing is not mandatory for obtaining care and the refusal to be tested is legal. However,
a mother-to-be who knows her HIV status will have more time to decide on effective ways to
protect her health and prevent mother-to-child transmission of HIV and to take steps to prevent
passing HIV to her partner. Suggesting counseling and consistently encouraging testing are
recommended.
B) HIV testing is not mandatory for obtaining care and the refusal to be tested is legal. However,
a mother-to-be who knows her HIV status will have more time to decide on effective ways to
protect her health and prevent mother-to-child transmission of HIV and to take steps to prevent
passing HIV to her partner. Suggesting counseling and consistently encouraging testing are
recommended.
C) HIV testing is not mandatory for obtaining care and the refusal to be tested is legal. However,
a mother-to-be who knows her HIV status will have more time to decide on effective ways to
protect her health and prevent mother-to-child transmission of HIV and to take steps to prevent
passing HIV to her partner. Suggesting counseling and consistently encouraging testing are
recommended.
D) HIV testing is not mandatory for obtaining care and the refusal to be tested is legal. However,
a mother-to-be who knows her HIV status will have more time to decide on effective ways to
protect her health and prevent mother-to-child transmission of HIV and to take steps to prevent
passing HIV to her partner. Suggesting counseling and consistently encouraging testing are
recommended.
E) HIV testing is not mandatory for obtaining care and the refusal to be tested is legal. However,
a mother-to-be who knows her HIV status will have more time to decide on effective ways to
protect her health and prevent mother-to-child transmission of HIV and to take steps to prevent
passing HIV to her partner. Suggesting counseling and consistently encouraging testing are
recommended.
Page Ref: 2572
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Nursing Process: Planning
Learning Outcome: 3. Critique the bioethical dilemmas that may arise during the care of clients
and families.

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11) A hospice nurse is working with a client who has ovarian cancer. The client is concerned that
her two daughters are at hereditary risk for cancer and asks for the nurse's help. What might the
nurse do?
Select all that apply.
A) Provide the family with information on hereditary cancer risks.
B) Assure the client that ovarian cancer is not hereditary.
C) Offer to refer the daughters to a genetic counselor.
D) Arrange for the client to have genetic testing.
E) Tell the client that her additional worrying is too stressful.
Answer: A, C, D
Explanation:
A) A nurse's role as educator is crucial to ethical practice. Inaccurate reassurance or avoidance
does not respect client rights. Providing appropriate alternatives and options for the client and the
family are correct responses to the client's concerns.
B) A nurse's role as educator is crucial to ethical practice. Inaccurate reassurance or avoidance
does not respect client rights. Providing appropriate alternatives and options for the client and the
family are correct responses to the client's concerns.
C) A nurse's role as educator is crucial to ethical practice. Inaccurate reassurance or avoidance
does not respect client rights. Providing appropriate alternatives and options for the client and the
family are correct responses to the client's concerns.
D) A nurse's role as educator is crucial to ethical practice. Inaccurate reassurance or avoidance
does not respect client rights. Providing appropriate alternatives and options for the client and the
family are correct responses to the client's concerns.
E) A nurse's role as educator is crucial to ethical practice. Inaccurate reassurance or avoidance
does not respect client rights. Providing appropriate alternatives and options for the client and the
family are correct responses to the client's concerns.
Page Ref: 2572
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk Potential
Nursing Process: Assessment
Learning Outcome: 4. Explore the nurse's role in supporting clients' rights to information and
counseling in making genetic testing decisions.

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Copyright © 2015 Pearson Education, Inc.
12) What are some reasons the nurse might withhold food and fluids from a client?
Select all that apply.
A) A competent and informed client refuses them.
B) A son decides that it is his father's time to die.
C) It is determined to be more harmful to administer them than to withhold them.
D) A schizophrenic client believes that they are being poisoned.
E) The nurse thinks that the client is in too much pain.
Answer: A, C
Explanation:
A) The autonomy of a competent and informed client must be respected. Family members cannot
overrule client choices. Forcing an individual with terminal illness to eat, or starting artificial
nutrition, will often make the client feel bloated, nauseated, and/or develop diarrhea. Clients
must be capable of making informed choices. The nurse's opinion about the client's pain status is
not a justification for withholding nourishment.
B) The autonomy of a competent and informed client must be respected. Family members cannot
overrule client choices. Forcing an individual with terminal illness to eat, or starting artificial
nutrition, will often make the client feel bloated, nauseated, and/or develop diarrhea. Clients
must be capable of making informed choices. The nurse's opinion about the client's pain status is
not a justification for withholding nourishment.
C) The autonomy of a competent and informed client must be respected. Family members cannot
overrule client choices. Forcing an individual with terminal illness to eat, or starting artificial
nutrition, will often make the client feel bloated, nauseated, and/or develop diarrhea. Clients
must be capable of making informed choices. The nurse's opinion about the client's pain status is
not a justification for withholding nourishment.
D) The autonomy of a competent and informed client must be respected. Family members cannot
overrule client choices. Forcing an individual with terminal illness to eat, or starting artificial
nutrition, will often make the client feel bloated, nauseated, and/or develop diarrhea. Clients
must be capable of making informed choices. The nurse's opinion about the client's pain status is
not a justification for withholding nourishment.
E) The autonomy of a competent and informed client must be respected. Family members cannot
overrule client choices. Forcing an individual with terminal illness to eat, or starting artificial
nutrition, will often make the client feel bloated, nauseated, and/or develop diarrhea. Clients
must be capable of making informed choices. The nurse's opinion about the client's pain status is
not a justification for withholding nourishment.
Page Ref: 2575
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Nursing Process: Implementation
Learning Outcome: 5. Analyze the challenges and dilemmas clients and their families face when
managing end-of-life care choices, advance directives, euthanasia, and the withdrawal of life
support.

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Copyright © 2015 Pearson Education, Inc.
13) A client with AIDS is admitted to the acute care floor. The nurse knows that according to a
1994 ANA position statement, nursing addresses this bioethical issue with which stance?
A) The nurse is morally obligated to care for the client unless the risk exceeds responsibility.
B) The nurse has the responsibility to ensure the client gets adequate medical care.
C) The client has the right to choose not to disclose his or her condition to staff.
D) The client is morally bound to disclose every aspect of his or her condition to staff.
Answer: A
Explanation:
A) AIDS continues to bear a social stigma in our society because of its association with illicit
drug use and sexual behavior. According to a 1994 ANA position statement, the nurse cannot set
aside the moral obligation to care for the client infected with HIV unless the risk exceeds the
responsibility.
B) AIDS continues to bear a social stigma in our society because of its association with illicit
drug use and sexual behavior. According to a 1994 ANA position statement, the nurse cannot set
aside the moral obligation to care for the client infected with HIV unless the risk exceeds the
responsibility.
C) AIDS continues to bear a social stigma in our society because of its association with illicit
drug use and sexual behavior. According to a 1994 ANA position statement, the nurse cannot set
aside the moral obligation to care for the client infected with HIV unless the risk exceeds the
responsibility.
D) AIDS continues to bear a social stigma in our society because of its association with illicit
drug use and sexual behavior. According to a 1994 ANA position statement, the nurse cannot set
aside the moral obligation to care for the client infected with HIV unless the risk exceeds the
responsibility.
Page Ref: 2572
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Implementation
Learning Outcome: 3. Critique the bioethical dilemmas that may arise during the care of clients
and families.

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14) The nurse on the transplant organ team encounters new ethical dilemmas with the advent of
social and technological changes. Which dilemmas might the transplant team encounter today?
Select all that apply.
A) Cloning
B) Genetic alteration of disease
C) Determining who "deserves" treatment
D) Physician loyalty to insurance companies
E) Staffing issues
Answer: A, B, C
Explanation:
A) Advances in the ability to decode and control the growth of tissues through gene
manipulation present new potential ethical dilemmas related to cloning organisms and altering
the course of hereditary diseases and biological characteristics. Today, with treatments that can
prolong and enhance biologic life, these questions arise: Should we do what we know we can?
Who should be treated–everyone, only those who can pay, only those who have a chance to
improve? Who decides who receives treatment?
B) Advances in the ability to decode and control the growth of tissues through gene manipulation
present new potential ethical dilemmas related to cloning organisms and altering the course of
hereditary diseases and biological characteristics. Today, with treatments that can prolong and
enhance biologic life, these questions arise: Should we do what we know we can? Who should
be treated–everyone, only those who can pay, only those who have a chance to improve? Who
decides who receives treatment?
C) Advances in the ability to decode and control the growth of tissues through gene manipulation
present new potential ethical dilemmas related to cloning organisms and altering the course of
hereditary diseases and biological characteristics. Today, with treatments that can prolong and
enhance biologic life, these questions arise: Should we do what we know we can? Who should
be treated–everyone, only those who can pay, only those who have a chance to improve? Who
decides who receives treatment?
D) Advances in the ability to decode and control the growth of tissues through gene
manipulation present new potential ethical dilemmas related to cloning organisms and altering
the course of hereditary diseases and biological characteristics. Today, with treatments that can
prolong and enhance biologic life, these questions arise: Should we do what we know we can?
Who should be treated–everyone, only those who can pay, only those who have a chance to
improve? Who decides who receives treatment?
E) Advances in the ability to decode and control the growth of tissues through gene manipulation
present new potential ethical dilemmas related to cloning organisms and altering the course of
hereditary diseases and biological characteristics. Today, with treatments that can prolong and
enhance biologic life, these questions arise: Should we do what we know we can? Who should
be treated–everyone, only those who can pay, only those who have a chance to improve? Who
decides who receives treatment?
Page Ref: 2572
Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Nursing Process: Assessment
Learning Outcome: 2. Analyze conflicts among nursing loyalties and obligations to clients,
families, and the multidisciplinary team and outside organizations.

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Copyright © 2015 Pearson Education, Inc.
15) A 17-year old client diagnosed with leukemia decides she wants to stop treatments. The
parents of the teenager, however, want the healthcare team to continue all treatments as
necessary. The nurse knows that which measure is necessary in providing appropriate care for
this client?
A) Helping the family by providing information and allowing them to voice concerns
B) Confronting the parents and telling them not to be "selfish" in their child's time of need
C) Calling the authorities immediately
D) Obtaining a court order to determine the child legally able to make his or her own decisions
Answer: A
Explanation:
A) Parents have the authority to make healthcare decisions for their children. Dilemmas arise
when parents and children do not agree on whether or not to go forward with a recommended
treatment. In most cases, the nurse and other members of the healthcare team who have
developed a therapeutic alliance with the child and family may be able to help the family come
to a joint decision by providing additional information and opportunity to discuss their concerns
with each other calmly and openly. In some cases, however, the healthcare team may need to
seek guidance from the agency's ethics committee.
B) Parents have the authority to make healthcare decisions for their children. Dilemmas arise
when parents and children do not agree on whether or not to go forward with a recommended
treatment. In most cases, the nurse and other members of the healthcare team who have
developed a therapeutic alliance with the child and family may be able to help the family come
to a joint decision by providing additional information and opportunity to discuss their concerns
with each other calmly and openly. In some cases, however, the healthcare team may need to
seek guidance from the agency's ethics committee.
C) Parents have the authority to make healthcare decisions for their children. Dilemmas arise
when parents and children do not agree on whether or not to go forward with a recommended
treatment. In most cases, the nurse and other members of the healthcare team who have
developed a therapeutic alliance with the child and family may be able to help the family come
to a joint decision by providing additional information and opportunity to discuss their concerns
with each other calmly and openly. In some cases, however, the healthcare team may need to
seek guidance from the agency's ethics committee.
D) Parents have the authority to make healthcare decisions for their children. Dilemmas arise
when parents and children do not agree on whether or not to go forward with a recommended
treatment. In most cases, the nurse and other members of the healthcare team who have
developed a therapeutic alliance with the child and family may be able to help the family come
to a joint decision by providing additional information and opportunity to discuss their concerns
with each other calmly and openly. In some cases, however, the healthcare team may need to
seek guidance from the agency's ethics committee.
Page Ref: 2572
Cognitive Level: Applying
Client Need: Psychosocial Integrity
Nursing Process: Implementation
Learning Outcome: 5. Analyze the challenges and dilemmas clients and their families face when
managing end-of-life care choices, advance directives, euthanasia, and the withdrawal of life
support.

