NCAS Nursing Ethics 2 — Questions and Answers
Question 1: A patient refuses a blood transfusion on religious grounds despite a life-threatening hemorrhage. The nurse's priority action is to:
- Administer the transfusion to save the patient's life
- Document the refusal and explore alternative treatments (Correct answer)
- Request a psychiatric evaluation to question competence
- Notify the hospital ethics committee before doing anything
Correct answer: Document the refusal and explore alternative treatments
A competent adult's refusal of treatment must be respected; the nurse documents the refusal and collaborates on alternatives.
Question 2: Which ethical principle is MOST directly violated when a nurse shares a patient's HIV status with the patient's employer without consent?
- Beneficence
- Justice
- Confidentiality (Correct answer)
- Veracity
Correct answer: Confidentiality
Unauthorized disclosure of protected health information violates the principle of confidentiality.
Question 3: A community health nurse discovers a colleague is falsifying home visit documentation. The nurse's FIRST obligation is to:
- Confront the colleague privately and give a warning
- Report the behavior to the appropriate supervisor or authority (Correct answer)
- Document personal observations and wait for a pattern to develop
- Discuss the situation with other team members for consensus
Correct answer: Report the behavior to the appropriate supervisor or authority
Nurses have a professional obligation to report unethical conduct that endangers patient safety to the appropriate authority.
Question 4: The ethical concept of 'double effect' is MOST applicable when a nurse:
- Balances two equally beneficial treatment options
- Administers high-dose opioids for pain that may hasten death (Correct answer)
- Withholds information to prevent patient anxiety
- Advocates for a patient against the physician's orders
Correct answer: Administers high-dose opioids for pain that may hasten death
Double effect justifies an action with both good (pain relief) and potentially harmful (hastened death) effects when the intent is the good outcome.
Question 5: A nurse working in a community clinic is asked by a pharmaceutical representative to recommend their product to patients in exchange for gifts. The nurse should:
- Accept gifts under a set dollar threshold as allowed by most facilities
- Decline and report the offer per the facility's conflict-of-interest policy (Correct answer)
- Accept only educational materials, not cash or food
- Consult colleagues before making a decision
Correct answer: Decline and report the offer per the facility's conflict-of-interest policy
Accepting gifts from vendors creates a conflict of interest that compromises objectivity and professional integrity.
Question 6: When a patient with limited English proficiency requires informed consent, the nurse should:
- Ask a bilingual family member to translate the consent form
- Use a professional medical interpreter to facilitate understanding (Correct answer)
- Have the patient sign the form and document language as a barrier
- Delay the procedure until the patient learns sufficient English
Correct answer: Use a professional medical interpreter to facilitate understanding
A qualified medical interpreter ensures accurate, unbiased communication and protects the patient's right to informed consent.
Question 7: Fidelity in nursing ethics refers to:
- Telling the truth to patients at all times
- Keeping promises and honoring commitments to patients (Correct answer)
- Distributing healthcare resources fairly
- Avoiding harm through careful clinical practice
Correct answer: Keeping promises and honoring commitments to patients
Fidelity means being faithful to commitments, including follow-up, care promises, and professional obligations.
NCAS Nursing Ethics 2
A patient refuses a blood transfusion on religious grounds despite a life-threatening hemorrhage.
The nurse's priority action is to: