NURSING ETHICS & PROFESSIONAL ISSUES
PRACTICE EXAM – 2026 UPDATED PACK
Comprehensive Ethical and Legal Practice
Examination
SECTION 1: BASIC ETHICAL PRINCIPLES
1. A nurse is caring for a patient who refuses a blood transfusion due to religious beliefs. The nurse's
actions should be guided by which ethical principle?
A) Beneficence
B) Autonomy
C) Nonmaleficence
D) Justice
Answer: B) Autonomy
Rationale: Autonomy respects the patient's right to make their own healthcare decisions, even if those
decisions conflict with medical advice. The nurse must respect the patient's religious beliefs and refusal
of treatment, while ensuring informed consent and exploring alternatives. The healthcare team cannot
override a competent patient's refusal.
2. A nurse discovers that a colleague is diverting narcotics for personal use. The nurse's ethical
obligation is to:
A) Ignore the situation to protect the colleague
B) Report the colleague to the nurse manager
C) Confront the colleague privately
D) Document the incident in the colleague's file
Answer: B) Report the colleague to the nurse manager
Rationale: Reporting unsafe or illegal practice is an ethical and professional obligation to protect patient
safety and uphold professional standards. The nurse should follow facility policy for reporting.
Confidentiality does not protect illegal acts. The nurse should not ignore the situation or handle it
informally.
,3. A patient asks the nurse to withhold information about a terminal diagnosis from their family. The
nurse should:
A) Respect the patient's wishes and maintain confidentiality
B) Inform the family despite the patient's wishes
C) Discuss the situation with the healthcare provider
D) Tell the patient they cannot withhold information
Answer: A) Respect the patient's wishes and maintain confidentiality
Rationale: Confidentiality is a fundamental ethical principle. The nurse must respect the patient's wishes
unless there is a legal or safety exception. The nurse should discuss the patient's concerns and support
them in sharing information if desired. The family should be encouraged to speak with the healthcare
provider.
4. The principle of beneficence requires the nurse to:
A) Do no harm
B) Act in the patient's best interest
C) Respect the patient's decisions
D) Ensure equitable care for all patients
Answer: B) Act in the patient's best interest
Rationale: Beneficence requires the nurse to actively promote the patient's well-being and act in their
best interest. Nonmaleficence (A) is "do no harm." Autonomy (C) respects patient decisions. Justice (D)
ensures equitable care. Beneficence guides the nurse to provide care that benefits the patient.
5. A nurse is caring for a patient who requires a procedure but has not been informed of the risks and
benefits. The nurse should:
A) Perform the procedure to avoid delaying care
B) Ensure informed consent is obtained before proceeding
C) Explain the procedure to the patient
D) Ask the family to consent for the patient
Answer: B) Ensure informed consent is obtained before proceeding
Rationale: Informed consent is a legal and ethical requirement. The healthcare provider is responsible for
obtaining consent, but the nurse can witness the consent and ensure the patient understands the
,information. The nurse should not proceed without consent. The patient has the right to know the risks,
benefits, and alternatives.
6. A nurse is caring for a patient who is being discharged. The patient asks for a copy of their medical
records. The nurse should:
A) Provide a copy of the records immediately
B) Explain that the patient has the right to access their records
C) Refuse to provide the records
D) Ask the healthcare provider for permission
Answer: B) Explain that the patient has the right to access their records
Rationale: Patients have the legal right to access their medical records under HIPAA. The nurse should
inform the patient of their right and guide them through the process (request in writing, facility policy).
The nurse should not deny access or provide records without following facility policy.
7. A nurse overhears two colleagues discussing a patient in the elevator. The nurse should:
A) Join the conversation
B) Remind the colleagues to maintain confidentiality
C) Report the colleagues to the manager
D) Ignore the conversation
Answer: B) Remind the colleagues to maintain confidentiality
Rationale: Discussing patient information in public areas is a breach of confidentiality. The nurse should
remind colleagues to maintain confidentiality and avoid discussing patient information in public. This is a
professional responsibility. Reporting may be needed if the behavior continues.
