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1

Which of the following organizational activities should be guided by ethical standards?
a. Recruitment practices
b. Leadership practices
c. Resource allocation
d. All of the above

ANS: D
Correct D: All of the above should be guided by ethical standards. Organizational and clinical systems and processes must meet the same ethical standards as does practice. These systems include human resource policies such as recruitment and retention, leadership practices that involve support and mentorship for staff as well as succession planning, and ethical resource allocation.

Incorrect A: All of the above should be guided by ethical standards. Organizational and clinical systems and processes must meet the same ethical standards as does practice. These systems include human resource policies such as recruitment and retention, leadership practices that involve support and mentorship for staff as well as succession planning, and ethical resource allocation.

Incorrect B: All of the above should be guided by ethical standards. Organizational and clinical systems and processes must meet the same ethical standards as does practice. These systems include human resource policies such as recruitment and retention, leadership practices that involve support and mentorship for staff as well as succession planning, and ethical resource allocation.

Incorrect C: All of the above should be guided by ethical standards. Organizational and clinical systems and processes must meet the same ethical standards as does practice. These systems include human resource policies such as recruitment and retention, leadership practices that involve support and mentorship for staff as well as succession planning, and ethical resource allocation.

2

During night-shift report, the nurse notes that one of his colleagues cannot seem to stay awake. Despite prompting and tea, she remains drowsy, and the nurse suspects substance abuse. The nurse reports this to the charge nurse. Which of the following describes the charge nurse’s responsibility?
a. The charge nurse should fire the employee immediately.
b. The charge nurse should send the employee home immediately.
c. The charge nurse should send the employee for drug testing immediately.
d. The charge nurse should suspend the employee with pay immediately.

ANS: B
Correct B: The employee should be sent home immediately after being told the reason for being sent home (that she is unfit for work at this time). The charge nurse notifies the manager, who then has the responsibility to follow up with this nurse prior to her return to work, express concern, and offer support, counselling, or medical treatment.

Incorrect A: Firing the employee immediately would be premature and not supportive. Firing is the role of the manager, not the charge nurse.

Incorrect C: Discussion with the employee must take place prior to drug testing, as the employee may admit to the substance misuse. If necessary, the manager would arrange for drug testing, not the charge nurse.

Incorrect D: Discussion with the employee must take place prior to any discipline. If necessary, the manager would be involved with the disciplinary actions, not the charge nurse.

3

Which of the following factors is having an impact on the current nursing shortage?
a. An aging population creates a growing demand on health resources.
b. An aging population means more young people are contemplating entering the nursing profession.
c. Advances in technology call for increased generalization of practice for new nurses.
d. All of the above

ANS: A
Correct A: As the population ages, its health care needs increase. An aging population results in a growing demand on health resources.

Incorrect B: An aging population means fewer young people are available to potentially enter the nursing profession.

Incorrect C: Advances in technology call for increased specialization of practice for new nurses.

Incorrect D: All of the above are not correct.

4

Which of the following is the most ethical method for recruiting internationally educated nurses?
a. Recruiting nurses from developing countries and offering them a better way of life in Canada
b. Booking a table at an international job fair for nurses and discussing opportunities with nurses who attend the fair
c. Offering large financial and transition incentives for internationally educated nurses to come to Canada
d. Hiring internationally educated nurses through international recruitment agencies

ANS: B
Correct B: Booking a table at a job fair is the most ethical method of attracting internationally educated nurses. Recruits are then voluntary, there are no incentives necessary, and the recruiters are not perceived as “poaching.”

Incorrect A: This is unethical, as developing countries can little afford to lose what resources they have.

Incorrect C: Incentives for internationally educated nurses may result in abuse from local nurses who may perceive reverse discrimination.

Incorrect D: International recruitment agencies often use aggressive strategies to lure internationally educated nurses away from developing countries with nursing shortages or promise financial or transition incentives that never materialize.

5

Which of the following best describes the expectations of a nurse caring for a patient with a different cultural background?
a. The nurse should ask another nurse with the same cultural background as the patient to care for the patient.
b. Nurses must be knowledgeable about all cultures and customs.
c. The nurse can identify the patient’s unique cultural practices during assessment and then plan the implementation of care and interventions accordingly.
d. Nurses should avoid discussion of unusual customs.

ANS: C
Correct C: Nurses should undertake a comprehensive cultural assessment of their patients in an effort to understand their unique values in order to design a care strategy consistent with their values and beliefs.

Incorrect A: The nurse should be able to care for this patient without involving another nurse. It is impossible for nurses to be knowledgeable about the cultural backgrounds and values of all the patients they care for.

Incorrect B: It is impossible for nurses to be knowledgeable about the cultural backgrounds and values of all the patients they care for.

Incorrect D: Nurses should encourage discussion of customs that are important to the patient.

6

Why are patients and clients from diverse cultural backgrounds at risk?
a. Language barriers always interfere with care.
b. Patients’ food preferences result in less than optimum nutrition.
c. Patients’ reluctance to disclose their feelings is an issue.
d. There may not be a shared understanding of what is meaningful to these patients and their families.

ANS: D
Correct D: Nurses should engage in actions that respect and empower cultural identity and make attempts to understand the values of patients and clients with different cultural backgrounds.

Incorrect A: Language barriers can sometimes be an issue, but not always.

Incorrect B: Family members may bring outside food to patients, and in most situations the care is short-term, so diet is not a major issue.

Incorrect C: This is a generalization and is not appropriate.

7

What does the term “multidisciplinarity” mean, with respect to the levels of team functioning?
a. Feeling competent and confident in one’s own discipline
b. Being willing and able to work with others in the joint evaluation, planning, and care of the patient
c. Believing that oneself and fellow professionals in one’s discipline can make an important contribution to care
d. Recognizing that other disciplines also have important contributions to make

ANS: D
Correct D: This is the correct definition of multidisciplinarity.

Incorrect A: This phrase describes unidisciplinarity.

Incorrect B: This phrase describes interdisciplinarity.

Incorrect C: This phrase describes intradisciplinarity.

8

Patients’ family members are an important aspect of care, and family-centred care is an important model of care. Which of the following is an example of inappropriate family involvement in the care of a patient involving a language barrier?
a. Translation by family members during decisions about cancer treatment
b. Translation by family members to assist the patient to eat
c. Translation by family members when culturally appropriate comfort measures are being provided
d. Translation by family members to help identify subtle signs of discomfort in the patient

ANS: A
Correct A: Family translation during important treatment decisions should be a last resort. Translation for significant care issues, where possible, should be performed by professional translators to avoid coercion and to ensure that any consent or refusal of treatment by the patient is informed.

Incorrect B: Family translation to assist with the patient’s mealtime is appropriate.

Incorrect C: Family translation during the provision of comfort measures is appropriate.

Incorrect D: Family translation to help identify subtle signs of discomfort in the patient is appropriate.

9

True or False

Organizational ethics deals with those values that establish standards and influence how the organization is perceived both internally and externally.

ANS: T
Correct: The ethical culture of the organization influences its image and reputation, establishes the legitimacy of its role in society, and clarifies what the organization stands for.

Incorrect: This statement is true.

10

True or False

Distributive justice refers to the perception that processes have been fair and inclusive regardless of the outcome.

ANS: F
Correct: Distributive justice relates to outcomes such as allocation of resources, salaries, benefits, and work conditions, whereas procedural justice refers to the perception that processes have been fair and inclusive regardless of the outcome.

Incorrect: This statement is false.

11

True or False

Nursing leaders are solely responsible for ensuring sound ethical practice and a healthy work environment.

ANS: F
Correct: Nurses share accountability with leaders in ensuring sound ethical practice, a healthy work environment, and staff satisfaction in order to create a culture and climate conducive to positive patient care outcomes.

Incorrect: This statement is false.