NCAS Nursing Ethics 5 — Questions and Answers
Question 1: A nurse is asked to participate in a research study involving vulnerable community members without IRB approval. The nurse should:
- Participate if the study seems beneficial to the community
- Refuse and report the absence of IRB oversight to the appropriate authority (Correct answer)
- Ask the principal investigator to obtain approval after data collection
- Participate only if participants give verbal consent
Correct answer: Refuse and report the absence of IRB oversight to the appropriate authority
IRB oversight is required before research involving human subjects begins; proceeding without it is an ethical and regulatory violation.
Question 2: When a nurse experiences a conflict between a patient's cultural beliefs and evidence-based medical recommendations, the BEST approach is to:
- Prioritize medical evidence and educate the patient until they comply
- Explore the patient's values and negotiate a culturally acceptable plan (Correct answer)
- Document the conflict and defer to the physician for resolution
- Refer the patient to a cultural liaison and withdraw from the case
Correct answer: Explore the patient's values and negotiate a culturally acceptable plan
Culturally competent ethical practice involves exploring beliefs, providing education, and collaboratively developing a mutually acceptable care plan.
Question 3: A patient with a known opioid use disorder is prescribed opioids for post-operative pain. A nurse's hesitation to administer the medication because of the patient's history BEST reflects:
- Responsible clinical judgment based on risk factors
- Stigma-based discrimination affecting equitable care (Correct answer)
- Appropriate application of nonmaleficence
- Standard pain management protocol adherence
Correct answer: Stigma-based discrimination affecting equitable care
Withholding legitimate pain management based on substance use history is a form of stigma that violates the principle of justice and equitable care.
Question 4: Which element is essential for valid informed consent in community nursing practice?
- A physician's signature on the consent form
- Patient comprehension of risks, benefits, and alternatives (Correct answer)
- Consent witnessed by two registered nurses
- Agreement from the patient's next of kin
Correct answer: Patient comprehension of risks, benefits, and alternatives
Valid informed consent requires that the patient understands and voluntarily agrees to the procedure, including its risks, benefits, and alternatives.
Question 5: A nurse has a conscientious objection to participating in a legal procedure. The nurse's ethical obligation includes:
- Refusing participation without any further responsibility
- Notifying the supervisor and ensuring the patient receives care from another provider (Correct answer)
- Persuading the patient to choose an alternative procedure
- Reporting the patient's request to the ethics committee
Correct answer: Notifying the supervisor and ensuring the patient receives care from another provider
While conscientious objection is recognized, the nurse must ensure continuity of care by transferring responsibility to a non-objecting provider.
Question 6: A nurse notices that patients from lower socioeconomic backgrounds in the community receive fewer follow-up home visits than wealthier patients. This disparity MOST directly violates the principle of:
- Autonomy
- Beneficence
- Justice (Correct answer)
- Fidelity
Correct answer: Justice
Justice requires equitable distribution of nursing services regardless of socioeconomic status; unequal access constitutes an injustice.
Question 7: An nurse overhears a colleague making derogatory comments about a patient's lifestyle choices. The MOST ethical response is to:
- Ignore the comment to avoid workplace conflict
- Address the behavior with the colleague and report it if it continues (Correct answer)
- Agree with the colleague to maintain team cohesion
- Document the incident without speaking to the colleague
Correct answer: Address the behavior with the colleague and report it if it continues
Derogatory comments about patients are unprofessional and potentially harmful; nurses must address such behavior to uphold patient dignity.
NCAS Nursing Ethics 5
A nurse is asked to participate in a research study involving vulnerable community members without IRB approval.
The nurse should: