PROFESSIONAL ADJUSTMENT and BIOETHICS

PRACTICE TEST
Situation: Options are weighed and selected based on different moral approaches or points of reference.
1. A manager who uses travel budget money to send many staff to local workshops rather than to fund one or two
more people to attend a national conference is utilizing what ethical framework?
a. Utilitarianism c. Right based reasoning
b. Duty based reasoning d. Intuitionist
ANSWER: A – Unitarianism encourages the manager to make decisions based on what provides the greatest good for the greatest number of
people. In doing so, the needs and wants of the individual are diminished; B – Duty-based reasoning says that some decisions must be made
because there is a duty to do something or to refrain from doing something; C – based on the belief that some things are a person’s just due; D
– This framework allows the decision maker to review each ethical problem or issue on case-by-case basis, comparing the relative weights of
goals, duties and rights.

2. Deontological theories arise from the intent of the action that the decision maker takes. Which of the following
ethical reasoning does not arise from deontological theory?
a. Utilitarianism c. Right based reasoning
b. Duty based reasoning d. Intuitionist
ANSWER: A - Deontological ethics or deontology is an approach to ethics that judges the morality of an action based on the action's
adherence to a rule or rules. Teleological theories are used to support utilitarianism. These are the theories that support decisions that favor
the common good.

3. Consequence-based theories is associated with:

a. Deontology b. Caring c. Autonomy d. Teleology
ANSWER: D - Consequence-based (teleological) theories look to the outcomes of an action in judging whether that action is right or wrong.
Principle-based (deontological) involve logical and formal processes and emphasize individual rights, duties and obligations. Relationships-
based (caring) theories stress courage, generosity, commitment, and the need to nurture and maintain relationships.

Situation: A nursing instructor is discussing about the different laws governing the practice of nursing.
4. Based on Republic No. 7305, also known as “The Magna Carta of Public Health Workers”, who is designated
to formulate and prepare a Code of Conduct for Public Health Workers?
a. President of the Philippines c. Secretary of Health
b. Members of the Board of Nursing d. Professional Regulation Commission
ANSWER: C - Section 14 RA 7305 says that within six (6) months from the approval of the act, the Secretary of Health, upon consultation with
other appropriate agencies, professional and health workers’ organization, shall formulate and prepare a Code of Conduct for Public Health
Workers, which shall be disseminated as widely as possible.

5. RA 7305 clearly states that a public health worker’s normal work hours shall not exceed:
a. 20 hours a week b. 40 hours a week c. 60 hours a week d. 70 hours a week
ANSWER: B - Section 15 of the act stipulates that the normal of wok of any public health worker shall not exceed eight (8) hours a day or forty
(40) hours a week. Hours worked shall include
ANSWER: B - Section 15 of the act stipulates that the normal of wok of any public health worker shall not exceed eight (8) hours a day or forty
(40) hours a week.

6. Based on RA 9173, the Board of Nursing (BON) is composed of:

a. Chairperson and six (6) members c. Chairperson and (7) members
b. Chairperson and five (5) members d. Chairperson and (8) members
ANSWER: A- There shall be created a Professional Regulatory Board of Nursing, hereinafter referred to as the Board, to be composed of
a Chairperson and six (6) members. They shall be appointed by the president of the Republic of the Philippines from among two (2)
recommendees, per vacancy, of the Professional Regulation Commission, hereinafter referred to as the Commission, chosen and ranked
from a list of three (3) nominees, per vacancy, of the accredited professional organization of nurses in the Philippines who possess the
qualifications prescribed in Section 4 of this Act

Situations:As nurses begin their professional obligations, their legal responsibilities begin as well.

7. Who is not entitled to report the death of a person?

a. Attending physician c. Family of the deceased
b. Health officer concerned d. All of them can report death
ANSWER: D- REPUBLIC ACT NO. 3753 (LAW ON REGISTRY OF CIVIL STATUS): No human body shall be buried unless the proper death
certificate has been presented and recorded in the office of the local civil registrar. The physician who attended the deceased or, in his default
the health officer concerned, or in default of the latter, any member of the family of the deceased or any person having knowledge of the death,
shall report the same to the local health authorities, who shall issue a death certificate and shall order the same to be recorded in the office of
the local civil registrar.

8. Emancipation is applicable in which of the following situations?

a. When a minor has been freed from the caregivers’ rules and now makes his or her own rules
b. When a minor is no longer required to go to school and now has a job
c. Someone who stays and is supported by parents
d. A minor who is now married
ANSWER: D - Executive Order No. 209 (The Family Code of the Philippines) Art. 234: Emancipation takes place by the attainment of majority.
Unless otherwise provided, majority commences at the age of twenty-one years. Emancipation also takes place: (1) By the marriage of the
minor; or (2) By the recording in the Civil Register of an agreement in a public instrument executed by the parent exercising parental authority
and the minor at least eighteen years of age. Such emancipation shall be irrevocable.
9. Trisha Macilad died of myocardial infarction while in transit in a plane. Spirit Airlines, where she is at board,
came from Aklan and was heading for Manila. Her untimely death was pronounced by one of the passengers, a
licensed medical doctor. Where would Trisha Macilad’s death certificate be filed?
a. Her birth place c. The place where Trisha will be buried
b. In Aklan where she came from d. In Manila where she is headed
ANSWER: C - The death of a person in a vehicle, airplane or vessel while in transit within the jurisdiction of the Philippines and where the
exact place of death cannot be determined, the Certificate of Death shall be issued by the health officer of the place of burial/cremation and
shall be registered in the Office of the Civil Registrar of the said city/municipality.

10. As members of the health team, nurses shall collaborate with other health care providers for restoration of
health and alleviation of suffering. The following are the duties of nurses, which one is not included?
a. Provide nursing care through the utilization of the nursing process
b. Be the leader in a surgical team inside the operating room
c. Provide health education to individuals, families and communities
d. Teach, guide and supervise students in nursing education programs

ANSWER: B - According to RA 9173, Article VI, Sec. 28 (Scope of nursing). It shall be the duty of the nurse to: Provide nursing care
through the utilization of the nursing process, establish linkages with community resources and coordination of the health team, provide
health education to individuals, families and communities, teach, guide and supervise students in nursing education programs, and
undertake nursing and health human resource development training and research.

11. Who does not INITIATE a lawsuit?

a. Claimant b. Complainant c. Defendant d. Plaintiff
ANSWER: C - The PLAINTIFF (claimant or complainant) is the party who initiates a lawsuit (also known as an action) before a court. The
DEFENDANT or defender is any party who is required to answer the complaint of a plaintiff or pursuer in a lawsuit before a court.

Situation: Nurses should adjust themselves to the organization and know its policies and procedures.
12. In obtaining an informed consent, the nurse should:
a. Describe in a vivid and simple statement what will happen during the surgery
b. Provide the informed consent for surgery and witnessing the client’s signature
c. Explain the pros and cons of surgery
d. Persuade the client in signing the consent by using the patient-nurse relationship
ANSWER: B - The nurse’s responsibility in obtaining an informed consent for surgery is providing the client with the consent form and
witnessing the client’s signature. The nurse-client relationship should never be used to persuade the client to sign a permit for surgery or other
medical treatments; A and D – are the responsibilities of the doctor/surgeon

13. A critically ill patient who is admitted to the hospital gives the Nurse Jayson an advance directive. The nurse
should understand that an advance directive is:
a. A written statement by the patient that defines accepted care if the patient becomes incapacitated
b. The name of the person designated by the patient to make health –related decisions should the patient
become incapacitated
c. a statement identifying the patient as an organ donor
d. a written statement authorizing a particular surgical procedure
ANSWER: A - An advance directive is a written document that contains directives of the person’s choices regarding end of life care. A person
must have the cognitive and communicative abilities to execute decisions regarding their desires. It includes wishes for treatment options
should the person become unable to do so.

14. DNR order was written for a client with end-stage renal disease. Which of the following activities would be
allowed for the nurse to continue to do?
a. Make sure self-inflating bag is at the bedside
b. Repositioning the client every two hours to prevent progression of bed sore
c. Cardiopulmonary resuscitation
d. Prepare to write an incident report after the patient dies
ANSWER: B - A DNR order is written to indicate that the goal of treatment is a comfortable (e.g repositioning a client), dignified death and that
further life-sustaining measures are NOT indicated (e.g. self-inflating bag in bedside and CPR). Writing an incident report is not necessary,
however accurate documentation is needed.

15. A “no code” order was made by the doctor and would mean the following, except:
a. With cardiac monitoring c. Prepare emergency cart
b. No cardiopulmonary resuscitation should be made d. Provide comfort measures
ANSWER: C - Physicians may order a “no code” or “do not resuscitate (DNR) (e.g. no cardiopulmonary resuscitation) for clients who are in
stage of terminal, irreversible illness or expected death. Cardiac monitoring has no relation to the goal of the decided order. A DNR order is
separate from other aspects of a client’s care and does not imply that other types of care should be withdrawn, for example, nursing care to
ensure comfort or medical treatment for chronic but non-life threatening illnesses.

16. Who can write a Do Not Resuscitate (DNR) order?

a. Attending Physician c. Family of the patient
b. Nurse d. Patient himself
ANSWER: A - The attending physician may write a DNR order on an inpatient, which directs the staff not to perform the casual CPR in the
event of a sudden cardiopulmonary arrest. The doctor may write such an order without the evidence of a living will on the medical record.
Often a DNR is considered a medical decision that the doctor can make, preferably in consultation with the family, even without a living will
executed by the patient. The nurse can never write such order.
Situation: Nursing ethics is concerned with the principles of right conduct as they apply to the nursing
profession.
17. Nurse Mila is facing a possible malpractice lawsuit after administering a wrong medication to the client. Mila
knows that there is proof of liability based on the following facts, except:
a. She is the assigned nurse at the time the act was committed based on the staffing schedule
b. She fails to perform her duty based on published nursing standards
c. Medical reports didn’t show any deleterious effect to the patient’s health
d. A cause-and-effect relationship must be clearly stated
ANSWER: C - Proof of liability depends on four elements:
a. There is a presence of duty
b. The nurse fails to act in accord with the standard of care
c. Injury must be demonstrated by the person making the claim to prove negligence
Causation is the breach of duty that must be proved to have legally caused the injury

18. What can a nurse do to reduce the risk of malpractice litigation?

a. Secure an incident report on file c. Give value judgment when appropriate
b. Be expert and competent in practice d. Do not discuss medication errors with the client and family
ANSWER: B - Being expert and competent in practice will allow the nurse to do interventions without error or minimal error that would not inflict
any harm to the patient. Securing an incident report on file is part of the actions done after a malpractice has transpired. Giving value
judgment is part of being competent in one’s practice.

19. In the O.R. during an operation, an O.R. nurse is inducing anesthesia to the patient. What type of legal issue will
be confronted by the nurse?
a. Malpractice b. Res ipsa loquitur c. Force majeure d. None of the above
ANSWER: A - improper and unskillful care of a patient by a nurse, it also denotes stepping beyond one’s authority with serious consequence;
B – “the thing speaks for itself”; C – This is an irresistible force, one that is unforeseen or inevitable, such as floods, fire, earthquakes, and
accidents fall, a nurse who failed to render care during this time shall not be held responsible.

20. Defamation is communication that is false, or made with a careless disregard for the truth, and results in injury
to the reputation of a person. Which action of a nurse less likely constitutes defamation?
a. Nurse Mia told her patients that Nurse Beth is an incompetent nurse
b. Nurse Petunia wrote on her diary that her co-worker Nurse Becky is obnoxious and incompetent
c. Nurse Trisha wrote in the nurse’s notes that Dr. Cruz is incompetent because he didn’t respond
immediately to a call
d. Nurse Gary posted on the hospital’s information board Nurse Mia’s vacation pictures where she is
wearing a flaunting swimsuit
ANSWER: B - DEFAMATION is communication that is false, or made with a careless disregard for the truth, and results in injury to the
reputation of the person. LIBEL is defamation by means of printing, writing (OPTION C) or pictures (OPTION D). SLANDER is defamation by
the spoken word, stating unprivileged or false words by which reputation is damaged (OPTION A). Only the person defamed may bring the
lawsuit. The defamatory material must be communicated to a third party such that a person’s reputation may be harmed. Writing about
someone in personal’s diary doesn’t involve any third party.

21. Kristian is about to have hemorrhoidectomy. While you are giving information about the procedure, you can
protect a client’s right to autonomy through:
a. Beneficence c. Advance Direcetives
b. Nonmalificence d. Informed Consent
ANSWER: D - AUTONOMY refers to the right to make one’s own decisions. Nurses who follow this principle recognize that each client is
unique, has the right to be what that person is, and has the right to choose personal goals. With INFORMED CONSENT the patient is given
the information he/she needs to be able to make a decision if treatment will be pursued; A – BENEFICENCE means “doing good.” Nurses are
obligated to do good, that is, ti implement actions that benefit clients and their support persons; B – NONMALEFICENCE is duty to “do no
harm.”; C – Advance directives, are instructions given by patients specifying instructions to be taken for their health in the event that they are
no longer able to make decisions due to illness or incapacity.

Situation: The appropriate authority to administer, implement, and enforce the regulatory policies of
government with respect to the regulation and licensing of the various professions and occupations under
ins jurisdiction is the Professional Regulatory Commission (PRC).
22. Which of the following is not included in the qualifications to be a member of BON?
a. Be a natural born citizen and resident of the Philippines
b. Be a member of good standing of the accredited professional organization of nurses
c. Be a registered nurse and holder of a master's degree in nursing, education or other allied medical
profession conferred by a college or university duly recognized by the Government
d. Have at least eight years of continuous practice of the profession prior to appointment
ANSWER: D - Have at least ten (10) years of continuous practice of the profession prior to appointment: Provided, however, That the last five
(5) years of which shall be in the Philippines

23. Which is not part of the duties and functions of the Board of Nursing?
a. Conduct the licensure examination for nurses
b. Has the authority to open and close colleges of nursing and/or nursing education programs
c. Issue, suspend or revoke certificates of registration for the practice of nursing
d. Monitor and enforce quality standards of nursing practice in the Philippines and exercise the powers
necessary to ensure the maintenance of efficient, ethical and technical, moral and professional
standards in the practice of nursing taking into account the health needs of the nation
 ANSWER: B - Ensure quality nursing education by examining the prescribed facilities of universities or colleges of nursing or
departments of nursing education and those seeking permission to open nursing courses to ensure that standards of nursing education
are properly complied with and maintained at all times. The authority to open and close colleges of nursing and/or nursing education
programs shall be vested on the Commission on Higher Education upon the written recommendation of the Board

24. A nurse should be cognizant that professional programs for specialty certification by the Board of Nursing are
accredited through the:
a. Professional Regulation Commission c. Association of Deans of Philippine Colleges of Nursing
b. Nursing Specialty Certification Council d. Philippine Nurses Association
ANSWER: D - Keyword = programs for specialty certification which is a part of the CPE Program for the renewal of licenses. PNA is the only
organization accredited to give CPE Programs with valid CPE units. Other professional organizations can give CPE programs. In fact even
colleges of nursing can apply for accreditation as CPE sponsoring agencies. Specialty programs are not ordinary CPE programs (seminars,
conventions, lectures) but aim to produce specialty nurse clinicians (examples critical care oncology, renal). Article VII sec 31 of RA 9173 says
“the board in coordination with the accredited professional organization, therefore PNA.

25. What are the requirements for inactive nurses who are returning to practice?
a. Undergo one (3) months of didactic training and one (1) month of practicum
b. Undergo one (2) months of didactic training and three (3) months of practicum
c. Undergo one (1) month of didactic training and three (3) months of practicum
d. Undergo one (3) months of didactic training and three (2) months of practicum
ANSWER: C - Nurses who have not actively practiced the profession for five (5) consecutive years are required to undergo one (1) month of
didactic training and three (3) months of practicum. The Board shall accredit hospitals to conduct the said training program.

Situation: The first association a nurse joins after graduation is the alumni association.
26. The objective of joining an alumni association is to provide graduates of institution with opportunities for: select
all that applies:
1. Keeping abreast of school activities
2. Keeping the school friendships alive
3. Assisting in securing endowment funds for variety of purposes
4. To establish linkage with government

a. 1,3,4
b. 1,2,3
c. 2,3,4
d. 1,2,4

Answer: B- all of the above options are opportunities for the graduates when joining the alumni association except for
number 4; to establish linkage with government which is a purpose when joining the PNA.

27. This is formerly known as the Department of Health National League of Nurses (DHNLN) which
is founded by Annie Sand:
a. The Philippine Nurses Association (PNA)
b. The National League of Government Nurses (NLGN)
c. Alumni Association
d. Association of Nursing Service Administrator of the Philippines, Inc (ANSAP)

Answer: B- NLGN is a duly incorporated organization of professional nurses employed by the

government of the Philippines. Option A- the PNA was organized on October 22, 1922, upon the
initiation of Mrs. ANastacia Giron Tupas. Option C-membership in the alumni association fosters
loyalty among its members. Option D- the ANSAP was founded in 1963 but was reorganized ten
years later in 1973. It is composed of nursing service administrators both in government and
private agencies.

28. Who is the founder of the Philippine Red Cross?

a. Henry Dunant
b. Anastacia Giron Tupas
c. Rosario Delgado
d. Annie Sand

Answer: A- Henry Dunant is the founder of Red Cross in the world. Anastacia Giron Tupas is the
founder of the PNA. Rosarion Delgado is the first president of the PNA. Annie Sand founded the
National League of Government Nurses (NLGN).
29. Moreover, with nursing practice flourishing in all government nurses so that they can be
presented well in government, thus the name National League of Government Nurses (NLGN)
1. To promote and maintain the highest standards of nursing in government
2. To attain optimal level of professional standards
3. To respond to the changing health needs of the Philippine society
4. To continuously upgrade professional competence through research, training

a. 1,4
b. 1,2
c. 1,2,3
d. 1,3

Answer: A- to promote and maintain the highest standards of nursing in government, and to
continuously upgrade professional competence through research, training, scholarship grants both
foreign and local and dissemination of information through nursing publications are some of the
objectives of the NLGN. Number 2 and 3 is a purpose of the PNA.

30. This is organized for the purpose of promoting friendship and to organize nurses in industrial
and commercial enterprises into an Industrial nursing unit.
a. Philippine Nurses Association
b. National League of Government Nurses
c. The Occupational Health Nurses Association of the Philippines
d. The Association of Nursing Service Administrators of the Philippines, Inc (ANSAP)

Answer: C- It was organized on November 21, 1950. Option A- it was organized on October 22,
1922. Option B- duly incorporated organization of professional nurses employed by the
government of the Philippines. Option D- composed of nursing service administrators both in
government and private agencies.

Situation: when nurses undertake to practice their profession, they are held responsible and
accountable and accountable for the quality of performance of their duties.

31. Thomas, a lawyer has been committed to a psychiatric facility after being diagnosed with
schizophrenia. One morning while walking outside with Nurse Emily, the client runs away.
The immediate responsibility of the nurse would be the notify the:
a. Client’s psychiatrist of the elopement
b. Probate judge who committed the client
c. Client’s family that the client has left the hospital
d. Local law enforcement officers of the client’s elopement

Answer: D- legally, it is the responsibility of the staff to notify law enforcement officers so that
the client can be returned.

32. After caring for a terminally ill client for several weeks, the nurse becomes increasingly
aware of a need to get away from this assignment. The best action by the nurse would be
to:
a. Request vacation time for a few days
b. Seek support from colleagues on the unit
c. Withdraw emotional involvement with the client
d. Stay with the client and try to work through feelings

Answer: B- talking with colleagues who face or have faced the same problems may provide
constructive help with the situation. A- this is an avoidance technique; feelings must be
addressed. C- this avoids feelings and may make the nurse more uncomfortable. D- this does
not address the needs of the nurse and may interfere with a productive nurse-client relationship.

33. A female nurse, who works in the intensive care unit of a large city hospital, has been
working double shifts to pay for a new car. These are stopped when frequent headaches
and fatigue ensue. The nurse manager notices that the care the nurse is providing is barely
 adequate, that she is working harder, and accomplishing less even staying an extra hour
every day. The nurse manager should handle this situation by stating:
a. “I think you are trying too much.”
b. “What can I do to help you get finished on time?”
c. “I’ve noticed you’ve been staying late almost every night.”
d. “I’ll help you get more organized so you can leave on time.”

Answer: C- an understanding and supportive approach to a colleague with burnout allows the
individual to identify that problem; this intervention points out behavior. A- this interferes with
self-identification of the problem; also, the individual may get defensive. B-this moves right into
trying to solve the problem the individual has an opportunity to share feelings or self-identify the
problem. D- this is an accusatory approach; this does not give the individual an opportunity to
address the overtime or to express feelings.

34. A client with dementia often assaults the nursing staff, and the staff decides to develop a
plan that will make this client’s personal care less of a problem. The plan should include:
a. Limiting staff time with the client
b. An outline of the consequences for uncooperative behavior
c. Identification of nursing staff members who the client prefers
d. The client’s likes and dislikes for use as a reward or punishment

Answer: C- the type of care needed by the client requires trust in the caregiver; trust develops
more rapidly when there is a cooperative relationship. A- limiting staff time may place the client
in jeopardy. B- the staff should not be put in the position of punishing the client; positive
reinforcement is more therapeutic. D- reward may be used to provide incentive for changes in
behavior; punishment is inappropriate.

35. After speaking with the parents of a child dying from leukemia, the physician gives a verbal
DNR order but refuses to put it in writing. The nurse should:
a. Follow the order as given by the physician
b. Refuse to follow the order unless the nursing supervisor OKs it.
c. Ask the physician to write the order in pencil on the client’s chart before leaving
d. Determine whether the family is in accord with the physician and follow hospital
policy

Answer: D- this verifies family and physician agreement and uses institutional policy developed
by the ethics committee. A and B- the nurse should not accept this inappropriate burden. C- the
order must be part of a written record.

Situation: Nurses employed in an agency, institution, or hospital are directly responsible to their
immediate supervisor.

36. The nurse manager who is helping a nurse with “burnout” should facilitate confrontation of
the problem by urging the nurse to:
a. Work on a primary nursing care unit
b. Choose a nursing position on a low-stress unit
c. Attend educational programs as often as possible
d. Identify her personal responses to daily work stresses

Answer: D- to confront burnout, the individual must first identify stressors, coping strategies
used, and effectiveness of these strategies. A- this may help, but prevention begins with
knowing oneself and the effectiveness of one’s coping strategies. B and C- this may help
prevent burnout, but it is not the first step in confronting the problem after it occurs.

37. The nurse should always take time to keep a client’s family informed about what is
happening to the client. The main reason for this action is that informed families:
a. Decrease the client’s anxiety
b. Commonly cause fewer nursing problems
c. Appear more relaxed and at ease with the client
d. Are better equipped to undertake necessary family role changes

Answer: D- early notification provides an opportunity to prepare for change. A, B, c- this may be
a secondary gain but it is not the primary purpose. D- early notification provides an opportunity
to prepare for change.
38. The husband of a client who is dying tells the nurse that he knows that his wife is asking the
nurse to leave her pain medication on the bedside table and fears she is saving it up for a
suicidal attempt. The nurse knows that many of the staff members have mixed feelings
about the client’s terminal status and prolonged pain. The nurse uses an approach that is
ethically sound by:
a. Reporting the information to the nurse manager responsible for the unit
b. Speaking to all of the nurses and telling them not to leave the medication at the
bedside
c. Asking the head nurse to handle the problems of the client’s medication and the
staff’s feelings
d. Suggesting a nursing conference be held to discuss staff feelings as well as the
medication problem

Answer: D- this approach is positive because it attempts to deal with the staff’s feeling as well
as the problem; the nurse therefore is taking an ethically sound action without being moralistic
or authoritarian. A, B, C- this abdicates the nurse’ responsibility and may create anger and guilt
in the staff members.

39. It is determined that a staff nurse has a drug abuse problem. As an initial intervention the
staff nurse should be:
a. Counseled by the staff psychiatrist
b. Dismissed from the job immediately
c. Forced to promise to abstain from drugs
d. Referred to the employee assistance program

Answer: D- this is a nonpunitive approach that attempts to help nurse as an individual and as a
professional. A- this may be necessary for long-term but would not be the initial approach. B-
this is a punitive, nontherapeutic response that offers no chance for rehabilitation. C- the client
has an addiction problem; promises will not keep the client from abusing drugs.

40. The nurse manager in the surgical intensive care unit notes that a number of clients do not
seem to be responding to morphine that has been administered for pain. Later that evening
the nurse manager finds a staff nurse in the nurses’ lounge dozing. When awakened, the
staff nurse appears somewhat uncoordinated and has slurred speech. The nurse manager
should:
a. Ask the other staff members whether they have noticed anything unusual.
b. Tell the staff nurse that everyone now knows who has been stealing the opiate.
c. Arrange to observe covertly the next time this staff nurse administers morphine
d. Call the nursing director and have the director present before confronting the staff

Answer: D- this is a serious charge, and confrontation should occur in the presence of a
supervisor. A- this is unnecessary; as a professional, the nurse manager has enough
information to confront the other nurse. B-this is an assumption that may result in an alteration;
a witness should be present. C- this is not a professional approach; the nurse manager has a
legal responsibility to intervene.

Situation:

41. A female client in the terminal stage of cancer is admitted to the hospital in severe pain. The
client refuses medication for the pain because it puts her to sleep and she wants to be
awake. One day, despite the client’s objection, a nurse administers the pain medication
saying, “You know that this will make you more comfortable.” The nurse in this situation
could be charged with:
a. Battery
b. Assault
c. Invasion of privacy
d. Lack of informed consent

42. A client who weighs 175 lb (79.4 kg) is receiving aminophylline (aminophyllin) (400 mg in
500 ml) at 50ml/hour. The theophylline level is reported as 6 mcg/ml. the nurse calls the
physician who instructs the nurse to change the dosage to 0.45 mg/kg/hr. the nurse should:
a. Question the order because it’s too low.
b. Question the order because it’s too high.
 c. Set the pump at 45 ml/hour.
d. Stop the infusion and have thelaboratory repeat the thwophylline measurement.
Answer: A- a therapeutic level theophylline level is 10 to 20 mcg/ml. the client is currently
receiving 0.5 mg/kg/hr of aminophylline. Because the client’s theophylline level is sub-
therapeutic, reducing the dose (which is what the physician’s order would do) would be
inappropriate. Therefore, the nurse should question the order.

43. Nurse Tom may not disclose confidential information about the client when:
a. The father of a woman who just delivered a baby is on the phone to find out the sex
of the baby
b. A researcher from an institutionally approved research study reviews the medical
record of a client with leukemia
c. The nurse discusses the client in a clinical conference with other nurses
d. A client asks the nurse to discuss the diagnosis with the client’s children

Answer: A- the nurse has no idea who the person is on the phone, and therefore may not share
the information, even if the client gives permission. Option B- limited disclosure for legitimate
approved research purposes to advance medical knowledge is permitted. Option C- limited
disclosure is permitted.

44. In terms of confidentiality, how should the nurse respond to a husband who wants to know
about his wife’s condition?
a. Suggest that he discuss it with his wife
b. Refer him to the doctor
c. Refer him to the nurse in charge
d. Find out what information he already has

Answer: D- Its best to establish baseline information first. Option A- It would be the next step, after
finding out what the husband knows,; it encourages direct communication with his wife. Option B-
it would not be the preferred response, because it is less direct. Option C- it is the least appropriate
of the choice, because it is the least direct.

45. Guian, tells Nurse Engel that he has something he wants to say but does not want the nurse to
tell anyone else. Nurse Engel should:
a. Agree not to “tell”.
b. Refuse to agree.
c. Say nothing, allowing him to go on.
d. Let him know that the nurse cannot promise this.

Answer: D- Information given to the nurse that may interfere with the client’s recovery must be
related to other team members. Option A- it is withholding information from other staff members
who are also responsible for care, and may interfere with recovery.

Situation: Clinical bioethics is the practical and applied discipline that aims to improve patient care
and patient outcomes by focus on a right and good medical decision.

46. A victim of a motor vehicle accident is brought to the emergency department and dies. The
nurse is aware that the organ donation card on the client’s driver’s license is signed. The
mother is distraught and refuses to permit the organ donation. The best response by Nurse Jb
would be:
a. “I understand how you feel, but you will have to inform the physicians.”
b. “You are the one who is experiencing the loss and I agree with your refusal.”
c. “Legally you can’t refuse the donation, but maybe the physician will reconsider.”
d. “I can see that you are distressed, but this organ donation is the request and legal right
of your loved one.”
Answer: D- this response recognizes the rights of the decreased while empathizing with the
feelings of the mother. Option A- it is not the family’s obligation to inform the physicians. Option B-
It is immaterial whether the nurse agrees and it fails to state the law correctly. Option C- the
physicians have no right to stop the organ donation against the donor’s wishes unless there is a
problem with the organs.

47. Nurse Brian is caring for a woman who is pregnant and terminally ill with inoperable cancer.
The woman has not been informed about her status by the physician. The woman has not been
informed about her status by the physician. The woman states to the nurse: “I know I am
terribly sick. I think you know what it is. I want you to tell me right now.” The nurse is legally and
ethically obligated:
a. Give the information requested by the client.
b. Deny knowledge about the client’s condition and not give the client any further
information.
c. Make the client’s medical record available to her because she is entitled to see it.
d. Discuss the situation with the physician.

Answer: D- it is the role and obligation of the physician to inform the client. The nurse is obligated
to make the physician aware that the client is demanding information. Option A- although the nurse
has an ethical obligation to be truthful, it is the role and obligation of the physician to inform the
client. Option B- the nurse would be lying to the client. Option C- regardless of whether the client
has a right to view the record, the client is not in a position to interpret the record appropriately, that
is the role of the physician.

48. Dr. Del Rosario has ordered a bronchoscopy for a client with a chronic cough. The nurse brings
the informed consent document into the client’s room for a signature. The client asks the nurse
to explain why the process of informed consent is necessary. The nurse responds that
informed consent means:
a. The client agrees to a procedure ordered by the physician, even if he or she does not
understand what the outcome will be.
b. The physician must give the client or surrogates enough information to make health-
[care judgments consistent with their values and goals.
c. The immediate family may make decisions against the client’s will.
d. The client releases the physician from all responsibility for the procedure.

Answer: B- it best explains what informed consent is and provided for legal rights of the client.
Option A- provision of the informed consent process is that the client understands what is to be
done. Option C- informed consent is based on the client’s wishes, not the family’s. Option D- the
informed consent process is not about the physician’s competence.

49. Nurse Richie on the postpartum unit is aware that one of the medical staff displays behavior
consistent with possible substance abuse: confusion, memory gaps, lethargy, agitation, and
unkempt appearance. The nurse has reported these observations to the nurse manager
several times, but nothing has happened. The nurse should:
a. Consider that the obligation to protect the client from harm has been met by the prior
reports and do nothing further.
b. Discuss the situation with friends who are also nurses to get ideas about what to do.
c. Approach the partner of this medical staff member with these concerns.
d. Continue to report observations of unusual behavior until the problem is resolve.

Answer: D- the submission of reports about incidents that expose clients to harm does not remove
the obligation to report ongoing behavior as long as the risk to the clients continues. Option A- the
legal obligation to report potential harm to clients is not removed by prior reporting if the potential
for harm continues. Option B- discussing the situation with others may expose the nurse to
accusations of slander. Option C – discussing the situation with others may expose the nurse to
accusations of slander, and the partner of the medical staff member has no administrative authority
to protect the clients.

50. A staff nurse comes to work smelling of alcohol, is ataxic, and confirms to the charge nurse that
she was drinking before work. What should the charge nurse do?
a. Ignore the behavior
b. Assign the staff nurse to a desk job
c. Tell the staff nurse that this behavior is not acceptable and send the nurse home
d. Inform the nursing supervisor

Answer: D- this situation calls for a higher line of authority (the supervisor). Option A- this behavior
cannot be ignored. This question is one of ethics and management. Option B- assigning the nurse
to a desk job may be seen as “ignoring” and “accepting” the unacceptable behavior. Option C- the
nursing supervisor, not the nurse, is the one in the nursing hierarchy with authority to send the
employee home.

51. In order to be a licensed nurse one has to pass the nurse licensure examination regulated primarily by the Board
of Nursing. Which is not included as a qualification for admission to the licensure examination?
a. Only a Filipino citizen can take the Philippine Nurse Licensure Examination
b. He/she must of good moral character
c. He/she must be a holder of a Bachelor’s Degree in Nursing
d. The school/university where the examinee received his/her degree has complied with the standards of
nursing education duly recognized by the proper government agency
ANSWER: A - According to RA 9173 (Section 13): He/she is a citizen of the Philippines, or a citizen or subject of a country which permits
Filipino nurses to practice within its territorial limits on the same basis as the subject or citizen of such country: Provided, That the requirements
for the registration or licensing of nurses in said country are substantially the same as those prescribed in this Act

52. Maria Criselda Assuncion has a 77% rating on her nursing board exam but is not eligible to become a licensed
nurse. You would expect that:
a. Her rating is below the required grade for passing
b. She may have score of 60% - 70% on one or more of the subjects
c. She would repeat the entire examination
d. She may have a score of below 60% on one of the subjects
ANSWER: A - RA 9173, Section 15: In order to pass the examination, an examinee must obtain a general average of at least seventy-five
percent (75%) with a rating of not below sixty percent (60%) in any subject. An examinee who obtains an average rating of seventy-five percent
(75%) or higher but gets a rating below sixty percent (60%) in any subject must take the examination again but only in the subject or subjects
where he/she is rated below sixty percent (60%).

53. A patient was admitted in your unit. She is verbally threatening everyone and starting to become combative.
When you asked her to calm down, she pushed you and was about to hit you with her fist. What would be the
appropriate action at this time?
a. Restrain the patient with the help of you co-workers c. Allow the patient to hit you mildly
b. Call the doctor immediately d. Document the incident
ANSWER: A - Restrain should always be accompanied by a doctor’s order. In the absence of such order and an emergency situation (e.g.
physically combative patient) where safety if the patient and the people around him/her is at stake, restrain can be administered. However,
after the intervention the nurse should immediately acquire an order from the doctor to avoid legal liabilities such as false imprisonment.

54. During the morning visit of the physician in the ICU, Dr. Schu ordered the nurse to administer Metoprolol to
the patient. What should be the initial action by the nurse in this situation?
a. Call the pharmacy to order the drug
b. Ask Dr. Schu to write the order in the patient’s chart
c. Refuse to follow the order since it is not written in the chart
d. Prepare the medication and administer to the patient
ANSWER: B - The nurse should first ask the doctor to write and sign the order in the chart before calling the pharmacy. Verbal orders can be
carried out, provided, the nurse should let the doctor sign the order within 24 hours.

55. Who is not considered as an impaired nurse?

a. A nurse who goes to work with has alcohol on breath and has blackouts
b. A nurse who lost a limb due to complications of diabetes mellitus
c. A nurse who consistently signs out more or larger amounts of controlled drugs than anyone else
d. A patient who is mentally ill
ANSWER: B - The term IMPAIRED NURSE refers to a nurse whose ability to perform functions of a nurse is diminished by chemical
dependency on drugs, alcohol or mental illness; A – is a characteristic of an alcoholic nurse; B – is may indicate a nurse who is a drug-addict.

56. Which is a non-reviewable sentinel event?

a. Suicide of any patient receiving care, treatment and services in a staffed around-the-clock care setting
or within 72 hours of discharge
b. Administering a medication not intended for the patient
 c. Unanticipated death of a full-term infant
d. Surgery on the wrong patient or wrong body part
ANSWER: B - A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof.
Serious injury specifically includes loss of limb or function. The phrase “or the risk thereof” includes any process variation for which a
recurrence would carry a significant chance of a serious adverse outcome. Such events are called “sentinel” because they signal the need for
immediate investigation and response. The terms “sentinel event” and “medical error” are not synonymous; not all sentinel events occur
because of an error and not all errors result in sentinel events. Administering a medication that do not result in death or major permanent loss
of function is non-reviewable sentinel event.

57. A nurse sees another nurse administer an incorrect medication to a client. The nurse who administered the
incorrect medication does not report the error. The initial action by the nurse who observed the error is which of
the following?
a. Ask the nurse if she intends to report the error c. Document the error in the clients record
b. Contact the supervisor d. Complete an incident report
ANSWER: A - The initial action by the nurse who observed the error would be to ask the nurse if he or she intends to report the error. To
ensure client safety, all errors need to be reported. The client also needs to be assessed immediately. An incident report needs to be
completed by the nurse who administered the incorrect medication. The appropriate documentation also needs to be made in the client’s
record by the nurse who administered the incorrect medication. If the nurse who made the error indicates that the error will not be reported then
it may be necessary to contact the supervisor. Use the process of elimination, noting the key words “initial action.”; (C) and (D) they are similar
and should be performed by the nurse who administered the incorrect medication. From the remaining options, focusing on the key words will
direct you to option A.

58. You are reading the chart of your patient and take note of which abbreviation needs correction?
a. DAT b. H2O c. D/C d. IV
ANSWER: C - Many of the abbreviations used in documentation are standard and used universally. In 2004, the JCAHO developed National
Patient Safety Goals (NPSGs) to reduce communication errors. The abbreviation D/C, which means for discharge, has been interpreted as
DISCONTINUE. Therefore, one should spell out the word discharge instead of using the abbreviation.

59. The International Council of Nurses (ICN) is a federation of national nurses’ associations (NNAs), representing
nurses in more than 128 countries. Founded in 1899, ICN is the world’s first and widest reaching international
organisation for health professionals. The ICN Code of Ethics for Nurses has four principal elements that
outline the standards of ethical conduct and these are: Nurses and People; Nurses and Practice; Nurses and the
Profession; and Nurses and co-workers. For the first element of the code “Nurses and People”, how could
educators and researchers translate the code of ethics?
a. In curriculum include references to human rights, equity, justice, solidarity as the basis for access to
care
b. Provide care that respects human rights and is sensitive to the values, customs and beliefs of all people.
c. Provide sufficient information to permit informed consent and the right to choose or refuse treatment.
d. Develop and monitor environmental safety in the workplace
ANSWER: A - Based from the first element of the code: Nurses and People, the nurse’s primary professional responsibility is to people
requiring nursing care. Specifically for educators and researchers, they can practice the standards of this code by including in the curriculum
references to human rights, equity, justice, solidarity as the basis for access to care. Other options are practices that can be done by the nurse
practitioners and managers.

60. Continuing education for nurses is provided for in the nurses’ code of ethics. Which of the following is type of a
formal continuing education?
a. Teleconference c. Attendance in seminars
b. Enrolment in graduate school d. Teaching
ANSWER: B - Other formal continuing education: conventions, residency (training at a graduate level), distance learning (use of manuals or
accredited modules), on the job training (externship at he post graduate level)

61. There are certain circumstances that affect liability. When a person voluntarily surrendered himself to a person
in authority before the court prior to the presentation of the evidence for the prosecution, this is would be
considered as:
a. Justifying Circumstance c. Exempting Circumstance
b. Mitigating Circumstance d. Aggravating Circumstance
ANSWER: B - MITIGATING CIRCUMSTANCE are those which when present results either to: (i) the penalty being reduced by at least one
degree or (ii) the penalty shall be imposed in its minimum period. They are those enumerated in Article 13 of the REVISED PENAL CODE;
JUSTIFYING CIRCUMSTANCE are the defenses in which the accused is deemed to have acted in accordance with the law and therefore the
act is lawful. Since the act is lawful, it follows that there is no criminal, no criminal liability and no civil liability; EXEMPTING CIRCUSMTANCES
are defenses where the accused committed a crime but is not criminally liable. There is a crime, and there is civil liability but no criminal;
AGGRAVATING CIRCUMSTANCES are those which when present will result either to: (i) a change in the nature of the offense as to make it
more serious and result to the imposition of a higher penalty (ii) the penalty being imposed in its maximum period.

62. A void contract:

a. is an agreement among parties and is written c. is concluded as a result of acts of conducts
b. is an expressed contract given orally d. cannot be reinforced
ANSWER: D - VOID CONTRACT is one that is inexistent from beginning and therefore may not be enforced; A– A FORMAL CONTRACT
refers to an agreement among parties involved and is required to be in writing; B – an EXPRESS CONTRACT is made if its terms and
conditions which are given orally or in writing by the parties; C – IMPLIED CONTRACTS is a result of acts of conduct of the parties to which the
law ascribes an objective intention to enter into a contract

63. Malpractice:
a. is an obligation one has incurred or might incur through any act or failure to act
b. refers to a professional person’s wrongful conduct
 c. is the breach of duty
d. is an act that harms a person
ANSWER: B - Malpractice also refers to improper discharge of professional duties, or failure to meet the standards of acceptable care
that results in harm to another person; A – This is the definition of LIABILITY; C – This is NEGLIGENCE; D – This is TORT
64. Which is true about a nurse who performed a malpractice in duty?
a. A nurse has to notify the physician to be freed from liability
b. The nurse will always face lawsuit because it is below the standard of practice
c. There would be no lawsuit if harm or injury is not sustained
d. A lawsuit cannot be filed if the patient is mentally handicapped
ANSWER: C - The client must demonstrate some type of harm or injury as a result of a wrongful ac for a lawsuit to be filed. Notifying the
physician does not absolve the nurse of wrongdoing if the client is harmed. The nurse's action may have been below the standard of practice,
but again, if no harm was done to the client, a lawsuit cannot ALWAYS be filed. Having a patient that is mentally challenged does not exclude a
nurse.

65. What is the appropriate nursing action for a patient who refuses treatment?
a. Notify the physician of the patient’s refusal
b. Tell the patient that he can die if he doesn’t cooperate
c. Give the treatment since the patient needs it
d. Explain the consequences if without treatment
NSWER: A - If the patient refuses treatment the doctor should be notified. Telling the patient that he can die if not treated is unethical and
nontherapeutic. Giving the treatment without consent (since patient is refusing) is violating the patient’s right to self-determination. Explaining
the consequences of not being treated is a primary responsibility of the doctor.

66. Children acquire moral reasoning in a developmental sequence. Moral development, as described by Kohlberg,
is based on cognitive development theory and consists of three major levels. A child that is culturally oriented
to the labels of good/bad and right/wrong is at what level of moral development?
a. Conventional Level c. Postconventional Level
b. Preconventional Level d. Autonomous Level
ANSWER: B - At PRECONVENTIONAL LEVEL a child determine the goodness or badness of an action in terms of its consequences. They
avoid punishment and obey without question those who have the power to determine and enforce the rules and labels.

67. An example of unintentional tort is:

a. Negligence b. Assault c. Battery d. False imprisonment
ANSWER: A - Tort is when damage to property or a personal injury caused by another person occurred. Several differences distinguish
unintentional torts from intentional torts. If the injury or damage was unintentional, then the wrong is called an unintentional tort such as in
negligence and malpractice. In contrast, with intentional torts, the defendant executed the act on purpose or with the intent. Assault, battery and
false imprisonment are all examples of intentional torts.
68. When a decision is made by the nurse based on what is right and wrong, or good and bad, related to the patient,
the decision was generated from?
a. Civil Law b. Torts c. Constitution d. Ethics
ANSWER: D – Option A – CIVIL LAW governs how individuals relate to each other in everyday matters; B – TORT is a private or civil wrong or
injury, including action for bad faith breach of contract, for which the court will provide a remedy in the form of an action for damages; C –
CONSTITUTION is a set of basic laws that specifies the powers of various segments of the government and how these segments relate to
each other.

69. Morality is most appropriately associated with:

a. Right and wrong c. Truths and principle of knowledge
b. Custom and traditions d. Personal beliefs about truth of ideals
ANSWER: B - MORALITY is a behavior in accordance with custom or tradition and usually reflects personal or religious beliefs. ETHICS is the
branch of philosophy that concerns the distinction of RIGHT AND WRONG on the basis of a body of knowledge, not just on the basis of
opinions. PHILOSOPHY is the rational investigation of the TRUTHS AND PRINCIPLE OF KNOWLEDGE, reality and human conduct.
VALUES are PERSONAL BELIEFS ABOUT THE TRUTH OF IDEALS, standards, principles, object, and behaviors that give meaning and
direction to life.

70. Which is a form of false imprisonment?

a. Nurse telling her patients that if they do not take their medication she will never get to eat their meals
b. Restraining a client who suddenly becomes physically aggressive and shows self-harming behaviors
c. Sedating a verbally abusive client
d. A nursing assistant hitting her patients’ hands whenever they refuse to eat
ANSWER: C - False imprisonment occurs when clients are made to wrongfully believe they cannot leave a place. An example of false
imprisonment is the use of physical restraints and chemical restraints (e.g. sedatives, hypnotics). In an emergency situation when a client
becomes violent and is in imminent danger of harming self or others, the nurse may apply restraints and then immediately obtain an order from
the physician. A verbally abusive client requires no sedation unless signs of possible physical harm are seen, sedating a client would be
tantamount to false imprisonment; A – is a form of ASSAULT; D – is a form of BATTERY.

71. In which of the following situations would a nurse be not liable for battery?
a. Giving an IV medication without the patient’s consent
b. If the nurse threatens someone by making a menacing gesture with a club or closed fist
c. Giving a medication that was ordered by the doctor but the patient refuses to cooperate
d. Forcefully restraining a patient without the doctor’s order
ANSWER: B - A nurse who threatens someone by making a menacing gesture with a club or closed fist is a form of ASSAULT. An assault is
an attempt or threat to touch another person unjustifiably. BATTERY is the willfull touching of a person that may or may not cause harm. To be
actionable at law, however, the touching done without permission, this is embarrassing, or that causes injury. Options A and B are both
 examples of battery. Option D is a common example of FALSE IMPRISONMENT (an unjustifiable detention of a person without legal warrant to
confine a person). False imprisonment accompanied by forceful restraint or threat is BATTERY as well.

72. Gary makes an appointment for 10:00 AM at the outpatient clinic and his neighbor, Mia, makes an 11:00 AM
appointment as well. Beth, who is a walk-in patient, was seen by the provider, Dr. Luvi, in place of the 10:00
AM appointment forcing Gary’s and Mia’s appointment to be delayed beyond the prearranged time. Dr. Luvi
has violated which ethical principle?
a. Justice b. Nonmalificence c. Veracity d. Beneficence
ANSWER: A- Justice includes both fairness and equality. Unequal treatment happened when DR. Luvi gave way to Beth who has not made an appointment; B –
Nonmaleficence is the requirement that health care providers do no harm to their patients, either intentionally or unintentionally. In a sense it is the opposite side of
the coin of beneficence, and it is difficult to speak of one concept without mentioning the other; C – Veracity is the virtue of truthfulness. It requires health care
providers to tell the truth and not intentionally deceive or mislead patients; D – Beneficence views the primary goal of health care as doing good for patients. In
general, the term good includes more than just technically competent care for patients. Good care requires a holistic approach to patients, including respect for their
beliefs, feelings, and wishes, as well as those of their family and significant others.

73. A client who coronary artery disease has a sudden episode of cyanosis and a change in respirations. The nurse starts oxygen
administration immediately. In this situation.
a. Oxygen had not been ordered and therefore should not be administered.
b. The nurse’s observations were sufficient to begin administration of oxygen
c. The symptoms were too vague for the nurse to diagnose a need for oxygen
d. The physician should have been called for an order before oxygen was begun
ANSWER: B - This shows the bioethical principle of beneficence. The Nurse Practice Acts states that nurses diagnose and treat human responses to actual or
potential health problems. Administration of oxygen in an emergency situation is within the scope of nursing practice; The rest of the options are incorrect since they
are not considering the danger imposed to the client if oxygen is not given. There is the so called “emergency rule”.

74. A client is placed on a stretcher and restrained with straps while being transported to the x-ray department. A strap breaks, and
the client fails to the floor, sustaining a fractured arm. Later the client states, “The strap was worn, just at the very spot where the
broken strap was worn. “ The nurse is:
a. Exempt from any lawsuit because of the doctrine of respondent superior
b. Totally and singly responsible for the obvious negligence because of failure to report defective equipment.
c. Liable, along with the employer, for misapplication of equipment or use of defective equipment that harms the client.
d. Completely exonerated, because only the hospital, as principal employer, is primarily responsible for the quality and
maintenance of equipment.
ANSWER: C - Respondeat Superior, this is the “master- servant rule”. Understand that the doctrine is applicable in cases of negligence by the nurse. The nurse was
negligent in using a stretcher with worn straps. Such an oversight did not reflect the actions of a reasonably prudent nurse. The hospital is also liable for not
providing the safe equipment; A – this is the “master- servant rule”. Yes this is applicable here, but the nurse is also held liable. Both the employee and the employer
may be held liable depending on what the investigation might show; B and D – Apply again Respondeat Superior; this is the “master- servant rule”. Both the
employee and the employer may be held liable depending on what the investigation might show.

75. Which of the following actions, if performed by the nurse, would be considered negligence?
a. The nurse obtains a blood specimen form the heel of the foot of a 2 day old infant
b. The nurse massages lotion on the abdomen of a 3 year old diagnosed with Wilm’s tumor
c. The nurse instructs a 5 year old asthmatic to blow on pinwheel
d. The nurse plays kick ball with a 10 year old with juvenile arthritis
ANSWER: B - Never massage the abdomen of a patient with Wilms tumor. In fact, the nurse should put a sign near the patient’s bed saying “NO ABDOMINAL
PALPATION.” Other options are correct nursing actions.

76. The newly licensed nurse has been asked to perform a procedure that he feels unqualified to perform. The nurse’s best response
at this time is to:
a. Attempt to perform the procedure
b. Refuse to perform the procedure and give a reason for the refusal
c. Request to observe a similar procedure and then attempt to complete the procedure
d. Agree to perform the procedure if the client is willing

Answer B is correct.
If the newly licensed nurse thinks he is unqualified to perform a procedure at this time, he should refuse, give a reason for the refusal,
and request training. Answers A, C, and D can result in injury to the client and bring legal charges against the nurse; therefore, they are
incorrect choices.

77. The nurse caring for a client in the neonatal intensive care unit administers adult-strength Digitalis to the 3-pound infant. As a
result of her actions, the baby suffers permanent heart and brain damage. The nurse can be charged with:
a. Negligence
b. Tort
c. Assault
d. Malpractice

Answer D is correct.
Injecting an infant with an adult dose of Digitalis is considered malpractice, or failing to perform or per forming an act that causes harm
to the client. In answer A, negligence is failing to perform care for the client and, thus, is incorrect. In answer B, a tort is a wrongful act
committed on the client or his belongings but, in this case, was accidental. Assault, in answer C, is not pertinent to this incident.

340
78. The nurse is suspected of charting medication administration that he did not give. The nurse can be charged with:
a. Fraud
b. Malpractice
c. Negligence
d. Tort

Answer A is correct.
If the nurse charts information that he did not perform, she can be charged with fraud. Answer B is incorrect because malpractice is
harm that results to the client due to an erroneous action taken by the nurse. Answer C is incorrect because negligence is failure to
perform a duty that the nurse knows should be performed. Answer D is incorrect because a tort is a wrongful act to the client or his
belongings.

79. The charge nurse witnesses the nursing assistant hitting the client in the long-term care facility. The nursing assistant can be
charged with:
a. Negligence
b. Tort
c. Assault
d. Malpractice

Answer C is correct.
Assault is defined as striking or touching the client inappropriately, so a nurse assistant striking a client could be charged with assault.
Answer A, negligence, is failing to perform care for the client. Answer B, a tort, is a wrongful act committed on the client or their
belongings. Answer D, malpractice, is failure to perform an act that the nurse assistant knows should be done, or the act of doing
something wrong that results in harm to the client.

80. A new nursing graduate indicates in charting entries that he is a licensed registered nurse, although he has not yet received the
results of the licensing exam. The graduate’s action can result in a charge of:
a. Fraud
b. Tort
c. Malpractice
d. Negligence

Answer A is correct.
Identifying oneself as a nurse without a license defrauds the public and can be prosecuted. A tort is a wrongful act; malpractice is
failing to act appropriately as a nurse or acting in a way that harm comes to the client; and negligence is failing to per form care.
Therefore, answers B, C, and D are incorrect.

81. The schizophrenic client has become disruptive and requires seclusion. Which staff member can institute seclusion?
a. The security guard
b. The registered nurse
c. The licensed practical nurse
d. The nursing assistant

Answer B is correct.
The registered nurse is the only one of these who can legally put the client in seclusion. The only other healthcare worker who is
allowed to initiate seclusion is the doctor; therefore, answers A, C, and D are incorrect.

82. The nurse is caring for a 12-year-old client with appendicitis. The client’s mother is a Jehovah’s Witness and refuses to sign the
blood permit. What nursing action is most appropriate?
a. Give the blood without permission
b. Encourage the mother to reconsider
c. Explain the consequences without treatment
d. Notify the physician of the mother’s refusal

Answer D is correct.
If the client’s mother refuses the blood transfusion, the doctor should be notified. Because the client is a minor, the court might order
treatment. Answer A is incorrect because the mother is the legal guardian and can refuse the blood transfusion to be given to her
daughter. Answers B and C are incorrect because it is not the primary responsibility of the nurse to encourage the mother to consent or
explain the consequences.

83. During the change of shift report, a nurse writes in her notes that she suspects illegal drug use by a client assigned to her care.
During the shift, the notes are found by the client’s daughter. The nurse could be sued for:
a. Libel
b. Slander
c. Malpractice
 d. Negligence

Answer A is correct.
By writing down her suspicions, the nurse leaves herself open for a suit of libel, a defamator y tort that discloses a privileged
communication and leads to a lowering of opinion of the client. Defamatory torts include libel and slander. Libel is a written statement,
whereas slander is an oral statement. Thus, answer B is incorrect because it involves oral statements. Malpractice is an unreasonable
lack of skill in performing professional duties that result in injury or death; therefore, answer C is incorrect. Negligence is an act of
omission or commission that results in injury to a person or property, making answer D incorrect.

84. On a home visit, the nurse finds four young children alone. The youngest of the children has bruises on the face and back and
circular burns on the inner aspect of the right forearm. The nurse should:
a. Contact child welfare services
b. Transport the child to the emergency room
c. Take the children to an abuse shelter
d. Stay with the children until an adult arrives

Answer A is correct.
The nurse has a legal responsibility to report suspected abuse and neglect. The nurse does not have the authority to remove the
children from the home; therefore, answers B and C are incorrect. Answer D is incorrect because it is unrealistic.

85. A patient refuses to take his dose of oral medication. The nurse tells the patient that if he does not take the medication that she will
administer it by injection. The nurse’s comments can result in a charge of:
a. Malpractice
b. Assault
c. Negligence
d. Battery

86. The nurse is suspected of charting medication administration that he did not give. After talking to the nurse, the charge nurse
should:
a. Call the Board of Nursing
b. File a formal reprimand
c. Terminate the nurse
d. Charge the nurse with a tort

Answer B is correct.
The next action after discussing the problem with the nurse is to document the incident by filing a formal reprimand. If the behavior
continues or if harm has resulted to the client, the nurse may be terminated and reported to the Board of Nursing, but these are not the
first actions requested in the stem. A tort is a wrongful act to the client or his belongings and is not indicated in this instance. Therefore,
Answers A, C, and D are incorrect.

87. Allowing the husband of a critically ill patient to read the patient’s chart without the wife’s consent constitutes which violation:
a. Violation of patient’s autonomy
b. invasion of patient’s privacy
c. Violation of patient’s anonymity
d. Violation of patient’s right
Answer: B- Invasion of patient’s privacy; A- self- determination; C-person’s identity; D- yes, but b is more specific.
Ref: Professional Nursing in the Philippines 10th ed., by Venzon p. 110

88. From which of the following situation does the patient exercise autonomy:
a. A cancer patient is given every information of his prognosis and diagnosis
b. A terminally ill patient decides a DNR order for him in his will
c. A patient talks to his nurse in any manner he wants
d. A sedated patient signed a consent for operation
Answer: B- a will written by a patient is a practice of patient’s autonomy/ self- determination.
A-practice of veracity or truth-telling; C-not a practice of autonomy; D- informed consent is an example of exercising a patient’s
autonomy but the patient should not be sedated.
Ref: Professional Nursing in the Philippines 10th ed., by Venzon p. 101
Handout from SLU College of nursing prepared by Mrs. Pitas, RN

89. Arrah, mother of 2 children has been told she needs to undergo a hysterectomy for having cervical cancer; she is upset about
being unable to have more children. The nurse should base her interventions on the principle of:
a. Beneficence
b. Non-maleficence
c. Two-fold effect
d. Justice
Answer: C- The nursing interventions should be based on this principle. It describes a good and a bad effect of a treatment. Although a
hysterectomy maybe performed to save the life of the woman, yet the consequence of the surgery is the inability of the woman to bear
a child again. The safety of the woman takes precedence above all.
A- This is doing good to patients; B- This is doing no harm to the patient; D- This is treating clients equally.
Ref: Professional Nursing in the Philippines 10th ed., by Venzon p. 119-120

90. A mentally ill patient became seriously aggressive, but his doctor cannot be contacted. The patient may be restrained by virtue of:
a. The golden rule
b. Two- fold effect
c. Totality
d. Epikia

Answer: D- Exception to the rule. It is true that restrain requires a doctor’s order but if patient threats to harm others in the situation,
might as well restrain him even without doctor’s order.
A- “Do unto others what you want others to do unto you.”
B-A nurse is faced with a situation which may have both good and bad effect.
C-the whole is greater than any of its parts.
Ref: Professional Nursing in the Philippines 10th ed., by Venzon p. 119-120

91. Anton was convicted to a crime of murdering a person. While he is in a hearing, he was asked by the lawyer of the plaintiff to
confess that he killed the person. The person is protected under the moral principle which states that:
a. One who acts through an agent is himself responsible.
b. The end does not justify the means.
c. No one is obliged to betray himself/ herself
d. For every rule there is always an exemption.
Answer: C- He cannot be forced to answer the question if it will incriminate him.
A-you are liable if you become an accomplice or accessory to a crime.
B- Doing a legally and morally wrong act for a good purpose.
D- Exception to a rule; Epikia.
Ref: Professional Nursing in the Philippines 10th ed., by Venzon p. 120-121

92. A nursing student asked the nurse on duty to give an example of the principle “the end does not justify the means”. Which of the
following situation would the nurse answer correctly:
a. A patient will undergo amputation of the upper knee because of a gangrenous foot
b. The nurse allows a visitor of a terminally ill patient who came from the states
c. A person cannot testify against himself in court
d. Giving a sleeping pill to a chronically ill patient so he can die in peace
Answer: D- A good intention cannot be used to justify a wrong deed.
A-Principle of totality; B-epikia; C- no one is obliged to betray himself/ herself.
Ref: Professional Nursing in the Philippines 10th ed., by Venzon p. 120-121

93. During a graded recitation, a nursing student is asked by her instructor in bioethics to give an example of the principle of totality.
Which of the following situation would give her a point in the graded recitation:
a. A patient will undergo amputation of the upper knee because of a gangrenous foot
b. The nurse allows a visitor of a terminally ill patient who came from the states
c. A person cannot testify against himself in court
d. Giving a sleeping pill to a chronically ill patient so he can die in peace
Answer: A- the whole is greater than the sum of all its parts. To prevent the whole body from getting infected, it is better to amputate
the gangrenous foot.
B-Epikia; C- no one is obliged to betray himself/ herself; D- the end does not justify the means.
Ref: Professional Nursing in the Philippines 10th ed., by Venzon p. 120-121

94. Patient Marimar participated in an experimental regarding a new drug. She signed a consent after full disclosure of the information
regarding the drug. After 1 week, the patient developed rashes and severe allergic reaction. Was the experimenting group liable
for what happened to the patient?
a. Yes, they should not experiment on human subjects.
b. Probably, depending on the courts investigation.
c. It depends if the patient signed consent.
d. No, because the patient was informed regarding the drug’s information before he gave consent.
Answer: D- this is under the moral principle which states that “if one is willing to cooperate in the act, no injustice is done to him/ her.
A- Incorrect, human can be a subject to an experiment as long as they gave consent.
B &C-incorrect; the group is not liable because the patient gave consent.
Ref: Professional Nursing in the Philippines 10th ed., by Venzon p. 120-121

95. A psyche patient is to undergo an Electroconvulsive Therapy because he has not responded to a any medications being given to
him. Who should sign the patient’s consent?
 a. The patient’s next of kin
b. The patient
c. The doctor
d. The nurse
Answer: C- Signing consent is a form of exercising patient’s autonomy. Although he is a psyche patient, he has a period of having a
sound mind, not all the time the patient is psychotic. He can still sign his consent. The consent must be signed before the patient
receives any medication or any procedures.
All the other options cannot sign for the patient.
Ref: Professional Nursing in the Philippines 10th ed., by Venzon p. 173-175

96. Anton is a patient suffering from cardiomyopathy. His only hope is for him to have a cardiac transplant. He asked the nurse if this
surgery will assure him of his survival. The nurse base her response to the principle:
a. If one is willing to cooperate no injustice is done to him.
b. The morality of cooperation
c. No one is held to the impossible
d. The end does not justify the means
Answer: C- The doctors and nurse cannot be held to the impossible if they have done their best to take care of a client and the latter
dies.
Ref: Professional Nursing in the Philippines 10th ed., by Venzon p. 120-121

97. All of the following are persons who could be a witness to a will except:
a. A person of sound mind.
b. A person of any age who can understand the situation.
c. Not blind, deaf or dumb.
d. Able to read and write.
Answer: B- The person should be at least 18 years of age.
All the other options are considered to be a witness to a will.
Ref: Professional Nursing in the Philippines 10th ed., by Venzon p. 117
Nursing Jurisprudence by Dumecquias 2006 p. 191

98. According to article 1318 of the civil code, “there is no contract unless the following requisites concur, which one is not included:
a. Consent of the contracting parties
b. Object certain which is the subject matter of the contract
c. Cause of the obligation which is established
d. Signature of an unemancipated minor.
Answer: D- this is not in the requisites; an unemancipated minor cannot give consent to a contract.
A, B, C are the other options are requisites of a contract. (Consent of the contracting parties, Object certain which is the subject matter
of the contract, Cause of the obligation which is established)
Ref: Nursing Jurisprudence by Dumecquias 2006 p.180

99. Mr. Socrates is in the terminal stage of cancer. He tells you that he has a living will. You know that the client’s living will involves
which of the following:
a. A document signed by the client’s family for the provider to withhold medical treatment when death is eminent.
b. The medical treatment the client chooses to withhold if he is rendered unable to make decisions.
c. Does not include DNR.
d. Provides that the client’s wishes need not be followed if life can be prolonged.
Answer: B- a will is an act whereby a person is permitted, with the formalities prescribed by law, to control to a certain degree the
disposition of his state, to take effect after his death.
A, C, D- incorrect. This is signed by the patient, it may include DNR orders, should be follwed as requested by the patient.
Ref: Nursing Jurisprudence by Dumecquias 2006 p.187

100. Alford, a 2-year old child is admitted to the Sta. Maria hospital with a diagnosis of pneumonia and is given antibiotics, fluids, and
oxygen. Alford’s temperature continues to rise until it reaches 103oF (39.4oC). Nurse Estrella calls the physician at the mother’s
request, but the physician sees no cause for alarm or change in treatment, even though the child has a history of convulsions
during previous periods of high fever. Although concerned, the nurse takes no further action. Later the child has a convulsion that
results in neurologic impairment of the left arm and leg, the nurse can be sued for:
a. Injustice
b. Negligence
c. Force majeur
d. Malpractice

Answer: B- This is negligence in the part of the nurse, she failed to observe the degree of precaution which the
circumstances justly demand, whereby the person suffers injury. Since part of a nurse’s responsibility is to foresee
potential harm and prevent risks, it is imperative that the nurse not only take a health history and perform a physical
assessment on each client, but act to ensure the safety of the client.
A- Incorrect.
C- This is not in the situation, it is described as “under any unavoidable circumstances, such as in times of
earthquake or floods, the nurse is not held liable if he/ she did not give care to the client during these circumstances.
D- This is described as practicing outside scope of his/her profession.
Ref: Nursing Jurisprudence by Dumecquias 2006 p.88