NCLEX - National Council Licensure Examination NCLEX-RN 8 — Questions and Answers
Question 1: A nurse is caring for a patient who refuses a blood transfusion due to religious beliefs. The nurse disagrees with this decision but proceeds to respect it. This action best demonstrates which ethical principle?
- Beneficence
- Autonomy (Correct answer)
- Justice
- Fidelity
Correct answer: Autonomy
Autonomy is the patient's right to make informed decisions about their own care, even when the healthcare provider disagrees. Respecting the patient's refusal upholds this principle.
Question 2: When a nurse administers medication and documents it accurately in the patient's chart, this action primarily reflects which component of professional nursing practice?
- Scope of practice
- Accountability (Correct answer)
- Delegation
- Advocacy
Correct answer: Accountability
Accountability means the nurse takes responsibility for their actions, including documentation of care given. It requires answering for one's own nursing judgments and actions.
Question 3: A patient asks the nurse to keep a piece of information confidential from the patient's family. The nurse agrees, then later shares the information with the care team for safety reasons. Which ethical conflict does this scenario best illustrate?
- Paternalism versus autonomy
- Fidelity versus beneficence (Correct answer)
- Justice versus nonmaleficence
- Veracity versus fidelity
Correct answer: Fidelity versus beneficence
Fidelity refers to keeping promises and maintaining loyalty, while beneficence means acting in the patient's best interest. Sharing information for safety creates a conflict between keeping the promise (fidelity) and promoting well-being (beneficence).
Question 4: A nurse notices that a colleague is consistently administering pain medication late to patients. The most appropriate initial action by the nurse is to:
- Report the colleague to the state nursing board immediately
- Document observations and confront the colleague professionally (Correct answer)
- Ignore the behavior since it is the colleague's responsibility
- Administer the medication on behalf of the colleague without informing anyone
Correct answer: Document observations and confront the colleague professionally
The nurse should first document observations and address the concern directly with the colleague in a professional manner. This follows the chain of appropriate escalation and upholds patient advocacy without prematurely bypassing internal resolution steps.
Question 5: During shift handoff, a nurse receives report on a patient with a new DNR order. Later, the patient goes into cardiac arrest. The nurse should:
- Begin CPR immediately since the patient's condition has changed
- Withhold resuscitation in accordance with the documented DNR order (Correct answer)
- Contact the physician before taking any action
- Ask the family for permission to resuscitate
Correct answer: Withhold resuscitation in accordance with the documented DNR order
A valid, documented DNR order must be honored as it reflects the patient's advance directive and right to self-determination. Initiating CPR would violate the patient's expressed wishes.
Question 6: The term 'nonmaleficence' in nursing ethics is best described as the duty to:
- Treat all patients fairly regardless of background
- Promote the health and well-being of patients
- Avoid causing harm to patients (Correct answer)
- Maintain honesty and truthfulness with patients
Correct answer: Avoid causing harm to patients
Nonmaleficence is the ethical principle obligating nurses to refrain from actions that cause unnecessary harm. It is often expressed as 'first, do no harm' (primum non nocere).
NCLEX - National Council Licensure Examination NCLEX-RN 8
A nurse is caring for a patient who refuses a blood transfusion due to religious beliefs.
The nurse disagrees with this decision but proceeds to respect it.
This action best demonstrates which ethical principle?