CARN Professional and Ethical Responsibilities 3 — Questions and Answers
Question 1: The concept of 'therapeutic use of self' in addiction nursing most closely relates to which professional responsibility?
- Maintaining objectivity by minimizing personal interaction
- Using the nurse-patient relationship as a healing tool while maintaining boundaries (Correct answer)
- Sharing personal recovery experiences to build rapport with patients
- Avoiding emotional engagement to prevent burnout
Correct answer: Using the nurse-patient relationship as a healing tool while maintaining boundaries
Therapeutic use of self means deliberately using one's personality and relationship skills as a clinical tool while maintaining professional boundaries.
Question 2: A CARN working in a rural area is asked to provide addiction counseling services beyond the nursing scope of practice due to staff shortages. The nurse should:
- Provide the services since patient need outweighs scope restrictions
- Decline and document the facility's failure to address the staffing gap (Correct answer)
- Perform a limited version of the counseling within nursing scope
- Seek emergency temporary credentials before providing services
Correct answer: Decline and document the facility's failure to address the staffing gap
Practicing outside the scope of licensure is illegal and unethical regardless of facility need; the nurse should decline and formally report the gap.
Question 3: Which scenario represents an appropriate use of clinical supervision for a CARN?
- Discussing a challenging case with a supervisor to process countertransference reactions (Correct answer)
- Seeking peer input to validate a decision already made about patient care
- Using supervision sessions to obtain prescriptive authority for addiction medications
- Reporting a colleague's performance issues to the supervisor
Correct answer: Discussing a challenging case with a supervisor to process countertransference reactions
Clinical supervision provides a structured space to process countertransference and complex clinical reactions that can affect patient care.
Question 4: A newly certified CARN is asked by a patient to recommend a specific 12-step sponsor. The most professionally appropriate response is to:
- Recommend a sponsor known to the nurse from their own community
- Provide general guidance about sponsor qualities without making specific recommendations (Correct answer)
- Decline to discuss sponsorship as it falls outside nursing scope
- Refer the patient to the addiction counselor for all peer support guidance
Correct answer: Provide general guidance about sponsor qualities without making specific recommendations
Nurses can educate patients about what qualities to look for in a sponsor without making specific personal recommendations that could create dual relationships.
Question 5: The ethical principle of veracity in addiction nursing practice requires the nurse to:
- Tell patients only what they need to know to remain compliant with treatment
- Provide truthful information even when it may be difficult for patients to hear (Correct answer)
- Withhold negative prognosis information to maintain patient hope
- Share information selectively based on the patient's stage of change
Correct answer: Provide truthful information even when it may be difficult for patients to hear
Veracity obligates nurses to be truthful with patients, which includes honest communication about prognosis, risks, and treatment limitations.
Question 6: A CARN discovers that a patient's family member has been attending Al-Anon and has been discussing the patient's treatment details with the group. The nurse should:
- Contact the Al-Anon group to address the confidentiality breach
- Educate the patient about their rights and options regarding this disclosure (Correct answer)
- File a formal complaint against the family member with the facility
- Inform the patient that Al-Anon discussions are not bound by HIPAA
Correct answer: Educate the patient about their rights and options regarding this disclosure
The nurse should empower the patient by explaining their confidentiality rights and what recourse, if any, they have regarding this situation.
Question 7: Which behavior by a CARN would be considered a violation of the ANA Code of Ethics?
- Reporting unsafe staffing levels to administration
- Participating in public education about addiction as a disease
- Refusing to care for a patient due to their substance of choice (Correct answer)
- Advocating for policy changes to improve addiction treatment access
Correct answer: Refusing to care for a patient due to their substance of choice
The ANA Code of Ethics prohibits discrimination in care provision; nurses may not refuse to care for patients based on diagnosis or substance use.
CARN Professional and Ethical Responsibilities 3
The concept of 'therapeutic use of self' in addiction nursing most closely relates to which professional responsibility?