8. A patient tells the nurse that they plan to harm themselves after discharge. The nurse should:
A) Respect the patient's confidentiality
B) Notify the healthcare provider and implement safety measures
C) Promise to keep the information confidential
D) Ask the patient to reconsider
Answer: B) Notify the healthcare provider and implement safety measures
Rationale: When a patient threatens harm to self or others, confidentiality is outweighed by the duty to
protect. The nurse should notify the healthcare provider, implement safety measures, and ensure the
patient is not discharged without a safety plan. This is a legal and ethical duty.
, 9. A nurse is asked to participate in a research study involving patients. The nurse's ethical obligation
includes:
A) Ensuring patients are informed and consent is obtained
B) Participating without question
C) Refusing to participate in research
D) Recruiting patients for the study
Answer: A) Ensuring patients are informed and consent is obtained
Rationale: Research involving human subjects requires informed consent, Institutional Review Board
(IRB) approval, and protection of patient rights. The nurse should ensure patients are informed, consent
is obtained, and patient safety is prioritized. Refusing to participate is not necessarily an obligation.
10. A nurse witnesses a colleague making a medication error and not reporting it. The nurse should:
A) Report the error to the nurse manager
B) Ignore the error to avoid conflict
C) Confront the colleague privately
D) Document the incident in the colleague's file
Answer: A) Report the error to the nurse manager
Rationale: Reporting medication errors is essential for patient safety and quality improvement. The nurse
has an obligation to report the error to ensure patient safety and follow facility policy. The colleague
should be supported but held accountable. Patient safety is the priority.
SECTION 2: LEGAL ISSUES IN NURSING
11. A nurse is sued for malpractice. The elements of malpractice include:
A) Duty, breach of duty, causation, and damages
B) Negligence and breach of contract
C) Duty and breach of duty only
D) Harm to the patient only
Answer: A) Duty, breach of duty, causation, and damages
Rationale: The four elements of malpractice are: duty (the nurse owed a duty to the patient), breach of
duty (the nurse failed to meet the standard of care), causation (the breach caused the harm), and
damages (the patient suffered harm). All four elements must be proven for malpractice liability.
PRACTICE EXAM – 2026 UPDATED PACK
Comprehensive Ethical and Legal Practice
Examination
SECTION 1: BASIC ETHICAL PRINCIPLES
1. A nurse is caring for a patient who refuses a blood transfusion due to religious beliefs. The nurse's
actions should be guided by which ethical principle?
A) Beneficence
B) Autonomy
C) Nonmaleficence
D) Justice
Answer: B) Autonomy
Rationale: Autonomy respects the patient's right to make their own healthcare decisions, even if those
decisions conflict with medical advice. The nurse must respect the patient's religious beliefs and refusal
of treatment, while ensuring informed consent and exploring alternatives. The healthcare team cannot
override a competent patient's refusal.
2. A nurse discovers that a colleague is diverting narcotics for personal use. The nurse's ethical
obligation is to:
A) Ignore the situation to protect the colleague
B) Report the colleague to the nurse manager
C) Confront the colleague privately
D) Document the incident in the colleague's file
Answer: B) Report the colleague to the nurse manager
Rationale: Reporting unsafe or illegal practice is an ethical and professional obligation to protect patient
safety and uphold professional standards. The nurse should follow facility policy for reporting.
Confidentiality does not protect illegal acts. The nurse should not ignore the situation or handle it
informally.
,3. A patient asks the nurse to withhold information about a terminal diagnosis from their family. The
nurse should:
A) Respect the patient's wishes and maintain confidentiality
B) Inform the family despite the patient's wishes
C) Discuss the situation with the healthcare provider
D) Tell the patient they cannot withhold information
Answer: A) Respect the patient's wishes and maintain confidentiality
Rationale: Confidentiality is a fundamental ethical principle. The nurse must respect the patient's wishes
unless there is a legal or safety exception. The nurse should discuss the patient's concerns and support
them in sharing information if desired. The family should be encouraged to speak with the healthcare
provider.
4. The principle of beneficence requires the nurse to:
A) Do no harm
B) Act in the patient's best interest
C) Respect the patient's decisions
D) Ensure equitable care for all patients
Answer: B) Act in the patient's best interest
Rationale: Beneficence requires the nurse to actively promote the patient's well-being and act in their
best interest. Nonmaleficence (A) is "do no harm." Autonomy (C) respects patient decisions. Justice (D)
ensures equitable care. Beneficence guides the nurse to provide care that benefits the patient.
5. A nurse is caring for a patient who requires a procedure but has not been informed of the risks and
benefits. The nurse should:
A) Perform the procedure to avoid delaying care
B) Ensure informed consent is obtained before proceeding
C) Explain the procedure to the patient
D) Ask the family to consent for the patient
Answer: B) Ensure informed consent is obtained before proceeding
Rationale: Informed consent is a legal and ethical requirement. The healthcare provider is responsible for
obtaining consent, but the nurse can witness the consent and ensure the patient understands the
,information. The nurse should not proceed without consent. The patient has the right to know the risks,
benefits, and alternatives.
6. A nurse is caring for a patient who is being discharged. The patient asks for a copy of their medical
records. The nurse should:
A) Provide a copy of the records immediately
B) Explain that the patient has the right to access their records
C) Refuse to provide the records
D) Ask the healthcare provider for permission
Answer: B) Explain that the patient has the right to access their records
Rationale: Patients have the legal right to access their medical records under HIPAA. The nurse should
inform the patient of their right and guide them through the process (request in writing, facility policy).
The nurse should not deny access or provide records without following facility policy.
7. A nurse overhears two colleagues discussing a patient in the elevator. The nurse should:
A) Join the conversation
B) Remind the colleagues to maintain confidentiality
C) Report the colleagues to the manager
D) Ignore the conversation
Answer: B) Remind the colleagues to maintain confidentiality
Rationale: Discussing patient information in public areas is a breach of confidentiality. The nurse should
remind colleagues to maintain confidentiality and avoid discussing patient information in public. This is a
professional responsibility. Reporting may be needed if the behavior continues.
8. A patient tells the nurse that they plan to harm themselves after discharge. The nurse should:
A) Respect the patient's confidentiality
B) Notify the healthcare provider and implement safety measures
C) Promise to keep the information confidential
D) Ask the patient to reconsider
Answer: B) Notify the healthcare provider and implement safety measures
Rationale: When a patient threatens harm to self or others, confidentiality is outweighed by the duty to
protect. The nurse should notify the healthcare provider, implement safety measures, and ensure the
patient is not discharged without a safety plan. This is a legal and ethical duty.
, 9. A nurse is asked to participate in a research study involving patients. The nurse's ethical obligation
includes:
A) Ensuring patients are informed and consent is obtained
B) Participating without question
C) Refusing to participate in research
D) Recruiting patients for the study
Answer: A) Ensuring patients are informed and consent is obtained
Rationale: Research involving human subjects requires informed consent, Institutional Review Board
(IRB) approval, and protection of patient rights. The nurse should ensure patients are informed, consent
is obtained, and patient safety is prioritized. Refusing to participate is not necessarily an obligation.
10. A nurse witnesses a colleague making a medication error and not reporting it. The nurse should:
A) Report the error to the nurse manager
B) Ignore the error to avoid conflict
C) Confront the colleague privately
D) Document the incident in the colleague's file
Answer: A) Report the error to the nurse manager
Rationale: Reporting medication errors is essential for patient safety and quality improvement. The nurse
has an obligation to report the error to ensure patient safety and follow facility policy. The colleague
should be supported but held accountable. Patient safety is the priority.
SECTION 2: LEGAL ISSUES IN NURSING
11. A nurse is sued for malpractice. The elements of malpractice include:
A) Duty, breach of duty, causation, and damages
B) Negligence and breach of contract
C) Duty and breach of duty only
D) Harm to the patient only
Answer: A) Duty, breach of duty, causation, and damages
Rationale: The four elements of malpractice are: duty (the nurse owed a duty to the patient), breach of
duty (the nurse failed to meet the standard of care), causation (the breach caused the harm), and
damages (the patient suffered harm). All four elements must be proven for malpractice liability.
