1
HESI Exit Exam Prep: Ethical
Decision-Making & Patient
Advocacy in Nursing
Table of Contents
Subtopic 1: Principles of Nursing Ethics in Clinical Practice.............................2
Subtopic 2: Informed Consent, Capacity, and Decision-Making Authority.....10
Subtopic 3: End-of-Life Care, Advance Directives, and Palliative Ethics.........19
Subtopic 4: Confidentiality, HIPAA Compliance, and Ethical Information
Handling.........................................................................................................27
Subtopic 5: Ethical Issues in Cultural Competence and Diversity in Care......36
Subtopic 6: Informed Consent, Autonomy, and Decision-Making Ethics........44
Subtopic 7: Legal Liability and Professional Boundaries in Advocacy............52
Subtopic 8: Culturally Competent Advocacy and Ethical Inclusion................61
Subtopic 9: Institutional Ethics and Systems-Level Advocacy.......................70
Subtopic 10: Global Ethics and Advocacy in Disaster, Crisis, and Public Health
Nursing..........................................................................................................78
, 2
Subtopic 1: Principles of Nursing Ethics in
Clinical Practice
(Questions 1–20)
Question 1:
A nurse refuses to administer a placebo to a patient without the patient’s
consent, stating it violates the ethical principle of:
A. Beneficence
B. Autonomy
C. Nonmaleficence
D. Veracity
Correct answer: B. Autonomy
Rationale: Respect for autonomy means honoring the patient's right to make
informed decisions about their care. Giving a placebo without consent denies
that right.
Question 2:
Which of the following best demonstrates the principle of beneficence in
nursing practice?
A. Keeping a terminal diagnosis from the patient
B. Providing pain medication promptly
C. Refusing to treat a patient due to past behavior
D. Avoiding discussion of risks during informed consent
Correct answer: B. Providing pain medication promptly
, 3
Rationale: Beneficence refers to actions that promote the well-being of
others. Relieving pain is a direct action to promote a patient's welfare.
Question 3:
The nurse advocates for a patient who refuses chemotherapy despite family
pressure. This action supports which ethical principle?
A. Fidelity
B. Nonmaleficence
C. Justice
D. Autonomy
Correct answer: D. Autonomy
Rationale: Advocacy for the patient’s right to choose reflects respect for
autonomy, even if others disagree.
Question 4:
A nurse documents a medication error she made and immediately reports it.
This reflects which ethical principle?
A. Veracity
B. Justice
C. Autonomy
D. Beneficence
Correct answer: A. Veracity
Rationale: Veracity involves truthfulness and honesty in interactions with
patients and documentation.
Question 5:
, 4
Which scenario best reflects the principle of justice in nursing?
A. Spending more time with polite patients
B. Offering information only when asked
C. Treating patients equally regardless of socioeconomic status
D. Allowing certain patients to skip the queue
Correct answer: C. Treating patients equally regardless of socioeconomic
status
Rationale: Justice requires fair and equal treatment for all patients.
Question 6:
A nurse refuses to participate in an abortion procedure due to personal
beliefs. What principle allows this?
A. Justice
B. Moral integrity/conscientious objection
C. Veracity
D. Paternalism
Correct answer: B. Moral integrity/conscientious objection
Rationale: Nurses have the right to refuse care that conflicts with deeply held
ethical or moral beliefs, provided patient care is not compromised.
Question 7:
A nurse notices a colleague falsifying documentation. What is the ethical
obligation?
A. Ignore it
B. Report it to the nurse manager
C. Warn the colleague privately
HESI Exit Exam Prep: Ethical
Decision-Making & Patient
Advocacy in Nursing
Table of Contents
Subtopic 1: Principles of Nursing Ethics in Clinical Practice.............................2
Subtopic 2: Informed Consent, Capacity, and Decision-Making Authority.....10
Subtopic 3: End-of-Life Care, Advance Directives, and Palliative Ethics.........19
Subtopic 4: Confidentiality, HIPAA Compliance, and Ethical Information
Handling.........................................................................................................27
Subtopic 5: Ethical Issues in Cultural Competence and Diversity in Care......36
Subtopic 6: Informed Consent, Autonomy, and Decision-Making Ethics........44
Subtopic 7: Legal Liability and Professional Boundaries in Advocacy............52
Subtopic 8: Culturally Competent Advocacy and Ethical Inclusion................61
Subtopic 9: Institutional Ethics and Systems-Level Advocacy.......................70
Subtopic 10: Global Ethics and Advocacy in Disaster, Crisis, and Public Health
Nursing..........................................................................................................78
, 2
Subtopic 1: Principles of Nursing Ethics in
Clinical Practice
(Questions 1–20)
Question 1:
A nurse refuses to administer a placebo to a patient without the patient’s
consent, stating it violates the ethical principle of:
A. Beneficence
B. Autonomy
C. Nonmaleficence
D. Veracity
Correct answer: B. Autonomy
Rationale: Respect for autonomy means honoring the patient's right to make
informed decisions about their care. Giving a placebo without consent denies
that right.
Question 2:
Which of the following best demonstrates the principle of beneficence in
nursing practice?
A. Keeping a terminal diagnosis from the patient
B. Providing pain medication promptly
C. Refusing to treat a patient due to past behavior
D. Avoiding discussion of risks during informed consent
Correct answer: B. Providing pain medication promptly
, 3
Rationale: Beneficence refers to actions that promote the well-being of
others. Relieving pain is a direct action to promote a patient's welfare.
Question 3:
The nurse advocates for a patient who refuses chemotherapy despite family
pressure. This action supports which ethical principle?
A. Fidelity
B. Nonmaleficence
C. Justice
D. Autonomy
Correct answer: D. Autonomy
Rationale: Advocacy for the patient’s right to choose reflects respect for
autonomy, even if others disagree.
Question 4:
A nurse documents a medication error she made and immediately reports it.
This reflects which ethical principle?
A. Veracity
B. Justice
C. Autonomy
D. Beneficence
Correct answer: A. Veracity
Rationale: Veracity involves truthfulness and honesty in interactions with
patients and documentation.
Question 5:
, 4
Which scenario best reflects the principle of justice in nursing?
A. Spending more time with polite patients
B. Offering information only when asked
C. Treating patients equally regardless of socioeconomic status
D. Allowing certain patients to skip the queue
Correct answer: C. Treating patients equally regardless of socioeconomic
status
Rationale: Justice requires fair and equal treatment for all patients.
Question 6:
A nurse refuses to participate in an abortion procedure due to personal
beliefs. What principle allows this?
A. Justice
B. Moral integrity/conscientious objection
C. Veracity
D. Paternalism
Correct answer: B. Moral integrity/conscientious objection
Rationale: Nurses have the right to refuse care that conflicts with deeply held
ethical or moral beliefs, provided patient care is not compromised.
Question 7:
A nurse notices a colleague falsifying documentation. What is the ethical
obligation?
A. Ignore it
B. Report it to the nurse manager
C. Warn the colleague privately
