NURS 440 | NURS440 Exam 2: Issues and Trends -
WCU Updated and Latest Questions and Correct
Answers with Rationale
1. A nurse is caring for a patient who refuses chemotherapy despite a high chance of
recovery. Which ethical principle is the nurse demonstrating by supporting the patient’s
decision?
A. Beneficence
B. Justice
C. Non-maleficence
D. Autonomy
Correct Answer: D
Rationale: Autonomy represents the right of patients to make their own healthcare
decisions without external control. Even when a patient’s choice seems detrimental to their
health, the nurse must respect their self-determination. This principle is fundamental to the
nurse-patient relationship and is protected by law under informed consent. Supporting
autonomy requires the nurse to provide all necessary information while remaining
unbiased. Understanding the priority of autonomy over paternalism is a key concept for
this nursing exam.
2. Which of the following is one of the four essential elements required to prove nursing
malpractice?
A. The nurse had a primary relationship with the family.
B. The patient was dissatisfied with the outcome.
C. The nurse breached the standard of care.
D. The nurse was working overtime during the shift.
Correct Answer: C
Rationale: Breach of duty is a core element where the nurse fails to meet the standard of
professional care. To win a malpractice case, the plaintiff must also prove duty, causation,
and actual damages occurred. Simply being dissatisfied with care does not constitute legal
malpractice without a specific violation of standards. Nurses are held to the standard of
what a reasonably prudent nurse would do in similar circumstances. Identifying these four
elements is critical for understanding legal liability in clinical practice.
3. What is the primary purpose of the Nurse Practice Act (NPA) in each state?
A. To regulate the cost of nursing education programs.
B. To provide a list of salary ranges for different roles.
,C. To ensure nurses receive adequate benefits and leave.
D. To protect the public from unsafe practitioners.
Correct Answer: D
Rationale: The main objective of the Nurse Practice Act is to safeguard the public by
defining the legal scope of nursing practice. Each state legislature creates its own NPA to
set standards for licensure and professional conduct. While it outlines what nurses can do,
its ultimate focus is patient safety rather than nurse advocacy. Violating the NPA can lead to
the suspension or revocation of a nurse’s license by the Board of Nursing. Mastery of the
NPA’s role is essential for passing professional regulation sections of the exam.
4. Under HIPAA regulations, which action by a nurse is considered a violation of patient
privacy?
A. Sharing a patient’s diagnosis with a colleague in the hospital cafeteria.
B. Reporting a case of tuberculosis to the local health department.
C. Discussing a patient’s lab results with the treating physician.
D. Checking the electronic health record of a patient assigned to the nurse.
Correct Answer: A
Rationale: Sharing patient information in public areas like a cafeteria is a clear breach of
HIPAA confidentiality rules. Even if the person listening is a healthcare professional, the
information must only be shared for legitimate treatment purposes. Nurses must maintain
professional boundaries by discussing sensitive data only in private, secure environments.
HIPAA allows for certain disclosures, such as reporting infectious diseases, without
violating the law. Protecting patient privacy is a legal and ethical mandate that nurses must
strictly follow.
5. The Patient Protection and Affordable Care Act (PPACA) was designed primarily to achieve
which goal?
A. Eliminate the need for private health insurance companies.
B. Reduce the number of nurses working in rural health settings.
C. Increase the number of citizens with access to health insurance.
D. Limit the use of electronic health records in small clinics.
Correct Answer: C
Rationale: The PPACA aimed to expand health insurance coverage to millions of uninsured
Americans through various mechanisms. It introduced health insurance exchanges and
expanded Medicaid eligibility to make care more affordable for low-income families. This
policy shift focuses on preventative care and reducing the overall financial burden of
chronic disease management. While controversial, the law has significantly impacted how
, healthcare is delivered and funded across the United States. Nurses need to understand
these policy changes as they directly affect patient access and resource allocation.
6. Which ethical principle involves the fair and equitable distribution of healthcare resources?
A. Fidelity
B. Veracity
C. Justice
D. Beneficence
Correct Answer: C
Rationale: Justice in nursing ethics refers to the fair treatment of all individuals regardless
of their background or status. This principle is often applied when deciding how to allocate
limited resources, such as organ transplants or ICU beds. It ensures that healthcare benefits
and burdens are distributed equally across the population. Nurses apply justice by
providing the same standard of care to every patient they encounter. This concept is vital
for addressing health disparities and advocating for social equity in medicine.
7. When a nurse witnesses a patient signing an informed consent form, what is the nurse
primarily attesting to?
A. The patient fully understands the risks of the procedure.
B. The signature on the document is authentic and voluntary.
C. The surgeon has explained all alternative treatments.
D. The patient is making the best possible medical decision.
Correct Answer: B
Rationale: The nurse’s role in witnessing informed consent is strictly to verify that the
signature is valid and the patient is competent. It is the physician’s legal responsibility to
explain the procedure, risks, and benefits to the patient. If the nurse realizes the patient
does not understand the surgery, they must notify the provider before the procedure
begins. The nurse does not guarantee the patient’s choice is correct, only that the process
was legal. This distinction is a frequent topic on nursing exams regarding legal
responsibilities.
8. A nurse administers a pain medication to a patient even though they know it causes minor
nausea, because the benefit of pain relief outweighs the side effect. Which principle is
applied?
A. Non-maleficence
B. Paternalism
C. Beneficence
WCU Updated and Latest Questions and Correct
Answers with Rationale
1. A nurse is caring for a patient who refuses chemotherapy despite a high chance of
recovery. Which ethical principle is the nurse demonstrating by supporting the patient’s
decision?
A. Beneficence
B. Justice
C. Non-maleficence
D. Autonomy
Correct Answer: D
Rationale: Autonomy represents the right of patients to make their own healthcare
decisions without external control. Even when a patient’s choice seems detrimental to their
health, the nurse must respect their self-determination. This principle is fundamental to the
nurse-patient relationship and is protected by law under informed consent. Supporting
autonomy requires the nurse to provide all necessary information while remaining
unbiased. Understanding the priority of autonomy over paternalism is a key concept for
this nursing exam.
2. Which of the following is one of the four essential elements required to prove nursing
malpractice?
A. The nurse had a primary relationship with the family.
B. The patient was dissatisfied with the outcome.
C. The nurse breached the standard of care.
D. The nurse was working overtime during the shift.
Correct Answer: C
Rationale: Breach of duty is a core element where the nurse fails to meet the standard of
professional care. To win a malpractice case, the plaintiff must also prove duty, causation,
and actual damages occurred. Simply being dissatisfied with care does not constitute legal
malpractice without a specific violation of standards. Nurses are held to the standard of
what a reasonably prudent nurse would do in similar circumstances. Identifying these four
elements is critical for understanding legal liability in clinical practice.
3. What is the primary purpose of the Nurse Practice Act (NPA) in each state?
A. To regulate the cost of nursing education programs.
B. To provide a list of salary ranges for different roles.
,C. To ensure nurses receive adequate benefits and leave.
D. To protect the public from unsafe practitioners.
Correct Answer: D
Rationale: The main objective of the Nurse Practice Act is to safeguard the public by
defining the legal scope of nursing practice. Each state legislature creates its own NPA to
set standards for licensure and professional conduct. While it outlines what nurses can do,
its ultimate focus is patient safety rather than nurse advocacy. Violating the NPA can lead to
the suspension or revocation of a nurse’s license by the Board of Nursing. Mastery of the
NPA’s role is essential for passing professional regulation sections of the exam.
4. Under HIPAA regulations, which action by a nurse is considered a violation of patient
privacy?
A. Sharing a patient’s diagnosis with a colleague in the hospital cafeteria.
B. Reporting a case of tuberculosis to the local health department.
C. Discussing a patient’s lab results with the treating physician.
D. Checking the electronic health record of a patient assigned to the nurse.
Correct Answer: A
Rationale: Sharing patient information in public areas like a cafeteria is a clear breach of
HIPAA confidentiality rules. Even if the person listening is a healthcare professional, the
information must only be shared for legitimate treatment purposes. Nurses must maintain
professional boundaries by discussing sensitive data only in private, secure environments.
HIPAA allows for certain disclosures, such as reporting infectious diseases, without
violating the law. Protecting patient privacy is a legal and ethical mandate that nurses must
strictly follow.
5. The Patient Protection and Affordable Care Act (PPACA) was designed primarily to achieve
which goal?
A. Eliminate the need for private health insurance companies.
B. Reduce the number of nurses working in rural health settings.
C. Increase the number of citizens with access to health insurance.
D. Limit the use of electronic health records in small clinics.
Correct Answer: C
Rationale: The PPACA aimed to expand health insurance coverage to millions of uninsured
Americans through various mechanisms. It introduced health insurance exchanges and
expanded Medicaid eligibility to make care more affordable for low-income families. This
policy shift focuses on preventative care and reducing the overall financial burden of
chronic disease management. While controversial, the law has significantly impacted how
, healthcare is delivered and funded across the United States. Nurses need to understand
these policy changes as they directly affect patient access and resource allocation.
6. Which ethical principle involves the fair and equitable distribution of healthcare resources?
A. Fidelity
B. Veracity
C. Justice
D. Beneficence
Correct Answer: C
Rationale: Justice in nursing ethics refers to the fair treatment of all individuals regardless
of their background or status. This principle is often applied when deciding how to allocate
limited resources, such as organ transplants or ICU beds. It ensures that healthcare benefits
and burdens are distributed equally across the population. Nurses apply justice by
providing the same standard of care to every patient they encounter. This concept is vital
for addressing health disparities and advocating for social equity in medicine.
7. When a nurse witnesses a patient signing an informed consent form, what is the nurse
primarily attesting to?
A. The patient fully understands the risks of the procedure.
B. The signature on the document is authentic and voluntary.
C. The surgeon has explained all alternative treatments.
D. The patient is making the best possible medical decision.
Correct Answer: B
Rationale: The nurse’s role in witnessing informed consent is strictly to verify that the
signature is valid and the patient is competent. It is the physician’s legal responsibility to
explain the procedure, risks, and benefits to the patient. If the nurse realizes the patient
does not understand the surgery, they must notify the provider before the procedure
begins. The nurse does not guarantee the patient’s choice is correct, only that the process
was legal. This distinction is a frequent topic on nursing exams regarding legal
responsibilities.
8. A nurse administers a pain medication to a patient even though they know it causes minor
nausea, because the benefit of pain relief outweighs the side effect. Which principle is
applied?
A. Non-maleficence
B. Paternalism
C. Beneficence
