1
NCLEX RN Exam Bank: Ethical Decision Making
& Patient Advocacy
Table of Contents
Subtopic 1: Principles of Nursing Ethics, Autonomy, Beneficence, Nonmaleficence, and
Justice.......................................................................................................................... 2
Subtopic 2: Informed Consent, Confidentiality, and the Nurse's Role in Ethical
Communication .......................................................................................................... 11
Subtopic 3: Patient Advocacy in Diverse and Vulnerable Populations .............................. 20
Subtopic 4: Ethical Dilemmas in End-of-Life and Palliative Care ..................................... 30
Subtopic 5: Informed Consent, Autonomy & Legal-Ethical Interfaces .............................. 40
Subtopic 6: Whistleblowing, Confidentiality Breaches, and Reporting Unsafe Practice .... 48
, 2
Subtopic 1: Principles of Nursing Ethics, Autonomy,
Beneficence, Nonmaleficence, and Justice
Question 1
A patient with end-stage renal disease refuses dialysis, stating they prefer to die naturally.
Which ethical principle is the nurse upholding by honoring this decision?
A. Autonomy
B. Nonmaleficence
C. Beneficence
D. Justice
Correct Answer: A. Autonomy
Rationale: Respecting a patient's right to make their own decisions, even when it conflicts
with the nurse's personal beliefs or recommended treatment, reflects the ethical principle
of autonomy.
Question 2
A nurse administers pain medication to a terminally ill patient to ensure comfort, even
though it may slightly hasten death. This is an example of:
A. Fidelity
B. Beneficence
C. Veracity
D. Justice
Correct Answer: B. Beneficence
, 3
Rationale: Beneficence involves doing good and acting in the best interest of the patient. In
this case, the nurse’s action aims to relieve suffering, which is ethically justified.
Question 3
Which action by a nurse best illustrates the principle of nonmaleficence?
A. Monitoring a patient closely after administering a high-risk medication
B. Ignoring a patient’s request for information about their treatment
C. Encouraging a patient to participate in a research study
D. Allocating resources equally among all patients
Correct Answer: A. Monitoring a patient closely after administering a high-risk medication
Rationale: Nonmaleficence means "do no harm." By closely monitoring the patient, the
nurse is preventing potential harm from adverse effects.
Question 4
A nurse treats all patients with fairness regardless of socioeconomic status. This is an
example of which ethical principle?
A. Veracity
B. Fidelity
C. Justice
D. Autonomy
Correct Answer: C. Justice
Rationale: Justice refers to treating patients fairly and distributing healthcare resources
equitably.
, 4
Question 5
A nurse lies to a patient about the side effects of a medication to encourage compliance.
Which ethical principle is violated?
A. Beneficence
B. Fidelity
C. Veracity
D. Autonomy
Correct Answer: C. Veracity
Rationale: Veracity involves truth-telling. Lying to a patient, even with good intentions,
breaches this ethical standard.
Question 6
A nurse promises to return with test results in 30 minutes but fails to do so. Which principle
is compromised?
A. Fidelity
B. Justice
C. Autonomy
D. Beneficence
Correct Answer: A. Fidelity
Rationale: Fidelity is the duty to keep promises. Failing to follow through undermines
patient trust.
NCLEX RN Exam Bank: Ethical Decision Making
& Patient Advocacy
Table of Contents
Subtopic 1: Principles of Nursing Ethics, Autonomy, Beneficence, Nonmaleficence, and
Justice.......................................................................................................................... 2
Subtopic 2: Informed Consent, Confidentiality, and the Nurse's Role in Ethical
Communication .......................................................................................................... 11
Subtopic 3: Patient Advocacy in Diverse and Vulnerable Populations .............................. 20
Subtopic 4: Ethical Dilemmas in End-of-Life and Palliative Care ..................................... 30
Subtopic 5: Informed Consent, Autonomy & Legal-Ethical Interfaces .............................. 40
Subtopic 6: Whistleblowing, Confidentiality Breaches, and Reporting Unsafe Practice .... 48
, 2
Subtopic 1: Principles of Nursing Ethics, Autonomy,
Beneficence, Nonmaleficence, and Justice
Question 1
A patient with end-stage renal disease refuses dialysis, stating they prefer to die naturally.
Which ethical principle is the nurse upholding by honoring this decision?
A. Autonomy
B. Nonmaleficence
C. Beneficence
D. Justice
Correct Answer: A. Autonomy
Rationale: Respecting a patient's right to make their own decisions, even when it conflicts
with the nurse's personal beliefs or recommended treatment, reflects the ethical principle
of autonomy.
Question 2
A nurse administers pain medication to a terminally ill patient to ensure comfort, even
though it may slightly hasten death. This is an example of:
A. Fidelity
B. Beneficence
C. Veracity
D. Justice
Correct Answer: B. Beneficence
, 3
Rationale: Beneficence involves doing good and acting in the best interest of the patient. In
this case, the nurse’s action aims to relieve suffering, which is ethically justified.
Question 3
Which action by a nurse best illustrates the principle of nonmaleficence?
A. Monitoring a patient closely after administering a high-risk medication
B. Ignoring a patient’s request for information about their treatment
C. Encouraging a patient to participate in a research study
D. Allocating resources equally among all patients
Correct Answer: A. Monitoring a patient closely after administering a high-risk medication
Rationale: Nonmaleficence means "do no harm." By closely monitoring the patient, the
nurse is preventing potential harm from adverse effects.
Question 4
A nurse treats all patients with fairness regardless of socioeconomic status. This is an
example of which ethical principle?
A. Veracity
B. Fidelity
C. Justice
D. Autonomy
Correct Answer: C. Justice
Rationale: Justice refers to treating patients fairly and distributing healthcare resources
equitably.
, 4
Question 5
A nurse lies to a patient about the side effects of a medication to encourage compliance.
Which ethical principle is violated?
A. Beneficence
B. Fidelity
C. Veracity
D. Autonomy
Correct Answer: C. Veracity
Rationale: Veracity involves truth-telling. Lying to a patient, even with good intentions,
breaches this ethical standard.
Question 6
A nurse promises to return with test results in 30 minutes but fails to do so. Which principle
is compromised?
A. Fidelity
B. Justice
C. Autonomy
D. Beneficence
Correct Answer: A. Fidelity
Rationale: Fidelity is the duty to keep promises. Failing to follow through undermines
patient trust.
