CFN Ethical and Professional Practice 4 — Questions and Answers
Question 1: A forensic nurse is caring for an incarcerated patient who is also a crime victim. Which ethical principle is MOST challenged in this dual-role scenario?
- Veracity
- Justice, balancing equitable care with institutional security obligations (Correct answer)
- Autonomy, as incarceration fully removes patient rights
- Fidelity, because nurses cannot be loyal to an inmate
Correct answer: Justice, balancing equitable care with institutional security obligations
Justice is challenged when nurses must balance fair, equitable care for incarcerated victims against institutional security constraints and policies.
Question 2: A patient discloses during a forensic exam that they want to harm someone specific after they are discharged. What is the forensic nurse's obligation?
- Maintain strict confidentiality as the disclosure was made in a clinical setting
- Warn the intended victim and notify appropriate authorities per the duty to protect (Correct answer)
- Document the disclosure and refer to psychiatry without further action
- Inform the patient that their statement is protected and will remain private
Correct answer: Warn the intended victim and notify appropriate authorities per the duty to protect
The duty to protect (Tarasoff obligation) requires healthcare providers to warn identifiable potential victims and notify authorities when a credible threat of harm is disclosed.
Question 3: When a forensic nurse maintains detailed, accurate records primarily to support accountability and professional integrity rather than legal requirement, this reflects which ethical concept?
- Nonmaleficence
- Fidelity
- Professional accountability and transparency (Correct answer)
- Paternalism
Correct answer: Professional accountability and transparency
Professional accountability involves maintaining accurate records to uphold integrity, transparency, and responsibility to patients, employers, and the public.
Question 4: A forensic nurse is asked to conduct a strip search of a detainee as part of a routine intake process. Before complying, the nurse should FIRST:
- Proceed since it is standard institutional procedure
- Assess whether the search is medically necessary and falls within nursing scope of practice (Correct answer)
- Request that a corrections officer perform the search instead
- Obtain written consent from the detainee
Correct answer: Assess whether the search is medically necessary and falls within nursing scope of practice
Forensic nurses must evaluate whether requested procedures are medically justified and within their professional scope before participating, as non-medically-indicated strip searches may constitute ethical violations.
Question 5: A sexual assault nurse examiner (SANE) documents findings that could exonerate an accused individual. Which ethical principle MOST requires the nurse to report these findings accurately?
- Beneficence toward the victim
- Veracity and justice, ensuring the legal system has accurate information (Correct answer)
- Non-maleficence toward the accused
- Autonomy of the examining nurse
Correct answer: Veracity and justice, ensuring the legal system has accurate information
Veracity and justice require forensic nurses to report all findings truthfully and completely, including those that may exonerate a suspect, because the legal system depends on accurate forensic evidence.
Question 6: A forensic nurse is asked to provide expert testimony outside their specialized area of forensic nursing. The most ethical response is to:
- Testify broadly to help the court
- Decline testimony on matters outside their established competence and scope of expertise (Correct answer)
- Ask another nurse to co-testify to cover knowledge gaps
- Testify but qualify every statement with 'I'm not certain'
Correct answer: Decline testimony on matters outside their established competence and scope of expertise
Professional ethics require experts to testify only within their established area of competence to prevent misleading the court and to uphold professional integrity.
Question 7: Which scenario BEST illustrates a conflict between patient autonomy and the forensic nurse's mandatory reporting obligation?
- A patient refusing pain medication during an exam
- A domestic violence victim requesting that no report be made to authorities (Correct answer)
- A patient asking for a copy of their own medical records
- A patient declining to answer questions about their medical history
Correct answer: A domestic violence victim requesting that no report be made to authorities
When a domestic violence victim requests no report be made but state law mandates reporting, the nurse faces a direct conflict between respecting patient autonomy and fulfilling legal reporting obligations.
CFN Ethical and Professional Practice 4
A forensic nurse is caring for an incarcerated patient who is also a crime victim.
Which ethical principle is MOST challenged in this dual-role scenario?