Contemporary Nursing: Issues, Trends, and

Management Cherry 5th Edition Test Bank

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Contemporary Nursing: Issues, Trends, and Management Cherry 5th Edition Test Bank

MULTIPLE CHOICE

1. Ethics applied to nursing can best be defined as

A. doing what is best for the patient.
B. making good decisions about care.
C. care based on what should be done in keeping with the values of the patient.
D. rules for providing competent care that is based on scientific principles.
ANS: C
Choice (C) is correct because nursing ethics is a system of principles intended to
guide the actions of the nurse in his or her relationships with patients, patients’
family members, other health care providers, policy makers, and society as a whole.
A nurse must make an attempt to understand what values are inherent in the
situation. (A), (B), and (D) are not definitions of ethics.

DIF: Knowledge REF: Page 188

2. A family requests that no additional heroic measures be instituted for their terminally
ill mother who has advance directives in place. The nurse respects this decision in
keeping with the principle of
A. accountability.
B. autonomy.
C. nonmaleficence.
D. veracity.
ANS: B
Choice (B) is correct because autonomy is the principle of respect for the individual
person. Within the concept of autonomy, people are free to form their own
judgments and perform whatever actions they choose. They are self-determining
agents who are entitled to decide their own destiny. (A) is incorrect because
accountability is inherent in the nurse’s ethical obligation to uphold the highest
standards of practice and care, assume full personal and professional responsibility
for every action, and commit to maintaining quality in the skill and knowledge base
of the profession. (C) is incorrect because nonmaleficence is a principle that implies
a duty not to inflict harm. In ethical terms, nonmaleficence means to abstain from
injuring others and to help others further their own well-being by removing harm
and eliminating threats. (D) is incorrect because veracity means telling the truth as a
moral and ethical requirement.

DIF: Application REF: Page 196

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 Test Bank 9-2

3. An older adult patient is comatose and had one electroencephalogram that indicated
no activity. The daughter is very distraught and notices her mother’s hand moves
when she is talking to her. The daughter asks the nurse, “Is mother responding to my
voice?” The nurse, attempting to console the daughter, knows the movement was
involuntary but states, “It does appear she did.” The nurse is violating which
principle of ethics?
A. Autonomy
B. Veracity
C. Utilitarianism
D. Deontology
ANS: B
Choice (B) is correct because veracity is the principle of telling the truth in a given
situation. (A) is incorrect because autonomy is the principle of respect for the
individual person; this concept states that humans have incalculable worth or moral
dignity. (C) is incorrect because utilitarianism is an approach that is rooted in the
assumption that an action or practice is right if it leads to the greatest possible
balance of good consequences or to the least possible balance of bad consequences.
Giving the daughter false reassurance is not a good consequence. (D) is incorrect
because deontologic theory claims that a decision is right only if it conforms to an
overriding moral duty and wrong only if it violates that moral duty. Persons are to be
treated as ends in themselves and never as means to the ends of others.

DIF: Application REF: Page 197

4. In attempting to decide which services should be offered to a community, the public

health nurse decides to implement hypertension screening and treatment because
most of the residents are hypertensive. This decision is based on the principle of
A. veracity.
B. values.
C. utilitarianism.
D. autonomy.
ANS: C
Choice (C) is correct because utilitarianism is an approach that is rooted in the
assumption that an action or practice is right if it leads to the greatest possible
balance of good consequences or to the least possible balance of bad consequences.
On the basis of this principle, an attempt is made to determine which actions will
lead to the greatest ratio of benefit to harm for all persons involved in the situation.
(A) is incorrect because veracity is defined as the moral and ethical requirement to
always tell the truth in personal communication. Although the public health nurse
did not lie, she did not use the concept of veracity to decide which health care issue
to address with this group. (B) is incorrect because values account for our moral
decisions and actions. The nurse based the decision on the needs of the group, not on
her personal values. (D) is incorrect because autonomy means respect for people.
The nurse did not base her decision for this group on her respect for them, but on
what the needs of the majority were.

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DIF: Application REF: Page 196

5. A nurse is caring for a patient who just consented to an elective abortion and is
unsure of her own values as they relate to this issue. When attempting to examine his
system of values, the nurse must first
A. know his own values and how these values relate to beliefs and the philosophy
of nursing.
B. get rid of impurities in his value system.
C. ignore his own values.
D. realize that values do not change and that they cannot be influenced by others.
ANS: A
Choice (A) is correct because nurses must make a deliberate effort to recognize their
own values and must learn to consider and respect the values of others. Health care
decisions are seldom made independently of other people. Decisions are made with
the patient, the family, other nurses, and other health care providers. (B) is incorrect
because there is no need to get rid of impurities in the value system; everyone’s
system is unique, and there really are no impurities. (C) is incorrect because the
nurse cannot ignore his own values; these are what shape the nurse’s ethics and
morals. (D) is incorrect because values can change as a person matures and passes
through different life experiences. Values also are often influenced by those around
us, especially authority figures.

DIF: Application REF: Page 192

6. When assessing an ethical issue, the nurse must first

A. ask, “What is the issue?”
B. identify all possible alternatives.
C. select the BEST option from a list of alternatives.
D. justify the choice of action or inaction.
ANS: A
Choice (A) is correct because the first step in the situational assessment procedure is
to find out the technical and scientific facts and assess the human dimension of the
situation—the feelings, emotions, attitudes, and opinions. Trying to understand the
full picture of a situation is time consuming and requires examination from many
different perspectives, but it is worth the time and effort that is required to
understand an issue fully before moving forward in the assessment procedure. (B) is
incorrect because it is the second step in the situation assessment procedure. A set of
alternatives cannot be established until an assessment has been completed. (C) is
incorrect because selecting the best option is actually the third step in the situation
assessment procedure. Options cannot be selected until an assessment has been done
to define the issue. (D) is incorrect because justifying the action or inaction is the
final step in the situational assessment procedure. No justification can be made until
the assessment and action phases have been completed.

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 Test Bank 9-4

DIF: Comprehension REF: Page 197

7. A researcher calculated the risk-to-benefit ratio and concluded that no harmful

effects were associated with a survey of college sophomores. The researcher was
applying the principles of
A. beneficence.
B. human dignity.
C. justice.
D. human rights.
ANS: A
Choice (A) is correct because beneficence is a term that is defined as promoting
goodness, kindness, and charity. In ethical terms, beneficence means to provide
benefit to others by promoting their good. (B) is incorrect because human dignity is
the inherent worth and uniqueness of a person. (C) is incorrect because justice
involves upholding moral and legal principles. (D) is incorrect because human rights
are the basic rights of each individual.

DIF: Application REF: Page 196

8. The physician who insists on providing treatment in spite of the patient’s wishes
because he “knows best” is reflecting
A. autonomy.
B. beneficence.
C. justice.
D. paternalism.
ANS: D
Choice (D) is correct because paternalism is an action and an attitude wherein the
provider tries to act on behalf of the patient and believes that his or her actions are
justified because of a commitment to act in the best interest of the patient.
Paternalism is a reflection of the “father knows best” way of thinking. (A) is
incorrect because autonomy is the principle of respect for the individual person. (B)
is incorrect because beneficence means promoting goodness, kindness, and charity.
(C) is incorrect because justice states that like cases should be treated alike and
equals ought to be treated equally.

DIF: Application REF: Page 202

9. The nurse who admits making a medication error and immediately files an incident
report is demonstrating
A. accountability.
B. individuality.
C. an injustice.
D. values clarification.
ANS: A

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 Test Bank 9-5

Choice (A) is correct because accountability is an ethical duty that states that one
should be answerable legally, morally, ethically, or socially for one’s activities. (B)
is incorrect because individuality is something that distinguishes one person or thing
from others. (C) is incorrect because injustice is when a person is denied a right or
entitlement. (D) is incorrect because values clarification is a tool that allows the
nurse to examine personal values in terms of ethical situations.

DIF: Application REF: Page 203

10. Three illegal immigrants with no health insurance or money sustained life-
threatening injuries during an automobile accident. Two of these individuals had
head trauma and lacerated internal organs. The decision was made to provide
extended care in the trauma center after emergency surgery was performed to save
their lives. The third individual received only minor injuries, which were treated in
the emergency department. The care of the two critical patients was based on the
ethical principle of
A. utilitarianism.
B. deontology.
C. autonomy.
D. veracity.
ANS: B
Choice (B) is correct because deontology is an approach that is rooted in the
assumption that humans are rational and act out of principles that are consistent and
objective and that compel them to do what is right. Deontologic theory claims that a
decision is right only if it conforms to an overriding moral duty and wrong only if it
violates that moral duty. (A) is incorrect because utilitarianism is an approach that is
rooted in the assumption that an action or practice is right if it leads to the greatest
possible balance of good consequences or to the least possible balance of bad
consequences. An attempt is made to determine which actions will lead to the
greatest ratio of benefit to harm for all persons involved in the dilemma. (C) is
incorrect because autonomy is the principle of respect for the individual person.
People are free to form their own judgments and perform whatever actions they
choose. (D) is incorrect because veracity is defined as telling the truth in personal
communication as a moral and ethical requirement.

DIF: Application REF: Page 194

11. A 13-year-old female is brought to the family planning clinic by her enraged father,
who has just learned that she is pregnant. The pregnant patient states, “I want to have
this baby and give it up for adoption”; however, the father is adamant that she will
disgrace the family and demands that the health care providers tell his daughter that
she has a physical condition that would prohibit her from carrying this baby to a
viable stage. The nurse realizes that this is a conflict that involves the ethical
principle of
A. deontology.
B. veracity.

