Ethics NCLEX Questions
Which statement about an institutional ethics committee is correct? A The ethics committee is an additional resource for clients and healthcare professionals B The ethics committee relieves health care professionals from dealing with ethical issues C The ethics committee would be the first option in addressing an ethical dilemma D The ethics committee replaces decision making by the client and health care providers
A
Which criterion is needed for someone to give consent to a procedure? A An appointed guardianship B Unemancipated minor C Minimum of 21 years or older D An advocate for a child
A (A guardian has been appointed by a court and has full legal rights to choose management of care.)
Which statement is correct? A Consent for medical treatment can be given by a minor with a sexually transmitted disease (STD). B A second trimester abortion can be given without state involvement. C Student nurses cannot be sued for malpractice while in a nursing clinical class. D Nurses who get sick and leave during a shift are not abandoning clients if they call their supervisor and leave a message about their emergency illness.
A (Anyone, at any age, can be treated without parental permission for an STD infection. The client is "advised" to contact sexual partners but is not "required" to give names. Permission from parents is not needed, based upon current privacy laws.)
A nurse practices beneficence when teaching a class of adolescents about the risks of drinking and driving. Beneficence is best described as: A The actions one takes should promote good. B Always telling the truth C The right to self-determination D Do no harm and safeguard the client.
A (Beneficence means "the actions one takes should promote good." A nurse teaching a class of adolescents is promoting the health and well-being of the community. Veracity is always telling the truth. The right to self-determination is autonomy. Nonmaleficence means to do no harm and safeguard the client.)
Ethical principles for professional nursing practice in a clinical setting are guided by the principles of conduct that are written as the: A American Nurses Association's (ANA's) Code of Ethics B Nurse Practice Act (NPA) written by state legislation C Standards of care from experts in the practice field D Good Samaritan laws for civil guidelines
A (This set of ethical principles provides the professional guidelines established by the ANA to maintain the highest standards for ideal conduct in practice. As a profession, the ANA wanted to establish rules and then incorporate guidelines for accountability and responsibility of each nurse within the practice setting.)
A client with cancer has decided against further treatment. Which action by the nurse would be most appropriate? A Making sure the client has accurate information and understands the consequences of the decision. B Informing the client's spouse, and encouraging the spouse to talk to the client and intervene, if necessary. C Accepting the decision and making no comments to the client. D Talking to the client and trying to persuade the client to think about reversing the decision.
A (To protect the client effectively, the nurse needs to understand what has influenced the client's decision and whether the client has thought about the results of the decision. The other choices do not respect the client's right to choose. )
When caring for a terminally ill client, it is important for the nurse maintain the client's dignity. This can be facilitated by: A Spending time to let clients share their life experiences B Decreasing emphasis on attending to the clients' appearance because it only increases their fatigue C Making decisions for clients so they do not have to make them D Placing the client in a private room to provide privacy at all times
A (Spending time to let clients share their life experiences enables the nurse to know clients better. Knowing clients then facilitates choice of therapies that promote client decision making and autonomy, thus promoting a client's self-esteem and dignity.)
Nurses are bound by a variety of laws. Which description of a type of law is correct? A Statutory law is created by elected legislature, such as the state legislature that defines the Nurse Practice Act (NPA). B Regulatory law includes prevention of harm for the public and punishment for those laws that are broken. C Common law protects the rights of the individual within society for fair and equal treatment. D Criminal law creates boards that pass rules and regulations to control society.
A (Statutory law is created by legislature. It creates statues such as the NPA, which defines the role of the nurse and expectations of the performance of one's duties and explains what is contraindicated as guidelines for breech of those regulations.)
Even though the nurse may obtain the clients signature on a form, obtaining informed consent is the responsibility of the: A Client B Physician C Student nurse D Supervising nurse
B
The nurse is working with parents of a seriously ill newborn. Surgery has been proposed for the infant, but the chances of success are unclear. In helping the parents resolve this ethical conflict, the nurse knows that the first step is: A Exploring reasonable courses of action B Collecting all available information about the situation C Clarifying values related to the cause of the dilemma D Identifying people who can solve the difficulty
B
Which action is the most important nursing responsibility when an ethical issue arises? A Remaining neutral and detached when making ethical decisions B Being able to defend the morality of one's own actions C Ensuring that a team is responsible for deciding ethical questions D Following the client and family wishes exactly
B (A nurse's actions in an ethical dilemma must be defensible according to moral and ethical standards. The nurse may have strong personal beliefs, but distancing oneself from the situation does not serve the client. A team is not always required to reach decisions, and the nurse is not obligated to follow the client's wishes automatically when they may have negative consequences for self or others. )
A bioethical issue should be described as: A The physician's making all decisions of client management without getting input from the client B A research project that included treating all the white men and not treating all the black men to compare the outcomes of a specific drug therapy. C The withholding of food and treatment at the request of the client in a written advance directive given before a client acquired permanent brain damage from an accident. D After the client gives permission, the physician's disclosing all information to the family for their support in the management of the client.
B (The ethical issue was the inequality of treatment based strictly upon racial differences. Secondly, the drug was deliberately withheld even after results showed that the drug was working to cure the disease process in the white men for many years. So after many years, the black men were still not treated despite the outcome of the research process that showed the drug to be effective in controlling the disease early in the beginning of the research project. Therefore harm was done. Nonmaleficence, veracity, and justice were not followed.)
A nurse is asked to care for an openly gay client with AIDS. The nurse tells her supervisor that caring for the client is against her religious beliefs. Does this nurse have an ethical obligation to care for the client? A No, because the client's behavior caused him to contract AIDS. B Yes, unless the risk exceeds the responsibility. C No, the nurse does not have to violate religious beliefs. D No, it may be distasteful to the nurse.
B (The ethical obligation to care for an HIV-infected client cannot be set aside unless the risk exceeds the responsibility. The nurse has an ethical obligation to care for the client regardless of the client's reason for contracting the disease. The nurse's religious beliefs are not a valid reason to decline to care for the client. There are many times when caring for a client may be distasteful, but the client has the right to be cared for by the nurse. )
A client's family member says to the nurse, "The doctor said he will provide palliative care. What does that mean?" The nurse's best response is: A "Palliative care is given to those who have less than 6 months to live." B "Palliative care aims to relieve or reduce the symptoms of a disease." C "The goal of palliative care is to affect a cure of a serious illness or disease." D "Palliative care means the client and family take a more passive role and the doctor focuses on the physiological needs of the client. The location of death will most likely occur in the hospital setting."
B (The goal of palliative care is the prevention, relief, reduction, or soothing of symptoms of disease or disorders without effecting a cure.)
The nurse hung a unit of blood on the wrong client, resulting in an anaphylactic reaction in the client. During the resuscitation, the nurse does not reveal that the wrong blood was given. Which moral principle was absent in the nurse's actions? A Human dignity B Veracity C Autonomy D Social justice
B (The moral principle of veracity refers to telling the truth, no matter the outcome. By lying, the nurse jeopardized the health of the client. Human dignity includes the belief of the inherent worth of the client. Autonomy is the right to self-determination. Social justice is the upholding of rules of equal treatment for all clients.)
The nurse, who is opposed to abortion, is asked to give a medication to the client that will terminate the client's pregnancy. Which strategy might help the nurse in this case? A Refuse to participate in the collaboration regarding this client. B Have self-awareness of values and beliefs. C Withhold the medication until the prescribing person arrives. D Tell the client that taking the medication is immoral.
B (The nurse must become aware of personal values and the ethical aspects of nursing. The nurse must collaborate with other members of the healthcare team. When values conflict, compromise is essential. The nurse might have the charge nurse administer the medication. Nurses must not impose personal values and beliefs on their clients. )
The parents of a child with no apparent brain function refuse to permit withdrawal of life support. Which moral principle is applied with the nurse's action to support the family's decision? A Beneficence B Justice C Respect for autonomy D Nonmaleficence
C (Autonomy is the client's (or surrogate's) right to make his or her own decision. The nurse is obliged to respect a parent's or significant other's informed decision regarding the client. This situation is not one of nonmaleficence (do no harm) or beneficence (do good). Justice (fairness) generally applies when the rights of one client are being balanced against those of another client. )
The distribution of nurses to areas of "most need" in the time of a nursing shortage is an example of: A Utilitarianism theory B Deontological theory C Justice D Beneficence
C (Justice is defined as the fairness of distribution of resources. However, guidelines for a hierarchy of needs have been established, such as with organ transplantation. Nurses are moved to areas of greatest need when shortages occur on the floors. No floor is left without staff, and another floor that had five staff will give up two to go help the floor that had no staff.)
Nurses agree to be advocates for their patients. Practice of advocacy calls for the nurse to: A Seek out the nursing supervisor in conflicting situations B Work to understand the law as it applies to the client's clinical condition C Assess the client's point of view and prepare to articulate this point of view D Document all clinical changes in the medical record in a timely manner
C (Nurses strengthen their ability to advocate for a client when nurses are able to identify personal values and then accurately identify the values of the client and articulate the client's point of view.)
Which situation is a violation of the underlying principles associated with professional nursing ethics? A A client reports that he didn't tell the doctor the truth when asked if he was following his therapeutic diet at home. B The nurses on the unit agree to sponsor a fund-raising event to support a labor strike proposed by fellow nurses at another facility. C A nurse colleague states, "I never look up medication indications. I just give what is prescribed." D The hospital policy permits use of internal fetal monitoring during labor even though there is literature that both supports and refutes the value of this practice.
C (The nurse has an ethical responsibility to act only when actions are safe or risks minimized. This nurse is putting the client at unnecessary risk for a medication error. Many medical practices are controversial but not necessarily unethical; the nurse should follow the agency policy. Although some may view nurses' strikes as unethical, supporting others who are striking is a personal decision. A client's statement to a nurse may have ethical overtones, but it does not automatically constitute an ethical dilemma. Since the assigned primary care provider is a member of the team, principles of confidentiality do not include him or her. )
In most ethical dilemmas, the solution to the dilemma requires negotiation among members of the health care team. The nurse's point of view is valuable because: A Nurses have a legal license that encourages their presence during ethical discussions. B The principle of autonomy guides all participants to respect their own self-worth C Nurses develop a relationship to the client that is unique among all professional health care providers D The nurse's code of ethics recommends that a nurse be present at any ethical discussion about client care
C (When ethical dilemmas arise, the nurses point of view unique and critical. The nurse usually interacts with clients over longer time intervals than do other disciples.)
A client who had a "Do Not Resuscitate" order passed away. After verifying there is no pulse or respirations, the nurse should next: A Have family members say goodbye to the deceased B Call the transplant team to retrieve vital organs C Remove all tubes and equipment (unless organ donation is to take place), clean the body, and position appropriately. D Call the funeral director to come and get the body
C (The body of the deceased should be prepared before the family comes in to view and say their goodbyes. This includes removing all equipment, tubes, supplies, and dirty linens according to protocol, bathing the client, applying clean sheets, and removing trash from the room.)
A new nurse is assigned to the client who is disappointed by the care given by another nurse. The family of the client asks the new nurse how they can make a formal complaint. The nurse's best action is to: A Refer them to the physician. B Refer them to the nurse manager. C Offer to notify the agency patient advocate. D Have them contact the risk manager.
C (Most agencies have patient advocates whose job is to assist the client when conflict arises and to protect the client's rights. Neither the nurse manager nor the physician is the appropriate person to deal with the client. A risk manager is concerned with client and staff injuries. )
A document that lists the medical treatment a person chooses to refuse if unable to make decisions is the: A Durable power of attorney B Informed consent C Living will D Advance directives
D
A health care issue often becomes an ethical dilemma because: A A clients legal rights coexist with a health professionals obligation B Decisions must be made quickly, often under stressful conditions C Decisions must be made based on value systems D The choices involved do not appear to be clearly right or wrong
D
The nurse is obligated to follow a physician's order unless: A The order is a verbal order B The physician's order is illegible C The order has not been transcribed D The order is an error, violates hospital policy, or would be detrimental to the client
D
A client is hospitalized in the end stage of terminal cancer. His family members are sitting at his bedside. What can the nurse do to best aid the family at this time? A Limit the time visitors may stay so they do not become overwhelmed by the situation B Avoid telling family members about the client's actual condition so they will not lose hope C Discourage spiritual practices because this will have little connection to the client at this time D Find simple and appropriate care activities for the family to perform
D (It is helpful for the nurse to find simple care activities for the family to perform, such as feeding the client, washing the client's face, combing hair, and filling out the client's menu. This helps the family demonstrate their caring for the client and enables the client to feel their closeness and concern. a. Older adults often become particularly lonely at night and may feel more secure if a family member stays at the bedside during the night. The nurse should allow visitors to remain with dying clients at any time if the client wants them. It is up to the family to determine if they are feeling overwhelmed, not the nurse.)
In the United States, access to health care usually depends on a client's ability to pay for health care, either through insurance or by paying cash. The client the nurse is caring for needs a liver transplant to survive. This client has been out of work for several months and does not have insurance or enough cash. A discussion about the ethics of this situation would involve predominantly the principle of: A Accountability, because you as the nurse are accountable for the well being of this client B Respect of autonomy, because this client's autonomy will be violated if he does not receive the liver transplant C Ethics of care, because the caring thing that a nurse could provide this patient is resources for a liver transplant D Justice, because the first and greatest question in this situation is how to determine the just distribution of resources
D (Justice refers to fairness. Health care providers agree to strive for justice in health care. The term often is used during discussions about resources. Decisions about who should receive available organs are always difficult)
The nurse overhears a client on the phone arguing with someone about having the right to choose a healthcare plan. The nurse recognizes that the client's topic is addressed in: A Medicare bill of rights B State law C The ANA Code of Ethics D U.S. Advisory Commission on Consumer Protection
D (The U.S. Advisory Commission on Consumer Protection addresses the client's right to choose a healthcare plan. The ANA Code of Ethics determines the practice ethics of nurses. State laws are enacted from federal laws. Medicare does not have a bill of rights. )
A client asks the nurse not to tell his wife that he has cancer. What would be the most appropriate response by the nurse? A "I'm sorry, but the doctor already told her." B "Why are you afraid to tell her?" C "Don't you think she has a right to know?" D "What benefits do you see from not telling your wife your diagnosis?"
D (When presented with an ethical situation, identify the moral issues and principles involved. The nurse should discuss the reasons the client does not want his wife to know the diagnosis. This will clarify the benefits the client sees in his decision. The other choices are disrespectful of the client's wishes, or imply something about the client that may not be true)
Which statement would best explain the role of the nurse when planning care for a culturally diverse population? The nurse will plan care to: A Include care that is culturally congruent with the staff from predetermined criteria B Focus only on the needs of the client, ignoring the nurse's beliefs and practices C Blend the values of the nurse that are for the good of the client and minimize the client's individual values and beliefs during care D Provide care while aware of one's own bias, focusing on the client's individual needs rather than the staff's practices
D (Without understanding one's own beliefs and values, a bias or preconceived belief by the nurse could create an unexpected conflict or an area of neglect in the plan of care for a client (who might be expecting something totally different from the care). During assessment values, beliefs, practices should be identified by the nurse and used as a guide to identify the choices by the nurse to meet specific needs/outcomes of that client. Therefore identification of values, beliefs, and practices allows for planning meaningful and beneficial care specific for this client.)
When signing a form as a witness, your signature shows that the client: A Is fully informed and is aware of all consequences. B Was awake and fully alert and not medicated with narcotics. C Was free to sign without pressure D Has signed that form and the witness saw it being done
D (Your signature as a witness only states that the person signing the form was the person who was listed in the procedure.)
A 67-year-old male client states that he and his 37-year-old wife would like to have a child. A 23-year-old surrogate will carry the child. Which response by the nurse is most appropriate? A "Why isn't your wife carrying your own child?" B "You will be 87 when your child is 20." C "You could adopt a child instead." D "I will ask our counselor to give you additional information."
D (A moral framework guides moral decisions, but it does not determine the outcome. The decision is the family's decision, not the nurse's decision. Providing the client and his wife with more information is the most appropriate response. The other responses are judgmental and inappropriate. )
