CMC Professional Standards & Ethics 4 — Questions and Answers
Question 1: A CMC nurse is asked by a journalist to comment on a high-profile cardiac patient's condition. The nurse should:
- Provide general information since the patient is a public figure
- Decline to comment and direct the journalist to the public relations department (Correct answer)
- Confirm only the patient's diagnosis, not the treatment plan
- Share information if the journalist agrees to keep it off the record
Correct answer: Decline to comment and direct the journalist to the public relations department
HIPAA protects all patients, including public figures; all media inquiries must be directed to authorized hospital representatives.
Question 2: A do-not-resuscitate (DNR) order is in place for a cardiac patient who arrests in the hallway during a visitor's presence. The visitor demands the team 'do everything.' The nurse should:
- Initiate CPR to avoid conflict with the visitor
- Honor the DNR order and calmly explain it to the visitor while providing comfort measures (Correct answer)
- Suspend the DNR temporarily until the visitor leaves the area
- Page the attending physician and withhold any action until instructions are received
Correct answer: Honor the DNR order and calmly explain it to the visitor while providing comfort measures
A valid DNR order must be honored regardless of family or bystander pressure; comfort care is provided instead.
Question 3: Which scenario BEST illustrates a conflict of interest for a CMC-certified nurse serving on a hospital formulary committee?
- Recommending a cardiac drug the nurse has used successfully in clinical practice
- Advocating for a cardiac medication manufactured by a company in which the nurse holds stock (Correct answer)
- Suggesting removal of a drug with a high adverse event profile based on published data
- Presenting cost-effectiveness data for two equivalent antiarrhythmic agents
Correct answer: Advocating for a cardiac medication manufactured by a company in which the nurse holds stock
Financial interest in a drug manufacturer creates a conflict of interest that can compromise objective decision-making on a formulary committee.
Question 4: A cardiac patient discloses to the nurse that they plan to stop taking their anticoagulant and does not want this shared with the physician. Ethically, the nurse should:
- Honor the patient's confidentiality and say nothing to the physician
- Document the disclosure and inform the physician because withholding poses significant clinical risk (Correct answer)
- Tell the patient's family so they can monitor the patient at home
- Report the patient to the ethics board for non-compliance
Correct answer: Document the disclosure and inform the physician because withholding poses significant clinical risk
When a patient's disclosure indicates significant clinical risk, the nurse's duty to prevent harm justifies informing the treating physician.
Question 5: Which of the following is an example of a nurse fulfilling the ethical obligation of fidelity?
- Administering a placebo instead of the prescribed cardiac medication
- Following through on a promise to return and explain a procedure to an anxious patient (Correct answer)
- Reporting a colleague to protect institutional reputation rather than patient safety
- Prioritizing multiple patients based on personal preferences
Correct answer: Following through on a promise to return and explain a procedure to an anxious patient
Fidelity means keeping promises and honoring commitments made to patients, such as returning to provide information.
Question 6: A cardiac nurse is floated to a telemetry unit and asked to perform rhythm interpretation, a skill the nurse has not practiced in two years. The ethical obligation is to:
- Perform the skill as instructed since the assignment came from management
- Inform the charge nurse of the competency gap and request supervision or reassignment (Correct answer)
- Attempt the task and consult a reference book if needed
- Refuse all patient assignments on the telemetry unit
Correct answer: Inform the charge nurse of the competency gap and request supervision or reassignment
Nurses must practice within their current competency and must disclose gaps to supervisors to ensure safe patient care.
Question 7: In a research study conducted in a cardiac unit, a patient's informed consent form is in English, but the patient only speaks Spanish. The most ethical action is to:
- Have the patient sign the English form and provide a verbal Spanish summary
- Delay study enrollment until a certified interpreter and translated consent form are obtained (Correct answer)
- Ask the patient's bilingual family member to translate and witness the signing
- Enroll the patient because the research poses minimal risk
Correct answer: Delay study enrollment until a certified interpreter and translated consent form are obtained
Ethical research standards require informed consent in the participant's primary language, using a certified interpreter and translated documents.
CMC Professional Standards & Ethics 4
A CMC nurse is asked by a journalist to comment on a high-profile cardiac patient's condition.
The nurse should: