BCEN Professional Practice 2 — Questions and Answers
Question 1: A nurse suspects a colleague is diverting opioids for personal use. What is the MOST appropriate initial action?
- Confront the colleague privately and warn them to stop
- Report the suspicion to the nurse manager or supervisor immediately (Correct answer)
- Document personal observations and wait to see if behavior continues
- Notify law enforcement directly without involving management
Correct answer: Report the suspicion to the nurse manager or supervisor immediately
Suspected diversion must be reported promptly to a supervisor or manager, as it is a patient safety and legal issue requiring institutional investigation.
Question 2: Under the Emergency Medical Treatment and Labor Act (EMTALA), which obligation does an emergency department have?
- Provide care only to patients with insurance or ability to pay
- Screen and stabilize all patients regardless of ability to pay (Correct answer)
- Transfer all unstable patients to tertiary centers immediately
- Collect payment information before initiating any medical screening
Correct answer: Screen and stabilize all patients regardless of ability to pay
EMTALA mandates that EDs provide a medical screening exam and stabilizing treatment to all individuals regardless of payment status.
Question 3: A patient's family member demands to see the patient's chart without the patient's consent. The patient is alert and oriented. What should the nurse do?
- Allow access if the family member is a spouse
- Allow access only after the family member shows valid ID
- Deny access and explain HIPAA protections to the family member (Correct answer)
- Allow access if the family member is listed as next of kin
Correct answer: Deny access and explain HIPAA protections to the family member
An alert, oriented patient's medical information is protected under HIPAA and cannot be shared without the patient's explicit authorization.
Question 4: Which action best demonstrates a commitment to evidence-based practice in emergency nursing?
- Following protocols established more than 10 years ago without review
- Applying interventions based on personal clinical experience alone
- Using current research findings to guide clinical decisions and protocols (Correct answer)
- Delegating protocol updates to administrative staff
Correct answer: Using current research findings to guide clinical decisions and protocols
Evidence-based practice integrates current best research evidence with clinical expertise and patient values to optimize care.
Question 5: A nurse is asked to float to a unit where they have limited experience. What is the BEST response?
- Refuse the assignment entirely
- Accept and independently manage all patients without disclosing inexperience
- Accept while communicating limitations and requesting appropriate support (Correct answer)
- Ask a coworker to sign off on their care without supervision
Correct answer: Accept while communicating limitations and requesting appropriate support
Nurses must communicate competency limitations when floated to unfamiliar units to ensure safe patient care and appropriate supervision.
Question 6: Which principle underlies the concept of informed consent in emergency nursing?
- Beneficence — acting in the patient's best interest without input
- Patient autonomy — the right to make informed decisions about their care (Correct answer)
- Justice — ensuring equal distribution of medical resources
- Fidelity — maintaining loyalty to the institution's policies
Correct answer: Patient autonomy — the right to make informed decisions about their care
Informed consent is rooted in patient autonomy, requiring that competent patients receive adequate information to make voluntary decisions about their care.
Question 7: A patient is brought in by police after being found unresponsive. No identification is available. What guides the emergency nurse's decision to treat?
- Implied consent, presuming the patient would consent if able (Correct answer)
- Express consent obtained from the transporting officers
- Proxy consent from the nearest hospital administrator
- Substituted judgment based on bystander statements
Correct answer: Implied consent, presuming the patient would consent if able
In emergency situations where an unconscious patient cannot consent, implied consent doctrine authorizes treatment under the assumption a reasonable person would agree.
BCEN Professional Practice 2
A nurse suspects a colleague is diverting opioids for personal use.
What is the MOST appropriate initial action?