NCAS Nursing Ethics 4 — Questions and Answers
Question 1: A community nurse suspects a homebound elderly patient is being financially exploited by a family member. The nurse's primary ethical and legal obligation is to:
- Discuss the concern with the family member to give them a chance to explain
- Report the suspected abuse to adult protective services (Correct answer)
- Document observations and wait for more evidence before acting
- Ask the patient to confirm abuse before taking any action
Correct answer: Report the suspected abuse to adult protective services
Suspected elder abuse must be reported to adult protective services; nurses are mandated reporters and waiting for confirmation is not required.
Question 2: Surrogate decision-making is most appropriate when a patient:
- Is temporarily unconscious following surgery
- Lacks decision-making capacity and has no advance directive (Correct answer)
- Disagrees with the clinical team's recommended treatment
- Is competent but prefers not to make decisions
Correct answer: Lacks decision-making capacity and has no advance directive
A surrogate decision-maker is designated when a patient lacks decision-making capacity and has not previously expressed wishes in a directive.
Question 3: Which action by a community health nurse BEST demonstrates the ethical principle of beneficence?
- Respecting a patient's refusal of the flu vaccine
- Providing smoking cessation counseling to a patient who smokes (Correct answer)
- Reporting a medication error to the supervising nurse
- Allocating visits equally among all assigned patients
Correct answer: Providing smoking cessation counseling to a patient who smokes
Beneficence requires actively promoting patient well-being, such as offering evidence-based health promotion interventions.
Question 4: A nurse learns through social media that a colleague is posting about patient experiences without using names. The nurse should recognize this as:
- Acceptable because no identifying information was shared
- A potential HIPAA violation if details could identify the patient (Correct answer)
- Only a concern if the colleague works in a small community
- An issue only if the patient files a formal complaint
Correct answer: A potential HIPAA violation if details could identify the patient
Even without names, contextual details can constitute a HIPAA violation if a patient could reasonably be identified.
Question 5: The ethical concept of paternalism in nursing refers to:
- Nurses acting as patient advocates in institutional settings
- Overriding a patient's autonomous choices for their perceived benefit (Correct answer)
- Fathers or male relatives making decisions for female patients
- Following physician orders without questioning clinical rationale
Correct answer: Overriding a patient's autonomous choices for their perceived benefit
Paternalism occurs when healthcare providers substitute their judgment for the patient's in the name of the patient's well-being.
Question 6: When a nurse participates in an ethics committee consultation, their PRIMARY role is to:
- Advocate exclusively for the patient's position
- Provide the clinical nursing perspective to inform ethical deliberation (Correct answer)
- Make the final decision about the patient's care plan
- Represent the hospital administration's interests in the case
Correct answer: Provide the clinical nursing perspective to inform ethical deliberation
Nurses on ethics committees contribute clinical observations and the nursing perspective to support balanced, informed ethical decision-making.
Question 7: A nurse in a rural community is also a neighbor of one of their patients. The MOST appropriate way to manage this relationship is to:
- Refuse to provide care for anyone known personally
- Maintain professional boundaries and separate the roles clearly (Correct answer)
- Share health information with mutual friends to coordinate community support
- Ask a colleague to assume care without explaining the conflict
Correct answer: Maintain professional boundaries and separate the roles clearly
Dual relationships require nurses to consciously maintain professional boundaries while providing equitable, unbiased care.
NCAS Nursing Ethics 4
A community nurse suspects a homebound elderly patient is being financially exploited by a family member.
The nurse's primary ethical and legal obligation is to: