CARN Professional and Ethical Responsibilities 5 — Questions and Answers
Question 1: A CARN suspects a patient is being coerced by a partner into entering treatment. The most appropriate initial response is to:
- Proceed with treatment admission since the patient is physically present and consenting
- Assess the patient's safety and voluntariness of consent in a private setting (Correct answer)
- Contact the partner to discuss the situation and clarify intentions
- Consult with the treatment team before meeting with the patient
Correct answer: Assess the patient's safety and voluntariness of consent in a private setting
Voluntary consent requires assessment of coercion; the nurse must assess the patient privately to ensure genuine willingness to participate.
Question 2: Which action demonstrates the CARN fulfilling the professional responsibility of evidence-based practice?
- Using treatment approaches that have worked well in the nurse's clinical experience
- Implementing interventions supported by current research while considering patient preferences (Correct answer)
- Following facility protocols even when emerging research suggests better alternatives
- Deferring all clinical decisions to the prescribing physician's judgment
Correct answer: Implementing interventions supported by current research while considering patient preferences
Evidence-based practice integrates current best research evidence with clinical expertise and patient values to guide decision-making.
Question 3: A CARN working with adolescents must balance parental rights with the minor patient's confidentiality. Which federal protection most directly governs substance use disorder treatment records for minors?
- FERPA (Family Educational Rights and Privacy Act)
- 42 CFR Part 2, which may protect minor SUD records from parental disclosure (Correct answer)
- HIPAA, which gives parents full access to all minor health records
- State mandatory reporting laws, which always supersede confidentiality
Correct answer: 42 CFR Part 2, which may protect minor SUD records from parental disclosure
42 CFR Part 2 can protect a minor's SUD treatment records from disclosure to parents when the minor has independently sought treatment.
Question 4: A CARN disagrees with a treatment team decision that the nurse believes is not in the patient's best interest. The most professional course of action is to:
- Comply with the team decision and document personal objection in personal notes only
- Express concern through appropriate channels such as team meetings or chain of command (Correct answer)
- Inform the patient of the disagreement so they can advocate for themselves
- Refuse to implement the decision until the team reconsiders
Correct answer: Express concern through appropriate channels such as team meetings or chain of command
Professional disagreements should be addressed through legitimate channels including team discussion, supervision, or formal chain of command processes.
Question 5: Mandatory reporting obligations for a CARN would most clearly apply in which situation?
- A patient discloses past childhood trauma experienced decades ago
- A patient reveals current plans to harm an identifiable third party (Correct answer)
- A patient discusses illegal substance use within a confidential treatment setting
- A patient reports that a family member uses alcohol excessively
Correct answer: A patient reveals current plans to harm an identifiable third party
Duty to warn/protect requires reporting when a patient makes credible threats against an identifiable third party, overriding confidentiality obligations.
Question 6: The IntNSA Code of Ethics for Addictions Nursing emphasizes which unique professional obligation compared to general nursing ethics codes?
- Greater emphasis on patient autonomy over beneficence in all treatment decisions
- Recognition of addiction as a chronic brain disorder requiring non-stigmatizing, patient-centered care (Correct answer)
- Prohibition of nurses in personal recovery from working in addiction treatment settings
- Mandatory peer support group participation for all addiction nursing staff
Correct answer: Recognition of addiction as a chronic brain disorder requiring non-stigmatizing, patient-centered care
The IntNSA Code emphasizes the disease model of addiction and the obligation to provide non-stigmatizing, evidence-based care that respects patient dignity.
Question 7: A CARN is asked to participate in a research study examining patient outcomes in addiction treatment. Which action reflects proper ethical conduct regarding research participation?
- Enroll patients who would benefit from the intervention without formal consent to maximize research benefit
- Ensure patients provide voluntary informed consent and understand the right to withdraw (Correct answer)
- Collect de-identified outcome data without consent since it poses minimal risk
- Prioritize research protocol adherence over individual patient clinical needs
Correct answer: Ensure patients provide voluntary informed consent and understand the right to withdraw
Research ethics require voluntary, informed consent and the right to withdraw without penalty, regardless of the perceived benefit of the intervention.
CARN Professional and Ethical Responsibilities 5
A CARN suspects a patient is being coerced by a partner into entering treatment.
The most appropriate initial response is to: