The distribution of nurses to areas of “most need” in the time of a nursing shortage is an example of:

Utilitarianism theory
Deontological theory
Justice
Beneficence

Solution

Justice

Justice is defined as the fairness of distribution of resources. However, guidelines for a hierarchy of needs have been established, such as with organ transplantation. Nurses are moved to areas of greatest need when shortages occur on the floors. No floor is left without staff, and another floor that had five staff will give up two to go help the floor that had no staff.

When the nurse described the client as “that nasty old man in 354,” the nurse is exhibiting which ethical dilemma?

Gender bias and ageism
HIPAA violation
Beneficence
Code of ethics violation

Solution

Gender bias and ageism

Stereotyping an “old man” as “nasty”is a gender bias and an ageism issue. The nurse is verbalizing a negative descriptor about the client.

A bioethical issue should be described as:

The physician’s making all decisions of client management without getting input from the client
A research project that included treating all the white men and not treating all the black men to compare the outcomes of a specific drug therapy.
The withholding of food and treatment at the request of the client in a written advance directive given before a client acquired permanent brain damage from an accident.
After the client gives permission, the physician’s disclosing all information to the family for their support in the management of the client.

Solution

A research project that included treating all the white men and not treating all the black men to compare the outcomes of a specific drug therapy.

The ethical issue was the inequality of treatment based strictly upon racial differences. Secondly, the drug was deliberately withheld even after results showed that the drug was working to cure the disease process in the white men for many years. So after many years, the black men were still not treated despite the outcome of the research process that showed the drug to be effective in controlling the disease early in the beginning of the research project. Therefore harm was done. Nonmaleficence, veracity, and justice were not followed.

Ethical principles for professional nursing practice in a clinical setting are guided by the principles of conduct that are written as the:

American Nurses Association’s (ANA’s) Code of Ethics
Nurse Practice Act (NPA) written by state legislation
Standards of care from experts in the practice field
Good Samaritan laws for civil guidelines

Solution

American Nurses Association’s (ANA’s) Code of Ethics

This set of ethical principles provides the professional guidelines established by the ANA to maintain the highest standards for ideal conduct in practice. As a profession, the ANA wanted to establish rules and then incorporate guidelines for accountability and responsibility of each nurse within the practice setting.

Which activity would not be expected by the nurse to meet the cultural needs of the client?

Promote and support attitudes, behaviors, knowledge, and skills to respectfully meet client’s cultural needs despite the nurse’s own beliefs and practices
Ensure that the interpreter understands not only the language of the client but feelings and attitudes behind cultural practices to make sure an ethical balance can be achieved
Develop structure and process for meeting cultural needs on a regular basis and means to avoid overlooking these needs with clients
Expect the family to keep an interpreter present at all times to assist in meeting the communication needs all day and night while hospitalized

Solution

Expect the family to keep an interpreter present at all times to assist in meeting the communication needs all day and night while hospitalized

It is not the family’s responsibility to assist in the communication process. Many families will leave someone to help at times, but it is the hospital’s legal obligation to find an interpreter for continued understanding by the client to make sure the client is fully informed and comprehends in his or her primary language.

What should the nurse do when planning nursing care for a client with a different cultural background? The nurse should:

Allow the family to provide care during the hospital stay so no rituals or customs are broken
Identify how these cultural variables affect the health problem
Speak slowly and show pictures to make sure the client always understands
Explain how the client must adapt to hospital routines to be effectively cared for while in the hospital

Solution

Identify how these cultural variables affect the health problem

Without assessment and identification of the cultural needs, the nurse cannot begin to understand how these might influence the health problem or health care management.

Transcultural nursing implies:

Using a comparative study of cultures to understand similarities and differences across human groups to provide specific individualized care that is culturally appropriate
Working in another culture to practice nursing within their limitations
Combining all cultural beliefs into a practice that is a non-threatening approach to minimize cultural barriers for all clients’ equality of care
Ignoring all cultural differences to provide the best generalized care to all clients.

Solution

Using a comparative study of cultures to understand similarities and differences across human groups to provide specific individualized care that is culturally appropriate

Transcultural care means that by understanding and learning about specific cultural practices the nurse can integrate these practices into the plan of care for a specific individual client who has the same beliefs or practices to meet the client’s needs in a holistic manner of care.

Which factor is least significant during assessment when gathering information about cultural practices?

Language, timing
Touch, eye contact
Biocultural needs
Pain perception, management expectations

Solution

Biocultural needs

Cultural practices do not influence biocultural needs because they are inborn risks that are related to a biological need and not a learned cultural belief or practice.

Which statement would best explain the role of the nurse when planning care for a culturally diverse population? The nurse will plan care to:

Include care that is culturally congruent with the staff from predetermined criteria
Focus only on the needs of the client, ignoring the nurse’s beliefs and practices
Blend the values of the nurse that are for the good of the client and minimize the client’s individual values and beliefs during care
Provide care while aware of one’s own bias, focusing on the client’s individual needs rather than the staff’s practices

Solution

Provide care while aware of one’s own bias, focusing on the client’s individual needs rather than the staff’s practices

Without understanding one’s own beliefs and values, a bias or preconceived belief by the nurse could create an unexpected conflict or an area of neglect in the plan of care for a client (who might be expecting something totally different from the care). During assessment values, beliefs, practices should be identified by the nurse and used as a guide to identify the choices by the nurse to meet specific needs/outcomes of that client. Therefore identification of values, beliefs, and practices allows for planning meaningful and beneficial care specific for this client.

The best explanation of what Title VI of the Civil Rights Act mandates is the freedom to:

Pick any physician and insurance company despite one’s income
Receive free medical benefits as needed within the county of residence
Have equal access to all health care regardless of race and religion
Have basic care with a sliding scale payment plan from all health care facilities

Solution

Have equal access to all health care regardless of race and religion

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