NCLEX-RN Practice Questions and Detailed
Explanation
A client asks why a diagnostic test has been ordered and the nurse replies, "I'm
unsure but will find out for you." When the nurse later returns and provides an
explanation, the nurse is acting under which principle?
1. Nonmaleficence
2. Veracity
3. Beneficence
4. Fidelity
Answer: 4
Rationale: Fidelity means being faithful to agreements and promises. This nurse is
acting on the client's behalf to obtain needed information and report it back to the
client. Nonmaleficence is the duty to do no harm. Veracity refers to telling the truth
for example, not lying to a client about a serious prognosis. Beneficence means
doing good, such as by implementing actions (e.g. keeping a salt shaker out of
sight) that benefit a client (heart condition requiring sodium-restricted diet).
Cognitive Level: Understanding
Client Need: Management of Care
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals
Strategy: Use the process of elimination. The correct answer is the one that
matches the description in the stem; that is, the nurse made a promise to a client
and kept it, which constitutes fidelity.
,An individual has a seizure while walking down the street. During the seizure, a
nurse from a physician's office is noticed driving past without stopping to assist.
The individual sues the nurse for negligence but fails to win a judgement for which
reason?
1. The nurse had no duty to the individual.
2. The nurse did what most nurses would do in the same circumstance.
3. The nurse did not cause the client's injuries.
4. The nurse was off-duty at the time.
Answer: 1
Rationale: To be guilty of negligence, the nurse must have a relationship with the
client that involves a duty to provide care. The relationship is usually a component
of employment. The nurse did not necessarily do what others would do in this
situation. Although the nurse did not cause the client's injuries, it does not prevent
the nurse from assisting in this situation. Although the nurse was off-duty, the
nurse could have assisted if motivated to do so.
Cognitive Level: Understanding
Client Need: Management of Care
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals
Strategy: Use the process of elimination and nursing knowledge. The correct
answer is the one that recognizes that the nurse was not in the role of employee at
the time of the incident, removing the requirement of acting on the client's behalf.
, An adult female ambulatory care client receiving an oral anticoagulant is given
aspirin for a headache while visiting a neighbor, who is a nurse. The client
subsequently has a bleeding episode because of a drug interaction. The legal nurse
consultant interprets that which necessary elements of malpractice are missing
from this case? Select all that apply.
1. Breech of duty
2. Duty owed
3. Injury experienced
4. Causation between nurse's action and injury
5. Intent to cause harm or injury
Answer: 2, 5
Rationale: There was no nurse-client relationship because the nurse was acting as a
neighbor and not in an employment capacity. Thus, there can be no duty owed.
Intent is not a necessary element of malpractice, because malpractice can occur
because of unintended actions as well. There was no breach of duty because there
was no official nurse-client relationship, which accompanies an employment
situation. There was injury experiences because of this event. The bleeding was
caused by the interaction of the aspirin with the anticoagulant.
Cognitive Level: Analyzing
Client Need: Management of Care
Integrated Process: Nursing Process: Evaluation
Content Area: Fundamentals
Strategy: Use the process of elimination. The wording of the question indicates
more than one option is correct, and the focus is on necessary elements that must
be present. First eliminate the intent to cause harm or injury, since this is not
necessary to a charge of malpractice. Next note that there is no duty owed, and
Explanation
A client asks why a diagnostic test has been ordered and the nurse replies, "I'm
unsure but will find out for you." When the nurse later returns and provides an
explanation, the nurse is acting under which principle?
1. Nonmaleficence
2. Veracity
3. Beneficence
4. Fidelity
Answer: 4
Rationale: Fidelity means being faithful to agreements and promises. This nurse is
acting on the client's behalf to obtain needed information and report it back to the
client. Nonmaleficence is the duty to do no harm. Veracity refers to telling the truth
for example, not lying to a client about a serious prognosis. Beneficence means
doing good, such as by implementing actions (e.g. keeping a salt shaker out of
sight) that benefit a client (heart condition requiring sodium-restricted diet).
Cognitive Level: Understanding
Client Need: Management of Care
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals
Strategy: Use the process of elimination. The correct answer is the one that
matches the description in the stem; that is, the nurse made a promise to a client
and kept it, which constitutes fidelity.
,An individual has a seizure while walking down the street. During the seizure, a
nurse from a physician's office is noticed driving past without stopping to assist.
The individual sues the nurse for negligence but fails to win a judgement for which
reason?
1. The nurse had no duty to the individual.
2. The nurse did what most nurses would do in the same circumstance.
3. The nurse did not cause the client's injuries.
4. The nurse was off-duty at the time.
Answer: 1
Rationale: To be guilty of negligence, the nurse must have a relationship with the
client that involves a duty to provide care. The relationship is usually a component
of employment. The nurse did not necessarily do what others would do in this
situation. Although the nurse did not cause the client's injuries, it does not prevent
the nurse from assisting in this situation. Although the nurse was off-duty, the
nurse could have assisted if motivated to do so.
Cognitive Level: Understanding
Client Need: Management of Care
Integrated Process: Nursing Process: Implementation
Content Area: Fundamentals
Strategy: Use the process of elimination and nursing knowledge. The correct
answer is the one that recognizes that the nurse was not in the role of employee at
the time of the incident, removing the requirement of acting on the client's behalf.
, An adult female ambulatory care client receiving an oral anticoagulant is given
aspirin for a headache while visiting a neighbor, who is a nurse. The client
subsequently has a bleeding episode because of a drug interaction. The legal nurse
consultant interprets that which necessary elements of malpractice are missing
from this case? Select all that apply.
1. Breech of duty
2. Duty owed
3. Injury experienced
4. Causation between nurse's action and injury
5. Intent to cause harm or injury
Answer: 2, 5
Rationale: There was no nurse-client relationship because the nurse was acting as a
neighbor and not in an employment capacity. Thus, there can be no duty owed.
Intent is not a necessary element of malpractice, because malpractice can occur
because of unintended actions as well. There was no breach of duty because there
was no official nurse-client relationship, which accompanies an employment
situation. There was injury experiences because of this event. The bleeding was
caused by the interaction of the aspirin with the anticoagulant.
Cognitive Level: Analyzing
Client Need: Management of Care
Integrated Process: Nursing Process: Evaluation
Content Area: Fundamentals
Strategy: Use the process of elimination. The wording of the question indicates
more than one option is correct, and the focus is on necessary elements that must
be present. First eliminate the intent to cause harm or injury, since this is not
necessary to a charge of malpractice. Next note that there is no duty owed, and