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Copyright © 2015 Pearson Education, Inc.
Exemplar 44.2 Patient Rights

1) What are some of the rights clients have in the healthcare system?
Select all that apply.
A) A client has the right to be given information only in English.
B) Clients have the right to refuse care.
C) Clients have the right to know when something goes wrong with their care.
D) Clients have the right to have a personal representative (advocate) with them during their
care.
E) Clients have the right to know the titles, but not necessarily the names, of their caregivers.
F) Clients have the right to be seen within 15 minutes of their scheduled time.
Answer: B, C, D
Explanation:
A) Clients have the right to get important information about their care in their preferred
language. Clients may reject as well as accept care. Clients should be informed of problems with
their care. An advocate can be a family member or friend of the client's choice. Clients have the
right to know the names of the caregivers who treat them. Although keeping appointments on
time is important, it is not a right.
B) Clients have the right to get important information about their care in their preferred
language. Clients may reject as well as accept care. Clients should be informed of problems with
their care. An advocate can be a family member or friend of the client's choice. Clients have the
right to know the names of the caregivers who treat them. Although keeping appointments on
time is important, it is not a right.
C) Clients have the right to get important information about their care in their preferred
language. Clients may reject as well as accept care. Clients should be informed of problems with
their care. An advocate can be a family member or friend of the client's choice. Clients have the
right to know the names of the caregivers who treat them. Although keeping appointments on
time is important, it is not a right.
D) Clients have the right to get important information about their care in their preferred
language. Clients may reject as well as accept care. Clients should be informed of problems with
their care. An advocate can be a family member or friend of the client's choice. Clients have the
right to know the names of the caregivers who treat them. Although keeping appointments on
time is important, it is not a right.
E) Clients have the right to get important information about their care in their preferred language.
Clients may reject as well as accept care. Clients should be informed of problems with their care.
An advocate can be a family member or friend of the client's choice. Clients have the right to
know the names of the caregivers who treat them. Although keeping appointments on time is
important, it is not a right.

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F) Clients have the right to get important information about their care in their preferred language.
Clients may reject as well as accept care. Clients should be informed of problems with their care.
An advocate can be a family member or friend of the client's choice. Clients have the right to
know the names of the caregivers who treat them. Although keeping appointments on time is
important, it is not a right.
Page Ref: 2579
Cognitive Level: Analyzing
Client Need: Safe and Effective Care Environment
Nursing Process: Caring
Learning Outcome: 1. Examine the rights of clients in the healthcare system.

