At the start of night duty, the nurse in charge learns of four problems. Which needs her action first?

A ventilated patient's oxygen supply alarm is sounding

The linen indent for tomorrow has not been sent

Two staff nurses want to swap next week's duties

A relative is complaining about the visiting hours

The main reason hospitals keep their incident reporting system non-punitive is to:

Make staff willing to report errors and near misses

Protect the doctors from any legal action

Ensure that no member of staff is ever held accountable

Reduce the paperwork on each ward

A patient dies after a nurse gives concentrated potassium chloride as an IV push by mistake. Which management action does most to prevent the same error again?

Remove concentrated KCl ampoules from ward stock

Allow KCl to be given only during day shifts

Issue a circular asking all staff to be careful

Dismiss the nurse involved without any inquiry

Nursing administration, ethics and legal aspects

40 Staff nurse recruitment practice questions on Nursing administration, ethics and legal aspects, part of Nursing Management, Education and Research. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Hard
At the start of night duty, the nurse in charge learns of four problems. Which needs her action first?
1. AThe linen indent for tomorrow has not been sent
2. BTwo staff nurses want to swap next week's duties
3. CA ventilated patient's oxygen supply alarm is sounding
4. DA relative is complaining about the visiting hours
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Answer: C · A ventilated patient's oxygen supply alarm is sounding
The in-charge nurse sorts problems by the threat to patient safety. An oxygen supply alarm on a ventilated patient is a life-threatening problem that needs action within minutes. The linen indent, the relative's complaint and the duty swap are real but can wait without harming anyone. After the oxygen problem is solved, she can delegate or schedule the other tasks.
- A: A late linen indent is an administrative task that can wait.
- B: A duty swap for next week can be settled later in the shift.
- D: A complaint about visiting hours is not an immediate safety threat.
Question 2 · Medium
A competent elderly woman refuses the nasogastric feeding that her doctor and family want for her. The nurse supports her refusal. Which principle has been given priority?
1. AJustice over fidelity
2. BAutonomy over beneficence
3. CNon-maleficence over veracity
4. DBeneficence over autonomy
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Answer: B · Autonomy over beneficence
The feeding would benefit her (beneficence), but she is competent and has refused it, so her right to decide (autonomy) prevails. A competent adult may refuse any treatment, even life-sustaining treatment, after being informed of the consequences. The nurse makes sure the refusal is informed, documents it and keeps offering alternatives. Family wishes cannot override a competent patient's decision.
- A: Neither fair allocation nor promise-keeping is the conflict here.
- C: No question of truth-telling or of harm-avoidance versus truth arises.
- D: Beneficence over autonomy would mean feeding her against her will.
Question 3 · Medium
The main reason hospitals keep their incident reporting system non-punitive is to:
1. AProtect the doctors from any legal action
2. BEnsure that no member of staff is ever held accountable
3. CMake staff willing to report errors and near misses
4. DReduce the paperwork on each ward
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Answer: C · Make staff willing to report errors and near misses
Most errors come from weak systems rather than careless individuals, and they can be fixed only if they are reported. When staff fear punishment, errors and near misses are hidden and the same faults recur. A just culture does not punish honest mistakes but still deals with reckless or deliberate acts. Reports are analysed to change systems, such as storage, labelling and staffing.
- A: Incident reporting is about patient safety, not shielding doctors.
- B: A just culture still holds staff accountable for reckless acts.
- D: Reducing paperwork is not the purpose; reporting adds paperwork.
Question 4 · Hard
A patient dies after a nurse gives concentrated potassium chloride as an IV push by mistake. Which management action does most to prevent the same error again?
1. AAllow KCl to be given only during day shifts
2. BIssue a circular asking all staff to be careful
3. CRemove concentrated KCl ampoules from ward stock
4. DDismiss the nurse involved without any inquiry
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Answer: C · Remove concentrated KCl ampoules from ward stock
Concentrated KCl is a high-alert drug, and the strongest safeguards are system changes that make the error hard to commit. Removing concentrated ampoules from general ward stock and supplying premixed, labelled bags is a recommended international safety measure. A root cause analysis looks for system faults rather than only blaming the individual. Warnings and reminders are weak controls because they depend on memory under pressure.
- A: Restricting timing does not stop the concentrated drug being given wrongly.
- B: Circulars rely on memory and are the weakest kind of control.
- D: Dismissal without inquiry does not fix the system fault and discourages reporting.
Question 5 · Easy
The portable card file that gives a quick summary of each patient's current orders and nursing care plan on the ward is the:
1. ACensus sheet
2. BKardex
3. CIncident report
4. DNursing audit
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Answer: B · Kardex
The Kardex is a card-index (or electronic) summary of each patient's diagnosis, current orders, activity, diet and care plan. Nurses use it for quick reference during care and at handover. It is a working tool and is often not kept as part of the permanent medical record. The census sheet, by contrast, only counts the patients on the ward.
- A: The census sheet counts admissions, discharges and patients, not care plans.
- C: An incident report records an unusual event, not routine orders.
- D: A nursing audit is an evaluation of care quality, not a patient summary card.
Question 6 · Easy
