DEVELOPING YOUR KNOWLEDGE BASE
FILL-IN-THE-BLANKS
1.Laissez-faire
2.Responsible choice
3.Values clarification
4.Prizing
5.Value system
6.Advocacy
MATCHING EXERCISES
1.g 2.d 3.a 4.f 5.i
6.b 7.e 8.c 9.d 10.e
11.a 12.c 13.b 14.e 15.d
16.a 17.c
SHORT ANSWER
1.Sample answers:
a.Values clarification: Have the mother state the
three most important things in her life. Explore
her answers with her and find out why she chose
them and how her choices may affect her situa-
tion.
b.Choosing: After exploring the mother’s values,
have her choose her key values freely. She may
choose her child or profession.
c. Prizing: Reinforce the mother’s choices and, if
possible, involve the husband and child in deci-
sion making.
d.Acting: Assist the mother to plan new behaviors
consistent with the values she has chosen and
incorporate them into her life. For example, if
she values her child, she may reduce the number
of classes she takes at night and spend more time
with her.
2.Sample answers:
a.Cost-containment issues
b.End-of-life decisions
c. Incompetent, unethical, or illegal practices of
colleagues
d.Pain management- a.Autonomy: Respect the decision-making capacity
of autonomous persons (e.g., patients have the
right to refuse treatment they do not feel would
be helpful to their condition).
b.Nonmaleficence: Avoid causing harm (e.g., be
sure you are fully knowledgeable about a proce-
dure before performing it).
c. Beneficence: Provide benefits and balance these
benefits against risks and harms (e.g., securing a
patient with restraints who is at high risk for falls).
d.Justice: Distribute benefits, risks, and costs fairly
(e.g., give service to all patients regardless of
their life circumstances).
e.Fidelity: Be faithful to promises you made to the
public to be competent, and be willing to use
your competence to benefit patients entrusted
to your care (e.g., not abandoning a patient
entrusted to your care without first seeing to
his/her needs). - a.Ethical sensibility: The nurse would recognize that a
patient’s right to confidentiality has been breached.
b.Ethical responsiveness: The nurse can decide to
ignore his/her superior’s breach of confidence, or
he/she can confront his/her superior or report
the superior to a higher authority.
c. Ethical reasoning: The nurse confides in his/her
mentor and discusses the options available.
d.Ethical accountability: The nurse is willing to
accept the repercussions of any actions he/she
takes to rectify the situation.
e.Ethical character: Because the nurse valued
patient confidentiality, his/her course of action
was obvious.
f. Ethical valuing: The nurse could not ignore the
situation because of good ethical character and
personal integrity.
g.Transformative ethical leadership: As a result of
confronting his/her superior, the nurse was able
to make a positive impact on the hospital envi-
ronment.
5.Answers will vary with student’s experiences.
6.Answers will vary with student’s experiences.
7.Sample answers:
a.Gather as much data as possible to support your
diagnosis.
b.Identify the ethical problem and explore
solutions to the problem.
c.Plan a course of action you can justify (e.g., seek-
ing assistance for the patient at a higher level).
d.Implement your decision by speaking to your
superiors and presenting your case in a competent
manner.
e.Evaluate your decision: What was the outcome?
How does this make me feel? Did I make the
right decision?
8.Sample answers:
a.Breach of confidentiality, incompetent practice
b.Covering for another nurse who is not perform-
ing her job competently, short-staffing
c. Physician incompetence, conflicts concerning
the role of the nurse in certain situations
d.Cost-containment vs. hospitalization, healthcare
rationing
REFLECTIVE PRACTICE USING CRITICAL
THINKING SKILLS
Sample Answers
1.How might the nurse react to Mr. Raines’ response
to filling his prescriptions?
The nurse should protect and support Mr. Raines’
rights by being a strong patient advocate. This could
be accomplished by investigating available social
services and community services for Mr. Raines. The
nurse could also check with the drug manufacturer to
see if the company has a discount for needy patients.
2.What would be a successful outcome for this patient?
Mr. Raines vocalizes the health benefits of taking his
blood pressure medication and lists three reasons for
seeking social services and other available assistance.
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