TEST BANK FOR ETHICS AND ISSUES IN
CONTEMPORARY NURSING 3RD
CANADIAN EDITION BURKHARDT
ľABLE OÏ CONľENľS
PARľ I: Guides foí Píincipled Behaviouí
Chapteí 1: Social, Philosophical, and Otheí Histoíical Foíces Influencing the Development of Nuísing
Chapteí 2: Ethical ľheoíy
Chapteí 3 Ethical Píinciples
PARľ II: Developing Píincipled BehaviouíChapteí
4 Values Claíification
Chapteí 5 Values Development
Chapteí 6 Ethical Decision Making
PARľ III: Píincipled Behaviouí in the Píofessional DomainChapteí
7 Legal Issues
Chapteí 8 Píofessional Issues
Chapteí 9 Píofessional Relationship Issues
Chapteí 10 Píactice Issues Related to End-of-Life Caíe
Chapteí 11 Píactice Issues Related to Patient Self-Deteímination Chapteí
12 Scholaíship Issues
Chapteí 13 ľhe Futuíe of Canadian Health Caíe: Challenges and Píioíities
PARľ IV: Nuísing in ľoday’s Woíld: Challenges and Oppoítunities
Chapteí 14: Health Policy Issues
Chapteí 15: Economic Issues
Chapteí 16: Social Issues
Chapteí 17: Issues of Gendeí and Cultuíe
Chapteí 18: Ruíal, Remote, and Indigenous Nuísing in Canada
Chapteí 19 Empoweíment foí Nuíses
Chapter 1 – Social, Philosophical, and Other Historical ForcesInfluencing the
Development of Nursing
Multiple Choice
1. For which of the following is empathy a motive?
a. meeting the needs of others
b. moral reasoning and action
c. becoming a nurse
d. determining right from wrong
ANSWER: b
2. Which of the following is an example of social need as an ethical foundation for nursing?
a. Nurses must determine the health and social needs of society.
b. Nursing finds its origin, purpose, and meaning within the context of perceived social need.
c. Theories of social need in sociology are utilized by nursing scholars, many of whom view them as
conceptual frameworks for nursing practice.
d. Social need determines the boundaries of the ethical principles of distributive justice, beneficence,
and non-maleficence.
ANSWER: b
3. What is the most critical factor that influences nursing practice?
a. the traditional role of healers
b. the role of women in society
c. the religious and spiritual aspects of health care
d. the introduction of male nurses into the profession
ANSWER: b
4. Why does the social status of women affect the status of the nursing profession?
a. Nursing has traditionally been a profession of women.
b. Throughout history, nurses have been afforded higher social status.
c. Women of higher social status rarely become nurses.
d. Women are more skilled than men at nurturing others.
ANSWER: a
5. What historical influences affected nursing as a moral discipline?
a. technology
b. society
c. spirituality
d. oppression
ANSWER: c
6. What is the term that relates to knowledge gained through observation and experience?
a. empirical
b. Cartesian philosophy
c. values
d. moral thought
ANSWER: a
7. Which of the following is an example of the significance of Nursing during the Middle Ages ?
a. Religious nursing orders and church-sanctioned secular nursing orders offered the only legitimate
avenues for women wishing to become nurses.
b. Increasing respect was given to nursing and midwifery, as nurses began to practise autonomously.
c. Healing arts in Denmark and Greece were performed in sacred ceremonies by priests, priestesses, or
shamans.
d. Most nurses were women of high social status seeking ways to legitimize their position and status.
ANSWER: a
8. What does the term empirical relate to?
a. serving God and thy neighbour the best way one can
b. knowledge gained through observation and experience
c. healing through religious intervention, chanting, and praying
d. the enforcement of religious doctrine related to the status of women in society
ANSWER: b
9. When was the “Dark Period of Nursing,” when convalescent patients, prostitutes, prisoners, and drunkards
provided hospital nursing care?
a. during the Reformation
b. during the Crusades
c. during the Middle Ages
d. during the early Christian era
ANSWER: a
10. Which of the following had the greatest influence on nursing traditions in Canada?
a. Britain
b. indigenous persons
c. France
d. Germany
ANSWER: c
11. Which of the following had the greatest influence on establishing the first hospital in the New World?
a. Marie Rollet Hebert
b. Marguerite d’Youville
c. Jeanne Mance
d. Renee Descartes
ANSWER: c
12. After the First and Second World Wars, the Canadian Red Cross Society and nursing groups noted an
important trend in health care that is still articulated in the Lalonde and Romanow report. What is that trend?
a. the formation of nursing groups such as the CNA and professional organizations
b. the political and economic action taken to correct the wrongs suffered by the military
c. the establishment of governments’ social and political responsibility in health care
d. the need for strong, well-established public health programs, health education, and care of those
living in poverty
ANSWER: d
13. Which of the following is an example of the CNA’s vision for the future of nursing?
a. Nurses must play varied roles in order to provide holistic care to a diverse and changing population.
b. Nursing professional organizations in both Canada and the United States need to join together.
c. An increasing appreciation for the role of public health nursing leads to improving the status of
nursing.
d. There will be further development of the relationship between social need and the evolution of the
practice of nursing.
ANSWER: a
14. Which of the following statements best describes Florence Nightingale?
a. She believed in traditional expectations for women.
b. She was a nurse and increased soldiers’ mortality rates.
c. She believed in nurses restricting their careers.
d. She was a social reformer and statistician.
ANSWER: d
15. How is Mary Agnes Snively significant to the development of Canadian nursing?
a. She established the mission of Grey Nuns to new settlers.
b. She established the International Council of Nursing.
c. She established the first national organization for nursing.
d. She established certification for nurses to become experts.
ANSWER: c
16. Which of the following concepts can be attributed to Florence Nightingale?
a. that caring for the body would bring healing to the mind and spirit
b. that separating clean and dirty conditions was important for patient healing
c. that nurses must embrace the traditional nurturing expectations of women
d. that it was necessary to separate caring from curing in nursing practice
ANSWER: b
Chapter 2: Ethical Theory
MULTIPLE CHOICE
1. Ethics is:
a. a formal process of making illogical and consistent decisions based upon one’s beliefs.
b. a formal process of making logical and random decisions based upon moral beliefs.
c. a formal process of making logical and consistent decisions based upon moral beliefs.
d. a formal process of making logical and consistent decisions based upon religious beliefs.
ANS: C
PTS: 1
2. The belief that people can figure out absolute moral rules that derive from the universe or a supreme
being is the basis for which moral perspective?
a. Moral belief
c. Deontology
b. Rationalism
d. Naturalism
ANS: B
PTS: 1
3. The nurse maintained confidentiality regarding a patient’s terminal illness even though family
members would have provided emotional and financial support to the patient had they known of the
diagnosis. Adhering to this principle regardless of outcome is an example of the application of which
ethical theory?
a. Deontology
c. Rationalism
b. Naturalism
d. Utilitarianism
ANS: A
PTS: 1
4. During a hurricane, there is no electricity in a hospital where floodwater is rapidly rising. An ICU
nurse manually ventilates a patient with an ambu bag for 6 hours before she makes the difficult
decision to leave her patient and help the solitary remaining nurse carry 12 newborns to safety. The
nurse’s decision is most clearly supported by which of the following?
a. Deontology
c. Rationalism
b. Virtue ethics
d. Utilitarianism
ANS: D
PTS: 1
5. Abortion, even to save the life of the mother, would most likely be considered morally wrong by a
person rigidly applying which type of moral theory?
a. Deontology
c. Naturalism
b. Virtue ethics
d. Utilitarianism
ANS: A
PTS: 1
6. The Kantian maxim requiring that no action be judged as right, which cannot reasonably become a law
by which every person should always abide, is known as:
a. the categorical imperative.
c. deontology.
b. the practical imperative.
d. utilitarianism.
ANS: A
PTS: 1
7. The Kantian maxim requiring that one treat others always as ends and never as a means is known as:
a. the categorical imperative.
c. deontology.
b. the practical imperative.
d. utilitarianism.
ANS: B
PTS: 1
8. Aristotle developed the concept of:
a. virtue ethics.
b. utilitarianism.
ANS: A
9.
c. deontology.
d. rationalism.
PTS: 1
attributes differences in moral codes to social conditions, while proposing that most people have
underlying psychological tendencies that lead to similar moral judgments.
a. Rationalism
c. Virtue ethics
b. Naturalism
d. Deontology
ANS: B
PTS: 1
10. What theory is based on the rationalist view that the rightness or wrongness of an act depends upon the
nature of the act, rather than its consequence?
a. Deontology
c. Kantianism
b. Formalism
d. Act utilitarianism
ANS: A
PTS: 1
11T.he intense and critical examination of beliefs and assumptions is:
11.11.
a. theory.
c. philosophy.
b. ethics.
d. religion.
ANS: C
PTS: 1
12. Who is considered to be the father of modern utilitarianism?
a. Immaneul Kant
c. Plato
b. Jeremy Bentham
d. John Stuart Mill
ANS: B
PTS: 1
13. A form of moral theory that embraces the uniqueness of cases, the culturally significant ethical
features, and ethical judgement in each particular case is called:
a. virtue ethics.
c. moral particularism.
b. naturalism.
d. utilitarianism.
ANS: C
PTS: 1
MULTIPLE RESPONSE
1. Which of the following statements accurately describes ethics? Select all that apply.
a. Ethics is concerned with the study of social morality and philosophical reflection about
society’s norms and practices.
b. Ethics furnishes us with the practical application of moral philosophy.
c. Ethics offers structured guidelines that tell us what we ought to do.
d. The study of ethics gives us a groundwork for making logical and consistent decisions.
e. Professional codes of ethics are tools that offer a formal process for applying moral
philosophy.
ANS: A, B, D, E
PTS: 1
2. Beauchamp and Childress propose focal virtues that are more pivotal than others in characterizing a
virtuous person. These focal virtues include (select all that apply):
a. compassion.
d. trustworthiness.
b. discernment.
e. integrity.
c. temperance.
f. devotion.
ANS: A, B, D, E
PTS: 1
Chapter 3 – Ethical Principles
MULTIPLE CHOICE
1. What does the principle of beneficence require the nurse to do?
a. to separate personal from professional life
b. to prevent harm or evil and do good
c. to make moral decisions that are motivated by what will benefit the patient
d. to morally regulate the conduct of others
ANS: B
PTS: 1
REF: p. 59–60
BLM: Remember
2. A nurse respects a patient’s decision not to undergo any further dialysis. Which principle is
this situation an example of?
respect for persons
justice
beneficence
autonomy
a.
b.
c.
d.
