Ethics

Most NCLEX ethics items are “which principle?” labeling questions or dilemma scenarios where the tell is a conflict between two principles. A patient refusing a transfusion pits autonomy against beneficence; rationing a scarce ICU bed tests justice; keeping a promise to return for pain meds is fidelity, and telling the truth about a diagnosis is veracity. For a competent adult, the answer almost always honors autonomy first — beneficence does not override a capacitated refusal. Watch the trap of confusing non-maleficence (“do no harm,” e.g., withholding a risky drug) with beneficence (“do good,” actively helping).

Distinguish ethics from its neighbors: autonomy is the patient’s right to decide; advocacy is your action protecting that right (you can advocate without it being a named principle). Students wrongly pick “advocate” when the stem wants the principle labeled, or pick beneficence (paternalism) over a valid refusal. Simplest anchor: autonomy = the patient drives; you don’t. When a conflict can’t be resolved at the bedside, escalate to the ethics committee, not your personal opinion.