NURSING ETHICS CE EXAM | 2026
UPDATED | QUESTIONS & VERIFIED
ANSWERS WITH DETAILED RATIONALES
1. A nurse is caring for a patient who refuses a blood transfusion due to religious beliefs,
even though the refusal may result in death. Which ethical principle is the nurse upholding
by respecting this decision?
A. Beneficence
B. Justice
C. Nonmaleficence
D. Autonomy
RATIONALE: Autonomy refers to the patient's right to make informed decisions about their
own care, including the right to refuse treatment. Even when the nurse disagrees, respecting the
patient's competent, informed refusal upholds this principle. Beneficence means doing good,
nonmaleficence means avoiding harm, and justice refers to fair treatment.
2. A nurse administers pain medication to a terminally ill patient knowing it may slightly
hasten death but primarily intends to relieve suffering. This is best described by which
ethical concept?
A. Euthanasia
B. Negligence
C. Doctrine of Double Effect
D. Beneficence violation
RATIONALE: The Doctrine of Double Effect permits an action that has both a good effect
(pain relief) and a potential harmful effect (hastened death), provided the intent is the good
effect. This is ethically distinct from euthanasia, which involves intentional ending of life.
3. A nurse notices that a physician's order will harm the patient. The nurse does not
question the order. Which principle is being violated?
A. Autonomy
B. Nonmaleficence
,C. Veracity
D. Fidelity
RATIONALE: Nonmaleficence obligates nurses to "do no harm." Failing to question a
harmful order violates this principle. The nurse has a professional duty to advocate for patient
safety.
4. A nurse ensures that limited ICU beds are distributed fairly among equally critical
patients regardless of socioeconomic status. Which ethical principle does this reflect?
A. Autonomy
B. Beneficence
C. Justice
D. Fidelity
RATIONALE: Justice refers to the fair, equitable distribution of resources and treatment.
Allocating ICU beds based on clinical need rather than social status exemplifies this principle.
5. Which action best demonstrates the ethical principle of veracity in nursing practice?
A. Withholding a terminal diagnosis to protect the patient from distress
B. Informing the patient honestly about risks of a procedure even when uncomfortable
C. Telling the family first before the patient
D. Avoiding discussion of prognosis to preserve hope
RATIONALE: Veracity is the obligation to tell the truth. Nurses must provide honest
information to patients to enable informed decision-making, even when the truth is difficult.
6. A nurse promises a patient she will return with pain medication in 10 minutes and does
so. This reflects which ethical principle?
A. Justice
B. Fidelity
C. Veracity
,D. Autonomy
RATIONALE: Fidelity means keeping promises and being faithful to commitments.
Following through on a promise to a patient demonstrates this principle.
7. Which scenario best illustrates a conflict between beneficence and autonomy?
A. A nurse allocates medications fairly among all patients
B. A nurse wants to administer a life-saving treatment that the patient refuses
C. A nurse reports a colleague's medication error
D. A nurse educates a patient about smoking cessation
RATIONALE: Beneficence drives the nurse to act in the patient's best interest (giving the
treatment), while autonomy requires respecting the patient's refusal. This is one of the most
common ethical conflicts in nursing.
8. A patient asks a nurse not to share their HIV status with their spouse. The nurse
complies. Which principle is primarily being honored?
A. Beneficence
B. Justice
C. Confidentiality
D. Fidelity
RATIONALE: Confidentiality is the ethical and legal obligation to protect patient
information. Unless there is a duty to warn (e.g., imminent threat), the nurse must honor the
patient's request for privacy.
9. A nurse disagrees with a patient's lifestyle choices but continues to provide non-
judgmental care. This reflects:
A. Paternalism
B. Respect for autonomy
C. Nonmaleficence
D. Beneficence
, RATIONALE: Respecting autonomy means acknowledging a patient's right to make their
own choices without judgment, even when the nurse personally disagrees.
10. Which best describes paternalism in nursing?
A. Allowing the patient to refuse treatment
B. Overriding a patient's wishes for what the nurse believes is their best interest
C. Providing care based on evidence-based guidelines
D. Informing patients of all treatment options
RATIONALE: Paternalism occurs when a healthcare provider substitutes their own judgment
for the patient's, overriding the patient's preferences under the belief they know best. This
conflicts with patient autonomy.
SECTION 2: PATIENT RIGHTS & AUTONOMY
11. A competent adult patient refuses a recommended surgery. The nurse's most
appropriate action is to:
A. Contact the patient's family to persuade them
B. Ask the physician to override the decision
C. Ensure the patient has received all information and document the refusal
D. Discharge the patient immediately
RATIONALE: A competent patient has the legal and ethical right to refuse any treatment. The
nurse must ensure informed refusal by confirming the patient understands the consequences, then
document accordingly.
12. Which document allows a patient to appoint someone to make healthcare decisions on
their behalf if they become incapacitated?
A. Living will
B. Do-Not-Resuscitate order
C. Durable Power of Attorney for Healthcare
UPDATED | QUESTIONS & VERIFIED
ANSWERS WITH DETAILED RATIONALES
1. A nurse is caring for a patient who refuses a blood transfusion due to religious beliefs,
even though the refusal may result in death. Which ethical principle is the nurse upholding
by respecting this decision?
A. Beneficence
B. Justice
C. Nonmaleficence
D. Autonomy
RATIONALE: Autonomy refers to the patient's right to make informed decisions about their
own care, including the right to refuse treatment. Even when the nurse disagrees, respecting the
patient's competent, informed refusal upholds this principle. Beneficence means doing good,
nonmaleficence means avoiding harm, and justice refers to fair treatment.
2. A nurse administers pain medication to a terminally ill patient knowing it may slightly
hasten death but primarily intends to relieve suffering. This is best described by which
ethical concept?
A. Euthanasia
B. Negligence
C. Doctrine of Double Effect
D. Beneficence violation
RATIONALE: The Doctrine of Double Effect permits an action that has both a good effect
(pain relief) and a potential harmful effect (hastened death), provided the intent is the good
effect. This is ethically distinct from euthanasia, which involves intentional ending of life.
3. A nurse notices that a physician's order will harm the patient. The nurse does not
question the order. Which principle is being violated?
A. Autonomy
B. Nonmaleficence
,C. Veracity
D. Fidelity
RATIONALE: Nonmaleficence obligates nurses to "do no harm." Failing to question a
harmful order violates this principle. The nurse has a professional duty to advocate for patient
safety.
4. A nurse ensures that limited ICU beds are distributed fairly among equally critical
patients regardless of socioeconomic status. Which ethical principle does this reflect?
A. Autonomy
B. Beneficence
C. Justice
D. Fidelity
RATIONALE: Justice refers to the fair, equitable distribution of resources and treatment.
Allocating ICU beds based on clinical need rather than social status exemplifies this principle.
5. Which action best demonstrates the ethical principle of veracity in nursing practice?
A. Withholding a terminal diagnosis to protect the patient from distress
B. Informing the patient honestly about risks of a procedure even when uncomfortable
C. Telling the family first before the patient
D. Avoiding discussion of prognosis to preserve hope
RATIONALE: Veracity is the obligation to tell the truth. Nurses must provide honest
information to patients to enable informed decision-making, even when the truth is difficult.
6. A nurse promises a patient she will return with pain medication in 10 minutes and does
so. This reflects which ethical principle?
A. Justice
B. Fidelity
C. Veracity
,D. Autonomy
RATIONALE: Fidelity means keeping promises and being faithful to commitments.
Following through on a promise to a patient demonstrates this principle.
7. Which scenario best illustrates a conflict between beneficence and autonomy?
A. A nurse allocates medications fairly among all patients
B. A nurse wants to administer a life-saving treatment that the patient refuses
C. A nurse reports a colleague's medication error
D. A nurse educates a patient about smoking cessation
RATIONALE: Beneficence drives the nurse to act in the patient's best interest (giving the
treatment), while autonomy requires respecting the patient's refusal. This is one of the most
common ethical conflicts in nursing.
8. A patient asks a nurse not to share their HIV status with their spouse. The nurse
complies. Which principle is primarily being honored?
A. Beneficence
B. Justice
C. Confidentiality
D. Fidelity
RATIONALE: Confidentiality is the ethical and legal obligation to protect patient
information. Unless there is a duty to warn (e.g., imminent threat), the nurse must honor the
patient's request for privacy.
9. A nurse disagrees with a patient's lifestyle choices but continues to provide non-
judgmental care. This reflects:
A. Paternalism
B. Respect for autonomy
C. Nonmaleficence
D. Beneficence
, RATIONALE: Respecting autonomy means acknowledging a patient's right to make their
own choices without judgment, even when the nurse personally disagrees.
10. Which best describes paternalism in nursing?
A. Allowing the patient to refuse treatment
B. Overriding a patient's wishes for what the nurse believes is their best interest
C. Providing care based on evidence-based guidelines
D. Informing patients of all treatment options
RATIONALE: Paternalism occurs when a healthcare provider substitutes their own judgment
for the patient's, overriding the patient's preferences under the belief they know best. This
conflicts with patient autonomy.
SECTION 2: PATIENT RIGHTS & AUTONOMY
11. A competent adult patient refuses a recommended surgery. The nurse's most
appropriate action is to:
A. Contact the patient's family to persuade them
B. Ask the physician to override the decision
C. Ensure the patient has received all information and document the refusal
D. Discharge the patient immediately
RATIONALE: A competent patient has the legal and ethical right to refuse any treatment. The
nurse must ensure informed refusal by confirming the patient understands the consequences, then
document accordingly.
12. Which document allows a patient to appoint someone to make healthcare decisions on
their behalf if they become incapacitated?
A. Living will
B. Do-Not-Resuscitate order
C. Durable Power of Attorney for Healthcare
