,BRUNNER & SUDDARTH'S MEDICAL-SURGICAL NURSING, 15TH EDITION
Chapter 1: Professional Nursing Practice
15 Questions with Answers and Detailed Rationales
1. A nurse has been offered a position on an obstetric unit and has learned that the
unit offers therapeutic abortions, a procedure that contradicts the nurse's personal
beliefs. What is the nurse's ethical obligation to these clients?
A) The nurse should adhere to professional standards of practice and offer service to these
clients.
B) The nurse should make the choice to decline this position and pursue a different nursing
role.
C) The nurse should decline to care for the clients considering abortion.
D) The nurse should express alternatives to women considering terminating their
pregnancy.
Answer: B
Rationale: To avoid facing the ethical dilemma of providing care that contradicts the
nurse's personal beliefs, the nurse should consider working in an area of nursing that
would not pose this dilemma. The nurse should not provide care to the client because it is a
conflict of personal values. The nurse should not deny care to these clients as this would be
a breach in the Code of Ethics for nurses. If the client is not requesting information for
alternatives to abortions, then the nurse should not be providing this information .
Cognitive Level: Analyzing
NCLEX Category: Safe Effective Care Environment
Nursing Process: Implementation
Priority Concept: Ethics
,2. An 80-year-old client is admitted with a diagnosis of community-acquired
pneumonia. During admission the client states, "I have a living will." What
implication of this should the nurse recognize?
A) This document is always honored, regardless of circumstances.
B) This document specifies the client's wishes before hospitalization.
C) This document is binding for the duration of the client's life.
D) This document has been drawn up by the client's family to determine DNR status.
Answer: B
Rationale: A living will is one type of advance directive. In most situations, living wills are
limited to situations in which the client's medical condition is deemed terminal. The other
answers are incorrect because living wills are not always honored in every circumstance,
they are not binding for the duration of the client's life, and they are not drawn up by the
client's family .
Cognitive Level: Understanding
NCLEX Category: Safe Effective Care Environment
Nursing Process: Assessment
Priority Concept: Legal
3. A nurse has been providing ethical care for many years and is aware of the need to
maintain the ethical principle of nonmaleficence. Which of the following actions
would be considered a violation of this principle?
A) Discussing a DNR order with a terminally ill client
B) Assisting a semi-independent client with ADLs
C) Refusing to administer pain medication as prescribed
D) Providing more care for one client than for another
Answer: C
Rationale: The duty not to inflict as well as prevent and remove harm is termed
nonmaleficence. Refusing to administer pain medication as prescribed would cause harm
to the client. Discussing a DNR order with a terminally ill client and assisting a client with
, ADLs would not be considered contradictions to the nurse's duty of nonmaleficence. Some
clients justifiably require more care than others .
Cognitive Level: Applying
NCLEX Category: Safe Effective Care Environment
Nursing Process: Implementation
Priority Concept: Ethics
4. A nurse is caring for a client who has just been diagnosed with terminal cancer.
The client states, "I don't want any life-sustaining treatment. I just want to be
comfortable." Which action by the nurse is most appropriate?
A) Explain that the client must discuss this with family members first
B) Document the client's wishes and notify the healthcare provider
C) Encourage the client to continue treatment "just in case"
D) Tell the client that it's too early to make such decisions
Answer: B
Rationale: The nurse's role includes advocating for client autonomy and ensuring that the
client's wishes are documented and communicated to the healthcare team. Documenting
the client's wishes and notifying the provider respects the client's right to self-
determination (autonomy). The nurse should not dismiss the client's wishes or require
family approval for end-of-life decisions .
Cognitive Level: Applying
NCLEX Category: Safe Effective Care Environment
Nursing Process: Implementation
Priority Concept: Ethics; Advocacy
5. A client tells the nurse, "I don't want my family to know I have HIV." Which
response by the nurse is most appropriate?
A) "Your family has a right to know for their own safety."
