Stage 3: the "Good boy-good girl" orientation, or the morality of interpersonal cooperation.
- The desire to obey rules can they promote social harmony first appears in the context of close personal ties. STAGE 3 individuals want to maintain the affection and approval of friends and relatives by being a "good person" — trustworthy, loyal respectful, helpful and nice. [Wants to be well-liked]
Stage 4: a the social-order-maintaining orientation.
- At this stage, the
individual takes into account a larger perspective — that of societal laws. Moral choices no longer depend on close ties to others. Instead, rules must be enforced in the same evenhanded fashion for everyone, and each member of society has a personal duty to uphold them. The stage 4 individual believes that laws should be obeyed because they are vital for ensuring societal order and cooperation between people. [Don't want to be disrespectful to societal rules] *typical response for
college-educated adults
Which of the following situations is an example of moral distress?
a. You hear nurses in the lounge making off-color jokes about a patient. You are afraid to speak up for fear of retaliation.
b. You have been late for work a couple of times in the last 2 weeks, and your co-workers are covering for you.
c. You become romantically involved with a co-worker, which is against the unit policy, so you resign your position.
d. You purposefully use vague language
when explaining a patient's condition to the family. Staff expects that the patient may be brain-dead, but test results are not yet conclusive.
ANS: A
Feedback
A The definition of "moral distress" is distress that results from participating in a perceived moral wrongdoing due to situational constraints despite attempting to make a moral choice.
B There is no breach of ethics in being late and having co-workers cover for you.
C The person acts
appropriately to the moral issue by resigning the position.
D The person is acting appropriately under current circumstances.
According to Kohlberg's theory of moral development, adolescents who shoplift are operating in which level of moral development?
a. Preconventional
b. Conventional
c. Postconventional
d. Developmental
ANS: A
Feedback
A In Kohlberg's preconventional level of moral
development, the individual is inattentive to the norms of society and is self-centered.
B In the conventional level, moral decisions conform to the norms of society.
C In the postconventional level, the individual has a highly developed moral value system independent of group norms.
D "Developmental" is not a level of moral development identified by Kohlberg.
According to Kohlberg's theory of moral development, individuals who act
"because it is the rule of society" are operating in which level of moral development?
a. Preconventional
b. Conventional
c. Postconventional
d. Developmental
ANS: B
Feedback
A In Kohlberg's preconventional level of moral development, the individual is inattentive to the norms of society and is self-centered.
B In the conventional level, moral decisions conform to the norms of society.
C In the postconventional level, the individual
has a highly developed moral value system independent of group norms.
D "Developmental" is not a level of moral development identified by Kohlberg.
Flight 93, hijacked on September 11, 2001, crashed into the Pennsylvania countryside because some of the passengers decided to try to take control of the plane and prevent it from being used as a weapon of mass destruction against structures in Washington, D.C. They decided to act despite grave
danger to themselves. This is an example of which level of Kohlberg's theory of moral development?
a. Preconventional
b. Conventional
c. Postconventional
d. Conventional phase 4
ANS: C
Feedback
A In the preconventional level, the person's self-interest takes precedence over group norms.
B In the conventional level, the person conforms to group norms.
C People in the postconventional level of moral development may ignore self-interest
and group norms when making decisions and may sacrifice themselves for the group.
D Phase 4 of the conventional level follows group and cultural norms.
According to Kohlberg's theory, which of the following is true of moral development?
a. Participating in decision making promotes moral reasoning.
b. Intellectual development has no effect on moral development.
c. Participating in debates on ethical issues decreases moral
development.
d. Holding people responsible for their actions does not improve moral development.
ANS: A
Feedback
A Kohlberg thought that certain conditions promote moral development, such as participating in decision making.
B Kohlberg thought that intellectual development was necessary for advanced moral development.
C Participating in debates on ethical issues does enhance moral development.
D Taking responsibility for actions promotes
moral development.
Gilligan's theory on moral development differed from Kohlberg's theory because Gilligan considered which population not addressed by Kohlberg?
a. Children
b. Men
c. Women
d. Adolescents
ANS: C
Feedback
A Kohlberg mostly tested his theory in men and boys.
B Men were the focus of Kohlberg's theory.
C Gilligan thought that Kohlberg's theory did not recognize the
experience of women in moral development.
D Gilligan's theory did not focus on adolescents.
