Professional Nursing Practice and Ethics
Professional Nursing Practice and Ethics tests how you apply legal and ethical standards to realistic nursing decisions: consent, confidentiality, delegation, documentation, advocacy, and professional accountability. Questions usually ask what the nurse should do first or which action is within scope, so identify the patient's right and the nurse's role before choosing an intervention.
Core rules and concepts
- Ethical principles. Autonomy is the competent patient's right to choose or refuse. Beneficence means acting for the patient's good; nonmaleficence means avoiding harm; justice means fair treatment and resource allocation; veracity means truthfulness; fidelity means keeping promises. When autonomy conflicts with beneficence, a competent refusal generally prevails.
- Informed consent. The provider discloses diagnosis, options, risks, benefits, and alternatives. The patient must have capacity and voluntariness. The nurse witnesses the signature and advocates for understanding; the nurse does not obtain consent for a procedure the nurse does not perform.
- Negligence. Four elements must be shown: duty, breach, causation, damages. Malpractice is professional negligence. Assault is a threat; battery is unauthorized touching; false imprisonment is unjustified restraint.
- Confidentiality. Share only with the care team on a need-to-know basis. Exceptions include mandated reporting, imminent danger, and legal orders.
- Delegation. Use the right task, circumstance, person, direction, and supervision. The registered nurse retains accountability and cannot delegate assessment, teaching, evaluation, or nursing judgment.
- Documentation. Record objective, timely, factual entries; correct errors according to policy; never alter a record retrospectively. Incident reports go to risk management, not the patient chart.
Worked example
A competent adult with postpartum hemorrhage refuses a blood transfusion after being told the risks. The nurse should confirm the patient understands the consequences, respect the refusal, notify the provider, document the discussion and refusal, and continue close monitoring and alternative treatments. The nurse should not ask the family to pressure the patient or administer blood secretly.
Traps that cost marks
- Choosing 'save life at all costs' when the patient has capacity and refuses.
- Delegating patient teaching or initial assessment to an unlicensed assistant.
- Breaking confidentiality for a curious family member without consent.
- Writing opinions or blame in the record instead of observed facts.