B) "I will document your request and ensure your confidentiality."
Chapter 1: Professional Nursing Practice
15 Questions with Answers and Detailed Rationales
1. A nurse has been offered a position on an obstetric unit and has learned that the
unit offers therapeutic abortions, a procedure that contradicts the nurse's personal
beliefs. What is the nurse's ethical obligation to these clients?
A) The nurse should adhere to professional standards of practice and offer service to these
clients.
B) The nurse should make the choice to decline this position and pursue a different nursing
role.
C) The nurse should decline to care for the clients considering abortion.
D) The nurse should express alternatives to women considering terminating their
pregnancy.
Answer: B
Rationale: To avoid facing the ethical dilemma of providing care that contradicts the
nurse's personal beliefs, the nurse should consider working in an area of nursing that
would not pose this dilemma. The nurse should not provide care to the client because it is a
conflict of personal values. The nurse should not deny care to these clients as this would be
a breach in the Code of Ethics for nurses. If the client is not requesting information for
alternatives to abortions, then the nurse should not be providing this information .
Cognitive Level: Analyzing
NCLEX Category: Safe Effective Care Environment
Nursing Process: Implementation
Priority Concept: Ethics
,2. An 80-year-old client is admitted with a diagnosis of community-acquired
pneumonia. During admission the client states, "I have a living will." What
implication of this should the nurse recognize?
A) This document is always honored, regardless of circumstances.
B) This document specifies the client's wishes before hospitalization.
C) This document is binding for the duration of the client's life.
D) This document has been drawn up by the client's family to determine DNR status.
Answer: B
Rationale: A living will is one type of advance directive. In most situations, living wills are
limited to situations in which the client's medical condition is deemed terminal. The other
answers are incorrect because living wills are not always honored in every circumstance,
they are not binding for the duration of the client's life, and they are not drawn up by the
client's family .
Cognitive Level: Understanding
NCLEX Category: Safe Effective Care Environment
Nursing Process: Assessment
Priority Concept: Legal
3. A nurse has been providing ethical care for many years and is aware of the need to
maintain the ethical principle of nonmaleficence. Which of the following actions
would be considered a violation of this principle?
A) Discussing a DNR order with a terminally ill client
B) Assisting a semi-independent client with ADLs
C) Refusing to administer pain medication as prescribed
D) Providing more care for one client than for another
Answer: C
Rationale: The duty not to inflict as well as prevent and remove harm is termed
nonmaleficence. Refusing to administer pain medication as prescribed would cause harm
to the client. Discussing a DNR order with a terminally ill client and assisting a client with
, ADLs would not be considered contradictions to the nurse's duty of nonmaleficence. Some
clients justifiably require more care than others .
Cognitive Level: Applying
NCLEX Category: Safe Effective Care Environment
Nursing Process: Implementation
Priority Concept: Ethics
4. A nurse is caring for a client who has just been diagnosed with terminal cancer.
The client states, "I don't want any life-sustaining treatment. I just want to be
comfortable." Which action by the nurse is most appropriate?
A) Explain that the client must discuss this with family members first
B) Document the client's wishes and notify the healthcare provider
C) Encourage the client to continue treatment "just in case"
D) Tell the client that it's too early to make such decisions
Answer: B
Rationale: The nurse's role includes advocating for client autonomy and ensuring that the
client's wishes are documented and communicated to the healthcare team. Documenting
the client's wishes and notifying the provider respects the client's right to self-
determination (autonomy). The nurse should not dismiss the client's wishes or require
family approval for end-of-life decisions .
Cognitive Level: Applying
NCLEX Category: Safe Effective Care Environment
Nursing Process: Implementation
Priority Concept: Ethics; Advocacy
5. A client tells the nurse, "I don't want my family to know I have HIV." Which
response by the nurse is most appropriate?
A) "Your family has a right to know for their own safety."
B) "I will document your request and ensure your confidentiality."