ANS: D
PTS: 1
REF: p. 49
BLM: Higher Order
3. The nurse promises a patient that she will return in five minutes to sit and speak with him.
What ethical principle does this situation exemplify?
a. morals
b. fidelity
c. confidentiality
d. justice
ANS: B
PTS: 1
REF: p. 75–76
BLM: Higher Order
4. Which ethical principle implies that others are worthy of high regard?
a. beneficence
b. respect for autonomy
c. respect for persons
d. distributive justice
ANS: C
PTS: 1
REF: p. 49
BLM: Remember
5. A patient requests multiple cosmetic surgeries. At a certain point, the health care team
questions whether the overall harm that will result from continuing to do these procedures
will outweigh the benefits. Which ethical principle is most related to this discussion about
weighing harms against benefits?
a. beneficence
b. non-maleficence
c. justice
d. veracity
ANS: B
PTS: 1
Chapter 3 Ethical Principles
REF: p. 62–63
BLM: Higher Order
Chapter 3 Ethical Principles
6. Which of the following ethical principles relates to noncompliance with care by a fully aware
patient?
a. beneficence
b. autonomy
c. fidelity
d. non-maleficence
ANS: B
BLM: Remember
PTS: 1
REF: p. 49–50 | p. 52
7. A nurse performs a pain assessment on a client and requests an order for an analgesic as an
intervention. Which of the following ethical principles is being given a practical application in
this situation?
a. beneficence
b. autonomy
c. veracity
d. non-maleficence
ANS: A
PTS: 1
REF: p. 59–60
BLM: Higher Order
8. The emergency room staff decide how quickly patients will be triaged through the emergency
room department. The emergency room team decides that the most critically ill patient will be
treated first. Which of the following ethical principles is illustrated by the decision-making
process in this case?
a. respect for persons
b. justice
c. beneficence
d. autonomy
ANS: B
PTS: 1
REF: p. 76–77
BLM: Higher Order
9. Which ethical principle requires nurses to uphold the profession’s code of ethics, to practise
within the established scope of practice, and to remain competent?
a. beneficence
b. autonomy
c. fidelity
d. non-maleficence
ANS: C
PTS: 1
REF: p. 75–76
BLM: Remember
10. What does the CNA Code of Ethics recognize about confidentiality?
a. It develops from respect for patients and is an absolute requirement in all
situations.
b. It is restricted to legal regulations and definitions.
c. It is not absolute and may be modified to protect the patient or other innocent
people.
d. It enables preservation of dignity for patients in intimate and private situations.
Chapter 3 Ethical Principles
ANS: C
PTS: 1
REF: p. 69
BLM: Higher Order
11. Which of the following statements best summarizes the Privacy Act, amended April 2011?
a. Individuals have the right to access their own information without constraints.
b. The provincial government sets out rules on how personal information is managed.
c. Each province protects the private information of Canadian citizens.
d. The Act sets out rules for how personal information should be managed by private-
sector organizations.
ANS: A
PTS: 1
REF: p. 71
BLM: Higher Order
12. Which principle of the Canada Health Act entitles 100 percent of the insured residents of a
province or territory to health services?
a. comprehensiveness
b. universality
c. accessibility
d. public administration
ANS: B
PTS: 1
REF: p. 78
BLM: Higher Order
13. In which of the following situations is the nurse applying the principles of the CNA Code of
Ethics?
a. The nurse maintains confidentiality of a gunshot victim who is a suspected gang
member.
b. The nurse carries out mandatory testing of pregnant women for hepatitis and
syphilis.
c. The nurse keeps information confidential when a patient states that he wants to
kill himself.
d. The nurse reports suspected abuse of a child and illegal activity of the parents to
the police.
ANS: D
PTS: 1
REF: p. 69–71
BLM: Higher Order
14. Which principle of the Canada Health Act entitles reasonable contact with insured health care
services in terms of physical availability of medically necessary services?
a. comprehensiveness
b. universality
c. accessibility
d. public administration
ANS: C
PTS: 1
REF: p. 79
BLM: Higher Order
15. Which principle of the Canada Health Act requires that residents moving from one province
or territory to another must continue to be covered for insured health care services?
a. comprehensiveness
b. portability
Chapter 3 Ethical Principles
c. accessibility
d. public administration
ANS: B
PTS: 1
REF: p. 78
BLM: Higher Order
Chapter 4 Values Clarification
MULTIPLE CHOICE
1. Axiology is a branch of philosophy that studies:
a. ethics.
c. awareness.
b. mathematics.
d. values.
ANS: D
PTS: 1
2. The process of becoming more conscious of and naming what we value or consider worthy is:
a. journaling.
c. overt values.
b. values clarification.
d. values conflict.
ANS: B
PTS: 1
3. The aim of values clarification is to facilitate the process of:
a. instilling personal values.
c. reacting to personal values.
b. teaching personal values.
d. choosing personal values.
ANS: D
PTS: 1
4. Values that are implicit in expectations of an institution, but not in writing, are termed:
a. formal values.
c. integral values.
b. covert values.
d. overt values.
ANS: B
PTS: 1
5. Nurses may experience values conflict if:
a. they develop and adhere to moral norms over time.
b. what they prize and cherish is at odds with patients.
c. what they see in practice reflects their own beliefs.
d. they find a common ground in dealing with patients.
ANS: B
PTS: 1
6. An institution’s mission statement is a reflection of:
a. overt values.
c. covert values.
b. personal values.
d. implicit values.
ANS: A
PTS: 1
7. A nurse who used to love her job and now frequently exhibits anger, dissatisfaction, frustration, and
poor work performance may be experiencing:
a. moral awareness.
c. moral distress.
b. moral thought.
d. moral values.
ANS: C
PTS: 1
8. Values of individual institutions and organized health care systems that are explicitly communicated
through philosophy and policy statements are called:
a. formal values.
c. institutional values.
b. overt values.
d. covert values.
ANS: B
PTS: 1
9. Ideals, beliefs, customs, modes of conduct, qualities, or goals that are highly prized or preferred by
individuals, groups, or society are termed:
a. thoughts.
c. concepts.
b. ethics.
d. values.
ANS: D
PTS: 1
10. Tools that may assist a person to expand self-awareness include which of the following?
a. Journaling
b. Meditation
c. Therapy
d. Feedback
e. All of the above
ANS: E
PTS: 1
MULTIPLE RESPONSE
1. Values are shaped by which of the following? Select all that apply.
a. Culture
b. Ethnicity
c. Professional experiences
d. Self-awareness
e. Education
ANS: A, B, C, D, E
PTS: 1
2. The valuing process includes which of the following? Select all that apply.
a. Promoting beliefs
b. Prizing beliefs
c. Choosing behaviors
d. Acting on beliefs
e. Cherishing behaviors
ANS: B, C, D, E
PTS: 1
3. When the values of the nurse and those of the patient are different, the patient may be labeled as which
of the following? Select all that apply.
a. Noncompliant
b. Difficult
c. Cooperative
d. Ignorant
e. Confident
ANS: A, B, D
PTS: 1
4. Statements that describe values may include which of the following? Select all that apply.
a. Values are concrete concepts that reflect what is meaningful and important to individuals.
b. Values are learned in conscious and unconscious ways and become a part of a person’s
makeup.
c. Values provide direction and meaning to life.
d. Values may be expressed overtly or in an indirect way.
e. Values have little influence over an individuals’ choices.
ANS: A, B, C, D
PTS: 1
Chapter 5 Values Development
MULTIPLE CHOICE
1. A basic method of fixing belief whereby the person obstinately adheres to beliefs already held is
called:
a. authority.
c. tenacity.
b. a priori.
d. reasoning.
ANS: C
PTS: 1
2. Which of the following is a stage in Level III of Kohlberg’s theory?
a. The Stage of Mutual Interpersonal Expectations, Relationships, and Conformity
b. The Stage of Punishment and Obedience
c. The Stage of Social System and Conscience Management
d. The Stage of Universal Ethical Principles
ANS: D
PTS: 1
3. In Fowler’s Stage of Faith Development, Stage 6 is called:
a. Individuative-Reflective faith.
c. Intuitive-Projective faith.
b. Universalizing faith.
d. Synthetic-Conventional faith.
ANS: B
PTS: 1
4. An organizing way of looking at the nature of the universe as a whole and the role of the human in it
that incorporates both the physical plane and the interconnected, multidimensional universe is called:
a. cosmology.
c. ethic of care.
b. values development.
d. faith development.
ANS: A
PTS: 1
5. Human values development is often referred to as:
a. moral development.
c. ethical values.
b. faith development.d.
formal
operations
development.
ANS: A
PTS: 1
6. Human values development reflects the content and process of learning what is right and wrong within
a culture.
a. True
b. False
ANS: A
PTS: 1
7. “Ethics of Justice” is associated with which of the following theorists?
a. Piaget
c. Kohlberg
b. Gilligan
d. Fowler
ANS: C
PTS: 1
8. The moral imperative grounded in relationship with and responsibility for one another is called:
a. ethic of justice.
c. faith development.
b. ethic of care.
d. cognitive development.
ANS: B
PTS: 1
9. The development of intellectual capacities through the time of childhood from birth to around age 15
years refers to:
a. Kohlberg’s theory of moral development.
b. Piaget’s stages of cognitive development.
c. Lao Tsu’s theory of development.
d. Fowler’s stages of faith development.
ANS: B
PTS: 1
10. In Kohlberg’s theory of moral development, the preconventional level includes two stages. They are:
a. punishment and obedience.
b. individual instrumental purpose and exchange.
c. rights and social utility.
d. a and b.
ANS: D
PTS: 1
11. Values development moves from a focus on self toward being guided in universal considerations.
a. True
b. False
ANS: A
PTS: 1
12. Nurses can avoid making inappropriate judgments about another’s moral capabilities by:
a. understanding that all people have the same ethical, moral, and cultural values; they are
just called by different names.
b. keeping strict adherence to hospital and unit guidelines while caring for the patient and
patient’s family.
c. understanding varying perspectives from which moral decisions are made by both the
nurse and the patient.
d. all of the above.
ANS: C
PTS: 1
13. The discussions of moral development found in current literature flow primarily from the frameworks
developed by:
a. Kohlberg and Gilligan.
c. Gilligan and Piaget.
b. Piaget and Fowler.
d. Kohlberg and Fowler.
ANS: A
PTS: 1
14. Phase 3 of Gilligan’s study of the psychological development of women includes which of the
following?
a. A focus on what is best for the self, and includes selfishness and dependence on others.
b. The movement into a world beyond the family in which values and beliefs derive from
experiences in interpersonal relationships.
c. Mutual interpersonal expectations, relationships, and conformity.
d. A deep appreciation of connectedness, including responsibility to self and others as moral
equals, and a clear imperative to harm no one.
ANS: D
MULTIPLE RESPONSE
PTS: 1
1. When considering developmental norms for moral development, nurses must be alert for (select all
that apply):
a. gender.
d. norms.
b. cultural factors.
e. bias.
c.
faith development.
ANS: A, B, D, E
PTS: 1
2. Which of the following statements are true regarding Gilligan’s study of the psychosocial development
of women? Select all that apply.
a. Progression through each of the three stages reflects greater depth in understanding the
relationship of self and others.
b. Phase 3 focuses on the concern for survival.
c. Gilligan suggests a linear progression moving from one phase to the next.
d. Phase 2, focusing on good, includes a sense of goodness as self-sacrifice.
e. Gilligan’s model is considered an ethic of care.
ANS: A, C, D, E
PTS: 1
Chapter 6 Ethical Decision Making
MULTIPLE CHOICE
1. Which term is described as a personal consciousness of the moral importance that guides personal
action in a particular situation?
a. Dilemma
c. Ethic
b. Problem
d. Moral integrity
ANS: C
PTS: 1
2. The first step in the ethical decision-making process is:
a. implementing the strategy.
c. evaluating outcomes of an action.
b. gathering data.
d. articulating the problem.
ANS: D
3.
PTS: 1
occurs when we sense that there is a moral problem but are not sure of the morally
correct action.
a. Moral distress
c. Moral dilemma
b. Moral uncertainty
d. Practical dilemma
ANS: B
PTS: 1
4. When a person is aware of a moral problem, acknowledges moral responsibility, and makes a
moral judgment about the correct action, yet is constrained from the self-determined morally
correct action, the person is experiencing:
a. moral distress.
b. moral uncertainty.
ANS: A
c. moral outrage.
d. moral reckoning.
PTS: 1
5. Moral dilemmas occur when:
a. the nurse is unsure of the morally correct action.
b. there are conflicting moral claims.
c. moral claims conflict with practical claims.
d. participants disagree on the appropriate course of action.
ANS: B
PTS: 1
6. The nurse manager asks Martha, a staff nurse, if she will work an additional 4 hours at the end of her
shift. Martha’s patient is unstable, and there is insufficient staff on the next shift to care for her
adequately. If she works overtime, Martha will break a promise she made to take her children to the
circus. This situation is an example of:
a. moral distress.
c. moral reckoning.
b. a moral dilemma.
d. a practical dilemma.
ANS: A
PTS: 1
7. A registered nurse witnesses another nurse violating a patient’s autonomy. Even though she did not
participate in the action, the nurse who witnessed the act experiences powerlessness, frustration, and
anger. This reaction describes which of the following?
a. Moral distress
c. Moral outrage
b. Moral uncertainty
d. Moral dilemma
ANS: C
PTS: 1
8. Physicians sometimes make unilateral decisions in morally important situations because:
a. moral decision making is reserved for physicians.
b. nurses are seldom aware of the patient’s wishes and life context.
c. there is, sometimes, power imbalance in the health care setting.
d. it is illegal for nurses to participate in moral decision making.
ANS: C
PTS: 1
9. Moral integrity is defined as:
a. the likelihood that someone will make the same decision repeatedly over time.
b. soundness, reliability, wholeness, and integration of moral character.
c. self-knowledge combined with decision-making skill.
d. the ability to make cogent moral decisions.
ANS: B
PTS: 1
10. A problem consists of:
a. uncertainties and unintended consequences.
b. disagreements among participants as to the best course of action.
c. moral claims that conflict with practical claims.
d. a discrepancy between the current situation and a desired state.
ANS: D
PTS: 1
11. George, an ICU nurse, worked with the team as they followed the physician’s order to discontinue life
support on a patient diagnosed with persistent vegetative state. George believes that life is sacred and
that he has a duty to do whatever it takes to preserve life. Nevertheless, he remained silent as the
decision was made, and he assisted his coworkers when they unplugged the respirator. George is likely
to experience which of the following?
a. Moral uncertainty
c. Moral outrage
b. Moral distress
d. Moral perplexity
ANS: B
PTS: 1
12. Which of the following is an example of a moral dilemma?
a. A nurse who is accustomed to working on the prenatal unit floats to the ER.
b. A nurse who has strong religious beliefs opposing abortion is assigned to assist with an
elective abortion.
c. A terminally ill patient on life support suffers from severe, intractable pain.
d. A patient has a cardiopulmonary arrest when the suction apparatus fails.
ANS: C
PTS: 1
13. Determining key participants is appropriate during which step of the moral decision-making process?
a. Data gathering
c. Strategy exploration
b. Problem articulation
d. Strategy implementation
ANS: A
PTS: 1
14. The physician and nurse participate with a patient in making a particularly difficult moral decision. If
the decision-making process is properly implemented, which of the following may occur?
a. The goal will be reached.
c. Other actions may be required.
b. Other dilemmas emerge.
d. All of the above
ANS: D
PTS: 1
MULTIPLE RESPONSE
1. Several types of moral problems exist and are discussed in chapter 7. Which of the following are
examples of a moral problem? Select all that apply.
a. Moral uncertainty
d. Practical dilemma
b. Moral dilemma
e. Moral distress
c.
Routine problem
ANS: A, B, E
PTS: 1
Chapter 7 Legal Issues
MULTIPLE CHOICE
1. Changes in Medicare and Medicaid laws and statutory recognition of nursing in advanced practice
(including prescriptive authority) are examples of what type of law?
a. Legislative law
c. Administrative law
b. Constitutional law
d. Common law
ANS: A
PTS: 1
2. Law that generally involves relationships between individuals, rather than between the state and
individuals, is:
a. public law.
c. tort law.
b. contract law.
d. civil law.
ANS: D
PTS: 1
3. Fraud, invasion of privacy, assault, battery, and false imprisonment are examples of:
a. intentional torts.
c. unintentional torts.
b. malpractice.
d. negligence.
ANS: A
PTS: 1
4. First- and second-degree murder, arson, burgarly, extortion, kidnapping, rape, and robbery are
examples of which type of crime?
a. Misdemeanor
c. Felony
b. Precedent
d. Citation
ANS: C
PTS: 1
5. The system of binding rules of action or conduct that governs the behavior of people in respect to
relationships with others and with the government is:
a. ethics.
c. morals.
b. law.
d. intentional tort.
ANS: B
PTS: 1
6. A set of rules and principles that describes the powers of a government and the rights of the people
refers to:
a. constitutional law.
c. common law.
b. statutory/legislative law.
d. administrative law.
ANS: A
PTS: 1
7. Formal laws written and enacted by federal, state, or local legislatures are known as:
a. statutory/legislative law.
c. administrative law.
b. constitutional law.
d. common law.
ANS: A
PTS: 1
8. Law that involves the operation of government agencies is:
a. common law.
c. constitutional law.
b. administrative law.
d. statutory/legislative law.
ANS: B
PTS: 1
9. Law that defines a person’s rights and obligations in relation to the government and describes the
various divisions of government and their powers refers to:
a. criminal law.
c. common law.
b. misdemeanors.
d. public law.
ANS: D
PTS: 1
10. The branch of law that deals with actions considered harmful to society is:
a. administrative law.
c. criminal law.
b. common law.
d. constitutional law.
ANS: C
PTS: 1
11. Serious crimes that carry significant fines and jail sentences refer to:
a. legislative laws.
c. misdemeanors.
b. felonies.
d. precedents.
ANS: B
PTS: 1
12. Disturbing the peace, solicitation, assault, and battery are examples of:
a. misdemeanors.
c. precedents.
b. felonies.
d. rioting.
ANS: A
PTS: 1
13. Law that deals with the rights and obligations of people who make agreements between two or more
people that can be enforced by law is:
a. tort law.
c. contract law.
b. negligence.
d. private law.
ANS: C
PTS: 1
14. A wrong or injury that a person suffers because of someone else’s action, either intentional or
unintentional, is a:
a. negligence.
c. private law.
b. tort.
d. breach.
ANS: B
PTS: 1
15. The omission to do something that a reasonable person would do, guided by those ordinary
considerations which ordinarily regulate human affairs, refers to:
a. negligence.
c. malpractice.
b. unintentional tort.
d. common law.
ANS: A
PTS: 1
16. A type of negligence committed by a person in a professional capacity in which there is an
unreasonable lack of professional skill or nonadherence to the accepted standard of care causes injury
to a patient is:
a. accident.
c. plaintiff.
b. unintentional tort.
d. malpractice.
ANS: D
PTS: 1
17. Components of malpractice include:
a. causal relationship with the breach of standard of care.
b. duty owed to the patient.
c. actual harm or injury suffered by the patient.
d. All of the above
ANS: D
PTS: 1
18. Willful acts that violate another person’s rights or property are:
a. intentional torts.
c. assault.
b. fraud.
d. battery.
ANS: A
PTS: 1
19. A deliberate deception for the purpose of securing an unfair or unlawful gain is:
a. assault.
c. battery.
b. fraud.
d. intentional tort(s).
ANS: B
PTS: 1
20. The unjustifiable attempt or threat to touch a person without consent that results in fear of immediately
harmful or threatening contact is referred to as:
a. assault.
c. fraud.
b. battery.
d. malpractice.
ANS: A
PTS: 1
21. Locking patients in rooms, denying use of the telephone, and restraining a patient who is not
intoxicated, mentally ill, disoriented, or a substance abuser is an example of:
a. defamation.
c. false imprisonment.
b. libel.
d. slander.
ANS: C
PTS: 1
22. When one harms a person’s reputation and good name, diminishes other’s value or esteem, or arouses
negative feelings toward the person in others by the communication of false, malicious, unprivileged,
or harmful words, this is referred to as:
a. fraud.
c. libel.
b. defamation.
d. slander.
ANS: B
PTS: 1
23.23S.peaking false and defamatory words is an example of:
a. slander.
c. false imprisonment.
b. libel.
d. gossiping.
ANS: A
PTS: 1
. efamation by written words or images is an example of:
24.24D
a. slander.
c. criminalization.
b. libel.
d. fraud.
ANS: B
PTS: 1
25. Reducing the risk of malpractice litigation can be accomplished by:
a. being courteous, keeping up to date with knowledge and skills, and seeking attention for
patients with changing health status.
b. involving patients in decision making, documenting objectively, avoiding physicians and
the telephone.
c. keeping up to date with current knowledge, seeking physician attention for patients with
changing health status, and challenging the patient.
d. all of the above.
ANS: A
PTS: 1
MULTIPLE RESPONSE
1. Liability insurance is an important risk-management strategy. Which of the following is true regarding
liability insurance? Select all that apply.
a. Nurses can have individual coverage or group coverage.
b. Liability insurance provides for payment of lawyer fees only.
c. Two basic types of insurance coverage are occurrence based and claim based.
d. Nurses should never be without coverage
e. Employer-sponsored coverage is the most limited type of insurance.
ANS: A, C, D, E
PTS: 1
Chapter 8 Professional Nursing
MULTIPLE CHOICE
1. Who authored the first ethics textbook, Nursing Ethics for Hospital and Private Use?
a. Florence Nightingale
c. Isabel Hampton Robb
b. Lillian Wald
d. Abraham Flexner
ANS: C
2.
PTS: 1
The roles of the state boards of nursing can include:
a. overseeing schools of nursing within the states.
b. enforcing the individual state’s nurse practice acts.
c. disciplining nurses.
d. all of the above.
ANS: D
PTS: 1
3. The minimum expectations for safe nursing care can be defined as:
a. accountability.
c. expertise.
b. standards of nursing practice.
d. authority.
ANS: B
PTS: 1
4. Who was the first nursing theorist to write about caring?
a. Martha Rogers
c. Madeleine Leninger
b. Jean Watson
d. Margaret Newman
ANS: C
PTS: 1
5. Standards of nursing practice are developed within the profession to describe practice and establish the
minimum level of safe practice. The purpose of standards of nursing practice can include:
a. helping to ensure that nurses are competent and safe to practice.
b. serving as a guide for nurses providing care.
c. determining whether the actions of nurses accused of malpractice are consistent with
reasonable expectations.
d. all of the above.
ANS: D
PTS: 1
6. A complex, organized occupation preceded by a long training program is a(n):
a. profession.
c. autonomy.
b. expert.
d. nurse.
ANS: A
PTS: 1
7. Flexner listed some of the following traits utilized to identify professions:
a. Intellectual operations.
b. Educationally communicable technique.
c. Self-organization.
d. Raw materials from science and learning.
e. All of the above.
ANS: E
PTS: 1
8.
relates to the characteristic of having a high level of specialized skill and knowledge.
a. Profession
c. Wisdom
b. Expertise
d. Skill
ANS: B
PTS: 1
9 . “Self-governing” is another word or definition for:
a. expertise.
c. autonomy.
b. profession.
d. accountability.
ANS: C
10.
PTS: 1
refers to a person who has an obligation to accept responsibility and to account for actions.
a. Autonomy
c. Authority
b. Expertise
d. Accountability
ANS: D
PTS: 1
11. An explicit declaration of primary goals and values of the profession that indicates the “profession’s
acceptance of the responsibility and trust with which it has been invested by society” is:
a. a code of nursing ethics.
c. autonomy.
b. a standards of nursing practice.
d. constitution.
ANS: A
PTS: 1
12. The foremost legal statute regulating nursing is:
a. State Board of Nursing.
c. Nurse Practice Act.
b. Code of Nursing Ethics.
d. Standards of Nursing Practice.
ANS: C
PTS: 1
13. Because society allows professionals a monopoly over the services they provide, ethics demands that
those services must be provided with expertise.
a. True
b. False
ANS: A
PTS: 1
MULTIPLE RESPONSE
1. Professions have many distinguishing attributes that have been proposed over the years, including
(select all that apply):
a. expertise.
d. low income.
b. absence of systematic theory.
e. licensure.
c. a scope of practice.
f. ethical codes.
ANS: A, C, E, F
PTS: 1
2. Which of the following is a function of nurse practice acts? Select all that apply.
a. Defines nursing practice
b. Protects practicing nurses
c. Describes the boundaries of nursing practice
d. Establishes standards for nursing
e. Protects the domain of nursing
ANS: A, C, D, E
PTS: 1
Chapter 9 Professional Relationship Issues
MULTIPLE CHOICE
1.
occurs when one directs hostile or aggressive behavior toward another member of the
same group.
a. Discrimination
c. Sexual harassment
b. Lateral violence
d. Disparate impact
ANS: B
PTS: 1
2. Any physiologic disorder or condition, cosmetic disfigurement, or anatomical loss affecting any body
system is a:
a. mental impairment.
c. physical impairment.
b. disability.
d. major life enjoyment.
ANS: C
PTS: 1
3. Cues for recognizing harassment could include:
a. invasion of space.
c. confirmation.
b. lack of respect.
d. all of the above.
ANS: D
PTS: 1
4. The nurse’s primary obligation is to which of the following?
a. The patient
c. The physician
b. The employer
d. The profession
ANS: A
PTS: 1
5. A staff nurse suspects that her friend, another nurse on her unit, is impaired by illicit drugs. The nurse
doesn’t want to get her friend in trouble, but she fears that patients may be harmed. This conflict of
loyalty is an example of:
a. a moral dilemma.
c. moral uncertainty.
b. a practical dilemma.
d. moral distress.
ANS: B
PTS: 1
6. A physician writes an order that the registered nurse believes will harm the patient. She views the
physician as incompetent. Which of the following is the most appropriate action for the nurse?
a. She should follow the order anyway because the physician’s education is superior to hers.
b. She should pursue the chain of authority. If the supervisor and others support the physician,
she should follow the order.
c. After pursuing the issue with the physician and her superiors, she should disobey all orders
that she believes are illegal, immoral, or incompetent.
d. If she is forced to follow the order, she should file a formal complaint against the
physician.
ANS: C
PTS: 1
7. When delegating patient care activities, the registered nurse has a responsibility to:
a. assess individual competency when assigning nursing care activities to other health care
workers.
b. divide the activities fairly between health care workers.
c. teach subordinate health care workers proper techniques and procedures.
d. observe ancillary staff as they perform delegated activities.
ANS: A
PTS: 1
8. A facility administrator systematically passes over all Hispanic nurses who apply for promotion,
regardless of their qualifications and abilities. According to the Civil Rights Act of 1964, this is an
example of which of the following?
a. Disparate impact
c. Stereotyping
b. Segregation
d. Disparate treatment
ANS: D
PTS: 1
9. Racism is prohibited by which of the following?
a. The Civil Rights Act of 1964
c. The ANA Code of Ethics for Nurses
b. The ICN Code of Ethics for Nurses
d. All of the above
ANS: D
PTS: 1
10. Sexual harassment is defined as:
a. unwelcome sexual advances, requests for sexual favors, and other verbal, nonverbal, or
physical conduct of a sexual nature.
b. multiple episodes of inappropriate sexual behavior in the workplace.
c. intermittent and continual threats of a sexual nature.
d. sexual advances, whether welcome or unwelcome, sexual contact, and oral and written
communication of a sexual nature.
ANS: A
PTS: 1
11. A 56-year-old African American nurse applied for a job at a small privately owned clinic. Even though
she was well qualified for the job, she was not hired because her preemployment physical revealed that
she has severe, long-term, uncontrolled hypertension. Which of the following is true?
a. Because the clinic is small and privately owned, the administrator must prove that the
woman’s medical condition will cause undue hardship on the business.
b. Because the nurse is an African American, this action violates the Civil Rights Act of 1964.
c. Because the clinic is an at-will employer, the administrator can institute these types of
criteria for employment.
d. To base employment decisions on preemployment physical examinations violates the
Americans with Disabilities Act.
ANS: D
PTS: 1
12. Employer discrimination based on race, gender, ethnicity, and disabilities violates which ethical
principle?
a. Justice
c. Nonmaleficence
b. Beneficence
d. Confidentiality
ANS: A
PTS: 1
13. In general, which is true of the physician-nurse relationship in a hospital setting?
a. The physician is the nurse’s “boss,” and the nurse is obligated to follow the physician’s
orders.
b. The physician has total autonomy. The nurse is a limited moral agent.
c. Facility policies and procedures determine the nature and extent of each person’s moral
agency.
d. Both the nurse and the physician are autonomous moral agents with primary obligation
owed to the patient.
ANS: D
PTS: 1
MULTIPLE RESPONSE
1. Sexual harassment is a form of sex discrimination that violates the Civil Rights Act of 1964. Which
statements are true regarding sexual harassment? Select all that apply.
a. The two categories of sexual harassment include quid pro quo and hostile work
environment.
b. Hostile-work-environment sexual harassment occurs when submission to or a rejection of
the sexual conduct of an individual is used as a basis for employment.
c. Majority of sexual harassment claims are filed by women.
d. Sexual harassment entails emotional costs such as anger, humiliation, and fear.
e. Direct costs of sexual harassment may include counseling and lawyers fees.
ANS: A, C, D, E
PTS: 1
2. The Americans with Disabilities Act (ADA) has several positions including which of the following?
Select all that apply.
a. It ensures people with disabilities are not excluded from job opportunities.
b. It allows the practice of requiring medical examinations before employment.
c. Prospective employers may ask questions about disabilities, past medical history, or
previous workers’ compensation claims.
d. Employers may question individuals about educational qualifications, experience, and their
ability to perform the job safely with or without accommodations.
e. Upon request from disabled employees, employers must make necessary physical
accommodations to the workplace.
ANS: A, D, E
PTS: 1
Chapter 10 Practice Issues Related to End-of-Life Care
MULTIPLE CHOICE
1. Which of the following can be both a benefit and challenge of technological advances in health care?
a. Supports healthy living
c. Can prolong living
b. Availability and cost
d. Alleviates suffering
ANS: C
PTS: 1
2. In assessing a patient’s quality of life (QOL), the nurse needs to understand that QOL:
a. is an objective measure of comfort and factors that make life worth living.
b. is only considered good if the patient feels fulfilled and can be independent.
c. generally means the same thing to most patients, families, and nurses.
d. includes subjective ideas about conditions of life and functional ability.
ANS: D
PTS: 1
3. Since a prime nursing focus is to relieve suffering, nurses must understand that health care
technologies:
a. are good because they always support a patient’s health and well-being.
b. may cause conflict between doing good and avoiding harm to patients.
c. are necessary interventions even if they cause patients to suffer.
d. may cause nurses to do harmful things to patients against their wishes.
ANS: B
PTS: 1
4. Appropriate utilization of health care technology requires that health care providers, patients, and
families understand its:
a. purpose, benefits, limitations.
c. outcomes, benefits, cost.
b. cost, availability, usefulness.
d. risks, availability, purpose.
ANS: A
PTS: 1
5. Ethical dilemmas that arise from use of life-sustaining technologies may be associated with all of the
following except:
a. attitudes and beliefs about when life begins.
b. attitudes about what constitutes death.
c. unreasonable expectations of medical interventions.
d. similar opinions regarding use of technology.
ANS: D
PTS: 1
6. Ethical considerations related to situations of medical futility relate to which of the following?
a. Views about whether the intervention is prolonging living or prolonging dying
b. Values and views of involved parties regarding what is benefit or burden
c. Values of involved parties regarding availability and cost of the medical care
d. a and b
e. All of the above
ANS: E
PTS: 1
7. Withholding or removing treatments where the burden or harm to the person is determined to outweigh
benefits is:
a.
b.
c.
d.
allowing the person to die as a result of the natural progression of the disease process.
causing the painless death of the person in order to end or prevent more suffering.
providing the person the means to end his or her own life when they are ready to die.
following the directives to avoid suffering included in do not resuscitate orders.
ANS: A
PTS: 1
8. Do not resuscitate (DNR) orders indicate that:
a. medical therapies and interventions are to be avoided.
b. life-sustaining interventions are to be discontinued.
c. cardiopulmonary resuscitation (CPR) is to be avoided.
d. palliative care is to be discontinued or avoided.
ANS: C
9.
PTS: 1
Palliative care includes all of the following except:
a. comprehensive, interdisciplinary, and total care.
b. aggressive treatment of chronic health problems.
c. comfort and support of patients and families.
d. delivery of coordinated and continuous services.
ANS: B
PTS: 1
10. Ethical and legal obligation to protect the confidentiality of patient information directs nurses to do
which of the following regarding electronic storing and transfer of personal health information?
a. Avoid using fax machines to transfer personal health information.
b. Share personal secure passwords with immediate co-workers only.
c. Rely on HIPAA regulations to assure the security of electronic devices.
d. Use password-protected screen savers and data encryption technology.
ANS: D
PTS: 1
11. Instructions indicating a client’s wishes regarding health care interventions or designating someone to
act as a surrogate in making such decisions are called:
a. healthcare provider orders
c. advance directives
b. palliative care
d. nursing care plan
ANS: C
12.
refers to situations in which interventions are judged to have very little or no medical
benefit, or in which the chance for success is low.
a. Euthanasia
c. Do not resuscitate (DNR)
b. Medical futility
d. Palliative care
ANS: B
13.
PTS: 1
PTS: 1
The ability to alter organisms genetically for a variety of purposes is:
a. eugenics
c.
genetic diagnosis
b. genetic screening
d. genetic engineering
ANS: D
PTS: 1
14. The process of creating a cell or an entire organism that is identical in every way to another is called:
a. stem cell research
c. genetic screening
b. cloning
d. eugenics
ANS: B
PTS: 1
MULTIPLE RESPONSE
1. Which of the following disciplines generally make up an ethics committee? Select all that apply.
a. Nursing
d. Chaplains
b. Medicine
e. Client’s family
c.
Social work
ANS: A, B, C, D
PTS: 1
Chapter 11 Practice Issues Related to Patient Self-Determination
MULTIPLE CHOICE
1. What is the legal protection of a patient’s right to personal autonomy?
a. Paternalism
c.
Informed consent
b. Advanced directives
d. Competence
ANS: C
PTS: 1
2. The nurse’s role and responsibilities in informed consent include all the following except:
a. verifying that the patient is aware of options and implications of each.
b. advocating to ensure that criteria for autonomous decision making is met.
c. explaining the procedure to the patient when the doctor cannot do so.
d. signing as a witness attesting that the patient is giving consent willingly.
ANS: C
PTS: 1
3. Competence is:
a. a legal action physicians can impose on patients who are elderly and confused.
b. the ability of a patient to understand medical options and treatment.
c. a legal ruling regarding a person’s ability to make meaningful life decisions.
d. the ability of a patient to communicate about current events.
ANS: C
PTS: 1
4. If a patient is not given the opportunity to ask questions about a procedure prior to the start of the
procedure, which patient right is being violated?
a. Autonomy
c. Advance directives
b. Justice
d. Informed consent
ANS: D
PTS: 1
5. The law passed in 1991 that requires institutions receiving Medicaid or Medicare funding to provide
written information to adult patients regarding their right to make health care decisions is the:
a. Uniform Health Care Information Act.
b. Patient Self-Determination Act.
c. Patient Bill of Rights.
d. Civil Rights Act.
ANS: B
PTS: 1
6. A nurse is caring for a patient with cancer, who describes using an herbal preparation and guided
imagery as part of her treatment. Considerations related to patient self-determination would direct the
nurse to:
a. honor the patient’s right to use therapies other than conventional medicine to address her
health care needs.
b. tell the patient that she should stop these therapies because they have no research to
support them.
c. inform the patient that she has a right to do what she wants, but that it’s crazy to mix
different traditions.
d. encourage the patient to share the herbal preparation with other patients to see if it might
help them as well.
ANS: A
PTS: 1
7. In dealing with a patient’s lifestyle choices, nurses need to remember the instructions in the American
Nurses Association Code of Ethics, which would include:
a. respect human dignity.
b. avoid value judgments.
c. practice compassion.
d. a and b.
e. all of the above.
ANS: E
PTS: 1
8. A nurse who discusses a patient’s condition and treatment with family members who were not
authorized to have medical information disclosed to them is breaching:
a. autonomy.
c. competence.
b. paternalism.
d. confidentiality.
ANS: D
PTS: 1
9. Having the freedom to make choices about issues that affect our own lives and to make decisions
about personal goals is called:
a. paternalism.
c. autonomy.
b. informed consent.
d. competence.
ANS: C
PTS: 1
10. Instructions that indicate health care interventions to initiate or withhold, or that designate someone
who will act as a surrogate in making such decisions in the event that we lose decision-making
capacity is termed:
a. informed consent.
c. paternalism.
b. autonomy.
d. advanced directives.
ANS: D
PTS: 1
11. The information that needs to be included in an informed consent document include which of the
following?
a. A description of all treatment options, even those that the health care provider does not
favor or cannot provide
b. The benefits, risks, and consequences of the various treatment alternatives including
nonintervention
c. The nature of the health concern and prognosis if nothing is done
d. All of the above
e. a and b
ANS: D
PTS: 1
MULTIPLE RESPONSE
1. Which of the following elements must be present when evaluating a patient’s decision-making
capacity? Select all that apply.
a. The ability to understand the information provided
b. The ability to communicate understanding
c. The ability to indicate personal choices and decisions
d. The ability to understand medical terminology
e. The ability to demonstrate values guiding the decision
ANS: A, B, C, E
PTS: 1
2. A nurse’s advocacy role regarding a patient’s advance directives (AD) include which of the following?
Select all that apply.
a. Ensuring that care is consistent with the patient’s wishes and AD
b. Telling patients about changes in their conditions so they can modify AD
c. Alerting physicians to changes in the patient’s decision-making capacity
d. Informing health team members of the content of a patient’s AD
e. Intervening appropriately when a patient’s wishes are not being followed
ANS: A, C, D, E
PTS: 1
3. Factors that may threaten autonomy in health care settings may include which of the following? Select
all that apply.
a. Persistent paternalistic attitude that promotes the dependent role of the patient.
b. Assumptions that a patient’s values and thought processes are the same as those of the
health care providers.
c. A focus on caring rather than technology.
d. Failure to appreciate a difference in knowledge level regarding health matters.
e. Patients and families who feel confident enough to share their choices with health care
providers.
ANS: A, B, D
PTS: 1
4. Which of the following statements about living wills are true? Select all that apply.
a. Living wills are documents giving directions to health care providers related to
withholding or withdrawing life support if certain conditions exist.
b. In all states, only persons who are terminally ill or whose death is imminent are allowed to
make living wills.
c. Statutes regulating living wills vary from state to state, so nurses must be familiar with
their own state laws.
d. Living wills may be vague and can address only the interventions a person does not want.
e. Allows a competent person to designate another as a surrogate or proxy to act on her or his
behalf.
ANS: A, C, D
PTS: 1
Chapter 12 Scholarship Issues
MULTIPLE CHOICE
1. Two core values basic to academic integrity and to ethical treatment of research data are:
a. plagiarism and cheating.
c. beneficence and integrity.
b. cheating and forgery.
d. veracity and integrity.
ANS: C
PTS: 1
2. Which of the following documents was developed to set forth principles for the ethical conduct of
research in response to human rights violations during World War II?
a. Belmont Report
c. Nuremberg Code
b. ANA Code of Ethics
d. Declaration of Helsinki
ANS: C
PTS: 1
3. A nurse researcher who decides to discontinue a research project because the findings indicate that the
risks of the study outweigh the benefits is applying the principle of:
a. beneficence.
c. trustworthiness.
b. justice.
d. confidentiality.
ANS: A
PTS: 1
4. A nurse researcher would address protection of human rights by assuring that the research protocol
includes all the following except:
a. right to freedom from injury.
c. right to autonomy.
b. right to privacy.
d. right to free medical care.
ANS: D
PTS: 1
5. Recruiting participants for a study by offering them a sizeable amount of money, travel expense, and
reimbursement of medical fees can be considered a form of:
a. full disclosure.
c. right to fair treatment.
b. coercion.
d. compensation.
ANS: B
PTS: 1
6. Of utmost importance in the ethical treatment of data are the integrity and honesty of the:
a. statistician.
c. researcher.
b. participants.
d. data collector.
ANS: C
PTS: 1
7. Issues affecting academic integrity include:
a. plagiarism and cheating.
b. cheating and editing.
ANS: A
c. editing and forgery.
d. forgery and consulting.
PTS: 1
8. The process of obtaining consent from children ages 7 to 18 years old is called:
a. full disclosure.
c. right to treatment.
b. assent.
d. trustworthiness.
ANS: B
PTS: 1
9. Taking anothers ideas or work and presenting them as our own is called:
a. veracity.
c. fidelity.
b. cheating.
d. plagiarism.
ANS: D
PTS: 1
10. The
was issued by the World Medical Assembly in 1964 and revised in 1975 and
2008 to guide clinical research.
a. Belmont Report
c. Declaration of Helsinki
b. ANA Code of Ethics
d. Nuremberg Code
ANS: C
PTS: 1
11. Authorization from research participants to use patient health information (PHI) for research purposes
should include which of the following?
a. What PHI will be disclosed.
b. The purpose for which the PHI will be used.
c. Who will have access to the PHI.
d. All of the above
e. b and c
ANS: D
PTS: 1
MULTIPLE RESPONSE
1. Which of the following are characteristics of ethical research that go beyond the protection of human
rights? Select all that apply.
a. Scientific objectivity
b. Cooperation
c. Courage
d. Personal gain
e. Equitability
ANS: A, B, C, E
PTS: 1
2. Which of the following are considered vulnerable populations needing special considerations in
research protocols? Select all that apply.
a. Pregnant women
b. Mentally disabled
c. Emotionally disabled
d. Young children
e. Incarcerated
ANS: A, B, C, D, E
PTS: 1
3. Beneficence, respect for human dignity, and justice imply protection from what? Select all that apply.
a. Physical harm
b. Emotional harm
c. Spiritual harm
d. Economic harm
e. Social harm
ANS: A, B, C, D, E
PTS: 1
4. Efforts to bolster protections for human research subjects focus on which of the following? Select all
that apply.
a. Auditing records for evidence of compliance with informed consent
b. Managing conflicts of interest so that research subjects are appropriately informed
c. Imposing monetary penalties for violations of important research practices such as
informed consent
d. Education and training of clinical investigators and Institutional Review Board members
e. Decreased monitoring of clinical trials
ANS: A, B, C, D
PTS: 1
5. Which of the following statements are true regarding factors to consider in the fair treatment of
participants? Select all that apply.
a. Selecting participants on the basis of research needs
b. Equitably distributing the risk and benefits of the research among study participants
c. Treating persons who decline to participate or withdraw from the study with prejudice
d. Debriefing as needed to clarify issues
e. Treating participants with respect
ANS: A, B, D, E
PTS: 1
Chapter 13 – The Future of Canadian Health Care: Challenges and Priorities
MULTIPLE CHOICE
1. What report emphasized the need for primary health care reform in Canada?
a. Drummond Report
b. Declaration of Alma-Ata
c. Romanow Report
d. Quinquennial Report
ANS: C
PTS: 1
REF: p. 336
BLM: Remember
2. Which of the following is an example of the federal responsibility for health care?
a. evaluating physician and hospital care
b. delivering direct health care services to native Canadians
c. delivering and managing insured health services
d. managing some public health and prescription care
ANS: B
PTS: 1
REF: p. 327
BLM: Higher Order
3. Which of the following is an example of provincial or territorial responsibility for health care?
a. deciding upon the principles for health care
b. delivering direct health care services to veterans
c. providing health-related functions such as health protection programs
d. evaluating physician and hospital care
ANS: D
PTS: 1
REF: p. 327
BLM: Higher Order
4. What health care changes evolved in the latter part of nineteenth century in Canada ?
a. public health
b. interprofessional care
c. immigrant health
d. curative programs
ANS: A
PTS: 1
REF: p. 328
BLM: Higher Order
5. Which act gives provinces the authority over health care, but gives the federal government the
responsibility to fund it?
a. Medicare Act, 1946
b. Constitution Act, 1982
c. British North America Act
d. Saskatchewan Medical Care Insurance Act
ANS: B
PTS: 1
REF: p. 331
BLM: Higher Order
Chapter 13 The Future of Canadian Health Care: Challenges and Priorities
6. Which report emphasized that the determinants of health did not simply exist within the health
care system but also in other sectors?
a. Canadian Health Report
b. Tommy Douglas Health Report
c. Quinquennial Report
d. Lalonde Report
ANS: D
PTS: 1
REF: p. 332
BLM: Higher Order
7. The main goal of primary health care is health for all in a community, and the involvement of
individuals and groups in communities. What is another key element of primary health care?
illness prevention
problem-based care
universal health care
intersectoral collaboration
a.
b.
c.
d.
ANS: D
PTS: 1
REF: p. 336
BLM: Higher Order
8. Accessibility is one of the five key features of the Canada Health Act. Which of the following
is NOT directly addressed in the Act?
a. reasonable access for citizens without financial barriers
b. extra billing and user fees for citizens
c. geographical accessibility
d. providing equitable care for all citizens
ANS: C
PTS: 1
REF: p. 337
BLM: Higher Order
9. Large immigrant populations may live in overcrowded situations and, in some cases, may be
unable to access health care. In addition to financial constraints, what is another issue that
immigrant populations might face with regard to health care?
a. burdening the health care system with longer wait times
b. language and cultural barriers to health care
c. burdening primary health care, and spending more on prescription drugs
d. lack of health care providers and facilities
ANS: B
PTS: 1
REF: p. 338
BLM: Higher Order
10. Which of the following contribute to the challenge of providing health care for populations
across the globe?
infant mortality and globalization
ecology and traditional healing systems
war and national crises
relationships and curative measures
a.
b.
c.
d.
ANS: C
PTS: 1
REF: p. 339
BLM: Higher Order
Chapter 14 Health Policy Issues
MULTIPLE CHOICE
1. Organized groups with distinct ideologies that seek to control government are called:
a. partisan parties.
c. political parties.
b. community groups.
d. municipal groups.
ANS: C
PTS: 1
2. Which branch of government is involved in the operation of government agencies, such as state boards
of nursing and medicine?
a. Judicial branch
c. Executive branch
b. Administrative branch
d. Legislative branch
ANS: B
PTS: 1
3. Nurses function in a variety of roles, and responsible political involvement is an important
function of each of these roles. These roles can include:
a.
b.
c.
d.
e.
f.
knowledgeable consumers of health care.
citizens.
professionals whose practice is regulated by the government.
advocates for patients.
all of the above
a, c, and d
ANS: E
PTS: 1
4. When political parties take opposing positions on an issue, the different opinions and subsequent
decisions are said to be:
a. invalid.
c. political.
b. partisan.
d. unethical.
ANS: B
PTS: 1
5. Which of the following is true?
a. Moral issues and political issues are very different.
b. Knowledge of moral principles will guide policy makers to the one correct policy.
c. A moral issue can become “political” in a number of ways.
d. Judicial precedents are rarely considered when policy is formulated.
ANS: C
PTS: 1
6. Which of the following is both a moral and political issue?
a. Abortion
b. Stem cell research
c. Physician-assisted suicide
d. All but b above
e. All of the above
ANS: E
PTS: 1
7. A nurse becomes concerned because her facility consistently requires mandatory overtime, up to 40
additional hours per week. The nurse brings the issue to the attention of her professional organization,
and together they approach their legislator. These acts can be considered which of the following?
a. Policy formulation
c. Policy evaluation
b. Policy implementation
d. Policy modification
ANS: A
PTS: 1
8. The nurses’ organization decides to work toward legislation that would limit mandatory overtime in
the workplace. They mobilize large numbers of nurses and community volunteers to write letters and
make personal contact with legislators. This form of political activism is known as which of the
following?
a. En masse lobbying
c. Grassroots lobbying
b. Partisan lobbying
d. Political lobbying
ANS: C
PTS: 1
9. A nursing professor is actively involved in lobbying for health policy issues. The professor tells the
class that these activities are moral duties. What is the best explanation for this statement?
a. The nursing professor likely learned the sense of duty from her upbringing.
b. The nursing professor has a deontological ethical perspective.
c. The ANA and ICN codes of ethics for nurses direct the nurse to promote efforts to meet the
health needs of society.
d. The nursing professor is attempting to influence the students to become politically active.
ANS: C
PTS: 1
10. Which of the following is a health policy issue of concern to the profession of nursing?
a. Abortion
b. Third-party reimbursement
c. Air pollution control
d. Gun control
e. All of the above
f. a, b, and c above
ANS: E
PTS: 1
11. Which of the following is a description of the most effective type of letter sent to a policy maker in a
lobbying campaign?
a. A long emotional plea that is very thorough and explanatory and includes many examples
b. A form letter with a handwritten salutation and signature
c. A concise handwritten letter written in your own words, using your own thoughts and logic
d. A letter that includes a list of all topics of interest to nurses in your area
ANS: C
PTS: 1
12. Issues that are created, affected, or regulated by any of the government branches are:
a. political issues
c. health policy issues
b. partisan issues
d. regulatory issues
ANS: A
PTS: 1
13. A politically active nurse lobbies legislators in her state to enact universal health insurance legislation.
Which ethical principle most likely serves as the foundation for this political activity?
a. Justice
c. Nonmaleficence
b. Fidelity
d. Autonomy
ANS: A
PTS: 1
MULTIPLE RESPONSE
1. Which of the following statements regarding allocative policies are true? Select all that apply.
a. Allocative policies are an area in which we see distributive justice in practice.
b. Allocative policies are essentially economic in nature.
c. Allocative policies determine what programs are funded.
d. Medicare and Medicaid are the most well-known allocative health policies.
e. Allocative policies are those designed to direct the actions, behaviors, and decisions of
individuals or groups.
ANS: A, B, C, D
PTS: 1
2. The process of health policy includes which of the following phases? Select all that apply.
a. Policy solutions
b. Policy implementation
c. Policy formulation
d. Policy problems
e. Policy modification
ANS: B, C, E
PTS: 1
Chapter 15 Economic Issues
MULTIPLE CHOICE
1. Which of the following ethical theories of justice are based upon the rule that it is good to maximize
the greatest good for the greatest number of people?
a. Libertarian theories
c. Deontological theories
b. Utilitarian theoriesd.
Communitarian
theories
ANS: B
PTS: 1
2. Three patients arrive at the free clinic in need of the same medication, but there is only enough in stock
for one person. The nurse in charge of the clinic asks herself, “Who needs this medicine most?” This
question suggests which of the following?
a. The nurse is utilizing a material rule of distributive justice to make her decision.
b. Decisions about how to distribute scarce medications are capricious.
c. The nurse should collaborate with the clinic physician when she makes this type of
decision.
d. There are no rules regulating distribution of scarce medications in this facility.
ANS: A
PTS: 1
3. The economics of Country A support the rights of property and liberty for each person and allow each
citizen to improve life circumstances by his or her own effort. Health care can be purchased or given
freely in Country A, but there is no entitlement program to ensure basic health care to vulnerable
people. This type of economic structure best describes which of the following?
a. Marxism
c. Democracy
b. Communitarianism
d. Libertarianism
ANS: D
PTS: 1
4. John Rawles suggested that in making decisions of distributive justice, one should examine the
situation behind a “veil of ignorance” so that no one would be able to design principles to favor his or
her particular condition. This idea supports which of the following economic theories for which
Rawles was a proponent?
a. Utilitarianism
c. Egalitarianism
b. Communitarianism
d. Libertarianism
ANS: C
PTS: 1
5. Different methods of paying for health care in the United States seek to provide superior care, equality
of access, and freedom of choice for all citizens, while promoting the public interest through costcontainment programs. Citizens discuss the ideal of equal access to health care for everyone, including
care for indigents. Yet, segments of the health care system maintain aspects of a free-market
competition. Which of the following statements best describes this system?
a. Utilitarian theory is the sole basis for U.S. health care financing, forming the foundation of
Medicare, Medicaid, and privately purchased health care insurance.
b. Libertarianism, which espouses a free market system and freedom of choice, undergirds
the basic principles of U.S. health care financing.
c. Several theories of justice try to achieve a balance between competing social goals in the
U.S. health care system.
d. Most health care financing occurs at the community level; therefore communitarian
principles are most applicable to U.S. health care economics.
ANS: C
PTS: 1
6. In Canada, almost all people are insured against the cost of all hospital and physician expenses through
a government health insurance program. This type of health care financing is commonly called:
a. fee for service.
c. universal health insurance.
b. managed care.
d. voluntary or private insurance.
ANS: C
PTS: 1
7. Which of the following health care financing systems has a strong focus on the principle of autonomy?
a. Fee for service
c. Universal health insurance
b. Managed care
d. Single payer systems
ANS: A
PTS: 1
8. Which of the following is a natural consequence of utilitarian forms of health care financing?
a. Resources and services will be distributed equally.
b. Some people will not receive resources and services.
c. Those people with the greatest need receive the bulk of resources and services.
d. People who have greater personal resources will receive greater benefit.
ANS: B
PTS: 1
9. Which of the following best describes the connection between ethics and health care financing?
a. Health care financing is an outcome of social morality and collective beliefs about
distribution of health care services in terms of good versus bad, right versus wrong, and
harm versus benefit.
b. Codes of ethics mandate that professionals in each discipline contribute to society through
participation in health care policy.
c. Health care professionals’ duties center on the individual patient, and health care financing
directly impacts each person’s ability to receive care.
d. Health care financing rests upon the ethical principles of distributive justice, beneficence,
and nonmaleficence.
ANS: A
PTS: 1
10. A “health care system which attempts clinically and financially to control primary health care services
in a medical group practice through elimination of redundant facilities and services for the purpose of
reducing costs” describes which of the following health care financing systems?
a. Fee for service
c. Categorical financing
b. Universal health care
d. Managed care
ANS: D
PTS: 1
11. Which of the following ethical theories place the community, rather than the individual, the state, the
nation, or any other entity, at the center of the value system?
a. Libertarian theories
c. Utilitarian theories
b. Deontological theories
d. Communitarian theories
ANS: D
PTS: 1
12. Examples of health care cost containment in the 1980s included:
a. a payment system based on Diagnosis related groups (DRGs).
b. certificate of need programs.
c. Professional standards review organizations (PSROs).
d. Peer review organizations (PROs).
e. all of the above.
f. a and b only.
ANS: E
PTS: 1
13. The traditional health care system in the United States is:
a. managed care.
c. universal health insurance.
b. fee-for-service.
d. single payer systems.
ANS: B
PTS: 1
MULTIPLE RESPONSE
1. Managed care gives rise to ethical problems associated with balancing utilitarian views of costeffective care with a respect for persons and the traditional view of a duty to care. Which of the
following statements are considerations for managed care organizations? Select all that apply.
a. Relationships are not critical in the delivery of health services.
b. Health plans, purchasers, clinicians, and the public share responsibility for the appropriate
stewardship of health care resources.
c. Patients do not need to be well informed about the financial benefit issues that affect the
provision of care.
d. All parties should foster an ethical environment for the delivery of effective and efficient
quality health care.
e. Patients should be well informed about care and treatment options.
ANS: B, D, E
PTS: 1
2. Which of the following statements about managed care are true? Select all that apply.
a. It attempts to control costs by modifying the behavior of providers and patients.
b. It is a system that is based on patient and provider autonomy.
c. It lowers cost through the elimination of waste and excess.
d. It aims toward lower premiums and preventive care benefits.
e. It is attentive to the needs of the membership group and individual patients.
ANS: A, C, D, E
PTS: 1
Chapter 16 Social Issues
MULTIPLE CHOICE
1.
and
continue to be prevalent in the United States as a consequence of the overall economy
and changes in government assistance programs and taxes.
a. Uninsured; racism
c. Elderly population; poverty
b. Racism; homelessness
d. Poverty; homelessness
ANS: D
PTS: 1
2. Higher incidence of conditions associated with poor nutrition, trauma, drugs, burns, mental illness, and
HIV are being seen in which population?
a. Children living in poverty
c. Elderly living in poverty
b. Adults living in poverty
d. Abused women living in poverty
ANS: A
PTS: 1
3. When considering health care options for patients, nurses need to be aware that federal programs for
the indigent cover what percentage of individuals living on incomes below the poverty line?
a. 25 percent
c. 75 percent
b. 50 percent
d. 100 percent
ANS: B
PTS: 1
4. An African American man returned to the emergency room for the fourth time in less than a week
complaining of severe epigastric pain. Talk begins at the nurses’ station regarding whether the patient
should even receive treatment as it is his fault the pain is back; they claim he has GERD but never
filled the prescription given to him. This behavior by the nurses is an example of what?
a. Racism
c. Victim blaming
b. Language of violence
d. Nonmaleficence
ANS: C
PTS: 1
5. All of the following factors contribute to a domestic violence victim returning to her abusive partner
except:
a. support from the criminal justice system.
b. lack of housing and suitable job.
c. pressure from family and friends.
d. concern for children’s well-being.
ANS: A
PTS: 1
6. Issues that influence the health and health care options of increasing numbers of elderly include which
of the following?
a. Social isolation
b. Economic hardships
c. Poverty
d. Chronic illness
e. All of the above
ANS: E
PTS: 1
7. If two patients need the same resources in the same medical situation, it is justifiable, when resources
are scarce, to limit them to patients having insurance and showing an ability to pay for the resources.
a. True
b. False
ANS: B
PTS: 1
8. Giving preference for health care to those who have the ability to pay is an example of disregarding
which ethical principle?
a. Nonmaleficence
c. Beneficence
b. Justice
d. Autonomy
ANS: B
PTS: 1
9. Refusing to discharge an abused child to her home when there is a possibility of further injury is an
example of which ethical principle?
a. Nonmaleficence
c. Beneficence
b. Justice
d. Autonomy
ANS: A
PTS: 1
10. The acquisition, harboring, and trade of persons through force, threat, deception, or other forms of
coercion with the aim of exploiting them is called:
a. racism.
c. domestic violence.
b. human trafficking.
d. poverty.
ANS: B
PTS: 1
11. Nursing responsibilities related to victims of human trafficking may include:
a. recognizing signs of this form of violence.
b. providing appropriate interventions and support.
c. working toward prevention of this form of violence
d. all of the above.
e. a and b only.
ANS: D
PTS: 1
MULTIPLE RESPONSE
1. Nursing care and policy need to address which of the following issues? Select all that apply.
a. Poverty
b. Homelessness
c. Domestic violence
d. Lack of insurance
e. Racism
ANS: A, B, C, D, E
PTS: 1
2. The elderly are a growing population worldwide. Which of the following statements are true regarding
this population? Select all that apply.
a. In developed countries, those aged 80 and above are the fastest growing population.
b. The incidence of elderly abuse is decreasing worldwide.
c. Many elderly, especially from minority populations, live without pensions and on incomes
below the poverty level.
d. Chronic illness, pain, cognitive problems, and disabilities increase in frequency in the
elderly.
e. Few elderly are socially isolated or susceptible to economic hardship.
ANS: A, C, D
PTS: 1
3. Poverty and homelessness are an issue among U.S. citizens. Which of the following statements are true
regarding poverty? Select all that apply.
a. Poverty is known to have a negative impact on the health of individuals.
b. Poorer individuals are sicker than individuals with adequate financial resources.
c. Individuals living below the poverty level frequently participate in preventive care
services.
d. The new homeless are families, single women with children, veterans, and elderly.
e. Children living in poverty have a higher incidence of conditions associated with trauma,
poor nutrition, drugs, burns, mental illness, and HIV infections.
ANS: A, B, D, E
PTS: 1
4. Intimate partner violence (IPV) is a common social condition affecting health and health care delivery.
Which of the following is true regarding IPV? Select all that apply.
a. Women comprise the vast majority of IPV victims.
b. IPV is the least common but most reported crime.
c. The vast majority of women eventually leave their abusive partners.
d. IPV does not affect women of all socioeconomic, racial, and ethnic groups.
e. Women living in abusive situations experience acute traumatic injuries and chronic
physical and emotional problems.
ANS: A, C, E
PTS: 1
Chapter 17 –Issues of Gender and Culture
MULTIPLE CHOICE
1. Which term refers to a disparity in earnings?
a. sameness salary
b. pay gap
c. feminist fee
d. comparable worth
ANS: B
PTS: 1
REF: p. 418
BLM: Higher Order
2. Which of the following is a male patient making the statement that “nurses are well-bred,
well-educated specimens of womanhood” an example of?
sexism
paternalism
nursism
parentalism
a.
b.
c.
d.
ANS: A
PTS: 1
REF: p. 424
BLM: Higher Order
3. Which of the following is a major limiting factor for men still entering into the profession of
nursing?
a. collective bargaining
b. pay gap
c. societal stereotyping
d. caring behaviours
ANS: C
PTS: 1
REF: p. 418
BLM: Remember
4. An experienced male nurse applies for a position in labour and delivery. Even though he is
better qualified than other applicants, the nurse manager hires a female nurse. The manager
explains that she wants to protect her patients from being uncomfortable with a male nurse.
Which of the following is this situation an example of?
a. sexism
b. transcultural respect
c. nursism
d. societal expectations
ANS: C
PTS: 1
REF: p. 424
BLM: Higher Order
5. Which of the following governs employment equity and equal pay for equal work as a right
protected in provinces across Canada?
a. Elimination of All Forms of Discrimination Against Women
b. Equal Wages Guidelines
c. Pay Gap Act
d. Fair-Labour Legislation
Chapter 17 Issues of Gender and Culture
ANS: B
PTS: 1
REF: p. 417
BLM: Remember
6. A female nurse manager is overly friendly toward a young male colleague. She makes
sexually explicit remarks and often corners him in the medication room, standing
uncomfortably close. Which of the following is this behaviour consistent with?
a. sexual assault
b. sexual deviance
c. sexual harassment
d. hostile work environment
ANS: C
PTS: 1
REF: p. 420
BLM: Higher Order
7. Which of the following does Williams identify as one of the several hidden advantages to
being a man in nursing?
a. men have increased responsibility and autonomy in health care
b. men learn and express caring faster than females
c. men are tracked into higher paying and more prestigious positions
d. men are territorial and authoritative with other health care professionals
ANS: C
PTS: 1
REF: p. 418
BLM: Higher Order
8. What is one factor that systematic discrimination against lesbians and gay men in nursing
results from in health care institutions?
a. avoidance
b. societal stereotyping
c. punitive supervisors
d. controversy
ANS: C
PTS: 1
REF: p. 425
BLM: Higher Order
9. According to recent statistics, on average, what does a woman get paid compared to a man in
a similar position?
80 percent as much
70 percent as much
60 percent as much
50 percent as much
a.
b.
c.
d.
ANS: B
PTS: 1
REF: p. 417
BLM: Remember
10. What is the term for knowing about the values, beliefs, behaviours, norms, and customs of a
patient who comes from a culture other than your own?
a. cultural awareness
b. cultural sensitivity
c. ethnocentrism
d. cultural competence
ANS: A
PTS: 1
REF: p. 426
BLM: Higher Order
Chapter 17 Issues of Gender and Culture
Chapter 17 Issues of Gender and Culture
11. Which forms of discrimination are clearly prohibited by Canada’s Charter of Rights and
Freedoms ?
a. any form of practised inequality
b. unwelcome conduct that detrimentally affects the work environment
c. nurses’ functioning subordinate to multiple layers of authority
d. disparity in earnings existing between men and women
ANS: A
PTS: 1
REF: p. 421
BLM: Higher Order
12. Through informal dress and communications, what type of powerful messages may nurses be
sending?
positive messages
negative messages
successful messages
friendly messages
a.
b.
c.
d.
ANS: B
PTS: 1
REF: p. 424
BLM: Remember
13. What is the term for the gender division of labour pertaining to nurses and physician and how
they relate to each other in health care settings?
a. physician–nurse relations
b. mean-spiritedness
c. the doctor–nurse game
d. male domination
ANS: C
PTS: 1
REF: p. 422
BLM: Higher Order
14. A nurse’s Aboriginal patient tells her that his health problem was caused by the Manitou and
that he needs some blue beads for protection and healing. What does cultural sensitivity direct
the nurse to do?
a. caringly inform the patient that the Manitou is an old belief and is not real
b. make a mental health referral to a local Aboriginal therapist
c. listen respectfully to the patient’s story and go on with the treatment
d. explore more about the blue beads and try to get some for the patient
ANS: D
PTS: 1
REF: p. 428
BLM: Higher Order
15. When are transcultural issues and conflicts more likely to arise?
a. when nurses are aware of their own biases and judgments of others
b. when nurses judge other people’s behaviour by their own cultural values
c. when nurses understand their own cultural beliefs and values
d. when nurses avoid judging others based on preconceived ideas
ANS: B
PTS: 1
REF: p. 428
BLM: Higher Order
Chapter 17 Issues of Gender and Culture
16. What does Achterberg cite in her article Woman as Healer as one of the many issues that
challenge nurses?
a. nursing gaining professional status
b. the masculinisation of medicine
c. maligning the caring role in society
d. oppression of women
ANS: B
PTS: 1
REF: p. 416
BLM: Higher Order
17. Which of the following demonstrates a nurse’s understanding that good communication is key
to providing culturally congruent care?
a. The nurse determines the patient’s understanding of the nurse’s written and spoken
language.
b. The nurse considers a family member to be the best interpreter when the language
is different.
c. The nurse understands that his/her own values and beliefs and those of the clients
are congruent.
d. The nurse discovers that expectations and patient perspectives are related to
acquiring a positive attitude.
ANS: A
PTS: 1
REF: p. 437
BLM: Higher Order
Chapter 18: Ruíal, Remote, and Indigenous Nuísing in Canada
MULTIPLE CHOICE
1. What is the percent of Canadians defined as living in a rural environment?
a. between 10 and 20 percent
b. between 20 and 30 percent
c. between 30 and 40 percent
d. between 40 and 50 percent
ANS: B
PTS: 1
REF: p. 446
BLM: Remember
2. Which of the following statements applies to Canadians living in a rural environment?
a. More new immigrants and visible minorities live in rural areas.
b. People are more ethnically diverse.
c. People have a wider variety of opportunities.
d. Families tend to have lower incomes.
ANS: D
PTS: 1
REF: p. 446
BLM: Higher Order
3. What health issue is more likely to be found in rural communities?
a. higher rates of infectious diseases
b. lower rates of “healthy heart” practices
c. overall poor nutrition
d. higher levels of stress
ANS: B
PTS: 1
REF: p. 447
BLM: Higher Order
4. Which of the following is an objective of the Canadian Association for Rural and Remote
Nursing?
to reduce inequities between groups and populations
to facilitate communication and networking
to regulate remote health care teamwork and interdisciplinary approaches
to highlight the professional and practice challenges of rural nursing
a.
b.
c.
d.
ANS: B
PTS: 1
REF: p. 448
BLM: Remember
5. Which of the following does the Registered Nurses Association of Ontario (RNAO) identify
as one of the eight attributes of nursing professional practice?
a. collegiality
b. consistency
c. accessibility
d. predictability
ANS: A
PTS: 1
REF: p. 449
BLM: Higher Order
6. Which of the following individuals would self-identify as being a part of at least one
Aboriginal group?
Amish
Acadian
Québécois
Inuit
a.
b.
c.
d.
ANS: D
PTS: 1
REF: p. 455
BLM: Remember
7. A nurse works in a small outpost hospital in Inuvik. The nurse attends a local hockey game at
the arena and is asked the following question by a resident of the town: “When I saw you last
week about the pain in my stomach and was given the medication it helped for a bit. Today it’s
the same but different, what do you think I should do?” What concept is this scenario an
example of?
a. being professional
b. meeting obligations
c. avoiding boundaries
d. being enmeshed
ANS: D
PTS: 1
REF: p. 450
BLM: Higher Order
8. A nurse in a small rural hospital is out grocery shopping and is asked the following in the
check-out lane: “How is Sarah doing? Was the operation successful?” Which of the following
statements must the nurse be aware of when working in a rural community?
a. Talking about patients to members in a small community is a cultural norm.
b. The confidentiality of patients’ information must be protected.
c. Being fully embedded as a nurse in a small community involves discussing all
patients.
d. Providing holistic nursing care in a rural setting implies overlap of a nurses’ role
patients.
ANS: B
PTS: 1
REF: p. 450
BLM: Higher Order
9. What type of nursing education may help nurses in rural and remote areas to access
continuing and graduate education?
a. university continuing education
b. college continuing education
c. modular courses
d. co-operative programs
ANS: C
PTS: 1
REF: p. 453
BLM: Higher Order
10. Which of the following is a factor that impacts the health and well-being of Aboriginal
persons?
a. social inclusion
b. civil war
c. population growth
d. physical environment
ANS: D
PTS: 1
REF: p. 456
BLM: Remember
11. Which of the following best defines Aboriginal nursing?
a. nurses working in outpost settings and northern territories
b. nurses with specialized knowledge, affirmed by a faith community
c. Aboriginal persons who work as nurses
d. nurses who work in Aboriginal communities
ANS: D
PTS: 1
REF: p. 458
BLM: Remember
12. Who typically employs the nurses who provide care on First Nations reserves?
a. Health Canada
b. First Nations band council
c. Aboriginal community
d. Aboriginal Nurses Association of Canada
ANS: A
PTS: 1
REF: p. 459
BLM: Remember
Chapter 19 Empowerment for Nurses
MULTIPLE CHOICE
1. A nurse’s response to ethical issues is influenced by:
a. attitudes about nursing’s responsibility in health care settings.
b. personal beliefs and perceptions about nursing and health care.
c. perceptions of ideal nursing from those outside the profession.
d. a and b.
e. a, b, and c.
ANS: E
PTS: 1
2. Emphasis on a nurse’s role in terms of responsibility to the institution reflects the mind-set that views
health care as:
a. medical cases.
c. basic human right.
b. basic human need.
d. commodity.
ANS: D
PTS: 1
3. Current nursing codes direct nurses to be responsible primarily to the patient and advocates for patient
rights and needs. This ethical imperative reflects which of these metaphors of nursing?
a. Legal
c. Angel
b. Military
d. Loyalty
ANS: C
PTS: 1
4. Ethical nursing conduct reflected in current nursing codes includes all of the following behaviors
except:
a. following physician orders without question.
b. being alert for incompetent practice and care.
c. taking appropriate action to safeguard patients.
d. reporting practice that might endanger patients.
ANS: A
PTS: 1
5. A nurse who shares knowledge about and involves patients in health care decisions is demonstrating:
a. power over.
c. power with.
b. power protection.
d. power control.
ANS: C
PTS: 1
6. Power over implies all of the following except:
a. controlling knowledge and people.
c. protecting limited resources.
b. sharing responsibility with others.
d. separating leaders and followers.
ANS: B
PTS: 1
7. Nursing empowerment that derives from the perspective of power with or power to:
a. is given to or delegated to the nurse.
b. is a directive process regarding change.
c. is more focused on outcome than process.
d. is based on mutual love and respect.
ANS: D
PTS: 1
8. Which of the following might hinder nursing empowerment?
a. Taking action to address system issues
b. Eliminating divergent and conflicting views
c. Collaborating and sharing in decision making
d. Participating in forming institutional policies
ANS: B
PTS: 1
9. For the past few months Antonio has complained about inadequate staffing on all shifts to the
administrator of the nursing home where he works as a nurse. He documented poor patient care,
including patients not being fed appropriately and several patients who developed serious bedsores
after being left for hours on wet linens without being turned. When the administrator repeatedly
refused to make any changes, citing economic reasons, Antonio spoke to a reporter at the local paper
about the situation. This action of Antonio’s would be considered:
a. unethical.
c. whistle-blowing.
b. making trouble.
d. unprofessional.
ANS: C
PTS: 1
10. Following physician orders, even if the nurse questions the appropriateness of these orders; upholding
the patient’s faith in the physician, even if the nurse questions the doctor’s competence; and being
loyal to health care colleagues, even at the expense of the patient reflects which of the following
metaphors of nursing?
a. Legal
c. Advocacy
b. Military
d. Loyalty
ANS: B
PTS: 1
11. The willingness to stand up for personal core values and ethical beliefs even when we stand alone is
called:
a. moral courage.
c. self-esteem.
b. empowerment.
d. power.
ANS: A
PTS: 1
12. An individual who attempts to expose wrongdoing within an organization through warning the public
about negligence, professional misconduct or incompetence, or other factors that may endanger
patients or staff is called:
a. moral courage.
c. beneficence
b. whistle blowing.
d. empowerment.
ANS: B
PTS: 1
MULTIPLE RESPONSE
1. Professional empowerment in nursing is influenced by which of the following factors? Select all that
apply.
a. Personal attitudes and accountability
b. Support of professional colleagues
c. Economic, political, and social forces
d. Structure of health care system
e. Interactions with patients
ANS: A, B, C, D, E
PTS: 1
2. Factors in our internal and external environments affect both personal and professional decision
making. External environment factors include which of the following? Select all that apply.
a. Ideals
b. Mind-set
c. Expectations of patients
d. Professional systems we interact with
e. Personal beliefs
ANS: A, C, D
PTS: 1
3. Which of the following statements accurately describe the concept of empowerment? Select all that
apply.
a. Self-esteem, personal values, and perceptions are factors that can influence empowerment.
b. Empowerment is understood to be a participative process or partnership between a nurse
and patient.
c. Empowerment does not require respect for an individual’s personal beliefs and goals.
d. Sharing of knowledge through education is important for empowerment.
e. Empowerment requires trust in the person’s ability to make decisions, take action, and be
accountable for the actions.
ANS: A, B, D, E
PTS: 1