1. A nurse has been offered a position on an obstetric unit and has learned that the unit offers therapeutic
abortions, a procedure which contradicts the
... [Show More] nurses personal beliefs. What is the nurses ethical
obligation to these patients?
A) The nurse should adhere to professional standards of practice and offer service to these patients.
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 patients considering abortion.
D) The nurse should express alternatives to women considering terminating their pregnancy.
Ans: B
Feedback:
To avoid facing ethical dilemmas, nurses can follow certain strategies. For example, when applying for a
job, a nurse should ask questions regarding the patient population. If a nurse is uncomfortable with a
particular situation, then not accepting the position would be the best option. The nurse is only required
by law (and practice standards) to provide care to the patients the clinic accepts; the nurse may not
discriminate between patients and the nurse expressing his or her own opinion and providing another
option is inappropriate.
2. A terminally ill patient you are caring for is complaining of pain. The physician has ordered a large dose
of intravenous opioids by continuous infusion. You know that one of the adverse effects of this medicine
is respiratory depression. When you assess your patients respiratory status, you find that the rate has
decreased from 16 breaths per minute to 10 breaths per minute. What action should you take?
A) Decrease the rate of IV infusion.
B) Stimulate the patient in order to increase respiratory rate.
C) Report the decreased respiratory rate to the physician.
D) Allow the patient to rest comfortably.
Ans: C
Feedback:
End-of life issues that often involve ethical dilemmas include pain control, do not resuscitate orders, life-
Test Bank - Brunner & Suddarth's Textbook of Medical-Surgical Nursing 15e 41
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support measures, and administration of food and fluids. The risk of respiratory depression is not the
intent of the action of pain control. Respiratory depression should not be used as an excuse to withhold
pain medication for a terminally ill patient. The patients respiratory status should be carefully monitored
and any changes should be reported to the physician.
3. An adult patient has requested a do not resuscitate (DNR) order in light of his recent diagnosis with late
stage pancreatic cancer. The patients son and daughter-in-law are strongly opposed to the patients
request. What is the primary responsibility of the nurse in this situation?
A) Perform a slow code until a decision is made.
B) Honor the request of the patient.
C) Contact a social worker or mediator to intervene.
D) Temporarily withhold nursing care until the physician talks to the family.
Ans: B
Feedback:
The nurse must honor the patients wishes and continue to provide required nursing care. Discussing the
matter with the physician may lead to further communication with the family, during which the family
may reconsider their decision. It is not normally appropriate for the nurse to seek the assistance of a
social worker or mediator. A slow code is considered unethical.
4. An elderly patient is admitted to your unit with a diagnosis of community-acquired pneumonia. During
admission the patient states, I have a living will. What implication of this should the nurse recognize?
A) This document is always honored, regardless of circumstances.
B) This document specifies the patients wishes before hospitalization.
C) This document that is binding for the duration of the patients life.
D) This document has been drawn up by the patients family to determine DNR status.
Ans: B
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