Republic of the Philippines
UNIVERSITY OF NORTHERN PHILIPPINES
Tamag, Vigan City
COLLEGE OF NURSING
COMPETENCY APPRAISAL I: ETHICS
1. The Universal Health Care Act mandates is
that everyone can:
A. Pick any physician and insurance company
despite one’s income
B. Receive free medical benefits from all
hospitals.
C. Have equal access to all health care.
D. Have basic care with a sliding scale payment
plan from all health care facilities
2. Which statement would best explain the role
of the nurse when planning care for a culturally
diverse population? The nurse will plan care to:
A. Include care that is culturally congruent with
the staff from predetermined criteria
B. Focus only on the needs of the client,
ignoring the nurse’s beliefs and practices
C. Blend the values of the nurse that are for the
good of the client and minimize the client’s
individual values and beliefs during care
D. Provide care while aware of one’s own bias,
focusing on the client’s individual needs rather
than the staff’s practices
3. Which factor is least significant during
assessment when gathering information about
cultural practices?
A. Language, timing
B. Touch, eye contact
C. Biocultural needs
D. Pain perception, management expectations
4. Transcultural nursing implies:
A. Using a comparative study of cultures to
understand similarities and differences across
human groups to provide specific individualized
care that is culturally appropriate
B. Working in another culture to practice
nursing within their limitations
C. Combining all cultural beliefs into a practice
that is a non-threatening approach to minimize
cultural barriers for all clients’ equality of care
D. Ignoring all cultural differences to provide the
best generalized care to all clients.
5. What should the nurse do when planning
nursing care for a client with a different cultural
background? The nurse should:
A. Allow the family to provide care during the
hospital stay so no rituals or customs are broken
B. Identify how these cultural variables affect
the health problem
C. Speak slowly and show pictures to make sure
the client always understands
D. Explain how the client must adapt to hospital
routines to be effectively cared for while in the
hospital
6. Which activity would not be expected by the
nurse to meet the cultural needs of the client?
A. Promote and support attitudes, behaviors,
knowledge, and skills to respectfully meet
client’s cultural needs despite the nurse’s own
beliefs and practices
B. Ensure that the interpreter understands not
only the language of the client but feelings and
attitudes behind cultural practices to make sure
an ethical balance can be achieved
C. Develop structure and process for meeting
cultural needs on a regular basis and means to
avoid overlooking these needs with clients
D. Expect the family to keep an interpreter
present at all times to assist in meeting the
communication needs all day and night while
hospitalized
7. Ethical principles for professional nursing
practice in a clinical setting are guided by the
principles of conduct that are written as the:
A. Code of Ethics
B. Nurse Practice Act (NPA) written by state
legislation
C. Standards of care from experts in the practice
field
D. Good Samaritan laws for civil guidelines
8. A bioethical issue should be described as:
A. The physician’s making all decisions of client
management without getting input from the
client
B. A research project that included treating all
the white men and not treating all the black
men to compare the outcomes of a specific drug
therapy.
C. The withholding of food and treatment at the
request of the client in a written advance
directive given before a client acquired
permanent brain damage from an accident.
D. After the client gives permission, the
physician’s disclosing all information to the
family for their support in the management of
the client.
9. When the nurse described the client as “that
nasty old man in 354,” the nurse is exhibiting
which ethical dilemma?
A. Gender bias and ageism
B. HIPAA violation
C. Beneficence
D. Code of ethics violation
10. The distribution of nurses to areas of “most
need” in the time of a nursing shortage is an
example of:
A. Utilitarianism theory
B. Deontological theory
C. Justice
D. Beneficence
11. Nurses are bound by a variety of laws.
Which description of a type of law is correct?
A. Statutory law is created by elected
legislature, such as the state legislature that
defines the Nurse Practice Act (NPA).
B. Regulatory law includes prevention of harm
for the public and punishment for those laws
that are broken.
C. Common law protects the rights of the
individual within society for fair and equal
treatment.
D. Criminal law creates boards that pass rules
and regulations to control society.
12. Besides the Joint Commission on
Accreditation of Healthcare Organizations
(JACHO), which governing agency regulates
hospitals to allow continued safe services to be
provided, funding to be received from the
government and penalties if guidelines are not
followed?
A. Board of Nursing (BON)
B. Nurse Practice Act (NPA)
C. Philippine Nurses Association (PNA)
D. Department of Health
13. When a client is confused, left alone with
the side rails down, and the bed in a high
position, the client falls and breaks a hip. What
law has been broken?
A. Assault
B. Battery
C. Negligence
D. Civil tort
14. When signing a form as a witness, your
signature shows that the client:
A. Is fully informed and is aware of all
consequences.
B. Was awake and fully alert and not medicated
with narcotics.
C. Was free to sign without pressure
D. Has signed that form and the witness saw it
being done
15. Which criterion is needed for someone to
give consent to a procedure?
A. An appointed guardianship
B. Unemancipated minor
C. Minimum of 21 years or older
D. An advocate for a child
16. Which statement is correct?
A. Consent for medical treatment can be given
by a minor with a sexually transmitted disease
(STD).
B. A second trimester abortion can be given
without state involvement.
C. Student nurses cannot be sued for
malpractice while in a nursing clinical class.
D. Nurses who get sick and leave during
a shift are not abandoning clients if they call
their supervisor and leave a message about
their emergency illness.
17. Most litigation in the hospital comes from
the:
A. Nurse abandoning the clients when going to
lunch
B. Nurse following an order that is incomplete
or incorrect
C. Nurse documenting blame on the physician
when a mistake is made
D. Supervisor watching a new employee check
his or her skills level
18. The nurse places an aquathermia pad on a
client with a muscle sprain. The nurse informs
the client the pad should be removed in 30
minutes. Why will the nurse return in 30
minutes to remove the pad?
A. Reflex vasoconstriction occurs.
B. Reflex vasodilation occurs.
C. Systemic response occurs.
D. Local response occurs.
19. A client has recently been told he has
terminal cancer. As the nurse enters the room,
he yells, “My eggs are cold, and I’m tired of
having my sleep interrupted by noisy nurses!”
The nurse may interpret the client’s behavior as:
A. An expression of the anger stage of dying
B. An expression of disenfranchised grief
C. The result of maturational loss
D. The result of previous losses
20. When helping a person through grief work,
the nurse knows:
A. Coping mechanisms that were effective in the
past are often disregarded in response to the
pain of a loss
B. A person’s perception of a loss has little to do
with the grieving process.
C. The sequencing of stages of grief may occur
in order, they may be skipped, or they may
recur.
D. Most clients want to be left alone.
21. A client is hospitalized in the end stage of
terminal cancer. His family members are sitting
at his bedside. What can the nurse do to best
aid the family at this time?
A. Limit the time visitors may stay so they do
not become overwhelmed by the situation.
B. Avoid telling family members about the
client’s actual condition so they will not lose
hope.
C. Discourage spiritual practices because this
will have little connection to the client at this
time.
D. Find simple and appropriate care activities for
the family to perform.
22. When caring for a terminally ill client, it is
important for the nurse maintain the client’s
dignity. This can be facilitated by:
A. Spending time to let clients share their life
experiences
B. Decreasing emphasis on attending to the
client’s appearance because it only increases
their fatigue
C. Making decisions for clients so they do not
have to make them
D. Placing the client in a private room to provide
privacy at all times
23. What are the stages of dying according to
Elizabeth Kubler-Ross?
A. Numbing; yearning and searching;
disorganization and despair; and reorganization.
B. Accepting the reality of loss, working through
the pain of grief, adjusting to the environment
without the deceased, and emotionally
relocating the deceased and moving on with
life.
C. Anticipatory grief, perceived loss, actual loss,
and renewal.
D. Denial, anger, bargaining, depression, and
acceptance.
24. Bereavement may be defined as:
A. The emotional response to loss.
B. The outward, social expression of loss.
C. Postponing the awareness of the reality of
the loss.
D. The inner feeling and outward reactions of
the survivor.
25. A client who had a “Do Not Resuscitate”
order passed away. After verifying there is no
pulse or respirations, the nurse should next:
A. Have family members say goodbye to the
deceased.
B. Call the transplant team to retrieve vital
organs.
C. Remove all tubes and equipment (unless
organ donation is to take place), clean the body,
and position appropriately.
D. Call the funeral director to come and get the
body.
26. A client’s family member says to the nurse,
“The doctor said he will provide palliative care.
What does that mean?” The nurse’s best
response is:
A. “Palliative care is given to those who have
less than 6 months to live.”
B. “Palliative care aims to relieve or reduce the
symptoms of a disease.”
C. “The goal of palliative care is to affect a cure
of a serious illness or disease.”
D. “Palliative care means the client and family
take a more passive role and the doctor focuses
on the physiological needs of the client. The
location of death will most likely occur in the
hospital setting.”
27. Which of the following is not included in
evaluating the degree of heritage consistency in
a client?
A. Gender
B. Culture
C. Ethnicity
D. Religion
28. When providing care to clients with varied
cultural backgrounds, it is imperative for the
nurse to recognize that:
A. Cultural considerations must be put aside if
basic needs are in jeopardy.
B. Generalizations about the behavior of a
particular group may be inaccurate.
C. Current health standards should determine
the acceptability of cultural practices.
D. Similar reactions to stress will occur when
individuals have the same cultural background.
29. To respect a client’s personal space and
territoriality, the nurse:
A. Avoids the use of touch
B. Explains nursing care and procedures
C. Keeps the curtains pulled around the clients
bed
D. Stands 8 feet away from the bed, if possible.
30. To be effective in meeting various ethnic
needs, the nurse should:
A. Treat all clients alike.
B. Be aware of client’s cultural differences.
C. Act as if he or she is comfortable with the
client’s behavior.
D. Avoid asking questions about the client’s
cultural background.
31. The most important factor in providing
nursing care to clients in a specific ethnic group
is:
A. Communication
B. Time orientation
C. Biological variation
D. Environmental control
32. A health care issue often becomes an ethical
dilemma because:
A. A client’s legal rights coexist with a health
professional’s obligation.
B. Decisions must be made quickly, often under
stressful conditions.
C. Decisions must be made based on value
systems.
D. The choices involved do not appear to be
clearly right or wrong.
33. A document that lists the medical treatment
a person chooses to refuse if unable to make
decisions is the:
A. Durable power of attorney
B. Informed consent
C. Living will
D. Advance directives
34. Which statement about an institutional
ethics committee is correct?
A. The ethics committee is an additional
resource for clients and healthcare
professionals.
B. The ethics committee relieves health care
professionals from dealing with ethical issues.
C. The ethics committee would be the first
option in addressing an ethical dilemma.
D. The ethics committee replaces decision
making by the client and health care providers.
35. The nurse is working with parents of a
seriously ill newborn. Surgery has been
proposed for the infant, but the chances of
success are unclear. In helping the parents
resolve this ethical conflict, the nurse knows
that the first step is:
A. Exploring reasonable courses of action
B. Collecting all available information about the
situation
C. Clarifying values related to the cause of the
dilemma.
D. Identifying people who can solve the
difficulty.
36. Miss Mary, an 88-year old woman, believes
that life should not be prolonged when hope is
gone. She has decided that she does not want
extraordinary measures taken when her life is at
its end. Because she feels this way, she has
talked with her daughter about her desires,
completing a living will and left directions with
her physician. This is an example of:
A. Affirming a value
B. Choosing a value
C. Prizing a value
D. Reflecting a value
37. The scope of Nursing practice is legally
defined by:
A. State nurses practice acts
B. Professional nursing organizations
C. Hospital policy and procedure manuals
D. Physicians in the employing institutions
38. A student nurse who is employed as a
nursing assistant may perform any functions
that:
A. Have been learned about in school
B. Are expected of a nurse at that level
C. Are identified in the positions job description
D. Require technical rather than professional
skill.
39. A confused client who fell out of bed
because side rails were not used is an example
of which type of liability?
A. Felony
B. Assault
C. Battery
D. Negligence
40. The nurse puts a restraint jacket on a client
without the client’s permission and without the
physicians order. The nurse may be guilty of:
A. Assault
B. Battery
C. Invasion of privacy
D. Neglect
41. In a situation in which there is insufficient
staff to implement competent care, a nurse
should:
A. Organize a strike
B. Inform the clients of the situation
C. Refuse the assignment
D. Accept the assignment but make a protest in
writing to the administration.
42. Which statement about loss is accurate?
A. Loss is only experienced when there is an
actual absence of something valued.
B. The more the individual has invested in what
is lost, the less the feeling of loss.
C. Loss may be maturational, situational, or
both.
D. The degree of stress experienced is unrelated
to the type of loss.
43. Trying questionable and experimental forms
of therapy is a behavior that is characterized of
which stage of dying?
A. Anger
B. Depression
C. Bargaining
D. Acceptance
44. All of the following are crucial needs of the
dying client except:
A. Control of pain
B. Preservation of dignity and self-worth
C. Love and belonging
D. Freedom from decision making
45. Cultural awareness is an in-depth self-
examination of one’s:
A. Background, recognizing biases and
prejudices.
B. Social, cultural, and biophysical factors
C. Engagement in cross-cultural interactions
D. Motivation and commitment to caring.
46. Cultural competence is the process of:
A. Learning about vast cultures
B. Acquiring specific knowledge, skills, and
attitudes
C. Influencing treatment and care of clients
D. Motivation and commitment to caring.
47. Ethnocentrism is the root of:
A. Biases and prejudices
B. Meanings by which people make sense of
their experiences.
C. Cultural beliefs
D. Individualism and self-reliance in achieving
and maintaining health.
48. When action is taken on one’s prejudices:
A. Discrimination occurs
B. Sufficient comparative knowledge of diverse
groups is obtained.
C. Delivery of culturally congruent care is
ensured.
D. People think/know you are a dumbass for
being prejudiced.
49. This is not a value orientation in the
Philippines:
A. Use of rituals symbolizing the supernatural.
B. Group reliance and interdependence
C. Healing emphasizing naturalistic modalities
D. Individualism and self-reliance in achieving
and maintaining health.
50. Disparities in health outcomes between the
rich and the poor illustrates: a (an)
A. Illness attributed to natural, impersonal, and
biological forces.
B. Creation of own interpretation and
descriptions of biological and psychological
malfunctions.
C. Influence of socioeconomic factors in
morbidity and mortality.
D. Combination of naturalistic, religious, and
supernatural modalities.
51. Culture strongly influences pain expression
and need for pain medication. However, cultural
pain:
A. May be suffered by a client whose valued
way of life is disregarded by practitioners.
B. Is more intense, thus necessitating more
medication.
C. Is not expressed verbally or physically
D. Is expressed only to others of like culture.
52. The dominant values in Philippine society on
individual autonomy and self-determination:
A. Rarely have an effect on other cultures
B. Do not have an effect on health care
C. Hinders hospice care program.
D. May be in direct conflict with diverse groups.
53. In the United States, access to health care
usually depends on a client’s ability to pay for
health care, either through insurance or by
paying cash. The client the nurse is caring for
needs a liver transplant to survive. This client
has been out of work for several months and
does not have insurance or enough cash. A
discussion about the ethics of this situation
would involve predominantly the principle of:
A. Accountability, because you as the nurse are
accountable for the well being of this client.
B. Respect of autonomy, because this client’s
autonomy will be violated if he does not receive
the liver transplant.
C. Ethics of care, because the caring thing that a
nurse could provide this patient is resources for
a liver transplant.
D. Justice, because the first and greatest
question in this situation is how to determine
the just distribution of resources.
54. The code of ethics for nurses is promulgated
by:
A. Philippine Nurses Association
B. Board of Nursing
C. The Medical American Association
D. The National Institutes of Health, Nursing
division.
55. Nurses agree to be advocates for their
patients. Practice of advocacy calls for the nurse
to:
A. Seek out the nursing supervisor in conflicting
situations
B. Work to understand the law as it applies to
the client’s clinical condition.
C. Assess the client’s point of view and prepare
to articulate this point of view.
D. Document all clinical changes in the medical
record in a timely manner.
56. Successful ethical discussion depends on
people who have a clear sense of personal
values. When many people share the same
values it may be possible to identify a
philosophy of utilitarianism, with proposes that:
A. The value of people is determined solely by
leaders in the Unitarian church.
B. The decision to perform a liver transplant
depends on a measure of the moral life that the
client has led so far.
C. The best way to determine the solution to an
ethical dilemma is to refer the case to the
attending physician.
D. The value of something is determined by its
usefulness to society.
57. The philosophy sometimes called the code
of ethics of care suggests that ethical dilemmas
can best be solved by attention to:
A. Relationships
B. Ethical principles
C. Clients
D. Code of ethics for nurses.
58. In most ethical dilemmas, the solution to
the dilemma requires negotiation among
members of the health care team. The nurse’s
point of view is valuable because:
A. Nurses have a legal license that encourages
their presence during ethical discussions.
B. The principle of autonomy guides all
participants to respect their own self-worth.
C. Nurses develop a relationship to the client
that is unique among all professional health
care providers.
D. The nurse’s code of ethics recommends that
a nurse be present at any ethical discussion
about client care.
59. Ethical dilemmas often arise over a conflict 62. The client’s right to refuse treatment is an
of opinion. Once the nurse has determined that example of:
the dilemma is ethical, a critical first step in A. Statutory law
negotiating the difference of opinion would be B. Common law
to: C. Civil laws
A. Consult a professional ethicist to ensure that D. Nurse practice acts
the steps of the process occur in full.
B. Gather all relevant information regarding the 63. Even though the nurse may obtain
clinical, social, and spiritual aspects of the the client’s signature on a form,
dilemma. obtaining informed consent is the responsibility
C. List the ethical principles that inform the of the:
dilemma so that negotiations agree on the A. Client
language of the discussion. B. Physician
D. Ensure that the attending physician has C. Student nurse
written an order for an ethics consultation to D. Supervising nurse.
support the ethics process.
64. The nurse is obligated to follow a physician’s
60. The nurse practice acts are an example of: order unless:
A. Statutory law A. The order is a verbal order
B. Common law B. The physician’s order is illegible
C. Civil law C. The order has not been transcribed
D. Criminal law D. The order is an error, violates hospital policy,
or would be detrimental to the client.
61. The scope of Nursing Practice, the
established educational requirements for 65. The nursing theorist who developed
nurses, and the distinction between nursing and transcultural nursing theory is
medical practice is defined by: A. Dorothea Orem
A. Statutory law B. Madeleine Leininger
B. Common law C. Betty Newman
C. Civil law D. Sr. Callista Roy
D. Nurse practice acts