Which of the following ethical theories is illustrated by the example of following the Golden Rule, "Do unto others as you wish them to do unto you"?
a. Deontology
b. Principlism
c. Utilitarianism
d. Virtue ethics
ANS: A
Feedback
A Deontology states that an act is moral if it originates from good
will.
B Principlism is the use of ethical principles in decision making.
C Decisions are made based on what will do the greatest good for the greatest number of people. A main tenet of utilitarian ethics is that right or useful actions bring about the greatest good for the greatest number of people.
D Virtue ethics refers to character traits of the decision maker, such as honesty, courage, kindness, and integrity.
Which of the
following ethical theories is illustrated by the example of triage in disaster nursing?
a. Deontology
b. Principlism
c. Utilitarianism
d. Virtue ethics
ANS: C
Feedback
A Deontology states that an act is moral if it originates from good will.
B Principlism is the use of ethical principles in decision making.
C Triage in disasters requires decisions to be made on how to do the greatest good for the greatest number of people. A main tenet
of utilitarian ethics is that right or useful actions bring about the greatest good for the greatest number of people.
D Virtue ethics refers to character traits of the decision maker, such as honesty, courage, kindness, and integrity.
Respecting the right of a patient with terminal cancer to refuse chemotherapy is based on a belief in the ethical principle of
a. justice.
b. autonomy.
c. nonmaleficence.
d. death with
dignity.
ANS: B
Feedback
A "Justice" refers to the equality of the allocation of services.
B Autonomy is based on the principle that patients have the right to determine their own course of action.
C "Nonmaleficence" refers to the responsibility to do no harm.
D Death with dignity is not an ethical principle.
Respecting an elderly woman's decision to stay in her own home is based on a belief
in the ethical principle of
a. justice.
b. autonomy.
c. nonmaleficence.
d. death with dignity.
ANS: B
Feedback
A "Justice" refers to the equality of the allocation of services.
B Autonomy is based on the principle that patients have the right to determine their own course of action.
C "Nonmaleficence" refers to the responsibility to do no harm.
D Death with dignity is not an ethical principle.
A school nurse teaching school-aged children about water safety is an example of which ethical principle?
a. Beneficence
b. Justice
c. Veracity
d. Autonomy
ANS: A
Feedback
A Beneficence can be seen as "the doing of good."
B "Justice" refers to the equal treatment of all.
C Veracity is truth telling.
D "Autonomy" refers to an individual's right to make his or her own decisions.
A nurse who advocates for a longer stay when a medically indigent patient is being prematurely discharged to reduce hospital cost is relying on which ethical principle?
a. Justice
b. Beneficence
c. Autonomy
d. Fidelity
ANS: A
Feedback
A "Justice" refers to the equal and fair allocation of services based on need. According to this principle, the patient should receive the same care as others in the same condition, regardless
of ability to pay.
B "Beneficence" simply refers to doing good.
C Autonomy asserts that individuals have the right to make their own decisions.
D "Fidelity" is an incomplete answer, because fidelity refers to faithfulness or honoring one's promises to patients.
The current emphasis on eliminating racially based health disparities is based on which of the following ethical principles?
a. Double effect
b. Fidelity
c.
Justice
d. Veracity
ANS: C
Feedback
A Double effect is the concept that justifies inflicting harm if the intent is to produce an overall good effect.
B "Fidelity" refers to honoring one's promises to patients.
C The principle of justice states that equals should be treated the same.
D Veracity is telling the truth.
A nurse is turning a bedfast patient to prevent pressure ulcers. The patient
complains that the process is painful. The nurse explains the reason for the turning schedule and completes the task. This is an example of the ethical principle of
a. autonomy.
b. fidelity.
c. nonmaleficence.
d. veracity.
ANS: C
Feedback
A Autonomy has to do with individuals being able to make their own decisions.
B "Fidelity" refers to honoring one's commitments and promises.
C "Nonmaleficence" is defined as the duty to do no harm.
Although temporarily painful, not turning the patient would cause actual harm [physical damage], and so this nurse is acting on the principle of nonmaleficence.
D "Veracity" refers to being truthful.
A patient who is terminally ill is experiencing great pain. To relieve the patient's suffering, the nurse needs to administer larger doses of morphine. This relieves the pain but also inhibits respiration. Which principle justifies the risk of
harm?
a. Justice
b. Fidelity
c. Veracity
d. Double effect
ANS: D
Feedback
A Justice relates to equal treatment of all.
B Fidelity is faithfulness to one's commitments.
C Veracity is being truthful.
D The principle of double effect addresses actions that may result in a negative effect if the end result is good. The end point justifies the risk of harm.
Taking a pediatric patient to
the playroom on a promised time and day is based on the belief in the ethical principle of
a. autonomy.
b. fidelity.
c. justice.
d. veracity.
ANS: B
Feedback
A Autonomy relates to the right of individuals to make their own decisions.
B Fidelity is being faithful to commitments made to others.
C "Justice" refers to the equal treatment of all.
D Veracity is being truthful.
17. When
nurses receive a patient assignment and accept reports on these patients, they are committed to providing care to those assigned to them. This is based on the ethical principle of
a. beneficence.
b. fidelity.
c. justice.
d. veracity.
ANS: B
Feedback
A Beneficence speaks to doing good.
B Fidelity is being faithful or keeping commitments made to others. In accepting the assignment, the nurse has committed to caring for the patients assigned
to her or him.
C Justice is related to the equal treatment of all.
D "Veracity" refers to one's truthfulness.
Answering a terminally ill child's questions about his or her condition honestly is based on a belief in the ethical principle of
a. autonomy.
b. fidelity.
c. justice.
d. veracity.
ANS: D
Feedback
A Autonomy relates to the right of an individual to make his or her own
decisions.
B "Fidelity" refers to being faithful to one's commitments.
C "Justice" refers to the equal treatment of all.
D "Veracity" is defined as telling the truth. Truthfulness is fundamental in the development and maintenance of trust in a relationship.
A father of four is admitted after an automobile accident in which two of the children were killed. Recognizing that he is in very serious condition, the nurse believes that it
would be appropriate to avoid telling him about the death of his children unless he asks directly. This could be considered a violation of the ethical principle of
a. beneficence.
b. fidelity.
c. justice.
d. veracity.
ANS: D
Feedback
A Beneficence is the expectation of doing good.
B "Fidelity" refers to keeping commitments and promises.
C Justice is the treatment of all equally.
D Veracity is truth telling. The nurse is not lying
but is not forthcoming with the information about the children.
Which of the following is the best description of a code of ethics?
a. A document that describes the correct course of action and does not change regardless of societal changes
b. A document that all professions must have even if not representative of practice
c. A document that permits others to know what principles guide professional decision making
d. A document
widely open to interpretation by professionals in various settings
ANS: C
Feedback
A Codes of ethics have been revised through the years to reflect changes in society.
B Codes are useful only if upheld by members of the profession in their daily practice.
C The Code of Ethics of nursing is an implied contract through which the profession informs society of the principles and rules by which it functions.
D The Code of Ethics should be
interpreted in a similar way regardless of practice setting.
A nurse is involved in an ethically challenging case. To use an ethical decision-making model, which step should the nurse perform first?
a. Gather and examine all possible solutions.
b. Identify the ethical dilemma in the case.
c. Identify all parties who will be impacted by the decision.
d. Gather all information important to the situation
ANS: B
Feedback
A The first step in many ethical decision-making models is to identify the ethical dilemma. Examining all possible solutions comes after this step and gathering information.
B The first step in many ethical decision-making models is to identify the ethical dilemma.
C The first step in many ethical decision-making models is to identify the ethical dilemma. Identifying parties affected is not a specific step but is part of identifying the dilemma.
D The first step in many
ethical decision-making models is to identify the ethical dilemma. The next step would be to gather all data related to the situation.
Which of the following are activities in the ethical decision making process? [Select all that apply.]
a. Avoid looking at legal cases or precedents related to the situation.
b. Determine if the people who are affected by the dilemma have value conflicts.
c. Brainstorm with others involved to identify
all possible solutions.
d. Evaluate the action taken to determine whether it accomplished its purpose.
e. Discuss only acceptable solutions that are practical to implement.
ANS: B, C, D
Feedback
Correct - Determining who is affected by the dilemma and identifying possible value conflicts among them, identifying all possible solutions, and evaluating the action taken to determine whether it accomplished its purpose clarify the situation and
determine whether the selected action achieved its goal.
Incorrect - A variety of materials including legal documents may help clarify the situation or help identify possible actions. Ethical decision making is not done in isolation. It may involve others but especially must involve the patient and family. All possible solutions should be considered even if they are unusual, complex, or may be difficult to implement.
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