| Course | NR 395 Ethics, Integrity, and Professional Nursing Trends |
|---|---|
| Week | 2 |
| Paper type | Ethics case analysis |
| Length | About 1,120 words, 4 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | RN-to-BSN |
| Updated | October 2026 |
Free sample paper for NR 395 Week 2
Ethics Case Analysis: A Daughter Asks the Night Nurse to Hide Her Mother's Blood Pressure Pills in Applesauce
Student Name
College of Nursing, Chamberlain University
NR 395: Ethics, Integrity, and Professional Nursing Trends
Instructor Name
Month Day, Year
Ethics Case Analysis: A Daughter Asks the Night Nurse to Hide Her Mother's Blood Pressure Pills in Applesauce
The Facts, Before Any Judgment
Mrs. F. is 84 and lives on the long-term care unit of a skilled nursing facility. She has moderate Alzheimer disease, high blood pressure and atrial fibrillation. For the past week she has refused her evening medications, pushing the cup away and saying, "I don't take pills from strangers." She takes her morning medications from the day nurse she knows. Her evening medications are amlodipine, metoprolol and apixaban. Her blood pressure this week has ranged from 150/88 to 172/94; before, it was in the 130s. Details are composite.
Her daughter, Carol, holds her mother's medical power of attorney, now in effect because a physician has documented that Mrs. F. lacks capacity for medical decisions. At 1930, Carol asks the night nurse: "Can you just crush them and put them in her applesauce? She'll never know, and she needs them."
Several facts are unknown. No one has asked the pharmacist whether these medicines can be crushed; one of them may not be suitable. The provider has not been told about the refusals. The team has not discussed whether all three evening medications are still necessary for an 84-year-old with dementia, or whether they could be moved to the morning, when she accepts them.
The Line That Names the Conflict
The conflict is between respect for Mrs. F. as a person, which includes not deceiving her and not overriding her refusal without a proper process, and the obligation to protect her from harm, which her daughter is exercising on her behalf with legal authority. The case is hard because both sides are acting for Mrs. F. Her refusal is not a considered decision about her blood pressure, but it is the expression of a person who still has preferences, and hiding medicine in food removes even the chance to express them.
There is also a practical side to the conflict that the ethical language can hide. Covert administration works only as long as the patient does not notice, and people with dementia often do notice a changed taste or texture. A woman who finds pills in her applesauce may begin refusing the applesauce, and then her meals, and the one route by which she still accepts food and medicine may be lost. So the question is not only whether deception is permitted, but whether it would even work for long, and what it would cost her trust in the staff who feed her if it failed.
Obligations, Attached to People
The nurse owes Mrs. F. the respect for her dignity and worth that opens the nursing code, and the trust and advocacy the code asks for a few lines later (American Nurses Association [ANA], 2025). A person who has lost capacity has not lost the right to be treated honestly, and deception, even for her good, is a serious step that should not be taken at the bedside by one nurse at night.
The nurse owes Carol a real answer and a real process. She has legal authority to consent to treatment for her mother, and her concern is reasonable: a blood pressure in the 170s and a missed anticoagulant raise the risk of stroke. She does not, however, have the authority to direct a nurse to conceal medication outside the facility's policy.
The nurse owes the team information: that a patient is refusing evening medications, that her blood pressure is rising, and that her agent has requested covert administration.
Haw and Stubbs (2010) reviewed studies of covert medication in older adults and found that disguising medicine in food was reported in 43% to 71% of nursing homes, and that the decision was often made by nursing staff alone, with incomplete documentation. That finding describes exactly the situation this case could become.
A Decision, in the Active Voice
I would not crush the medications into applesauce tonight. I would tell Carol: "I understand why you're asking, and I'm worried about her blood pressure too. Hiding medicine in her food is a decision that has to be made by the team with you, not by me tonight. I'm going to tell her doctor about the refusals and your request, and ask for a meeting this week."
I would then try what does not require deception. I would offer the medications again in 20 minutes, with Carol sitting beside her mother, since Mrs. F.'s refusal is about strangers. If she refused again, I would record the refusal, the blood pressure and the conversation with Carol, and notify the on-call provider tonight because of the missed anticoagulant.
I would ask the team to consider three things before covert administration is even discussed: whether the evening medications can move to the morning, when she takes medicine from a nurse she knows; whether all three are still necessary; and whether the pharmacist confirms that each can be safely crushed. If after that the team, Carol and the provider decide that disguising a necessary medicine is in Mrs. F.'s best interest, it should be a written plan, reviewed regularly, with the pharmacist's approval and a documented reason, never a habit that starts with one nurse on one night.
What the Losing Side Is Still Owed
Carol has not received what she asked for tonight. She is still owed a great deal: a clear explanation that her request is being taken seriously, not dismissed; a meeting with the team within days, not weeks; and recognition that her worry about her mother's stroke risk is the same worry the team has. She is also owed a plain account of what happened tonight: whether her mother took the medicines when Carol sat with her, and what the provider decided about the missed dose. If the team later agrees to covert administration, she is owed a part in writing the plan.
Mrs. F. is owed something too, if her refusal is overridden later: the least deceptive method that works, regular review, and an end to the plan if her refusals change or the medicine is no longer needed.
Finally, the night nurse is owed something by the system. A request like Carol's should not land on one nurse at 1930 with no policy to point to. If the facility has no written procedure for covert medication, the case should prompt one, so that the next nurse asked this question can answer it with the same clarity and without having to decide alone.
References
American Nurses Association. (2025). Code of ethics for nurses. https://codeofethics.ana.org/
Haw, C., & Stubbs, J. (2010). Covert administration of medication to older adults: A review of the literature and published studies. Journal of Psychiatric and Mental Health Nursing, 17(9), 761-768. https://doi.org/10.1111/j.1365-2850.2010.01613.x
NR 395 Week 2 instructions, in plain terms
The Week 2 case analysis has you apply ethical principles to a practice dilemma and recommend a course of action. Required parts tend to be the facts of the case, the ethical conflict, the obligations of the nurse to each party, relevant standards or evidence, a justified decision and APA. Present the facts before any judgment, including what is unknown. State the conflict in one sentence. Attach obligations to named people rather than listing principles in the abstract. Use evidence to show how common or risky the practice is. State your decision in the active voice, with the words you would say. Try what does not require deception first. Finish with what the side that loses is still owed.
How this NR 395 Week 2 example is built
The facts section describes Mrs. F.'s diagnoses, her week of refusals and Carol's 1930 request, and lists unknowns such as whether the pills can be crushed and whether the provider knows. The conflict section frames respect for her as a person against protection from harm and notes that covert dosing only works until she notices. The obligations section sets out what the nurse owes Mrs. F., Carol and the team under the ANA Code, and cites Haw and Stubbs's finding that disguising medicine in food was reported in 43% to 71% of nursing homes. The decision section declines to crush the pills tonight, scripts the words to Carol and offers the dose again with Carol beside her. The closing section lists what Carol, Mrs. F. and the night nurse are owed.
NR 395 Week 2 rubric: what full points look like
Ethics case analysis rubrics in this course usually score accurate facts, identification of the ethical conflict, application of principles and the Code of Ethics, use of evidence, a justified decision, consideration of the losing side and APA. Identification of the conflict and the justified decision count most, and the paper delivers both with a one-line conflict and a decision stated in the nurse's own words. Facts are credited because unknowns are named before judgment. Code application scores when obligations are attached to Mrs. F., Carol and the team. Evidence earns points through Haw and Stubbs on covert medication. The section on what the losing side is owed shows the depth graders reward. Two references complete APA.
NR 395 Week 2 help: mistakes that cost points
The costliest failure on this analysis is a case that was never in conflict, where the summary makes one choice obviously right and the rest is ceremony. Another is a decision written in the passive voice, such as "it would be best if," with no one acting. Students also skip the unknowns, list principles without attaching them to people, or end with the decision and forget the person who loses. A formal decision model can help but does not replace reasoning. Two to three sources are typical. If your assigned case has an obvious answer on first reading, look for the fact that makes it hard. Send your case and an NR 395 analysis can be planned around its real conflict.
Get a NR 395 Week 2 example written to your instructions
Send the case your section supplies, the rubric or grading template that comes with it, and any page limit. A custom example is written to those instructions and returned inside 24-48h, the first one free. Name the model your section wants applied and the example follows it. You get the finished analysis, including the decision paragraph most drafts leave out.
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NR 395 Week 2 questions, answered
What if the case seems to have an obvious right answer?
Then the paper's job is to find the price of it. Most supplied cases are built so that the defensible course still costs somebody something: time, dignity, a relationship, a job. A finished example makes that cost explicit and defends the decision anyway. Analyses that treat the answer as free tend to lose marks under reasoning even when the conclusion is correct.
Do I have to use a formal decision-making model?
It varies by section. Some classrooms name a model and expect its stages as headings, others leave the structure open. Either way the model is only useful if it changes something. In a finished example you can see where applying the framework redirected the reasoning, rather than a set of labels laid over a conclusion the writer had already reached.
How many sources does a case analysis usually need?
Fewer than a research paper and used differently. The nursing code plus two or three scholarly sources is common, and each one should be doing work inside an argument rather than supporting a sentence nobody would dispute. A citation attached to the claim that patient safety matters is wasted. A citation attached to the contested step is what a grader is looking for.
Where can I find a free NR 395 Week 2 sample paper?
Here is the full Week 2 analysis of the applesauce request, with the facts and unknowns, the conflict, the obligations, the decision in the nurse's words, what the losing side is owed and two references.
What does the nurse decide in the NR 395 Week 2 case?
Not to crush the pills into applesauce that night, to explain the reason to Carol in plain words, to offer the dose again with Carol beside her mother and to bring the request to the team.