Emergency drugs and oxygen, without which patient care would stop, fall into which class of VED analysis?
1. AEssential
2. BDesirable
3. CExpendable
4. DVital
Answer and explanation in LearnFree account
Question 7 · Easy
A nurse tells a confused patient that she will tie him to the bed if he does not take his tablets. Legally, this threat alone amounts to:
1. ANegligence
2. BDefamation
3. CBattery
4. DAssault
Answer and explanation in LearnFree account
Question 8 · Medium
A doctor gives a telephone order at night for a stat dose of IV furosemide. The nurse's correct practice is to:
1. AGive it and let the doctor write it in the morning
2. BRead it back, record it, and get it countersigned
3. CAsk another nurse to remember it until the round
4. DRefuse it, since nurses may never act on telephone orders
Answer and explanation in LearnFree account
Question 9 · Medium
On a ward that uses decentralised scheduling, the monthly duty roster is prepared by the:
1. ANursing superintendent's office
2. BMedical superintendent
3. CWard in-charge nurse
4. DHospital personnel department
Answer and explanation in LearnFree account
Question 10 · Medium
A semi-conscious man is admitted at night wearing a gold chain and carrying cash, with no relative present. The nurse should:
1. AGive them to the ward attendant to look after
2. BKeep them in her own locker until a relative comes
3. CLeave them on the patient so they stay with him at all times
4. DList them with a witness and lodge them in safe custody
Answer and explanation in LearnFree account
Question 11 · Medium
A staff nurse finds that a prescribed dose of digoxin is ten times the usual dose. What should she do?
1. AGive it, since the prescriber is responsible for the dose
2. BGive half the dose and inform the doctor in the morning
3. CChange it to the usual dose and give that dose
4. DWithhold it and clarify the order with the prescriber
Answer and explanation in LearnFree account
Question 12 · Medium
On a ward that uses charting by exception, the nurse writes a narrative note mainly when:
1. AThe doctor asks for the notes to be written
2. BAny routine care is given to the patient
3. CA finding departs from the set normal standards
4. DThe patient is about to be discharged
Answer and explanation in LearnFree account
Question 13 · Hard
A unit needs two staff nurses on each of three 8-hour shifts, every day of the week. Each nurse works six shifts a week. Ignoring leave reserve, how many nurses are needed?
1. A5
2. B8
3. C7
4. D6
Answer and explanation in LearnFree account
Question 14 · Medium
A post-operative patient was told clearly not to get out of bed alone, but he walked to the toilet unaided and fell. In a negligence claim, his own conduct may be argued as:
1. ARes ipsa loquitur
2. BCriminal negligence
3. CContributory negligence
4. DVicarious liability
Answer and explanation in LearnFree account
Question 15 · Medium
A staff nurse ticks the chart to show that she turned a bedridden patient every two hours overnight, although she did not. This is:
1. ADefamation
2. BContributory negligence
3. CVicarious liability
4. DFalsification of records
Answer and explanation in LearnFree account
Question 16 · Hard
A staff nurse on a 12-patient ward finishes her shift, but her reliever has not arrived. Two patients are on IV infusions. What should she do?
1. AStop both infusions and then leave the ward
2. BHand the ward to the attendant and go home
3. CLeave once the handover notes are written on the desk
4. DInform the supervisor and stay until relieved
Answer and explanation in LearnFree account
Question 17 · Medium
During an appendicectomy under general anaesthesia, the surgeon finds a benign-looking ovarian cyst that is causing no emergency. Removing it now:
1. ACan be done if the husband agrees by phone
2. BNeeds separate consent, so it should wait
3. CIs covered by the consent for appendicectomy
4. DCan be authorised by the theatre nurse
Answer and explanation in LearnFree account
Question 18 · Medium
Written instructions signed in advance by the medical officer, which allow a nurse to start set treatment in defined emergencies, are called:
1. AStanding orders
2. BPRN orders
3. CTelephone orders
4. DStat orders
Answer and explanation in LearnFree account
Question 19 · Easy
Only one ICU bed is free, and the nurse in charge gives it to the patient with the greatest clinical need, not the most influential one. This applies the principle of:
1. ABeneficence
2. BVeracity
3. CAutonomy
4. DJustice
Answer and explanation in LearnFree account
Question 20 · Medium
How often should the ward's emergency (crash) trolley normally be checked?
1. ADaily and after every use
2. BOnly when it has been used
3. COnce a month by pharmacy
4. DOnce a week by the sister
Answer and explanation in LearnFree account
Question 21 · Medium
An off-duty nurse gives first aid to a road accident victim and takes him to hospital. Under India's Good Samaritan provisions, she:
1. AMust wait at the hospital until the police record her statement
2. BMust pay for the victim's first treatment at the hospital
3. CIs not liable for harm from emergency care given in good faith
4. DMust give her name and address before she may leave
Answer and explanation in LearnFree account
Question 22 · Easy
Which of these bodies is a voluntary professional association of nurses rather than a statutory regulatory body?
1. ADelhi Nursing Council
2. BIndian Nursing Council
3. CMaharashtra Nursing Council
4. DTrained Nurses' Association of India
Answer and explanation in LearnFree account
Question 23 · Hard
In June (30 days), a 50-bed ward recorded 1,200 inpatient days and 300 discharges, including deaths. What was its average length of stay?
1. A4 days
2. B5 days
3. C6 days
4. D24 days
Answer and explanation in LearnFree account
Question 24 · Hard
A 40-bed ward discharged 160 patients in a 30-day month and recorded 1,000 inpatient days. What was its bed turnover interval?
1. A4 days
2. B1.25 days
3. C6.25 days
4. D0.83 days
Answer and explanation in LearnFree account
Question 25 · Medium
A nursing audit carried out on the records of patients after their discharge is called a:
1. AConcurrent (open-chart) audit
2. BPeer review
3. CRetrospective audit
4. DProspective audit
Answer and explanation in LearnFree account

