LEGAL & ETHICAL ISSUES IN NURSING
EXAM
2026/2027 | Winter Session
60 Questions with Correct Answers and Rationales
100% Correct | 100% Verified
Aligned with ANA Code of Ethics, State Nurse Practice Acts,
and NCSBN Regulatory Standards
Publication Date: May 08, 2026
ABSTRACT
This examination document comprises 60 evidence-based questions addressing the core
legal and ethical competencies required of professional registered nurses. Content
spans ten critical domains including the ANA Code of Ethics, patient rights and
informed consent, HIPAA compliance, negligence and malpractice standards, scope of
practice and delegation, mandatory reporting, end-of-life ethics, professional
boundaries, ethical decision-making frameworks, and risk management strategies. Each
question is accompanied by a concise rationale grounded in statutory law, case
precedent, and professional ethical standards to support pre-licensure preparation and
ongoing professional development in legal-ethical nursing practice.
Keywords: Nursing Ethics, Legal Issues, ANA Code of Ethics, HIPAA, Informed Consent,
Malpractice, Scope of Practice, End-of-Life Care, Mandatory Reporting, Risk Management
,
,Domain 1: ANA Code of Ethics for Nurses
1. A nurse is caring for a client who refuses a blood transfusion based on religious beliefs. Which
provision of the ANA Code of Ethics supports the nurse's obligation to respect this decision?
A) Provision 1: Respect for human dignity
B) Provision 2: Commitment to the patient
C) Provision 3: Protection of patient rights
D) Provision 7: Advancement of the profession
Rationale: Provision 1 of the ANA Code of Ethics emphasizes respect for human dignity and the
uniqueness of each individual, including the right to self-determination. Respecting a competent patient's
refusal of treatment based on personal or religious beliefs directly upholds this foundational ethical
principle. While Provision 2 addresses commitment to the patient and Provision 3 addresses rights,
Provision 1 most specifically addresses the inherent dignity that includes autonomous decision-making.
2. A nurse witnesses a colleague providing substandard care but fears retaliation if reported. Which
ANA Code of Ethics provision addresses this ethical dilemma?
A) Provision 1
B) Provision 3: The nurse promotes, advocates for, and protects the rights, health, and
safety of the patient
C) Provision 6
D) Provision 9
Rationale: Provision 3 establishes the nurse's duty to advocate for and protect patient safety, even when
doing so involves confronting colleagues or reporting unsafe practices. The obligation to report
incompetent, unethical, or illegal practice overrides personal concerns about retaliation. This provision
creates a professional mandate that supersedes interpersonal comfort.
3. A nurse is asked to work a double shift despite feeling exhausted and compromised in clinical
judgment. Which ethical principle should guide the nurse's response?
A) Beneficence
B) Non-maleficence: the obligation to avoid causing harm
C) Justice
D) Fidelity
Rationale: Non-maleficence (do no harm) is the primary ethical principle at stake. Working while
significantly impaired by fatigue increases the risk of medication errors, assessment omissions, and clinical
judgment failures that could directly harm patients. The nurse has an ethical and professional
responsibility to decline assignments that compromise patient safety.
, 4. A nurse manager is allocating limited nursing staff across multiple units. Which ethical principle
is most applicable?
A) Autonomy
B) Veracity
C) Justice: fair and equitable distribution of resources
D) Beneficence
Rationale: Justice involves the fair, equitable, and appropriate distribution of healthcare resources. When
allocating limited nursing staff, the manager must consider patient acuity, staff competence, and overall
patient safety needs across all units rather than arbitrary or preferential assignments. Justice ensures that
no single patient population is disproportionately disadvantaged by resource allocation decisions.
5. A nursing student observes a nurse providing care while appearing intoxicated. The student asks
the nurse educator for guidance. Which action best demonstrates adherence to the ANA Code of
Ethics?
A) Ignore the observation to avoid conflict
B) Report the concern through the appropriate chain of command to protect patient safety
C) Confront the nurse directly during the shift
D) Wait to see if the behavior recurs before taking action
Rationale: The ANA Code of Ethics Provision 3 obligates nurses to protect patient safety by reporting
impaired practice through appropriate channels. Reporting through the chain of command (rather than
direct confrontation or inaction) follows proper institutional protocols, protects the reporter, and ensures a
structured investigation. Inaction or delay could result in patient harm.
6. A nurse is caring for a patient who is undocumented and uninsured. Which ANA Code of Ethics
provision addresses the nurse's obligation in this situation?
A) Provision 1: Respect for human dignity and provision of care without discrimination
B) Provision 5: Professional responsibility and integrity
C) Provision 8: Participation in health policy
D) Provision 9: Professional growth
Rationale: Provision 1 mandates that nurses provide care with respect for human dignity regardless of
immigration status, insurance, or socioeconomic background. Nursing care is a universal right that must
not be contingent on legal status or ability to pay. Discrimination based on these factors violates the
foundational ethical commitment of the profession.
7. A nurse is considering accepting a gift from a pharmaceutical representative valued at $200.
Which ethical consideration is most relevant?
EXAM
2026/2027 | Winter Session
60 Questions with Correct Answers and Rationales
100% Correct | 100% Verified
Aligned with ANA Code of Ethics, State Nurse Practice Acts,
and NCSBN Regulatory Standards
Publication Date: May 08, 2026
ABSTRACT
This examination document comprises 60 evidence-based questions addressing the core
legal and ethical competencies required of professional registered nurses. Content
spans ten critical domains including the ANA Code of Ethics, patient rights and
informed consent, HIPAA compliance, negligence and malpractice standards, scope of
practice and delegation, mandatory reporting, end-of-life ethics, professional
boundaries, ethical decision-making frameworks, and risk management strategies. Each
question is accompanied by a concise rationale grounded in statutory law, case
precedent, and professional ethical standards to support pre-licensure preparation and
ongoing professional development in legal-ethical nursing practice.
Keywords: Nursing Ethics, Legal Issues, ANA Code of Ethics, HIPAA, Informed Consent,
Malpractice, Scope of Practice, End-of-Life Care, Mandatory Reporting, Risk Management
,
,Domain 1: ANA Code of Ethics for Nurses
1. A nurse is caring for a client who refuses a blood transfusion based on religious beliefs. Which
provision of the ANA Code of Ethics supports the nurse's obligation to respect this decision?
A) Provision 1: Respect for human dignity
B) Provision 2: Commitment to the patient
C) Provision 3: Protection of patient rights
D) Provision 7: Advancement of the profession
Rationale: Provision 1 of the ANA Code of Ethics emphasizes respect for human dignity and the
uniqueness of each individual, including the right to self-determination. Respecting a competent patient's
refusal of treatment based on personal or religious beliefs directly upholds this foundational ethical
principle. While Provision 2 addresses commitment to the patient and Provision 3 addresses rights,
Provision 1 most specifically addresses the inherent dignity that includes autonomous decision-making.
2. A nurse witnesses a colleague providing substandard care but fears retaliation if reported. Which
ANA Code of Ethics provision addresses this ethical dilemma?
A) Provision 1
B) Provision 3: The nurse promotes, advocates for, and protects the rights, health, and
safety of the patient
C) Provision 6
D) Provision 9
Rationale: Provision 3 establishes the nurse's duty to advocate for and protect patient safety, even when
doing so involves confronting colleagues or reporting unsafe practices. The obligation to report
incompetent, unethical, or illegal practice overrides personal concerns about retaliation. This provision
creates a professional mandate that supersedes interpersonal comfort.
3. A nurse is asked to work a double shift despite feeling exhausted and compromised in clinical
judgment. Which ethical principle should guide the nurse's response?
A) Beneficence
B) Non-maleficence: the obligation to avoid causing harm
C) Justice
D) Fidelity
Rationale: Non-maleficence (do no harm) is the primary ethical principle at stake. Working while
significantly impaired by fatigue increases the risk of medication errors, assessment omissions, and clinical
judgment failures that could directly harm patients. The nurse has an ethical and professional
responsibility to decline assignments that compromise patient safety.
, 4. A nurse manager is allocating limited nursing staff across multiple units. Which ethical principle
is most applicable?
A) Autonomy
B) Veracity
C) Justice: fair and equitable distribution of resources
D) Beneficence
Rationale: Justice involves the fair, equitable, and appropriate distribution of healthcare resources. When
allocating limited nursing staff, the manager must consider patient acuity, staff competence, and overall
patient safety needs across all units rather than arbitrary or preferential assignments. Justice ensures that
no single patient population is disproportionately disadvantaged by resource allocation decisions.
5. A nursing student observes a nurse providing care while appearing intoxicated. The student asks
the nurse educator for guidance. Which action best demonstrates adherence to the ANA Code of
Ethics?
A) Ignore the observation to avoid conflict
B) Report the concern through the appropriate chain of command to protect patient safety
C) Confront the nurse directly during the shift
D) Wait to see if the behavior recurs before taking action
Rationale: The ANA Code of Ethics Provision 3 obligates nurses to protect patient safety by reporting
impaired practice through appropriate channels. Reporting through the chain of command (rather than
direct confrontation or inaction) follows proper institutional protocols, protects the reporter, and ensures a
structured investigation. Inaction or delay could result in patient harm.
6. A nurse is caring for a patient who is undocumented and uninsured. Which ANA Code of Ethics
provision addresses the nurse's obligation in this situation?
A) Provision 1: Respect for human dignity and provision of care without discrimination
B) Provision 5: Professional responsibility and integrity
C) Provision 8: Participation in health policy
D) Provision 9: Professional growth
Rationale: Provision 1 mandates that nurses provide care with respect for human dignity regardless of
immigration status, insurance, or socioeconomic background. Nursing care is a universal right that must
not be contingent on legal status or ability to pay. Discrimination based on these factors violates the
foundational ethical commitment of the profession.
7. A nurse is considering accepting a gift from a pharmaceutical representative valued at $200.
Which ethical consideration is most relevant?
