ETHICS FOR HEALTH PROFESSIONALS

At the end of this exercise, the nurse learner shall be able to:
1. Explore negligence and its elements;
2. Discriminate ethical principles; and
3. Apply laws and ethics in nursing scenarios.
Situation 1
Laws and Nurse Practice Acts
1. Examples of administrative laws that affect nursing care
A. Civil rights acts
C. Nurse practice acts
B. Negligence Laws
D. Substance abuse laws
2. Which situation would be covered under criminal law?
A. A patients hospitalization is prolonged because of an action on the part of the nurse.
B. The nurse breaks a patients false teeth.
C. The nurse injures a patient while performing a procedure.
D. The nurse takes narcotics from the narcotics cabinet and uses them for himself.
3. Guidelines of the Nurse Practice Act are enforced by the:
A. Board of Health
C. Board of Nursing
B. Board of Medicine
D. Board of Patient Safety
4. Which of the following is not one of the rights of patients?
A. The right to choose when to die and how to die.
B. The right to dignity.
C. The right to make decisions regarding their case.
D. The right to respect.
Situation 2
Negligence
5. Negligence is defined as:
A. An intentional and unlawful offer to touch a person in an offensive, insulting, or physically
intimidating manner.
B. An obligation one has incurred or might incur through any act or failure to act.
C. Improper discharge of professional duties or failure to meet the standards of acceptable
care which results in harm to another person.
D. The failure of an individual to provide care that a reasonable person would ordinarily use
in a similar circumstance.
6. When negligence case is brought against a nurse, it is necessary to prove liability. Which
element is not essential for proof of liability?
A. Causation
C. Injury
B. Duty
D. Witnesses
7. Which one of the following is the first element that must be proved for malpractice as it arises
from the nurse-client relationship?
A. Breach of duty
C. Duty
B. Causation
D. Injury
Situation 3
Applied health ethics
8. When a nurse is sued, the reasonable man standard asks
A. If the action taken was reasonable in the eyes of the plaintiff.
B. If the institutions standards were reasonable.
C. What a reasonable nurse would do in a similar situation.
D. What the public considers being a reasonable action.
9. A nurse is working in a neonatal intensive care unit is being sued. An expert witness is called.
The expert witness would be?
A. A faculty member in a university school of nursing.
B. A neonatal intensive care nurse.
C. A physician who specializes in neonatology.
D. The chief of nursing in the hospital.
10. In which situation may the nurse legally use restraints?
A. The newly admitted patient is confused as to the location of his bathroom.
B. The patient keeps asking for help to go to the bathroom and the nurse I very busy.
C. The patient states he wants to get out of bed, but the doctor has ordered bed rest.
D. The patient who is critically ill becomes violent and is removing IV lines and medical
monitoring devices.

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11. The hospitalized patients uncle, who is a physician, asks the nurse for the patients chart. The
uncle is not the physician on the case. The best response for the nurse is to:
A. Extend professional courtesy and let him see the chart.
B. Ask the patient for a written consent before allowing the relative to see the chart.
C. Tell the physician where the chart, but not actually giving it to the physician.
D. Call the supervisor.
12. Which statement is true about fraud?
A. It is written information given to a third party that causes damage to someones
reputation.
B. It is oral information given to a third party that causes damage to someones reputation.
C. It results form a deliberate deception intended to produce unlawful gain.
D. It results from revealing confidential information without the persons permission.
13. In which situation is the nurse NOT subject to liability?
A. The nurse correctly administers first aid at the scene of an automobile accident. The
patient sustains permanent injuries.
B. The nurse performs a procedure, but does not document it. The patient claims injuries
because the procedure was not performed.
C. The nurse performs a new procedure for which she has not received training. The patient
claims injury.
D. The nurse wraps tape around a frayed electrical cord. The equipment malfunctions and
the patient claims injuries.
14. If a nurse suspects a coworker is abusing chemicals, the nurse should:
A. Try to help the coworker.
C. Report the coworker to nursing
B. Refer the coworker to nursing
administration.
administration.
D. Call the police.
15. When is a nurse not obligated to follow the orders of a licensed physician?
A. When there is not enough staff to
C. When the orders are written illegibly.
complete all the orders.
D. When the orders would result in harm
B. When the orders are given verbally.
to the patient.
16. All of the following statements about Good Samaritan Acts are false EXCEPT:
A. They are same across the world.
B. They are examples of common and statutory law.
C. They provide immunity from civil liability for health care providers at the scene of an
emergency.
D. Provide immunity to the nurse who is providing care as an employee.
17. The best definition of euthanasia is:
A. Death by choice
C. Illegal death
B. Good or gentle death
D. Quick death
18. A methodology for organizing patient care through an episode of illness so that specific
clinical and financial outcomes are achieved within an allotted time frames describes:
A. A critical pathway.
C. Problem-oriented records.
B. Case management.
D. Source-oriented charting.
19. Which of the following is not an advantage of walking nursing rounds?
A. Involvement of the patient.
C. Team-building among nurses.
B. Opportunity for teaching.
D. Time efficiency.
Situation 4
Charting and documentation
20. Which of the following is not a legal requirement of documentation?
A. Time-sequenced.
C. Use of authorized abbreviations.
B. Proper use of spelling and grammar.
D. Typed legibly.
21. What is the primary reason why professionals document?
A. Education
C. Accountability
B. Research
D. Reimbursement
22. The nurse who forgets to document an element of clinical significance and recalls it later
should:
A. Not add this information to the chart since it will be out of sequence.
B. Add this information to the original entry and initial it.
C. Rewrite the original entry.
D. Include this information, dating and signing the additional material.

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23. The nurse notes a significant change in the patients condition. The nurse should:
A. Notify the physician and document the change and the notification of the physician in
the chart.
B. Document the change in the chart.
C. Notify the physician and chart that the physician was notified.
D. Chart the change and notify the nursing supervisor.
24. The nurses makes mistake when charting on the patients record. To correct this mistake the
nurse should:
A. White-out the mistake and make the correct entry.
B. Blot out the error with ink and make the correct entry.
C. Draw line through the error, sign and date the correction.
D. Leave the error intact and chart the correction immediately following the error.
25. Which of the following entries is charted correctly:
A. Wound appears at same as
C. More oriented.
yesterday.
D. 100-ml coffee ground-appearing
B. Range of motion improved today.
emesis.
26. Which of the following entries is charted correctly:
A. Triple-lumen catheter inserted.
C. Wound improving.
B. Dr. Green inserted chest tube in right
D. Patient more comfortable.
pleural cavity.
27. Which type of documentation system allows the nurses the quickest access to all information
about the patient?
A. Narrative
C. Problem-oriented
B. Point of care
D. Source-oriented
28. Using the SOAP or SOAPIER format is part of which type of documentation?
A. Charting by exception
C. Problem-oriented
B. Narrative
D. Source-oriented
29. Which statement is true regarding incident reports? The incident report
A. assists in risk management.
B. in accessible only by the physician and hospital employees.
C. is part of the patients medical record.
D. may not be used in a case involving litigation.
30. The major reasons for accurate and thorough documentation of nursing care rendered and
the patients response to interventions include of the following?
A. Documentation is required for accreditation and reimbursement.
B. Documentation prevents lawsuits.
C. Documentation is required if the patient sues.
D. Document is a long-held custom.
31. Which of the following would require an incident report?
A. The patient develops a rash when
C. The patients relatives complain
taking a medication
about a clients care
B. The nurse notes a change in the
D. The patient falls out of bed
patients condition
32. Where in the chart would the nurse most likely find a statement of whether the patient has
an advanced care directive?
A. Clinical pathway
C. Medical history & examination
B. Face sheet
D. Consent form
33. The most traditional form of charting is
A. Narrative
C. Problem-oriented
B. Focus
D. Charting by exception
34. In which location of the chart would the nurse likely find hourly urinary output?
A. Kardex
C. Flow sheet
B. Care path
D. Critical pathway
Situation 5
Informed consent
35. Which statement is NOT true regarding informed consent?
A. Benefits and risks of the procedure should be explained to the patient by the HCP before
the consent is obtained
B. Consent forms must be obtained for invasive procedures
C. The patient must be mentally competent
D. Informed consent is required for emergency procedures

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36. The nurse would anticipate that the patient would need to complete an informed consent
EXCEPT
A. Pacemaker insertion
C. Insertion of IFC
B. Conscious sedation
D. ECT
37. After being told that surgery would probably benefit the client, the patient refuses surgery. In
accepting the patients choice of action, the nurse is acting on which ethical principle?
A. Nonmaleficence
C. Veracity
B. Justice
D. Autonomy
38. The patient has not signed for surgery and has received a narcotic before going to surgery.
The nurse should
A. Have the patient sign the consent
C. Notify the physician in the OR
form
D. Send the patient to surgery
B. Have the patients closest relative
sign the consent form
39. The nurse who witnesses the patients signature on an informed consent form is confirming
A. The patient understands what is to be done
B. The physician explained the procedure
C. The patient understands the cost of the procedure
D. The person who signed is the patient, and the patient is competent, alert, and aware
40. Who may act as witness for an informed consent?
A. The unit secretary
B. A pharmacist
C. The nurse
D. All of the above
41. The following may sign the consent form EXCEPT:
A. A 16-year old married girl
C. A 35-year old who is premedicated
B. A 23-year old who says, God help
for surgery
me!
D. A 45-year old mental health patient
Situation 6
Advance care directives
42. A living will is a document that
A. Provides direction regarding medical care in the event the person is unable to make
decisions personally
B. Enables any competent individual to name someone to exercise decision-making
authority under specific circumstances, on the patients behalf
C. Provides general information about an individuals personal beliefs, values, and
preferences that would be useful in guiding the treatment decisions made by health
care professionals
D. Provides precise instructions for the type of care the client wants of does not want in any
number of scenarios
Situation 7
Ethical principles
43. The obligation to do no harm is known as:
A. Autonomy
C. Nonmaleficence
B. Beneficence
D. Veracity
44. The concept of justice as an ethical principle refers to:
A. Equitable distribution of potential benefits and risks
B. Maintaining a balance between benefits and harms
C. Respect for individual liberty
D. The duty to do what one has promised
45. What is the ethical theory that considers the intrinsic significance of the act itself as the
criterion for determination of the good?
A. Deontology
C. Teleology
B. Nemology
D. Theology
46. A nurse who follows through with the patients request to keep her as pain-free as possible
until her time of death is practicing which principle?
A. Autonomy
B. Fidelity
C. Justice
D. Veracity

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47. When telling the patient about the side effects, consequences, and costs of treatment, the
nurse is practicing which ethical principle?
A. Beneficence
C. Justice
B. Compassion
D. Nonmaleficence
Situation 8
Ethics and morality
48. Which statement is true about morality?
A. Reflects the political values of our society
B. Rooted in the legal system
C. The study of the rightness of conduct
D. Usually reflects personal or religious beliefs
49. Values clarification is a three-step process that includes
A. Analyzing, planning, and implementing
B. Believing, questioning, and justifying
C. Choosing, prizing, and acting
D. Understanding, selecting, and evaluating
50. All of the following are true of bioethics EXCEPT:
A. Easy answers to health care issues are derived from its use
B. It affects direct care of patients
C. It affects utilization of staff
D. It is involved with the allocation of finances
Situation 9
Mrs. Jones, a Jehovahs Witness, is admitted to an intensive care unit in a terminal condition,
suffering from breast cancer. She has a slow internal hemorrhage and is only semiconscious.
Before her alteration in consciousness, she had given her doctors a written statement specifically
requesting she not be given a blood transfusion under any circumstances. Upon her arrival in
the unit, however, the attending doctor prescribes a unit of blood and requests that it be given
immediately.
51. The doctor, with the aid of a technologist who held Mrs. Jones arm, continued with the
blood transfusion. What intentional tort occurred?
A. Battery
C. Infliction of emotional distress
B. False imprisonment
D. Invasion of privacy
52. Mrs. Jones written statement refusing blood transfusion constitutes
A. An advanced care medical
C. Health proxy
directive
D. None of the above
B. A living will
53. Three days before her alteration in consciousness, Mrs. Jones tells Nurse Smith that she tested
positive for HIV. What is the best action for the nurse to take?
A. Document this information on Mrs. Jones chart.
B. Tell Mrs. Jones physician
C. Inform the health care team who will come in contact with Mrs. Jones.
D. Encourage Mrs. Jones to disclose this information to her physician.
54. Mrs. Jones is offered the opportunity to participate in research on a new therapy. The
researcher asks the nurse to obtain Mrs. Jones consent. What is the most appropriate action
for Nurse Smith to make?
A. Be sure Mrs. Jones understands the project before she signs the consent form.
B. Give the form to Mrs. Jones and tell her to read it carefully before she signs it.
C. Read the consent form to Mrs. Jones and give her an opportunity to ask questions.
D. Refuse to be the one to obtain Mrs. Jones consent.
55. Mrs. Jones decides not to participate in the research project. She has signed the consent
form, but she has changed her mind. The nurse tells Mrs. Jones she has the right to change
her mind based upon which of the following principles?
A. Autonomy
C. Double effect
B. Beneficence
D. Justice
56. Suppose Mrs. Jones refused admission, the nurse knows which of the following are true? Mrs.
Jones
A. can be restrained if one physician declares her incompetent.
B. cannot be hospitalized against her will.
C. cannot choose which treatment to refuse.
D. may sign against medical advice (AMA)

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57. Mrs. Jones is medicated for surgery. The operating room nurse, when going through the
clients chart, realizes that the consent form has not been signed. Which of the following is
the best action for the nurse to take?
A. Assume it is emergency surgery and the consent is implied.
B. Get the consent form and have the client sign it.
C. Have a family member sign the consent form.
D. Tell the physician that the consent form is not signed.
58. Mrs. Jones has just returned to the unit from surgery. The nurse transferred her to her bed but
did not put up the siderails. The client fell and was injured. What kind of liability does the
nurse have?
A. Assault and battery
C. Negligence
B. Intentional tort
D. None
59. Nurse Smith is in the hospitals public cafeteria and hears two student nurses talking about
Mrs. Jones. They are using her name and discussing intimate details about her illness. Which
of the following actions is best for the nurse to take?
A. Go over and tell the student nurses that their actions are inappropriate, especially in
public areas.
B. Wait and tell the student nurses later that they were overheard discussing the client.
Otherwise they will be embarrassed.
C. Tell the student nurses clinical instructor about the incident. It is the clinical instructors
responsibility to address the issue.
D. Say nothing. It is not the nurses job and she is not responsible for the student nurses
actions.
60. The healthcare proxy of Mrs. Jones wants to see Mrs. Jones chart. Which of the following is
the best response for the nurse to take?
A. Hand the health care proxy the clients chart to review.
B. Have another staff nurse review the chart with the healthcare proxy.
C. Call the attending physician and have the doctor speak with the healthcare proxy.
D. Tell the healthcare proxy that the request cannot be granted.
61. Mrs. Jones is admitted back to the hospital. She is in the terminal stages of AIDS. During the
admission assessment, the nurse would ask her if she had which of the following?
A. A will.
B. A do-not-resuscitate (DNR) order.
C. An organ donation card.
D. A durable power of attorney for healthcare.
62. Nurse Smith is unfamiliar with a new piece of equipment that is scheduled to be used today.
In making her decision, Nurse Smith would best appeal to which of the following principles?
A. Nonmaleficence
C. Either
B. Beneficence
D. Neither
63. Mrs. Jones becomes verbally abusive. Nurse Alex obtains leather restraints and threatens to
place Mrs. Jones in the restraints. With which of the following can the client legally charge
the nurse as a result of the nursing action.
A. Assault
C. Negligence
B. Battery
D. Invasion of privacy
64. Mrs. Jones tells Nurse Smith that a living will is being prepared and that the lawyer will be
bringing the will to the hospital today for witness signatures. The client asks the nurse for
assistance in obtaining a witness to the living will. The most appropriate response to the
client is which of the following?
A. I need to know if you understood what you signed.
B. You will need to find a witness on your own.
C. I will call the nursing supervisor to seek assistance regarding your request.
D. Whoever is available at the time will sign as a witness for you.
65. The nursing staff is sitting in the lounge taking their morning break. A clinical instructor tells
the group that she heard that Nurse Smith has acquired immunodeficiency syndrome. The
clinical instructor proceeds to tell the nursing staff that Nurse Smith contracted the disease
from her husband who is supposedly a drug addict. Which legal tort has the clinical
instructor violated?
A. Slander
C. Assault
B. Libel
D. Negligence
66. Nurse Smith listens attentively to another nurses opinions. This is indicative of
A. Respect
C. Compassion
B. Humility
D. Greed

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67. Nurse Smith acts in the same way she says Mrs. Jones should act. She teaches Mrs. Jones to
regularly do Breast Self Examination (BSE), which she does at the same day of every month.
This is indicative of
A. Compassion
C. Fidelity
B. Integrity
D. Prudence
68. After a particularly painful dressing change on the operative site of Mrs. Jones, she tells to the
student nurse, Thank you. Youve been a wonderful nurse to me. The student nurse
responded, I appreciate your compliment. This is an example of
A. Respect
C. Humility
B. Courage
D. Honesty
Situation 10
VITAL LEGAL DOCTRINES IN NURSING PRACTICE
Nurse Alex, a RN HEALS parenterally administered a dose of a presumed skeletal muscle relaxant
to an adolescent client. The dose proved to be lethal as the patient immediately went into
cardiac and respiratory depression, and consequently death in only a matter of minutes.
69. The basis of civil liability of the hospital in the selection of Nurse Alex is:
A. Culpa in eligiendo
C. Pater de familias
B. Culpa in vigilando
D. Respondeat superior
70. Under which of the following doctrines is Nurse Alex who caused the injury or damage acting
within the scope of his authority and in the course of his employment in the hospital?
A. Culpa in eligiendo
C. Pater de familias
B. Culpa in vigilando
D. Respondeat superior
71. Under this doctrine, Nurse Alex is liable for damages or injuries to the patient as a result of
negligent performance or nonperformance of duty or obligation to the hospital: Doctrine of
A. negligent conduct
C. for the good of the many
B. Good Samaritan
D. no-harm
72. The administration of the parenteral medication has been proven as a proximate cause of
the eventual death of the adolescent. The evidence, which is ordinarily required to show not
only what occurred, but how and why it occurred need not be presented because of:
A. Doctrine of common knowledge
C. Force majeure
B. Doctrine of damnum absque injuria
D. Res ipsa loquitor
73. In the course of the transfer of another patient, the nurse and patient were trapped in the
elevator due to a strong earthquake and the patient died of asphyxiation despite the proper
nursing intervention. The nurse can invoke:
A. Culpa in eligiendo
C. Force majeure
B. Culpa in vigilando
D. Respondeat superior
74. Performance of an act which ought not to be done:
A. Afeasance
C. Misfeasance
B. Malfeasance
D. Nonfeasance
Situation 11
CODE OF ETHICS FOR REGISTERED NURSES
75. The promulgation of the code of ethics for nurses is contained in which of the following
board resolutions?
A. 08
C. 220
B. 27
D. 541

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