NCSBN - National Council of State Boards of Nursing Ethical and Legal Principles Questions and Answers

Question 1

A surgeon asks a nurse to witness a client's signature on a surgical consent form. The nurse enters the room, and the client states, "I'm not really sure what the doctor is going to do, but I trust him." What is the nurse's most appropriate legal and ethical action?

Accepted Answer

Notify the surgeon that the client does not have informed consent.

Answer

The nurse's role in witnessing consent is to attest to the authenticity of the signature and the client's competency, not to provide the primary explanation of the procedure. If the client does not understand the procedure, they cannot provide informed consent. The nurse has a duty to act as a patient advocate and must notify the surgeon, who is legally responsible for explaining the procedure and ensuring the client is truly informed.

Question 2

Which of the following actions by a nurse would be a violation of the Health Insurance Portability and Accountability Act (HIPAA)?

Accepted Answer

Looking up the lab results of a neighbor who is a client on another unit.

Answer

Accessing a client's protected health information (PHI) without a legitimate, job-related reason ('need to know') is a clear violation of HIPAA's privacy rule. The other options describe permissible disclosures of PHI for the purposes of treatment, payment, or healthcare operations.

Question 3

A client with a terminal illness has a valid living will that explicitly refuses the use of mechanical ventilation. The client becomes unconscious and experiences respiratory failure. The client's distraught spouse demands that the healthcare team "do everything possible" to save the client. What is the nurse's primary legal responsibility?

Accepted Answer

Honor the client's wishes as stated in the living will.

Answer

A living will is a legal advance directive that outlines a person's wishes for medical treatment when they are no longer able to communicate. It represents the client's autonomous decision and must be honored by the healthcare team, even if family members disagree.

Question 4

A nurse administers an incorrect dose of an antihypertensive medication. The client's blood pressure drops slightly but remains within a safe range, and the client experiences no adverse effects. Which essential element of professional negligence (malpractice) is missing in this scenario?

Accepted Answer

Damages or harm

Answer

For a malpractice claim to be successful, four elements must be proven: duty, breach of duty, causation, and damages (harm). In this case, although the nurse breached the standard of care (breach of duty), the client did not suffer any actual injury or harm. Therefore, the element of damages is missing.

Question 5

A nurse who consistently provides pain relief, repositions clients for comfort, and advocates for their nutritional needs is primarily demonstrating which ethical principle?

Accepted Answer

Beneficence

Answer

Beneficence is the ethical principle of acting for the good and well-being of others. The nurse's actions are all aimed at promoting the client's welfare and doing good, which is the core of beneficence.

NCSBN - National Council of State Boards of Nursing Practice Test

NCSBN - National Council of State Boards of Nursing Practice Test

NCSBN - National Council of State Boards of Nursing Ethical and Legal Principles Questions and Answers