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2) A nurse providing hospice care for an 83-year-old man is approached by the man's daughter.
She believes that her mother, who is in a nursing home, is being neglected. What suggestion(s)
can the nurse offer?
Select all that apply.
A) Contact the client advocate at the nursing facility.
B) Contact the local newspaper.
C) Encourage the daughter to immediately place her mother in a different facility.
D) Contact the consumer protection agency.
E) Report suspicions to the licensing agency.
Answer: A, E
Explanation:
A) Many large agencies have client advocates who can help ensure that client rights are
maintained. It is important to consider institutionalized remedies before taking extraordinary
action. Transferring clients in long-term facilities is often very difficult. The consumer protection
agency is not usually involved in nursing home issues. Nursing homes, homes for the aged, and
licensed facilities for the disabled are regulated at the state level, and violations committed by
these agencies may be reported for investigation.
B) Many large agencies have client advocates who can help ensure that client rights are
maintained. It is important to consider institutionalized remedies before taking extraordinary
action. Transferring clients in long-term facilities is often very difficult. The consumer protection
agency is not usually involved in nursing home issues. Nursing homes, homes for the aged, and
licensed facilities for the disabled are regulated at the state level, and violations committed by
these agencies may be reported for investigation.
C) Many large agencies have client advocates who can help ensure that client rights are
maintained. It is important to consider institutionalized remedies before taking extraordinary
action. Transferring clients in long-term facilities is often very difficult. The consumer protection
agency is not usually involved in nursing home issues. Nursing homes, homes for the aged, and
licensed facilities for the disabled are regulated at the state level, and violations committed by
these agencies may be reported for investigation.
D) Many large agencies have client advocates who can help ensure that client rights are
maintained. It is important to consider institutionalized remedies before taking extraordinary
action. Transferring clients in long-term facilities is often very difficult. The consumer protection
agency is not usually involved in nursing home issues. Nursing homes, homes for the aged, and
licensed facilities for the disabled are regulated at the state level, and violations committed by
these agencies may be reported for investigation.
E) Many large agencies have client advocates who can help ensure that client rights are
maintained. It is important to consider institutionalized remedies before taking extraordinary
action. Transferring clients in long-term facilities is often very difficult. The consumer protection
agency is not usually involved in nursing home issues. Nursing homes, homes for the aged, and
licensed facilities for the disabled are regulated at the state level, and violations committed by
these agencies may be reported for investigation.
Page Ref: 2579
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Caring
Learning Outcome: 2. Analyze support systems that exist for clients who feel that their rights
have been violated by a healthcare agency or provider.
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Copyright © 2015 Pearson Education, Inc.
3) A nurse educator is explaining the idea of health care as a partnership. What are client
responsibilities that some hospitals have included in their client bill of rights?
Select all that apply.
A) Involving your family in your healthcare decisions
B) Reporting accurate and complete information about your health to your healthcare team
C) Asking questions asked by your healthcare team
D) Immediately paying all expenses not covered by insurance
E) Accepting the consequences if you fail to comply with instructions given to you
F) Paying for missed appointments
Answer: B, C, E
Explanation:
A) It is not essential for clients to involve their family members in healthcare decisions. Clients
have the responsibility to provide complete and accurate information about their symptoms,
history, and status to their healthcare team. Accepting financial responsibility for treatment does
not require immediate payment. Clients must understand that noncompliance with treatment
recommendations may result in poor outcomes. Clients are not usually financially responsible for
missed appointments.
B) It is not essential for clients to involve their family members in healthcare decisions. Clients
have the responsibility to provide complete and accurate information about their symptoms,
history, and status to their healthcare team. Accepting financial responsibility for treatment does
not require immediate payment. Clients must understand that noncompliance with treatment
recommendations may result in poor outcomes. Clients are not usually financially responsible for
missed appointments.
C) It is not essential for clients to involve their family members in healthcare decisions. Clients
have the responsibility to provide complete and accurate information about their symptoms,
history, and status to their healthcare team. Accepting financial responsibility for treatment does
not require immediate payment. Clients must understand that noncompliance with treatment
recommendations may result in poor outcomes. Clients are not usually financially responsible for
missed appointments.
D) It is not essential for clients to involve their family members in healthcare decisions. Clients
have the responsibility to provide complete and accurate information about their symptoms,
history, and status to their healthcare team. Accepting financial responsibility for treatment does
not require immediate payment. Clients must understand that noncompliance with treatment
recommendations may result in poor outcomes. Clients are not usually financially responsible for
missed appointments.
E) It is not essential for clients to involve their family members in healthcare decisions. Clients
have the responsibility to provide complete and accurate information about their symptoms,
history, and status to their healthcare team. Accepting financial responsibility for treatment does
not require immediate payment. Clients must understand that noncompliance with treatment
recommendations may result in poor outcomes. Clients are not usually financially responsible for
missed appointments.

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Copyright © 2015 Pearson Education, Inc.
F) It is not essential for clients to involve their family members in healthcare decisions. Clients
have the responsibility to provide complete and accurate information about their symptoms,
history, and status to their healthcare team. Accepting financial responsibility for treatment does
not require immediate payment. Clients must understand that noncompliance with treatment
recommendations may result in poor outcomes. Clients are not usually financially responsible for
missed appointments.
Page Ref: 2579
Cognitive Level: Analyzing
Client Need: Safe and Effective Care Environment
Client Need Sub: Management of Care
Nursing Process: Communication and Documentation
Learning Outcome: 3. Compare the contents of different documents or laws that address patient
rights.

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4) A client tells his nurse, "I really don't like the nurse on first shift; she treats me bad." Which
action should the nurse take as an advocate for this client?
A) Call the agency client advocacy department.
B) Confront the nurse when she comes to work.
C) Tell the client he has the right to switch nurses.
D) Call the local authorities.
Answer: A
Explanation:
A) Individual clients who feel their rights have been violated or are endangered have a number of
options. Many hospitals and large provider agencies have client advocates who can help clients
navigate the system and intervene to ensure that their rights are maintained. Many states have an
office designated by the governor or secretary of health to assist clients with issues related to
patient rights in long-term care. The state's department of health may also be able to help.
B) Individual clients who feel their rights have been violated or are endangered have a number of
options. Many hospitals and large provider agencies have client advocates who can help clients
navigate the system and intervene to ensure that their rights are maintained. Many states have an
office designated by the governor or secretary of health to assist clients with issues related to
patient rights in long-term care. The state's department of health may also be able to help.
C) Individual clients who feel their rights have been violated or are endangered have a number of
options. Many hospitals and large provider agencies have client advocates who can help clients
navigate the system and intervene to ensure that their rights are maintained. Many states have an
office designated by the governor or secretary of health to assist clients with issues related to
patient rights in long-term care. The state's department of health may also be able to help.
D) Individual clients who feel their rights have been violated or are endangered have a number of
options. Many hospitals and large provider agencies have client advocates who can help clients
navigate the system and intervene to ensure that their rights are maintained. Many states have an
office designated by the governor or secretary of health to assist clients with issues related to
patient rights in long-term care. The state's department of health may also be able to help.
Page Ref: 2579
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Implementation
Learning Outcome: 2. Analyze support systems that exist for clients who feel that their rights
have been violated by a healthcare agency or provider.

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5) The nurse performing an admission assessment on a client must inform the client of his patient
rights. Which patient rights are considered standard by various healthcare agencies?
Select all that apply.
A) You have a right to be informed about the care you receive.
B) You have the right to refuse care.
C) You have the right to be treated with courtesy and respect.
D) You have the right to know the names of your caregivers.
E) You have the right to have a personal advocate of your choice.
Answer: A, B, C, D, E
Explanation:
A) The importance of patient rights is evident in the American Nurses Association's Standards of
Practice and Code of Ethics as well as in the standards set for accreditation of various types of
healthcare agencies by the Joint Commission. The Joint Commission's Speak Up program is
dedicated to patient rights and begins as follows: You have the right to: be informed about the
care you will receive; get important information about your care in your preferred language; get
information in a manner that meets your needs; make decisions about your care; refuse care;
know the names of the caregivers who treat you; safe care; have your pain addressed; care that is
free from discrimination; know when something goes wrong with your care; get a list of all your
current medications; be listened to; be treated with courtesy and respect; have a personal
representative of your choice.
B) The importance of patient rights is evident in the American Nurses Association's Standards of
Practice and Code of Ethics as well as in the standards set for accreditation of various types of
healthcare agencies by the Joint Commission. The Joint Commission's Speak Up program is
dedicated to patient rights and begins as follows: You have the right to: be informed about the
care you will receive; get important information about your care in your preferred language; get
information in a manner that meets your needs; make decisions about your care; refuse care;
know the names of the caregivers who treat you; safe care; have your pain addressed; care that is
free from discrimination; know when something goes wrong with your care; get a list of all your
current medications; be listened to; be treated with courtesy and respect; have a personal
representative of your choice.
C) The importance of patient rights is evident in the American Nurses Association's Standards of
Practice and Code of Ethics as well as in the standards set for accreditation of various types of
healthcare agencies by the Joint Commission. The Joint Commission's Speak Up program is
dedicated to patient rights and begins as follows: You have the right to: be informed about the
care you will receive; get important information about your care in your preferred language; get
information in a manner that meets your needs; make decisions about your care; refuse care;
know the names of the caregivers who treat you; safe care; have your pain addressed; care that is
free from discrimination; know when something goes wrong with your care; get a list of all your
current medications; be listened to; be treated with courtesy and respect; have a personal
representative of your choice.

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D) The importance of patient rights is evident in the American Nurses Association's Standards of
Practice and Code of Ethics as well as in the standards set for accreditation of various types of
healthcare agencies by the Joint Commission. The Joint Commission's Speak Up program is
dedicated to patient rights and begins as follows: You have the right to: be informed about the
care you will receive; get important information about your care in your preferred language; get
information in a manner that meets your needs; make decisions about your care; refuse care;
know the names of the caregivers who treat you; safe care; have your pain addressed; care that is
free from discrimination; know when something goes wrong with your care; get a list of all your
current medications; be listened to; be treated with courtesy and respect; have a personal
representative of your choice.
E) The importance of patient rights is evident in the American Nurses Association's Standards of
Practice and Code of Ethics as well as in the standards set for accreditation of various types of
healthcare agencies by the Joint Commission. The Joint Commission's Speak Up program is
dedicated to patient rights and begins as follows: You have the right to: be informed about the
care you will receive; get important information about your care in your preferred language; get
information in a manner that meets your needs; make decisions about your care; refuse care;
know the names of the caregivers who treat you; safe care; have your pain addressed; care that is
free from discrimination; know when something goes wrong with your care; get a list of all your
current medications; be listened to; be treated with courtesy and respect; have a personal
representative of your choice.
Page Ref: 2579
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Implementation
Learning Outcome: 1. Examine the rights of clients in the healthcare system.

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6) The nurse on the mom-baby unit is confronted by a client who states, "I know my rights and
you have to do what I tell you!" Which statement is the best response by the nurse?
A) "I don't mind doing anything within reason, but you have a responsibility to be considerate to
the staff as well."
B) "That statement is not included in your patient rights; don't yell at me."
C) "Why do you feel angry…did I do something you did not like?"
D) "Do you want me to take the baby to the nursery so you can calm down?
Answer: A
Explanation:
A) Most hospitals now publish lists of patient responsibilities, emphasizing that health care is a
partnership between the patient and caregivers, that other patients have a right to be comfortable
too, and that there are consequences if patients don't comply with treatment plans, cooperate with
the healthcare team, or be considerate of the staff and other patients.
B) Most hospitals now publish lists of patient responsibilities, emphasizing that health care is a
partnership between the patient and caregivers, that other patients have a right to be comfortable
too, and that there are consequences if patients don't comply with treatment plans, cooperate with
the healthcare team, or be considerate of the staff and other patients.
C) Most hospitals now publish lists of patient responsibilities, emphasizing that health care is a
partnership between the patient and caregivers, that other patients have a right to be comfortable
too, and that there are consequences if patients don't comply with treatment plans, cooperate with
the healthcare team, or be considerate of the staff and other patients.
D) Most hospitals now publish lists of patient responsibilities, emphasizing that health care is a
partnership between the patient and caregivers, that other patients have a right to be comfortable
too, and that there are consequences if patients don't comply with treatment plans, cooperate with
the healthcare team, or be considerate of the staff and other patients.
Page Ref: 2579
Cognitive Level: Applying
Client Need: Psychosocial Integrity
Nursing Process: Implementation
Learning Outcome: 9. Distinguish illegal, immoral, or unethical activities of professionals.

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