Sample Chapter




Ethics Issues Contemporary Nursing Canadian Edition By Burkhardt – Test Bank 


Chapter 1 – Social, Philosophical, and Other Historical Forces Influencing the Development of Nursing




  1. What historical influences affected nursing as a moral discipline?
a. technology
b. society
c. spirituality
d. oppression



REF:   p. 3


  1. For which of the following is empathy a motive?
a. meeting the needs of others
b. moral reasoning and action
c. becoming a nurse
d. determining right from wrong



REF:   p. 5


  1. Why do professions exist?
a. to meet the needs of employers
b. to meet the needs of individuals
c. to meet the needs of society
d. to meet the needs of families



REF:   p. 6


  1. Which of the following statements best describes Florence Nightingale?
a. She believed in traditional expectations for women.
b. She was a nurse and increased soldiers’ mortality rates.
c. She believed in nurses restricting their careers.
d. She was a social reformer and statistician.



REF:   p. 23


  1. In which of the following influences do the helping professions find their origin?
a. inhumane actions
b. perceived social needs
c. serving one’s own needs
d. visualizing the suffering of others



REF:   p. 5


  1. What is the term that relates to knowledge gained through observation and experience?
a. empirical
b. Cartesian philosophy
c. values
d. moral thought



REF:   p. 8


  1. Why were the Middle Ages significant for nursing?
a. Religions and church-sanctioned secular nursing orders offered the only legitimate avenue for women wishing to become nurses.
b. There was an upsurge in the respect afforded to nursing and midwifery, and nurses began to practise autonomously.
c. Healing arts in Denmark and Greece were performed in sacred ceremonies by priests, priestesses, or shamans.
d. Most nurses were women of high social status.



REF:   p. 8–11


  1. When was the “Dark Period of Nursing,” when convalescent patients, prostitutes, prisoners, and drunkards provided hospital nursing care?
a. during the Reformation
b. during the Crusades
c. during the Middle Ages
d. during the early Christian era



REF:   p. 12


  1. Why is the concept of social need important to the ethical foundations of the nursing professional?
a. Nurses must determine the health needs of society.
b. Nursing finds its origin, purpose, and meaning within the context of perceived social need.
c. Theories of sociology are utilized by nursing scholars, many of whom view them as conceptual frameworks for nursing practice.
d. Social need determines the boundaries of the ethical principles of distributive justice, beneficence, and non-maleficence.



REF:   p. 5


  1. Why does the social status of women affect the status of the nursing profession?
a. Nursing has traditionally been a profession of women.
b. Throughout history, nurses have been afforded higher social status.
c. Women of higher social status rarely become nurses.
d. Women are more skilled than men at nurturing others.



REF:   p. 6–7


  1. What does the term empirical relate to?
a. serving God and thy neighbour
b. knowledge gained through observation and experience
c. healing through religious intervention, touching of religious relics, chanting, and other methods
d. the enforcement of religious doctrine related to the status of women in society



REF:   p. 8


  1. Which of the following had the greatest influence on nursing traditions in Canada?
a. Britain
b. Aboriginal persons
c. France
d. Germany



REF:   p. 12


  1. After the First and Second World Wars, the Canadian Red Cross Society and nursing groups noted an important trend in health care that is still articulated in the Lalonde and Romanow report. What is that trend?
a. the formation of nursing groups such as the CNA and professional organizations
b. the political and economic action taken to correct the wrongs suffered by the military
c. the establishment of governments’ social and political responsibility in health care
d. the need for strong, well-established public health programs, health education, immunization, hygiene, and care of those living in poverty



REF:   p. 14–15


  1. What does the CNA’s vision for the future of nursing embrace?
a. the varied roles that nurses must play in order to provide holistic care to a diverse and changing population
b. the formation of joint nursing professional organizations in both Canada and the United States
c. the important role of military and public health nursing
d. the relationship between social need and the evolution of the practice of nursing



REF:   p. 15


  1. What is the most critical factor that influences nursing practice?
a. the traditional role of healers
b. the role of women in society
c. the religious and spiritual aspects of health care
d. the introduction of male nurses into the profession



REF:   p. 6


  1. How is Mary Agnes Snively significant to the development of Canadian nursing?
a. She established the mission of Grey Nuns to new settlers.
b. She established the International Council of Nursing.
c. She established the first national organization for nursing.
d. She established certification for nurses to become experts.



REF:   p. 14

Chapter 2 – Ethical Theory




  1. A client is refusing a blood transfusion, despite the possible consequences. The nurse caring for this client knows that the client will die without the blood transfusion. What is this an example of?
a. personal philosophy
b. virtue ethics
c. ethical dilemma
d. practical imperative



REF:   p. 23


  1. Which moral perspective propounds the belief that people can figure out absolute moral rules which derive from the universe and that these truths are superior to the information received from the senses?
a. moral belief
b. rationalism
c. deontology
d. naturalism



REF:   p. 27


  1. A nurse performs CPR on a choking patient and in the process breaks the sternum, which then leads to the patient’s death. Which ethical theory would say that the nurse’s actions were inherently good because of the intent, regardless of the outcome?
a. deontology
b. naturalism
c. rationalism
d. utilitarianism



REF:   p. 34


  1. Scenario: In a clinic where there is only one functioning haemodialysis machine, there are two patients waiting for dialysis. One patient is a female, married, with four children; the other is a male, unmarried, and a homeless alcoholic. The nurse decides that the female is the right choice. Which of the following most clearly supports the nurse’s decision?
a. deontology
b. virtue ethics
c. rationalism
d. utilitarianism



REF:   p. 29



  1. Which type of moral theory, rigidly applied, would most likely lead a person to consider euthanasia morally wrong, even when it is done to end the pain and suffering of a patient?
a. deontology
b. virtue ethics
c. naturalism
d. utilitarianism



REF:   p. 34


  1. What is the term for the Kantian maxim requiring that no action be judged as right which cannot reasonably become a law by which every person should always abide?
a. the categorical imperative
b. the practical imperative
c. deontology
d. utilitarianism



REF:   p. 34


  1. What is the Kantian maxim requiring that one treat others always as ends and never as a means?
a. the categorical imperative
b. the practical imperative
c. deontology
d. utilitarianism



REF:   p. 45


  1. Which concept was first noted in the writings of Socrates?
a. virtue ethics
b. utilitarianism
c. deontology
d. rationalism



REF:   p. 25


  1. Which ethical theory, when applied, would most likely lead to making meals for a needy family?
a. rationalism
b. naturalism
c. virtue ethics
d. deontology



REF:   p. 27



  1. What theory is based on the view that the rightness or wrongness of an act depends upon the nature of the act, rather than its consequences?
a. deontology
b. formalism
c. Kantianism
d. act utilitarianism



REF:   p. 34


  1. What kind of philosophy is a nurse engaged in when debating what is considered good or bad, right or wrong?
a. empathy
b. sympathy
c. moral
d. virtualism



REF:   p. 26


  1. A nurse recognizes and shares with a client the understanding of the amount of pain that the client is experiencing. What focal virtue is this situation based on?
a. discernment
b. compassion
c. trustworthiness
d. integrity



REF:   p. 39


  1. A nurse notices a patient crying and decides to offer some reassurance, rather walking away and giving the patient privacy. What focal virtue is the nurse exhibiting?
a. discernment
b. compassion
c. trustworthiness
d. integrity



REF:   p. 39


  1. What focal virtue is best exemplified by soundness, reliability, and wholeness of moral character?
a. discernment
b. conscientiousness
c. trustworthiness
d. integrity



REF:   p. 40



  1. What focal virtue is measured by other people’s recognition of the nurse’s consistency and predictability in following moral norms?
a. discernment
b. conscientiousness
c. trustworthiness
d. integrity



REF:   p. 40


  1. During a healthcare team meeting, the physician asks the other members of the team for their input on how best to care for a particular patient, rather than dictating a prescribed plan of care. What ethical theory does this situation best exemplify?
a. feminist ethics
b. relational ethics
c. hierarchy ethics
d. virtue ethics



REF:   p. 41

Chapter 3 – Ethical Principles




  1. What does the principle of beneficence require the nurse to do?
a. to separate personal from professional life
b. to prevent harm or evil and do good
c. to  make moral decisions that are motivated by what will benefit the patient
d. to morally regulate the conduct of others



REF:   p. 59–60


  1. A nurse respects a patient’s decision not to undergo any further dialysis. Which principle  is this situation an example of?
a. respect for persons
b. justice
c. beneficence
d. autonomy



REF:   p. 49


  1. The nurse promises a patient that she will return in five minutes to sit and speak with him.  What ethical principle does this situation exemplify?
a. morals
b. fidelity
c. confidentiality
d. justice



REF:   p. 75–76


  1. Which ethical principle implies that others are worthy of high regard?
a. beneficence
b. respect for autonomy
c. respect for persons
d. distributive justice



REF:   p. 49


  1. A patient requests multiple cosmetic surgeries. At a certain point, the health care team questions whether  the overall harm that will result from continuing to do these procedures will outweigh the benefits. Which ethical principle is most related to this discussion about weighing harms against benefits?
a. beneficence
b. non-maleficence
c. justice
d. veracity



REF:   p. 62–63



  1. Which of the following ethical principles relates to noncompliance with care by a fully aware patient?
a. beneficence
b. autonomy
c. fidelity
d. non-maleficence



REF:   p. 49–50 | p. 52



  1. A nurse performs a pain assessment on a client and requests an order for an analgesic as an intervention. Which of the following ethical principles is being given a practical application in this situation?
a. beneficence
b. autonomy
c. veracity
d. non-maleficence



REF:   p. 59–60


  1. The emergency room staff decide  how quickly patients will be triaged through the emergency room department. The emergency room team decides that the most critically ill patient will be treated first.   Which of the following ethical principles is illustrated by the decision-making process in this case?
a. respect for persons
b. justice
c. beneficence
d. autonomy



REF:   p. 76–77


  1. Which ethical principle requires nurses to uphold the profession’s code of ethics, to practise within the established scope of practice, and to remain competent?
a. beneficence
b. autonomy
c. fidelity
d. non-maleficence



REF:   p. 75–76


  1. What does the CNA Code of Ethics recognize about confidentiality?
a. It develops from respect for patients and is an absolute requirement in all situations.
b. It is restricted to legal regulations and definitions.
c. It is not absolute and may be modified to protect the patient or other innocent people.
d. It enables preservation of dignity for patients in intimate and private situations.



REF:   p. 69


  1. Which of the following statements best summarizes the Privacy Act, amended April 2011?
a. Individuals have the right to access their own information without constraints.
b. The provincial government sets out rules on how personal information is managed.
c. Each province protects the private information of Canadian citizens.
d. The Act sets out rules for how personal information should be managed by private-sector organizations.



REF:   p. 71


  1. Which principle of the Canada Health Act entitles 100 percent of the insured residents of a province or territory to health services?
a. comprehensiveness
b. universality
c. accessibility
d. public administration



REF:   p. 78


  1. In which of the following situations is the nurse applying the principles of the CNA Code of Ethics?
a. The nurse maintains confidentiality of a gunshot victim who  is a suspected gang member.
b. The nurse carries out mandatory testing of pregnant women for hepatitis and syphilis.
c. The nurse keeps  information confidential when a  patient states that he wants to kill himself.
d. The nurse reports suspected abuse of a child and illegal activity of the parents to the police.



REF:   p. 69–71


  1. Which principle of the Canada Health Act entitles reasonable contact with  insured health care services in terms of physical availability of medically necessary services?
a. comprehensiveness
b. universality
c. accessibility
d. public administration



REF:   p. 79


  1. Which principle of the Canada Health Act requires that residents moving from one province or territory to another must continue to be covered for insured health care services?
a. comprehensiveness
b. portability
c. accessibility
d. public administration



REF:   p. 78

Chapter 4 – Values Clarification




  1. What does the axiology branch of philosophy study?
a. ethics
b. mathematics
c. awareness
d. values



REF:   p. 87


  1. What is the correct terminology for the process of becoming more conscious of and expressing what we value or consider worthy?
a. journalling
b. values clarification
c. overt values
d. values conflict



REF:   p. 91


  1. A nurse informs her supervisor that she holds the belief that abortions should not be performed and finds conflict working on a unit where they are performed. Which of the following terms best describes this situation?
a. societal values
b. incongruent values
c. overt values
d. values clarification



REF:   p. 91


  1. What is the correct terminology for values that are implicit in expectations of an institution, but not in set out writing?
a. formal values
b. covert values
c. integral values
d. overt values



REF:   p. 97



  1. A female patient is hospitalized with traumatic injuries caused by a vehicular collision. Her daughter, who was killed in the accident, was taken to the same hospital. The patient, who had been driving the vehicle, constantly asks the nurse about her daughter. The orthopedic surgeon has told the nurse not to tell the patient about the death of her daughter. The orthopedic surgeon does not give the nurse any reason for these instructions. The nurse expresses concern to the nurse manager, who says that the orthopedic surgeon will decide when the patient should be told. However, the nurse is not comfortable with this and wonders what should be done. Which of the following terms best describes this situation?
a. incongruent values
b. values conflict
c. overt values
d. societal values



REF:   p. 95


  1. What is an institution’s mission statement a reflection of?
a. overt values
b. formal values
c. covert values
d. integral values



REF:   p. 96


  1. A nurse used to love her job but now frequently exhibits anger, dissatisfaction, frustration, and poor work performance. What may she be experiencing?
a. moral awareness
b. moral thought
c. moral distress
d. moral values



REF:   p. 97


  1. What should nurses be aware of when working with patients regarding health care decisions?
a. personal and patient values
b. moral development and perceptions
c. conflicting values and priorities
d. institutional values and influence



REF:   p. 100


  1. How can values be acquired?
a. by challenging dilemmas faced in professional or personal lives
b. through the determination of genetic and hereditary influences
c. by openly expressing our ideals to other people
d. in both conscious and unconscious ways throughout our lives



REF:   p. 87



  1. In what way can keeping a journal or diary of experiences in work situations be a useful tool for a nurse?
a. to develop awareness and gain insight into personal values
b. to identify negative actions and interpretations that need to be reinforced
c. to identify challenging situations and apply alternative responses
d. to develop and monitor professional reactions in situations



REF:   p. 93


  1. How can values best be defined?
a. as principles of right or wrong
b. as ideals, beliefs, customs, and modes of conduct
c. as self-knowledge and the willingness to express that awareness
d. as reflections upon and evaluations of one’s own experiences



REF:   p. 87


  1. Which of the following statements best summarizes moral autonomy?
a. actions to remove harms or to simply improve the situation of others
b. the attempt to think clearly and consistently about matters of concern
c. the ability to independently choose right or wrong, without any outside influence
d. the process of examining the impact of personal values, beliefs, and experiences



REF:   p. 88–89


  1. When a patient is unable to clearly articulate their values, what is most likely to occur?
a. It may result in distress and feelings of marginalization.
b. It may result in frustration and negatively affect care.
c. It may result in an unwillingness to seek healthcare advice.
d. It may result in confusion and inadequate decision-making.



REF:   p. 101


  1. What is the correct term for the attribute of maintaining and articulating consistent values and beliefs over time?
a. personal values
b. authenticity
c. moral thought
d. implicit values



REF:   p. 91


  1. When the values of the nurse and those of the institution are different, which of the following will the nurse likely experience?
a. incongruencies with personal values
b. judgment of values being imposed
c. divergence of moral beliefs and restraints
d. commitment to develop more awareness



REF:   p. 97

Chapter 5 – Values Development




  1. What is another term that can be used interchangeably with “human values development”?
a. moral development
b. faith development
c. ethical values
d. formal operations development



REF:   p. 107


  1. Which of the following is believed to be learned within, and shared by, a group of interacting persons?
a. etiquette
b. independence
c. values
d. connections



REF:   p. 107


  1. What are the key factors associated with Kohlberg’s theory of moral development?
a. relationships and logic
b. responsibility and caring
c. personal liberty and rights
d. reciprocity and equality



REF:   p. 109


  1. What is the term for the moral imperative being grounded in relationship with and responsibility for one another?
a. ethic of justice
b. ethic of care
c. faith development
d. cognitive development



REF:   p. 111


  1. Which of the following describes the development of intellectual capacities through the time of childhood, from birth to around age 15 years?
a. Kohlberg’s theory of moral development
b. Piaget’s stages of cognitive development
c. Lao Tsu’s theory of development
d. Fowler’s stages of faith development



REF:   p. 2



  1. What are two of the stages at the post-conventional level in Kohlberg’s theory of moral development?
a. prior rights and social contract
b. individual instrumental purpose and exchange
c. punishment and obedience
d. universal moral principles



REF:   p. 111


  1. According to Kohlberg and Gilligan, which of the following is the final stage in an adult’s values development?
a. universal consideration
b. renewed perspective
c. perceived authority
d. general consensus



REF:   p. 113


  1. How can nurses avoid making inappropriate judgments about another’s moral capabilities?
a. by understanding that all people have the same ethical, moral, and cultural values; they are just named differently
b. by keeping strict adherence to hospital and unit guidelines while caring for the patient and patient’s family
c. by understanding varying perspectives from which moral decisions are made by both the nurse and the patient
d. by recognizing that needs are not always clear and that emotions encompass perspectives of care



REF:   p. 109


  1. From whose frameworks do the discussions of moral development found in current literature primarily flow?
a. Kohlberg and Gilligan
b. Piaget and Fowler
c. Thomas
d. Colby and Kohlberg



REF:   p. 110–111


  1. What does Phase 3 of Gilligan’s study of the psychological development of women include?
a. a focus on what is best for the self, including selfishness and dependence on others
b. responsibility to self is taken into account, along with responding to needs of others
c. mutual interpersonal expectations, relationships, and conformity
d. responsibility to self and others as moral equals, and a clear imperative to harm no one



REF:   p. 112


  1. In Piaget’s stages of cognitive development, what are the two stages of the pre-operational level called?
a. punishment and obedience
b. environmental interaction and stimuli
c. language and logical thought
d. magical thinking and some reasoning



REF:   p. 109–110


  1. What does Phase 2 of Gilligan’s study of the psychological development of women include?
a. a sense of goodness as self-sacrifice, in which the needs of others are often put ahead of self
b. a concern about the reaction of others as a basis for decisions and behaviour
c. reflecting a movement into a world beyond the family and a deep appreciation of connectedness
d. a deep appreciation of connectedness, including responsibility to self and others as moral equals, and a clear imperative to harm no one



REF:   p. 112


  1. Which of the following does Stage 1 of Gilligan’s study of the Psychological Development of Women include?
a. a focus on what is best for the self, and includes selfishness and dependence on others
b. a sense of being responsible for others, so that one is regarded positively
c. a period when the imperatives of absolute love and justice become prime, and energy is focused on transforming the present reality toward transcendent actuality
d. a deep appreciation of connectedness, including responsibility to self and others as moral equals, and a clear imperative to harm no one



REF:   p. 112


  1. Which level of Thomas’s moral response is “Blind following of standards set by somebody else” an example of?
a. expressive level
b. pre-reflective level
c. self-reflective level
d. reflective level



REF:   p. 113

Chapter 6 – Ethical Decision Making




  1. When do moral dilemmas occur?
a. when the nurse is unsure of the morally correct action
b. when there are conflicting moral claims
c. when moral claims conflict with practical claims
d. when participants disagree on the appropriate course of action



REF:   p. 123


  1. The nurse manager asks Martha, a staff nurse, if she will work an additional four hours at the end of her shift. Martha’s patient is unstable, and there are not enough nurses on the next shift to care for him adequately. If she works overtime, Martha will have to break a promise she made to watch her children’s soccer game. What is this situation an example of?
a. moral distress
b. a moral dilemma
c. moral reckoning
d. a practical dilemma



REF:   p. 124


  1. A registered nurse witnesses another nurse violating a patient’s autonomy. Even though she did not participate in the action, the nurse who witnessed the act experiences powerlessness, frustration, and anger. What does this reaction describe?
a. moral distress
b. moral uncertainty
c. moral outrage
d. moral disengagement



REF:   p. 126


  1. Why do physicians sometimes make unilateral decisions in morally important situations?
a. Moral decision making is reserved for physicians.
b. Nurses are seldom aware of the patient’s wishes and life context.
c. There is sometimes a power imbalance in the health care setting.
d. It is illegal for nurses to participate in moral decision making.



REF:   p. 122


  1. Which of the following best defines moral residue?
a. when you see that there is a moral problem but are not sure of the correct action
b. being asked to compromise your values time and time again
c. self-knowledge combined with decision-making skill
d. the ability to make cogent moral decisions



REF:   p. 127


  1. The nurse is involving all stakeholders and has identified and proposed new options to institutional guidelines. Applying the nursing process, what stage would the nurse be using, according to the College of Nurses Practice Standard for Ethics?
a. Assessing the situation
b. Deciding upon an approach
c. Taking action
d. Evaluation



REF:   p.  129


  1. Michael, an ICU nurse, worked with the team as they followed the physician’s order to discontinue life support on a patient diagnosed with persistent vegetative state. Michael believes that life is sacred and that he has a duty to do whatever it takes to preserve life. Nevertheless, he remained silent as the decision was made, and he assisted his coworkers when they unplugged the respirator. In this situation, what is Michael likely to experience?
a. moral uncertainty
b. moral distress
c. moral outrage
d. moral perplexity



REF:   p. 124–125


  1. Which of the following is an example of a moral dilemma?
a. A nurse who is accustomed to working on the prenatal unit floats to the ER.
b. A nurse who has strong religious beliefs opposing abortion is assigned to assist with an elective abortion.
c. A terminally ill patient on life support suffers from severe, intractable pain.
d. A patient has a cardiopulmonary arrest when the suction apparatus fails.



REF:   p. 123


  1. During which step of the moral decision-making process is it appropriate to determine the key participants?
a. data gathering
b. problem articulation
c. strategy exploration
d. strategy implementation



REF:   p. 133


  1. The nurse and other members of the healthcare team participate with the patient in making a particularly difficult moral decision. If the CNO Practice Standard for Ethics is properly implemented, which of the following may occur?
a. The nurse disagrees with the decision.
b. Emotions are active and determine the decision.
c. The patient’s feelings are devalued, as they are too emotional.
d. Support is provided to the healthcare team and the patient.



REF:   p. 128–129


  1. When does moral uncertainty occur?
a. when we sense that there is a moral problem, but are not sure of the morally correct action
b. when someone else in the health care setting performs an act the nurse believes to be immoral
c. when two or more mutually exclusive moral claims clearly apply
d. when participants disagree on the appropriate course of action



REF:   p. 122–123


  1. What step in the process of ethical decision making involves the nurse examining the situation for evidence of conflicting obligations, principles, duties, rights, loyalties, values, or beliefs?
a. Identify options.
b. Determine moral perspective.
c. Gather facts in order to clarify issues.
d. Determine desired outcomes.



REF:   p.  132


  1. What step in the process of ethical decision making involves participants excluding results that are totally unacceptable, along with their potential consequences?
a. Identify options.
b. Determine moral perspective.
c. Gather data and identify conflicting moral claims.
d. Determine desired outcomes.



REF:   p. 135


  1. According to Thomas and Waluchow, which of the following is an example of a pre-reflective statement in response to a moral question?
a. “Abortion should never happen because it is murder.”
b. “Abortion is a difficult concept to accept for many because of the social values we place on life.”
c. “I disagree with abortion because it will directly cause death. My spiritual beliefs prohibit this on the basis of protecting sanctity of life.”
d. “Abortion is morally permissible because the rights of the pregnant woman take priority over the right of the fetus.”



REF:   p. 134



  1. A couple are pregnant with their second child and, during a routine ultrasound, the physician discovers that the fetus is anencephalic. The life expectancy of an anencephalic baby is only a few weeks after birth. The couple struggle with the choice of whether to terminate the pregnancy at this time or to carry to term. The couple decide to terminate the pregnancy. What stage of the ethical decision making process is this?
a. determining desired outcomes
b. evaluating outcomes of action
c. identifying options
d. acting on the choice



REF:   p.  136

Chapter 7 – Legal Issues




  1. What system of binding rules governs the behaviour of people in their relationships with others and with the government?
a. ethics
b. laws
c. morals
d. intentional tort



REF:   p. 147


  1. Which of the following best defines a set of rules and principles that describe the powers of a government and the rights of the people?
a. constitutional law
b. statutory law
c. common law
d. administrative law



REF:   p.  150


  1. What is the term used to define formal laws written and enacted by a federal or provincial legislature?
a. statutory law
b. constitutional law
c. administrative law
d. common law



REF:   p. 151


  1. Which of the following is an example of administrative law?
a. the Regulated Health Professions Act, which defines the role of the nurse
b. the roles of colleges of nursing, which enforce rules
c. the way nurses collect and use personal health information
d. the way to identify the difference between negligence and incompetence



REF:   p. 151


  1. Which of the following type of law best defines a person’s rights and obligations in relation to the government?
a. common law
b. misdemeanours
c. constitutional law
d. public law



REF:   p. 154



  1. What type of law would apply to nurses caught falsifying medical records to conceal their thefts of narcotics?
a. administrative law
b. common law
c. criminal law
d. constitutional law



REF:   p. 154


  1. Which of the following would apply to a nurse removing life support from a terminally ill patient without permission?
a. legislative law
b. indictable offence
c. misdemeanour
d. summary offence



REF:   p. 155


  1. Which of the following is an example of a summary offence?
a. a nurse giving an injection without consent
b. a nurse who unintentionally causes the death of a patient
c. a nurse failing to provide competent care
d. a nurse signing an employment contract



REF:   p. 155


  1. Which law deals with the rights and obligations between two or more people who make agreements that can be enforced by law?
a. tort law
b. public law
c. contract law
d. private law



REF:   p. 155


  1. What is the term for a wrong or injury that a person suffers because of someone else’s action, either intentional or unintentional?
a. negligence
b. tort
c. private law
d. breach



REF:   p. 156



  1. Which legal issue would a nurse failing to communicate new patient symptoms, complaints, or concerns to a doctor best exemplify?
a. negligence
b. unintentional tort
c. malpractice
d. common law



REF:   p. 158


  1. How are the majority of lawsuits against nurses and other health care professionals classified?
a. as accidental claims
b. as unintentional tort
c. as civil law
d. as indictable offences



REF:   p. 156


  1. Which of the following is a component of negligence?
a. failing to fulfil the legal responsibility to obey laws
b. failing to act to prevent foreseeable harm
c. failing to protect personal information
d. failing to keep patients free of interference



REF:   p.  158


  1. Which of the following best defines a wilful act that violates another person’s rights or property?
a. intentional tort
b. fraud
c. assault
d. battery



REF:   p. 159


  1. Which of the following legal issues would falsification of patient records to cover up an error be an example of?
a. assault
b. fraud
c. battery
d. intentional tort



REF:   p. 160


  1. What is the term for the unjustifiable attempt or threat to touch a person without consent that results in fear of immediately harmful or threatening contact?
a. assault
b. battery
c. fraud
d. malpractice



REF:   p. 160


  1. A nurse refuses to give a patient their clothing or car keys.  What is this an example of?
a. defamation
b. libel
c. false imprisonment
d. slander



REF:   p. 161


  1. Which of the following terms would apply to an employer placing the label “Unwanted Persons” at the top of a hospital bulletin board and placing a photograph of a nurse on the bulletin board under the label?
a. fraud
b. defamation
c. libel
d. slander



REF:   p.  161


  1. Which of the following legal terms applies to speaking harmful and defamatory words?
a. slander
b. libel
c. false imprisonment
d. gossiping



REF:   p. 162


  1. Which of the following legal terms applies to defamation by written words or images?
a. slander
b. libel
c. criminalization
d. fraud



REF:   p. 162


  1. How can a nurse reduce the risk of malpractice litigation?
a. by keeping up to date with knowledge and skills, and seeking attention for patients with changing health status
b. by involving patients in decision making, documenting objectively, and avoiding physicians
c. by keeping up to date with current knowledge, seeking physician attention for patients with changing health status, and challenging the patient
d. by keeping up to date with current and outmoded knowledge, and providing patients with challenges



REF:   p. 178



  1. Which of the following terms is best defined as “acting in a heinous, reckless, or extreme way, and bringing about mental or psychological pain”?
a. defamation of character
b. intentional infliction of emotional distress
c. invasion of privacy
d. false imprisonment



REF:   p. 178


  1. In a jurisdiction where there is no specific legislation regarding consent, what elements are usually noted when defining a valid consent?
a. There must be urgency in the decision-making process.
b. There must be efficiency in the decision-making process.
c. The patient must have capacity to consent.
d. The patient must articulate a moral agency.



REF:   p. 165


  1. A pregnant woman admits herself to the hospital to give birth under the care of her obstetrician and gives permission for the obstetrician to examine her. What is this an example of?
a. coercive consent
b. explicit consent
c. implied consent
d. informed consent



REF:   p. 165


  1. Which of the following is characteristic when making nursing notes?
a. being nonjudgmental
b. having significant gaps
c. falsifying facts and events
d. maintaining confidentiality



REF:   p. 173


  1. In Canada, what federal privacy law imposes obligations on how federal government departments collect, manage, use, and share personal information?
a. the Personal Information Protection and Electronic Documents Act
b. the Health Information Act
c. the Privacy Act
d. the Health Information Protection Act



REF:   p. 175

Chapter 8 – Professional Issues




  1. What term best describes knowledge necessary to provide a service that is either essential or desired by society?
a. professional education
b. professional recognition
c. professional autonomy
d. professional responsibility



REF:   p. 185


  1. Which of the following traits did Flexner include in his list of criteria to identify professions?
a. They acknowledge other kinds of influences.
b. They are motivated by altruism.
c. They include ethical codes.
d. They describe a scope of practice.



REF:   p. 186


  1. Which of the following terms relates to the characteristic of having a high level of specialized skill and knowledge?
a. profession
b. expertise
c. wisdom
d. authority



REF:   p. 189


  1. Which of the following terms is synonymous with “self-governing”?
a. expertise
b. authority
c. autonomy
d. accountability



REF:   p. 189


  1. Which of the following refers to being answerable to another person or persons for something one has done?
a. autonomy
b. expertise
c. authority
d. accountability



REF:   p. 194



  1. Which of the following is universally accepted as one criterion of a profession that is profoundly important to nursing?
a. codes of nursing ethics
b. standards of nursing practice
c. scope of practice statutes
d. nursing theories and practice



REF:   p. 195


  1. Which documents, developed within the profession as a guide for providing nursing care, can also be used as a consistent baseline to measure the practice of individual nurses?
a. external standards of nursing practice
b. internal standards of nursing practice
c. codes of nursing ethics
d. scope of practice statutes



REF:   p. 195


  1. Which of the following consist of guides for nursing care that are developed by non-nurses, the government, or institutions?
a. external standards of nursing practice
b. internal standards of nursing practice
c. codes of nursing ethics
d. scope of practice statutes



REF:   p. 196


  1. What is the foremost law that governs the regulation of nursing?
a. Coordination and Patient Choice Act
b. Controlled Acts Model
c. Scope of Practice Statute
d. Professions of Medicine Law



REF:   p. 198


  1. According to Degazon, what must be taken into account in the changing face of nursing?
a. gender
b. accountability
c. authority
d. competence



REF:   p. 201



  1. Which of the following qualities relates to the ability of nurses to organize for the purpose of fulfilling the profession’s promises and maintaining the relationship that nurses have with one another?
a. autonomy
b. unity
c. expertise
d. skill



REF:   p. 200


  1. What is one of the benefits of nurses contributing to the growing body of unique nursing knowledge and research?
a. It empowers nurses.
b. It ensures that members conduct ongoing competency reviews.
c. It permits autonomy in nursing affairs.
d. It aids in validating nursing as a true profession.



REF:   p. 199


  1. According to the Canadian Nurses Association, which of the following is one of the four principles that must be included in any practice statement?
a. to engage in interdisciplinary collaboration
b. to conduct ongoing competency reviews
c. to review ethical implications for institutions that allow nurses to practice
d. to acknowledge that nursing is a diversified group of professionals



REF:   p. 201


  1. Which of the following is a mechanism of accountability that has been developed by the profession of nursing?
a. a collective professional autonomy
b. making decisions regarding disciplinary action
c. educational requirements for practice
d. adjudicating risks



REF:   p. 194

Chapter 9 – Professional Relationship Issues




  1. Which of the following individuals is the nurse’s primary obligation to?
a. the patient
b. the employer
c. the physician
d. the profession



REF:   p. 212


  1. A staff nurse suspects that her friend, another nurse on her unit, is impaired by illicit drugs. The nurse does not want to get her friend in trouble, but she fears that patients may be harmed. What is this conflict of loyalties an example of?
a. a moral dilemma
b. a practical dilemma
c. moral uncertainty
d. moral distress



REF:   p. 221


  1. A physician writes an order that the registered nurse believes will harm the patient. The nurse believes the physician to be incompetent. What is the most appropriate action for the nurse?
a. The nurse should follow the order since the physician’s education is superior.
b. The nurse should pursue the chain of authority. If the supervisor and others support the physician, the nurse should follow the order.
c. After pursuing the issue with the physician and supervisors, the nurse should disobey all orders that are believed to be illegal, immoral, or incompetent.
d. If the nurse is forced to follow the order, the nurse should file a formal complaint against the physician.



REF:   p. 222


  1. When delegating patient care activities, what does the nurse have a responsibility to do?
a. to assess competency when assigning nursing care activities to other health care workers
b. to divide the activities fairly between other health care workers
c. to teach subordinate health care workers proper techniques and procedures
d. to observe other health care workers as they perform delegated activities



REF:   p. 229



  1. “Hello, I my name is Dan Lee. I am a third-year nursing student who is part of the interprofessional team that will be caring for you during your hospitalization. I would like to hear about what brought you into the hospital.” According to the ICN Code of Ethics for Nurses (2000), what is this an example of?
a. professional values
b. personal values
c. an appeal to conscience
d. a fiduciary relationship



REF:   p. 213


  1. Which of the following prohibits harassment related to race?
a. Workplace Code of Ethics
b. ICN Code of Harassment for Nurses
c. Canada’s Labour Code
d. Canadian Human Rights Act



REF:   p. 225


  1. Which of the following statements best defines harassment?
a. behaviour that demeans, humiliates, or embarrasses a person
b. multiple episodes of distressing behaviour with intermittent and continual threats
c. situations or thoughts that make an individual feel frustrated, angry, nervous, or anxious.
d. unwelcome, abusive behaviour, including oral and written communication of an aggressive nature



REF:   p. 225


  1. Which of the following would be described as “showing sympathy, care, and reciprocity to those with whom the nurse appropriately identifies, as well as working closely with others toward shared goals”??
a. self-sacrifice
b. loyalty
c. beneficence
d. leadership



REF:   p. 222


  1. A nurse chooses to go without lunch so that a patient can be taken outside to get a newspaper and a strong cup of coffee. Which of the following terms best applies to this situation?
a. self-sacrifice
b. beneficence
c. non-maleficence
d. obligation



REF:   p. 219



  1. Which of the following statements best describes the physician–nurse relationship in a hospital setting?
a. The physician is the nurse’s “boss,” and the nurse is obligated to follow the physician’s orders.
b. The physician has total autonomy. The nurse is a limited moral agent.
c. Facility policies and procedures determine the nature and extent of each person’s moral agency.
d. Both the nurse and the physician are autonomous moral agents whose primary obligation is owed to the patient.



REF:   p. 226


  1. What guideline could a nurse use to consider alternative actions that require quick solutions, as well as to address urgent problems that require immediate responses simultaneously?
a. loyalty
b. whistle-blowing
c. spectrum of urgency
d. primary obligation



REF:   p. 227


  1. A nurse attempts to perform a urinary catheterization on a patient who is unable to void. The novice nurse is nervous and is unable to accurately catheterize the client. An experienced nurse storms into the patient’s room, grabs the catheter out of the nurse’s hands and loudly proclaims, “What’s wrong with you, haven’t you ever done this before?!” What definition best exemplifies this situation?
a. moral integrity
b. poor leadership
c. self-discipline
d. eating their young



REF:   p. 229


  1. Which of the following is characteristic of workplace incivility?
a. acknowledgement of diverse opinions
b. recognizing adversity
c. maintaining moral integrity
d. demeaning treatment of patients



REF:   p. 223

Chapter 10 – Practice Issues Related to End-Of-Life Care




  1. Which of the following can be both a benefit and a challenge of technological advances in health care?
a. supporting healthy living
b. availability and cost
c. prolonging life
d. alleviating suffering



REF:   p. 236


  1. What does the nurse need to understand about assessing a patient’s quality of life (QOL)?
a. It is an objective measure of comfort and factors that make life worth living.
b. It is considered good only if the patient feels fulfilled and can be independent.
c. It generally means the same thing to most patients, families, and nurses.
d. It includes subjective ideas about conditions of life and functional ability.



REF:   p. 238


  1. Since a prime nursing focus is to relieve suffering, what must nurses understand about health care technologies?
a. They are good because they always support a patient’s health and well-being.
b. They may cause conflict between doing good and avoiding harm to patients.
c. They are necessary interventions even if they cause patients to suffer.
d. They may cause nurses to do harmful things to patients against their wishes.



REF:   p. 237


  1. To appropriately utilize health care technology, what must health care providers, patients, and families understand?
a. its purpose, benefits, and limitations
b. its cost, availability, and usefulness
c. its outcomes, benefits, and cost
d. its risks, availability, and purpose



REF:   p. 237


  1. What ethical dilemma may arise from the use of life-sustaining technologies associated with health care providers ?
a. having each person define a quality of life
b. when families typically opt for fewer interventions
c. that technology permits a more peaceful death
d. the idea that death is an enemy to be overcome



REF:   p. 240



  1. According to Taylor (1950), how might the subject of medical futility be approached?
a. whether the intervention is prolonging living or prolonging dying
b. as non-beneficial, with involvement of parties regarding what is benefit or burden
c. as treatment valued by the patient but not medically indicated
d. that only the perspective of the physician determines what is a futile measure



REF:   p. 245


  1. How can withholding or removing treatments where the burden or harm to the person is determined to outweigh the benefits be viewed?
a. as allowing the person to die as a result of the natural progression of the disease process
b. as causing the painless death of the person in order to end or prevent more suffering
c. as providing the person the means to end his or her own life when he or she is ready to die
d. as following the directives to avoid suffering included in do not resuscitate orders



REF:   p. 245


  1. What is the legal indication associated with a do not resuscitate (DNR) order?
a. Medical therapies and interventions are to be avoided.
b. Life-sustaining interventions are to be discontinued.
c. Cardiopulmonary resuscitation (CPR) is to be avoided.
d. Palliative care is to be discontinued or avoided.



REF:   p. 251


  1. Which of the following is synonymous with palliative care?
a. support of patients who face illness that is not responsive to curative treatment
b. aggressive treatment of chronic health problems to support symptom relief
c. short-term treatment for an episode of illness in an urgent manner
d. delivery of co-ordinated and continuous services for an acute disease or illness



REF:   p. 241


  1. According to the textbook, what does the term “medical futility” mean?
a. a physician alone defining overall treatment and the value of medically indicated care
b. causing painless death of the person in order to end suffering
c. treatment beneficial to both physical and overall well-being
d. treatment valued by the patient but not medically indicated



REF:   p. 245



  1. What is the term for a situation where a competent patient is refusing food or fluid when there is a prediction of death, yet the family requests tube feeding?
a. medical futility
b. advance directives
c. technological dilemma
d. palliative care



REF:   p. 245


  1. What is the term for instructions designating someone to act as a surrogate in a very specific context if one loses decision-making capacity?
a. guardian ad litem
b. advance directives
c. self-determination
d. do not resuscitate



REF:   p. 257


  1. In which circumstance does Curtin suggest that artificial sources of nutrition may be terminated?
a. when utilizing other technologies at the end of life
b. when there is a reliable prediction of permanent unconsciousness
c. when other interventions will relieve a patient’s suffering
d. when changes in the patient’s condition will eventually lead to starvation



REF:   p. 255


  1. Regardless of technological development and scientific advances, what are the important considerations for nursing to relate to?
a. basing decisions on personal values
b. acknowledging the importance of advanced technology
c. being attentive to technology
d. maintaining the human focus of care



REF:   p. 261

Chapter 11 – Practice Issues Related to Patient Self-Determination




  1. What is the legal protection of a patient’s right to personal autonomy called?
a. paternalism
b. advanced directives
c. informed consent
d. competence



REF:   p. 273


  1. Which of the following actions are part of the nurse’s role and responsibilities in informed consent?
a. verifying that the patient is aware of options and the implications of each option
b. providing recommendations about care to the patient
c. explaining the procedure to the patient when the doctor cannot do so
d. signing as a witness attesting that the patient is unable to give consent



REF:   p. 275


  1. What is the definition of competence?
a. a legal action physicians can impose on patients who are elderly and confused
b. the ability of a patient to understand medical options and treatment
c. a legal ruling regarding a person’s ability to make meaningful life decisions
d. the ability of a patient to communicate about current events



REF:   p. 281


  1. A patient asks the surgeon what will be gained by having the procedure and the surgeon does not respond. Which patient right is being violated?
a. autonomy
b. justice
c. advance directives
d. informed consent



REF:   p. 275


  1. Which source document acknowledges the importance of living wills and clearly identifies promoting and respecting informed decision making?
a. Substitute Decision Maker Proxy
b. Code of Ethics
c. Lifestyle Choices Policy
d. Advance Directives Act



REF:   p. 282



  1. A nurse is caring for a patient with cancer who describes using ozone therapy and mega intravenous doses of vitamin C as part of her treatment. Which of the following nursing actions would take into consideration the patient’s ability to self-determination?
a. Honour the patient’s right to use therapies other than conventional medicine to address their health care needs.
b. Tell the patient that they should stop these therapies because the research does not support them.
c. Inform the patient that they have a right to do what they want, but that it is unwise to mix different modalities of therapy
d. Encourage the patient to share the alternative therapies with other patients to see if they might help them as well.



REF:   p. 270


  1. A patient is refusing to participate in his plan of care. The nurse is aware that the patient’s refusal will negatively affect his health outcome. According to the Canadian Nurses Association Code of Ethics, what must the nurse take into consideration?
a. that the patient’s unhealthy life practices require further allocation of resources
b. that the nurse has the right to refuse to continue care
c. that the quality of nursing care must NOT be affected
d. that the plan of care should NOT be revised



REF:   p. 286


  1. When a nurse discusses a patient’s condition and treatment with family members who were not authorized to have medical information disclosed to them, what principle is the nurse breaching?
a. autonomy
b. non-maleficence
c. competence
d. confidentiality



REF:   p. 296


  1. A nurse encourages a patient to take narcotics for severe cancer pain. The patient is concerned about the possible side effects. The nurse gives the patient the narcotic and tells the patient; “It’s for your own good and it’s important to get your pain under control.” What is the nurse’s behaviour an example of?
a. paternalism
b. justice
c. autonomy
d. competence



REF:   p. 271



  1. What is the purpose of a patient completing a living will?
a. prolonging life or improving quality of life
b. identifying a proxy or substitute decision-maker
c. a medical determination relating only to the issue at hand
d. evaluating health care decisions and reducing choices



REF:   p. 279


  1. Which law states that active euthanasia and assisted suicide are both illegal and that taking part in them is against the law, even if carried out for merciful intentions or relieve suffering?
a. the Criminal Code of Canada
b. the Code of Ethics
c. the Advance Directives Act
d. the Lifestyle Choices Policy



REF:   p. 294


  1. A nurse is injured with a percutaneous exposure of blood while on duty. The nurse wishes to have the patient tested for HIV; however, the patient refuses. Which of the following statements best summarizes testing issues related to HIV?
a. The nurse’s right to have the testing completed supersedes any patient’s objections.
b. It is illegal to perform testing without the patient’s consent.
c. It is mandatory for all patients to be HIV tested and therefore the nurse would have results available.
d. The nurse needs to advise the patient of the potential risks of refusing to have the testing completed.



REF:   p. 295


  1. Which of the following elements must be present when evaluating a patient’s decision-making capacity?
a. the ability to determine a positive outcome
b. the ability to communicate understanding
c. the ability to behave in an ethical manner
d. the ability to understand medical terminology



REF:   p. 280


  1. What does a nurse’s advocacy role regarding a patient’s advance directives (AD) include?
a. making sure that the patient is not resuscitated in a cardiac arrest situation
b. telling patients about changes in their condition so they can modify their AD
c. informing health team members about healthcare decisions when the patient cannot do so
d. informing health team members of the content of a patient’s AD



REF:   p. 282



  1. Which of the following elements must be included in an informed consent?
a. description of common practices of the healthcare institute
b. needs and expectations of the patient
c. description of the health concern
d. verification of understanding



REF:   p. 275

Chapter 12 – Scholarship Issues




  1. What are two core values basic to academic honesty and to ethical treatment of research data?
a. plagiarism and cheating
b. cheating and fidelity
c. beneficence and integrity
d. veracity and fidelity



REF:   p. 304


  1. Which document was developed to set forth principles for the ethical conduct of research in response to human rights violations during the Second World War?
a. World Humanities Research
b. CNA Code of Ethics
c. Nuremberg Code
d. Declaration of Helsinki



REF:   p. 308


  1. A nurse researcher decides to discontinue a research project because the findings indicate that the risks of the study outweigh the benefits. Which principle is the nurse researcher applying?
a. beneficence
b. justice
c. trustworthiness
d. confidentiality



REF:   p. 313


  1. Which of the following does a nurse researcher include in the research protocol to protect human rights?
a. the right to have no risk involved
b. the right to be assigned to any group
c. the right to autonomy
d. the right to free medical care



REF:   p. 308


  1. What is recruiting participants for a study by offering them a sizeable amount of money, travel expense allowances, and reimbursement of medical fees considered a form of?
a. full disclosure
b. coercion
c. right to fair treatment
d. compensation



REF:   p. 315



  1. Whose integrity and honesty are of utmost importance in the ethical treatment of data?
a. statistician
b. participants
c. researcher
d. data collector



REF:   p. 304


  1. Which of the following issues affect academic integrity?
a. plagiarism and cheating
b. cheating and editing
c. editing and fidelity
d. forgery and consulting



REF:   p. 304


  1. Which document includes statements that object to the phenomenon of researchers who “parachute” into developing countries to conduct research, then abandon the research participants after completion?
a. World Humanities Research
b. CNA Code of Ethics
c. Nuremberg Code
d. Declaration of Helsinki



REF:   p. 309


  1. Which document provides guidelines on research involving Aboriginal persons, and the use of vulnerable populations in general?
a. Tri Council Policy Statement
b. CNA Code of Ethics
c. Nuremberg Code
d. Declaration of Helsinki



REF:   p. 309


  1. Which of the following statements is an example of ethical treatment of data?
a. removal of invalid research values and entries
b. authentically describing the experiences of others
c. adjustment of facts for positive outcomes
d. episodic treatment of vulnerable participants



REF:   p. 319


  1. Which of the following characteristics of ethical research goes beyond the protection of human rights?
a. scientific objectivity
b. scientific competitiveness
c. indifference
d. personal gain



REF:   p. 318


  1. Which of the following examples would be considered a vulnerable population needing special consideration in research protocols?
a. 17-year-old male high school students
b. 21-year-old female university students
c. 65-year-old males with heart disease
d. 41-year-old incarcerated females



REF:   p. 317


  1. Which of the following statements best exemplifies the principle of plagiarism?
a. paraphrasing of the work of another and providing credit to that person
b. submitting your original work without citations
c. citing the work of another and using referencing
d. “cutting and pasting” sections from a previous paper into a current paper



REF:   p. 305


  1. Which of the following characteristics may a nurse experience when participating in conducting research?
a. academic dishonesty
b. personal bias
c. misrepresentation
d. role conflict



REF:   p. 318


  1. Which of the following is an example of fraudulent research?
a. reporting studies that were never conducted
b. reporting outcomes of studies
c. reporting of a research hypothesis
d. reporting of exclusion and inclusion criteria



REF:   p. 320

Chapter 13 – The Future of Canadian Health Care: Challenges and Priorities




  1. What report emphasized the need for primary health care reform in Canada?
a. Drummond Report
b. Declaration of Alma-Ata
c. Romanow Report
d. Quinquennial Report



REF:   p. 336


  1. Which of the following is an example of the federal responsibility for health care?
a. evaluating physician and hospital care
b. delivering direct health care services to native Canadians
c. delivering and managing insured health services
d. managing some public health and prescription care



REF:   p. 327


  1. Which of the following is an example of provincial or territorial responsibility for health care?
a. deciding upon the principles for health care
b. delivering direct health care services to veterans
c. providing health-related functions such as health protection programs
d. evaluating physician and hospital care



REF:   p. 327


  1. What health care changes evolved in the latter part of nineteenth century in Canada ?
a. public health
b. interprofessional care
c. immigrant health
d. curative programs



REF:   p. 328


  1. Which act gives provinces the authority over health care, but gives the federal government the responsibility to fund it?
a. Medicare Act, 1946
b. Constitution Act, 1982
c. British North America Act
d. Saskatchewan Medical Care Insurance Act



REF:   p. 331



  1. Which report emphasized that the determinants of health did not simply exist within the health care system but also in other sectors?
a. Canadian Health Report
b. Tommy Douglas Health Report
c. Quinquennial Report
d. Lalonde Report



REF:   p. 332


  1. The main goal of primary health care is health for all in a community, and the involvement of individuals and groups in communities. What is another key element of primary health care?
a. illness prevention
b. problem-based care
c. universal health care
d. intersectoral collaboration



REF:   p. 336


  1. Accessibility is one of the five key features of the Canada Health Act. Which of the following is NOT directly addressed in the Act?
a. reasonable access for citizens without financial barriers
b. extra billing and user fees for citizens
c. geographical accessibility
d. providing equitable care for all citizens



REF:   p. 337


  1. Large immigrant populations may live in overcrowded situations and, in some cases, may be unable to access health care. In addition to financial constraints, what is another issue that immigrant populations might face with regard to health care?
a. burdening the health care system with longer wait times
b. language and cultural barriers to health care
c. burdening primary health care, and spending more on prescription drugs
d. lack of health care providers and facilities



REF:   p. 338


  1. Which of the following contribute to the challenge of providing health care for populations across the globe?
a. infant mortality and globalization
b. ecology and traditional healing systems
c. war and national crises
d. relationships and curative measures



REF:   p. 339

Chapter 14 – Health Policy Issues




  1. What is the term for plans of action that guide the actions of governments, institutions, corporations, and communities?
a. common law
b. policies
c. legislation
d. torts



REF:   p. 347


  1. What type of policy governs decisions about where to build hospitals, what programs to offer at specific hospitals, and how many physicians to put into place?
a. institutional policy
b. judicial policy
c. allocative policy
d. regulatory policy



REF:   p. 349


  1. Which of the following is both an ethical and a political issue?
a. genetic testing and research
b. urban and rural health priority setting
c. safety and workplace legislation
d. food safety and labelling



REF:   p. 354


  1. A nurse becomes concerned because her facility consistently requires mandatory overtime, up to 40 additional hours per week. The nurse brings the issue to the attention of her professional organization, and together they approach their legislator. What are these acts considered?
a. policy formulation
b. policy implementation
c. policy evaluation
d. policy modification



REF:   p. 351


  1. A nurses’ organization decides to work toward legislation that would limit mandatory overtime in the workplace. The group mobilizes large numbers of nurses and community volunteers to write letters and make personal contact with legislators. What is the term for this form of political activism?
a. en masse lobbying
b. partisan lobbying
c. grassroots lobbying
d. political lobbying



REF:   p. 360


  1. A nursing professor is actively involved in lobbying for health policy issues. The professor tells the class that these activities are moral duties. What is the best explanation for this statement?
a. The nursing professor likely learned the sense of duty from her upbringing.
b. The nursing professor has a deontological ethical perspective.
c. The ICN code of ethics for nurses directs the professor to promote efforts to meet the health needs of society.
d. The nursing professor is attempting to influence the students’ political action or influence the pursuit of health.



REF:   p. 357


  1. Which of the following is a health policy issue of concern to the profession of nursing?
a. setting up quarantine stations
b. changing the age of consent
c. trusting and sustainable relationships
d. monitoring entry to practice



REF:   p. 359


  1. Which of the following describes the most effective type of letter sent to a policy maker in a lobbying campaign?
a. a long emotional plea that is very thorough and explanatory and includes many examples
b. a form letter with a handwritten salutation and signature
c. a concise handwritten letter written in your own words, using your own thoughts and logic
d. a letter that includes a list of all topics of interest to nurses in your area



REF:   p. 361


  1. What is the term for issues that are created, affected, or regulated by any of the government branches?
a. political issues
b. partisan issues
c. health policy issues
d. regulatory issues



REF:   p. 349


  1. A student nurse speaks to a senator about hospitals, saying they need to set unit-by-unit staffing levels based upon patient acuity and individual hospital unit characteristics in order to promote better patient outcomes. What is this an example of?
a. lobbying
b. statutes
c. policy modification
d. regulations



REF:   p. 359


  1. What is the term for pieces of legislation that have been enacted by legislative bodies and approved by the government?
a. allocative policies
b. regulations
c. judicial decisions
d. statutes



REF:   p. 349


  1. Which phase of the health policy process occurs when studying the consequences of existing policies indicates that the original problem still exists?
a. policy implementation
b. policy modification
c. policy formulation
d. policy circumstances



REF:   p. 352


  1. Which of the following is an example of a federal regulatory act in Canada?
a. Assisted Human Reproductive Act
b. Future of Health Care Act
c. Canadian Policy Research Act
d. Canada Health Act



REF:   p. 350


  1. Which of the following is NOT a method that a nurse should use when preparing to engage in political action?
a. understanding the processes and levels of government
b. writing many personal letters
c. bringing personal biases to the issue
d. enlisting interested and informed allies to the cause



REF:   p. 361

Chapter 15 – Economic Issues




  1. Which ethical theories of justice are based on the concept that it is good to maximize the greatest good for the greatest number of people?
a. libertarian theories
b. utilitarian theories
c. deontological theories
d. communitarian theories



REF:   p. 379


  1. Three patients arrive at a health care facility in a remote northern area of Canada. All have serious injuries, but there is only enough room on a small plane for one patient. The nurse in charge of the facility asks; “Who needs access to specialties the most?” What does this scenario suggest?
a. The nurse is using a material rule of distributive justice to make the decision.
b. Decisions about how to distribute scarce medical resources are unpredictable.
c. The nurse should collaborate with the physician when this type of decision is made.
d. There are no rules regulating distribution of scarce medical resources in this facility.



REF:   p. 371


  1. The economics of Country A support the rights of property and liberty for each person and allow each citizen to improve life circumstances by his or her own effort. Health care can be purchased or given freely in Country A, but there is no entitlement program to ensure basic health care to vulnerable people. Which of the following best describes this type of economic structure?
a. Marxism
b. communitarianism
c. democracy
d. libertarianism



REF:   p. 379


  1. John Rawls suggested that in making decisions of distributive justice, one should examine the situation behind a “veil of ignorance” so that no one would be able to design principles to favour his or her own particular condition. This idea supports a political philosophy for which Rawls was a proponent. What is that political philosophy called?
a. utilitarianism
b. communitarianism
c. egalitarianism
d. libertarianism



REF:   p. 379



  1. Different models of health care exist. Which model of health care is the Russian health care system modelled after?
a. national health systems model
b. public insurance model
c. entrepreneurial model
d. financing systems model



REF:   p. 369


  1. In Canada, almost all people are insured against the cost of hospital and physician expenses through a government health insurance program. What is this type of health care financing commonly called?
a. fee for service
b. out-of-pocket expenses
c. universal health insurance
d. voluntary or private insurance



REF:   p. 372


  1. How does the Canada Health Act describe Canadian health care?
a. as a constitutional right
b. as facilitating reasonable access to health services
c. as the protection of basic needs, including a right to the protection of health
d. as treating health care as a commodity, not a right



REF:   p. 374


  1. What is a natural consequence of utilitarian forms of health care financing?
a. Resources and services will be distributed equally.
b. Some people will not receive resources and services.
c. The people with the greatest need will receive the bulk of resources and services.
d. People who have greater personal resources will receive greater benefit.



REF:   p. 379


  1. What is one of the ethical problems associated with the traditional fee-for-service system that medicine is predominantly driven by?
a. overutilization
b. privatization
c. privileges
d. opportunities



REF:   p. 369



  1. A “health care system willing to be held accountable both clinically and financially for the health outcomes of an enrolled population for a capitated (fixed) payment” describes which of the following health care financing systems?
a. fee for service
b. universal health care
c. categorical financing
d. managed care



REF:   p. 384


  1. Which of the following can recent trends in Canadian health policy in areas concerning reform be related to?
a. changing values and stronger trade relationships with the United States.
b. increased efficiency based on private market entrepreneurialism
c. not enough accountability on the part of the government
d. reduced transfer payments to the provinces and territories



REF:   p. 381


  1. According to the Romanow Commission Report, what is one of the challenges to the health care system?
a. guaranteed reasonable access to care
b. resources not being used optimally
c. decisions being made by physicians
d. considerations of how rationing should occur



REF:   p. 383


  1. Which of the following health care financing systems has a strong focus on the principle of autonomy?
a. fee for service
b. managed care
c. universal health insurance
d. single payer systems



REF:   p. 369


  1. What is the term for an out-of-pocket payment that some provinces still require?
a. fee for service
b. premium
c. allied service fee
d. voluntary health fee



REF:   p. 373



  1. Which of the following is an example of the element of privatization in Canadian health care?
a. a national “drug agency” to oversee and monitor pharmaceutical activity
b. laundry services outsourced to private companies
c. integration between “pharmacare” and medicare
d. national platform for home care



REF:   p. 382

Chapter 16 – Social Issues




  1. Which of the following challenges is an important structural issue in health care?
a. abortion
b. research
c. pandemics
d. poverty



REF:   p. 392


  1. Which population shows an increased incidence of conditions associated with poor nutrition, inadequate exercise, and illnesses from environmental factors?
a. children living in poverty
b. adults living in poverty
c. elder population living in poverty
d. abused women living in poverty



REF:   p. 392


  1. Compared to Murphy’s original estimate of the number of homeless people in Canada in 2000, how much higher is the estimated number now?
a. 5 times
b. 10 times
c. 20 times
d. 30 times



REF:   p. 394


  1. A patient returned to the hospital for the fourth time in less than a week complaining of diabetes-related complications. Talk begins at the nurses’ station regarding whether the patient should receive treatment, since it is his fault because he has never filled the prescription given to him for his diabetes. What is the term for the nurses’ behaviour?
a. racism
b. language of violence
c. victim blaming
d. non-maleficence



REF:   p. 405


  1. Which factor contributes to a domestic violence victim returning to their abusive partner several times before permanently terminating the relationship?
a. poor support from the criminal justice system
b. poor health
c. health care system minimizing the abuse
d. victims being uninformed about violence



REF:   p. 398


  1. Which issue has the greatest effect on the health and health care options of the increasing elder population?
a. prescription costs
b. economic hardship
c. inadequate respect
d. discrimination



REF:   p. 400


  1. Which ethical principle would lead to working with an abused woman to develop a strong sense of identity and to help her see various options?
a. non-maleficence
b. justice
c. beneficence
d. autonomy



REF:   p. 404


  1. Which ethical principle is being disregarded when preference for health care is given to those who are not homeless?
a. non-maleficence
b. justice
c. beneficence
d. autonomy



REF:   p. 403


  1. Which ethical principle would lead to refusing to discharge an abused child to her home when there is a possibility of further injury?
a. non-maleficence
b. justice
c. beneficence
d. autonomy



REF:   p. 403


  1. Which of the following can get in the way when working with vulnerable groups?
a. self-determination
b. language that colours speech and actions
c. exploring personal beliefs
d. inadequate research



REF:   p. 406


  1. Which of the following go beyond delivering health care that is grounded in the sexism, classism, and racism that often dominate health care delivery?
a. empathy; exploration
b. autonomy; perception
c. vigilance; justice
d. advocacy; caring



REF:   p. 408


  1. According to Raphael, what is one reason that Canadians should be concerned with economic inequality and poverty?
a. It may strain the health care system and social safety net of the country.
b. It requires a close partnership with a wide range of stakeholders.
c. It creates hurdles in health care policy.
d. It impacts the ability to maintain good health.



REF:   p. 393


  1. Which of the following health-related issues should nursing care and policy address?
a. social exclusion
b. financial resources
c. intimate-partner violence
d. higher mortality rates



REF:   p. 393


  1. Which of the following social determinants is extremely important for nurses to consider in the holistic care of any patient?
a. healthy relationships
b. chronic medical conditions
c. unhealthy diet
d. level of education



REF:   p. 391

Chapter 17 –Issues of Gender and Culture




  1. Which term refers to a disparity in earnings?
a. sameness salary
b. pay gap
c. feminist fee
d. comparable worth



REF:   p. 418


  1. Which of the following is a male patient making the statement that “nurses are well-bred, well-educated specimens of womanhood” an example of?
a. sexism
b. paternalism
c. nursism
d. parentalism



REF:   p. 424


  1. Which of the following is a major limiting factor for men still entering into the profession of nursing?
a. collective bargaining
b. pay gap
c. societal stereotyping
d. caring behaviours



REF:   p. 418


  1. An experienced male nurse applies for a position in labour and delivery. Even though he is better qualified than other applicants, the nurse manager hires a female nurse. The manager explains that she wants to protect her patients from being uncomfortable with a male nurse. Which of the following is this situation an example of?
a. sexism
b. transcultural respect
c. nursism
d. societal expectations



REF:   p. 424


  1. Which of the following governs employment equity and equal pay for equal work as a right protected in provinces across Canada?
a. Elimination of All Forms of Discrimination Against Women
b. Equal Wages Guidelines
c. Pay Gap Act
d. Fair-Labour Legislation



REF:   p. 417


  1. A female nurse manager is overly friendly toward a young male colleague. She makes sexually explicit remarks and often corners him in the medication room, standing uncomfortably close. Which of the following is this behaviour consistent with?
a. sexual assault
b. sexual deviance
c. sexual harassment
d. hostile work environment



REF:   p. 420


  1. Which of the following does Williams identify as one of the several hidden advantages to being a man in nursing?
a. men have increased responsibility and autonomy in health care
b. men learn and express caring faster than females
c. men are tracked into higher paying and more prestigious positions
d. men are territorial and authoritative with other health care professionals



REF:   p. 418


  1. What is one factor that systematic discrimination against lesbians and gay men in nursing results from in health care institutions?
a. avoidance
b. societal stereotyping
c. punitive supervisors
d. controversy



REF:   p. 425


  1. According to recent statistics, on average, what does a woman get paid compared to a man in a similar position?
a. 80 percent as much
b. 70 percent as much
c. 60 percent as much
d. 50 percent as much



REF:   p. 417


  1. What is the term for knowing about the values, beliefs, behaviours, norms, and customs of a patient who comes from a culture other than your own?
a. cultural awareness
b. cultural sensitivity
c. ethnocentrism
d. cultural competence



REF:   p. 426


  1. Which forms of discrimination are clearly prohibited by Canada’s Charter of Rights and Freedoms ?
a. any form of practised inequality
b. unwelcome conduct that detrimentally affects the work environment
c. nurses’ functioning subordinate to multiple layers of authority
d. disparity in earnings existing between men and women



REF:   p. 421


  1. Through informal dress and communications, what type of powerful messages may nurses be sending?
a. positive messages
b. negative messages
c. successful messages
d. friendly messages



REF:   p. 424


  1. What is the term for the gender division of labour pertaining to nurses and physician and how they relate to each other in health care settings?
a. physician–nurse relations
b. mean-spiritedness
c. the doctor–nurse game
d. male domination



REF:   p. 422


  1. A nurse’s Aboriginal patient tells her that his health problem was caused by the Manitou and that he needs some blue beads for protection and healing. What does cultural sensitivity direct the nurse to do?
a. caringly inform the patient that the Manitou is an old belief and is not real
b. make a mental health referral to a local Aboriginal therapist
c. listen respectfully to the patient’s story and go on with the treatment
d. explore more about the blue beads and try to get some for the patient



REF:   p. 428


  1. When are transcultural issues and conflicts more likely to arise?
a. when nurses are aware of their own biases and judgments of others
b. when nurses judge other people’s behaviour by their own cultural values
c. when nurses understand their own cultural beliefs and values
d. when nurses avoid judging others based on preconceived ideas



REF:   p. 428


  1. What does Achterberg cite in her article Woman as Healer as one of the many issues that challenge nurses?
a. nursing gaining professional status
b. the masculinisation of medicine
c. maligning the caring role in society
d. oppression of women



REF:   p. 416


  1. Which of the following demonstrates a nurse’s understanding that good communication is key to providing culturally congruent care?
a. The nurse determines the patient’s understanding of the nurse’s written and spoken language.
b. The nurse considers a family member to be the best interpreter when the language is different.
c. The nurse understands that his/her own values and beliefs and those of the clients are congruent.
d. The nurse discovers that expectations and patient perspectives are related to acquiring a positive attitude.



REF:   p. 437

Chapter 18 – Rural and Aboriginal Nursing in Canada




  1. What is the percent of Canadians defined as living in a rural environment?
a. between 10 and 20 percent
b. between 20 and 30 percent
c. between 30 and 40 percent
d. between 40 and 50 percent



REF:   p. 446


  1. Which of the following statements applies to Canadians living in a rural environment?
a. More new immigrants and visible minorities live in rural areas.
b. People are more ethnically diverse.
c. People have a wider variety of opportunities.
d. Families tend to have lower incomes.



REF:   p. 446


  1. What health issue is more likely to be found in rural communities?
a. higher rates of infectious diseases
b. lower rates of “healthy heart” practices
c. overall poor nutrition
d. higher levels of stress



REF:   p. 447


  1. Which of the following is an objective of the Canadian Association for Rural and Remote Nursing?
a. to reduce inequities between groups and populations
b. to facilitate communication and networking
c. to regulate remote health care teamwork and interdisciplinary approaches
d. to highlight the professional and practice challenges of rural nursing



REF:   p. 448


  1. Which of the following does the Registered Nurses Association of Ontario (RNAO) identify as one of the eight attributes of nursing professional practice?
a. collegiality
b. consistency
c. accessibility
d. predictability



REF:   p. 449



  1. Which of the following individuals would self-identify as being a part of at least one Aboriginal group?
a. Amish
b. Acadian
c. Québécois
d. Inuit



REF:   p. 455


  1. A nurse works in a small outpost hospital in Inuvik. The nurse attends a local hockey game at the arena and is asked the following question by a resident of the town: “When I saw you last week about the pain in my stomach and was given the medication it helped for a bit. Today it’s the same but different, what do you think I should do?” What concept is this scenario an example of?
a. being professional
b. meeting obligations
c. avoiding boundaries
d. being enmeshed



REF:   p. 450


  1. A nurse in a small rural hospital is out grocery shopping and is asked the following in the check-out lane: “How is Sarah doing? Was the operation successful?” Which of the following statements must the nurse be aware of when working in a rural community?
a. Talking about patients to members in a small community is a cultural norm.
b. The confidentiality of patients’ information must be protected.
c. Being fully embedded as a nurse in a small community involves discussing all patients.
d. Providing holistic nursing care in a rural setting implies overlap of a nurses’ role patients.



REF:   p. 450


  1. What type of nursing education may help nurses in rural and remote areas to access continuing and graduate education?
a. university continuing education
b. college continuing education
c. modular courses
d. co-operative programs



REF:   p. 453


  1. Which of the following is a factor that impacts the health and well-being of Aboriginal persons?
a. social inclusion
b. civil war
c. population growth
d. physical environment



REF:   p. 456


  1. Which of the following best defines Aboriginal nursing?
a. nurses working in outpost settings and northern territories
b. nurses with specialized knowledge, affirmed by a faith community
c. Aboriginal persons who work as nurses
d. nurses who work in Aboriginal communities



REF:   p. 458


  1. Who typically employs the nurses who provide care on First Nations reserves?
a. Health Canada
b. First Nations band council
c. Aboriginal community
d. Aboriginal Nurses Association of Canada



REF:   p. 459

Chapter 19 – Empowerment for Nurses




  1. What is a nurse demonstrating when sharing knowledge about health care decisions and involving patients in making those decisions?
a. power over
b. power protection
c. power with
d. power control



REF:   p. 470


  1. Which of the following is implied by the term power over?
a. incorporating diversity
b. sharing responsibility with others
c. protecting limited resources
d. enhancing patients’ abilities



REF:   p. 470


  1. How is nursing empowerment derived from the perspective of power with or power to?
a. It is given to or delegated to the nurse.
b. It is a directive process regarding change.
c. It is more focused on outcome than process.
d. It is based on mutual love and respect.



REF:   p. 484


  1. Which of the following might hinder nursing empowerment?
a. taking action to address system issues
b. eliminating divergent and conflicting views
c. collaborating and sharing in decision making
d. participating in forming institutional policies



REF:   p. 476


  1. For the past few months Matthew has complained about inadequate staffing on all shifts to the administrator of the nursing home where he works as a nurse. He documented poor patient care, which included patients not being fed appropriately and several patients who developed serious bedsores after being left for hours on wet linens without being turned. When the administrator repeatedly refused to make any changes, citing economic reasons, Matthew spoke to a reporter at the local paper about the situation. How would this action of Matthew’s be viewed?
a. as unethical
b. as making trouble
c. as whistle-blowing
d. as unprofessional



REF:   p. 475


  1. Which of the following does the process of motivating and empowering individuals and groups require?
a. positive self-esteem
b. protectionism
c. attitude of superiority
d. obligations of beneficence



REF:   p. 470


  1. What is the term for a person who waits and hopes something or someone else will change, and makes excuses for not taking action?
a. disempowered
b. a whistle-blower
c. a victim
d. an empowered person



REF:   p. 473


  1. Which of the following factors influences professional empowerment in nursing?
a. professional disobedience
b. support of professional colleagues
c. faith that the right thing is done
d. abdicating responsibility for decision making



REF:   p. 474


  1. What descriptive term do nurse scholars use when discussing people who are empowered?
a. rigid
b. disobedient
c. assertive
d. aggressive



REF:   p. 470


  1. To enable patient empowerment, what do nurses need to recognize?
a. Health professionals know what is best for patients.
b. Patients need help in making health care decisions.
c. Patients are responsible for their own health.
d. Health professionals give power to patients.



REF:   p. 481


  1. What nursing focus does patient empowerment evolve from?
a. advocacy
b. patient care
c. paternalism
d. locus of control



REF:   p. 478


  1. Which of the following nursing attitudes enables patient empowerment?
a. surrendering the need for control
b. directing patients toward decisions that support good health outcomes
c. encouraging patients to value nursing trust
d. providing services for patients



REF:   p. 478


  1. What skills does nursing knowledge foster in order to enable empowerment?
a. decision making based on intuition
b. values development and their impact on choices
c. application of scientific principles and evidence-based practice
d. imposing personal values on others



REF:   p. 479


  1. A patient tells you that he cannot lose weight because his job keeps him on the road so he cannot exercise, and his wife fixes too many high-calorie meals. What is he demonstrating?
a. internal locus of control
b. external locus of control
c. negative locus of control
d. positive locus of control



REF:   p. 480


  1. Which of the following is a potential barrier to patient empowerment?
a. comfort with change
b. sufficient knowledge
c. social labelling
d. available resources



REF:   p. 482


  1. A patient tells you that the more he exercises and the healthier he eats, the healthier he gets. What is he demonstrating?
a. internal locus of control
b. external locus of control
c. negative locus of control
d. positive locus of control



REF:   p. 480