NCLEX - National Council Licensure Examination NCLEX-RN 7 — Questions and Answers
Question 1: A nurse who discloses a patient's diagnosis to a family member without the patient's consent has violated which ethical principle?
- Beneficence
- Confidentiality (Correct answer)
- Nonmaleficence
- Justice
Correct answer: Confidentiality
Confidentiality requires that patient information be kept private and shared only with those who have a legitimate need to know and have been authorized by the patient. Sharing a diagnosis without consent is a direct violation of this principle.
Question 2: Which of the following best describes the ethical principle of nonmaleficence?
- Doing good for the patient
- Treating all patients equally
- Avoiding actions that cause harm (Correct answer)
- Respecting the patient's decisions
Correct answer: Avoiding actions that cause harm
Nonmaleficence is the obligation to avoid causing harm to patients. It is often summarized by the Latin phrase 'primum non nocere,' meaning 'first, do no harm,' and it guides nurses to weigh potential risks of any intervention.
Question 3: A nurse is caring for a competent adult patient who refuses a blood transfusion for religious reasons. The nurse's best action is to:
- Administer the transfusion because it is medically necessary
- Notify the physician and document the patient's refusal (Correct answer)
- Contact the patient's family to obtain consent
- Consult the hospital chaplain to change the patient's mind
Correct answer: Notify the physician and document the patient's refusal
A competent adult has the legal and ethical right to refuse any medical treatment, including life-saving procedures. The nurse must respect this decision, notify the physician, and document the refusal thoroughly to ensure continuity of care and legal protection.
Question 4: Which document allows a patient to designate another person to make healthcare decisions on their behalf if they become incapacitated?
- Living will
- Do-not-resuscitate order
- Durable power of attorney for healthcare (Correct answer)
- Informed consent form
Correct answer: Durable power of attorney for healthcare
A durable power of attorney for healthcare (also called a healthcare proxy) legally designates a surrogate decision-maker to act on the patient's behalf when the patient cannot make their own decisions. A living will states the patient's wishes but does not name a decision-maker.
Question 5: The concept of justice in nursing ethics primarily requires the nurse to:
- Always act in the patient's best interest
- Distribute care and resources fairly among patients (Correct answer)
- Maintain honesty in all communications
- Prevent harm from occurring during care
Correct answer: Distribute care and resources fairly among patients
Justice refers to the fair and equitable distribution of resources, treatment, and care. It requires nurses to allocate care without discrimination based on race, gender, socioeconomic status, or other factors, ensuring every patient receives what they are rightfully due.
Question 6: A patient signs a consent form for surgery but later tells the nurse they do not fully understand the procedure. The nurse's priority action is to:
- Reassure the patient that the surgeon is highly experienced
- Proceed with pre-operative preparation as ordered
- Notify the surgeon so that additional explanation can be provided (Correct answer)
- Have the patient sign a new consent form
Correct answer: Notify the surgeon so that additional explanation can be provided
Informed consent requires that the patient fully understands the procedure, risks, benefits, and alternatives before agreeing. If the patient lacks understanding, the nurse must notify the surgeon or provider, who is legally responsible for obtaining true informed consent before proceeding.
NCLEX - National Council Licensure Examination NCLEX-RN 7
A nurse who discloses a patient's diagnosis to a family member without the patient's consent has violated which ethical principle?