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Nursing administration, ethics and legal aspects

At the start of night duty, the nurse in charge learns of four problems. Which needs her action first?

A competent elderly woman refuses the nasogastric feeding that her doctor and family want for her. The nurse supports her refusal. Which principle has been given priority?

The main reason hospitals keep their incident reporting system non-punitive is to:

A patient dies after a nurse gives concentrated potassium chloride as an IV push by mistake. Which management action does most to prevent the same error again?

The portable card file that gives a quick summary of each patient's current orders and nursing care plan on the ward is the:

Emergency drugs and oxygen, without which patient care would stop, fall into which class of VED analysis?

A nurse tells a confused patient that she will tie him to the bed if he does not take his tablets. Legally, this threat alone amounts to:

A doctor gives a telephone order at night for a stat dose of IV furosemide. The nurse's correct practice is to:

On a ward that uses decentralised scheduling, the monthly duty roster is prepared by the:

A semi-conscious man is admitted at night wearing a gold chain and carrying cash, with no relative present. The nurse should:

A staff nurse finds that a prescribed dose of digoxin is ten times the usual dose. What should she do?

On a ward that uses charting by exception, the nurse writes a narrative note mainly when:

A unit needs two staff nurses on each of three 8-hour shifts, every day of the week. Each nurse works six shifts a week. Ignoring leave reserve, how many nurses are needed?

A post-operative patient was told clearly not to get out of bed alone, but he walked to the toilet unaided and fell. In a negligence claim, his own conduct may be argued as:

A staff nurse ticks the chart to show that she turned a bedridden patient every two hours overnight, although she did not. This is:

A staff nurse on a 12-patient ward finishes her shift, but her reliever has not arrived. Two patients are on IV infusions. What should she do?

During an appendicectomy under general anaesthesia, the surgeon finds a benign-looking ovarian cyst that is causing no emergency. Removing it now:

Written instructions signed in advance by the medical officer, which allow a nurse to start set treatment in defined emergencies, are called:

Only one ICU bed is free, and the nurse in charge gives it to the patient with the greatest clinical need, not the most influential one. This applies the principle of:

How often should the ward's emergency (crash) trolley normally be checked?

An off-duty nurse gives first aid to a road accident victim and takes him to hospital. Under India's Good Samaritan provisions, she:

Which of these bodies is a voluntary professional association of nurses rather than a statutory regulatory body?

In June (30 days), a 50-bed ward recorded 1,200 inpatient days and 300 discharges, including deaths. What was its average length of stay?

A 40-bed ward discharged 160 patients in a 30-day month and recorded 1,000 inpatient days. What was its bed turnover interval?

A nursing audit carried out on the records of patients after their discharge is called a: