Saudi Prometric Nursing Patient Safety and Ethics 3 — Questions and Answers
Question 1: A patient refuses a blood transfusion on religious grounds despite a life-threatening hemorrhage. What is the nurse's primary ethical obligation?
- Administer the transfusion to save the patient's life
- Respect the patient's autonomy and document the refusal (Correct answer)
- Consult the family to override the patient's decision
- Sedate the patient and proceed with the transfusion
Correct answer: Respect the patient's autonomy and document the refusal
Respecting autonomy means honoring a competent adult's informed refusal even when the nurse disagrees with the choice.
Question 2: Which action by a nurse BEST demonstrates the ethical principle of justice in patient care?
- Spending extra time with patients who are most cooperative
- Allocating care based on severity of need regardless of social status (Correct answer)
- Prioritizing patients who have private insurance
- Giving preferential treatment to patients referred by senior physicians
Correct answer: Allocating care based on severity of need regardless of social status
Justice requires fair distribution of care based on clinical need, not social or financial factors.
Question 3: A nurse discovers that a colleague administered the wrong medication dose but the patient appears unharmed. What should the nurse do FIRST?
- Ignore it since no harm occurred
- Report the incident to the charge nurse and complete an incident report (Correct answer)
- Confront the colleague privately and ask them to self-report
- Document it only in personal notes
Correct answer: Report the incident to the charge nurse and complete an incident report
Near-miss and adverse events must be reported through official channels to prevent recurrence, regardless of patient outcome.
Question 4: Under the SCFHS code of conduct, a nurse is ethically required to maintain patient confidentiality EXCEPT when:
- The patient asks for a second opinion
- There is a duty to warn about imminent danger to others (Correct answer)
- A family member requests the diagnosis
- The patient is transferred to another unit
Correct answer: There is a duty to warn about imminent danger to others
Confidentiality may be breached when there is a serious and credible threat to the safety of others.
Question 5: Which element is ESSENTIAL for obtaining valid informed consent from a patient?
- Presence of a witness who is a hospital employee
- Patient's voluntary agreement after receiving adequate information (Correct answer)
- Consent signed at least 24 hours before the procedure
- Agreement from the patient's next of kin
Correct answer: Patient's voluntary agreement after receiving adequate information
Valid informed consent requires that the patient is competent, adequately informed, and agrees voluntarily without coercion.
Question 6: A nurse uses the SBAR tool when handing over a deteriorating patient. Which component addresses the nurse's assessment of the situation?
- Situation
- Background
- Assessment (Correct answer)
- Recommendation
Correct answer: Assessment
The 'Assessment' component of SBAR is where the nurse communicates their clinical judgment about what is happening with the patient.
Question 7: Which practice is MOST effective in reducing central line-associated bloodstream infections (CLABSI)?
- Changing the dressing every 24 hours regardless of condition
- Using maximum sterile barrier precautions during insertion (Correct answer)
- Flushing the line with normal saline only once per shift
- Keeping the line clamped when not in use
Correct answer: Using maximum sterile barrier precautions during insertion
Maximum sterile barrier precautions (cap, mask, gown, gloves, large drape) during insertion is a key evidence-based bundle element to prevent CLABSI.
Saudi Prometric Nursing Patient Safety and Ethics 3
A patient refuses a blood transfusion on religious grounds despite a life-threatening hemorrhage.
What is the nurse's primary ethical obligation?