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A nurse is asked by a family member to withhold sensitive diagnostic information from a patient because they believe “the truth will devastate them.” The patient is competent and has previously expressed a desire to be fully informed about their condition. What is the nurse’s ethical obligation?

  • Respect the family's wishes to protect the patient.
  • Disclose only part of the information to the patient.
  • Uphold the patient's right to full information (veracity) and autonomy.
  • Delay disclosure until the family is ready.

A nurse discovers a “workaround” to a hospital policy that makes a certain task faster but bypasses a safety check designed to prevent medication errors. Several colleagues use this workaround regularly. The nurse is pressured to conform to the group practice. What is the most ethical decision for the nurse?

  • Use the workaround to be efficient and fit in.
  • Report the workaround immediately to management.
  • Refuse to use the workaround and follow proper policy, while advocating for a safer, more efficient process if possible.
  • Only use the workaround when short on time.

A nurse is present when a patient, clearly experiencing cognitive impairment, signs a consent form for a major surgical procedure. The nurse observes that the patient appears confused and is simply nodding along without fully grasping the explanation. What is the nurse’s ethical duty in this moment?

  • Allow the signing to proceed, assuming the physician has assessed capacity.
  • Obtain a second signature from a family member.
  • Stop the signing process and inform the physician that the patient's capacity for informed consent appears compromised.
  • Document that the patient signed the form.

A nurse discovers that a patient’s medical records contain outdated or inaccurate information that could potentially lead to inappropriate care or harm. The nurse has attempted to have the information corrected through official channels, but the process is slow and bureaucratic. What is the nurse’s immediate ethical responsibility?

  • Administer care based on the outdated information.
  • Document a note in the chart about the inaccuracy and proceed with care based on current assessment.
  • Refuse to provide care until the chart is fully corrected.
  • Inform the patient about the inaccuracies and let them resolve it.

A nurse is working with a patient who has limited English proficiency. The patient’s family member offers to translate complex medical information, but the nurse is concerned about the accuracy and completeness of the translation, especially for critical consent forms. What is the most ethical approach?

  • Rely on the family member for translation to save time.
  • Use a certified medical interpreter to ensure accurate communication and informed consent.
  • Provide written materials in the patient's language without verbal translation.
  • Ask the patient if they understand after the family member translates.

A nurse is involved in a medical error that resulted in harm to a patient. The error was due to a complex system failure, but the nurse was directly involved in the final step. The hospital administration suggests minimizing the nurse’s role in the incident to avoid legal repercussions for the institution. What is the nurse’s ethical responsibility in this situation?

  • Follow the administration's suggestion to protect the hospital.
  • Accept full blame for the error.
  • Accurately and honestly report their involvement and the circumstances of the error to relevant parties and in official documentation.
  • Conceal the error to avoid personal blame.

A nurse is working in a hospital that is experiencing a severe nursing shortage, leading to excessive workload and inadequate patient-to-nurse ratios. The nurse feels that patient safety is being compromised due to these conditions. What is the most ethical and professional action for the nurse to take?

  • Work harder and longer hours to compensate.
  • Resign immediately due to unsafe conditions.
  • Document concerns, communicate them through official channels (e.g., charge nurse, union, nursing administration), and advocate for systemic changes.
  • Complain openly to patients and families.

A nurse is preparing to administer a medication, but the patient states, “I don’t usually take that pill; my other pill looks different.” The nurse double-checks the medication and order and confirms it is correct according to the chart. However, the patient continues to express doubt. What is the most ethical action for the nurse?

  • Administer the medication as ordered, ignoring the patient's doubt.
  • Explain the medication again and reassure the patient, then administer it.
  • Withhold the medication until the prescribing physician can be consulted to clarify the patient's concerns.
  • Ask the patient to describe their usual pill.

A nurse is caring for a patient who has a Do Not Resuscitate (DNR) order. During a cardiac arrest event, a new physician, unfamiliar with the patient’s chart, orders resuscitation. The family is present and also unaware of the DNR order, urging the team to save their loved one. What is the nurse’s immediate ethical responsibility?

  • Begin resuscitation as per the physician's order.
  • Resuscitate while quickly checking the chart.
  • Immediately inform the physician and family of the DNR order and advocate for its adherence.
  • Wait for the family to clarify their wishes.

A nurse witnesses a colleague providing substandard care due to being technologically incompetent with a new electronic charting system, leading to delayed documentation of critical vital signs. The colleague is otherwise a good nurse but resistant to learning new tech. What is the nurse’s ethical obligation?

  • Avoid interfering to prevent embarrassment.
  • Offer to complete the colleague's charting.
  • Report the technical incompetence to the charge nurse for appropriate training or intervention.
  • Provide one-on-one technical training to the colleague during patient care.

A nurse is participating in a research study where patients are blinded to whether they receive the experimental drug or a placebo. A patient in the placebo group experiences worsening symptoms and asks the nurse if they are on the active drug. The nurse knows they are not but is ethically bound by the study protocol to maintain blinding. What is the most ethical response?

  • Confirm the patient is on the placebo to encourage them to withdraw.
  • Suggest the patient discuss their concerns with the principal investigator.
  • Tell the patient that they are on the active drug to maintain hope.
  • Disclose the blinding status if symptoms worsen further.

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