A person's informal, personal beliefs about right and wrong behavior, often shaped by upbringing and experience, are described by which term?
Morality
✓
Ethics
Law
Jurisprudence
Correct Answer
Morality
Morality is a person's or a society's idea of right and wrong, usually informal and tied to personal values and behavior. Ethics is the formal, systematic study of moral beliefs and the values a community agrees on, such as a professional code. Law is a set of rules enforced by government, which can differ from personal beliefs. Jurisprudence is the theory and philosophy of law.
Category: Ethical Principles
Question 2
During an admission interview, a patient describes a specific plan to seriously injure a named coworker. What should the nurse do?
Keep the statement private to protect confidentiality
Notify the provider and the risk management department
✓
Wait to act until the patient repeats the threat
Contact the coworker personally from the nurse's own phone
Correct Answer
Notify the provider and the risk management department
A credible threat against an identifiable person triggers duty-to-warn or duty-to-protect obligations, which most states recognize but define differently, so the nurse brings in the provider and risk management to act within state law. Keep the statement private to protect confidentiality is wrong because confidentiality yields when others are in danger. Wait to act until the patient repeats the threat delays action while a person is at risk. Contact the coworker personally from the nurse's own phone bypasses the legal process the facility must follow.
Category: Ethical Decision Making
Question 3
A cognitively intact patient with a terminal illness asks that the diagnosis not be shared with family. Later, the patient's adult daughter asks the nurse what the tests showed. How should the nurse respond?
Share the results because adult children are next of kin
Tell her the tests were normal so she does not worry
Explain that the patient's health information cannot be shared without the patient's consent
✓
Ask the provider to give her the results privately
Correct Answer
Explain that the patient's health information cannot be shared without the patient's consent
A competent patient controls who receives their health information, and keeping that commitment preserves the patient's trust. Share the results because adult children are next of kin is wrong because family status does not override a competent patient's wishes. Tell her the tests were normal so she does not worry is dishonest and harms trust. Ask the provider to give her the results privately still discloses the diagnosis against the patient's wishes.
Category: Privacy and Confidentiality
Question 4
Which activity is a role of a hospital ethics committee?
Suspending the license of a nurse who acted unethically
Writing the state's nurse practice act
Deciding which patients an insurer will cover
Helping the care team reach a decision in a difficult case
✓
Correct Answer
Helping the care team reach a decision in a difficult case
Ethics committees advise and educate: they facilitate decision making in individual cases, help develop policy, and support staff facing ethical conflicts. Suspending the license of a nurse who acted unethically is the job of the state board of nursing. Writing the state's nurse practice act is done by the state legislature. Deciding which patients an insurer will cover is a decision made by the insurer.
Category: Ethical Decision Making
Question 5
A nurse reported a colleague's repeated unsafe practice to the unit manager and then to hospital administration, but the practice continues. What is the nurse's next step?
Report it to an outside authority such as the state board of nursing
✓
Stop reporting, because the internal reports fulfilled the duty
Describe the problem in a post on social media
Confront the colleague in front of patients
Correct Answer
Report it to an outside authority such as the state board of nursing
When an incompetent, unethical, illegal, or impaired practice is not corrected inside the organization, the nurse reports it to an external authority such as a licensing board or regulatory agency. Stop reporting, because the internal reports fulfilled the duty is wrong because patients remain at risk. Describe the problem in a post on social media is unprofessional and can breach privacy. Confront the colleague in front of patients is disrespectful and does not correct the practice.
Category: Reporting and Advocacy
Question 6
Which reason is a valid basis for a nurse's conscientious objection to taking part in care?
Personal dislike of the patient's lifestyle
A sincere moral or religious objection to a specific procedure
✓
A wish to avoid a heavy patient assignment
Discomfort with the patient's diagnosis
Correct Answer
A sincere moral or religious objection to a specific procedure
A conscientious objection rests on a deeply held moral or religious belief about a particular act, and the nurse states it in advance so care can be reassigned. Personal dislike of the patient's lifestyle is prejudice, which conscience-based refusal does not cover. A wish to avoid a heavy patient assignment is convenience, not conscience. Discomfort with the patient's diagnosis is bias, and nurses owe the same level of care to every patient.
Category: Refusing Care
Question 7
Which action by a nurse is a breach of patient privacy?
Reviewing the chart of an assigned patient before rounds
Giving bedside report to the oncoming nurse
Leaving a printed patient summary on a counter in a public hallway
✓
Discussing a patient's care with the patient's treating provider
Correct Answer
Leaving a printed patient summary on a counter in a public hallway
Leaving chart documents where the public can see them exposes health information to people with no need to know. Reviewing the chart of an assigned patient before rounds is part of providing care. Giving bedside report to the oncoming nurse shares information needed for continuity of care. Discussing a patient's care with the patient's treating provider is a permitted use of information for treatment.
Category: Privacy and Confidentiality
Question 8
A patient who was discharged last week sends a friend request to the nurse's personal social media account. What should the nurse do?
Accept it, because the patient has already been discharged
Accept it but avoid posting about the hospital
Accept it and send health tips through private messages
Decline the request to keep the relationship professional
✓
Correct Answer
Decline the request to keep the relationship professional
Connecting with patients on personal social media blurs professional boundaries, so the nurse declines. Accept it, because the patient has already been discharged is wrong because discharge does not turn a nurse-patient relationship into a personal friendship. Accept it but avoid posting about the hospital still creates a personal relationship with a patient. Accept it and send health tips through private messages moves care into an unsecured, unprofessional channel.
Category: Practice Challenges
Question 9
During a safety check, a nurse finds no clinical reason for the patient to receive an ordered medication. The nurse calls the provider, who insists the order stands. What should the nurse do next?
Withhold the dose and go up the chain of command, notifying the nursing supervisor
✓
Give the medication because the provider accepted responsibility
Ask the patient to decide whether to take it
Skip the dose without telling anyone
Correct Answer
Withhold the dose and go up the chain of command, notifying the nursing supervisor
A nurse who believes an order could harm the patient advocates by escalating to a higher-ranking provider and the nursing supervisor. Give the medication because the provider accepted responsibility is wrong because the nurse is accountable for what the nurse administers and risks both harm and discipline. Ask the patient to decide whether to take it shifts a clinical safety question onto the patient. Skip the dose without telling anyone leaves the problem unresolved and undocumented.
Category: Practice Challenges
Question 10
A patient who is a Jehovah's Witness and has severe anemia refuses blood products after hearing the risks. How should the nurse advocate for this patient?
Arrange for a transfusion after the patient is sedated
Ask the provider whether a nonblood alternative can be ordered
✓
Ask the family to override the patient's refusal
Tell the patient the refusal is not allowed in an emergency
Correct Answer
Ask the provider whether a nonblood alternative can be ordered
A competent patient may refuse blood, and the nurse respects that choice while advocating for acceptable alternatives, such as a drug that stimulates red blood cell production. Arrange for a transfusion after the patient is sedated would be treatment without consent. Ask the family to override the patient's refusal ignores the competent patient's autonomy. Tell the patient the refusal is not allowed in an emergency is false and coercive.
Category: Practice Challenges
Question 11
A patient with terminal cancer has severe pain, and the nurse hesitates to give the prescribed opioid out of fear it might slow the patient's breathing. Which approach is ethically sound?
Withhold the opioid so the patient cannot become dependent
Give half the prescribed dose without telling the provider
Give analgesia based on the patient's pain and monitor for and report respiratory depression
✓
Wait until the family requests pain medication
Correct Answer
Give analgesia based on the patient's pain and monitor for and report respiratory depression
Relieving pain is an ethical duty, and slowed breathing is not the purpose of giving the drug, so the patient's need governs administration while the nurse watches for and reports respiratory depression. Withhold the opioid so the patient cannot become dependent leaves a dying patient in pain. Give half the prescribed dose without telling the provider changes an order on the nurse's own authority. Wait until the family requests pain medication delays relief that the patient needs now.
Category: Practice Challenges
Question 12
A newly admitted patient tells the nurse, "If my heart stops, I don't want anyone to do CPR." What should the nurse do?
Treat the spoken statement as a valid order
Write the request on the patient's wristband
Tell the family to decide later if it happens
Notify the provider so a signed do-not-resuscitate order can be placed in the record
✓
Correct Answer
Notify the provider so a signed do-not-resuscitate order can be placed in the record
A patient's spoken wish is not enough on its own, so the nurse notifies the provider, who discusses the decision with the patient and writes the do-not-resuscitate order in the record. Treat the spoken statement as a valid order is wrong because staff cannot withhold resuscitation without a documented order. Write the request on the patient's wristband is not a legal order. Tell the family to decide later if it happens ignores the decision the patient has already made.
Category: Practice Challenges
Question 13
A nurse personally doubts the value of a vaccine that a patient is considering. Which approach to teaching is ethical?
Present accurate, evidence-based information about what the vaccine does
✓
Share personal doubts so the patient hears both sides
Skip the teaching and let the patient research it alone
Describe only the possible side effects
Correct Answer
Present accurate, evidence-based information about what the vaccine does
Ethical teaching is based on what a treatment does and on current standards of care, not on the nurse's personal beliefs. Share personal doubts so the patient hears both sides presents opinion as if it were evidence. Skip the teaching and let the patient research it alone abandons the nurse's teaching role. Describe only the possible side effects gives a one-sided picture that prevents an informed decision.
Category: Ethical Patient Education
Question 14
A patient has just been diagnosed with a chronic illness and is anxious about going home. Which teaching approach is appropriate for the first session?
Explain the full disease process in technical detail
Cover the essential points in plain language and provide written materials
✓
Use medical terms so the patient learns the correct vocabulary
Hold all teaching until the morning of discharge
Correct Answer
Cover the essential points in plain language and provide written materials
Too much information can overwhelm a newly diagnosed patient, so teaching starts simple, uses plain terms, and adds written materials to review later. Explain the full disease process in technical detail is more than the patient can absorb at first. Use medical terms so the patient learns the correct vocabulary creates a barrier for many patients. Hold all teaching until the morning of discharge wastes the chance to teach at every encounter.
Category: Ethical Patient Education
Question 15
A patient with low vision needs discharge teaching about a new medication. Which adaptation supports ethical, unbiased education?
Handing over the standard printed instructions only
Leaving out written materials because the patient cannot use them
Providing large-print materials and reviewing the content aloud
✓
Teaching only the family and not the patient
Correct Answer
Providing large-print materials and reviewing the content aloud
Ethical education accounts for communication barriers, including sensory impairments, so every patient receives the same information in a form they can use. Handing over the standard printed instructions only ignores the impairment. Leaving out written materials because the patient cannot use them denies the patient a reference for home. Teaching only the family and not the patient excludes the patient from their own care.
Category: Ethical Patient Education
Question 16
How does the American Nurses Association describe its Code of Ethics for Nurses?
As a federal law that licenses nurses
As a hospital's policy and procedure manual
As a set of clinical practice guidelines
As a social contract between nurses and the public
✓
Correct Answer
As a social contract between nurses and the public
The ANA calls the Code a social contract with the public: the profession's promise to provide and advocate for safe, quality care. As a federal law that licenses nurses is wrong because licensure is a state matter. As a hospital's policy and procedure manual describes an employer's documents. As a set of clinical practice guidelines describes evidence-based treatment recommendations, not ethical commitments.
Category: Ethical Principles
Question 17
A nurse recognizes that a patient situation involves an ethical dilemma. What should the nurse do first?
Gather the facts and identify the people involved
✓
Choose the option the provider prefers
Evaluate the outcome of the decision
Select whichever action is quickest
Correct Answer
Gather the facts and identify the people involved
Ethical decision making begins like any clinical judgment: by recognizing and analyzing cues, which means collecting the medical facts, the patient's values, and who the key decision makers are. Choose the option the provider prefers skips analysis and the patient's voice. Evaluate the outcome of the decision is the final step, not the first. Select whichever action is quickest puts convenience ahead of ethical reasoning.
Category: Ethical Decision Making
Question 18
A patient with heart failure is readmitted for the third time because of difficulty following the self-care plan, and the nurse feels frustrated. Which response reflects the nurse's ethical duty?
Spend less time with the patient until the plan is followed
Continue compassionate care and reinforce self-care teaching
✓
Tell the patient that care will be limited next time
Ask to be reassigned because of the patient's choices
Correct Answer
Continue compassionate care and reinforce self-care teaching
Beneficence calls on nurses to act in the patient's best interest with individualized, compassionate care, even when nonadherence is frustrating. Spend less time with the patient until the plan is followed punishes the patient and worsens outcomes. Tell the patient that care will be limited next time is a threat that has no ethical basis. Ask to be reassigned because of the patient's choices is not a valid reason to refuse care.
Category: Ethical Principles
Question 19
Which use of patient information is permitted under defined facility policies without a separate patient authorization?
Telling a reporter about a well-known patient
Sharing test results with the patient's employer
Peer review of a nurse's documentation
✓
Describing a patient's case to friends at dinner
Correct Answer
Peer review of a nurse's documentation
Health information may be used for defined purposes such as continuity of care, peer review, quality improvement, and risk management, as long as patients' rights are protected. Telling a reporter about a well-known patient is a privacy violation. Sharing test results with the patient's employer requires the patient's authorization. Describing a patient's case to friends at dinner breaches confidentiality even off duty.
Category: Privacy and Confidentiality
Question 20
A nurse notices that a colleague has slurred speech and smells of alcohol at the start of a shift. What should the nurse do?
Cover the colleague's patients quietly until the shift ends
Wait to see whether a patient is harmed
Discuss it with coworkers before deciding
Notify the supervisor promptly so the colleague is removed from patient care
✓
Correct Answer
Notify the supervisor promptly so the colleague is removed from patient care
An impaired colleague is a threat to patient safety, so the nurse consults supervisory staff right away, which also allows the colleague to be referred for help. Cover the colleague's patients quietly until the shift ends hides the problem and leaves patients at risk. Wait to see whether a patient is harmed puts patients in danger. Discuss it with coworkers before deciding delays action and spreads the matter as gossip.
Category: Reporting and Advocacy