HESI Specialty Exam Bank: Legal & Ethical
Decision Making in Clinical Practice
Table of Contents
Subtopic 1: Patient Autonomy and Informed Consent (Questions 1–20) ............................ 2
Subtopic 2: Confidentiality, HIPAA, and Patient Privacy (Questions 21–40) ...................... 11
Subtopic 3: Ethical Principles and Professional Boundaries (Questions 41–60) ................ 20
Subtopic 4: Mandatory Reporting, Abuse, and Advocacy (Questions 61–80) .................... 30
Subtopic 5: Ethical Principles in End-of-Life Care and Advance Directives....................... 39
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Subtopic 1: Patient Autonomy and Informed Consent
(Questions 1–20)
Question 1:
A nurse is preparing to witness a patient’s signature on an informed consent form for a
surgical procedure. What is the nurse's primary responsibility in this situation?
A. Explain the risks and benefits of the procedure
B. Assess the surgeon’s competence
C. Confirm the patient voluntarily signed and appears competent
D. Describe alternatives to the procedure
Correct Answer: C
Rationale: The nurse’s role is to witness the patient's signature and ensure the patient is
signing voluntarily and appears to understand what they are signing—not to provide
detailed explanations about the procedure.
Question 2:
A competent patient refuses a blood transfusion due to religious beliefs. What should the
nurse do next?
A. Proceed with the transfusion to save the patient's life
B. Respect the patient’s decision and notify the provider
C. Seek a court order
D. Transfer the patient to another facility
Correct Answer: B
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Rationale: Patients have the legal and ethical right to refuse treatment, including life-saving
measures, based on their beliefs.
Question 3:
Which of the following elements is NOT required for informed consent?
A. Patient comprehension
B. Family approval
C. Disclosure of risks and benefits
D. Voluntary agreement
Correct Answer: B
Rationale: Family approval is not a legal requirement for informed consent if the patient is
competent and of legal age.
Question 4:
Which statement about informed consent is most accurate?
A. The nurse is responsible for obtaining informed consent
B. The physician must provide detailed information about the procedure
C. Informed consent only applies to surgeries
D. A minor can always give informed consent
Correct Answer: B
Rationale: The physician performing the procedure is responsible for explaining it,
including risks, benefits, and alternatives.
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Question 5:
A nurse is caring for a 16-year-old emancipated minor. Who must provide informed consent
for a procedure?
A. The minor’s parents
B. The minor
C. The attending physician
D. The court
Correct Answer: B
Rationale: Emancipated minors have the legal right to make healthcare decisions,
including giving informed consent.
Question 6:
Which of the following best demonstrates a breach of patient autonomy?
A. Offering alternatives
B. Pressuring a patient to accept treatment
C. Discussing care plans
D. Respecting religious beliefs
Correct Answer: B
Rationale: Coercing a patient undermines autonomy by limiting their freedom to make
voluntary health decisions.
Question 7: