NCLEX RN Practice Questions are an essential tool for nursing students preparing for their licensure exam.
NCLEX Ethical and Legal Aspects Questions
Ethical and Legal Aspects NCLEX Questions Test Strategies
Here are some key points before entering the practice question section. Remember, we will study the theoretical concepts more in the explanation part of the practice questions. These are just important concepts:
- Administering incorrect medication to a client can lead to adverse consequences, such as allergic reactions, side effects, and interactions with other medications.
- Nurses have a professional and moral obligation to report medication errors to their superiors, irrespective of whether the mistake resulted in harm to the client.
- Failure to report medication errors can result in a nurse facing disciplinary action, legal penalties, and damage to their professional reputation.
- Before performing any surgical or invasive operation, obtaining informed consent is a legal and ethical requirement, and not doing so can result in legal and ethical ramifications for the healthcare provider.
- Informed consent necessitates that the client is thoroughly informed about the proposed procedure's risks, benefits, and alternatives and has the capacity to make an informed decision.
- The privacy and confidentiality of patients are essential rights, and healthcare providers have a moral and legal obligation to safeguard patient information.
- Breaching confidentiality can have legal and ethical implications for healthcare providers, including disciplinary action and harm to their professional reputation.
- Patients have the right to access their medical records and have the information explained to them, as well as the right to give or withhold consent for treatment.
- Honoring a patient's autonomy includes recognizing their right to make informed decisions about their healthcare, even if healthcare providers may not make the same choices for themselves.
- Maintaining accurate documentation is a critical aspect of healthcare since it ensures a complete record of the care provided and aids in maintaining continuity of care.
Ethical and Legal Aspects NCLEX Practice Questions
Question 1.
Highlight one of the following examples that talks about beneficence ethical principles of nursing.
Example 1. A patient with terminal cancer is given information about all the treatment options available to them, along with their risks and benefits. The patient chooses to forego chemotherapy because they value quality of life over quantity, even though the nurse believes they should try everything to fight the cancer.
Example 2. A nurse notices that a patient who had been receiving chemotherapy for several weeks is extremely anxious and uncomfortable. Instead of simply administering the medication, the nurse takes the time to provide additional comfort measures such as positioning the patient for optimal breathing, providing a warm blanket, and offering emotional support.
Example 3. In a busy emergency department, a nurse must triage patients to determine who needs care first. The nurse evaluates each patient's condition objectively, without considering factors such as age, gender, or socioeconomic status, to ensure that the most urgent cases are seen first.
Example 4. A nurse is aware of the risk of medication errors and takes extra precautions to ensure that the correct medication and dose are administered to each patient. The nurse double-checks the medication label and dosage with another nurse or the physician before administering it to the patient.
Answer:
A nurse notices that a patient who had been receiving chemotherapy for several weeks is extremely anxious and uncomfortable. Instead of simply administering the medication, the nurse takes the time to provide additional comfort measures such as positioning the patient for optimal breathing, providing a warm blanket, and offering emotional support.
Explanation:
Example 2 is the answer we are searching for because it shows the nurse's commitment to promoting the patient's well-being and comfort, even beyond the immediate medical need. The nurse is going above and beyond the basic duty of administering the medication and taking the time to provide additional comfort measures, showing that the nurse is acting in the best interest of the patient.
The other examples are not the right answers because:
Example 1. relates to Autonomy, as the nurse respects the patient's decision and allows them to make their own choice about their treatment.
Example 3. relates to Justice, as the nurse is ensuring fairness and equal distribution of care by objectively evaluating each patient's condition and prioritizing the most urgent cases.
Example 4. relates to Nonmaleficence, as the nurse is taking steps to minimize the risk of harm to the patient by double-checking the medication and dosage to prevent medication errors.
Question 2.
Which of the following statements from the nurse is the most appropriate action to take after administering the wrong medication to the client?
(a) "I’ll wait and see if the symptoms persist before reporting the incident"
(b) "I'll document the incident in the client's chart but won't report it to the supervisor"
(c) "I’ll report the incident to the supervisor and follow the agency's protocol for reporting medication errors"
(d) "I'll continue to monitor the client but won't report the incident to the supervisor since the client's symptoms are not severe"
Answer:
(c) "I'll report the incident to the supervisor and follow the agency's protocol for reporting medication errors".
Explanation:
Administering the wrong medication to a client is a serious medication error that poses a risk to the client’s health and well-being. Nurses are responsible for reporting such incidents to their supervisors as soon as possible. Failure to report such incidents can lead to further harm to the client and potential legal consequences for the nurse and the healthcare agency. Therefore, it is crucial for the nurse to follow the agency's protocol for reporting medication eirors and take immediate action to ensure the client's safety.
Option (a) is incorrect as waiting to see if the symptoms persist is not an appropriate response to a medication error that has already occurred. The client's symptoms may worsen, and the nurse must take immediate action to address the issue.
Option (b) is incorrect as documenting the incident in the client's chart but not reporting it to the supervisor does not address the issue or ensure that the client receives appropriate care.
Option (d) is incorrect as the severity of the client's symptoms is not a factor in determining whether or not to report a medication error. Any medication error should be reported and addressed promptly to ensure the safety of the client.
Question 3.
Mrs. Alvin, a 70-year-old female patient, is scheduled to undergo a hip replacement surgery next week. The nurse providing preoperative care explains the procedure and its risks and benefits to Mrs. Alvin and obtains her surgical consent. However, on the day of the surgery, Mrs. Alvin expresses doubts about the surgery and questions if it is really necessary.
Which of the following statements from Mrs. Alvin indicates that the nurse did not obtain an informed consent for the surgery?
(a) "I am worried about the anesthesia, but I trust my surgeon,"
(b) "I am not sure if I really need this surgery."
(c) "I am excited to have the surgery and get back to my normal activities."
(d) "I have signed the consent form, but I don't know what it says."
(e) "I have discussed the surgery with my family and they support my decision."
(f) "I understand that there are risks involved in the surgery, but I trust my healthcare team."
Answer:
(b) "I am not sure if I really need this surgery."
Explanation:
Informed consent is a legal and ethical requirement for all surgical or invasive procedures. The consent form documents that the client has been informed of the risks, benefits, and possible alternatives to the proposed procedure. In this case, Mrs. Alvin's expression of doubt about the surgery indicates that she may not have fully understood the risks and benefits of the procedure, and therefore, the nurse may not have obtained an informed consent from her.
Option (a) is incorrect because it indicates that Mrs. Alvin trusts her surgeon, which is not related to whether an informed consent w-as obtained or not.
Option (c) is incorrect because it indicates that Mrs. Alvin is excited to have the surgery, but it does not provide any information about whether an informed consent was obtained or not.
Option (d) is incorrect because it indicates that Mrs. Alvin signed the consent form, but it does not provide any information about whether she was informed about the risks and benefits of the surgery.
Option (e) is incorrect because it indicates that Mrs. Alvin discussed the surgery with her family, but it does not provide any information about whether an informed consent was obtained or not.
Option (f) is incorrect because it indicates that Mrs. Alvin understands the risks involved in the surgery, but it does not provide any information about whether an informed consent was obtained or not.
Question 4.
Anita, a 28-year-old woman, is admitted to the hospital with severe depression and suicidal thoughts. She is diagnosed with major depressive disorder and is receiving treatment from a multidisciplinary team of healthcare professionals, including a psychiatric nurse. During her stay. Anita expresses concern about her rights and asks the nurse about what she is entitled to as a mentally ill patient.
Which of the following statements made by Anita reflects her right as a mentally ill patient?
(a) "I have the right to refuse medication even if my doctor says it will help me."
(b) "I have the right to physical restraints if I become agitated or violent."
(c) "I have the right to be restrained whenever the staff feels it is necessary for my safety."
(d) "I have the right to privacy and confidentiality in all aspects of my care."
Answer:
(d) "I have the right to privacy and confidentiality in all aspects of my care."
Explanation:
(a) "I have the right to refuse medication even if my doctor says it will help me" is incorrect because while mentally ill patients do have the right to refuse medication, this statement does not specifically address her rights as a mentally ill patient.
(b) "I have the right to physical restraints if I become agitated or violent" is incorrect because while restraints may be necessary in certain situations, they should only be used as a last resort and in accordance with the patient's individual care plan.
(c) "I have the right to be restrained whenever the staff feels it is necessary for my safety" is incorrect because this statement contradicts the right to the least restrictive treatment environment and could potentially be used to justify unnecessary or excessive use of restraints.
(d) "I have the right to privacy and confidentiality in all aspects of my care" is the correct answer because this statement directly reflects one of the fundamental rights of mentally ill patients. Patients have the right to privacy and confidentiality in their care, which means that their medical information should be kept confidential and only shared on a need-to-know basis. This right helps to protect patients from discrimination, stigma, and other negative consequences that can arise from disclosure of their mental health status.
Question 5.
Mr. Alvin is admitted to the hospital for surgery. He has been anxious about the procedure and has expressed concerns about his privacy. During his stay, he overhears the nurse telling his neighbor about his medical condition. When he confronts the nurse, she dismisses his concerns and tells him that she was just making small talk.
Which of the following statements by the nurse is a violation of Mr. Alvin's privacy?
(a) "I was just trying to be friendly and make conversation with your neighbor."
(b) "I didn't know you could hear me, I'm sorry if I made you uncomfortable."
(c) "I didn't disclose any private medical information, so I don't see the problem."
(d) "I understand your concerns and I will make sure to respect your privacy moving forward."
Answer:
(a) "I was just trying to be friendly and make conversation with your neighbour."
Explanation:
Option (a) is the correct answer as the nurse violated Mr. Alvin's privacy by releasing his medical information to an unauthorized person without his permission. Even if the nurse was trying to make small talk or be friendly, it is not appropriate to discuss a patient's medical condition with anyone who is not directly involved in their care. This breach of confidentiality can cause unnecessary embarrassment and discomfort to the patient and can lead to legal consequences for the healthcare provider.
Option (b) is incorrect as it does not address the nurse's violation of Mr. Alvin's privacy.
Option (c) is incorrect as it disregards the fact that any discussion of a patient's medical condition without their consent is a violation of their privacy, regardless of the level of detail disclosed.
Option (d) is incorrect as it does not acknowledge the nurse's previous violation of Mr. Al vin's privacy and does not offer a solution to prevent future breaches of confidentiality.
Question 6.
Saigrace is a 45-year-old man who has been hospitalized for pneumonia. He has been in the hospital for a week and has been receiving intravenous antibiotics. He is feeling better, but he is concerned about the length of his hospital stay and wants to know more about his rights as a patient.
Which of the following statements from Saigrace indicates he understands his rights as a hospitalized patient?
(a) "I don't care who the doctors and nurses are, as long as they help me get better."
(b) "I want to see my medical records so I can make sure everything is accurate."
(c) "I'm not sure if I'm allowed to refuse a treatment if I don't want it."
(d) "I don't need to know about hospital rules or payment methods, that's not important."
Answer:
(b) "I want to see my medical records so I can make sure everything is accurate."
Explanation:
Saigrace's statement indicates that he understands his right to review his medical record and have information explained to him, as well as his right to expect that medical records are confidential.
Option (a) is incorrect because it does not address any of Saigrace's rights as a patient.
Option (c) is incorrect because Saigrace expresses uncertainty about his right to consent or refuse a treatment, indicating he may not fully understand this right.
Option (d) is incorrect because Saigrace's statement dismisses the importance of knowing about hospital rules and payment methods, which are important aspects of his rights as a patient.
Question 7.
A nurse is caring for a patient who has been diagnosed with a terminal illness and has expressed their wish to end their life. The patient's family members are against euthanasia and have requested the nurse to not provide any information to the patient that would support their decision.
Which of the following statements from the patient or which of the following statements given by the nurse would demonstrate a violation of the ethical principle of autonomy?
(a) The patient expresses their wish to end their life peacefully and without pain.
(b) The patient's family members request the nurse to withhold information from the patient.
(c) The nurse explains to the patient the potential benefits and harms of various treatment options.
(d) The nurse encourages the patient to consider alternative treatments to prolong their life.
(e) The patient agrees to consider alternative treatments after discussing their options with the nurse.
(f) The nurse respects the patient's washes and provides information about end-of-life care and hospice services.
(g) The nurse administers a lethal dose of medication to the patient to end their suffering.
Answer:
(b) The patient's family members request the nurse to withhold information from the patient.
(g) The nurse administers a lethal dose of medication to the patient to end their suffering.
Explanation:
Option (b) violates the ethical principle of autonomy, which involves respecting an individual's right to self-determination. The family's request to withhold information from the patient infringes upon the patient's right to make informed decisions about their own healthcare.
Option (g) violates the ethical principle of nonmaleficence, which involves the obligation to do or cause no harm to another. Administering a lethal dose of medication to the patient would result in harm and therefore goes against this principle.
Option (a) is not a violation of autonomy as the patient is expressing their own wishes.
Option (c) is an example of respecting autonomy as the nurse is providing the patient with information to help them make informed decisions.
Option (d) is not a violation of autonomy as long as the nurse is not discouraging the patient from pursuing their own wishes.
Option (e) is an example of respecting autonomy as the patient is making an informed decision after discussing their options with the nurse.
Option (f) is an example of respecting autonomy as the nurse is providing the patient with information and respecting their wishes.
Question 8.
A nurse is documenting the care provided to a patient in the hospital. The nurse has been trained on the appropriate documentation guidelines, but is feeling rushed and stressed due to a heavy workload. As a result, the nurse fails to document a medication administration that was given to the patient.
Which of the following statements given by the nurse is correct regarding the appropriate documentation guidelines?
(a) It is acceptable to use red ink pen for narrative documentation.
(b) There is no need to document care, medications, treatments, and procedures as soon as possible after completion.
(c) It is not necessary to document client responses to interventions.
(d) Documentation should include subjective data only.
(e) Abbreviations should be used as much as possible to save time.
(f) Blank spaces on documentation forms are acceptable.
(g) Errors in documentation should be corrected by erasing and re-writing the information.
Answer:
(a) It is acceptable to use red ink pen for narrative documentation.
(g) Errors in documentation should be corrected by erasing and re-writing the information.
Explanation:
(a) Using a black-colored ink pen for narrative documentation is one of the correct statements from the nurse regarding the appropriate documentation guidelines. Red ink pens or other colors can be difficult to read or may not show up well when copies are made. Using black ink ensures that the documentation is legible and professional.
(b) The incorrect statement is that there is no need to document care, medications, treatments, and procedures as soon as possible after completion. It is important to document these items promptly and accurately to ensure that there is a complete record of the care provided.
(c) Documenting client responses to interventions is important in order to track progress and make adjustments as needed. This is a necessary part of providing comprehensive care.
(d) While subjective data can be important to document in certain situations, it is important to provide objective, factual, and complete documentation as much as possible.
(e) Using abbreviations can be helpful to save time, but it is important to use only acceptable abbreviations that are understood by all members of the healthcare team. Unacceptable abbreviations can lead to misunderstandings and errors.
(f) Leaving blank spaces on documentation forms can be seen as incomplete or unprofessional. It is important to fill in all necessary information to provide a complete record of care.
(g) When an error is made in documentation, it is important to follow agency policies to correct the error. This may include drawing one line through the error, initialing, and dating it. Erasing and re-writing information can make the documentation unclear and may be seen as unprofessional. Overall, accurate and complete documentation is essential to providing safe and effective care to patients. Nurses must follow appropriate documentation guidelines to ensure that they are providing a complete record of the care they provide.
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