1. Autonomy is requiring the client to have an advance directive
2. Beneficence is withholding prognosis from a client due to family wishes
3. Fidelity is administering medication as prescribed to the client
4. Justice is telling the client the truth that the biopsy is positive
5. Nonmaleficence is refusing to give report to a nurse who is impaired
Ethical principles guide the nurse in making appropriate decisions and acting accordingly. They speak to the essence but not to the specifics of the law. Fidelity is exhibiting loyalty and fulfilling commitments made to oneself and others. It includes meeting the expected responsibilities of professional nursing practice and provides the basis of accountability (taking responsibility for one’s actions) (Option 3). Nonmaleficence means to do no harm and relates to protecting clients from danger when they are unable to do so themselves due to a mental/physical condition (eg, children, client with Alzheimer disease) and from a nurse who is impaired (Option 5). (Option 1) Autonomy is the right to make decisions for oneself (eg, informed consent). Although having an advance directive is an example of autonomy, requiring one violates this principle. The client has a right to refuse even if the nurse believes it is in the client’s best interest. (Option 2) When a diagnosis is withheld, even if due to the nurse’s or family’s good intentions, it violates the principle of autonomy. Beneficence means to do good (eg, implementing interventions to promote the client’s well-being). (Option 4) The principle of justice refers to treating all clients fairly (ie, without bias). Veracity is telling the truth as a fundamental part of building a trusting relationship.