CCRN - Review Professional and Ethical Practice Questions and Answers

Question 1

An alert and competent patient with end-stage cancer has a valid advance directive that explicitly refuses mechanical ventilation. The patient develops acute respiratory distress, and their panicked family insists the medical team "do everything possible." What is the nurse's primary ethical responsibility in this situation?

Accepted Answer

Advocate for the patient's wishes as stated in the advance directive and facilitate a discussion with the family and medical team.

Answer

The nurse's primary role is to be a patient advocate. The principle of patient autonomy dictates that a competent patient's wishes, especially when documented in a legal advance directive, must be respected. The nurse's most appropriate action is to uphold these wishes while compassionately communicating with the family and involving the medical team to ensure a unified, patient-centered approach.

Question 2

A critical care nurse ensures that a patient fully understands the risks, benefits, and alternatives to a proposed invasive procedure before the patient signs the consent form. This action primarily demonstrates which ethical principle?

Accepted Answer

Autonomy

Answer

Autonomy is the ethical principle that recognizes a patient's right to make their own informed decisions about their healthcare. By ensuring the patient has all the necessary information to make a choice, the nurse is directly supporting their right to self-determination. Beneficence is doing good, non-maleficence is avoiding harm, and justice relates to fairness in care delivery.

Question 3

A nurse in the ICU notices that a colleague has become irritable, has had multiple charting errors, and frequently volunteers to administer narcotics for other nurses' patients. The nurse suspects the colleague may be diverting medications. What is the nurse's most appropriate and professional initial action?

Accepted Answer

Report the specific observations and concerns to the nurse manager or charge nurse according to facility policy.

Answer

The nurse's ethical and professional duty is to protect patients from harm. The appropriate action is to follow the established chain of command and report the objective concerns to management. This allows for a formal, confidential investigation while ensuring patient safety. Confronting the colleague can be unsafe, and discussing it with peers is unprofessional.

Question 4

A nurse is caring for a patient with a catastrophic brain injury. The medical team has determined that further treatment is futile, but the family insists on continuing all life-sustaining measures. The nurse feels powerless and emotionally conflicted by providing care they believe is not in the patient's best interest. This feeling is best described as:

Accepted Answer

Moral distress

Answer

Moral distress is the specific psychological and emotional suffering that occurs when a healthcare professional knows the ethically appropriate action to take but is constrained from doing so by institutional or other barriers. In this scenario, the nurse is providing care that conflicts with their professional judgment and values, leading to moral distress.

Question 5

During a pandemic, an ICU has only one available ventilator. Two patients require mechanical ventilation: a 28-year-old with a high probability of survival and a 85-year-old with multiple comorbidities and a very poor prognosis. Which ethical principle most directly guides the difficult decision to allocate the ventilator to the patient with the higher chance of survival?

Accepted Answer

Justice

Answer

The principle of justice, specifically distributive justice, addresses the fair and equitable allocation of scarce resources. In mass casualty or crisis situations, this often involves using triage criteria that aim to produce the greatest good for the greatest number, which includes prioritizing those with a higher likelihood of survival.

CCRN Review Practice Test

CCRN Review Practice Test

CCRN - Review Professional and Ethical Practice Questions and Answers