Ethics and Professional Conduct
Ethics questions ask you to apply principles, not to pick the most sympathetic option. The core principles are autonomy (the patient's right to decide), beneficence (do good), nonmaleficence (do no harm), justice (fair distribution of resources), fidelity (keep promises), and veracity (tell the truth). Most stems map cleanly onto one of these.
Understand the ethical decision-making process: identify the problem, gather facts, consider stakeholders, weigh principles, choose an action, act, and evaluate. When values conflict, the nurse advocates for the patient's stated wishes and uses the ethics committee or chain of command rather than deciding unilaterally.
Traps in questions:
- Autonomy vs. beneficence. A competent adult may refuse treatment even if the nurse believes it is best. The correct answer respects the refusal and documents it.
- Paternalism. Options that override a competent patient's choice are usually wrong.
- Confidentiality exceptions. Duty to warn, mandatory reporting, and court orders can justify disclosure; gossip and curiosity cannot.
- Professional boundaries. Accepting large gifts, sharing personal problems, or socializing with patients crosses lines.
Worked example: A competent patient with a treatable infection refuses antibiotics. The nurse's best action is to explore the patient's reasons, ensure understanding, respect the decision, and document the refusal and teaching-not to administer the drug covertly or coerce.
Rule of thumb: Advocate, educate, document, escalate-in that order-before overriding a patient's informed choice.