Nursing Foundations: Values, Ethics, Law, Pharmacology, and Communication

Comprehensive Question and Answer practice flashcards covering Values, Ethics, Advocacy, Medication Administration, Legal Dimensions of Nursing, Pharmacodynamics, Pharmacokinetics, and Therapeutic Communication based on 5 core nursing study guides.

What are the five common modes of value transmission described in nursing practice?

The five modes are Modeling (observing others), Moralizing (taught a complete system with little choice), Laissez-faire (independent exploration without guidance), Rewarding and punishing (desired behavior rewarded, unacceptable punished), and Responsible choice (exploring competing values and consequences with guidance).

What are the three essential steps in the valuing process?

The three steps are Choosing (freely selecting from alternatives after considering consequences), Prizing/Treasuring (feeling pride or happiness about the choice and affirming it), and Acting (behaving consistently according to the chosen value).

What is the primary role of the nurse when performing values clarification in clinical practice?

The nurse helps the patient clarify their own values, explore alternatives, and make informed choices without imposing the nurse's personal values or choosing for the patient.

How do principle-based bioethics and care-based bioethics differ?

Principle-based bioethics uses formal ethical principles (such as autonomy, nonmaleficence, beneficence, and justice) to direct action. Care-based bioethics focuses on the specific patient context, narrative, caring relationship, responsiveness, and virtues like empathy and compassion.

What is the key distinction between moral distress and moral resilience?

Moral distress occurs when a nurse knows the ethically correct action but cannot carry it out due to personal or institutional barriers. Moral resilience is the capacity to recover, adapt, and thrive when facing morally challenging situations.

What are the five steps in the ethical decision-making process?

The five steps are: 1. Assess/gather data, 2. Identify/diagnose the ethical problem, 3. Plan/identify and weigh alternatives, 4. Implement, and 5. Evaluate.

What are the four primary functions of an institutional ethics committee?

The four functions are Education, Policy making, Case review and consultation, and Quality (and in some cases, research).

What is the overarching goal of the nurse serving as a patient advocate?

To support and protect the patient's voice, rights, health, safety, dignity, and autonomy without replacing the patient's own decision-making.

What rule governs the safety of medication administration by specific routes?

A nurse should not administer a medication by any route for which they have not been trained or are not capable of performing.

Why must enteric-coated or extended-release oral medications never be crushed, chewed, or broken?

Crushing or breaking them destroys the special formulation or coating that controls where or how rapidly the drug is absorbed, risking altered absorption rate or toxicity.

What are the standard metric metric conversions for mass ($1\,\text{g}$ to $\text{mg}$, $1\,\text{mg}$ to $\text{mcg}$) and liquid volume ($1\,\text{L}$ to $\text{mL}$)?

$1\,\text{g} = 1{,}000\,\text{mg}$, $1\,\text{mg} = 1{,}000\,\text{mcg}$, and $1\,\text{L} = 1{,}000\,\text{mL}$.

What are the common metric milliliter equivalents for $1\,\text{teaspoon}$, $1\,\text{tablespoon}$, and $1\,\text{fluid ounce}$?

$1\,\text{tsp} = 5\,\text{mL}$, $1\,\text{tbsp} = 15\,\text{mL}$, and $1\,\text{fl oz} = 30\,\text{mL}$.

What are the three accepted calculation methods for determining medication dosages?

Ratio and proportion, Desired over Have, and Dimensional analysis.

What formula is used to calculate manual IV drip rates in drops per minute?

$$\text{drops/min} = \frac{\text{volume (mL)}}{\text{time (min)}} \times \text{drop factor (gtt/mL)}$$

What is the Mosteller formula for calculating Body Surface Area (BSA)?

$$\text{BSA (m}^2\text{)} = \sqrt{\frac{\text{height (cm)} \times \text{weight (kg)}}{3600}}$$

Why do pediatric patients require specific dosing considerations compared to adult patients?

Children have immature organ systems affecting drug absorption, distribution, metabolism, and excretion, which changes how drugs act in their bodies.

What are the four sources of law in the legal system?

Constitutional law, Statutory law, Administrative law, and Common law.

What is the purpose of a state Nurse Practice Act?

It broadly defines the legal scope of nursing practice in that state to protect the public and establishes grounds for disciplinary action.

What are the four elements required to prove legal malpractice or liability?

1. Duty, 2. Breach of duty, 3. Causation, and 4. Damages.

How do assault and battery differ as intentional torts?

Assault is a threat or attempt to make unauthorized bodily contact. Battery is the assault carried out, involving willful, angry, violent, or unauthorized physical touching.

What is the distinction between slander and libel?

Slander is spoken defamation of character, while libel is written defamation.

What key rule must nurses follow regarding documentation and incident reports?

Document the factual details of the incident and patient care in the medical record, but NEVER state in the patient record that an incident report was filed.

What is the legal standard of care applied to nursing students?

Nursing students are held to the exact same standard of care used to evaluate a licensed Registered Nurse.

How are pharmacodynamics and pharmacokinetics defined?

Pharmacodynamics is the study of how a drug affects the body. Pharmacokinetics is the study of how the body processes a drug through absorption, distribution, metabolism, and excretion (ADME).

What is the difference between a drug agonist and an antagonist?

An agonist interacts with a receptor site to produce a cellular response. An antagonist binds to a receptor site to block or prevent a response.

What is selective toxicity in antimicrobial and antineoplastic therapy?

The ability of a drug to target and destroy systems present in foreign or abnormal cells without harming healthy host human cells.

What is the first-pass effect?

The metabolism of orally administered drugs in the liver via portal circulation before the drug reaches general systemic circulation, reducing the amount of active drug available.

How do hepatic enzyme induction and enzyme inhibition alter drug levels?

Enzyme induction speeds up drug metabolism, leading to lower therapeutic drug levels. Enzyme inhibition slows drug metabolism, leading to higher drug levels and potential toxicity.

What is a drug's half-life?

The time required for the total amount of drug in the body to decrease by half of its peak concentration.

What is the purpose of administering a loading dose?

A higher initial dose given to reach the therapeutic concentration in the blood more rapidly before initiating routine maintenance dosing.

How do drug tolerance and drug accumulation differ?

Tolerance is a decreased physiological response to a drug over time, requiring higher doses for the same effect. Accumulation is drug buildup resulting from doses given faster than the body can eliminate them.

What are the five core components of the communication process?

Source/encoder, message, channel, receiver/decoder, and feedback.

What are the three primary channels used in nursing communication?

Auditory (spoken words/cues), visual (sight, observation, perception), and kinesthetic (touch).

What are the patient goals for the three phases of the therapeutic nurse-patient relationship?

Orientation phase: learn nurse's name/role and establish agreement on goals and duration. Working phase: actively participate and work toward mutually agreed goals. Termination phase: review progress and express feelings about ending the relationship.

What do the safety communication acronyms SBAR and CUS stand for?

SBAR: Situation, Background, Assessment, Recommendation. CUS: Concerned, Uncomfortable, Unsafe.

What communication techniques are recommended when caring for a patient with cognitive impairment?

Reduce environmental distractions, maintain eye contact, keep messages simple and concrete, break instructions into small steps, ask one question at a time, and allow adequate time for responses.

What is the correct communication approach for a patient who is unconscious?

Assume the patient can hear, speak in a normal tone, explain all care being provided, use touch appropriately, and keep environmental noise low.

How does assertive professional communication differ from aggressive communication?

Assertive communication is open, direct, honest, respectful, and focused on the issue. Aggressive communication violates the rights of others and may be hostile, intimidating, or threatening.