NCLEX - National Council Licensure Examination NCLEX-RN 12 — Questions and Answers
Question 1: A nurse is caring for a patient who refuses a blood transfusion based on religious beliefs, even though the physician believes it is necessary. Which ethical principle is the nurse upholding by supporting the patient's decision?
- Beneficence
- Autonomy (Correct answer)
- Justice
- Fidelity
Correct answer: Autonomy
Autonomy refers to the patient's right to make informed decisions about their own care, including the right to refuse treatment. Supporting the patient's informed refusal upholds this principle even when it conflicts with the provider's medical recommendation.
Question 2: Which of the following best describes the ethical principle of nonmaleficence as it applies to nursing practice?
- Providing equal care to all patients regardless of background
- Keeping promises made to patients and families
- Avoiding actions that cause unnecessary harm to the patient (Correct answer)
- Acting in the best interest of the patient at all times
Correct answer: Avoiding actions that cause unnecessary harm to the patient
Nonmaleficence means 'do no harm.' It obligates nurses to avoid interventions or behaviors that could cause unnecessary injury, pain, or suffering to patients, distinguishing it from beneficence, which focuses on doing good.
Question 3: A nurse witnesses a colleague falsifying a patient's medication record. According to the ANA Code of Ethics, what is the nurse's primary obligation?
- Confront the colleague privately before taking any further action
- Report the behavior through appropriate institutional channels (Correct answer)
- Document the incident in the patient's chart immediately
- Contact the patient's family to inform them of the discrepancy
Correct answer: Report the behavior through appropriate institutional channels
The ANA Code of Ethics obligates nurses to report unsafe, illegal, or unethical practices through appropriate channels to protect patient safety. While private confrontation may also occur, the primary obligation is formal reporting to ensure accountability.
Question 4: Which of the following situations represents a nurse experiencing an ethical dilemma?
- A nurse is unsure of the correct dose of a medication and consults a pharmacist
- A nurse must choose between honoring a patient's DNR order and responding to family pressure to resuscitate (Correct answer)
- A nurse disagrees with a physician's choice of antibiotic but administers it as ordered
- A nurse is asked to work a double shift and feels fatigued
Correct answer: A nurse must choose between honoring a patient's DNR order and responding to family pressure to resuscitate
An ethical dilemma occurs when two or more ethical principles conflict, making the right course of action unclear. Choosing between a valid DNR order and family pressure creates a genuine conflict between patient autonomy and family wishes.
Question 5: The concept of 'fidelity' in nursing ethics refers to the nurse's duty to:
- Distribute healthcare resources equitably among all patients
- Keep promises and honor commitments made to patients (Correct answer)
- Provide truthful information to patients and families
- Protect the confidentiality of patient health information
Correct answer: Keep promises and honor commitments made to patients
Fidelity refers to faithfulness and the obligation to keep promises and honor commitments. It is the foundation of the trust relationship between a nurse and patient, encompassing reliability and loyalty in care.
Question 6: A terminally ill patient asks the nurse not to tell his family about his prognosis. Which of the following actions by the nurse best reflects the ethical principle of confidentiality?
- Inform the family because they have a right to know
- Honor the patient's request and maintain confidentiality unless there is a legal obligation to disclose (Correct answer)
- Ask the physician to speak with the family on the nurse's behalf
- Document the patient's wishes and defer the decision to the ethics committee
Correct answer: Honor the patient's request and maintain confidentiality unless there is a legal obligation to disclose
Competent adult patients have the right to control the disclosure of their personal health information. Unless there is a legal mandate or imminent safety issue, the nurse must respect the patient's wishes and maintain confidentiality, honoring both autonomy and privacy.
NCLEX - National Council Licensure Examination NCLEX-RN 12
A nurse is caring for a patient who refuses a blood transfusion based on religious beliefs, even though the physician believes it is necessary.
Which ethical principle is the nurse upholding by supporting the patient's decision?