NUR 312: ETHICAL ISSUES IN NURSING PRACTICE
Section 1: Foundations and Ethical Principles (Questions 1–15)
1. Which principle in nursing ethics is defined as “to do good” for patients?
A. Autonomy
B. Beneficence
C. Justice
D. Non-maleficence
Correct Answer: B
Rationale: Beneficence requires nurses to act in the best interest of patients by promoting their
well-being.
2. “Non-maleficence” means:
A. Respecting patient autonomy
B. Providing care that benefits the patient
C. “Do no harm”
D. Ensuring equal treatment for all
Correct Answer: C
Rationale: Non-maleficence is the ethical duty to avoid causing harm to patients.
3. The principle of “autonomy” in nursing practice refers to:
A. Ensuring that all patients receive the same treatment
B. Allowing patients to make their own informed decisions
C. Prioritizing the nurse’s judgment over the patient’s wishes
D. Delegating decisions only to family members
Correct Answer: B
Rationale: Autonomy respects a patient’s right to self-determination and to be fully involved in
their care decisions.
4. “Justice” in nursing ethics involves:
A. Distributing resources fairly among patients
B. Focusing on the most profitable treatments
C. Giving preferential treatment based on personal relationships
D. Ignoring socioeconomic factors
Correct Answer: A
Rationale: Justice requires that healthcare be provided fairly and equitably to all patients.
5. Which ethical principle requires that patient care not only benefits the patient but also avoids
harm?
A. Beneficence
B. Non-maleficence
C. Autonomy
D. Fidelity
Correct Answer: B
, Rationale: Non-maleficence emphasizes avoiding harm while beneficence emphasizes doing
good; together they balance care to ensure safety.
6. In ethical decision-making, “veracity” refers to:
A. Maintaining patient confidentiality
B. Telling the truth to patients
C. Acting in the patient’s best interest
D. Ensuring fairness in resource allocation
Correct Answer: B
Rationale: Veracity means truthfulness, requiring honesty in all patient interactions.
7. “Fidelity” in nursing means:
A. Maintaining confidentiality
B. Being loyal and keeping promises made to patients
C. Always following orders
D. Ensuring equal distribution of resources
Correct Answer: B
Rationale: Fidelity involves loyalty, trustworthiness, and commitment to keeping promises,
which is essential to the nurse-patient relationship.
8. Which principle is often in conflict with autonomy when patients refuse life-saving treatment?
A. Justice
B. Beneficence
C. Fidelity
D. Veracity
Correct Answer: B
Rationale: Beneficence (acting in the patient’s best interest) may conflict with autonomy when a
patient refuses treatment that would likely benefit them.
9. In a scenario where a patient lacks decision-making capacity, the nurse should:
A. Ignore the patient’s previous wishes
B. Rely on the legal surrogate or advance directive
C. Make decisions based on the nurse’s judgment alone
D. Ask another patient
Correct Answer: B
Rationale: When capacity is absent, the nurse must follow legal guidelines—using a designated
surrogate decision-maker or an advance directive to guide care.
10. Ethical dilemmas in nursing often arise when:
A. There is a clear-cut answer
B. Two or more ethical principles conflict
C. The patient is fully informed
D. Only one ethical principle is applicable
Correct Answer: B
Rationale: Ethical dilemmas occur when principles such as autonomy and beneficence conflict,
requiring careful balance and ethical reasoning.
, 11. In the context of ethics, “moral distress” in nursing occurs when:
A. A nurse disagrees with hospital policy
B. A nurse is unable to act according to what they believe is ethically correct due to external
constraints
C. A nurse makes an error in documentation
D. A nurse follows all ethical guidelines
Correct Answer: B
Rationale: Moral distress is experienced when a nurse knows the right action to take but is
prevented from taking it due to institutional or other constraints.
12. Which of the following is a tool often used to guide ethical decision-making in nursing?
A. SWOT analysis
B. The Four-Box Method
C. The Maslow Hierarchy
D. The Nursing Process only
Correct Answer: B
Rationale: The Four-Box Method (or similar ethical decision-making models) helps nurses
analyze ethical dilemmas by considering medical indications, patient preferences, quality of life,
and contextual features.
13. When considering informed consent, which of the following is essential?
A. The patient must be coerced to consent
B. The patient must receive adequate information and have the capacity to understand it
C. Consent is only required for surgical procedures
D. Consent is optional if the patient trusts the nurse
Correct Answer: B
Rationale: Informed consent requires that the patient understands the risks, benefits, and
alternatives of a procedure and has the capacity to make an informed decision.
14. In a scenario where a patient’s family disagrees with the patient’s expressed wishes, the nurse
should:
A. Immediately follow the family’s wishes
B. Respect the patient’s autonomy if the patient is competent
C. Ignore the patient’s wishes
D. Call the police
Correct Answer: B
Rationale: When a competent patient expresses clear wishes, those wishes take precedence
over family opinions in ethical practice.
15. Which ethical principle supports a nurse’s duty to protect vulnerable patients?
A. Autonomy
B. Justice
C. Beneficence
D. Non-maleficence
Correct Answer: D
Section 1: Foundations and Ethical Principles (Questions 1–15)
1. Which principle in nursing ethics is defined as “to do good” for patients?
A. Autonomy
B. Beneficence
C. Justice
D. Non-maleficence
Correct Answer: B
Rationale: Beneficence requires nurses to act in the best interest of patients by promoting their
well-being.
2. “Non-maleficence” means:
A. Respecting patient autonomy
B. Providing care that benefits the patient
C. “Do no harm”
D. Ensuring equal treatment for all
Correct Answer: C
Rationale: Non-maleficence is the ethical duty to avoid causing harm to patients.
3. The principle of “autonomy” in nursing practice refers to:
A. Ensuring that all patients receive the same treatment
B. Allowing patients to make their own informed decisions
C. Prioritizing the nurse’s judgment over the patient’s wishes
D. Delegating decisions only to family members
Correct Answer: B
Rationale: Autonomy respects a patient’s right to self-determination and to be fully involved in
their care decisions.
4. “Justice” in nursing ethics involves:
A. Distributing resources fairly among patients
B. Focusing on the most profitable treatments
C. Giving preferential treatment based on personal relationships
D. Ignoring socioeconomic factors
Correct Answer: A
Rationale: Justice requires that healthcare be provided fairly and equitably to all patients.
5. Which ethical principle requires that patient care not only benefits the patient but also avoids
harm?
A. Beneficence
B. Non-maleficence
C. Autonomy
D. Fidelity
Correct Answer: B
, Rationale: Non-maleficence emphasizes avoiding harm while beneficence emphasizes doing
good; together they balance care to ensure safety.
6. In ethical decision-making, “veracity” refers to:
A. Maintaining patient confidentiality
B. Telling the truth to patients
C. Acting in the patient’s best interest
D. Ensuring fairness in resource allocation
Correct Answer: B
Rationale: Veracity means truthfulness, requiring honesty in all patient interactions.
7. “Fidelity” in nursing means:
A. Maintaining confidentiality
B. Being loyal and keeping promises made to patients
C. Always following orders
D. Ensuring equal distribution of resources
Correct Answer: B
Rationale: Fidelity involves loyalty, trustworthiness, and commitment to keeping promises,
which is essential to the nurse-patient relationship.
8. Which principle is often in conflict with autonomy when patients refuse life-saving treatment?
A. Justice
B. Beneficence
C. Fidelity
D. Veracity
Correct Answer: B
Rationale: Beneficence (acting in the patient’s best interest) may conflict with autonomy when a
patient refuses treatment that would likely benefit them.
9. In a scenario where a patient lacks decision-making capacity, the nurse should:
A. Ignore the patient’s previous wishes
B. Rely on the legal surrogate or advance directive
C. Make decisions based on the nurse’s judgment alone
D. Ask another patient
Correct Answer: B
Rationale: When capacity is absent, the nurse must follow legal guidelines—using a designated
surrogate decision-maker or an advance directive to guide care.
10. Ethical dilemmas in nursing often arise when:
A. There is a clear-cut answer
B. Two or more ethical principles conflict
C. The patient is fully informed
D. Only one ethical principle is applicable
Correct Answer: B
Rationale: Ethical dilemmas occur when principles such as autonomy and beneficence conflict,
requiring careful balance and ethical reasoning.
, 11. In the context of ethics, “moral distress” in nursing occurs when:
A. A nurse disagrees with hospital policy
B. A nurse is unable to act according to what they believe is ethically correct due to external
constraints
C. A nurse makes an error in documentation
D. A nurse follows all ethical guidelines
Correct Answer: B
Rationale: Moral distress is experienced when a nurse knows the right action to take but is
prevented from taking it due to institutional or other constraints.
12. Which of the following is a tool often used to guide ethical decision-making in nursing?
A. SWOT analysis
B. The Four-Box Method
C. The Maslow Hierarchy
D. The Nursing Process only
Correct Answer: B
Rationale: The Four-Box Method (or similar ethical decision-making models) helps nurses
analyze ethical dilemmas by considering medical indications, patient preferences, quality of life,
and contextual features.
13. When considering informed consent, which of the following is essential?
A. The patient must be coerced to consent
B. The patient must receive adequate information and have the capacity to understand it
C. Consent is only required for surgical procedures
D. Consent is optional if the patient trusts the nurse
Correct Answer: B
Rationale: Informed consent requires that the patient understands the risks, benefits, and
alternatives of a procedure and has the capacity to make an informed decision.
14. In a scenario where a patient’s family disagrees with the patient’s expressed wishes, the nurse
should:
A. Immediately follow the family’s wishes
B. Respect the patient’s autonomy if the patient is competent
C. Ignore the patient’s wishes
D. Call the police
Correct Answer: B
Rationale: When a competent patient expresses clear wishes, those wishes take precedence
over family opinions in ethical practice.
15. Which ethical principle supports a nurse’s duty to protect vulnerable patients?
A. Autonomy
B. Justice
C. Beneficence
D. Non-maleficence
Correct Answer: D
