Ethics in Nursing
A nurse is faced with an ethical dilemma regarding the care of a terminally ill patient. The nurse’s personal values emphasize the sanctity of life, while the patient has expressed a desire to discontinue treatment and enter hospice care. Which of the following best describes how the nurse should approach this situation?
A) The nurse should override the patient's wishes and continue aggressive treatment based on their personal belief in the sanctity of life.
B) The nurse should involve the patient’s family in the decision-making process to ensure all perspectives are considered.
C) The nurse should respect the patient’s autonomy and support their decision to discontinue treatment, even if it conflicts with the nurse's personal values.
D) The nurse should refer the patient to another provider who shares the same personal values regarding the sanctity of life.
Correct Answer: C) The nurse should respect the patient’s autonomy and support their decision to discontinue treatment, even if it conflicts with the nurse's personal values.
Rationale: The principle of autonomy emphasizes a patient's right to make their own health care decisions, even if it conflicts with the nurse's personal beliefs. Nurses should respect the patient's wishes, provide necessary information, and ensure informed consent is obtained.
A nurse is experiencing an ethical dilemma regarding a patient's care, where they feel their professional values conflict with the patient’s wishes. Which of the following is the most appropriate action for the nurse to take?
A) Discuss the situation with a colleague to seek their opinion.
B) Refuse to care for the patient because the situation is uncomfortable.
C) Seek guidance from the ethics committee or use institutional resources for ethical decision-making support.
D) Avoid discussing the issue and proceed with care without addressing the conflict.
Correct Answer: C) Seek guidance from the ethics committee or use institutional resources for ethical decision-making support.
Rationale: When faced with ethical dilemmas, it is important to seek guidance from resources such as an ethics committee or supervisor to ensure that decisions align with ethical standards and policies. Collaboration and support can help resolve complex ethical issues.
A nurse observes another healthcare worker administering the wrong medication to a patient. What is the nurse’s legal obligation in this situation?
A) Ignore the mistake, as it is not the nurse’s responsibility.
B) Report the incident to the supervisor or appropriate authority according to the institution’s policies.
C) Confront the healthcare worker privately without informing anyone else.
D) Document the mistake in the patient’s chart and leave it at that.
Correct Answer: B) Report the incident to the supervisor or appropriate authority according to the institution’s policies.
Rationale: Nurses have a legal and ethical duty to report unsafe practices to protect patient safety. Reporting the incident to the supervisor or appropriate authority is part of the nurse’s professional responsibility.
A nurse accidentally discards a patient’s personal belongings, including valuable items, while cleaning their room. The patient demands compensation. What type of liability does the nurse face in this situation?
A) No liability because the nurse did not intend to cause harm.
B) Tort liability, specifically negligence, for failing to properly care for the patient’s belongings.
C) Criminal liability for theft.
D) No liability because the nurse was not directly involved with the personal belongings.
Correct Answer: B) Tort liability, specifically negligence, for failing to properly care for the patient’s belongings.
Rationale: Nurses have a duty to provide proper care for patients and their belongings. If a nurse negligently discards a patient’s belongings, it may lead to a tort claim for negligence.
A nurse is caring for a postoperative patient who is at risk for developing a pressure ulcer. Which of the following interventions is most effective in preventing pressure ulcers in this patient?
A) Repositioning the patient every two hours.
B) Applying a warm compress to the affected areas.
C) Ensuring the patient’s bedding is wrinkle-free.
D) Encouraging the patient to remain in one position for as long as possible to reduce movement
Correct Answer: A) Repositioning the patient every two hours.
Rationale: Regular repositioning (every two hours) is a key intervention to prevent pressure ulcers by alleviating pressure on vulnerable areas. This helps maintain blood flow to tissues and reduces the risk of skin breakdown.
Which of the following statements reflects the ethical principles outlined in the ANA Code of Ethics for Nurses?
A) The nurse's first obligation is to follow the directives of the hospital administration, even when they conflict with patient care.
B) Nurses must always prioritize patient well-being and respect the dignity, rights, and autonomy of every individual.
C) Nurses are responsible for making ethical decisions based on their personal beliefs and preferences.
D) Nurses may accept gifts from patients if the gift is deemed appropriate by hospital policy.
Correct Answer: B) Nurses must always prioritize patient well-being and respect the dignity, rights, and autonomy of every individual.
Rationale: The ANA Code of Ethics emphasizes the importance of patient advocacy, prioritizing patient welfare, respecting dignity and rights, and promoting autonomy. Nurses must ensure that their decisions and actions are ethically sound and focused on patient-centered care.
A nurse is caring for a patient who refuses treatment for a chronic illness, citing personal beliefs that are not aligned with medical recommendations. The nurse believes that continuing treatment is essential for the patient's health. How should the nurse respond?
A) The nurse should try to convince the patient to accept treatment based on the nurse's personal values.
B) The nurse should respect the patient’s decision and support their right to make informed decisions about their health.
C) The nurse should tell the patient that their refusal of treatment will lead to immediate death.
D) The nurse should inform the patient’s family and ask them to intervene in the decision-making process.
Correct Answer: B) The nurse should respect the patient’s decision and support their right to make informed decisions about their health.
Rationale: The nurse must respect the patient’s autonomy and right to make their own health decisions, even if they conflict with the nurse’s personal values. It is important to provide the patient with all relevant information to make an informed decision.
A nurse is assigned to care for a patient who has a known allergy to penicillin. The nurse inadvertently administers penicillin to the patient. What is the first step the nurse should take?
A) Wait for the physician to notice the error and take action.
B) Monitor the patient for any allergic reaction and document the error.
C) Report the error immediately to the physician and document the occurrence.
D) Ignore the incident and proceed with the patient’s treatment.
Correct Answer: C) Report the error immediately to the physician and document the occurrence.
Rationale: The nurse must report the error immediately, document it, and monitor the patient for an allergic reaction. Prompt reporting is necessary for patient safety and to initiate appropriate interventions.
A nurse is caring for a patient in a psychiatric unit who is expressing suicidal ideation. The nurse knows the patient is at high risk for self-harm but has not explicitly stated an intent to act on their thoughts. Which action should the nurse take to ensure legal and ethical responsibilities are met?
A) Leave the patient alone to allow them privacy.
B) Ensure the patient’s room is free of harmful objects and perform constant monitoring.
C) Document the patient’s suicidal thoughts but take no immediate action.
D) Wait for the physician to address the issue at the next scheduled visit.
Correct Answer: B) Ensure the patient’s room is free of harmful objects and perform constant monitoring.
Rationale: The nurse is legally and ethically obligated to ensure the safety of patients expressing suicidal ideation. Taking immediate actions to prevent self-harm, including removing harmful objects and providing close monitoring, is essential.
A nurse is using evidence-based practice (EBP) to improve patient care in a surgical unit. Which of the following best describes the concept of evidence-based practice?
A) Relying on a nurse’s personal experience to make decisions about patient care.
B) Using scientific research and clinical expertise to guide patient care decisions.
C) Following hospital protocols without considering individual patient needs.
D) Listening to patients’ opinions about treatment options, regardless of medical guidelines
Correct Answer: B) Using scientific research and clinical expertise to guide patient care decisions.
Rationale: Evidence-based practice involves using the best available research, clinical expertise, and patient preferences to guide care decisions. This approach improves the quality and outcomes of patient care by integrating research evidence with clinical expertise.
A nurse is caring for a patient who expresses concern about the potential side effects of a medication that has been prescribed. The nurse’s role in this situation is to:
A) Ignore the patient’s concerns if the physician has already made the decision.
B) Provide information about the medication and its potential side effects, allowing the patient to make an informed decision.
C) Assume the patient is not knowledgeable enough to understand the side effects and disregard their concerns.
D) Advise the patient to stop the medication immediately, even without consulting the physician.
Correct Answer: B) Provide information about the medication and its potential side effects, allowing the patient to make an informed decision.
Rationale: Nurses are advocates for patients and have a duty to provide accurate and complete information about medical treatments. This allows patients to make informed decisions about their care and promotes autonomy.
A nurse is caring for a patient who is requesting a medication that is not prescribed by the doctor. The nurse is aware that the patient is asking for the medication to alleviate anxiety. What is the nurse's best course of action?
A) Administer the medication because the patient is requesting it to alleviate their symptoms.
B) Deny the request and inform the patient that the medication is not appropriate for their anxiety.
C) Discuss the patient’s symptoms with the physician to determine if there is a need for medication and involve the patient in the decision.
D) Ignore the patient’s request and proceed with the treatment plan without discussing it further.
Correct Answer: C) Discuss the patient’s symptoms with the physician to determine if there is a need for medication and involve the patient in the decision.
Rationale: Nurses are responsible for advocating for patients and collaborating with other healthcare professionals. The nurse should discuss the patient's symptoms with the physician to explore appropriate options, while also ensuring the patient is involved in the decision-making process.
Which of the following actions by a nurse would be considered an example of negligence?
A) A nurse administers medication to the correct patient at the correct time.
B) A nurse fails to perform a routine check on a postoperative patient, resulting in the patient developing a wound infection.
C) A nurse accurately documents a patient’s vital signs every shift.
D) A nurse provides emotional support to a family member after a patient's death.
Correct Answer: B) A nurse fails to perform a routine check on a postoperative patient, resulting in the patient developing a wound infection.
Rationale: Negligence occurs when a nurse fails to perform duties that result in harm to a patient. In this case, failing to perform a routine check led to patient harm (wound infection), which is an example of negligence.
A nurse discloses confidential patient information to a family member without the patient’s consent. This is a violation of which of the following?
A) The nurse’s duty to act in the patient’s best interest.
B) The nurse’s duty of confidentiality and HIPAA regulations.
C) The nurse’s responsibility to collaborate with the family for patient care.
D) The nurse’s duty to protect the hospital from legal liability
Correct Answer: B) The nurse’s duty of confidentiality and HIPAA regulations.
Rationale: Nurses are legally required to protect patient confidentiality under HIPAA. Disclosing patient information without consent violates this legal and ethical responsibility.
A nurse is conducting a quality improvement project to reduce hospital-acquired infections (HAIs) on a medical-surgical unit. Which of the following actions should the nurse take to help achieve this goal?
A) Review and reinforce hand hygiene protocols with staff and patients.
B) Provide the staff with a list of new infection control policies.
C) Decrease the frequency of patient bathing to reduce skin irritation.
D) Implement stricter visitor restrictions to prevent infections.
Correct Answer: A) Review and reinforce hand hygiene protocols with staff and patients.
Rationale: Hand hygiene is one of the most effective strategies for preventing hospital-acquired infections. Reviewing and reinforcing proper hand hygiene protocols with both staff and patients helps reduce the transmission of harmful microorganisms.
Which of the following is an example of a controversial health care issue that nurses may encounter in clinical practice today?
A) Providing care to patients with communicable diseases without using personal protective equipment.
B) Assisting patients with legal euthanasia in countries where it is allowed.
C) Administering medications without the patient’s informed consent in emergency situations.
D) Referring patients to specialists without considering the patient’s financial resources.
Correct Answer: B) Assisting patients with legal euthanasia in countries where it is allowed.
Rationale: Euthanasia remains a controversial issue in nursing practice, particularly regarding ethical dilemmas around patient autonomy, the role of the nurse, and the legal implications of assisting in death. Nurses must navigate these difficult issues with sensitivity, following both legal and ethical guidelines.
A nurse is faced with a situation where the patient's family wants to discontinue life-sustaining treatment, but the patient has not made their wishes known. The nurse is unsure of how to proceed. Which of the following is the most appropriate action for the nurse to take?
A) Follow the family’s wishes because they have authority over the patient's decisions.
B) Proceed with discontinuing treatment to avoid further conflict.
C) Consult with the hospital ethics committee for guidance on how to handle the situation.
D) Ignore the family’s request and continue life-sustaining treatment indefinitely.
Correct Answer: C) Consult with the hospital ethics committee for guidance on how to handle the situation.
Rationale: When faced with complex ethical dilemmas, it is essential to consult with the hospital’s ethics committee or other resources to guide the decision-making process. The committee can provide expert guidance based on ethical principles and institutional policies.
A nurse is caring for a patient who is unable to make decisions for themselves due to a cognitive impairment. Who can legally give consent for the patient’s treatment?
A) The patient’s family member.
B) The nurse in charge of the patient’s care.
C) The physician treating the patient.
D) A legal guardian or power of attorney for healthcare.
Correct Answer: D) A legal guardian or power of attorney for healthcare.
Rationale: When a patient is unable to make decisions, a legal guardian or power of attorney for healthcare can provide informed consent on behalf of the patient.
A nurse administers a medication without checking the patient’s identification band, resulting in the wrong medication being given. What legal issue is the nurse potentially facing?
A) Malpractice for failing to check the patient’s identification before administering the medication.
B) Criminal negligence for not verifying the patient’s identity.
C) Battery for administering medication without consent.
D) No legal issue, as medication administration errors are common.
Correct Answer: A) Malpractice for failing to check the patient’s identification before administering the medication.
Rationale: Malpractice refers to professional negligence. Failing to verify patient identification before administering medication is a preventable error that could lead to legal consequences.
A nurse is involved in a quality improvement (QI) initiative to reduce patient falls in a hospital. Which of the following is the most important first step in the QI process?
A) Develop a new policy to prevent falls.
B) Gather data to identify the current rate of patient falls.
C) Immediately implement fall prevention interventions.
D) Create a fall prevention committee with no patient involvement.
Correct Answer: B) Gather data to identify the current rate of patient falls.
Rationale: The first step in a quality improvement process is to gather data to understand the current problem. This allows the team to identify trends, risk factors, and areas for improvement before creating solutions. Without baseline data, it’s difficult to measure the effectiveness of any interventions.
A nurse is counseling a patient who has received genetic counseling for a hereditary condition. The patient expresses fear about the potential genetic predisposition to a condition and is unsure whether to undergo genetic testing. What should the nurse do first in this situation?
A) Encourage the patient to undergo genetic testing to know for sure.
B) Reassure the patient that genetic testing is unnecessary and will not change their care plan.
C) Provide information about the benefits and limitations of genetic testing and ensure the patient is aware of the implications.
D) Tell the patient that it’s best to avoid genetic testing and focus on the symptoms they are experiencing.
Correct Answer: C) Provide information about the benefits and limitations of genetic testing and ensure the patient is aware of the implications.
Rationale: Nurses should provide information and support to help patients make informed decisions regarding genetic testing, emphasizing the potential implications of test results. Nurses must respect the patient’s autonomy while providing the necessary education and resources.
Which of the following is most consistent with the ethical principles outlined in the ICN Code of Ethics for Nurses?
A) Nurses should make decisions based on the recommendations of their hospital’s administration, without considering individual patient needs.
B) Nurses are accountable for their own actions and must ensure that patient care is delivered with integrity and compassion.
C) Nurses should prioritize personal interests over the needs of the patient to ensure a balanced work-life environment.
D) Nurses should act only in accordance with their personal beliefs, disregarding professional ethical guidelines.
Correct Answer: B) Nurses are accountable for their own actions and must ensure that patient care is delivered with integrity and compassion.
Rationale: The ICN Code of Ethics stresses the nurse’s accountability for their actions and emphasizes delivering care with integrity, compassion, and respect for patient rights. Nurses are also expected to adhere to ethical standards, regardless of personal beliefs.
A nurse is accused of assault and battery after physically restraining a patient who refused to take medication. Which of the following best describes assault in this context?
A) The nurse’s actions are considered assault only if the patient was injured.
B) Assault occurs if the nurse threatens to restrain the patient but does not touch them.
C) Assault occurs if the nurse physically restrains the patient without consent.
D) The nurse cannot be charged with assault because the patient refused medication.
Correct Answer: B) Assault occurs if the nurse threatens to restrain the patient but does not touch them.
Rationale: Assault involves threatening harm or force, whereas battery involves actual physical contact without consent. In this case, the threat of restraint could be considered assault if it caused fear of harm.
A nurse is caring for a patient who is scheduled for a procedure. The patient signs a consent form for surgery, but the nurse realizes the patient has not been fully informed about the potential risks and benefits of the procedure. What is the nurse’s best course of action?
A) The nurse should proceed with the procedure, as the patient has already signed the consent form.
B) The nurse should inform the physician that the patient has not received adequate information, and ensure the patient is properly informed before proceeding.
C) The nurse should explain the risks and benefits of the procedure to the patient themselves.
D) The nurse should tell the patient that signing the consent form is sufficient and no further explanation is necessary.
Correct Answer: B) The nurse should inform the physician that the patient has not received adequate information, and ensure the patient is properly informed before proceeding.
Rationale: Informed consent requires that the patient fully understands the procedure, including its risks, benefits, and alternatives. If the nurse notices that the patient has not been properly informed, they have a legal and ethical responsibility to inform the physician so that the patient can be adequately educated before proceeding.
A nurse is working on a quality improvement project to enhance patient satisfaction in a clinic. After reviewing patient feedback, the nurse identifies a common theme of long wait times. What is the next appropriate step for improving quality in this area?
A) Ignore the feedback, as long wait times are often unavoidable.
B) Analyze the clinic's scheduling system and patient flow to identify bottlenecks.
C) Notify patients that the clinic will no longer be accepting new appointments.
D) Provide patients with a survey to collect additional feedback on wait times.
Correct Answer: B) Analyze the clinic's scheduling system and patient flow to identify bottlenecks.
Rationale: Analyzing the clinic’s scheduling system and patient flow is an essential step in identifying specific causes for long wait times. This will help pinpoint where improvements can be made, such as optimizing scheduling, adjusting staffing, or improving patient flow to enhance patient satisfaction.