Ethical Principles on the NCLEX
Autonomy, beneficence, nonmaleficence, justice, fidelity, veracity, one scenario each.
The exam gives you a scenario and asks which principle it shows. Learn one clean example per principle and you own these questions.
Autonomy
The patient's right to make their own decisions, even ones you disagree with. Scenario: a competent patient with cancer declines chemotherapy after full explanation. The nurse supports the decision and does not pressure him. Respecting refusal = autonomy. Informed consent exists to protect it.
Beneficence
Acting for the patient's good. Active promotion of benefit, not just avoiding harm. Scenario: a post-op patient refuses to ambulate; the nurse explains why walking prevents pneumonia and clots, then helps her to the hallway. Advocating and acting for the patient's benefit = beneficence.
Nonmaleficence
First, do no harm, and prevent harm. Scenario: a nurse questions a morphine dose ten times the usual range instead of giving it. Withholding a potentially harmful action = nonmaleficence. Double-checking high-alert meds and stopping unsafe orders live here.
Justice
Fair distribution of care and resources. Scenario: two patients arrive at a rural ED; the nurse triages by acuity, not by who has insurance or who arrived louder. Allocating the last ICU bed by clinical need = justice.
Fidelity
Keeping promises and commitments. Scenario: the nurse tells a patient 'I'll be back in 20 minutes with your pain medicine' and returns on time. Following through, staying loyal to the patient's interests, honoring the nurse-patient relationship = fidelity.
Veracity
Telling the truth. Scenario: a patient asks 'is this injection going to hurt?' The nurse says 'it stings for a few seconds' instead of 'you won't feel a thing.' Honest answers about diagnoses, errors, and procedures = veracity. Disclosure of a med error to the patient is veracity plus fidelity.
Frequently asked
Autonomy vs beneficence: patient refuses a treatment that would clearly help. Which wins?
Autonomy, if the patient is competent and informed. You educate, you do not override.
Beneficence vs nonmaleficence: what's the actual difference?
Beneficence actively does good. Nonmaleficence avoids and prevents harm. Giving pain meds is beneficence; refusing to give an unsafe dose is nonmaleficence.
Which principle does breaking confidentiality violate?
Fidelity primarily, since you break the trust commitment. Many questions accept autonomy too; read the options given.
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