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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 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 observes that the healthcare facility is frequently understaffed during night shifts, leading to increased patient falls and medication delays. The nurse reports this concern to the nursing supervisor, but no immediate action is taken. What further ethical action might the nurse consider?

  • Remain silent and continue to do their best.
  • Publicly criticize the hospital on social media.
  • Document all incidents of compromised care and escalate concerns to higher management or regulatory bodies if necessary.
  • Refuse to work night shifts.

A nurse is caring for an individual from a cultural background where discussing illness directly with the patient is considered disrespectful; instead, all information is communicated through the eldest family member. The patient, however, seems to want to know more about their condition directly. How should the nurse ethically navigate this situation?

  • Always defer to the family's cultural practice.
  • Insist on direct communication with the patient regardless of culture.
  • Respect cultural norms but also seek opportunities to assess and honor the patient's individual desire for information directly, perhaps with the family's understanding.
  • Only provide information in writing to avoid direct confrontation.

A nurse is assigned to care for a patient who was recently involved in a highly controversial public incident. The media is intensely interested in the patient’s condition, and colleagues are asking the nurse for updates. What is the nurse’s most important ethical obligation in this situation?

  • Provide limited, generalized information to colleagues.
  • Respond to media inquiries if approached directly.
  • Maintain strict confidentiality regarding all patient information.
  • Seek the patient's permission to share information with colleagues.

A nurse identifies that a patient’s advanced directive, which outlines specific wishes for end-of-life care, is not being followed by the medical team due to miscommunication or oversight. The patient is no longer able to advocate for themselves. What is the nurse’s ethical duty?

  • Assume the team knows best and remain silent.
  • Inform the family and let them handle it.
  • Act as a patient advocate to ensure the patient's autonomous wishes as expressed in the advanced directive are honored.
  • Document the discrepancy but take no further action.

A nurse is caring for a patient whose religious beliefs prohibit certain medical interventions, such as blood transfusions. The patient is a competent adult and has clearly communicated these wishes. The nurse disagrees with these beliefs and feels the interventions would save the patient’s life. What is the nurse’s ethical responsibility?

  • Attempt to convince the patient to change their mind.
  • Respect the patient's autonomy and religious freedom by upholding their decision.
  • Seek legal counsel to override the patient's decision.
  • Prioritize medical necessity over religious belief.

A nurse observes a more experienced nurse consistently delegating tasks beyond the scope of practice for a nursing assistant, putting patients at risk. The new nurse is hesitant to challenge the senior nurse due to their hierarchy. What is the ethical course of action for the new nurse?

  • Quietly complete the delegated tasks to avoid conflict.
  • Inform the nursing assistant of the improper delegation.
  • Report the improper delegation and potential patient safety issues to the charge nurse or supervisor.
  • Confront the senior nurse directly in front of other staff.

A nurse is reviewing a patient’s medication list and notices a potentially dangerous drug-drug interaction that was overlooked by the prescribing physician. The nurse verifies the interaction with a pharmacist. What is the nurse’s immediate ethical responsibility?

  • Administer the medication as ordered, trusting the physician.
  • Withhold the medication and report the interaction to the prescribing physician for clarification or modification of the order.
  • Administer one of the interacting drugs and hold the other.
  • Document the interaction in the chart and wait for the physician to notice.

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