Chapter 39 Ethics & Values

Chapter 39 Ethics & Values of the Test Bank for Davis Advantage Basic Nursing Thinking, Doing, and Caring 4th Edition by Treas, Leslie S. Barnett, Karen L. Smith, Mable H.

3.   A mentally competent patient has an extremely low blood count and will likely die without a blood transfusion. The patient knows the risk, but continues to refuse the blood. Which action by the nurse is the most appropriate?

• a.   Assume the patient is confused and give the blood anyway.
• b.   Request a psychological evaluation to ensure that the patient understands the risk.
• c.   Ask family members to intervene and make the patient consent to receiving blood.
• d.   Follow the patient’s wishes and do not administer a blood transfusion.

ANS: D

You should follow the patient’s wishes and do not administer a blood transfusion. There is no evidence of confusion; the patient is competent, is aware of the risk, and has given a valid refusal. The nurse should not assume that a patient is confused simply because of the choice a patient makes. A psychological evaluation is not needed simply because the patient refuses treatment that might result in his death. Family members cannot override a patient’s decision. The nurse should respect the patient’s decision.

4.   A nurse is providing care to a patient who is a Jehovah’s Witness. Against the patient’s wishes, the physician ordered the nurse to give the patient two units of packed red blood cells. The nurse knows that the blood will save the patient’s life, but also that it is against the patient’s wishes; she is unsure what is the right thing for her to do. The nurse is experiencing a(n):

• a.   Reflection encounter
• b.   Ethical dilemma
• c.   Moral outrage
• d.   Moral distress

ANS: B

The nurse is experiencing an ethical dilemma based on the conflict between the ethical principles of beneficence and autonomy. The nurse has not yet made a decision. This is not a situation of moral distress, in which the nurse would have made an acceptable moral decision, but was unable to implement it because of external constraints. The nurse does not perceive that others are acting immorally; thus, this is not moral outrage.