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Chapter 1: Professional Nursing Practice
Hinkle: Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, 15th Edition
MULTIPLE CHOICE
- A nurse has been offered a position on an obstetric unit and has learned that the unit offers therapeutic
abortions, a procedure that contradicts the nurse’s personal beliefs. What is the nurse’s ethical
obligation to these clients?
A. The nurse should adhere to professional standards of practice and offer service to these
clients.
B. The nurse should make the choice to decline this position and pursue a different nursing
role.
C. The nurse should decline to care for the client’s considering abortion.
D. The nurse should express alternatives to women considering terminating their pregnancy.
ANS: B
Rationale: To avoid facing the ethical dilemma of providing care that contradicts the nurse’s personal
beliefs, the nurse should consider working in an area of nursing that would not pose this dilemma. The
nurse should not provide care to the client because it is a conflict of personal values. The nurse should
not deny care to these clients as this would be a breach in the Code of Ethics for nurses. If the client is
not requesting information for alternatives to abortions, then the nurse should not be providing this
information.
PTS: 1 REF: p. 27
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Professional Nursing Practice KEY: Integrated Process: Caring
BLM: Cognitive Level: Apply NOT: Multiple Choice - An 80-year-old client is admitted with a diagnosis of community-acquired pneumonia. During
admission the client states, “I have a living will.” What implication of this should the nurserecognize?
A. This document is always honored, regardless of circumstances.
B. This document specifies the client’s wishes before hospitalization.
C. This document is binding for the duration of the client’s life.
D. This document has been drawn up by the client’s family to determine DNR status.
ANS: B
Rationale: A living will is one type of advance directive. In most situations, living wills are limited to
situations in which the client’s medical condition is deemed terminal. The other answers are incorrect
because living wills are not always honored in every circumstance, they are not binding for the
duration of the client’s life, and they are not drawn up by the client’s family.
PTS: 1 REF: p. 29
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Professional Nursing Practice
KEY: Integrated Process: Communication and Documentation BLM: Cognitive Level: Analyze
NOT: Multiple Choice - A nurse has been providing ethical care for many years and is aware of the need to maintain the ethical
principle of nonmaleficence. Which of the following actions would be considered a violation of this
principle?
A. Discussing a DNR order with a terminally ill client
B. Assisting a semi-independent client with ADLs
C. Refusing to administer pain medication as prescribed
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D. Providing more care for one client than for another
ANS: C
Rationale: The duty not to inflict as well as prevent and remove harm is termed nonmaleficence.
Discussing a DNR order with a terminally ill client and assisting a client with ADLs would not be
considered contradictions to the nurse’s duty of nonmaleficence. Some clients justifiably require more
care than others.
PTS: 1 REF: p. 25
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Professional Nursing Practice
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
NOT: Multiple Choice
- A nurse has begun creating a client’s plan of care shortly after the client’s admission. The nurse knows
that it is important that the wording of the chosen nursing diagnoses falls within the taxonomy of
nursing. Which organization is responsible for developing the taxonomy of a nursing diagnosis?
A. American Nurses Association (ANA)
B. North American Nursing Diagnosis Association (NANDA)
C. National League for Nursing (NLN)
D. Joint Commission
ANS: B
Rationale: NANDA International is the official organization responsible for developing the taxonomy
of nursing diagnoses and formulating nursing diagnoses acceptable for study. The ANA, NLN, and
Joint Commission are not charged with the task of developing the taxonomy of nursing diagnoses.
PTS: 1 REF: p. 15
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Professional Nursing Practice
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice - A medical nurse has obtained a new client’s health history and has completed the admission
assessment. The nurse followed this by documenting the results and creating a care plan for the client.
Which of the following is the most important rationale for documenting the client’s care?
A. It provides continuity of care.
B. It creates a teaching log for the family.
C. It verifies appropriate staffing levels.
D. It keeps the client fully informed.
ANS: A
Rationale: This record provides a means of communication among members of the health care team
and facilitates coordinated planning and continuity of care. It serves as the legal and business record
for a health care agency and for the professional staff members who are responsible for the client’s
care. Documentation is not primarily a teaching log; it does not verify staffing; and it is not intended to
provide the client with information about treatments.
PTS: 1 REF: p. 14
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Professional Nursing Practice
KEY: Integrated Process: Communication and Documentation BLM: Cognitive Level: Understand
NOT: Multiple Choice
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- The nurse has been assigned to care for a client admitted with an opportunistic infection secondary to
AIDS. The nurse informs the clinical nurse leader that the nurse refuses to care for a client with AIDS.
