Let the Nursing Code of Ethics Guide Your Response to NCLEX-RN® Ethical Scenarios

• When you come across NCLEX-RN® ethical scenarios, always refer back to the Nursing Code of Ethics. 
• The guiding principles in the code will help you navigate the most complex of ethical dilemmas. 
• To deepen your understand of NCLEX-RN® ethical scenarios, discuss them with your fellow future nurses as you prepare for exam day. 

The Nursing Code of Ethics, developed by the American Nurses Association (ANA), stands as a crucial framework guiding nurses in their practice. It provides not only foundational principles but also illuminates the path for handling complex client interactions.  

I know it may seem odd that this is such a focus, but it’s core to the nursing profession to ensure that the client comes first. I would invite you to embrace the chance to integrate these principles into diverse client scenarios, particularly in areas like informed consent, confidentiality, and honoring the beliefs that significantly impact each client’s care experience.  

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This code of ethics is a need-to-know item for your NCLEX-RN® exam. Let’s break down what you need to know to prepare for NCLEX-RN® ethical scenarios. 

Explore the ANA Code of Ethics 

Immerse yourself in the provisions of the Code, analyzing how each principle applies to real-world situations you may encounter in practice.

Terms to Know for NCLEX-RN® Ethical Scenarios: 

• Autonomy: Empower your clients to make informed decisions about their healthcare, respecting their right to independence even in situations where you may have differing opinions. This principle underscores the importance of recognizing each client’s individual values and choices as paramount in their care journey. 
• Beneficence: Dedicate yourself to promoting the overall well-being of your clients through every action you undertake. By prioritizing their health and comfort, you embody the essence of compassionate care. 
• Nonmaleficence: Uphold a strong commitment to avoiding any harm while ensuring the dignity and respect of every individual under your care. This principle encourages vigilance and responsibility, fostering a safe environment for healing and support. 
• Justice: Stand firm in your advocacy for fairness and equity within the healthcare system, ensuring that all clients receive the care they rightfully deserve without discrimination. 
• Fidelity: Cultivate trust by honoring your commitments and promises. Every interaction with your clients should reflect reliability and integrity, establishing a strong foundation for the client-nurse relationship. 
• Veracity: Approach communication with honesty and openness, fostering a climate of trust where clients feel safe to ask questions and express concerns. Your integrity in sharing information is vital to establishing a therapeutic rapport. 
• Accountability: You are answerable for your actions as a nurse when caring for a client. Nurses take ownership of their judgments and actions in practice, regardless of external directives or policies. 

The code of ethics also identifies nine provisions of what a nurse must do to perform their duties as an ethically sound nurse. 

The Code of Ethics for Nurses 9 Provisions 

• Provision 1: “The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person.” 
  • This includes treating patients and their families with dignity and adhering to professional communication guidelines. All individuals have the right to decide their level of participation in care. 
• Provision 2: “The nurse’s primary commitment is to the patient, whether an individual, family, group, community, or population.” 
  • The patient’s perspective should be included in care practices. Conflicts of interest must be disclosed, and collaboration with internal and external teams is necessary for optimal patient outcomes. 
• Provision 3: “The nurse promotes, advocates for, and protects the rights, health, and safety of the patient.” 
  • Understanding privacy guidelines and informed consent is crucial, especially for those involved in research. Nurses must report any misconduct or safety concerns and never provide care under the influence of impairing substances. 
• Provision 4: “The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to provide optimal patient care.” 
  • Authority must be exercised professionally and ethically, and any delegation of nursing tasks should be handled with care for potential outcomes. 
• Provision 5: “The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence, and continue personal and professional growth.” 
  • Continuous learning and adapting to new healthcare trends are vital for personal and professional development. 
• Provision 6: “The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care.” 
  • Standards should be clear, and any deviations must be reported to uphold ethical obligations. 
• Provision 7: “The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy.” 
  • Nursing education should incorporate research principles, and involvement in committees is encouraged to contribute to health and nursing standards. 
• Provision 8: “The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities.”  
  • Nurses believe healthcare is a fundamental right and are committed to continuous learning to address challenges in various settings through advocacy and diplomacy. 
• Provision 9: “The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.”  
  • Nurses should unite to discuss their values and advocate for social justice, while maintaining political awareness to strengthen their voice in global health policy. 

NCLEX-RN® Ethical Scenarios: Practice Questions 

Actively engage with study guides and online resources that offer scenarios centered on ethical decision-making, honing your critical thinking skills. Here are some important and friendly reminders about nursing ethics for the NCLEX®:

• Client-Centered Care is the Root of NCLEX® and Nursing: Let the needs and desires of your clients guide every decision you make. By prioritizing their autonomy and values, you ensure that care is tailored to meet their unique preferences and circumstances, thereby enhancing their overall experience. 
• Understanding Informed Consent: Ensure that your clients are well-informed about the risks and benefits associated with procedures, fully empowering them to make choices about their healthcare. This process involves clear explanations and an open dialogue, helping clients to feel secure and in control of their treatment decisions. 
• Keeping Confidentiality: Vigilantly protect your client’s privacy, treating their personal information with the utmost confidentiality. Share details only when absolutely necessary and always with the clients’ consent, reinforcing their trust in the healthcare system. Remember client information is ALWAYS on a need-to-know basis. 
• Navigating Ethical Dilemmas: Be prepared to recognize and confront ethical dilemmas as they arise, thoughtfully evaluating the available options. Seek guidance when faced with challenging situations, engaging in reflective practice to navigate through ethical complexities effectively. 
• Analyze each situation: Carefully consider the client’s preferences, pertinent legal regulations, and the possible ramifications associated with various courses of action. 

Discuss Ethical Dilemmas 

Foster discussions around ethical challenges with your peers and instructors. Utilizing role-playing techniques can deepen your understanding and improve your decision-making abilities in high-stakes situations.

NCLEX-RN® Ethical Scenario Examples: 

1. A client who is deemed competent refuses life-saving treatment: (autonomy). 
2. A nurse must disclose confidential client information to protect others from harm: (confidentiality with legal implications). 
3. A family requests aggressive treatment for a client, even though the client has a living will that states otherwise: (respecting advance directives). 
4. A nurse contemplates administering medication that could have serious side effects without clear client consent: (informed consent). 
5. A situation where a nurse must prioritize one client’s needs over another due to limited resources: (resource allocation). 
6. How would you handle a situation where a colleague discloses confidential client information?  
7. How do you balance a client’s autonomy with the obligation to provide necessary care? (autonomy with beneficence) 
8. If a client requests that you withhold information about their diagnosis from their family, how should you respond while considering ethical principles? (autonomy) 
9. If you observe a colleague administering medication incorrectly, what is your ethical duty in this situation? (veracity & accountability) 
10. A client with limited decision-making capacity requires surgery. How can you ensure that informed consent is obtained in an ethical manner? (autonomy) 

The Bottom Line 

As you advance in your nursing career, never forget the profound impact you have on the lives of your clients. You are equipped with the knowledge and skills necessary to uphold the highest standards of care, making a significant difference in the world around you!