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A nurse working in a busy clinic frequently sees patients who cannot afford necessary medications or treatments. The nurse often provides free samples or directs patients to charity programs, sometimes bending rules or using their own resources. While well-intentioned, this practice could be seen as blurring professional boundaries or misusing resources. Which ethical concept is the nurse primarily demonstrating, even if potentially misguided?

  • Autonomy
  • Veracity
  • Beneficence
  • Fidelity

A nurse is providing care to a patient who repeatedly expresses racist and discriminatory remarks towards staff members and other patients. The nurse finds these remarks personally offensive but understands the patient’s cognitive impairment may be contributing to the behavior. How should the nurse ethically respond to this situation?

  • Confront the patient about their discriminatory remarks immediately.
  • Document the behavior and continue to provide professional, non-judgmental care.
  • Refuse to provide care to the patient due to personal offense.
  • Request a different nurse be assigned to the patient.

A nurse working in an emergency department receives an unconscious patient who is a known organ donor. The patient has suffered irreversible brain damage, and the medical team determines there is no hope of recovery. The patient’s family is strongly against organ donation, despite the patient’s clear wishes documented in an advance directive. What is the nurse’s ethical priority?

  • Persuade the family to honor the patient's wishes.
  • Respect the family's immediate decision regarding donation.
  • Prioritize the patient's previously expressed autonomous decision (advance directive).
  • Delay the decision to allow more time for family grief.

A nurse is caring for a patient who has been diagnosed with a highly stigmatized infectious disease. The patient requests that this diagnosis not be disclosed to their family members, even though it could impact the family’s health. The nurse is torn between respecting the patient’s confidentiality and protecting the family’s health. Which ethical principle is primarily in conflict with confidentiality in this situation?

  • Beneficence
  • Non-maleficence
  • Autonomy
  • Justice

A nurse observes that a physician is consistently rude and dismissive towards nursing staff, undermining their professional judgment in front of patients and other colleagues. This behavior is impacting team morale and potentially patient care outcomes. The nurse feels uncomfortable confronting the physician directly. What is the most ethical course of action?

  • Ignore the behavior to avoid conflict.
  • Discuss the issue only with other nursing colleagues.
  • Document specific instances and report the behavior through the appropriate channels (e.g., charge nurse, nursing supervisor, or ethics committee).
  • Confront the physician privately but immediately.

A patient’s family member insists on being present during a highly technical and sensitive procedure, stating they have the right to monitor the care being provided. The nurse believes their presence could compromise patient safety and distract the healthcare team, especially during a critical moment. What is the most appropriate ethical action for the nurse?

  • Allow the family member to stay but warn them not to interfere.
  • Request the family member to wait outside, explaining the reasons for safety and privacy.
  • Proceed with the procedure without informing the family member.
  • Document the family's request and proceed with the procedure, ignoring their presence.

A physician orders a blood transfusion for a patient who is a Jehovah’s Witness. The patient, who is conscious and competent, explicitly refuses the transfusion based on their religious beliefs, even after understanding the life-threatening consequences of refusal. The nurse’s personal belief is that life should be preserved at all costs. What is the nurse’s ethical obligation in this situation?

  • Persuade the patient to accept the transfusion for survival.
  • Administer the transfusion as ordered by the physician in an emergency.
  • Respect the patient's autonomous decision, even if it conflicts with the nurse's personal values.
  • Seek a court order to override the patient's refusal.

A nurse discovers that a colleague is consistently coming to work late, appears drowsy, and has made several minor errors in patient care, such as charting inaccuracies and delayed medication administration. The nurse suspects substance abuse but has no direct proof. The nurse is concerned about patient safety but also fears alienating their colleague. Which ethical duty takes precedence for the nurse?

  • Advocating for patient safety.
  • Maintaining collegial relationships.
  • Protecting the colleague's reputation.
  • Avoiding confrontation.

A nurse is attending a community health fair and is approached by a former patient who asks for specific details about another patient they both know, who recently underwent a highly publicized surgery. The former patient assures the nurse they won’t share the information with anyone else. What is the nurse’s immediate ethical responsibility in this situation?

  • Provide general information without specifics
  • Inform the former patient that they cannot disclose any patient information due to privacy regulations and ethical codes.
  • Verify if the patient has given consent for information sharing.
  • Refer the former patient to the hospital's public relations department.

A nurse is part of a healthcare team discussing an elderly patient with severe dementia. The patient lacks capacity to make medical decisions. The family is divided on whether to pursue aggressive treatment for a new acute illness or opt for palliative care. The team’s physician is leaning towards aggressive treatment, citing the possibility of improvement, while some nurses advocate for palliative care based on the patient’s long-term quality of life. Which ethical dilemma is most prominent here?

  • Resource allocation
  • Surrogate decision-making and best interest
  • Professional boundary violation
  • Informed consent for research

A new graduate nurse is assigned to a complex patient case and feels overwhelmed. During a shift, they realize they made a medication error but quickly corrected it before it reached the patient. The patient suffered no harm. The nurse is now debating whether to report the error to their charge nurse, fearing disciplinary action and damage to their new career. Which ethical concept is primarily at play in the nurse’s dilemma regarding disclosure?

  • Confidentiality
  • Fidelity
  • Accountability
  • Veracity

A nurse is caring for a terminally ill patient who is experiencing severe pain. The patient has repeatedly expressed a desire to discontinue all life-sustaining treatments, including pain medication, citing a wish for a peaceful, natural end. The patient’s family, however, insists that all measures, including aggressive pain management, be continued, believing it is their duty to prolong life. Which ethical principle is most directly challenged in this situation?

  • Beneficence
  • Non-maleficence
  • Autonomy
  • Justice

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