Nursing Ethics CE Exam Prep – Real Practice Questions, Answers &
Detailed Rationales (Updated 2026) | Ethical Principles in Nursing
Practice, Patient Rights & Advocacy, Confidentiality & HIPAA Compliance,
Informed Consent & End-of-Life Care, Professional Boundaries &
Accountability, Cultural Competence, Legal Responsibilities, Ethical
Decision-Making & Continuing Education Nursing Review
Question 1: A nurse is caring for a patient who refuses a life-saving blood
transfusion due to religious beliefs. Which ethical principle is primarily being
upheld when the nurse respects this decision?
A. Beneficence
B. Non-maleficence
C. Autonomy
D. Justice
CORRECT ANSWER: C. Autonomy
Rationale: Autonomy refers to a patient's right to make informed decisions about their
own care, even when those decisions may result in harm or death. Respecting a
patient's refusal of treatment based on religious beliefs upholds their right to self-
determination, which is the core of the autonomy principle in nursing ethics.
Question 2: Which of the following scenarios best illustrates the ethical principle of
beneficence in nursing practice?
A. Administering pain medication as ordered to alleviate a patient's suffering
B. Refusing to share patient information with family members without consent
C. Ensuring all patients receive equal access to available resources
D. Documenting care accurately to protect against legal liability
CORRECT ANSWER: A. Administering pain medication as ordered to alleviate a
patient's suffering
Rationale: Beneficence is the ethical obligation to act in the best interest of the patient
and to promote their well-being. Administering pain medication to relieve suffering
directly demonstrates the nurse's commitment to doing good and promoting patient
comfort, which embodies the principle of beneficence.
Question 3: A nurse discovers that a colleague has been documenting care that
was not provided. What is the nurse's primary ethical obligation in this situation?
A. Confront the colleague privately and demand they stop
B. Report the behavior through the appropriate institutional channels
C. Ignore the situation to avoid workplace conflict
D. Document the observation in the patient's chart immediately
CORRECT ANSWER: B. Report the behavior through the appropriate institutional
channels
,Rationale: Nurses have an ethical duty to protect patient safety and maintain
professional integrity. Falsifying documentation compromises patient care and violates
standards of practice. Reporting unethical behavior through proper channels fulfills the
nurse's obligation to uphold professional standards while following due process.
Question 4: When obtaining informed consent for a surgical procedure, which
element is NOT required for the consent to be considered valid?
A. The patient must be provided with information about risks and benefits
B. The patient must sign the consent form in the presence of a witness
C. The patient must demonstrate understanding of the information provided
D. The patient must be free from coercion or undue influence
CORRECT ANSWER: B. The patient must sign the consent form in the presence of a
witness
Rationale: While witnessing signatures may be an institutional policy, it is not an ethical
or legal requirement for valid informed consent. The essential elements include
disclosure of relevant information, patient comprehension, voluntariness, and
competence. A witness signature is procedural, not foundational to the ethical validity
of consent.
Question 5: A nurse is assigned to care for a patient whose values and lifestyle
choices conflict with the nurse's personal beliefs. What is the most ethically
appropriate action for the nurse to take?
A. Request reassignment to avoid providing care to this patient
B. Provide care while consciously setting aside personal judgments
C. Attempt to counsel the patient toward different choices
D. Limit interactions to only essential clinical tasks
CORRECT ANSWER: B. Provide care while consciously setting aside personal
judgments
Rationale: Nursing ethics requires professionals to provide nonjudgmental,
compassionate care to all patients regardless of personal beliefs. Setting aside
personal judgments while maintaining professional boundaries allows the nurse to
fulfill their ethical obligation to respect patient dignity and provide equitable care.
Question 6: Which statement best describes the ethical concept of non-
maleficence in nursing?
A. Taking positive actions to help patients achieve optimal health outcomes
B. Avoiding actions that may cause harm or injury to patients
C. Ensuring fair distribution of healthcare resources among all patients
D. Respecting patients' rights to make decisions about their care
CORRECT ANSWER: B. Avoiding actions that may cause harm or injury to patients
,Rationale: Non-maleficence is the ethical principle often summarized as "first, do no
harm." It obligates nurses to avoid interventions that could reasonably cause harm, to
minimize risks, and to carefully weigh potential benefits against potential harms before
proceeding with any action.
Question 7: A patient with advanced dementia has no advance directive, and family
members disagree about treatment goals. What should guide the nurse's ethical
approach in this situation?
A. Follow the wishes of the family member who is most vocal
B. Advocate for the treatment option that is least expensive
C. Promote decisions that align with what the patient would likely have wanted
D. Defer all decisions to the attending physician without input
CORRECT ANSWER: C. Promote decisions that align with what the patient would
likely have wanted
Rationale: When patients lack decision-making capacity and have no advance
directive, the ethical standard is substituted judgment—making decisions based on
what the patient would have chosen if competent. The nurse's role is to advocate for
this patient-centered approach while facilitating family communication and ethical
consultation if needed.
Question 8: Which action by a nurse constitutes a breach of patient
confidentiality?
A. Discussing a patient's condition with the healthcare team during rounds
B. Sharing de-identified patient data for quality improvement purposes
C. Telling a friend about an interesting case without using the patient's name
D. Documenting care in the electronic health record per policy
CORRECT ANSWER: C. Telling a friend about an interesting case without using the
patient's name
Rationale: Confidentiality requires protecting all patient information, not just
identifiers. Even without using a name, sharing details that could allow someone to
recognize the patient violates privacy standards. Ethical practice requires discussing
patient information only with those directly involved in care or with appropriate
authorization.
Question 9: A nurse experiences moral distress when required to continue
aggressive treatment for a terminally ill patient against the nurse's professional
judgment. What is the most appropriate initial response?
A. Refuse to participate in the patient's care
B. Document personal objections in the patient's medical record
C. Seek support through ethics consultation or debriefing resources
D. Discuss concerns directly with the patient to gain their agreement
, CORRECT ANSWER: C. Seek support through ethics consultation or debriefing
resources
Rationale: Moral distress occurs when nurses know the ethically appropriate action but
feel constrained from taking it. Seeking ethics consultation, peer support, or
institutional debriefing resources addresses the distress constructively while
maintaining professional responsibilities and patient care continuity.
Question 10: Which scenario best exemplifies the ethical principle of justice in
nursing practice?
A. Spending extra time with a patient who is anxious about surgery
B. Advocating for a patient to receive a costly medication not covered by insurance
C. Ensuring all patients on the unit receive pain assessments at scheduled intervals
D. Prioritizing care for a patient with the most severe symptoms
CORRECT ANSWER: C. Ensuring all patients on the unit receive pain assessments
at scheduled intervals
Rationale: Justice in healthcare ethics refers to fairness and equitable treatment.
Ensuring standardized pain assessments for all patients demonstrates distributive
justice—applying care protocols consistently regardless of personal characteristics,
preferences, or biases.
Question 11: A nurse is caring for a minor patient whose parents refuse a medically
indicated vaccination due to personal beliefs. What is the nurse's primary ethical
consideration?
A. Respect the parents' autonomy as legal decision-makers
B. Advocate for the child's best interests and right to health
C. Follow hospital policy without questioning parental decisions
D. Provide the vaccination despite parental refusal to protect public health
CORRECT ANSWER: B. Advocate for the child's best interests and right to health
Rationale: While parents generally have decision-making authority for minors, nurses
have an ethical obligation to advocate for the child's welfare. When parental decisions
may cause significant harm, the nurse should engage in thoughtful dialogue, provide
evidence-based education, and involve ethics or child protection resources as
appropriate.
Question 12: Which action demonstrates appropriate professional boundaries in a
nurse-patient relationship?
A. Accepting a small handmade gift from a grateful patient at discharge
B. Sharing personal contact information with a patient for follow-up questions
C. Meeting a former patient for coffee after the therapeutic relationship ends
D. Discussing personal struggles to build rapport with a distressed patient
Detailed Rationales (Updated 2026) | Ethical Principles in Nursing
Practice, Patient Rights & Advocacy, Confidentiality & HIPAA Compliance,
Informed Consent & End-of-Life Care, Professional Boundaries &
Accountability, Cultural Competence, Legal Responsibilities, Ethical
Decision-Making & Continuing Education Nursing Review
Question 1: A nurse is caring for a patient who refuses a life-saving blood
transfusion due to religious beliefs. Which ethical principle is primarily being
upheld when the nurse respects this decision?
A. Beneficence
B. Non-maleficence
C. Autonomy
D. Justice
CORRECT ANSWER: C. Autonomy
Rationale: Autonomy refers to a patient's right to make informed decisions about their
own care, even when those decisions may result in harm or death. Respecting a
patient's refusal of treatment based on religious beliefs upholds their right to self-
determination, which is the core of the autonomy principle in nursing ethics.
Question 2: Which of the following scenarios best illustrates the ethical principle of
beneficence in nursing practice?
A. Administering pain medication as ordered to alleviate a patient's suffering
B. Refusing to share patient information with family members without consent
C. Ensuring all patients receive equal access to available resources
D. Documenting care accurately to protect against legal liability
CORRECT ANSWER: A. Administering pain medication as ordered to alleviate a
patient's suffering
Rationale: Beneficence is the ethical obligation to act in the best interest of the patient
and to promote their well-being. Administering pain medication to relieve suffering
directly demonstrates the nurse's commitment to doing good and promoting patient
comfort, which embodies the principle of beneficence.
Question 3: A nurse discovers that a colleague has been documenting care that
was not provided. What is the nurse's primary ethical obligation in this situation?
A. Confront the colleague privately and demand they stop
B. Report the behavior through the appropriate institutional channels
C. Ignore the situation to avoid workplace conflict
D. Document the observation in the patient's chart immediately
CORRECT ANSWER: B. Report the behavior through the appropriate institutional
channels
,Rationale: Nurses have an ethical duty to protect patient safety and maintain
professional integrity. Falsifying documentation compromises patient care and violates
standards of practice. Reporting unethical behavior through proper channels fulfills the
nurse's obligation to uphold professional standards while following due process.
Question 4: When obtaining informed consent for a surgical procedure, which
element is NOT required for the consent to be considered valid?
A. The patient must be provided with information about risks and benefits
B. The patient must sign the consent form in the presence of a witness
C. The patient must demonstrate understanding of the information provided
D. The patient must be free from coercion or undue influence
CORRECT ANSWER: B. The patient must sign the consent form in the presence of a
witness
Rationale: While witnessing signatures may be an institutional policy, it is not an ethical
or legal requirement for valid informed consent. The essential elements include
disclosure of relevant information, patient comprehension, voluntariness, and
competence. A witness signature is procedural, not foundational to the ethical validity
of consent.
Question 5: A nurse is assigned to care for a patient whose values and lifestyle
choices conflict with the nurse's personal beliefs. What is the most ethically
appropriate action for the nurse to take?
A. Request reassignment to avoid providing care to this patient
B. Provide care while consciously setting aside personal judgments
C. Attempt to counsel the patient toward different choices
D. Limit interactions to only essential clinical tasks
CORRECT ANSWER: B. Provide care while consciously setting aside personal
judgments
Rationale: Nursing ethics requires professionals to provide nonjudgmental,
compassionate care to all patients regardless of personal beliefs. Setting aside
personal judgments while maintaining professional boundaries allows the nurse to
fulfill their ethical obligation to respect patient dignity and provide equitable care.
Question 6: Which statement best describes the ethical concept of non-
maleficence in nursing?
A. Taking positive actions to help patients achieve optimal health outcomes
B. Avoiding actions that may cause harm or injury to patients
C. Ensuring fair distribution of healthcare resources among all patients
D. Respecting patients' rights to make decisions about their care
CORRECT ANSWER: B. Avoiding actions that may cause harm or injury to patients
,Rationale: Non-maleficence is the ethical principle often summarized as "first, do no
harm." It obligates nurses to avoid interventions that could reasonably cause harm, to
minimize risks, and to carefully weigh potential benefits against potential harms before
proceeding with any action.
Question 7: A patient with advanced dementia has no advance directive, and family
members disagree about treatment goals. What should guide the nurse's ethical
approach in this situation?
A. Follow the wishes of the family member who is most vocal
B. Advocate for the treatment option that is least expensive
C. Promote decisions that align with what the patient would likely have wanted
D. Defer all decisions to the attending physician without input
CORRECT ANSWER: C. Promote decisions that align with what the patient would
likely have wanted
Rationale: When patients lack decision-making capacity and have no advance
directive, the ethical standard is substituted judgment—making decisions based on
what the patient would have chosen if competent. The nurse's role is to advocate for
this patient-centered approach while facilitating family communication and ethical
consultation if needed.
Question 8: Which action by a nurse constitutes a breach of patient
confidentiality?
A. Discussing a patient's condition with the healthcare team during rounds
B. Sharing de-identified patient data for quality improvement purposes
C. Telling a friend about an interesting case without using the patient's name
D. Documenting care in the electronic health record per policy
CORRECT ANSWER: C. Telling a friend about an interesting case without using the
patient's name
Rationale: Confidentiality requires protecting all patient information, not just
identifiers. Even without using a name, sharing details that could allow someone to
recognize the patient violates privacy standards. Ethical practice requires discussing
patient information only with those directly involved in care or with appropriate
authorization.
Question 9: A nurse experiences moral distress when required to continue
aggressive treatment for a terminally ill patient against the nurse's professional
judgment. What is the most appropriate initial response?
A. Refuse to participate in the patient's care
B. Document personal objections in the patient's medical record
C. Seek support through ethics consultation or debriefing resources
D. Discuss concerns directly with the patient to gain their agreement
, CORRECT ANSWER: C. Seek support through ethics consultation or debriefing
resources
Rationale: Moral distress occurs when nurses know the ethically appropriate action but
feel constrained from taking it. Seeking ethics consultation, peer support, or
institutional debriefing resources addresses the distress constructively while
maintaining professional responsibilities and patient care continuity.
Question 10: Which scenario best exemplifies the ethical principle of justice in
nursing practice?
A. Spending extra time with a patient who is anxious about surgery
B. Advocating for a patient to receive a costly medication not covered by insurance
C. Ensuring all patients on the unit receive pain assessments at scheduled intervals
D. Prioritizing care for a patient with the most severe symptoms
CORRECT ANSWER: C. Ensuring all patients on the unit receive pain assessments
at scheduled intervals
Rationale: Justice in healthcare ethics refers to fairness and equitable treatment.
Ensuring standardized pain assessments for all patients demonstrates distributive
justice—applying care protocols consistently regardless of personal characteristics,
preferences, or biases.
Question 11: A nurse is caring for a minor patient whose parents refuse a medically
indicated vaccination due to personal beliefs. What is the nurse's primary ethical
consideration?
A. Respect the parents' autonomy as legal decision-makers
B. Advocate for the child's best interests and right to health
C. Follow hospital policy without questioning parental decisions
D. Provide the vaccination despite parental refusal to protect public health
CORRECT ANSWER: B. Advocate for the child's best interests and right to health
Rationale: While parents generally have decision-making authority for minors, nurses
have an ethical obligation to advocate for the child's welfare. When parental decisions
may cause significant harm, the nurse should engage in thoughtful dialogue, provide
evidence-based education, and involve ethics or child protection resources as
appropriate.
Question 12: Which action demonstrates appropriate professional boundaries in a
nurse-patient relationship?
A. Accepting a small handmade gift from a grateful patient at discharge
B. Sharing personal contact information with a patient for follow-up questions
C. Meeting a former patient for coffee after the therapeutic relationship ends
D. Discussing personal struggles to build rapport with a distressed patient
