CMC Professional Standards & Ethics 3 — Questions and Answers
Question 1: A cardiac nurse witnesses a physician make a medication error but the physician asks the nurse not to report it. The nurse's ethical and legal obligation is to:
- Honor the physician's request to protect collegial relationships
- File an incident report and report to the appropriate supervisor (Correct answer)
- Only report if the patient experiences an adverse outcome
- Consult the hospital attorney before taking any action
Correct answer: File an incident report and report to the appropriate supervisor
Nurses have a professional and legal duty to report errors regardless of who made them to ensure patient safety.
Question 2: Which ethical principle is MOST directly violated when a cardiac patient is not told the risks of a coronary angiogram before signing the consent form?
- Non-maleficence
- Justice
- Autonomy (Correct answer)
- Fidelity
Correct answer: Autonomy
Informed consent requires full disclosure of risks; withholding this information violates the patient's right to autonomous decision-making.
Question 3: In the context of cardiac nursing, 'scope of practice' is BEST defined as:
- Any task a nurse feels competent to perform regardless of training
- The range of roles, functions, and responsibilities legally authorized for a nurse's license and credential (Correct answer)
- Activities permitted only by hospital policy, independent of state law
- Skills a nurse has performed successfully in the past without adverse events
Correct answer: The range of roles, functions, and responsibilities legally authorized for a nurse's license and credential
Scope of practice is defined by state nurse practice acts and is the legal boundary within which a nurse may practice.
Question 4: A nurse practicing in a cardiac ICU suspects a patient lacks decision-making capacity. The MOST appropriate next step is:
- Have the patient sign consent forms quickly before their condition worsens
- Perform a formal capacity evaluation and involve the ethics committee if needed (Correct answer)
- Ask the patient's family to make all decisions without further assessment
- Proceed with all planned treatments because time is critical
Correct answer: Perform a formal capacity evaluation and involve the ethics committee if needed
Capacity must be formally assessed; if lacking, a surrogate decision-maker or ethics consultation guides care decisions.
Question 5: A pharmaceutical company offers a cardiac nurse a gift card for attending a product promotion dinner. According to professional ethics, the nurse should:
- Accept the gift since it does not affect clinical decisions
- Decline the gift to avoid a conflict of interest and maintain professional integrity (Correct answer)
- Accept only if the gift is under a $50 threshold set by the hospital
- Accept and disclose it only if asked by the employer
Correct answer: Decline the gift to avoid a conflict of interest and maintain professional integrity
Professional standards and most institutional policies prohibit accepting gifts from industry to prevent conflicts of interest.
Question 6: When documenting a cardiac patient's hemodynamic data, the nurse accidentally enters incorrect values and realizes the error after saving. The correct action is:
- Delete the erroneous entry and re-enter the correct data without noting the change
- Draw a single line through the error, initial it, note the date and time, and add the correct entry (Correct answer)
- Leave the error and add a separate note at the end of the shift
- Report the error only if the incorrect values influenced a clinical decision
Correct answer: Draw a single line through the error, initial it, note the date and time, and add the correct entry
Proper error correction in medical records requires a single line strike-through, initials, date, time, and the correct entry to maintain an accurate, legal record.
Question 7: The principle of justice in cardiac care ethics most directly relates to:
- Always acting in the best clinical interest of the individual patient
- Fair and equitable distribution of healthcare resources across patient populations (Correct answer)
- Keeping all patient information confidential
- Maintaining honesty in all patient communications
Correct answer: Fair and equitable distribution of healthcare resources across patient populations
Justice requires that healthcare resources and treatments be distributed fairly among all patients regardless of socioeconomic or other factors.
CMC Professional Standards & Ethics 3
A cardiac nurse witnesses a physician make a medication error but the physician asks the nurse not to report it.
The nurse's ethical and legal obligation is to: