CFA Professionalism, Ethics & Legal Considerations 2 — Questions and Answers
Question 1: A surgeon asks the first assistant to perform a task outside their credentialed scope of practice. What is the most appropriate response?
- Perform the task since the surgeon is responsible
- Decline and explain the scope limitation to the surgeon (Correct answer)
- Perform the task only if the patient consents
- Ask a scrub tech to perform the task instead
Correct answer: Decline and explain the scope limitation to the surgeon
First assistants must decline tasks outside their scope of practice regardless of who requests them, as each practitioner is accountable for their own actions.
Question 2: Which federal law primarily governs the protection of individually identifiable patient health information in the perioperative setting?
- EMTALA
- HIPAA (Correct answer)
- OSHA
- COBRA
Correct answer: HIPAA
HIPAA (Health Insurance Portability and Accountability Act) sets national standards for protecting sensitive patient health information from disclosure without the patient's consent.
Question 3: A patient has a signed DNR order on file. During a procedure, the patient experiences cardiac arrest. The first assistant should:
- Initiate full resuscitation immediately
- Defer to the DNR and refrain from resuscitation unless the surgeon overrides it (Correct answer)
- Contact the patient's family before acting
- Transfer the patient to the ICU immediately
Correct answer: Defer to the DNR and refrain from resuscitation unless the surgeon overrides it
A valid DNR order is a legal document that must be honored in the OR; the first assistant supports the attending surgeon in respecting the patient's documented wishes.
Question 4: Which ethical principle requires the first assistant to act in the patient's best interest even when the patient cannot speak for themselves?
- Autonomy
- Beneficence (Correct answer)
- Non-maleficence
- Justice
Correct answer: Beneficence
Beneficence obligates healthcare providers to take positive actions that promote the well-being and best interests of the patient.
Question 5: The primary purpose of malpractice insurance for a first assistant is to:
- Replace hospital liability coverage entirely
- Cover the cost of continuing education
- Provide financial protection against claims of negligent patient care (Correct answer)
- Satisfy state licensing board requirements only
Correct answer: Provide financial protection against claims of negligent patient care
Malpractice (professional liability) insurance protects practitioners against financial losses resulting from claims of negligent care that caused patient harm.
Question 6: Which action best demonstrates the ethical principle of justice in perioperative care?
- Refusing to assist in elective cases on personal moral grounds
- Ensuring all patients receive equitable care regardless of background (Correct answer)
- Prioritizing complex cases over routine cases
- Limiting assistance to board-certified surgeons only
Correct answer: Ensuring all patients receive equitable care regardless of background
Justice requires fair and equitable distribution of care and resources without discrimination based on race, socioeconomic status, or other personal characteristics.
Question 7: A first assistant witnesses a colleague falsifying a surgical count documentation. The first assistant's legal and ethical obligation is to:
- Ignore it to avoid workplace conflict
- Correct the record and report the incident through proper channels (Correct answer)
- Mention it only if a patient complication arises
- Notify the patient's family directly
Correct answer: Correct the record and report the incident through proper channels
Falsifying medical records is both illegal and unethical; reporting through proper channels (charge nurse, risk management, or compliance) is a professional and legal duty.
CFA Professionalism, Ethics & Legal Considerations 2
A surgeon asks the first assistant to perform a task outside their credentialed scope of practice.
What is the most appropriate response?