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 Test Bank 9-6

C. autonomy.
D. beneficence.
ANS: B
Choice (B) is correct because veracity is telling the truth in personal communication
as a moral and ethical requirement. (A) is incorrect because deontology is an
approach that is rooted in the assumption that an action or practice is right if it leads
to the greatest possible balance of good consequences or to the least possible balance
of bad consequences. (C) is incorrect because autonomy is the principle of respect
for the individual person. All persons have unconditional intrinsic value. People are
self-determining agents who are entitled to decide their own destiny. (D) is incorrect
because beneficence means promoting goodness, kindness, and charity.

DIF: Analysis REF: Page 197

12. During a seminar on ethics, the educator realizes that more information is needed
when a participant describes which of the following situations as a violation of the
ethical principle of autonomy?
A. An elderly person with Alzheimer’s disease is denied the right to ambulate in the
hallway.
B. A mentally competent adult refuses medical treatment for the autoimmune
disease, lupus erythematosus, stating that this condition reflects the will of a
higher power.
C. A visitor removed money from the patient’s bedside table, and the nurse chose
not to report the incident.
D. An adult with a broken wrist refuses to be given a local anesthetic prior to the
procedure.
ANS: A
Choice (A) is correct because autonomy is defined as personal freedom, the right to
make choices. (B), (C), and (D) are incorrect because these are all examples of
autonomy.

DIF: Analysis REF: Page 196

13. A nurse who is infected with HIV while working in the operating room seeks
revenge by deliberately placing patients at risk by not adhering to universal
precautions. This nurse is violating the ethical principle of
A. veracity.
B. beneficence.
C. nonmaleficence.
D. autonomy
ANS: C

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 Test Bank 9-7

Choice (C) is correct because nonmaleficence means to abstain from injuring others
and to help others further their own well-being by removing harm and eliminating
threats. The nurse is definitely violating this principle through her actions. (A) is
incorrect because veracity is telling the truth in personal communication. (B) is
incorrect because beneficence is promoting goodness, kindness, and charity. (D) is
incorrect because autonomy is the principle of respect for the individual person. This
concept maintains that all persons have unconditional intrinsic value.

DIF: Application REF: Page 196

14. A patient and her husband used in vitro fertilization to become pregnant. The unused
sperm was frozen, so the couple could have more children later. The husband is
killed while in combat, and the patient journals her choices and the possible
ramifications. She comes to the fertility clinic after looking at the situation from
many perspectives and after considering many alternatives; she asks that the sperm
be destroyed because her husband’s faith prohibited remarrying, and allowing
another person to use the sperm would conflict with her late husband’s beliefs. The
nurse realizes
A. that the patient is in the second step of ethical decision making and that the
patient’s value system is influencing her choices of alternative actions.
B. that a logical line of reasoning has led to validation of the decision to destroy the
husband’s sperm.
C. that the patient has not been able to navigate the complicated issues inherent in
this situation.
D. that a rational decision was reached that was based on reflection and on the value
systems of the wife and the husband.
ANS: D
Choice (D) is correct because after completing all steps in the situation assessment
procedure, the patient is now ready to justify her selection. In this phase, the person
will specify reasons for the action, will clearly present the ethical basis for these
reasons, will understand the shortcomings of the justification, and will anticipate
objections to the justification. (A) is incorrect because the second step of ethical
decision making is identification of hidden issues. (B) is incorrect because validation
of the decision considers many factors and requires analysis of all possible
alternatives. (C) is incorrect because no situational decision can be made unless an
individual begins with the first step of actually identifying and stating the actual
issue.

DIF: Analysis REF: Pages 199-200

15. A patient is in extreme pain after he was involved in a motor vehicle accident, and
morphine has been ordered every hour for pain. The nurse injects saline into the
patient’s IV line and takes the morphine for herself. The nurse is violating which
principle of ethics?
A. Autonomy
B. Utilitarianism

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Contemporary Nursing: Issues, Trends, and Management Cherry 5th Edition Test Bank

Test Bank 9-8

C. Beneficence
D. Dilemmas
ANS: C
Choice (C) is correct because beneficence is providing benefit to others by
promoting their good. In general terms, to be beneficent is to promote goodness,
kindness, and charity. By taking the patient’s pain medication and substituting
saline, the nurse did harm, not good for this patient. (A) is incorrect because
autonomy is the principle of respect for the individual person; the nurse does not
respect someone that he or she is inflicting harm upon. (B) is incorrect because
utilitarianism is the principle that assumes that an action is right if it leads to the
greatest possible balance of good consequences or to the least possible balance of
bad consequences. Because the patient’s pain medication was taken from him, the
consequences were all bad. (D) is incorrect because dilemmas are not included as a
principle of ethics.

DIF: Application REF: Page 196

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