HUM 301
Applied Ethics
Final Exam Review
(With Solutions)
2025
1. A hospital faces ventilator shortages during a pandemic. The
ethics committee must decide which patients receive mechanical
ventilation. Which ethical principle should primarily guide
allocation?
a. Autonomy
b. Justice
c. Fidelity
d. Nonmaleficence
ANS: b. Justice
Rationale: Justice demands fair distribution of scarce resources
based on consistent criteria rather than on social status or first-
come, first-served.
2. An unconscious patient has no advance directive on file. The on-
call nurse must obtain consent for an emergent procedure. Whose
decision-making standard applies?
a. Best-interest standard
b. Substituted-judgment standard
c. Assumed-consent standard
d. Utilitarian standard
ANS: a. Best-interest standard
Rationale: When patient preferences are unknown and no
surrogate is available, clinicians act according to what would
maximize benefit and minimize harm.
3. A nurse is ordered to administer a high dose of opioids for
comfort in a terminally ill patient. The nurse fears this may hasten
death. What doctrine protects the nurse legally and ethically?
a. Double effect
b. Maternal-fetal conflict
, c. Therapeutic privilege
d. DNR order
ANS: a. Double effect
Rationale: The doctrine of double effect permits an action that
has a good intention (pain relief) despite a foreseeable but
unintended harmful effect (possible life-shortening).
4. A patient refuses blood transfusion for religious reasons despite
life-threatening anemia. Which action aligns with ethical nursing
practice?
a. Override refusal to save life
b. Ensure refusal is informed and document it
c. Administer a reduced transfusion covertly
d. Discharge the patient immediately
ANS: b. Ensure refusal is informed and document it
Rationale: Respecting autonomy requires verifying capacity,
ensuring understanding of risks, and recording the patient’s
informed refusal.
5. A new RN observes that a colleague frequently enters patient
data into the EHR on behalf of others. Which ethical breach is most
likely occurring?
a. Beneficence
b. Veracity
c. Accountability
d. Confidentiality
ANS: c. Accountability
Rationale: Delegating charting to unassigned staff undermines
professional responsibility and accountability for the accuracy of
documentation.
6. A home care nurse uses a tablet to video-chat with patients.
Which step best protects patient privacy under HIPAA?
a. Use a public Wi-Fi network for convenience
b. Ensure end-to-end encryption on the telehealth platform
c. Record all sessions and upload to social media for transparency
d. Allow family members to share login credentials
ANS: b. Ensure end-to-end encryption on the telehealth
platform
Rationale: Encryption prevents unauthorized interception of
ePHI during transmission, maintaining confidentiality.
, 7. An RN is approached by a pharmaceutical rep offering expensive
gifts. According to professional ethics, what should the nurse do?
a. Accept the gift and thank the rep
b. Decline the gift and report the interaction
c. Accept gift but disclose in the patient record
d. Share the gift with patients for goodwill
ANS: b. Decline the gift and report the interaction
Rationale: Accepting gifts can create conflicts of interest;
professional standards require declining and documenting such
offers.
8. A nurse researcher proposes a study involving hospitalized
elderly patients who may lack full capacity. Which committee must
approve the protocol?
a. Performance improvement committee
b. Institutional review board (IRB)
c. Ethics consultation service
d. Quality assurance council
ANS: b. Institutional review board (IRB)
Rationale: The IRB ensures that vulnerable populations are
protected and that informed consent procedures meet regulatory
standards.
9. A manager learns a staff member falsified shift reports to hide
medication errors. Which ethical obligation does the manager have?
a. Remain silent to preserve team morale
b. Address the error through just-culture reporting channels
c. Publicly reprimand in front of the unit
d. Encourage the staff member to continue reporting inaccurately
ANS: b. Address the error through just-culture reporting
channels
Rationale: A just culture encourages transparent reporting of
errors for system improvement while fairly assessing individual
accountability.
10. A busy ED nurse is asked to join a committee on cultural
competence. Participation requires two evenings of unpaid training.
Which ethical principle supports accepting this role?
a. Nonmaleficence
b. Justice
c. Advocacy
Applied Ethics
Final Exam Review
(With Solutions)
2025
1. A hospital faces ventilator shortages during a pandemic. The
ethics committee must decide which patients receive mechanical
ventilation. Which ethical principle should primarily guide
allocation?
a. Autonomy
b. Justice
c. Fidelity
d. Nonmaleficence
ANS: b. Justice
Rationale: Justice demands fair distribution of scarce resources
based on consistent criteria rather than on social status or first-
come, first-served.
2. An unconscious patient has no advance directive on file. The on-
call nurse must obtain consent for an emergent procedure. Whose
decision-making standard applies?
a. Best-interest standard
b. Substituted-judgment standard
c. Assumed-consent standard
d. Utilitarian standard
ANS: a. Best-interest standard
Rationale: When patient preferences are unknown and no
surrogate is available, clinicians act according to what would
maximize benefit and minimize harm.
3. A nurse is ordered to administer a high dose of opioids for
comfort in a terminally ill patient. The nurse fears this may hasten
death. What doctrine protects the nurse legally and ethically?
a. Double effect
b. Maternal-fetal conflict
, c. Therapeutic privilege
d. DNR order
ANS: a. Double effect
Rationale: The doctrine of double effect permits an action that
has a good intention (pain relief) despite a foreseeable but
unintended harmful effect (possible life-shortening).
4. A patient refuses blood transfusion for religious reasons despite
life-threatening anemia. Which action aligns with ethical nursing
practice?
a. Override refusal to save life
b. Ensure refusal is informed and document it
c. Administer a reduced transfusion covertly
d. Discharge the patient immediately
ANS: b. Ensure refusal is informed and document it
Rationale: Respecting autonomy requires verifying capacity,
ensuring understanding of risks, and recording the patient’s
informed refusal.
5. A new RN observes that a colleague frequently enters patient
data into the EHR on behalf of others. Which ethical breach is most
likely occurring?
a. Beneficence
b. Veracity
c. Accountability
d. Confidentiality
ANS: c. Accountability
Rationale: Delegating charting to unassigned staff undermines
professional responsibility and accountability for the accuracy of
documentation.
6. A home care nurse uses a tablet to video-chat with patients.
Which step best protects patient privacy under HIPAA?
a. Use a public Wi-Fi network for convenience
b. Ensure end-to-end encryption on the telehealth platform
c. Record all sessions and upload to social media for transparency
d. Allow family members to share login credentials
ANS: b. Ensure end-to-end encryption on the telehealth
platform
Rationale: Encryption prevents unauthorized interception of
ePHI during transmission, maintaining confidentiality.
, 7. An RN is approached by a pharmaceutical rep offering expensive
gifts. According to professional ethics, what should the nurse do?
a. Accept the gift and thank the rep
b. Decline the gift and report the interaction
c. Accept gift but disclose in the patient record
d. Share the gift with patients for goodwill
ANS: b. Decline the gift and report the interaction
Rationale: Accepting gifts can create conflicts of interest;
professional standards require declining and documenting such
offers.
8. A nurse researcher proposes a study involving hospitalized
elderly patients who may lack full capacity. Which committee must
approve the protocol?
a. Performance improvement committee
b. Institutional review board (IRB)
c. Ethics consultation service
d. Quality assurance council
ANS: b. Institutional review board (IRB)
Rationale: The IRB ensures that vulnerable populations are
protected and that informed consent procedures meet regulatory
standards.
9. A manager learns a staff member falsified shift reports to hide
medication errors. Which ethical obligation does the manager have?
a. Remain silent to preserve team morale
b. Address the error through just-culture reporting channels
c. Publicly reprimand in front of the unit
d. Encourage the staff member to continue reporting inaccurately
ANS: b. Address the error through just-culture reporting
channels
Rationale: A just culture encourages transparent reporting of
errors for system improvement while fairly assessing individual
accountability.
10. A busy ED nurse is asked to join a committee on cultural
competence. Participation requires two evenings of unpaid training.
Which ethical principle supports accepting this role?
a. Nonmaleficence
b. Justice
c. Advocacy
