Nursing Capstone Comprehensive Pre-Test Exam 2026/2027
Complete Questions & Verified Answers | NCLEX-RN® Readiness Assessment
Aligned with the 2026–2027 NCSBN NCLEX-RN® Test Plan and Capstone Course Competencies
Total Questions: 150 • Sections: 9 • Suggested Time: 180 minutes • Format: Single-Best-Answer Multiple Choice + Extended
NGN Case Studies
Instructions: Select the single best answer for each question (Q1–Q145). For NGN clinical judgment items (Q146–Q150),
apply the NCSBN Clinical Judgment Measurement Model (Recognize Cues → Analyze Cues → Prioritize Hypotheses →
Generate Solutions → Take Action → Evaluate Outcomes). Each question includes a verified answer and rationale
grounded in current evidence-based nursing practice, prioritization frameworks (ABC, Maslow, Safety, Least Restrictive),
and pharmacological and physiological principles. The correct answer is marked [CORRECT].
Section 1: Management of Care
Safe and Effective Care Environment — Advocacy, Delegation, Supervision, Ethics, Legal Issues, Client Rights, Advance
Directives, HIPAA, & Interdisciplinary Collaboration (Q1–Q25)
Q1. A registered nurse (RN) on a medical-surgical unit is caring for four clients. Which client should the RN assign
to a licensed practical nurse/licensed vocational nurse (LPN/LVN)?
A. A client who was admitted 2 hours ago with acute GI bleeding and requires continuous hemodynamic
monitoring
B. A stable client with a chronic pressure injury requiring wound packing and sterile dressing change
[CORRECT]
C. A client receiving their first unit of packed red blood cells for symptomatic anemia
D. A newly admitted client with suspected sepsis who needs initial assessment and IV antibiotic titration
Correct Answer: B
Rationale: Assignment must match the LPN/LVN scope of practice, which includes caring for stable clients with
predictable outcomes and performing established procedures such as sterile dressing changes. The client in option B is
stable with a chronic wound requiring routine care within LPN competency. Options A, C, and D involve unstable clients,
complex assessments, blood product administration, and rapid clinical deterioration requiring RN-level clinical judgment.
The Five Rights of Delegation (right task, right circumstance, right person, right direction/communication, right
supervision) mandate that RNs retain clients with high acuity, complex care needs, and unpredictable trajectories.
Q2. The RN delegates morning vital signs to unlicensed assistive personnel (UAP). Which statement by the RN
reflects appropriate delegation and supervision?
A. Take all vital signs on the unit; report any systolic blood pressure less than 90 mmHg or heart rate
greater than 120 immediately. [CORRECT]
B. Take vital signs on every client and write them in the chart; I will review them later this afternoon.
C. Take vital signs on assigned clients and use your best judgment about what to report to me.
D. Take vital signs only on stable clients; skip any client who looks ill and tell me at the end of shift.
Correct Answer: A
Rationale: Effective delegation to UAP requires clear, specific directions including the task, expected parameters, and
explicit reporting criteria. Option A provides specific numeric thresholds for immediate reporting, ensuring timely
identification of clinical deterioration. Vague direction (option C) places inappropriate clinical judgment burden on UAP,
deferred review (option B) delays intervention for unstable clients, and skipping unstable clients (option D) violates the
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,Nursing Capstone Comprehensive Pre-Test Exam 2026/2027 | NCLEX-RN Readiness Assessment
supervisory duty. The RN retains accountability for client outcomes and must define explicit feedback parameters when
delegating measurement tasks.
Q3. A nurse overhears a colleague discussing a client's diagnosis in a hospital elevator with another staff member.
Which action by the nurse is most appropriate?
A. Report the colleague to the state board of nursing immediately for license revocation.
B. Privately remind the colleague that discussing client information in public areas violates HIPAA and
may compromise client confidentiality. [CORRECT]
C. File an incident report but do not confront the colleague to avoid interpersonal conflict.
D. Ignore the conversation because the colleague did not use the client's full name.
Correct Answer: B
Rationale: Discussing protected health information (PHI) in public areas such as elevators, hallways, or cafeterias violates
the HIPAA Privacy Rule regardless of whether the client is named. The nurse's professional obligation is to address the
breach directly through a private, respectful reminder to the colleague, which often resolves the issue and reinforces unit
culture. Reporting to the state board (option A) is disproportionate for a first occurrence and bypasses internal resolution.
Filing an incident report without addressing the colleague (option C) misses the teachable moment, and ignoring the
violation (option D) makes the nurse complicit in the breach.
Q4. A client scheduled for an elective cholecystectomy tells the preoperative nurse, 'I'm not sure I want to sign this
form because the doctor didn't really explain what they're going to do.' What is the nurse's best response?
A. Sign the form now so the surgery isn't delayed; the surgeon will explain everything in the operating room.
B. I'll notify the surgeon so they can return and discuss the procedure with you before you sign the
consent. [CORRECT]
C. It's normal to feel anxious; let me give you something to help you relax before signing.
D. You signed a general consent at admission, so this form is just a formality and can be signed later.
Correct Answer: B
Rationale: Informed consent requires that the client understands the procedure, risks, benefits, and alternatives, and that
consent is given voluntarily without coercion. The nurse's role is to advocate for the client by ensuring the provider has
fulfilled this obligation; if the client reports inadequate explanation, the nurse must notify the surgeon to return and clarify
before consent is obtained. Coercing the client to sign (option A), administering sedation before consent (option C), or
treating the form as a formality (option D) all violate the legal and ethical principles of informed consent and would render
the consent invalid.
Q5. A client with a do-not-resuscitate (DNR) order is unresponsive and pulseless. A newly hired nurse begins chest
compressions. What should the charge nurse do?
A. Allow the resuscitation to continue because once started it cannot be stopped.
B. Immediately stop the resuscitation effort and clarify the DNR order with the new nurse. [CORRECT]
C. Continue compressions until the healthcare provider arrives to confirm the DNR.
D. Ask the family to decide whether to continue resuscitation efforts.
Correct Answer: B
Rationale: A valid DNR order must be honored immediately and overrides default resuscitation. The charge nurse must
intervene to stop the resuscitation, ensure the new nurse understands the order, and provide education about the unit's
DNR protocol. Continuing resuscitation (options A and C) violates the client's documented wishes and advance directive.
Deferring to family (option D) is inappropriate because the written DNR is the legally binding directive; family cannot
override a competent client's documented decision unless the client has designated a surrogate and the order is being
questioned.
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,Nursing Capstone Comprehensive Pre-Test Exam 2026/2027 | NCLEX-RN Readiness Assessment
Q6. An older adult client tells the nurse, 'My son wants me to move into a nursing home, but I want to stay in my
own apartment.' The client is oriented and demonstrates sound decision-making ability. What is the nurse's best
advocacy action?
A. Encourage the client to comply with the son's wishes because family input should be respected.
B. Support the client's autonomy by exploring community resources that enable safe independent living.
[CORRECT]
C. Contact adult protective services to investigate the son for potential elder abuse.
D. Recommend a cognitive capacity evaluation before allowing the client to make this decision.
Correct Answer: B
Rationale: The ethical principle of autonomy holds that competent adults have the right to make their own decisions about
living arrangements, health care, and lifestyle. The nurse's role as advocate is to support the client's expressed wishes by
connecting them with resources such as home health, meal delivery, fall-prevention programs, and emergency response
systems that enable safe aging in place. Overriding the client's wishes (option A) violates autonomy, escalating to APS
without evidence of abuse (option C) is unwarranted, and requiring capacity evaluation (option D) is inappropriate absent
cognitive impairment.
Q7. A school nurse notes patterned bruises and cigarette burns on a 7-year-old client. The child says, 'Mommy got
really mad when I spilled juice.' What is the nurse's priority action?
A. Interview the mother to obtain her explanation before taking any further action.
B. Document findings, ensure the child's immediate safety, and report suspected child abuse to child
protective services per state law. [CORRECT]
C. Wait to see if the child returns with additional injuries before reporting.
D. Counsel the mother on appropriate discipline techniques and provide parenting resources.
Correct Answer: B
Rationale: Nurses are mandated reporters of suspected child abuse in all 50 states; reporting is required when there is
reasonable suspicion, not when abuse is proven. Patterned injuries, cigarette burns, and a history inconsistent with the
injury pattern raise immediate concern. The priority is to ensure the child's safety, document objectively, and report to
child protective services or law enforcement per state statute. Confronting the caregiver first (option A) may endanger the
child or prompt flight, waiting for additional injuries (option C) places the child at further risk, and counseling without
reporting (option D) fails the legal mandate.
Q8. A competent adult client diagnosed with terminal cancer refuses a blood transfusion recommended by the
healthcare provider, citing religious beliefs. Which action by the nurse demonstrates ethical practice?
A. Administer the transfusion because the client's life is in danger and the provider ordered it.
B. Respect the client's refusal, document the decision, and notify the healthcare provider of the client's
choice. [CORRECT]
C. Obtain a court order to override the refusal because the client is terminal.
D. Have the family sign a consent form so the transfusion can be given against the client's wishes.
Correct Answer: B
Rationale: A competent adult client has the legal and ethical right to refuse any treatment, including life-sustaining
interventions, based on autonomy and informed refusal. Religious refusal of blood products, such as by Jehovah's
Witnesses, must be honored even when the consequence is death. The nurse documents the refusal, ensures the client
understands the consequences, notifies the provider, and continues to provide alternative care. Forcing treatment (option
A), seeking a court order for a competent adult (option C), or using family to override the client (option D) constitute
battery and violate autonomy.
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, Nursing Capstone Comprehensive Pre-Test Exam 2026/2027 | NCLEX-RN Readiness Assessment
Q9. A nurse on a telemetry unit needs to report a critical potassium value of 6.8 mEq/L to the on-call provider.
Which SBAR communication is most appropriate?
A. Hi, this is Sam from the telemetry unit. I have a client with a high potassium level, and I think we need to do
something about it.
B. Hello, Dr. Patel, this is Sam RN on 5 West calling about Mr. Lee in room 412. I am calling because his
serum potassium just resulted at 6.8 mEq/L. The client is reporting muscle weakness and has peaked T
waves on the cardiac monitor. I recommend we obtain a 12-lead ECG, administer calcium gluconate to
stabilize the myocardium, and treat with insulin and dextrose. Are you available to come evaluate?
[CORRECT]
C. Dr. Patel, I have a critical lab. Please call me back as soon as possible so we can decide what to do.
D. Hello Dr. Patel, this is Sam. Mr. Lee's potassium is 6.8. What do you want me to do?
Correct Answer: B
Rationale: SBAR (Situation, Background, Assessment, Recommendation) is the standardized handoff communication tool
endorsed by The Joint Commission to ensure complete, structured, and efficient communication. Option B demonstrates
each component: identifies the nurse and client (S), explains why the call is being made with the critical value (B), provides
the clinical assessment with symptoms and ECG changes (A), and offers a specific evidence-based recommendation while
inviting provider input (R). The other options lack critical information, omit assessment data, or fail to offer a
recommendation, increasing the risk of communication failure and delayed treatment.
Q10. A charge nurse on a medical unit receives four admissions simultaneously. Using the ABC priority framework,
which client should the RN assess first?
A. A client with COPD and an SpO2 of 88% on room air, reporting increased dyspnea. [CORRECT]
B. A client with a femoral fracture and a blood pressure of 100/70 mmHg.
C. A client admitted with vomiting and a temperature of 38.5 degrees Celsius (101.3 degrees Fahrenheit).
D. A client with new-onset confusion and a blood glucose of 60 mg/dL.
Correct Answer: A
Rationale: The ABC framework (Airway, Breathing, Circulation) establishes that respiratory compromise is the highest
priority because hypoxemia threatens organ viability within minutes. Option A demonstrates both airway/breathing
compromise (SpO2 88%, dyspnea) in a client with underlying COPD, requiring immediate assessment and intervention.
Option B represents circulatory concern but is not yet in shock; option C is an infection; option D is hypoglycemia
requiring treatment but is less immediately life-threatening than respiratory failure. The nurse must address the client most
at risk of rapid clinical deterioration first.
Q11. A nurse is caring for a client whose family insists on withholding a terminal diagnosis from the client. The
client repeatedly asks the nurse, 'What is wrong with me?' What is the most ethical response?
A. Tell the client the diagnosis because they have a right to know.
B. Acknowledge the client's concern and facilitate a discussion between the client, family, and provider
about how much information the client wishes to receive. [CORRECT]
C. Defer the question by saying, 'Your family doesn't want me to discuss that with you.'
D. Tell the client they are fine and will be discharged soon.
Correct Answer: B
Rationale: Ethical practice requires balancing the client's right to information with cultural and family dynamics. The
nurse should not unilaterally disclose the diagnosis (option A) without exploring the client's wishes, nor lie (option D) or
shift responsibility to the family (option C). Facilitating a structured conversation with the client, family, and provider
honors the client's autonomy, explores cultural context, and supports the principle of truth-telling while allowing the client
to determine how much information they want. This approach respects the ethical principles of autonomy, beneficence, and
nonmaleficence.
Page 4
Complete Questions & Verified Answers | NCLEX-RN® Readiness Assessment
Aligned with the 2026–2027 NCSBN NCLEX-RN® Test Plan and Capstone Course Competencies
Total Questions: 150 • Sections: 9 • Suggested Time: 180 minutes • Format: Single-Best-Answer Multiple Choice + Extended
NGN Case Studies
Instructions: Select the single best answer for each question (Q1–Q145). For NGN clinical judgment items (Q146–Q150),
apply the NCSBN Clinical Judgment Measurement Model (Recognize Cues → Analyze Cues → Prioritize Hypotheses →
Generate Solutions → Take Action → Evaluate Outcomes). Each question includes a verified answer and rationale
grounded in current evidence-based nursing practice, prioritization frameworks (ABC, Maslow, Safety, Least Restrictive),
and pharmacological and physiological principles. The correct answer is marked [CORRECT].
Section 1: Management of Care
Safe and Effective Care Environment — Advocacy, Delegation, Supervision, Ethics, Legal Issues, Client Rights, Advance
Directives, HIPAA, & Interdisciplinary Collaboration (Q1–Q25)
Q1. A registered nurse (RN) on a medical-surgical unit is caring for four clients. Which client should the RN assign
to a licensed practical nurse/licensed vocational nurse (LPN/LVN)?
A. A client who was admitted 2 hours ago with acute GI bleeding and requires continuous hemodynamic
monitoring
B. A stable client with a chronic pressure injury requiring wound packing and sterile dressing change
[CORRECT]
C. A client receiving their first unit of packed red blood cells for symptomatic anemia
D. A newly admitted client with suspected sepsis who needs initial assessment and IV antibiotic titration
Correct Answer: B
Rationale: Assignment must match the LPN/LVN scope of practice, which includes caring for stable clients with
predictable outcomes and performing established procedures such as sterile dressing changes. The client in option B is
stable with a chronic wound requiring routine care within LPN competency. Options A, C, and D involve unstable clients,
complex assessments, blood product administration, and rapid clinical deterioration requiring RN-level clinical judgment.
The Five Rights of Delegation (right task, right circumstance, right person, right direction/communication, right
supervision) mandate that RNs retain clients with high acuity, complex care needs, and unpredictable trajectories.
Q2. The RN delegates morning vital signs to unlicensed assistive personnel (UAP). Which statement by the RN
reflects appropriate delegation and supervision?
A. Take all vital signs on the unit; report any systolic blood pressure less than 90 mmHg or heart rate
greater than 120 immediately. [CORRECT]
B. Take vital signs on every client and write them in the chart; I will review them later this afternoon.
C. Take vital signs on assigned clients and use your best judgment about what to report to me.
D. Take vital signs only on stable clients; skip any client who looks ill and tell me at the end of shift.
Correct Answer: A
Rationale: Effective delegation to UAP requires clear, specific directions including the task, expected parameters, and
explicit reporting criteria. Option A provides specific numeric thresholds for immediate reporting, ensuring timely
identification of clinical deterioration. Vague direction (option C) places inappropriate clinical judgment burden on UAP,
deferred review (option B) delays intervention for unstable clients, and skipping unstable clients (option D) violates the
Page 1
,Nursing Capstone Comprehensive Pre-Test Exam 2026/2027 | NCLEX-RN Readiness Assessment
supervisory duty. The RN retains accountability for client outcomes and must define explicit feedback parameters when
delegating measurement tasks.
Q3. A nurse overhears a colleague discussing a client's diagnosis in a hospital elevator with another staff member.
Which action by the nurse is most appropriate?
A. Report the colleague to the state board of nursing immediately for license revocation.
B. Privately remind the colleague that discussing client information in public areas violates HIPAA and
may compromise client confidentiality. [CORRECT]
C. File an incident report but do not confront the colleague to avoid interpersonal conflict.
D. Ignore the conversation because the colleague did not use the client's full name.
Correct Answer: B
Rationale: Discussing protected health information (PHI) in public areas such as elevators, hallways, or cafeterias violates
the HIPAA Privacy Rule regardless of whether the client is named. The nurse's professional obligation is to address the
breach directly through a private, respectful reminder to the colleague, which often resolves the issue and reinforces unit
culture. Reporting to the state board (option A) is disproportionate for a first occurrence and bypasses internal resolution.
Filing an incident report without addressing the colleague (option C) misses the teachable moment, and ignoring the
violation (option D) makes the nurse complicit in the breach.
Q4. A client scheduled for an elective cholecystectomy tells the preoperative nurse, 'I'm not sure I want to sign this
form because the doctor didn't really explain what they're going to do.' What is the nurse's best response?
A. Sign the form now so the surgery isn't delayed; the surgeon will explain everything in the operating room.
B. I'll notify the surgeon so they can return and discuss the procedure with you before you sign the
consent. [CORRECT]
C. It's normal to feel anxious; let me give you something to help you relax before signing.
D. You signed a general consent at admission, so this form is just a formality and can be signed later.
Correct Answer: B
Rationale: Informed consent requires that the client understands the procedure, risks, benefits, and alternatives, and that
consent is given voluntarily without coercion. The nurse's role is to advocate for the client by ensuring the provider has
fulfilled this obligation; if the client reports inadequate explanation, the nurse must notify the surgeon to return and clarify
before consent is obtained. Coercing the client to sign (option A), administering sedation before consent (option C), or
treating the form as a formality (option D) all violate the legal and ethical principles of informed consent and would render
the consent invalid.
Q5. A client with a do-not-resuscitate (DNR) order is unresponsive and pulseless. A newly hired nurse begins chest
compressions. What should the charge nurse do?
A. Allow the resuscitation to continue because once started it cannot be stopped.
B. Immediately stop the resuscitation effort and clarify the DNR order with the new nurse. [CORRECT]
C. Continue compressions until the healthcare provider arrives to confirm the DNR.
D. Ask the family to decide whether to continue resuscitation efforts.
Correct Answer: B
Rationale: A valid DNR order must be honored immediately and overrides default resuscitation. The charge nurse must
intervene to stop the resuscitation, ensure the new nurse understands the order, and provide education about the unit's
DNR protocol. Continuing resuscitation (options A and C) violates the client's documented wishes and advance directive.
Deferring to family (option D) is inappropriate because the written DNR is the legally binding directive; family cannot
override a competent client's documented decision unless the client has designated a surrogate and the order is being
questioned.
Page 2
,Nursing Capstone Comprehensive Pre-Test Exam 2026/2027 | NCLEX-RN Readiness Assessment
Q6. An older adult client tells the nurse, 'My son wants me to move into a nursing home, but I want to stay in my
own apartment.' The client is oriented and demonstrates sound decision-making ability. What is the nurse's best
advocacy action?
A. Encourage the client to comply with the son's wishes because family input should be respected.
B. Support the client's autonomy by exploring community resources that enable safe independent living.
[CORRECT]
C. Contact adult protective services to investigate the son for potential elder abuse.
D. Recommend a cognitive capacity evaluation before allowing the client to make this decision.
Correct Answer: B
Rationale: The ethical principle of autonomy holds that competent adults have the right to make their own decisions about
living arrangements, health care, and lifestyle. The nurse's role as advocate is to support the client's expressed wishes by
connecting them with resources such as home health, meal delivery, fall-prevention programs, and emergency response
systems that enable safe aging in place. Overriding the client's wishes (option A) violates autonomy, escalating to APS
without evidence of abuse (option C) is unwarranted, and requiring capacity evaluation (option D) is inappropriate absent
cognitive impairment.
Q7. A school nurse notes patterned bruises and cigarette burns on a 7-year-old client. The child says, 'Mommy got
really mad when I spilled juice.' What is the nurse's priority action?
A. Interview the mother to obtain her explanation before taking any further action.
B. Document findings, ensure the child's immediate safety, and report suspected child abuse to child
protective services per state law. [CORRECT]
C. Wait to see if the child returns with additional injuries before reporting.
D. Counsel the mother on appropriate discipline techniques and provide parenting resources.
Correct Answer: B
Rationale: Nurses are mandated reporters of suspected child abuse in all 50 states; reporting is required when there is
reasonable suspicion, not when abuse is proven. Patterned injuries, cigarette burns, and a history inconsistent with the
injury pattern raise immediate concern. The priority is to ensure the child's safety, document objectively, and report to
child protective services or law enforcement per state statute. Confronting the caregiver first (option A) may endanger the
child or prompt flight, waiting for additional injuries (option C) places the child at further risk, and counseling without
reporting (option D) fails the legal mandate.
Q8. A competent adult client diagnosed with terminal cancer refuses a blood transfusion recommended by the
healthcare provider, citing religious beliefs. Which action by the nurse demonstrates ethical practice?
A. Administer the transfusion because the client's life is in danger and the provider ordered it.
B. Respect the client's refusal, document the decision, and notify the healthcare provider of the client's
choice. [CORRECT]
C. Obtain a court order to override the refusal because the client is terminal.
D. Have the family sign a consent form so the transfusion can be given against the client's wishes.
Correct Answer: B
Rationale: A competent adult client has the legal and ethical right to refuse any treatment, including life-sustaining
interventions, based on autonomy and informed refusal. Religious refusal of blood products, such as by Jehovah's
Witnesses, must be honored even when the consequence is death. The nurse documents the refusal, ensures the client
understands the consequences, notifies the provider, and continues to provide alternative care. Forcing treatment (option
A), seeking a court order for a competent adult (option C), or using family to override the client (option D) constitute
battery and violate autonomy.
Page 3
, Nursing Capstone Comprehensive Pre-Test Exam 2026/2027 | NCLEX-RN Readiness Assessment
Q9. A nurse on a telemetry unit needs to report a critical potassium value of 6.8 mEq/L to the on-call provider.
Which SBAR communication is most appropriate?
A. Hi, this is Sam from the telemetry unit. I have a client with a high potassium level, and I think we need to do
something about it.
B. Hello, Dr. Patel, this is Sam RN on 5 West calling about Mr. Lee in room 412. I am calling because his
serum potassium just resulted at 6.8 mEq/L. The client is reporting muscle weakness and has peaked T
waves on the cardiac monitor. I recommend we obtain a 12-lead ECG, administer calcium gluconate to
stabilize the myocardium, and treat with insulin and dextrose. Are you available to come evaluate?
[CORRECT]
C. Dr. Patel, I have a critical lab. Please call me back as soon as possible so we can decide what to do.
D. Hello Dr. Patel, this is Sam. Mr. Lee's potassium is 6.8. What do you want me to do?
Correct Answer: B
Rationale: SBAR (Situation, Background, Assessment, Recommendation) is the standardized handoff communication tool
endorsed by The Joint Commission to ensure complete, structured, and efficient communication. Option B demonstrates
each component: identifies the nurse and client (S), explains why the call is being made with the critical value (B), provides
the clinical assessment with symptoms and ECG changes (A), and offers a specific evidence-based recommendation while
inviting provider input (R). The other options lack critical information, omit assessment data, or fail to offer a
recommendation, increasing the risk of communication failure and delayed treatment.
Q10. A charge nurse on a medical unit receives four admissions simultaneously. Using the ABC priority framework,
which client should the RN assess first?
A. A client with COPD and an SpO2 of 88% on room air, reporting increased dyspnea. [CORRECT]
B. A client with a femoral fracture and a blood pressure of 100/70 mmHg.
C. A client admitted with vomiting and a temperature of 38.5 degrees Celsius (101.3 degrees Fahrenheit).
D. A client with new-onset confusion and a blood glucose of 60 mg/dL.
Correct Answer: A
Rationale: The ABC framework (Airway, Breathing, Circulation) establishes that respiratory compromise is the highest
priority because hypoxemia threatens organ viability within minutes. Option A demonstrates both airway/breathing
compromise (SpO2 88%, dyspnea) in a client with underlying COPD, requiring immediate assessment and intervention.
Option B represents circulatory concern but is not yet in shock; option C is an infection; option D is hypoglycemia
requiring treatment but is less immediately life-threatening than respiratory failure. The nurse must address the client most
at risk of rapid clinical deterioration first.
Q11. A nurse is caring for a client whose family insists on withholding a terminal diagnosis from the client. The
client repeatedly asks the nurse, 'What is wrong with me?' What is the most ethical response?
A. Tell the client the diagnosis because they have a right to know.
B. Acknowledge the client's concern and facilitate a discussion between the client, family, and provider
about how much information the client wishes to receive. [CORRECT]
C. Defer the question by saying, 'Your family doesn't want me to discuss that with you.'
D. Tell the client they are fine and will be discharged soon.
Correct Answer: B
Rationale: Ethical practice requires balancing the client's right to information with cultural and family dynamics. The
nurse should not unilaterally disclose the diagnosis (option A) without exploring the client's wishes, nor lie (option D) or
shift responsibility to the family (option C). Facilitating a structured conversation with the client, family, and provider
honors the client's autonomy, explores cultural context, and supports the principle of truth-telling while allowing the client
to determine how much information they want. This approach respects the ethical principles of autonomy, beneficence, and
nonmaleficence.
Page 4
