1
NCLEX PN Exam Bank Incident Reporting and
Ethical Responsibilities
Table of Contents
Subtopic 1: Principles of Incident Reporting in Clinical Settings........................................ 2
Subtopic 2: Ethical Decision-Making and Accountability in Practical Nursing .................... 9
Subtopic 3: Legal Implications and Documentation in Incident Reporting ....................... 17
Subtopic 4: Professional Boundaries and Ethical Violations in Reporting ......................... 25
Subtopic 5: Reporting Near Misses, Unsafe Practice, and Sentinel Events ....................... 33
Subtopic 6: Whistleblower Protections, Retaliation, and Reporting Unsafe Practices ....... 42
Subtopic 7: Whistleblowing, Retaliation, and Advocacy Protections ............................... 49
Subtopic 8: Ethical Dilemmas in Long-Term Care and End-of-Life Settings ...................... 57
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Subtopic 1: Principles of Incident Reporting in Clinical
Settings
(Questions 1–20)
1. A nurse accidentally administers 10 units of insulin instead of 5 units to a diabetic
patient. What is the first action the nurse should take after ensuring patient safety?
A. Report the incident to the family
B. Complete an incident report
C. Wait to see if symptoms develop
D. Avoid documenting the error in the medical record
Correct Answer: B. Complete an incident report
Rationale: After ensuring patient safety, the nurse must document the error via an incident
report, which helps track trends and improve safety protocols.
2. Which of the following best defines an incident report in nursing practice?
A. A disciplinary form sent to the state board
B. A confidential document used to report unusual occurrences
C. A daily log of nurse-patient interactions
D. A legal record included in the patient’s chart
Correct Answer: B. A confidential document used to report unusual occurrences
Rationale: Incident reports are internal quality improvement tools, not part of the patient’s
legal chart unless subpoenaed.
3. A nurse witnesses another nurse giving medication to the wrong patient. What is the
nurse's ethical responsibility?
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A. Ignore the incident if the patient appears stable
B. Alert the patient’s physician only
C. Report the error using the facility’s incident protocol
D. Tell the nurse supervisor privately and leave it at that
Correct Answer: C. Report the error using the facility’s incident protocol
Rationale: Ethical practice requires reporting all medical errors through proper institutional
channels.
4. What is the primary purpose of an incident report?
A. To identify the nurse responsible
B. To improve patient safety through analysis and prevention
C. To punish negligence
D. To protect the patient from legal action
Correct Answer: B. To improve patient safety through analysis and prevention
Rationale: The goal is system improvement, not individual punishment.
5. When documenting an incident report, which of the following should be avoided?
A. Date and time of event
B. Objective description of what occurred
C. Personal opinions and emotional language
D. Names of individuals involved
Correct Answer: C. Personal opinions and emotional language
Rationale: Documentation must be factual, concise, and devoid of bias or emotion.
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6. A fall occurs in the hallway, and the nurse was not present. What should the incident
report include?
A. What the nurse assumes happened
B. Statements from the patient or witnesses
C. That the patient is always careless
D. That the nurse had warned the patient
Correct Answer: B. Statements from the patient or witnesses
Rationale: Objective documentation includes first-hand statements when the nurse did not
witness the event.
7. Which action best demonstrates accountability in incident reporting?
A. Delaying the report to avoid blame
B. Reporting the event immediately and accurately
C. Letting another staff member handle it
D. Altering details to protect coworkers
Correct Answer: B. Reporting the event immediately and accurately
Rationale: Timely, truthful reporting is a core part of professional accountability.
8. Which of the following would most likely not require an incident report?
A. A visitor faints in the waiting area
B. A patient receives the wrong meal
C. A medication is missed due to shift change
D. A patient requests a second blanket
NCLEX PN Exam Bank Incident Reporting and
Ethical Responsibilities
Table of Contents
Subtopic 1: Principles of Incident Reporting in Clinical Settings........................................ 2
Subtopic 2: Ethical Decision-Making and Accountability in Practical Nursing .................... 9
Subtopic 3: Legal Implications and Documentation in Incident Reporting ....................... 17
Subtopic 4: Professional Boundaries and Ethical Violations in Reporting ......................... 25
Subtopic 5: Reporting Near Misses, Unsafe Practice, and Sentinel Events ....................... 33
Subtopic 6: Whistleblower Protections, Retaliation, and Reporting Unsafe Practices ....... 42
Subtopic 7: Whistleblowing, Retaliation, and Advocacy Protections ............................... 49
Subtopic 8: Ethical Dilemmas in Long-Term Care and End-of-Life Settings ...................... 57
, 2
Subtopic 1: Principles of Incident Reporting in Clinical
Settings
(Questions 1–20)
1. A nurse accidentally administers 10 units of insulin instead of 5 units to a diabetic
patient. What is the first action the nurse should take after ensuring patient safety?
A. Report the incident to the family
B. Complete an incident report
C. Wait to see if symptoms develop
D. Avoid documenting the error in the medical record
Correct Answer: B. Complete an incident report
Rationale: After ensuring patient safety, the nurse must document the error via an incident
report, which helps track trends and improve safety protocols.
2. Which of the following best defines an incident report in nursing practice?
A. A disciplinary form sent to the state board
B. A confidential document used to report unusual occurrences
C. A daily log of nurse-patient interactions
D. A legal record included in the patient’s chart
Correct Answer: B. A confidential document used to report unusual occurrences
Rationale: Incident reports are internal quality improvement tools, not part of the patient’s
legal chart unless subpoenaed.
3. A nurse witnesses another nurse giving medication to the wrong patient. What is the
nurse's ethical responsibility?
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A. Ignore the incident if the patient appears stable
B. Alert the patient’s physician only
C. Report the error using the facility’s incident protocol
D. Tell the nurse supervisor privately and leave it at that
Correct Answer: C. Report the error using the facility’s incident protocol
Rationale: Ethical practice requires reporting all medical errors through proper institutional
channels.
4. What is the primary purpose of an incident report?
A. To identify the nurse responsible
B. To improve patient safety through analysis and prevention
C. To punish negligence
D. To protect the patient from legal action
Correct Answer: B. To improve patient safety through analysis and prevention
Rationale: The goal is system improvement, not individual punishment.
5. When documenting an incident report, which of the following should be avoided?
A. Date and time of event
B. Objective description of what occurred
C. Personal opinions and emotional language
D. Names of individuals involved
Correct Answer: C. Personal opinions and emotional language
Rationale: Documentation must be factual, concise, and devoid of bias or emotion.
, 4
6. A fall occurs in the hallway, and the nurse was not present. What should the incident
report include?
A. What the nurse assumes happened
B. Statements from the patient or witnesses
C. That the patient is always careless
D. That the nurse had warned the patient
Correct Answer: B. Statements from the patient or witnesses
Rationale: Objective documentation includes first-hand statements when the nurse did not
witness the event.
7. Which action best demonstrates accountability in incident reporting?
A. Delaying the report to avoid blame
B. Reporting the event immediately and accurately
C. Letting another staff member handle it
D. Altering details to protect coworkers
Correct Answer: B. Reporting the event immediately and accurately
Rationale: Timely, truthful reporting is a core part of professional accountability.
8. Which of the following would most likely not require an incident report?
A. A visitor faints in the waiting area
B. A patient receives the wrong meal
C. A medication is missed due to shift change
D. A patient requests a second blanket