The nurse has an obligation to this client under which of the following?
A. Good Samaritan Act
B. Nursing Interventions Classification (NIC)
C. The nurse practice act in the nurse’s jurisdiction
D. International Council of Nurses (ICN) Code of Ethics for Nurses
ANS: D
Rationale: The ethical obligation to care for all clients is included in the Code of Ethics for Nurses.
The Good Samaritan Act relates to lay people helping others in need. The NIC is a standardized
classification of nursing treatment that includes independent and collaborative interventions. Nurse
practice acts primarily address scope of practice.
PTS: 1 REF: p. 27
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Professional Nursing Practice
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand
NOT: Multiple Choice - The nurse, in collaboration with the client’s family, is determining priorities related to the care of the
client. The nurse explains that it is important to consider the urgency of specific problems when setting
priorities. What should the nurse adopt as the best framework for prioritizing client problems?
A. Availability of hospital resources
B. Family member statements
C. Maslow hierarchy of needs
D. The nurse’s skill set
ANS: C
Rationale: The Maslow hierarchy of needs provides a useful framework for prioritizing problems, with
the first level given to meeting physical needs of the client. Availability of hospital resources, family
member statements, and nursing skill do not provide a framework for prioritization of client problems,
though each may be considered.
PTS: 1 REF: p. 6
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Professional Nursing Practice
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice - A medical nurse is caring for a client who is receiving palliative care following cancer metastasis. The
nurse is aware of the need to uphold the ethical principle of beneficence. How can the nurse best
exemplify this principle in the care of this client?
A. The nurse tactfully regulates the number and timing of visitors as per the client’s wishes.
B. The nurse stays with the client during their death.
C. The nurse ensures that all members of the care team are aware of the client’s DNR order.
D. The nurse collaborates with members of the care team to ensure continuity of care.
ANS: A
Rationale: Beneficence is the duty to do good and the active promotion of benevolent acts. Enacting
the client’s wishes regarding visitors is an example of this. Each of the other nursing actions is
consistent with ethical practice, but none directly exemplifies the principle of beneficence.
PTS: 1 REF: p. 25
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
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TOP: Chapter 1: Professional Nursing Practice KEY: Integrated Process: Caring
BLM: Cognitive Level: Apply NOT: Multiple Choice
- In the process of planning a client’s care, the nurse has identified a nursing diagnosis of Ineffective
Health Maintenance related to alcohol use. What must precede the determination of this nursing
diagnosis?
A. Establishing of a plan to address the underlying problem
B. Assigning a positive value to each consequence of the diagnosis
C. Collecting and analyzing data that corroborate the diagnosis
D. Evaluating the client’s chances of recovery
ANS: C
Rationale: In the diagnostic phase of the nursing process, the client’s nursing problems are defined
through analysis of client data. Establishing a plan comes after collecting and analyzing data;
evaluating a plan is the last step of the nursing process; and assigning a positive value to each
consequence is not done.
PTS: 1 REF: p. 16
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Professional Nursing Practice
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply
NOT: Multiple Choice - The provider has recommended an amniocentesis for an 18-year-old primiparous client. The client is at
34 weeks’ gestation and does not want this procedure, but the health care provider arranges for the
amniocentesis to be performed. The nurse should recognize that the provider is in violation of which
ethical principle?
A. Veracity
B. Beneficence
C. Nonmaleficence
D. Autonomy
ANS: D
Rationale: The principle of autonomy specifies that individuals have the ability to make a choice free
from external constraints. The provider’s actions in this case violate this principle. This action may or
may not violate the principle of beneficence. Veracity centers on truth-telling, and nonmaleficence is
avoiding the infliction of harm.
PTS: 1 REF: p. 25
NAT: Client Needs: Safe, Effective Care Environment: Management of Care
TOP: Chapter 1: Professional Nursing Practice
KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze
NOT: Multiple Choice - During a discussion with the client and the client’s spouse, the nurse discovers that the client has a
living will. How does the presence of a living will influence the client’s care?
A. The client is legally unable to refuse basic life support.
B. The health care provider can override the client’s desires for treatment if desires are not
evidence based.
C. The client may nullify the living will during the hospitalization.
D. Power of attorney may change while the client is hospitalized.
ANS: C