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NCLEX-RN Legal responsibilities practice questions

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These are original practice items written to the NCLEX-RN blueprint (4 options, no penalty for wrong answers), not actual exam questions. Try each one before you open the answer.

What this topic covers

Legal responsibilities sits inside the Management of Care category of the NCLEX-RN. Our bank holds 44 verified items tagged to it, and the 4 below are a fixed sample so the page stays the same every time you open it. Each one shows the reasoning, not just the letter.

The topic tag comes from our own items rather than from a published syllabus, so treat it as a map of what we cover. For the official category breakdown see the NCLEX-RN page.

Legal responsibilities sample questions

Question 1

A registered nurse who normally works on a postpartum unit is floated to a pediatric intensive care unit because of a staffing shortage. The charge nurse assigns the float nurse to care for a 2-year-old client on a ventilator. The float nurse has no pediatric critical care experience. Which action is the float nurse's legal responsibility?

  1. A Complete the assignment while avoiding all ventilator-specific nursing tasks.
  2. B Refuse to work the shift because the assignment exceeds current competency.
  3. C Accept the assignment and ask another nurse to double-check all care given.
  4. D Notify the charge nurse of the lack of pediatric critical care experience.
Show the answer and explanation

Correct answer: D

A nurse assigned to care beyond their competence must tell the charge nurse about the gap in experience so the assignment can be changed or support can be provided. This protects the client and meets the float nurse's legal and professional duty.

Why the other options are wrong:
A: Skipping ventilator tasks without telling anyone leaves essential care undone and does not address the competency problem.
B: Refusing the shift is not the first step; the nurse should first communicate the concern so the charge nurse can adjust the assignment.
C: A second nurse checking the work does not make the float nurse competent, and the float nurse remains accountable for all care given.

Question 2

A 72-year-old client with advanced dementia is admitted from a long-term care facility with pneumonia. The client has a living will that states no mechanical ventilation. The spouse, who is the durable power of attorney for healthcare, requests that the nurse initiate BiPAP for respiratory distress. What is the nurse's best action?

  1. A Explain that the living will prohibits BiPAP and refuse to apply the device.
  2. B Initiate BiPAP as requested by the spouse and document the decision.
  3. C Contact the facility's ethics committee before taking any further action.
  4. D Notify the provider of the conflict between the living will and the spouse's request.
Show the answer and explanation

Correct answer: D

The living will refuses mechanical ventilation, while the health care agent requests BiPAP, so whether BiPAP falls within that refusal needs clarification. The nurse notifies the provider, who must order any ventilation and can resolve the conflict with the spouse.

Why the other options are wrong:
A: Refusing outright skips the provider's role in interpreting the directive and discussing it with the agent.
B: BiPAP requires a prescription, and starting it could violate the client's directive.
C: An ethics consult may follow, but the provider should be notified first.

Question 3

A nurse is caring for a 29-year-old client with a spinal cord injury who is alert and oriented. The client tells the nurse, 'I want to sign out against medical advice because I need to get back to work.' The provider documents a risk of respiratory failure if the client leaves. Which legal responsibility must the nurse fulfill?

  1. A Notify the provider immediately and request an involuntary hold to prevent the client from leaving.
  2. B Contact the client's family to explain the risks before allowing the client to leave.
  3. C Advise the client that leaving against medical advice will void their health insurance coverage.
  4. D Ask the client to sign a against-medical-advice form and explain the consequences of leaving.
Show the answer and explanation

Correct answer: D

An alert, oriented adult has the right to leave against medical advice. The nurse's legal duty is to make sure the client understands the risks, including possible respiratory failure, notify the provider, and have the client sign an AMA form documenting that the decision was informed and voluntary.

Why the other options are wrong:
A: An involuntary hold is not legally justified for a competent adult who is not a danger to self or others.
B: Contacting family without the client's consent breaches confidentiality and does not override the client's decision.
C: This statement is inaccurate and coercive; leaving AMA does not automatically void insurance coverage.

Question 4

A 78-year-old client with terminal pancreatic cancer is admitted to the oncology unit for pain management. The client has a signed advance directive stating no cardiopulmonary resuscitation. The client's adult child demands that the nurse initiate chest compressions when the client becomes pulseless and apneic. What action should the nurse take first?

  1. A Call the rapid response team to begin resuscitation while the charge nurse contacts the provider.
  2. B Notify the hospital ethics committee and await their decision before taking any clinical action.
  3. C Page the attending physician to clarify the advance directive and obtain a verbal order for do not resuscitate.
  4. D Explain to the child that the advance directive is legally binding and cannot be overridden.
Show the answer and explanation

Correct answer: D

A competent client's advance directive refusing CPR must be honored, and a family member cannot override it. The nurse should not begin compressions and should gently explain this to the client's child while offering emotional support.

Why the other options are wrong:
A: Starting resuscitation would violate the client's documented refusal of CPR.
B: Waiting for an ethics committee during an arrest is impractical, and the client's documented wishes already answer the question.
C: The client's refusal of CPR is already documented; the immediate need is to honor it and support the family, not to seek a new decision.

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