NCAS Nursing Ethics 3 — Questions and Answers
Question 1: A nurse disagrees with a physician's order but carries it out without raising concerns. This behavior BEST reflects:
- Moral courage
- Moral distress (Correct answer)
- Moral residue
- Moral uncertainty
Correct answer: Moral distress
Moral distress occurs when a nurse knows the ethically correct action but institutional or hierarchical constraints prevent acting on it.
Question 2: In community health nursing, justice as an ethical principle is BEST demonstrated by:
- Providing the highest-quality care to the most severely ill patients first
- Allocating scarce resources based on patient need and equitable access (Correct answer)
- Ensuring every patient receives the same treatment regardless of diagnosis
- Prioritizing care for patients who comply with treatment recommendations
Correct answer: Allocating scarce resources based on patient need and equitable access
Justice in healthcare requires fair distribution of resources based on need, not social status or ability to pay.
Question 3: A nurse administers the correct medication to the wrong patient. The ethical principle of veracity requires the nurse to:
- Document the event and monitor the patient without disclosure
- Disclose the error to the patient and appropriate parties immediately (Correct answer)
- Consult with the charge nurse before deciding whether to disclose
- Only disclose if the patient or family asks directly
Correct answer: Disclose the error to the patient and appropriate parties immediately
Veracity obligates the nurse to tell the truth, including disclosure of errors, to maintain trust and enable appropriate medical response.
Question 4: Which scenario BEST illustrates a violation of patient autonomy in community nursing?
- A nurse explains treatment risks before the patient decides
- A nurse schedules a home visit without asking the patient's preferred time (Correct answer)
- A nurse documents a patient's refusal of medication accurately
- A nurse provides education on available treatment options
Correct answer: A nurse schedules a home visit without asking the patient's preferred time
Scheduling visits without patient input overrides the patient's right to self-determination in their own home environment.
Question 5: A terminally ill patient asks the community nurse not to tell family members about the prognosis. The nurse should:
- Inform the family anyway because they need to plan for caregiving
- Honor the patient's request and maintain confidentiality
- Encourage the patient to tell the family but respect the final decision (Correct answer)
- Refer the decision to the attending physician
Correct answer: Encourage the patient to tell the family but respect the final decision
While respecting confidentiality, the nurse may provide therapeutic communication to encourage disclosure while ultimately honoring the patient's autonomous decision.
Question 6: The principle of nonmaleficence obligates a nurse to:
- Promote the patient's best interests above all else
- Avoid actions that cause unnecessary harm to patients (Correct answer)
- Distribute care resources equitably across the community
- Be honest with patients about their diagnosis and prognosis
Correct answer: Avoid actions that cause unnecessary harm to patients
Nonmaleficence ('first, do no harm') requires nurses to avoid causing harm through actions, negligence, or omission.
Question 7: A nurse believes a patient's advance directive conflicts with what the family wants. The nurse's BEST action is to:
- Follow the family's wishes as the primary decision-makers
- Honor the advance directive as it reflects the patient's autonomous wishes (Correct answer)
- Request a new psychiatric evaluation to reassess patient competence
- Defer entirely to the physician to resolve the conflict
Correct answer: Honor the advance directive as it reflects the patient's autonomous wishes
A valid advance directive represents the patient's autonomous pre-expressed wishes and takes precedence over surrogate preferences.
NCAS Nursing Ethics 3
A nurse disagrees with a physician's order but carries it out without raising concerns.
This behavior BEST reflects: