BIOETHICS P1 EXAM Key Answers with Rationale

1. Congress in US enacted HIPAA in 1996 to encourage electronic transmission of health

information. What does HIPAA stands for?
Answer: Health Insurance Portability and Accountability Act
Ratio: Health Insurance Portability and Accountability Act (HIPAA) encourage the use of
electronic transmission of health information (to assist in cost containment) and provide new
safeguards to protect the security and confidentiality of the information
2. Invasion of privacy is a breach of what health care principle?
Answer: Confidentiality
Ratio: Invading of patient’s privacy will result in breach of confidentiality. It can create
distrust between patient and practitioner.
3. He is a humanist psychologist who is known for his work regarding the interaction of needs and
behavior which the Hierarchy of needs. Who is this author of Hierarchy of Needs?
Answer: Abraham Maslow
Ratio: Abraham Maslow was an American psychologist who was best known for creating
Maslow’s Hierarchy of Needs, a theory of psychological health predicated on fulfilling innate
human needs in priority, culminating in self-actualization.
4. What generation are born from the mid 90’s to around 2000?
Answer: Millenials
Ratio: Millenials are known to be born from mid 90’s to around 2000 and they are socially
aware.
5. This theory believes that all morality is relative to society in which one is brought up?
Answer: Ethical Relativism
Ratio: Ethical relativism is the theory hold morality is relative to the norms of one’s culture.
Whether action is right or wrong depends on moral norms of the society.
6. A school of thought which promotes the greatest good for the greatest number of people.
Answer: Utilitarianism
Ratio: Rule utilitarianism seeks to avoid the hedonic calculus of act of utilitarianism in which
each option must by measured by the principle of utility. Rule utilitarianism holds that action
can be right if it conforms to a rule that has been previously validated by the principle of
utility.
7. The following are measures to protect client’s confidentiality except:
Answer: Placing patient records where it can easily be obtained.
8. You are a nurse accepting a telephone call from someone who claims to be your patient’s father.
He asks for the information on your patient’s health status. What is your next best action?
Answer: Decline in giving him further information and ask him to visit patient personally.
Ratio: Protecting client’s confidentiality is an important responsibility of nursing.
- Access to protected health information is limited to those authorized to obtain the
information
- Charts should be in a secure, nonpublic location to prevent the public from viewing or
accessing confidential health information.
- HCPs need a password to access client’s electronic chart.
- Voice levels should be lowered to minimized disclosure of information
9. In Barrio Lamuyak, health care resources are limited. Which principle must guide the health
workers in prioritizing and providing health care services?
Answer: Distributive Justice
 Ratio: In prioritizing health services and activities, health workers in general should be
guided by the principle, “the greatest good for the greatest number”. Another principle that
guides the provision of health services, particularly in government-owned health facility is
distributive justice. In a “micro-setting”, this could mean fair, equitable, and appropriate
distribution.

Beneficence – doing good

Non-Maleficence – doing no harm
Fidelity – being faithful to agreements and promises
Veracity – truth-telling
10. Amy is a nurse in the medical-surgical ward of The Medical City. She is starting to learn about the
legal and ethical aspects to consider when she is on duty. Nurse Amy notices that the call light of
Patient Mico is turned on. However, the nurse assigned to him is on break. Nurse Amy did not
respond to the call light and Patient’s Mico’s condition worsened due to this. What consequences
will Nurse Amy face?
Answer: There are enough grounds for Nurse Amy to face negligence in nursing practice.
Ratio: Responding to a patient’s call light is a responsibility of all nurses, even though she is
not assigned to that patient.
11. A tort can be filed to a nurse who performs nursing care outside the scope and standards of practice.
Which of the following statements correctly differentiates intentional from unintentional tort.
Answer: Unintentional torts include malpractice and negligence.
12. Amy is caring for an elderly patient who had hip fracture after slipping on the hospital floor due to
spilled water. The following elements must be present for negligence to be validly filed against
Amy, except?
Answer: Association
Ratio: Duty, Breach of duty, Foreseeability, Causation, Injury, Damages
13. The patient verbalizes that she wants to get discharged from the ward. She still hasn’t paid the bills.
The management for her is still not complete. What is Amy’s next best action?
Answer: Explain to her the terms and consequence of this action, then allow her to go home.
Ratio: If the patient opts to be discharged from the ward despite uncompleted management,
the healthcare team must allow her to go home provided that the terms and consequences of
that action were clearly explained. Doing otherwise provides grounds for false imprisonment.
14. In a health facility where Amy is working at, the policy states that the patient may not go home
unless 60% of all the hospital bills and medications are paid. Amy’s patient disclosed that they
cannot pay their bills. The hospital holds the discharge of the patient. There are grounds for filing
lawsuit against the hospital for which tort?
Answer: Illegal Detention (False Imprisonment)
15. The Physician ordered that an IV access be established in the patient. As the nurse approaches the
patient, he was reluctant of the procedure and asked her to come back later. She continued to insert
the needle because it is the doctor’s order. What legal responsibility will the nurse face?
Answer: Battery
Ratio: Battery is willful touching of a person (or the person’s clothes or even something the
person is carrying) that may or may not cause harm.
16. Nurse Amy is taking her break in the cafeteria. Nurse Seth approached her and silently gossiped
about the doctor who was incompetent and constantly ordering incorrect dosages. To what legal
consequence is Nurse Seth responsible to?
Answer: None of the above
 Ratio: Defamation (Libel or Slander) is a communication that is false, or made with a careless
disregard for the truth, and results in injury to the reputation of a person. Only the person
defamed may bring the lawsuit. The defamatory material must be communicated to a third
party such that the person’s reputation may be harmed.
Libel – public defamation with use of prints, writing, or pictures
Slander – public defamation within a small area with use of false spoken word
17. Marcus is a nurse in the ward where a stroke patient died. Without supporting facts, he wrote in the
chart that it was the physician’s fault which led to the death of the patient. The chart was used as
evidence in the investigation of the death. What tort can be filed against Marcus?
Answer: Libel
18. A newly hired nurse started a prescribed blood transfusion to her assigned client without a consent
form signed. This can lead to which of the following liabilities?
Answer: Assault and Battery
19. “Nurses should practice nursing and allied health specialist should only practice within their
specialty areas” is an application of the basic principle of _________.
Answer: Role fidelity
Ratio: Role fidelity is to do your role within your scope of practice. E.g. Role of nurse is to
provide competent care to patients and to do in a way that is honest, responsible and fair.
20. In case an informed consent is signed by a client who is scheduled for vaginal hysterectomy, the
nurse acts as:
Answer: Advocate
Ratio: when you are an advocate to your patient you include the client in making decision
regarding his care
21. You stared to chart for the shift when you discovered that there was an error in medication.
Fortunately, your client did not manifest any untoward reaction. Even so, you still have to
accomplish a/an:
Answer: Incident report
Ratio: to document the report for subsequent evaluation and improvement in the care.
22. In the patient’s chart, the following should be documented EXCEPT:
Answer: The fact that you wrote an incident report
23. The incident report should not be viewed as an acceptance of negligence because it offers the
following advantages. Identify all the benefits derived from an incident report. Select all that apply.
Answer: For potential liability claims, Identify risks area, Find ways to prevent similar
incident in the future, Rich source for research
24. An incident report is best written when all facts are still fresh in the mind of the nurse. It should
include all of the following EXCEPT?
Answer: Your own conclusion
25. A 32-year old married client is for elective CS expresses her wish to have a bilateral tubal ligation
performed after the CS. The nurse should make sure that the consent is legally binding. Who should
sign the consent for surgery?
Answer: Client and the husband
26. The main function of the patient’s record is to:
Answer: Serve as a vehicle for communication
Ratio: The main purpose of the patient’s record is to communicate the progress of her
condition and the provision of nursing care among health care providers.
27. Which of the following qualities are relevant in documenting patient’s care? Select all that apply.
 Answer: Accuracy and Conciseness, Thoroughness and Currentness, Systematic and
Orderly, Legibly, Properly dated and signed
Ratio: the following are characteristics of proper documentation
28. Nurse Pia moves a confused, disruptive patient to a private room at the end of the hall so that other
patients can rest, even though the patient becomes more agitated. Nurse Pia’s judgment is based
on:
Answer: Consequentialism
Ratio: Duty of obligation is an action regardless of its results, is justified if the decision
making was based on moral principles; prima facie duty,, by which an action is justified if it
does not conflict with a strong duty; categorical imperative, the results of an action are
deemed less important than the means to the end. Consequentialism means “good
consequences for the greatest number are maximized”
29. Patient Charm is very irritable and disruptive due to discomforts of the operation, she was shouting
at her nurse, Fiona. Nurse Fiona was having a very bad day and was not in the mood to calm the
client. When patient Charm kept on yelling at Nurse Fiona, the nurse suddenly slaps the patient.
Fiona will be charged with?
Answer: Misdemeanor
Ratio: Felony is a crime of a serious nature and with intention; manslaughter is a second-
degree murder such as accidentally giving a lethal dose of medicine to the patient;
malpractice is the failure to do one’s duty. Misdemeanor is an offense of a less serious nature
and is usually punishable by a fine or short term jail sentence, or both.
30. Doctor Lance’s orders indicate that a surgical consent form needs to be signed by the patient. Since
Nurse Jenny was not present when the doctor discussed the surgical procedure, which of the
following statements by Nurse Jenny best illustrates that she is fulfilling the client advocate role?
Answer: What were you told about the procedure you are going to have?
Ratio: This is the best answer because the nurse is assessing the client’s level of knowledge.
Based on that assessment, the nurse could initiate other actions especially when the client still
has a lot of questions and expressed doubts about the procedure.
31. Following a vehicular accident, Nurse John stops and offers assistance. Which of the following
actions is/are most appropriate? Select all that apply.
Answer: Nurse John needs to know the Good Samaritan Act, Nurse John is not held liable
unless there is gross negligence, Nurse John can offer to help but cannot insist on helping
Ratio: The nurse should be familiar with the state law and with the Good Samaritan Act.
Gross negligence will be described by the state law. The same client rights apply at the scene
of accident as well as those in the workplace, the client may refuse treatment.
32. Nurse Tina has a new patient admitted to her care. After interviewing, she found out that her client,
Raffy, is a Muslim and adheres to the dietary laws of his faith. He is in traction and confined to
bed. He needs assistance with his evening meal of rice pork, beans, a roll and carton of milk. Choose
the best nursing approach that is most representative of promoting wellness.
Answer: Nurse Tina withholds feeding and call dietary department to clarify religion to them.
Ratio: In dietary planning, the health care provider must consider region/culture of a patient.
At this way, health care provider shows respect to the patient as well as the religion/culture.
33. A patient has certain rights concerning data collection, such as right to know:
Answer: All of the above.
Ratio: Patient has the right to know but tell them that all data are kept confidential and for
hospital use only.
34. The nurse is aware that an ethics committee in a health care facility serves to:
 Answer: Serve as a resource for specific situations that may occur
Ratio: Ethics committee serve as a resource to support the processing of ethical dilemmas.
Ethics committees serve several purposes: education, policy recommendation, and case
consultation or review.
35. A student nurse realizes that she has administered the wrong dose of medication to a patient. She
immediately informs her clinical instructor. This student nurse is best described professionally as:
Answer: Accountable
Ratio: Accountability internalized responsibility whereby an individual agrees to be morally
responsible for the consequences of his actions. Ability to answer for one’s own actions. The
goal is the prevention of injury to the client. The student nurse who informs her instructor of
an error is being accountable for her actions and has a goal to prevent injury to the client.
36. The nurse gives two pills instead of the ordered one pill. The physician is notified. The client is
carefully monitored and no untoward effects occur. Can the nurse be sued for malpractice.
Answer: No, the client was not harmed.
Ratio: Malpractice in the unusual sense implies the idea of improper or unskillful care of the
patient by a nurse and denotes stepping beyond one’s authority with serious consequences. If
the client was not harmed, all elements of malpractice were not present.
37. The nurse is to give a medication she has not given before. When checking the drug handbook, she
reads that the ordered amount is unusually large dose. A nurse who is aware of nursing liability
would do which of the following actions?
Answer: Call the physician
Ratio: First action for the nurse would be to contact the physician and clarify the order. The
nurse realizes she/she is ultimately responsible for the administration of the drug. The nurse
is expected to carry our not only doctor’s order but help plan and implement patient care as
well. Clarify misconceptions as needed.
38. The professional code of ethics for nurses provides direction for the nurse to act morally. It has the
interpretive statement that provides:
Answer: Guidelines in performing nursing responsibilities to provide quality care and for
ethical obligation of nursing profession.
Ratio: Code of ethics are defined as systemic guides for developing ethical behavior, thus
answering normative normative questions of what beliefs and values should be
morally accepted in the field of nursing.
39. Failure to comply or breach of the standard resulted in an injury of the plaintiff maybe held liable
for:
Answer: Negligence
Ratio: refer to the commission or omission of an act, pursuant to a duty, that a reasonably
person in the same or similar circumstances would or would not do and acting or the non-
acting of which is the proximate cause of injury to another person or his property.
40. When carelessness happens resulting to an accident that is preventable, the nurse responsible can
be charged of:
Answer: Negligence
Ratio: Existence of a duty on the part of the person charged to use due care which is one of
the element of negligence is present.
41. You are taking care of a patient with thrombocytopenia. Conservative treatment was initiated;
however, the patient’s condition did not improve. His attending physician recommended
splenectomy as treatment. While doing your morning care, your patient verbalized, “I don’t need
 surgery. My illness will go away on its own.” In considering your response, you must depend on
what ethical principle?
Answer: Beneficence
Rationale: The action itself portrays an act of mercy and kindness that will directly benefit
the patient.
42. You are the head nurse in the medical ward. While doing your rounds, you overheard one of your
staff nurses telling that if he will not take his medicines he can’t have his favorite dessert. You
report your staff nurse behavior as:
Answer: Assault
Ratio: Is the imminent threat of harmful or offensive bodily contact.
43. The family of a dead patient who filed an administrative case against the nurse is considered which
of the following:
Answer: Complainant
Ratio: The family of the client is the one who files the complaint to the nurse is considered
the complainant
44. There are standard parameters to test if negligence is present in a case. All of the following are
parameters EXCEPT:
Answer: The failure was committed intentionally
Rationale: It is considered a crime with intent and knowledge of the circumstances.
45. Ethical principles are tenets that govern action. The principle that is seen when a nurse prevents
medication errors from occurring is known as:
Answer: Non-maleficence
Ratio: one must accept a substantial risk to one’s safety in order not to cause harm
46. Providing truthful explanation to a client regarding his diagnosis is?
Answer: Veracity
Ratio: The patient and health care providers are bound to tell the truth
47. The ICU nurse administers medication but the client complaint of its side effect:
Answer: Non-maleficence
Rationale: one must accept a substantial risk to one’s safety in order not to cause harm
48. Nurse BJ learns that his co-staff nurse in the unit steals medicine from one patient, substitutes it
with a cheaper brand, and sells the stolen one to another patient. BJ recognizes that there are at least
two ethical principles violated his act.
Answer: Veracity and Justice
Rationale: Veracity = sells the stolen one to another patient; Justice = substitutes it with a
cheaper brand
49. This means “let the master answer”:
Answer: Respondeat superior
Ratio: Respondeat superior means let the master answer. Liability assessment against
employer for negligent act committed by their employees during the course of their work.
50. This theory of justice emphasizes equal access to goods and services.
Answer: Egalitarianism
Ratio: Egalitarian Theories emphasize equal access to goods and services. Egalitarian
thinkers believe that an affluent society such as ours must find a way to provide universal
health care to all its citizens.